Effects of aerobic exercise on components of the metabolic syndrome in older adults with type 2 diabetes mellitus: systematic review and meta-analysis. / Efectos del ejercicio aeróbico sobre los componentes del síndrome metabólico en adultos mayores con diabetes mellitus tipo 2: revisión sistemática y metaanálisis.

OBJECTIVE.: To determine the effects of aerobic exercise on the components of the metabolic syndrome in older adult diabetic patients by means of a systematic review with meta-analysis. MATERIALS AND METHODS.: We used the PubMed/Medline, Scopus, Cochrane library, Web of Science databases and the Google Scholar search engine. Randomized controlled trials (RCTs) were selected according to the inclusion criteria. Two reviewers independently determined whether studies met the inclusion criteria, extracted data, and used the Cochrane risk of bias tool (RoB 2). Quantitative analyses were performed in R v 4.0.5, using random effects. RESULTS.: We identified 8697 studies, of which 7 RCTs were included in the qualitative synthesis. Most studies were assessed as having a high or low RoB in at least three domains. Meta-analysis showed that aerobic exercise was effective in improving glucose levels (standardized mean difference [SMD]: -1.04; 95% confidence interval [95% CI] -1.27, -0.81), systolic blood pressure (SMD: -0.79; 95% CI: -1.02, -0.56), diastolic blood pressure (SMD: -0.75; 95% CI: -0.98, -0.52), glycosylated hemoglobin (SMD: -0.57, 95% CI: -0.77, -0.37), HDL (SMD: 0.35, 95% CI: 0.15, 0.55), triglycerides (SMD: -0.26, 95% CI: -0.47, -0.06). No significant adverse effects were reported. The level of certainty of the results was low for fasting glucose, moderate for systolic and diastolic blood pressure, and very low for the other outcomes, in addition to few adverse effects. However, these results should be interpreted with caution due to the use of surrogate markers. CONCLUSIONS.: Aerobic exercise was shown to have a significant improvement in the components of the metabolic syndrome in older diabetic adults, and no major adverse effects were reported. However, we recommend more RCTs with longer intervention time to establish the impact on symptoms and complications.Motivation for the study. The motivation for this research arises from the high prevalence of metabolic syndrome and diabetes mellitus around the world. Despite their impact, there is a gap in knowledge regarding non-pharmacological interventions in older adults aimed at improving the metabolic profile of these patients. Main findings. Our results show a significant improvement in glucose, blood pressure, glycosylated hemoglobin, HDL, and triglyceride levels after the aerobic exercise intervention. In addition, no significant adverse effects were observed. Public health implications. Physical exercise is an affordable and globally available strategy. It improves the metabolic profile of older adult patients with metabolic syndrome.

A Bibliometric Analysis on Tuberculosis and Diabetes Mellitus 2: Visualization, Patterns, and Trends.

BACKGROUND: The convergence of type 2 diabetes mellitus (DM2) and tuberculosis (TB) may lead to increased mortality and complications, so the underlying mechanism is under investigation. Therefore, a bibliometric analysis was performed to describe the bibliometric indicators of publications evaluating the relationship between TB and DM2. METHODS: A descriptive and observational bibliometric study was conducted using the Scopus database to identify documents published from 2016-2023, for which free and controlled terms (Medical subject headings and Emtree) were used. The variables collected comprised the number of published documents, institutions, countries, authors, journals, and type of collaboration, which were exported to Excel 2016 and analyzed with SciVal. RESULTS: A total of 456 documents, 1624 authors, and 2173 citations were identified, with Medicine and Immunology-Microbiology being the subcategories with the highest and lowest number of documents (367 and 80 documents), respectively, with a strong decreasing trend correlation (R2: 0.95; P < 0.5) between the number and year of publication. While the country with the highest production was China (71 papers), the country with the highest citation was the United States (952 citations). In terms of authors, the highest production was by the American Venketaraman, and the highest impact was by the Asian Kimberly To. The institution with the highest number of papers was the Western University of Health Sciences, while Stellenbosch had the highest impact. CONCLUSION: Although the scientific productivity of DM2 and TB have reported growth rates of 158.75% and 7.3%, respectively, our results found a decreasing trend in publications associating these two diseases. The thematic evolution of the concepts in both diseases suggests that the relationship between them is not yet known, so future studies evaluating the underlying mechanisms of this comorbidity are suggested.

Peri-ictal psychiatric manifestations in people with epilepsy: An umbrella review.

OBJECTIVE: We aimed to conduct an umbrella review to summarize the existing evidence regarding the prevalence of peri-ictal psychiatric manifestations (PM) in people with epilepsy (PWE) including pre-ictal, ictal, and postictal stages. METHODS: Databases were searched up to June 2023 for systematic reviews (SR) of observational studies that included patients with epilepsy peri-ictal PM. Data selection, data extraction, and risk of bias assessment (with the AMSTAR-2 instrument) were performed by two independent reviewers. We performed a narrative synthesis using previous guidelines. We used a self-developed decision table according to the GRADE system adapted for narrative outcomes if the certainty of outcomes was not determined by systematic review authors. RESULTS: Four SRs were included comprising 66 primary studies (n = 10 217). Three SRs evaluated one period (pre-ictal, ictal, and postictal), and one did not determine it. During the pre-ictal period, the more prevalent symptom was confusion, although with a low certainty (due to the heterogeneity and serious risk of bias). One systematic review that only included case reports evaluated the ictal period, finding mood/anxiety disorders, psychosis, and personality changes. The postictal period included the most PM (anxiety: 45.0% and depressive symptoms: 43.0%), with very low certainty, due to risk of bias, potential publication bias, heterogeneity, and failure to report the confidence intervals. SIGNIFICANCE: With very low certainty, epileptic periods are characterized by a wide spectrum of PM, being postictal symptoms the most prevalent, predominantly anxiety, and depressive symptoms. Further understanding of these PM of epilepsy could improve the attention of the people with epilepsy. PLAIN LANGUAGE SUMMARY: In this review of reviews, we summarize the frequency in which psychiatric manifestations occur in relation to an epileptic seizure. A total of 10 217 patients were reported in the reviews. The most common manifestations included symptoms of anxiety and depression, as well as changes in the normal behavior of the patient. These manifestations occurred most frequently right after the seizure finished.

Incidence of hypopituitarism in adults undergoing radiotherapy for neck and head cancer: protocol for a systematic review and meta-analysis.

INTRODUCTION: When children with head and neck cancer receive radiation therapy as part of their treatment, a considerable frequency of hypopituitarism has been recognised. However, in adults, it has been little studied and it is possible that patients may be inadvertently affected. The objective is to estimate the incidence of anterior pituitary dysfunction in adults undergoing radiotherapy for head and neck cancer. METHODS AND ANALYSIS: A total of five databases will be used to perform the document search: PubMed, Scopus, Web of Science (Core Collection), Ovid-MEDLINE and Embase. Cohort studies will be included without restriction by language or date. The main outcome will be the incidence of adenohypophyseal dysfunction for each axis: prolactin, growth hormone, thyroid-stimulating hormone, adrenocorticotropic hormone, luteinising hormone and follicle-stimulating hormone. Incidence meta-analysis will be performed using the Freeman-Tukey double arcsine method. In addition, a random-effects model will be used along with a 95% CI. Subgroup analyses will be performed according to tumour location, radiation dose and endocrine assessment time. Meta-regression will be applied according to patient's age and time elapsed until diagnosis. ETHICS AND DISCLOSURE: Since this will be a systematic review of published data, no ethics committee approval is required. The results will be presented at conferences and finally published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42021235163.

Global Scientific Overview of Dermatology Related to COVID-19: A Bibliometric Analysis.

Background: Coronavirus disease 2019 (COVID-19) has had a significant impact on dermatology, but to date no bibliometric analysis of this field has been identified. Therefore, the aim of this study was to perform a bibliometric indicator analysis of the worldwide scientific production of COVID-19 in dermatology. Materials and Methods: An advanced bibliographic search was performed in the Scopus database to identify articles on COVID-19 and dermatology from 2020 to 2021. The collected information was analysed with SciVal software. Bibliometric data were described through figures and summary tables. Results: A total of 1448 documents were collected and analysed. Torello Lotti was the author with the greatest scientific production; however, Esther Freeman had the greatest impact. Harvard University was the institution with the highest number of published articles. Most papers were published in the first quartiles. The United States and Italy were the leading countries in terms of production. Articles with international collaboration had the highest impact. Conclusion: Articles related to dermatology and COVID-19 are mostly published with American and Italian affiliations. In addition, there has been an increase in the distribution of articles published in the first quartile, which would reflect a growing interest in the community. Publications with international collaboration reported the highest impact, so future authors should take this into account.

Effect of Bariatric Surgery on Gut Microbiota: A Scientometric Analysis.

Objective: To perform a bibliometric analysis of the scientific production related to intestinal microbiota and bariatric surgery between January 2016 and December 2022. Materials and Methods: A bibliographic search was performed in the Scopus database to identify published papers. Free and controlled terms (MeSH and Emtree) were used. The information collected was analyzed with SciVal. Results: A total of 518 published papers were included in the analysis. Carel Le Roux was the author with the highest scientific production; however, Edi Prifti had the highest impact. French National Institute of Health and Medical Research (Institut national de la santé et de la recherche médicale) was the institution with the highest number of published articles. Six of the 10 institutions with the highest production were in France, yet the United States had the highest volume of scientific production in this research topic. Most papers were published in first quartile journals. Articles with international collaboration had the highest impact. There is a sustained increase in the number of publications since 2019. Conclusions: The study found that the vast majority of research on gut microbiota changes following bariatric surgery are conducted in the United States and European countries. In addition, the sustained increase in production coupled with the articles being published in high-quality journals and having good citation impact are indictors of the current interest in this research field.

Association between self-perceived consultation time and understanding of the prescribed treatment: An analysis of a national survey in Peru.

OBJECTIVE: To assess the relationship between the self-perceived consultation time and the knowledge of the proposed treatment. METHODS: Secondary data from a 2015 national survey of health services in Peru were analyzed. The self-perceived consultation time was calculated by asking how long it took from when you entered the consultation until you departed. It was then categorized as low, medium, and high. Five self-reported questions were used to construct a knowledge of the prescribed treatment. Adjusted regression models from the Poisson family models were used to evaluate the relationship. We report adjusted prevalence ratios (aPR) with their 95% confidence intervals (95%CI). RESULTS: A total of 9939 outpatients were analyzed, with 58% women; the average age was 44 years; and 45.4% had higher education. Using low self-perceived consultation time as references, medium and high consultation times were associated with understanding the prescribed treatment (aPR=1.17; 95%CI, 1.04-1.33 and aPR=1.30; 95%CI, 1.20-1.40, respectively). CONCLUSION: Patients who reported a medium and high self-perceived consultation time better understood the prescribed treatment. IMPLICATIONS FOR PRACTICE: Healthcare professionals should strive to maximize consultation time to ensure effective communication and improve patient knowledge of treatments, improving overall patient satisfaction and health outcomes.

Efectos del ejercicio aeróbico sobre los componentes del síndrome metabólico en adultos mayores con diabetes mellitus tipo 2: revisión sistemática y metaanálisis / Effects of aerobic exercise on the components of metabolic syndrome in the older population with type 2 diabetes mellitus: a systematic review and meta-analysis

Objetivo. Determinar los efectos del ejercicio aeróbico sobre los componentes del síndrome metabólico en pacientes adultos mayores diabéticos mediante una revisión sistemática con meta-análisis. Materiales y métodos. Utilizamos las bases de datos PubMed/Medline, Scopus, Cochrane library, Web of Science y el buscador Google Scholar. Se seleccionaron los ensayos controlados aleatorizados (ECA) según los criterios de inclusión. Dos revisores determinaron de forma independiente si los estudios cumplían con los criterios de in-clusión, extrajeron los datos y utilizaron la herramienta Cochrane de riesgo de sesgo (RoB 2). Los análisis cuantitativos se realizaron en el programa R v 4.0.5, utilizando efectos aleatorios. Resultados. Las búsquedas identificaron 8697 estudios, de los que siete ECA se incluyeron en la síntesis cualitativa. Se evaluó que la mayoría de los estudios tenían un RoB alto o bajo en al menos tres dominios. El metaanálisis mostró que el ejercicio aeróbico fue eficaz para mejorar los niveles de glucosa (diferencia de medias estandarizada [DME]: -1,04; intervalo de confianza al 95% [IC 95%] -1,27; -0,81), presión arterial sistólica (DME: -0,79; IC 95%: -1,02; -0,56), presión arterial diastólica (DME: -0,75; IC 95%: -0,98; -0,52), hemoglobina glucosilada (DME: -0,57; IC 95%: -0,77; -0,37), HDL (DME: 0,35; IC 95%: 0,15; 0,55), triglicéridos (DME: -0,26; IC 95%: -0,47; -0,06). No se informaron efectos adversos significativos. El nivel de certeza de los resultados fue baja para la glucosa en ayunas, moderado para la presión arterial sistólica y diastólica, y muy bajo para los demás resulta-dos, además de pocos efectos adversos. Sin embargo, estos resultados deben ser interpretados con cautela debido al uso de marcadores subrogados. Conclusiones. El ejercicio aeróbico demostró tener una mejoría significativa en los componentes del síndrome metabólico en adultos mayores diabéticos y no se reportaron efectos adversos importantes. Sin embargo, recomendamos más ECA que tengan un mayor tiempo de intervención para establecer el impacto sobre los síntomas y las complicaciones.

Prevalence and incidence of neuropsychiatric disorders in post hospitalized COVID-19 patients in South America: a systematic review and meta-analysis.

Introduction: There are multiple reports of neuropsychiatric disorders (NDs) such as stress, depression, post-traumatic stress disorder (PTSD), or anxiety, in patients who have survived the acute phase of COVID-19, being even more frequent in people who were hospitalized with moderate or severe disease. South America (SA) was one of the most affected continents during this time due to its health, social, political and economic context. We aimed to determine the prevalence and incidence of NDs in patients following hospitalization for COVID-19 in SA. Materials and methods: We searched in PubMed, Embase, Scopus, Web of Science, LILACS, SciELO, and Google Scholar databases up to October 2022. We performed proportion meta-analysis with a random-effect model and Freeman-Tukey Double Arcsine transformation using the STATA 16.1 program. Finally, we evaluated heterogeneity by subgroup analysis and certainty of evidence with the GRADE approach. Results: We included eight studies from four countries. We only pooled six studies with prevalence measures. The estimated prevalence of all NDs was 31.48% (two-studies, 95%CI: 25.82-37.43). Depression, anxiety, insomnia, PTSD, and memory alterations had a pooled prevalence of 16.23% (three-studies, 95%CI: 7.18-27.93, I2: 94.22), 18.72% (three-studies, 95%CI: 11.65-26.97, I2: 87.56), 43.07% (three-studies, 95%CI: 32.77-53.37, I2: 92.61), 31.78% (three-studies, 95%CI: 14.33-52.40, I2: 97.96), and 38.24% (two-studies, 95%CI: 35.5-40.97), respectively. The evidence included was deemed as moderate to high certainty. Conclusion: We suggest that NDs should be prioritized in research and care in South America with public policies that can support their identification and prompt management to improve the quality of life of patients. More studies are needed to adequately study the prevalence of NDs in South America, their associated factors, and evaluate the causes of heterogeneity. Systematic review registration: https://doi.org/10.6084/m9.figshare.21901041.v1.

Ethnic disparities in out-of-pocket expense on medicines in Peru: Evidence from a nationwide survey.

Background: Despite improvements in health insurance coverage, out-of-pocket (OOP) health spending remains a public health issue in Peru, and OOP payment has implications for disease treatment in ethnic minorities. We aimed to analyze the ethnic disparities in the OOP payment and estimate the gaps related to observable risk factors in the OOP payment on medicines by ethnic conditions during 2014-2016 in Peru. Study design: cross-sectional study. Methods: We conducted a secondary data analysis using the National Health User Satisfaction Survey. The outcome was the participants' OOP payment in self-reported medications. Ethnic minorities were considered participants who habitually spoke a language other than Spanish at home. Crude and adjusted linear regression models were performed, and the Oaxaca-Blinder decomposition method was used to assess the OPP payment differential by ethnic minority condition, explained by their individual and sociodemographic characteristics. Results: We analyzed 11,346 surveyed, the mean age was 40.78 years, and 57.67 % were women. There was lower OOP payment in medications among ethnic minorities in the adjusted analysis (Beta coefficient [ß]: -0.11; 95 % confidence interval [95%CI]: -0.21 to -0.01; p = 0.043). In the Oaxaca-Blinder decomposition analysis, a gap of 0.19 USD in the OOP payment in medicines among ethnic minorities was found (p < 0.001), and the explained component by the variables measured in this research only represents 40.5 % of the gap (p = 0.001). Conclusion: There was less OOP expenditure on medicines in ethnic minorities. However, the measured variables explain only 40.5 % of these gaps. Therefore, we recommend future research that measures other variables that explain aspects of OOP spending on medicines not identified in this research. Likewise, our findings can be used to establish policies with an intercultural approach that adapt health documents to native languages or are disseminated by trained people from their communities.

Bibliometric analyses of global output on neuromyelitis optica spectrum disorder.

BACKGROUND: Neuromyelitis optica spectrum disorder (NMOSD) is a neuroimmune disease, i.e. under constant research. The aim of this bibliometric study is to perform a bibliometric indicator analysis of the worldwide academic production of NMOSD during the period 2017-2021. METHODS: A bibliographic search was assessed in the Scopus database to identify NMOSD-related articles published during the period 2017-2021. Collected publications were exported and analyzed in Scival (Elsevier). Bibliographic data were described through absolute values and percentages in descriptive tables. VOSviewer was used to visualize collaborative networks. RESULTS: A total of 1920 documents were collected, and the highest percentage of these belonged to the area of neurology. Friedemann Paul was the author with the highest scientific production, but Brian Weinshenker had the greatest impact worldwide. Three of the institutions with the highest production were North American. Multiple sclerosis and related disorders were the journal with the highest production of publications. Most papers were published in Q1 or Q2 journals. CONCLUSION: NMOSD-related articles are mostly published in first and second quartile journals, which would reflect a high interest of the scientific community. Publications with international collaboration reported a higher impact. Although African and South American regions have considerable prevalence of this disease, they do not have institutions with high productivity developing research on this disease.

The neutrophil-to-lymphocyte ratio as a prognostic biomarker in Guillain-Barre syndrome: a systematic review with meta-analysis.

Background and objectives: Guillain-Barre syndrome (GBS) is an immune-mediated neuropathy. This has raised the possibility that the neutrophil-lymphocyte ratio (NLR) may be a biomarker of its activity. We conducted a systematic review and meta-analysis to summarize the evidence of NLR as a potential biomarker for GBS. Methods: We systematically searched databases (PubMed, Ovid-Medline, Embase, Scopus, Web of Science, SciELO Citation Index, LILACS, and Google Scholar) until October 2021 for studies evaluating pre-treatment NLR values in GBS patients. A meta-analysis using a random-effects model to estimate pooled effects was realized for each outcome and a narrative synthesis when this was not possible. Subgroup and sensitivity analysis were realized. GRADE criteria were used to identify the certainty of evidence for each result. Results: Ten studies from 745 originally included were selected. Regarding GBS patients versus healthy controls, a meta-analysis of six studies (968 patients) demonstrated a significant increase in NLR values in GBS patients (MD: 1.76; 95% CI: 1.29, 2.24; I2 = 86%) with moderate certainty due to heterogeneity of GBS diagnosis criteria used. Regarding GBS prognosis, assessed by Hughes Score ≥ 3, NLR had a sensitivity between 67.3 and 81.5 and a specificity between 67.3 and 87.5 with low certainty due to imprecision, and heterogeneity. In relation to respiratory failure, NLR had a sensitivity of 86.5 and specificity of 68.2 with high and moderate certainty, respectively. Discussion: With moderate certainty, mean NLR is higher in GBS patients compared to healthy controls. Furthermore, we found that NLR could be a prognostic factor for disability and respiratory failure with low and moderate certainty, respectively. These results may prove useful for NLR in GBS patients; however, further research is needed. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42021285212.

Clinical and imagenologic significance of the neutrophil-to-lymphocyte ratio in neuromyelitis optica spectrum disorder: A systematic review with meta-analysis.

BACKGROUND: Recently, the neutrophil-lymphocyte ratio (NLR) has become a biomarker for assessing inflammatory stress and prognosis in different diseases. OBJECTIVE: We aimed to conduct a systematic review and meta-analysis to summarize the current evidence on the capacity of the NLR to serve as a biomarker in neuromyelitis optica spectrum disorder (NMOSD). METHODS: Through a comprehensive systematic search up to December 2021 and using the search terms "neutrophil-to-lymphocyte ratio" and "neuromyelitis optica spectrum disorder" we selected studies evaluating NLR values in NMOSD patients. A meta-analysis was planned, and a narrative synthesis was performed when this was not possible. Subgroup and sensitivity analyses were planned. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach was used to assess certainty of the evidence. RESULTS: Six studies were included (1036 patients). A significant increase in the NLR was observed between NMOSD patients and healthy controls with high heterogeneity (MD: 1.04; 95% CI: 0.76; 1.32; I2 = 59%). Regarding NMOSD prognosis, relapse (OR: 1.33 -OR: 2.14) was evaluated as being related to NLR with low certainty. An association with Expanded Disability Status Scale (EDSS) score ≥4 (OR: 1.23 -OR: 1.43) was reported with moderate certainty. An association with the occurrence of lesions on MRI was reported with an OR of 1.52. CONCLUSION: We found the NLR to be useful as a biomarker of NMOSD as it was significantly increased in the patient group compared to the healthy control group with high certainty. Additionally, the NLR was applicable as an indicator of poor prognosis with low to moderate certainty.

A Bibliometric Analysis of the International Dental Journal (2011-2020).

INTRODUCTION: Bibliometrics is an area that allows for the evaluation of scientific publications by means of different indicators. The aim of this research was to perform a bibliometric study of the scientific production of the International Dental Journal (IDJ) between 2011 and 2020. METHODS: All publications of the journal between 2011 and 2020 extracted from the Scopus database were included. The number of publications, most productive institutions, type of collaboration, most productive countries, most cited articles, and authors with the highest academic production were used as bibliographic indicators. It was exported to the SciVal tool for analysis. RESULTS: A total of 630 documents published in IDJ by 1947 authors were collected, with a total of 7212 citations (11.4 citations per document). The United States was the country with the highest number of documents (100). The University of Adelaide (Australia) was the institution with the highest scientific production (16 publications), whilst the institution with the highest impact was the Universidade de São Paulo (Brazil), with 12.2 citations per paper. Marc Luiz Tennant was the author with the highest number of published manuscripts (13). Finally, most of the publications had international collaboration (146 documents). CONCLUSIONS: IDJ is a high-quality journal and, in the dental field, it has a high impact worldwide, which allows for a greater number of citations of its articles and placing it in the forefront of future research.

Clinical practice guidelines for the diagnosis and management of Duchenne muscular dystrophy: a scoping review.

Introduction: Our objective was to identify recent CPGs for the diagnosis and management of DMD and summarize their characteristics and reliability. Methods: We conducted a scoping review of CPGs using MEDLINE, the Turning Research Into Practice (TRIP) database, Google Scholar, guidelines created by organizations, and other repositories to identify CPGs published in the last 5 years. Our protocol was drafted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses for scoping reviews. To assess the reliability of the CPGs, we used all the domains included in the Appraisal of Guidelines Research and Evaluation II. Results: We selected three CPGs published or updated between 2015 and 2020. All the guidelines showed good or adequate methodological rigor but presented pitfalls in stakeholder involvement and applicability domains. Recommendations were coherent across CPGs on steroid treatment, except for minor differences in dosing regimens. However, the recommendations were different for new drugs. Discussion: There is a need for current and reliable CPGs that develop broad topics on the management of DMD and consider the challenges of developing recommendations for RDs.

Global academic output on COVID-19 and Guillain-Barre Syndrome: A bibliometric analysis.

The purpose of this study was to bibliometrically analyze scientific publications on Guillain-Barré syndrome (GBS) related to COVID-19. A specialized search of the Scopus was used (December 2019 to February 2022). Collected publications were evaluated in Scival (Elsevier). The results were arranged in tables for presentation. We found 959 papers that were collected and the highest percentage of these belonged to the area of Neurology. Josef Finsterer was the author with the highest academic production, but Benedict Michael was the one with the highest impact worldwide. Although the Universidade Federal de São Paulo (Brazil) was the college with the highest scientific production, it was King's College London that reported the highest impact. Regarding the journals, the Journal of Neurology is the one with the highest worldwide production. In addition, an increase in first quartile publication and articles with national collaboration was reported. Scholarly output on COVID-19 and GBS have been increasing. Although national collaboration has the highest proportion of manuscripts, it is the international type that reported a greater impact, this would show a great interest on the part of researchers from all over the world regarding this topic.

A 10-Year Bibliometric Analysis of Global Research on Gut Microbiota and Parkinson's Disease: Characteristics, Impact, and Trends.

Objective: To perform a bibliometric analysis of scientific production related to gut microbiota and Parkinson's disease between 2011 and 2020. Methods: A descriptive, retrospective, cross-sectional, and bibliometric study was carried out. The Scopus database was used as a source to evaluate the worldwide scientific production on intestinal microbiota and its relationship with Parkinson's disease. Data were extracted from Scopus using a formula developed with thesaurus terms MeSH (Medline) and Emtree (Embase). Results: A total of 591 documents were found. The retrieved manuscripts received an average of 41.9 citations per document. Four of the 10 most productive authors were Italian. The University of Helsinki (Finland) was the institution with the highest scientific production (19 papers) and the highest impact (5921 citations). In terms of productivity and impact, Movement Disorders ranked first with 38 papers and 2782 citations, and those papers published in Q1 quartile journals exceeded the sum of the remaining quartiles. Papers with international collaboration were the most cited. Keyword analysis showed that the terms Parkinson Disease, Disease, and Intestine Flora were the most frequent. Conclusion: The number of papers on Parkinson's disease and gut microbiota has been increasing; however, high-quality journals maintain the same high publication rate. International collaboration from high-income countries played an important role in the impact generated by the publications.

A Scientometric Analysis of Scholarly Output on COVID-19 and Dentistry.

INTRODUCTION: Scientometrics is a discipline that allows the analysis of the characteristics of publications in each field of knowledge using different indicators. The aim of this research was to analyse world scientific publication as to COVID-19 related to dentistry. METHODS: A specialised search strategy was used to obtain all the documents published in journals indexed in the Scopus database between December 2019 and February 2022. The study variables were exported and analysed in SciVal (Elsevier). RESULTS: In all, 2071 documents were retrieved; of those, Oral Diseases has the highest impact with an average of 12.3 citations per publication, and the British Medical Journal was identified as the journal with the highest scientific output (107). India (292) and the UK (287) were the countries with the most published papers. The Universidade de São Paulo in Brazil was the institution with the highest number of published papers (61) and with the highest impact. CONCLUSIONS: During the pandemic, scientific publications on dentistry and COVID-19 have been increasing considerably. International collaboration has the highest percentage of publications whilst India and the UK are the countries with the highest scientific production.

Neutrophil-to-lymphocyte ratio and mean platelet volume in the diagnosis of bacterial infections in COVID-19 patients. A preliminary analysis from Ecuador.

INTRODUCTION: Hospitalized COVID-19 patients are at risk of hospital infection. The neutrophil-to-lymphocyte ratio (NLR), lymphocyte-C-reactive protein ratio (LCR) and mean platelet volume (MPV) are established inflammation markers reflecting the systemic inflammatory response. The objective of this study was to evaluate the clinical characteristics of patients with COVID-19 and bacterial co-infections, as well as the correlation with NLR and MPV. METHODS: We assessed the role of the NLR and MPV in diagnosing bacterial infections in COVID-19 patients. The Wilcoxon test was used to compare the mean NLR and MPV between the diagnostic evaluation moments, while the Mann-Whitney test was used to compare NLR and MPV by sex and age. RESULTS: The NLR was compared three days before the culture and the day of taking the culture, observing significant differences (p=0.020). MPV three days before the culture and the day of the culture were compared, also observing significant differences (p=0.031). NLR and MPV were compared at the different evaluation times according to sex and age group, observing for the age group significant differences for the NLR three days before the culture (p=0.004). CONCLUSION: In our study, there were significant differences in NLR and MPV between the three days before culture and the day of culture. It is advisable to continue to enrol more patients in the study so that in the future, we can add results on the diagnostic accuracy of the NLR and MPV in the timely diagnosis of bacterial infection in patients with COVID-19.

OXA-48 Carbapenemase in Klebsiella pneumoniae Sequence Type 307 in Ecuador.

Antibiotic resistance is on the rise, leading to an increase in morbidity and mortality due to infectious diseases. Klebsiella pneumoniae is a Gram-negative bacterium that causes bronchopneumonia, abscesses, urinary tract infection, osteomyelitis, and a wide variety of infections. The ubiquity of this microorganism confounds with the great increase in antibiotic resistance and have bred great concern worldwide. K. pneumoniae sequence type (ST) 307 is a widespread emerging clone associated with hospital-acquired infections, although sporadic community infections have also been reported. The aim of our study is to describe the first case of Klebsiella pneumoniae (ST) 307 harboring the blaOXA-48-like gene in Ecuador. We characterized a new plasmid that carry OXA-48 and could be the source of future outbreaks. The strain was recovered from a patient with cancer previously admitted in a Ukrainian hospital, suggesting that this mechanism of resistance could be imported. These findings highlight the importance of programs based on active molecular surveillance for the intercontinental spread of multidrug-resistant microorganisms with emergent carbapenemases.