ABSTRACT The objective of the study was to conduct a systematic review to synthesize the current evidence on the accuracy of IgM and IgA to early diagnosis the dengue virus. The review protocol was registered at PROSPERO (CRD 42015024808). We searched for studies in the following electronic database from 1990 to January 2018. The search identified 3507 studies. Five studies were included for quantitative analysis. Three studies included evaluations of salivary IgM provided a sensitivity of 86% and specificity of 93%. Two studies included evaluating of IgA salivary showed a combined sensitivity of 69% and a combined specificity of 98%. Despite the results found and the low methodological quality of the studies included in the meta-analysis it is still soon to claim that IgA is better than IgM to diagnosis Dengue.

Resumo O objetivo desta revisão sistemática e meta-análise foi avaliar a acurácia do ELISA IgM para o diagnóstico precoce da leptospirose em humanos. A busca foi realizada nas seguintes bases de dados: Medline, PubMed, LILACS, Embase e Cochrane Central Register of Controlled Trials e Grey literature (Google Scholar and British Library). As palavras-chaves usadas foram: “leptospirosis”, “human leptospirosis” e “IgM ELI-SA”. Foram analisados 52 estudos, que incluíram 10.775 amostras. A sensibilidade e especificidade combinada de todos os estudos foram 86% (CI 95%, 85%-87%) e 90% (CI 95%, 89%-91%), respectivamente. Nos estudos de fase aguda, a sensibilidade e especificidade foram, respectivamente, 84% (CI 95%, 82%-85%) e 91% (CI 95%, 90%-91%). Conclui-se que o ELISA IgM é um teste sensível para rastreamento inicial da leptospirose.

Abstract A systematic review with meta-analysis was performed to estimate the accuracy of IgM ELISA for Leptospirosis diagnosis. A search of Medline, Lilacs, Embase, Cochrane Central Register of Controlled Trials and Grey literature (Google Scholar and British Library) was conducted. The medical subject headings (MeSHs) and the words “leptospirosis”, “human leptospirosis” and “IgM ELISA” were used. Fifty-two studies were analyzed, which included 10,775 samples. The pooled sensitivity of all the studies was 86% (CI 95%, 85%-87%) and specificity was 90% (CI 95%, 89%-91%). In studies of the acute phase, the sensitivity and specificity were 84% (CI 95%, 82%-85%) and 91% (CI 95%, 90%-91%), respectively. In conclusion, IgM ELISA is sensitive for use as an initial screen for leptospiral infections.

Resumo O objetivo desta revisão sistemática e meta-análise foi avaliar a acurácia do ELISA IgM para o diagnóstico precoce da leptospirose em humanos. A busca foi realizada nas seguintes bases de dados: Medline, PubMed, LILACS, Embase e Cochrane Central Register of Controlled Trials e Grey literature (Google Scholar and British Library). As palavras-chaves usadas foram: “leptospirosis”, “human leptospirosis” e “IgM ELI-SA”. Foram analisados 52 estudos, que incluíram 10.775 amostras. A sensibilidade e especificidade combinada de todos os estudos foram 86% (CI 95%, 85%-87%) e 90% (CI 95%, 89%-91%), respectivamente. Nos estudos de fase aguda, a sensibilidade e especificidade foram, respectivamente, 84% (CI 95%, 82%-85%) e 91% (CI 95%, 90%-91%). Conclui-se que o ELISA IgM é um teste sensível para rastreamento inicial da leptospirose.

Abstract A systematic review with meta-analysis was performed to estimate the accuracy of IgM ELISA for Leptospirosis diagnosis. A search of Medline, Lilacs, Embase, Cochrane Central Register of Controlled Trials and Grey literature (Google Scholar and British Library) was conducted. The medical subject headings (MeSHs) and the words “leptospirosis”, “human leptospirosis” and “IgM ELISA” were used. Fifty-two studies were analyzed, which included 10,775 samples. The pooled sensitivity of all the studies was 86% (CI 95%, 85%-87%) and specificity was 90% (CI 95%, 89%-91%). In studies of the acute phase, the sensitivity and specificity were 84% (CI 95%, 82%-85%) and 91% (CI 95%, 90%-91%), respectively. In conclusion, IgM ELISA is sensitive for use as an initial screen for leptospiral infections.

Resumo Introdução: O câncer de próstata é o segundo tipo de câncer diagnosticado e a quinta causa de morte em homens em todo o mundo. O diagnóstico precoce é fundamental para o prognóstico da doença. Atualmente, o antígeno específico da próstata (PSA) é o biomarcador mais utilizado; porém, biomarcadores mais específicos devem ser estudados. Objetivo: Avaliar a acurácia da proteína engrenada-2 (EN2) na urina como biomarcador de câncer de próstata. Método: Foi realizada uma busca abrangente no período de janeiro de 2005 a julho de 2016, utilizando as seguintes bases de dados eletrônicas: Medline (PubMed), Embase, Cochrane Library e Lilacs. As palavras-chave utilizadas foram: "engrailed-2", "EN2", "prostatic neoplasms". A busca foi limitada a humanos e não houve restrição de idioma. A avaliação da qualidade dos estudos incluídos foi realizada de acordo com Quadas-2. A análise estatística foi realizada usando o software Meta-DiSc® e RevMan 5.3. Resultados: Foram identificados 248 estudos. Após a triagem dos títulos e resumos, foram excluídos 231. Um total de 17 foram lidos na íntegra e dois, incluídos na metanálise. A sensibilidade combinada foi de 66% (IC95% 0,56-0,75). A especificidade foi de 89% (IC95% 0,86-0,92). O DOR foi de 15,08 (IC95% 8,43-26,97). Conclusão: O teste EN2 mostrou alta especificidade (89%) e baixa sensibilidade (66%).

Summary Introduction: Prostate cancer is the second type of cancer diagnosed and the fifth cause of death in men worldwide. Early diagnosis helps to control disease progression. Currently, prostate specific antigen is the standard biomarker, as it has a broad scope of identification and, thus, new and more specific biomarkers must be studied. Objective: To evaluate the accuracy of engrailed-2 protein (EN2) in urine as a prostate cancer biomarker. Method: A comprehensive search was conducted in the period from January 2005 to July 2016 using the following electronic databases: Medline (PubMed), Embase, Cochrane Library and Lilacs. The keywords used in the databases were: "engrailed-2," "EN2," "prostatic neoplasms." The search was limited to humans and there was no language restriction. Critical appraisal of the included studies was performed according to Quadas-2. Statistical analysis was performed using Meta-DiSc® and RevMan 5.3 softwares. Results: A total of 248 studies were identified. After title and abstract screening, 231 studies were removed. A total of 17 studies were read in full and two studies were included in the meta-analysis. The pooled sensitivity was 66% (95CI 0.56-0.75) and specificity was 89% (95CI 0.86-0.92). The DOR was 15.08 (95CI 8.43-26.97). Conclusion: The EN2 test showed high specificity (89%) and low sensitivity (66%).

O objetivo deste trabalho foi avaliar a acurácia da mesotelina como um biomarcador para o câncer de ovário. Realizou-se uma revisão sistemática quantita tiva. Uma pesquisa global nas bases de dados Medline, LILACS, SCOPUS, Embase, Cochrane Central Register of Controlled Trials, Biomed Central, e ISI Web of Science foi realizada de janeiro de 1990 a junho de 2015. Para a inclusão nesta revisão sistemática, os estu dos deveriam ter mensurado os níveis mesotelina em pelo menos dois diagnósticos histológicos; câncer de ovário (câncer de ovário ou limítrofe) vs. tumores de ovário benignos ou normais. Para cada estudo foram construídas tabelas de contingência 2 x 2. Calculou-se a sensibilidade, especificidade e odds ratio diagnóstica globais. A qualidade dos estudos foi realizado de acordo com o QUADAS-2. A análise estatística foi realizada com o software Stata 11, Meta-DiSc(r) e RevMan 5.2. Doze estudos foram realizados incluindo 1.561 mulhe res. A sensibilidade agrupada foi de 0,62 (IC 95% 0,58-0,66) e a especificidade foi de 0,94 (IC 95% 0,92-0,95). A DOR foi 38,92 (IC 95% 17,82-84,99). Nossa revisão sistemática mostrou que a mesotelina não pode servir como um biomarcador isolado para o câncer de ovário.

The objective of this work was to estimate the accuracy of mesothelin as a biomarker for ovarian cancer. A quantitative systematic review was performed. A comprehensive search of the Medline, LILACS, SCOPUS, Embase, Cochrane Central Register of Controlled Trials, Biomed Central, and ISI Web of Science databases was conducted from January 1990 to June 2015. For inclusion in this systematic review, the papers must have measured mesothelin levels in at least two histological diagnoses; ovarian cancer (borderline or ovarian tumor) vs. benign or normal ovarian tissue. For each study, 2 x 2 contingency tables were constructed. We calculated the sensitivity, specificity and diagnostic odds ratio. The verification bias was performed according to QUADAS-2. Statistical analysis was performed with the software Stata 11, Meta-DiSc(r) and RevMan 5.2. Twelve studies were analyzed, which included 1,561 women. The pooled sensitivity was 0.62 (CI 95% 0.58 - 0.66) and specificity was 0.94 (CI 95% 0.92 - 0.95). The DOR was 38.92 (CI 95% 17.82 - 84.99). Our systematic review shows that mesothelin cannot serve alone as a biomarker for the detection of ovarian cancer.

Realizamos uma revisão sistemática com o objetivo de verificar a eficácia do uso tópico de aciclovir 5% e Creme de hidrocortisona 1% em comparação com o grupo placebo para o tratamento herpes labial simplex. Realizamos uma pesquisa bibliográfica usando o Medline, Embase, BIOSIS, LILACS, Scopus, literatura cinza, Central de Registros de Ensaios Controlados Cochrane, o ISI Web of Science e IBECS do início de 1990 a junho de 2014. Nós relatamos os resultados usando risco relativo (RR) com intervalos de confiança de 95%. A pesquisa bibliográfica encontrou 180 publicações potencialmente relevantes. Buscas nas listas de referência encontraram mais duas citações. Entre esses estudos, dois foram considerados elegíveis para inclusão nesta revisão. Ambos os ensaios incluíram 1.213 pacientes. Uma metanálise desses estudos mostrou um RR = 0,77 (95% CI,70-0,86; p <0,001). Este resultado sugere que um tratamento precoce com a combinação de um antiviral e um esteróide é benéfico para o tratamento de herpes labial simplex.

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.