Neurología : publicación oficial de la Sociedad Española de Neurología
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With reference to the article "Assessment of the efficiency of the clinical management of neuropathic pain in specialist clinics compared to general clinics in neurology health care units in Spain" by Matias-Guiu et al, a reflection is made on the methodological and operational difficulties of working with results in health, quality of life or costs in something so subjective as pain, and its impact on daily life. It then highlights the importance of the decision to establish a specialist clinic or other type specific care team for neuropathic pain, adding another level of care. Some points are given for the analysis of that decision.
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Editors of scientific publications have, traditionally, been unaware of frauds and misconduct, being more concerned with subjects associated to impact or with editorial review. But, in the last few years they have been checking and reporting that there is misconduct in the scientific field, and furthermore, it is not uncommon. ⋯ Many editors are demanding clear regulations to prevent misconduct. Editorial review and the provision of evaluation tools for reviewers are prevention, but not infallible formulas. What is most important could be that editorial teams be aware of its existence.
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Intravenous fibrinolysis in the first 3 hours from the onset of the symptoms and admission to a Stroke Unit (SU) are fundamental cornerstones of the acute ischemic stroke treatment. Intravenous fibrinolysis in Spain has been performed by the neurologists since the beginning of the century within the safety registries. The number of patients treated and accredited centers have progressively increased in recent years. ⋯ Fibrinolysis has served to dynamize the Care regarding Stroke in Spain through the creation of the Regional Health Care Plans and the SU. The SU is the best treatment of stroke since they improve the morbidity-mortality with a favorable cost/efficacy balance, reducing the complications and dependence. Most of the strokes (including transient ischemic attacks and cerebral hemorrhages) benefit from them. The SU is the basis from which the number of fibrinolyses can be increased, where general cares can be applied and where new therapeutic measures such as Neuro-Interventionism, Tele-Medicine or the development of new drugs can be implemented. The publication of the National Strategy in Stroke by the Health Care Ministry is a unique opportunity to improve neurological care of stroke. No one more than the neurologists know how to treat stroke and up to now, we are the only specialists who have demonstrated that we know how to apply intravenous fibrinolysis.
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Recently it has been demonstrated safety and efficacy of treatment with intravenous recombinant tissue-type plasminogen activator (rt-PA) for acute ischemic stroke in Europe, however there are differences in different European countries that may have variations in the response to treatment. In this study we reviewed the experience of thrombolytic therapy in Spain in a prospective observational register. ⋯ In Spain, treatment with rt-PA for ischemic stroke is safe and effective when administered within the first 3 hours after symptom onset, and have a higher benefit than in the rest of the world.
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There is an on-going debate on questions of authorship in the scientific publications. Adherence to the International Committee of Medical Journal Editors (ICMJE) recommendations for medical journals is low, which should be cause for reflection. ⋯ Authorship criteria for our journal include demonstration of their relevance in the development of the research and manuscript as well as the responsibility in it. This line is not as restrictive as that of the ICMJE criteria, whose recommendations may not be easy to adapt to the current organization of the multidisciplinary research groups.