Evaluation of Brazilian women's participation in the CNPQ in the field of medical research / Avaliação da participação das mulheres brasileiras no CNPQ na área de pesquisa médica

Abstract Introduction: Brazilian scientific production has shown substantial growth and achieved international visibility. However, in general, the participation of women in scientific activities remains limited. Objective: This study aimed to evaluate the indicators of scientific productivity of women fellows of the Council for Scientific and Technological Development (CNPq) in the field of Medicine. Method: This cross-sectional study was conducted on 541 (211 women, 39%) researchers registered as recipients of CNPq research productivity (PQ) scholarships in Medicine according to a list provided in December 2022. Results: There was a predominance of male researchers (n=330; 61%). In both the male and female groups, most researchers were at level 2, with 62.5% women and 47.2% men (p=0.018). All 211 female PQ scholars were distributed among 37 different institutions and published 34,969 papers in scientific journals, averaging 165.7 articles per researcher. In the last five years of the study period (from 2018 to 2022), 9,679 papers were published. Over their careers, the 211 researchers supervised 5,440 undergraduate research students, 4,144 master's degree students, and 2,923 PhD candidates. There was a significant difference between the scholarship levels for the development of human resources in undergraduate research (p=0.040), master's degree (p=0.027), and PhD. (p<0.001). Conclusion: There are still less women participating in CNPq medical research than men. However, we observed a substantial participation of women in all the assessed items, including technical and scientific production and the human resources training.

Resumo Introdução: A produção científica brasileira apresentou crescimento substancial e visibilidade internacional. Contudo, em geral, a participação das mulheres em atividades científicas ainda é limitada. Objetivo: Este estudo objetivou avaliar os indicadores de produtividade científica de mulheres bolsistas do Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) na área de medicina. Método: Foi realizado estudo transversal com 541 (211 mulheres, 39%) pesquisadores cadastrados como bolsistas de produtividade em medicina do CNPq conforme lista disponibilizada em dezembro de 2022. Resultado: Houve predomínio de pesquisadores do sexo masculino (n = 330; 61%). Em ambos os grupos, masculino e feminino, a maioria dos investigadores encontra-se no nível 2, sendo 62,5% mulheres e 47,2% homens (p = 0,018). Todos os 211 pesquisadores foram distribuídos em 37 instituições diferentes e publicaram 34.969 artigos em revistas científicas, com média de 165,7 artigos por pesquisador. De 2018 a 2022, foram publicados 9.679 artigos. Ao longo de suas carreiras, os 211 pesquisadores orientaram 5.440 alunos de iniciação científica, 4.144 alunos de mestrado e 2.923 alunos de doutorado. Houve diferença significativa entre os níveis de bolsas quanto ao desenvolvimento de recursos humanos em iniciação científica (p = 0,040), mestrado (p = 0,027) e doutorado (p < 0,001). Conclusão: Ainda há menor participação de mulheres do que de homens entre os pesquisadores médicos do CNPq. Contudo, foi possível observar participação substancial das mulheres em todos os quesitos avaliados, incluindo a produção técnica e científica e a formação de recursos humanos.

Epidemiology and Estimated Cost of Surgery for Cubital Tunnel Syndrome Conducted by the Unified Health System in Brazil (2005­2015)

Introduction Cubital tunnel syndrome (CTS) is responsible for one of the types of ulnar nerve neuropathy and is the second cause of compressive neuropathy of the upper limb, only surpassed by carpal tunnel syndrome. Objective To describe the epidemiological data of the ulnar nerve transposition surgical code in the treatment of CTS by the United Health System (SUS) from 2005 to 2015. Methodology This is a descriptive epidemiological study, in which data were obtained through consultation of the DATASUS database. Results/Discussion During this period, 774 procedures were performed and, despite the addition of 20.3 million people to the Brazilian population, the incidence was 0.33/ 1,000,000. National and international epidemiology point to a slightly higher prevalence of the procedure between men, in the fourth and fifth decades of life. Low permanence rate, as well as the absence of hospital deaths related to the procedure, infer that the procedure is safe, with low morbidity and mortality rates. Conclusion The annual incidence of the cubital syndrome submitted to surgical treatment at SUS in the Brazilian population was 1/7,670,833 in 2005 and½,174,468 in 2015. The cost of each surgical procedure during the same period ranged from R$ 318.88 to R$ 539.74. The mean hospitalization time for CTS surgery was 1.85 days.

Double Crush Syndrome of the Median Nerve: A Literature Review

Double crush syndrome (DCS) is defined as the compressive involvement of the same peripheral nerve in different segments.When this syndrome affects the median nerve, a proximal compression of a spinal nerve that will constitute this structure (often the spinal nerve at the C6 vertebra) is usually noted at the cervical spine level as a herniated disc and as a distal compression at the level of the carpal tunnel. Epidemiological data on median nerve compromise by DCS are still very scarce in the medical literature. The diagnosis can be inferred by symptoms and signs occurring proximally and distally in the arm, as well as by alterations revealed by upper limb electromyography and neuroimaging studies, such as magnetic resonance imaging (MRI) of the cervical spine. Nowadays, information on which compressed neuroanatomical point should be initially addressed still depends on further studies. Limited data infer that these patients, when submitted to surgical treatment in only one of the median nerve compression points, evolve with worse functional outcomes than the surgically-treated group with carpal tunnel syndrome without DCS.

Resting Tremor after Mild Head Injury: Case Report

Over the past few decades, it has been recognized that traumatic brain injury (TBI) may result in various movement disorders. However, moderate or mild TBI only rarely causes persistent post-traumatic movement disorders. In the present report, we describe a case of secondary tremor due to amild head injury with a transitory loss of consciousness. A 26- year-old man developed an isolated rest tremor of the hands and legs without other neurologic signs. The interval between the head trauma and the onset of the symptomswas 4 months. Neuroimaging studies reveled gliosis in the lentiform nucleus. Haloperidol administration resulted in tremor reduction. A rest tremor, similar to essential tremor, can be a rare complication of head trauma. Haloperidolmay be an effective and safe treatment modality for post-traumatic tremor. Further studies are needed to clarify the optimal drug for the treatment of post-traumatic tremor.

Síndrome compressiva de múltiplos nervos na dermatopolimiosite: relato de caso / Multiple Nerve Compression Syndrome in Dermatopolymyositis: Case Report

A dermatopolimiosite émiopatia inflamatória de etiologia provavelmente autoimune e comportamento heterogêneo, afetando principalmente pele e músculos e ocasionando manifestações exantemáticas características, como o eritema heliótropo e a pápula de Gottron, e fraqueza muscular proximal simétrica. A associação dessa patologia a neuropatias periféricas é pouco conhecida, podendo raramente ocorrer neuropatia múltipla. O objetivo deste artigo é relatar um caso de síndrome compressiva de múltiplos nervos em portador de dermatopolimiosite. O paciente apresentava fraqueza muscular proximal e exantema característico e foi submetido à revisão laboratorial, ressonância magnética de abdome e eletroneuromiografia, que mostraram alterações. Foi então tratado através da neurólise do nervo mediano ao nível do túnel do carpo e do nervo ulnar ao nível do túnel cubital. Trata-se de importante possibilidade terapêutica em casos como o descrito,mas estudos de maior porte sobre a descompressão simultânea dos túneis carpal e ulnar são necessários.

Dermatopolymyositis is an inflammatory myopathy ­ whose etiology is probably autoimmune ­ that has heterogeneous manifestations that occur mainly in skin and muscles and cause characteristic rash, such as heliotrope rash, Gottron's sign and symmetric proximal weakness. The association between this pathology and peripheral neuropathies is little known and multiple neuropathies rarely occur. The purpose of this article is to report a case of multiple nerve compression syndrome in a patient with dermatopolymyositis. The patient had proximal weakness and characteristic rash and underwent a laboratorial review, abdominal MRI and electromyography, which showed changes. So he was treated by neurolysis of median and ulnar nerves at carpal and cubital tunnels levels, respectively. It is an important therapeutic possibility in cases like this, but larger studies on simultaneous decompression of carpal and cubital tunnels are necessary.

Neuralgia occipital: relato de caso e revisão / Occipital Neuralgia: Case Report and Review

Neuralgia occipital (NO) é uma causa incomum de cefaleia caracterizada por dor paroxística, do tipo pontada, que se irradia para a região occipital. O objetivo deste artigo é relatar o caso de uma paciente com NO e descrever a técnica cirúrgica utilizada. O estudo compreende um levantamento bibliográfico para o conhecimento e melhor abordagem sobre o assunto. Com base na literatura, observa-se que a etiologia pode variar desde traumas, infecções, cirurgias de base de crânio, compressões de nervos ou vértebras até alterações degenerativas e anomalias congênitas. Porém, em sua maioria, os casos são idiopáticos. Apesar de o diagnóstico ser essencialmente clínico, é fundamental que sejam excluídos outros tipos de cefaleias primárias. De acordo com a gravidade e o tempo de evolução do caso, o tratamento da NO pode basear-se em bloqueios nervosos, medicamentos ­ como anti-inflamatórios não-esteroides e relaxantes musculares ­ ou cirurgias. Entre os procedimentos cirúrgicos disponíveis, encontram-se a descompressão do nervo occipital maior, ablação por radiofrequência e implantação de neuroestimulador.

Occipital Neuralgia (ON) is an uncommon cause of headache, characterized by paroxysmal pain, stabbing that radiates to occipital region. This article aims at reviewing the literature to the approach to the subject and performs the case report of patient who present with ON and underwent a surgical treatment. Based on the literature and analysis showed the etiologymay vary from trauma, infections, skull base surgery, compression of nerves or vertebrae to degenerative changes and congenital anomalies. However, most cases are idiopathic. Although the diagnosis is essentially clinical, it is essential that other types of primary headaches are excluded. According to severity and the time course of the case, the treatment of ON may be based on nerve blocks, medications like non-steroidal anti-inflammatory drugs and muscle relaxants. Surgical treatment for ON are nerve decompression, pulsed radiofrequency ablation and stimulator implantation.