RESUMEN
OBJECTIVE: The percentage of women publishing high-impact neurosurgical research might be perceived as a representation of our specialty and may influence the perpetuation of the existing gender gap. This study investigated whether the trend in women taking lead roles in neurosurgical research has mirrored the increase in female neurosurgeons during the past decade and whether our most prestigious publications portray enough female role models to stimulate gender diversity among the new generation of neurosurgeons. METHODS: Two of the most prominent neurosurgical journals-Journal of Neurosurgery and Neurosurgery-were selected for this study, and every original article that was published in 2009 and 2019 in each of those journals was investigated according to the gender of the first and senior authors, their academic titles, their affiliations, and their institutions' region. RESULTS: A total of 1328 articles were analyzed. The percentage of female authors was significantly higher in Europe and Russia compared with the US and Canada (first authors: 60/302 [19.9%] vs 109/829 [13.1%], p = 0.005; and senior authors: 32/302 [10.6%] vs 57/829 [6.9%], p = 0.040). Significantly increased female authorship was observed from 2009 to 2019, and overall numbers of both first and senior female authors almost doubled. However, when analyzing by regions, female authorship increased significantly only in the US and Canada. Female authors of neurosurgical research articles were significantly less likely to hold an MD degree compared with men. Female neurosurgeons serving as senior authors were represented in only 3.6% (48/1328) of articles. Women serving as senior authors were more likely to have a female colleague listed as the first author of their research (29/97 [29.9%] vs 155/1231 [12.6%]; χ2 = 22.561, p = 0.001). CONCLUSIONS: Although this work showed an encouraging increase in the number of women publishing high-impact neurosurgical research, the stagnant trend in Europe may suggest that a glass ceiling has been reached and further advances in equity would require more aggressive measures. The differences in the researchers' profiles (academic title and affiliation) suggest an even wider gender gap. Cultural unconscious bias may explain why female senior authors have more than double the number of women serving as their junior authors compared with men. While changes in the workforce happen, strategies such as publishing specific issues on women, encouraging female editorials, and working toward more gender-balanced editorial boards may help our journals to portray a more equitable specialty that would not discourage bright female candidates.
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Rol de Género , Neurocirugia , Autoria , Bibliometría , Femenino , Humanos , Masculino , Factores SexualesRESUMEN
OBJETIVO: El objetivo de este estudio fue evaluar las variables que condicionan el rendimiento diagnóstico de la BSTsm y las complicaciones de esta técnica. MATERIAL Y MÉTODO: Estudio retrospectivo de las BSTsm realizadas entre julio del 2008 y diciembre de 2011 en el Hospital Universitario Donostia. En el que estudiamos las variables tamaño, distancia al córtex, captación de contraste y localización. RESULTADOS: Incluimos 70 pacientes (75 biopsias), 39 varones y 31 mujeres con un rango de edad entre 39 y 83 años. El rendimiento diagnóstico total de nuestra serie fue del 97,1%. El punto de corte de la variable tamaño, a partir del cual encontramos el rendimiento más alto fue de 19 mm; así para las lesiones > 19 mm se obtuvo una sensibilidad del 95,2% (IC 95%: 86,9-98,4) y una especificidad del 57,1% (IC 95%: 25,0-84,2). Las lesiones localizadas a menos de 17 mm del córtex mostraron un rendimiento menor, con una sensibilidad del 74,6% (IC 95%: 62,1-84,7) y una especificidad del 71,4% (IC 95%: 29,0-96,3). Siete (10%) pacientes desarrollaron complicaciones después de la primera biopsia y ninguno tras la segunda. CONCLUSIONES: El rendimiento diagnóstico fue menor en las lesiones menores de 2 cm de diámetro y superficiales (< 17 mm del córtex). En esta serie no observamos un aumento de las complicaciones después de realizar una segunda biopsia
OBJECTIVE: The aim of this study was to evaluate the variables that could modify the diagnostic yield of frameless stereotactic biopsy, as well as its complications. MATERIALS AND METHOD: This was a retrospective study of frameless stereotactic biopsies carried out between July 2008 and December 2011 at Donostia University Hospital. The variables studied were size, distance to the cortex, contrast uptake and location. RESULTS: A total of 70 patients were included (75 biopsies); 39 males and 31 females with an age range between 39 and 83 years. The total diagnostic yield in our series was 97.1%. For lesions > 19 mm, the technique offered a sensitivity of 95.2% (95% CI: 86.9-98.4) and specificity of 57.1% (95% CI: 25.0-84.2). The yield was lower for lesions within 17 mm of the cortex: sensitivity of 74.6% (95% CI: 62.1-84.7) and specificity of 71.4% (95% CI: 29.0-96.3). Seven (10%) patients developed complications after the first biopsy and none after the second. CONCLUSIONS: The diagnostic yield was lower for lesions less than 2 cm in size and located superficially. In this series we did not observe an increased rate of complications after a second biopsy
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Humanos , Biopsia/métodos , Técnicas Estereotáxicas , Neoplasias Encefálicas/patología , Sensibilidad y Especificidad , Estudios Retrospectivos , Biopsia/efectos adversosRESUMEN
OBJECTIVE: The aim of this study was to evaluate the variables that could modify the diagnostic yield of frameless stereotactic biopsy, as well as its complications. MATERIALS AND METHOD: This was a retrospective study of frameless stereotactic biopsies carried out between July 2008 and December 2011 at Donostia University Hospital. The variables studied were size, distance to the cortex, contrast uptake and location. RESULTS: A total of 70 patients were included (75 biopsies); 39 males and 31 females with an age range between 39 and 83 years. The total diagnostic yield in our series was 97.1%. For lesions >19mm, the technique offered a sensitivity of 95.2% (95% CI: 86.9-98.4) and specificity of 57.1% (95% CI: 25.0-84.2). The yield was lower for lesions within 17mm of the cortex: sensitivity of 74.6% (95% CI: 62.1-84.7) and specificity of 71.4% (95% CI: 29.0-96.3). Seven (10%) patients developed complications after the first biopsy and none after the second. CONCLUSIONS: The diagnostic yield was lower for lesions less than 2cm in size and located superficially. In this series we did not observe an increased rate of complications after a second biopsy.
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Biopsia/métodos , Neoplasias Encefálicas/diagnóstico , Encéfalo/patología , Glioma/diagnóstico , Neuronavegación , Adulto , Anciano , Anciano de 80 o más Años , Área Bajo la Curva , Biopsia/efectos adversos , Neoplasias Encefálicas/patología , Neoplasias Encefálicas/secundario , Carcinoma/diagnóstico , Carcinoma/secundario , Medios de Contraste/uso terapéutico , Enfermedades Desmielinizantes/diagnóstico , Enfermedades Desmielinizantes/patología , Femenino , Glioma/patología , Hematoma/etiología , Humanos , Linfoma no Hodgkin/diagnóstico , Linfoma no Hodgkin/patología , Masculino , Persona de Mediana Edad , Neuronavegación/efectos adversos , Curva ROC , Estudios Retrospectivos , Convulsiones/etiología , Sensibilidad y Especificidad , Carga TumoralRESUMEN
El Grupo de Trabajo de Neurooncología (GTNO) de la SENEC ha encargado a los miembros del comité de neurooncología del Hospital Universitario Donostia de San Sebastián (España) la elaboración del presente documento, para que sirva como Guía del consenso establecido en el seno del GTNO y recomendación propuesta en todos los hospitales, públicos o privados, que manejan esta patología. Es obligado la constitución y funcionamiento normalizado de comités de neurooncología en todos los centros con servicio de neurocirugía, y lo expuesto a continuación debe contemplarse a la luz de las condiciones particulares de los mismos, con las variaciones pertinentes según los recursos diagnósticos y terapéuticos. Nos presentan a continuación el ejemplo de la constitución, funcionamiento y experiencia que han contraído en más de 8 años de trabajo multidisciplinar en pacientes con tumores cerebrales (AU)
The Neuro-Oncology Study Group (NOSG) at SENEC has commissioned the elaboration of the present document to the Neuro-Oncology Committee at Donostia University Hospital. It is intended to serve as a NOSG Consensus Guide and a proposed recommendation for the management of his pathological conditionatallSpanishHospitals,bothpublicandprivate.Neuro-Oncology Committees must be established and active at all centres with a Neurosurgery Service, taking into account the specific diagnostic and therapeutic capacity available. The work presents an example of the constitution, functioning and experience of such a Committee, drawing on 8 years of multidisciplinary work with brain tumour patients (AU)
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Humanos , Comité de Profesionales/organización & administración , Neurocirugia/organización & administración , Neoplasias Encefálicas/cirugía , Neoplasias del Sistema NerviosoRESUMEN
The Neuro-Oncology Study Group (NOSG) at SENEC has commissioned the elaboration of the present document to the Neuro-Oncology Committee at Donostia University Hospital. It is intended to serve as a NOSG Consensus Guide and a proposed recommendation for the management of this pathological condition at all Spanish Hospitals, both public and private. Neuro-Oncology Committees must be established and active at all centres with a Neurosurgery Service, taking into account the specific diagnostic and therapeutic capacity available. The work presents an example of the constitution, functioning and experience of such a Committee, drawing on 8 years of multidisciplinary work with brain tumour patients.