Mala conducta como principal causa para la retractación. Un estudio descriptivo de las publicaciones retractadas y sus autores

Objective : To analyze the causes of retracted publications and the main characteristics of their authors. Method : A descriptive cross-sectional study was designed including all retracted publications from January 1st, 2013-December 31st, 2016 indexed in PubMed. The causes of retraction were classified as: data management, authorship issues, plagiarism, unethical research, journal issues, review process, conflict of interest, other causes, and unknown reasons. Then, misbehaviour was classified as misconduct, suspicion of misconduct or no misconduct suspicion. Results : 1,082 retracted publications were identified. The retraction rate for the period was 2.5 per 10,000 publications. The main cause of retraction was misconduct (65.3%), and the leading reasons were plagiarism, data management and compromise of the review process. The highest proportion of retracted publications corresponded to Iran (15.52 per 10,000), followed by Egypt and China (11.75 and 8.26 per 10,000). Conclusions : Currently, misconduct is the main cause of retraction. Specific strategies to limit this phenomenon must be implemented. It would be useful to standardize reasons and procedures for retraction. The development of a standard retraction form to be permanently indexed in a database might be relevant.Objetivo : Analizar las causas de las retractaciones y las características fundamentales de sus autores. Método : Se diseñó un estudio descriptivo, transversal, que incluyó todas las publicaciones con retractación entre el 1 de enero de 2013 y el 31 de diciembre de 2016 indexadas en PubMed. Las causas de la retractación fueron clasificadas como manejo de datos, asuntos de autoría, plagio, investigación no ética, asuntos de las revistas, proceso de revisión, conflictos de intereses, otras causas y razones desconocidas. Tras esto, la conducta indebida fue clasificada como mala conducta, sospecha de mala conducta y sin sospecha de mala conducta. Resultados : Se identificaron 1.082 publicaciones retractadas. La proporción de publicaciones retractadas fue de 2,5 por cada 10.000 publicaciones para el periodo evaluado. La principal causa de retractación fue la mala conducta (65,3%), y las causas principales fueron plagio, manejo de los datos y compromiso del proceso de revisión. La mayor proporción de publicaciones retractadas correspondió a Irán (15,52 por 10.000), seguido de Egipto y China (11,75 y 8,26 por 10.000, respectivamente). Conclusiones : Actualmente, la mala conducta es la principal causa de retractación. Deberían implementarse estrategias específicas para limitar este fenómeno. Sería de utilidad uniformar los motivos y procedimientos para la retractación. Podría ser apropiado el desarrollo de un formulario estándar de retractación que sea indexado permanentemente en una base de datos.S

Radioterapia intraoperatoria en el cáncer de páncreas

Introducción: La Radioterapia Intraoperatoria (RIO) es una modalidad terapéutica que permite la administración única de una alta dosis de radiación ionizante durante la intervención quirúrgica en el tumor no resecado o en el lecho quirúrgico con la finalidad del control local del tumor. Dado que las tasas de recurrencia local son muy altas en el cáncer de páncreas y las estrategias terapéuticas hasta el momento empleadas no han logrado frenar la alta letalidad de este tumor, la RIO se presenta como una alternativa a considerar. 2. Objetivos: Valorar la eficacia/efectividad y seguridad de la RIO como tratamiento en el cáncer de páncreas. Valorar la calidad de vida de los pacientes con cáncer de páncreas que han recibido tratamiento con RIO. 3. Métodos: Se ha realizado una revisión de la literatura científica desde enero de 1995 hasta febrero de 2007 en las siguientes bases de datos: 3.1. Bases de datos especializadas en Revisiones Sistemáticas: Tales como HTA (Health Technology Assessment) DARE (Database of Abstracts of Reviews of Effectiveness), NHS EED (Economic Evaluation Database del National Health Service) y la Cochrane Library Plus. avalia-t 10 3.2. Bases de datos generales: Medline, Embase e ISI Web os Science. 4. Resultados: Del resultado de la búsqueda bibliográfica se seleccionaron los 13 artículos que cumplían los criterios de selección que se habían prefijado. Uno de los estudios era un informe de evaluación sobre RIO, 4 eran estudios de cohortes retrospectivas y los 8 restantes eran estudios de series de casos, 2 de los cuales pertenecían a la misma serie. En general muestran que la RIO podría aumentar ligeramente la supervivencia en pacientes con cáncer de páncreas en estadios localizados, sin embargo los resultados no son concluyentes a favor de RIO en el caso de cáncer de páncreas en estadios localmente avanzados y metastásicos. No existen estudios publicados que evalúen la calidad de vida. 5. Discusión: La mayor parte de los estudios primarios incluidos son series de casos en los que no existe grupo de comparación. No se describen en todos los estudios los resultados por separado en función de la estadificación y existe variabilidad de aplicación de tratamientos y en la descripción de los resultados. En muchos de los estudios publicados el ámbito de realización es Japón lo cual compromete su validez externa a la hora de extrapolar los resultados a nuestra población de referencia. 6. Conclusiones y recomendaciones: • La principal conclusión es que en el momento actual no existe clara evidencia acerca de una mayor efectividad de la RIO como tratamiento del cáncer de páncreas frente a otros tratamientos en estadios localmente avanzados y metastásicos.1. Introduction: Intraoperative radiotherapy (IOR) is a form of therapy that allows for a single high dose of ionizing radiation to be delivered during surgical interventions and targeted at unresected tumours or the surgical site to achieve local control of tumours. As local recurrence rates are very high in cancer of the pancreas and as the therapeutic strategies used until now have failed to reduce the high lethality of this tumour, IOR is an alternative to be considered. 2. Objectives: To assess the efficacy/effectiveness and safety of IOR as treatment in pancreatic cancer. To assess the quality of life of patients with pancreatic neoplasms receiving intraoperative radiotherapy. 3. Methods: We conducted a review of scientific literature from January 1995 to February 2007, covering the following databases: 3.1. Specialised databases in systematic reviews, namely: Health Technology Assessment (HTA); Database of Abstracts of Reviews of Effectiveness (DARE); National Health Service Economic Evaluation Database (NHS EED); and Cochrane Library Plus. avalia-t 12 3.2. General databases: Medline, Embase and ISI Web of Science. 4. Results: Of the papers retrieved by the bibliographic search, 13 were selected that met the pre-established selection criteria. One of the studies was an IOR assessment report, 4 were retrospective cohort studies, and the remaining 8 were case-series studies, 2 of which belonged to the same series. In general, these studies showed that IOR could slightly increase survival among patients with pancreatic cancer in localised stages. However, the results were not conclusively in favour of IOR in the case of pancreatic cancer in locally advanced and metastatic stages. There were no published studies that assessed quality of life. 5. Discussion: Most of the primary studies included were case series in which there was no comparison group. Not all studies reported outcomes with a breakdown by staging and there was variability in the application of treatments and description of outcomes. Many of the studies published were set in Japan, a factor that compromises their external validity when it comes to extrapolating the results to our reference population. 6. Conclusions and recommendations: • The principal conclusion is that at the present time there is no clear evidence as to the greater effectiveness of IOR as treatment of pancreatic cancer versus other treatments in locally advanced and metastatic stages

Controles poblaciones frente a controles hospitalarios: ¿son comparables?

Objective:To compare whether there are differences amonghospital and population controls. Methods:Two case-control studies were conducted on lungcancer risk factors in the Santiago de Compostela Public Health District. Whereas one used randomly chosen census-based population controls, the other used consecutive hos-pital controls that went to the reference hospital for non-smo-king-related trivial interventions. The differences were analyzedusing logistic regression. The dependent variable was type ofcontrol (hospital or population). Results:Hospital controls had a similar tobacco habit thanpopulation controls, but consumed more alcohol. For those con-suming more than 50 ml daily, the risk of being a hospital con-trol was 4.83 (95%CI: 2.55-9.14). Conclusions:There may be some differences between hos-pital and population-based controls, which must be taken intoaccount in the design of case-control studies. It is necessaryto ascertain whether such differences are reproduced at othergeographic locations and whether they can affect estimationof exposure-diseaseObjetivo:Comparar si hay diferencias entre los controles po-blacionales y los hospitalarios.Métodos:Se llevaron a cabo dos estudios de casos y con-troles sobre factores de riesgo de cáncer de pulmón en el ÁreaSanitaria de Santiago de Compostela. En uno de los estudioslos controles fueron seleccionados aleatoriamente entre la po-blación general, y en el otro los controles hospitalarios fue-ron incluidos de manera consecutiva entre los individuos queacudían al hospital por intervenciones quirúrgicas banales norelacionadas con el consumo de tabaco. Las diferencias fue-ron analizadas mediante regresión logística. La variable de-pendiente fue el tipo de control (hospitalario o poblacional).Resultados:Los controles hospitalarios y los poblacionalestenían un hábito tabáquico similar, pero los controles hospi-talarios consumían más alcohol. Para los que consumían másde 50 ml al día, el riesgo de ser un control hospitalario fuede 4,83 (intervalo de confianza del 95%: 2,55-9,14).Conclusiones:Podría haber algunas diferencias entre los con-troles poblacionales y los hospitalarios que deberían tenerseen cuenta cuando se diseñe un estudio de casos y contro-les. Es necesario saber si esas diferencias son similares enotras áreas geográficas y si podrían afectar a la estimaciónde las medidas de efecto entre exposición y enfermedadThis work has been partly funded by two investigationgrants, one from the Fondo de Investigaciones Sanitarias (FIS)(Health Research Fund) (grant FIS 92/0176) and the GalicianRegional Health Authority (grant XUGA 91010)S

Antibiotic prophylaxis and its appropriate timing for urological surgical procedures in patients with asymptomatic bacteriuria: a systematic review

Objective To review the existing literature on when and how to treat patients with asymptomatic bacteriuria (AB) who undergo urological surgery, as uncertainty about this issue persists. Methods A systematic review was conducted to compare the different timing of administration of antibiotic prophylaxis in patients with AB undergoing urological surgery. We used predefined inclusion and exclusion criteria, and we also developed a specific quality scale to assess the quality of the papers included. Results Nine studies met the inclusion criteria. Of the nine studies included, eight evaluated antibiotic prophylaxis regardless of the presence of AB, as their purpose was to evaluate the effectiveness of antibiotic prophylaxis for urological procedures. Of these, four studies showed a significant reduction in the rate of infections in the intervention group compared with placebo, or with the same antibiotic therapy but using different durations of therapy. Four studies found no significant differences in infectious complications between the intervention and comparison arms. Only one study assessed the duration of antibiotic prophylaxis in patients with AB. Conclusions With the available evidence, antibiotic therapy should be considered only for procedures in which studies have shown a clinical benefit in the prevention of infection. It is important to establish the duration and type of treatment for antimicrobial therapy for surgical prophylaxis in patients with AB who are going to receive urological invasive procedures.Open Access funded by Arab Association of UrologyS

Screening for Chronic Obstructive Pulmonary Disease: Validity and Reliability of a Portable Device in Non-Specialized Healthcare Settings

Introduction and Objectives The underdiagnosis of chronic obstructive pulmonary disease (COPD) could be improved through screening using portable devices simpler than conventional spirometers in specific healthcare settings to reach a higher percentage of the at-risk population. This study was designed to assess the validity and reliability of the COPD-6 portable device to screen for COPD in non-specialized healthcare settings. Methods Prospective cohort study to validate a diagnostic test. Three cohorts were recruited: primary care (PC), emergency services (ES) and community pharmacies (CPh). Study population: individuals with risk factors for COPD (>40 years, smoking >10 pack-years, with respiratory symptoms). The values measured using the COPD-6 were FEV1, FEV6 and the FEV1/FEV6 ratio. Subsequently, participants underwent conventional spirometry at hospital, using a post-bronchodilator FEV1/FVC value <0.7 as the gold standard criterion for the COPD diagnosis. Results 437 participants were included, 362 were valid for the analysis. COPD was diagnosed in 114 patients (31.5%). The area under the ROC curve for the COPD-6 for COPD screening was 0.8.The best cut-off point for the FEV1/FEV6 ratio was 0.8 (sensitivity, 92.1%) using spirometry with the bronchodilator test as the gold standard. There were practically no differences in the COPD-6 performancein the different settings and also regarding age, gender and smoking status. Conclusions The COPD-6 device is a valid tool for COPD screening in non-specialized healthcare settings. In this context, the best cut-off point for the FEV1/FEV6 ratio is 0.8This research was partially supported by Fundación de la Sociedad Gallega de Patología Respiratoria (SOGAPAR), and funding from the European Union Seventh Framework Programme [FP7/REGPOT-2012-2013.1] under grant agreement n° 316265, BIOCAPSS

Screening for Chronic Obstructive Pulmonary Disease: Validity and Reliability of a Portable Device in Non-Specialized Healthcare Settings.

The underdiagnosis of chronic obstructive pulmonary disease (COPD) could be improved through screening using portable devices simpler than conventional spirometers in specific healthcare settings to reach a higher percentage of the at-risk population. This study was designed to assess the validity and reliability of the COPD-6 portable device to screen for COPD in non-specialized healthcare settings. Prospective cohort study to validate a diagnostic test. Three cohorts were recruited: primary care (PC), emergency services (ES) and community pharmacies (CPh). individuals with risk factors for COPD (>40 years, smoking >10 pack-years, with respiratory symptoms). The values measured using the COPD-6 were FEV1, FEV6 and the FEV1/FEV6 ratio. Subsequently, participants underwent conventional spirometry at hospital, using a post-bronchodilator FEV1/FVC value <0.7 as the gold standard criterion for the COPD diagnosis. 437 participants were included, 362 were valid for the analysis. COPD was diagnosed in 114 patients (31.5%). The area under the ROC curve for the COPD-6 for COPD screening was 0.8.The best cut-off point for the FEV1/FEV6 ratio was 0.8 (sensitivity, 92.1%) using spirometry with the bronchodilator test as the gold standard. There were practically no differences in the COPD-6 performance in the different settings and also regarding age, gender and smoking status. The COPD-6 device is a valid tool for COPD screening in non-specialized healthcare settings. In this context, the best cut-off point for the FEV1/FEV6 ratio is 0.8.Fundación de la Sociedad Gallega de Patología Respiratoria (SOGAPAR)European Union Seventh Framework Programme [FP7/REGPOT-2012-2013.1] under grant agreement n° 316265, BIOCAP

Radônio residencial e câncer de pulmão: um estudo de coorte na Galícia, Espanha

Case-control studies show an association between residential radon and lung cancer. The aim of this paper is to investigate this association through a cohort study. We designed an ambispective cohort study using the Galician radon map, Spain, with controls drawn from a previous case-control study. Subjects were recruited between 2002 and 2009. The data were cross-checked to ascertain lung cancer incidence and then analysed using a Cox regression model. A total of 2,127 subjects participated; 24 lung cancer cases were identified; 76.6% of subjects were drawn from the radon map. The adjusted hazard ratio was 1.2 (95%CI: 0.5-2.8) for the category of subjects exposed to 50Bq/m3 or more. This risk rose when subjects from the case-control study were analyzed separately. In conclusion, we did not observe any statistically significant association between residential radon exposure and lung cancer; however, it appears that with a sample of greater median age (such as participants from the case-control study), the risk of lung cancer would have been higher.Los estudios de casos y controles muestran una asociación entre el radón residencial y el cáncer de pulmón. El objetivo del artículo fue investigar esa asociación a través de un estudio de cohorte. Proyectamos un estudio de cohorte ambispectivo, utilizando el mapa de radón de Galicia, España, con los controles obtenidos de un estudio anterior de casos y controles. Los individuos fueron reclutados entre 2002 y 2009. Los datos fueron verificados para confirmar la incidencia de cáncer de pulmón y después analizados con un modelo de regresión de Cox. Participaron un total de 2.127 individuos; se identificaron 24 casos de cáncer de pulmón; un 76,6% de los individuos fueron obtenidos a través del mapa de radón. El hazard ratio ajustado era 1,2 (IC95%: 0,5-2,8) para la categoría de individuos expuestos a 50Bq/m3 o más. El riesgo aumentó cuando los individuos del estudio de casos y controles fueron analizados separadamente. En conclusión, no se observó una asociación estadísticamente significativa entre exposición al radón residencial y cáncer de pulmón; sin embargo, parece que con una muestra con una media de edad más elevada (tales como los participantes del estudio de casos y controles), el riesgo de cáncer de pulmón habría sido más alto.Estudos de casos e controles mostram uma associação entre radônio residencial e câncer de pulmão. O artigo teve como objetivo investigar essa associação através de um estudo de coorte. Projetamos um estudo ambispectivo coorte, utilizando o mapa de radônio da Galícia, Espanha, com os controles obtidos de um estudo anterior de casos e controles. Os indivíduos foram recrutados entre 2002 e 2009. Os dados foram verificados para confirmar a incidência de câncer de pulmão e depois analisados com um modelo de regressão de Cox. Participaram um total de 2.127 indivíduos; foram identificados 24 casos de câncer de pulmão; 76,6% dos indivíduos foram obtidos através do mapa de radônio. O hazard ratio ajustado era 1,2 (IC95%: 0,5-2,8) para a categoria de indivíduos expostos a 50Bq/m3 ou mais. O risco aumentou quando os indivíduos do estudo de casos e controles foram analisados separadamente. Em conclusão, não foi observada associação estatisticamente significativa entre exposição ao radônio residencial e câncer de pulmão; entretanto, parece que com uma amostra com mediana de idade mais elevada (tais como os participantes do estudo de casos e controles), o risco de câncer de pulmão teria sido mais alto.This work was supported by the Carlos III Institute of Health, Ministry of Science & Innovation under grant PI10/00296 and PI03/1248. Galician Regional Authority (Xunta de Galicia) under grant PGIDT01MAM20801PR. Part of this work has been performed during a Fulbright grant for Senior Researchers awarded to Alberto Ruano-Ravina at Brown University (Providence, Rhode Island, USA) (REF PRX14/00365)S

COPD prevalence and hospital admissions in Galicia (Spain). An analysis using the potential of new health information systems

Introduction and objectives: Chronic obstructive pulmonary disease (COPD) is a major public health problem. The aim of this study was to ascertain the prevalence of COPD and whethersuch prevalence was positively or negatively associated with COPD admissions, using all thedata of a regional health care system.Materials and methods: We designed a descriptive cross-sectional study which included all sub-jects aged over 45 years, diagnosed with COPD in primary care in 2013. We also calculated the number of such patients who had a record of hospital admissions due to this disease. COPDprevalence and incidence of admissions were calculated. Poisson regression models were thenused to analyse the association between cases with diagnosis of COPD and admissions due toCOPD, by sex, adjusting for socio-demographic variables and distance to hospital. Sensitivitysubanalyses were performed by reference to the respective municipal rurality indices.Results: Median municipal prevalence of COPD was 5.29% in men and 2.19% in women. Amongpatients with COPD, 28.22% of men and 16.00% of women had at least one hospital admission.The relative risk of admission per unit of the standardised prevalence ratio was 0.37 (95% CI0.34---0.41) for men and 0.39 (95% CI 0.34---0.45) for women.Conclusions: There is a significant negative association between COPD prevalence and hospital admissions due to this disease. The proportion of admissions is lower in municipalities lyingfurthest from hospitals. There is considerable municipal variability in terms of COPD preva-lence and proportion of admissions. In-depth attention should be given to disease-managementtraining programmesS