Publication Trends of Nonobstetric Brachial Plexus Injury Research: A Bibliometric Analysis.

OBJECTIVE: To evaluate publication trends in nonobstetric brachial plexus injury research. METHODS: In September 2020, Scopus was searched for articles on nonobstretric brachial plexus injury. Citation count, year of publication, country of corresponding author and its income category, destiny journal and its 5-year impact factor (IF), and research type were retrieved. RESULTS: The analysis comprised 1245 articles. Mean number of citations per article was 18.01 (95% confidence interval 16.46-19.55). Mean IF was 3.60 (95% confidence interval 3.25-3.95). The 5 most prolific journals had an IF <5. The journal with the highest number of articles was the Journal of Hand Surgery (American Volume) (n = 70, 5.6%). The most prolific country was the United States (n = 313, 25.1%). There were 913 articles (73.3%) from high-income countries, 246 (19.8%) from upper middle-income countries, and 68 (5.5%) from lower middle-income countries. No articles were from low-income countries. The representation of middle-income countries increased from 2.1% of published articles in 1980-1989 to 40.0% in 2010-2019. Primary research represented 64.0% (n = 797) of articles, while secondary research and case reports represented 13.0% (n = 162) and 23.0% (n = 286) of articles, respectively. Narrative reviews (n = 142, 11.4%;) and systematic reviews (n = 20, 1.6%) comprised articles from the secondary research group. CONCLUSIONS: While high-income countries still represent the majority of publications, the contribution of researchers from middle-income countries is increasing. The most common destiny journals are field specific, with a relatively low IF. Although most articles are primary research, a representative portion have a shallow level of evidence (case reports and narrative reviews).

Viral Infections in Renal Transplantation: A Clue to Excessive Immunosuppression

As infecções virais são comuns após o transplante e podem se constituir em biomarcadores de imunossupressão excessiva. A monitorização da reativaçãodas infecções virais, tais como CMV e BK, deveria ser uma rotina. As técnicas moleculares incluindo o PCR são as preferidas. Vírus ativadoresimunológicos, tais como CMV, produzem efeitos bidirecionais que predispõem a rejeição e evolução ruim dos enxertos. As infecções com ativação nãoimunológicas, como as causadas pelo vírus BK, podem promover inflamação com função inadequada ou perda do enxerto renal. Em caso dedisponibilidade de um tratamento específico antivírus, este deveria ser considerado, mesmo quando as infecções forem assintomáticas, tais como CMV,visto que estas se associam com mortalidade e disfunção do enxerto. A redução antecipada ou “preemptive” da imunossupressão pode prevenir aprogressão de viremia para nefropatia pelo vírus BK. O risco versus benefício de se retornar com os medicamentos imunossupressores ou com as dosesutilizadas antes da depuração viral permanece desconhecido.