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Our purpose was to determine the effectiveness and harms of vaccination in patients with any sexual history to prevent the prevalence of papillomavirus infection. A search strategy was conducted in the MEDLINE, CENTRAL, EMBASE and LILACS databases. Searches were also conducted in other databases and unpublished literature. The risk of bias was evaluated with the Cochrane Collaboration's tool. Analysis of fixed effects was conducted. The primary outcome was the infection by any and each human papillomavirus (HPV) genotype, serious adverse effects and short-term adverse effects. The measure of the effect was the risk difference (RD) with a 95% confidence interval (CI). The planned interventions were bivalent vaccine/tetravalent/nonavalent vs. placebo/no intervention/other vaccines. We included 29 studies described in 35 publications. Bivalent HPV vaccine offers protection against HPV16 (RD -0.05, 95% CI -0.098 to -0.0032), HPV18 (RD -0.03, 95% CI -0.062 to -0.0004) and HPV16/18 genotypes (RD of -0.1, 95% CI -0.16 to -0.04). On the other side, tetravalent HPV vaccine offered protection against HPV6 (RD of -0.0500, 95% CI -0.0963 to -0.0230), HPV11 (RD -0.0198, 95% CI -0.0310 to -0.0085). Also, against HPV16 (RD of -0.0608, 95% CI -0.1126 to -0.0091) and HPV18 (RD of -0.0200, 95% CI -0.0408 to -0.0123). There was a reduction in the prevalence of HPV16, 18 and 16/18 genotypes when applying the bivalent vaccine, with no increase in adverse effects. Regarding the tetravalent vaccine, we found a reduction in the prevalence of HPV6, 11, 16 and 18 genotypes, with no increase in adverse effects.

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PURPOSE: To determine the association between mutations in CDKN2A and FGFR3 genes and the diagnosis of bladder carcinoma (BCa). METHODS: A systematic search strategy was carried out through MEDLINE, EMBASE, LILACS, CENTRAL and unpublished literature. We included RCTs, cohort, case-control and cross-sectional studies that involved patients > 18-year-old assessing the association between CDKN2A and FGFR3 mutated genes and BCa. The primary outcome was bladder cancer defined by histology of the sample. We assessed the risk of bias with QUADAS2 and performed a meta-analysis with Review Manager v5.3. RESULTS: We found 97 records with the search strategies. After duplicates were removed, six studies were included in meta-analysis. Regarding the association between mutated FGFR3 and bladder cancer, we found an OR 31 95% CI (15-64). However, there was no association for CDKN2A and BCa. CONCLUSION: There is a strong association between FGFR3 mutated gene and the diagnosis of bladder cancer, which has not been observed with CDKN2A. Such a result supports FGFR3 mutated gene as a promissory bladder cancer screening and monitoring biomarker.

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Objetivo Describir la evidencia que existe en la actualidad acerca del uso del antibiótico profiláctico en el manejo conservador del trauma renal. Material y métodos Decidimos realizar una revisión de la literatura para intentar resolver la controversia existente acerca de la efectividad del uso de antibiótico profiláctico en pacientes con trauma renal para prevenir complicaciones infecciosas. Resultados El trauma renal es un problema importante en los servicios de urgencias en el mundo. La mayoría corresponden a traumatismos cerrados y principalmente a accidentes de tránsito, aunque pueden ser secundarios a un trauma penetrante. Los abscesos perirrenales son poco frecuentes, se estima que ocurren en menos del 1% de todos los casos de trauma renal y en aproximadamente 5% de los casos de trauma renal penetrante. Dada la baja incidencia de abscesos perirrenales y las diferentes corrientes existe controversia para el tratamiento antibiótico. El manejo es conservador en la mayoría de los casos, y depende del grado de la lesión, el compromiso vascular y el estado hemodinámico del paciente. Conclusión Aún no existe claridad acerca de la utilización de antibiótico profiláctico en el manejo conservador del paciente con un traumatismo renal, relacionado con el tipo de trauma y el grado de la lesión. Sugerimos el uso de antibiótico profiláctico en pacientes con trauma penetrante grado IV dada la mezcla de ambiente externo, cuerpo extraño y orina, sin embargo, no hay evidencia de alta calidad al respecto.

Objective To describe the current evidence on the use of the prophylactic antibiotic in the conservative management of renal trauma. Materials and Methods We decided to review the general and updated literature to try to solve the controversy about the effectiveness of the use of antibiotic prophylaxis in patients with renal trauma to prevent infectious complications. Results Renal trauma is an important trauma in emergency services around the world. Most of them are blunt and mainly because of transit accidents, although they could be due to penetrating trauma. Perirenal abscesses are uncommon, it is estimated that occur in less than 1% of all cases of renal trauma and ∼5% of cases of penetrating renal trauma. Given the low incidence of perirenal abscesses and different streams, controversy exists for antibiotic treatment. Conservative management is the preferred choice, normally according to the grade of the trauma, the vascular compromise and the patient́s hemodynamic response. Conclusion There is still no consensus about the use of prophylaxis antibiotics in conservative management of patients with renal trauma, related to type and the grade of trauma. We suggest the use of a prophylactic antibiotic in patients with grade IV penetrating trauma given the mixture of external environment, foreign body and urine, however there is no evidence of high quality on this regard.

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Resumen Introducción. El cáncer de próstata es una patología importante en la salud pública y tiene alto impacto mundial. El conocimiento y manejo de esta enfermedad debe ser del dominio de todo médico general y especialista que tenga a cargo pacientes que la padezcan. Objetivo. Obtener una visión actualizada de la epidemiología, los factores de riesgo, la clasificación, el diagnóstico y el tratamiento del cáncer de próstata. Materiales y métodos. Se realizó una búsqueda en las bases de datos Embase y MEDLINE desde enero del 2000 hasta marzo del 2017 mediante la cual se hizo un recorrido a través de las condiciones de riesgo, tamizaje, diagnóstico, nuevos biomarcadores y tratamiento del cáncer de próstata. Resultados. Factores genéticos y medioambientales son foco de estudio en la actualidad. La sospecha diagnóstica del cáncer de próstata sigue siendo con el antígeno específico prostético y el tacto rectal y su diagnóstico se debe hacer con la biopsia de próstata. Se han hecho cambios importantes en cuanto a la clasificación y tratamiento de los pacientes con esta enfermedad. Conclusión. Existe mucha investigación en curso y por venir sobre la prevención, el diagnóstico y el tratamiento de esta condición tan importante, relevante y pertinente para los hombres alrededor del mundo.

Abstract Introduction: Prostate cancer is a major public health concern with a high impact worldwide. Knowledge and management of this disease should be mastered by general practitioners and specialists who treat patients with this pathology. Objective: To obtain an updated and detailed review of the epidemiology, risk factors, classification, diagnosis and treatment of prostate cancer. Materials and methods: A search was carried out in the Embase and MEDLINE databases from January 2000 to March 2017, comprising risk factors, screening, diagnosis, new biomarkers and treatment of prostate cancer. Results: Genetic and environmental factors are currently the focus of studies. Prostate-specific antigen and digital rectal examination are still used to suspect prostate cancer, while diagnosis is achieved with a prostate biopsy. Important changes have been made regarding the classification and treatment of patients with this disease. Conclusion: Significant changes have been made in the area. Several ongoing and upcoming researches on prevention, diagnosis and treatment of this condition are available, which are relevant for men around the world.