Patrícia Duarte Simões Pires

Prevalence of human papillomavirus in breast cancer: a systematic review.

Objective We performed a systematic review and meta-analyses to estimate the prevalence of human papillomavirus (HPV) in breast carcinoma and to explore the reasons for the ongoing controversies about this issue. Materials and Methods A comprehensive search of the Cochrane Library, MEDLINE, CANCERLIT, LILACS, and EMBASE databases was performed for papers published from January 1990 to January 2011. The medical subject heading terms were searched for the following: breast neoplasm, breast lesions, breast cancer, and HPV or human papillomavirus. Statistical analysis was performed using REVMAN 5.0. Results Twenty-nine primary studies, including 2211 samples, were analyzed. Overall, HPV prevalence in patients with breast cancer was 23.0% (95% CI, 21.2%–24.8%). The prevalence of HPV ranged from 13.4% (95% CI, 10.2%–16%) in Europe to 42.9% (95% CI, 36.4%–49.4%) in North America and Australia. The prevalence of HPV in controls was 12.9%. Combinations of 9 case-control studies showed that breast cancer was associated with HPV (odds ratio, 5.9; 95% CI, 3.26–10.67). Conclusion We found a high prevalence of HPV DNA in breast cancer. There is strong evidence to suggest that HPV has an important role in the development of breast cancer.

Weekly fluconazole therapy for recurrent vulvovaginal candidiasis: a systematic review and meta-analysis.

OBJECTIVE To investigate the efficacy, compared to placebo, of fluconazole 150 mg weekly, given for six months as prophylaxis against recurrent vulvovaginal candidiasis (RVVC). STUDY DESIGN A quantitative systematic review was performed, and randomized controlled trials were included. We conducted searches at Medline, EMBASE, Lilacs, Cochrane Library and ICI Web of Science from 1980 to March 2012. We used the odds ratio (OR) with confidence intervals (CI) of 95% using a random effects model of Mantel-Haenszel. The software used was Review Manager version 5.0. RESULTS Through the search strategies we identified 249 articles, of which only two were part of the meta-analysis. Fluconazole was more effective than placebo in reducing symptomatic episodes of VVC, immediately after treatment (OR 0.10, 95% CI 0.03-0.34), 3 months after treatment (OR 0.23, 95% CI 0.07-0.74) and 6 months after treatment (OR 0.39, 95% CI 0.24-0.64). CONCLUSION Weekly treatment with fluconazole (150 mg) for six months is effective against RVVC.

Meta-analysis of magnetic resonance imaging accuracy for diagnosis of oral cancer

Objective To establish the diagnostic accuracy of magnetic resonance imaging (MRI) as an auxiliary means for the diagnosis of oral cancer through a systematic review and meta-analysis. Methods An exhaustive search of publications from 1986 to 2016 was performed of Medline, Embase and Cochrane (and related databases), including grey literature. Primary diagnostic accuracy studies that assessed oral cancer (target condition) using MRI (index test) were included. Diagnostic threshold, sensitivity and meta-regression analyses were performed. A meta-analysis was performed using Meta-DiSc® v. 1.4 software. Results A total of 24 primary studies were assessed, comprising 1,403 oral cancer lesions. Nine studies used diffusion-weighted MRI, with a diagnostic odds ratio (DOR) of 30.7 (95% confidence interval [CI]: 12.7–74.3) and area under the curve (AUC) of 0.917 (95% CI: 0.915–0.918); seven studies used dynamic contrast-enhanced MRI, with a DOR of 48.1 (95%CI: 22.4–103.2) and AUC of 0.936 (95% CI: 0.934–0.937); and 13 studies used traditional MRI, with a DOR of 23.9 (95%CI: 13.2–43.3) and AUC of 0.894 (95% CI: 0.894–0.895). Meta-regression analysis indicated that the magnetic field strength may have influenced the heterogeneity of the results obtained (p = 0.0233) using traditional MRI. Sensitivity analysis revealed a discrete reduction of inconsistency in some subgroups. Conclusion The three types of MRI assessed exhibited satisfactory accuracy compared to biopsy. Considering the relevance of early treatment and screening and that better health care results in improved survival rates and quality of life for oral cancer patients, we suggest the use of MRI as a part of the pre-treatment and monitoring protocol at public health services.

Meta-Analysis of Prevalence of Xerostomia in Diabetes Mellitus

Background: As with other complications of diabetes mellitus, the occurrence of dry mouth can lead to a poor quality of life. Therefore, this study aimed to identify the prevalence of xerostomia in patients with diabetes mellitus through a systematic review and meta-analysis. Method: Systematic review and meta-analysis. Results: After the screening process, 23 studies were included in the meta-analysis. Overall, the incidence of dry mouth was investigated in 1979 people with diabetes (cases) and 1225 controls. The global prevalence of diabetes in xerostomia was 42.22% (95% CI: 33.97%-50.92%). In the analysis by specific subtype, the overall prevalence was 37.42% (95% CI: 22.33%-55.44%) among individuals with Type 1 diabetes and 46.09% (95% CI: 23.99%-69.85%) among those with type 2 diabetes. The prevalence of xerostomia found in Asia (49.01%; 95% CI: 32.08%-66.16%) was higher than that found in Europe (40.04%; 95% CI: 29.58%-51.50%) and America (38.39%; 95% CI: 23.63%-55.65%). Analysis of the case-control studies showed a statistically significant association between xerostomia and diabetes mellitus (OR=3.15; 95% CI: 2.11-4.70; p<0.001). Conclusion: Through the data collected, we can infer that the prevalence of xerostomia in individuals affected by diabetes mellitus types 1 and 2 was high and independent of geographic location.

Efficacy of Topical 5% Acyclovir-1% Hydrocortisone Cream (ME-609) for Treatment of Herpes Labialis: a systematic review

We performed a systematic review with the objective of verifying the efficacy of topical use 5% Acyclovir-1% Hydrocortisone cream compared to the placebo group for herpes simplex labialis treatment. We performed a literature search using MEDLINE, Embase, BIOSIS, LILACS, Scopus, Grey literature, the Cochrane Central Register of Controlled Trials, the ISI Web of Science and IBECS from 1990 to June 2014. We reported the outcomes using relative risk (RR) with 95% confidence intervals. The literature search yielded 180 potentially relevant publications. Reviews of the reference lists yielded two further citations. Among these papers, two were considered eligible for inclusion in this review. Both trials included 1,213 patients. A meta-analysis of these studies showed a RR = 0.77, (95% CI 0.70-0.86; p<0.001).This result suggests that an early episodic treatment with the combination of an antiviral and a steroid is beneficial for herpes simplex labialis treatment.