Resumo Antecedentes Em 2012, a Neurocritical Care Society lançou uma compilação de protocolos sobre as questões centrais que devem ser abordadas nas primeiras horas de emergências neurológicas – Emergency neurological life support (ENLS). Objetivo Avaliar a repercussão do ENLS por meio de uma análise bibliométrica. Métodos A base de dados Scopus foi utilizada em outubro de 2022 para a busca por artigos mencionando o ENLS. As seguintes variáveis foram obtidas: número de citações; número de citações por ano; número de publicações por ano; ano de publicação; tipo de pesquisa; país do autor correspondente e sua categoria de renda; revista de publicação e seu fator de impacto de 5 anos (IF); e seção onde o ENLS apareceu. Resultados Os 421 artigos incluídos foram publicados de 2012 a 2022. A média de citações por artigo foi de 17.46 (intervalo de confiança (IC) 95% = 8.20–26.72), enquanto a de citações por ano por artigo foi de 4.05 (IC95% = 2.50–5.61). O IF médio por revista foi de 5.14 (IC95% = 4.19–6.09). A maioria dos artigos era de pesquisa secundária (57.48%; n= 242/421), dos quais a maioria eram revisões narrativas (71.90%; n= 174/242). Os países de alta renda foram os mais prolíficos (80.05%; n= 337/421 artigos). Não houve publicações de países de baixa ou média renda. Conclusão Embora ainda baixo, o número de publicações mencionando o ENLS vem aumentando recentemente. A maioria dos artigos foram publicados em revistas de medicina intensiva, neurologia, neurocirurgia e medicina de emergência. Artigos de pesquisa secundária foram os mais comuns, com revisões narrativas sendo o subtipo mais frequente. . (ENLS) bibliométrica 202 obtidas (IF) apareceu 42 201 1746 17 46 17.4 intervalo IC (IC 95 8.20–26.72, 8202672 8.20–26.72 , 8 20 26 72 8.20–26.72) 405 4 05 4.0 IC95% IC95 (IC95 2.50–5.61. 250561 2.50–5.61 2 50 61 2.50–5.61) 514 14 5.1 4.19–6.09. 419609 4.19–6.09 19 6 09 4.19–6.09) 57.48% 5748 57 48 (57.48% n 242/421, 242421 242/421 242 242/421) 71.90% 7190 71 90 (71.90% 174/242. 174242 174/242 174 174/242) 80.05% 8005 80 (80.05% 337421 337 337/42 artigos. artigos) baixo recentemente intensiva neurologia emergência comuns frequente (ENLS (IF 1 17. 9 820267 8.20–26.7 7 40 0 4. IC9 (IC9 25056 2.50–5.6 51 5. 41960 4.19–6.0 57.48 574 (57.48 24242 242/42 24 71.90 719 (71.90 17424 174/24 80.05 800 (80.05 33742 33 337/4 82026 8.20–26. 2505 2.50–5. 4196 4.19–6. 57.4 (57.4 2424 242/4 71.9 (71.9 1742 174/2 80.0 (80.0 3374 3 337/ 8202 8.20–26 250 2.50–5 419 4.19–6 57. (57. 242/ 71. (71. 174/ 80. (80. 820 8.20–2 25 2.50– 41 4.19– (57 (71 (80 82 8.20– 2.50 4.19 (5 (7 (8 8.20 2.5 4.1 ( 8.2 2. 8.

Abstract Background In 2012, the Neurocritical Care Society launched a compilation of protocols regarding the core issues that should be addressed within the first hours of neurological emergencies – the Emergency neurological life support (ENLS). Objective We aim to evaluate this repercussion through a bibliometric analysis. Methods We searched Scopus on October 2022 for articles mentioning ENLS. The following variables were obtained: number of citations; number of citations per year; number of publications per year; year of publication; research type; research subtype; country of corresponding author and its income category and world region; journal of publication and its 5-year impact factor (IF); and section where ENLS appeared. Results After applying eligibility criteria, we retrieved 421 articles, published from 2012 to 2022. The mean number of citations per article was 17.46 (95% Confidence Interval (CI) = 8.20–26.72), while the mean number of citations per year per article was 4.05 (95% CI = 2.50–5.61). The mean destiny journal 5-year IF was 5.141 (95% CI = 4.189–6.093). The majority of articles were secondary research (57.48%; n= 242/421) of which most were narrative reviews (71.90%; n= 174/242). High-Income countries were the most prominent (80.05%; n= 337/421 articles). There were no papers from low-income countries. There were no trials or systematic reviews from middle-income countries. Conclusion Although still low, the number of publications mentioning ENLS is increasing. Articles were mainly published in journals of intensive care medicine, neurology, neurosurgery, and emergency medicine. Most articles were published by authors from high-income countries. The majority of papers were secondary research, with narrative review as the most frequent subtype. . (ENLS) analysis 202 obtained type subtype region 5year 5 (IF) appeared criteria 42 201 1746 17 46 17.4 95% 95 (95 (CI 8.20–26.72, 8202672 8.20–26.72 , 8 20 26 72 8.20–26.72) 405 4 05 4.0 2.50–5.61. 250561 2.50–5.61 2 50 61 2.50–5.61) 5141 141 5.14 4.189–6.093. 41896093 4.189–6.093 189 6 093 4.189–6.093) 57.48% 5748 57 48 (57.48% n 242/421 242421 242 71.90% 7190 71 90 (71.90% 174/242. 174242 174/242 174 174/242) HighIncome High Income 80.05% 8005 80 (80.05% 337421 337 337/42 articles. articles) lowincome low middleincome middle increasing medicine neurology neurosurgery highincome high (ENLS (IF 1 17. 9 (9 820267 8.20–26.7 7 40 0 4. 25056 2.50–5.6 514 14 5.1 4189609 4.189–6.09 18 09 57.48 574 (57.48 242/42 24242 24 71.90 719 (71.90 17424 174/24 80.05 800 (80.05 33742 33 337/4 ( 82026 8.20–26. 2505 2.50–5. 51 5. 418960 4.189–6.0 57.4 (57.4 242/4 2424 71.9 (71.9 1742 174/2 80.0 (80.0 3374 3 337/ 8202 8.20–26 250 2.50–5 41896 4.189–6. 57. (57. 242/ 71. (71. 174/ 80. (80. 820 8.20–2 25 2.50– 4189 4.189–6 (57 (71 (80 82 8.20– 2.50 418 4.189– (5 (7 (8 8.20 2.5 41 4.189 8.2 2. 4.18 8. 4.1

Abstract Objective To evaluate the efficacy of immunotherapy for GTN treatment after methotrexate-resistance or in cases of multiresistant disease, through a systematic review, as well as to present the first 4 Brazilian cases of immunotherapy for GTN treatment. Methods Three independent researchers searched five electronic databases (EMBASE, LILACS, Medline, CENTRAL and Web of Science), for relevant articles up to February/2023 (PROSPERO CRD42023401453). The quality assessment was performed using the Newcastle Ottawa scale for case series and case reports. The primary outcome of this study was the occurrence of complete remission. The presentation of the case reports was approved by the Institutional Review Board. Results Of the 4 cases presented, the first was a low-risk GTN with methotrexate resistance unsuccessfully treated with avelumab, which achieved remission with sequential multiagent chemotherapy. The remaining 3 cases were high-risk multiagent-resistant GTN that were successfully treated with pembrolizumab, among which there were two subsequent gestations, one of them with normal pregnancy and healthy conceptus. Regarding the systematic review, 12 studies were included, only one of them on avelumab, showing a 46.7% complete remission rate. The remaining 11 studies were on pembrolizumab, showing an 86.7% complete remission rate, regardless of tumor histology. Both immunotherapies showed good tolerability, with two healthy pregnancies being recorded: one after avelumb and another after pembrolizumab. Conclusion Immunotherapy showed effectiveness for GTN treatment and may be especially useful in cases of high-risk disease, where pembrolizumab achieves a high therapeutic response, regardless of the histological type, and despite prior chemoresistance to multiple lines of treatment. methotrexateresistance disease review EMBASE, EMBASE (EMBASE LILACS Medline Science, Science , Science) February2023 February 2023 February/202 PROSPERO CRD42023401453. CRD42023401453 CRD . CRD42023401453) Board presented lowrisk low risk avelumab chemotherapy highrisk multiagentresistant resistant gestations conceptus 1 included 467 46 7 46.7 rate 867 86 86.7 histology tolerability recorded response type February202 202 February/20 CRD4202340145 46. 8 86. February20 20 February/2 CRD420234014 February2 2 February/ CRD42023401 CRD4202340 CRD420234 CRD42023 CRD4202 CRD420 CRD42 CRD4