Resumo Introdução: À medida que o conhecimento científico cresceu em biomedicina, também se tornou necessário o desenvolvimento de ferramentas para gerenciar e entender o corpo de evidências. Nesse sentido, a bibliometria tornou-se uma disciplina consolidada para a análise da atividade científica, possibilita a caracterização de um campo ou área de conhecimento específica através da quantificação das características bibliográficas das publicações científicas. Objetivo: Determinar os artigos mais citados na área de rinorreia e otorreia por líquido cefalorraquidiano. Método: As buscas foram feitas na plataforma Clarivate Analytics Web of Science, que inclui o banco de dados Medline. O período do estudo foi limitado a 1945–2018. Resultados: Os 101 artigos mais citados no campo da fístula liquórica foram publicados em 36 periódicos e as especialidades mais importantes que contribuíram para a literatura foram a neurocirurgia e a otorrinolaringologia. Dos 101 artigos mais citados, 70% foram publicados de 1990 a 2018, com dois períodos de alta produtividade científica: 1990 a 1999 e 2000 a 2009. No primeiro período, o principal tópico de interesse da pesquisa foi a cirurgia endoscópica do seio para fístulas liquóricas, enquanto de 2000 a 2009 os artigos se concentraram mais nos aspectos cirúrgicos das abordagens estendidas da base do crânio. Os artigos receberam 73 a 767 citações. O artigo principal, durante todo o período do estudo, foi ‘‘Uma nova técnica reconstrutiva após abordagens endonasais expandidas endoscópicas: retalho nasoseptal do pedículo vascular’’, de Hadad et al., publicado em 2006 no periódico Laryngoscope. Sua publicação representou um ponto de inflexão na literatura sobre fístula liquórica e cirurgia endoscópica da base do crânio e deu origem a inúmeras outras publicações de pesquisa. Conclusão: Diferentes inovações cirúrgicas no campo da fístula liquórica desencadearam dois períodos diferentes de intensa atividade científica. Otorrinolaringologia e neurocirurgia foram as especialidades dominantes. O tópico mais frequentemente estudado foi cirurgia endoscópica; outros incluíram características clínicas e de diagnóstico, cirurgia de neurinoma e fístula liquórica relacionado a fraturas do osso temporal.

Abstract Introduction: As scientific knowledge has grown in biomedicine, it has also become necessary to develop tools to manage and understand the body of evidence. In that sense, bibliometrics has become a consolidated discipline for analyzing scientific activity, enabling the characterization of a particular field or area of knowledge by means of the quantification of the bibliographic characteristics of scientific publications. Objective: The objective of this study was to determine the most frequently cited articles in the field of cerebrospinal fluid rhinorrhea and otorrhea. Methods: The searches took place on the Clarivate Analytics Web of Science platform, which includes the MEDLINE database. The study period was limited to 1945–2018. Results: The 101 most cited articles in the field of cerebrospinal fluid leak were published in 36 journals, and the most important specialties contributing to the literature were neurosurgery and otorhinolaryngology. Of the 101 top-cited articles, 70% were published from 1990 to 2018, with two distinct periods of high scientific productivity: 1990–1999 and 2000–2009. In the first period, the main topic of research interest was endoscopic sinus surgery for cerebrospinal fluid fistulas, whereas from 2000 to 2009, documents focused more on surgical aspects of extended skull base approaches. The articles received 73–767 citations. The top article over the whole study period was ‘‘A novel reconstructive technique after endoscopic expanded endonasal approaches: vascular pedicle nasoseptal flap’’ by Hadad et al., which was published 2006 in Laryngoscope. Its publication represented an inflection point in the literature on cerebrospinal fluid leak and endoscopic skull base surgery, and it gave rise to numerous other research publications. Conclusion: Different surgical innovations in the field of cerebrospinal fluid leak sparked two different periods of intense scientific activity. Otorhinolaryngology and neurosurgery were the dominant specialties. The most frequent topic studied was endoscopic surgery; others included clinical and diagnostic features, neurinoma surgery, and cerebrospinal fluid leak related to temporal bone fractures.

Resumen Introducción. El tratamiento neoadyuvante con radioterapia y quimioterapia radiosensibilizante en el cáncer de recto localmente avanzado (CRLA) disminuye significativamente las tasas de recurrencia local. Por tanto el objetivo de este estudio es analizar la respuesta patológica completa (RPC) y parcial (RPP) tras el tratamiento neoadyuvante con quimioradioterapia en pacientes con CRLA. Material y método. Se realizó un estudio descriptivo, retrospectivo en pacientes con diagnóstico de CRLA desde enero 2016 a diciembre 2018 en el Servicio de Oncología-Radioterápica del Hospital Universitario La Paz. Se incluyeron 140 pacientes. Un grupo de pacientes (92,9%) se trató con radioterapia 3D conformada con una dosis de 45Gy sobre pelvis y una sobreimpresión de 5,4Gy sobre tumor primario y otro grupo (7,1%) se trató con radioterapia con técnica volumétrica y en arcoterapia (VMAT) guiado por imagen (IGRT) con una dosis de 53,7Gy en pelvis con sobreimpresión concurrente al tumor. La dosis de capecitabina oral fue de 850mg/m2 dos veces al día durante el tratamiento. Todos los pacientes fueron reevaluados con resonancia magnética (RM) post-neoadyuvancia. Los pacientes se operaron entre 6-8 semanas tras quimioradioterapia. Resultados. Se obtuvo una RPC de 17,1% y RPP de 80,1% con una tasa global de downstaging de 31,8%. Conclusión. Se concluye que la quimioradioterapia neoadyuvante es un tratamiento seguro con aceptables tasas de control local en los pacientes con CRLA.

Abstract Introduction. Neoadjuvant treatment with radiotherapy and radiosensitizing chemotherapy in locally advanced rectal cancer (LARC) significantly decreases local recurrence rates. Therefore the objective of this study is to analyze the pathological complete response (PCR) and partial response (PPR) of neoadjuvant treatment with exclusive chemoradiotherapy in patients with locally advanced rectal cancer. Matherial and Method. It has been made a study descriptive, retrospective in a cohort of patients with LARC in the January 2016 to December 2018 period in the Radiation-Oncology Department of Hospital Universitario La Paz. 140 patients were included. A group of patients (92,9%) received treatment with radiotherapy 3D conformed technique with a dose administered the 45 Gy on pelvis and a boost of 5,4 Gy on tumor and other group (7,1%) received treatment with volumetric archotherapy radiotherapy (VMAT) guided by image (IGRT) with a dose administered of 53,7% on pelvis with concurrent boost and. The dose of capecitabine was 850 mg/m2, twice a day during the treatment. The patients were re-evaluated with post-neoadjuvant MRI. Patients were operated 6 to 8 weeks post chemoradiotherapy. Results. CPR was obtained of 17,1% and pPR of 80,1% with a global rate downstaging of 31,8%. Conclusion. It concludes that chemoradiotherapy neoadjuvant is a safe treatment with acceptable rates of local control in patients with LARC.

Resumen Introducción. Múltiples marcadores hematológicos de inflamación pueden tener relación con un peor pronóstico en los pacientes oncológicos. Propósito. Este estudio evaluó si los cambios en marcadores hematológicos antes y después del tratamiento quimio-radioterápico (QT-RT) en cáncer de recto pueden estar asociados con la respuesta patológica completa. Material y método. Se revisaron retrospectivamente las historias clínicas de 140 pacientes con cáncer de recto que recibieron tratamiento radioterápico neoadyuvante seguido de resección quirúrgica fueron revisados retrospectivamente. Se realizó analítica completa antes y después del tratamiento QTRT. Se evaluaron leucocitos, hemoglobina, neutrófilos, linfocitos, monocitos, ratio neutrófilo-linfocitos (NLR), ratio plaqueta-linfocitos (PLR) y ratio linfocitos-monocitos (LMR). Resultados. La respuesta patológica completa fue de 17,5%. Los marcadores hematológicos tuvieron una disminución significativa tras el tratamiento de QT-RT (p<0,05), sin embargo en nuestro análisis no se relacionó con la respuesta patológica completa, salvo el PLR (p=0,027). Conclusión. Los marcadores hematológicos antres y después del tratamiento neoadyuvante no predicen la respuesta tumoral tras QT-RT en este estudio. Sin embargo una muestra mayor puede presentar resultados estadísticamente signifiacativos, especialmente con los monocitos.

Abstract Introduction. Multiple haematological markers of inflammation might be related with poor prognosis in oncological patients. Purpose. This study evaluated whether changes of haematological markers before and after chemoradiotherapy treatment in rectal cancer might be associated to pathological complete response. Material and Methods. Medical records of 140 patients with rectal cancer who received neoadjuvant radiotherapy followed by surgical resection were retrospectively review. Complete bloods counts (CBC) was measured days before and after period of RT. We assessed white blood cells count (WBC), hemoglobin levels (Hb), neutrophils count, lymphocytes count, monocytes count, neutrophil-to-lymphocye ratio (NLR), platelet-to-lymphocyte ratio (PLR) and lymphocyte-to-monocyte ratio (LMR). Results. The overall rate of pCR was 17,5%. Hematological markers had a statistically significant decrease after CRT treatment (p<0,05), however in our analysis they do not predict complete pathological response. Conclusion. Haematological markers before and after neoadjuvant treatment do not predict tumor responses in this study. However, a larger sample can show statistically significant results, especially in monocytes ratio.

Objective: To determine the utilization rate of a dermatology service among the immigrant population and compare this rate with that among the autochthonous population. Methods: Over a 1-year period, data on all patients attended in the Dermatology Service of Health Department 19 in the autonomous community of Valencia were prospectively collected. Results: Of 39,160 consultations, 1,625 were made by immigrants (4.1%). Attendance for dermatologic emergencies was greater in immigrants than in the autochthonous population (7.7% vs 3.0%; p < 0.001), while surgical activity was lower in immigrants than in Spanish-born patients (2.6% vs 5%; p < 0.001). Demand for consultation in the immigrant population was 5.7 visits per 100 immigrants, lower than that in the autochthonous population (16.2). The standardized rate ratio was 0.34. North Africans (5.6 per 100 immigrants), East Europeans (4.8), sub-Saharan Africans (5.3) and Asians (4.2) consulted less than Latin Americans (8.5; p<0.001). Conclusions: Demand was lower in the immigrant than in the autochthonous population, and the utilization patters differed according to country.

Objetivos: Conocer la demanda asistencial en dermatología de la población inmigrante (PI) y compararla con la de la población autóctona (PA). Métodos: Durante un año, se recogió prospectivamente el número de enfermedades atendidas en dermatología en el Departamento de Salud 19 de la Comunidad Valenciana. Resultados: De 39.160 episodios, 1.625 fueron en PI (4,1%). La asistencia por urgencias fue mayor en PI que en PA (el 7,7 frente al 3,0%; p < 0,001) y la actividad quirúrgica en PI fue menor que en PA (el 2,6 frente al 5%; p < 0,001). La demanda en la PI fue de 5,7 episodios por 100 inmigrantes, inferior a la PA (16,2). La razón de tasas estandarizada fue de 0,34. Los pacientes del norte de África (5,6 por 100 inmigrantes), Europa del Este (4,8), África subsahariana (5,3) y Asia (4,2) consultaron menos que los latinoamericanos (8,5; p < 0,001). Conclusiones: La demanda en PI fue inferior a la PA y con un patrón de utilización diferente por países.

Objective: To determine the utilization rate of a dermatology service among the immigrant population and compare this rate with that among the autochthonous population. Methods: Over a 1-year period, data on all patients attended in the Dermatology Service of Health Department 19 in the autonomous community of Valencia were prospectively collected. Results: Of 39,160 consultations, 1,625 were made by immigrants (4.1%). Attendance for dermatologic emergencies was greater in immigrants than in the autochthonous population (7.7% vs 3.0%; p < 0.001), while surgical activity was lower in immigrants than in Spanish-born patients (2.6% vs 5%; p < 0.001). Demand for consultation in the immigrant population was 5.7 visits per 100 immigrants, lower than that in the autochthonous population (16.2). The standardized rate ratio was 0.34. North Africans (5.6 per 100 immigrants), East Europeans (4.8), sub-Saharan Africans (5.3) and Asians (4.2) consulted less than Latin Americans (8.5; p<0.001). Conclusions: Demand was lower in the immigrant than in the autochthonous population, and the utilization patters differed according to country.

Objetivos: Conocer la demanda asistencial en dermatología de la población inmigrante (PI) y compararla con la de la población autóctona (PA). Métodos: Durante un año, se recogió prospectivamente el número de enfermedades atendidas en dermatología en el Departamento de Salud 19 de la Comunidad Valenciana. Resultados: De 39.160 episodios, 1.625 fueron en PI (4,1%). La asistencia por urgencias fue mayor en PI que en PA (el 7,7 frente al 3,0%; p < 0,001) y la actividad quirúrgica en PI fue menor que en PA (el 2,6 frente al 5%; p < 0,001). La demanda en la PI fue de 5,7 episodios por 100 inmigrantes, inferior a la PA (16,2). La razón de tasas estandarizada fue de 0,34. Los pacientes del norte de África (5,6 por 100 inmigrantes), Europa del Este (4,8), África subsahariana (5,3) y Asia (4,2) consultaron menos que los latinoamericanos (8,5; p < 0,001). Conclusiones: La demanda en PI fue inferior a la PA y con un patrón de utilización diferente por países.

Objective: To describe Spain's scientific production in the field of bioethics from 1966 to 2003. Methods: Manuscripts published by Spanish authors between 1966 and 2003 and containing key word references to bioethics, ethics, and 22 other related terms were retrieved from the Medline database. Results: 858 documents were selected: 78 (9.1%) were published between 1966 and 1983, 163 (19%) between 1984 and 1993, and 617 (71.9%) between 1994 and 2003. The main subject areas treated were laws and rights (15.4%) and research and ethics committees (13.1%). The last of these periods witnessed an increase in publications on genetics and human cloning and a decrease in those treating abortion. Institutional affiliations referred mainly to universities (38.9%) and hospitals (38.5%). Conclusions: There was a progressive increase in the number of scientific publications on bioethics by Spanish authors during the study period.

Fundamento: Describir la producción científica española en bioética entre 1966 y 2003. Métodos: Se seleccionaron los documentos publicados por autores españoles y recogidos en la base de datos MEDLINE, mediante el cruce de las palabras bioética con otras diversas del mismo ámbito. Resultados: Se estudiaron 858 documentos, de los cuales 78 (9,1%) se publicaron entre 1966 y 1983, 163 (19%) entre 1984 y 1993, y 617 (71,9%) entre 1994 y 2003. Los principales temas publicados fueron: legislación y derechos (15,4%) e investigación y comités de ética (13,1%). En el último período se ha observado un aumento significativo de las publicaciones sobre genética y clonación y un descenso sobre las de aborto. El 38,9% de los documentos se atribuyó a universidades y el 38,5% a hospitales. Conclusiones: La publicaciones científicas de bioética se incrementó durante el período de estudio, lo que demuestra un aumento progresivo de la producción científica española en bioética.

Objective: To describe Spain's scientific production in the field of bioethics from 1966 to 2003. Methods: Manuscripts published by Spanish authors between 1966 and 2003 and containing key word references to bioethics, ethics, and 22 other related terms were retrieved from the Medline database. Results: 858 documents were selected: 78 (9.1%) were published between 1966 and 1983, 163 (19%) between 1984 and 1993, and 617 (71.9%) between 1994 and 2003. The main subject areas treated were laws and rights (15.4%) and research and ethics committees (13.1%). The last of these periods witnessed an increase in publications on genetics and human cloning and a decrease in those treating abortion. Institutional affiliations referred mainly to universities (38.9%) and hospitals (38.5%). Conclusions: There was a progressive increase in the number of scientific publications on bioethics by Spanish authors during the study period.

Fundamento: Describir la producción científica española en bioética entre 1966 y 2003. Métodos: Se seleccionaron los documentos publicados por autores españoles y recogidos en la base de datos MEDLINE, mediante el cruce de las palabras bioética con otras diversas del mismo ámbito. Resultados: Se estudiaron 858 documentos, de los cuales 78 (9,1%) se publicaron entre 1966 y 1983, 163 (19%) entre 1984 y 1993, y 617 (71,9%) entre 1994 y 2003. Los principales temas publicados fueron: legislación y derechos (15,4%) e investigación y comités de ética (13,1%). En el último período se ha observado un aumento significativo de las publicaciones sobre genética y clonación y un descenso sobre las de aborto. El 38,9% de los documentos se atribuyó a universidades y el 38,5% a hospitales. Conclusiones: La publicaciones científicas de bioética se incrementó durante el período de estudio, lo que demuestra un aumento progresivo de la producción científica española en bioética.