Diferencias de género en las publicaciones originales de Archivos de Bronconeumología en el periodo 2001-2018

IntroductionGender inequality exists in scientific publications. The aim of this study was to determine changing patterns in gender differences and factors associated with the positioning of authors’ names in original articles published in Archivos de Bronconeumología (AB).MethodsWe performed a bibliometric study of articles published in AB between 2001 and 2018. Author gender was analysed in four scenarios: first author, last author, middle authors, and mentee authors. Comparisons were made by authors’ specialties, funding received, multicentre studies, specialist areas, and others. Multivariate models adjusted for the percentage of registered physicians in the Spanish health system were created to predict the female gender of the first, middle, and last author.ResultsA total of 828 publications were analysed in which women appeared as first authors in 286 (34.5%) and last authors in 169 (20.4%). A gradual increase in women as first authors was observed (P = .0001), but not as last authors (P = .570). Overall, the average number of female authors increased over time (from 1.6 ± 1.4 in 2001-2005 to 3.3 ± 2.3 in 2016-2018, P = .0001), with no differences in male averages. The adjusted multivariate models reflected a positive bi-directional relationship between the first author and the middle authors, and a negative association between the first author being Spanish and the last author being female (OR 0.57; 95% CI 0.36-0.88, P = .012).ConclusionsGender differences were found in various aspects of authorship in AB, summarized by a greater participation of women as first and intermediate authors, but not as last authors.     

Caracterización del carcinoma hepatocelular en México

Introduction and aims

In Mexico, complications of cirrhosis are the third leading cause of death in adult males. In recent decades, the incidence of hepatocellular carcinoma has increased worldwide. The aim of this study was to determine the characteristics of patients with hepatocellular carcinoma at two Mexican tertiary care hospitals.

Perspectiva de género en el estudio OFRECE: diferencias en la atención entre pacientes que consultan por dolor torácico o por palpitaciones

Introduction and objectivesTo analyze differences between sexes in the clinical management of patients presenting with symptoms of chest pain and/or palpitations within a population-based study.MethodsThe OFRECE study included a random sample of 8400 individuals from the Spanish population aged 40 years and older; 1132 (13.5%) had previously consulted for chest pain and 1267 (15.1%) had consulted for palpitations and were included in the present study. We calculated both the crude and adjusted odds ratios (OR) of undergoing certain tests and the results of consultations by sex. Adjustment was performed by classic cardiovascular risk factors, a personal history of cardiovascular disease, and a diagnosis of stable angina or atrial fibrillation confirmed in the OFRECE study in each case.ResultsNo differences were observed in history of consultation for chest pain between women and men (13% vs 14.1%; P = .159) but differences were found in palpitations (19% vs 10.4%, respectively; P < .001). Women who had previously consulted for chest pain underwent fewer echocardiograms (32.5% vs 45.3%, respectively; P < .001), were less frequently referred to a cardiologist (49.1% vs 60.1%; P < .001), were less often admitted to hospital (20.1% vs 39.4%; P < .001), and less frequently received a confirmed diagnosis (60.9 vs 71, 9; P < .001). After full adjustment, all differences decreased and become nonsignificant echocardiograms: adjusted OR, 0.81; 95%CI, 0.60-1.09; referral to a cardiologist: adjusted OR, 0.86; 95%CI, 0.63-1.16; hospital admission: adjusted OR, 0.76; 95%CI, 0.54-1.09). For palpitations, crude differences were smaller and all became nonsignificant after adjustment.ConclusionsThis study does not confirm the existence of sex-related bias in the management of chest pain and palpitations. However, such bias cannot be completely ruled out in diagnoses confirmed within the OFRECE study, which might limit its ability to detect sex-related differences in health care.     

Diagnóstico microbiológico de las infecciones causadas por el género Mycobacterium

Mycobacterial culture has a high sensitivity and is the test of choice for the microbiological diagnosis of tuberculosis and nontuberculous mycobacterial infections. However, the results of this culture require at least 2-3 weeks to obtain positivity. Staining is rapid and can be used as a complementary study, although its sensitivity is low. Gene amplification tests have an intermediate sensitivity and obtain results in 1-2 days. These last tests are indicated in cases with moderate or high clinical suspicion. In HIV patients with severe immunodeficiency (< 200 CD4), lipoarabinomannan antigen detection in urine may be useful.The identification of isolates from positive cultures is essential to evaluate the clinical significance of the culture results and consider the therapeutic options available. At present, there is a wide range of identification techniques available, which provide results within just 1-4 days.The future of diagnostic techniques in tuberculosis and nontuberculous mycobacterial infections lies in greater development of gene amplification techniques and promoting the search for biomarkers which enable a new approach to the diagnosis of these infections.     

Rituximab en el tratamiento del síndrome del pulmón encogido del lupus eritematoso sistémico

Shrinking lung syndrome (SLS) is a rare manifestation of systemic lupus erythematosus. We report the case of a patient with non-responding SLS (neither to glucocorticoids nor immunosupresors), who showed remarkable improvement after the onset of treatment with rituximab. Although there is a little evidence, treatment with rituximab could be proposed in SLS when classical treatment fails.