RISalud-ANDALUCÍA
Not a member yet
18682 research outputs found
Sort by
The duration of intervals on the oral cancer care pathway and implications for survival: a systematic review and meta-analysis
No full textIntroduction: Previous studies measuring intervals on the oral cancer care pathway have been heterogenous, showing mixed results with regard to patient outcomes. The aims of this research were (1) to calculate pooled meta-analytic
estimates for the duration of the patient, diagnostic and treatment intervals in oral cancer, considering the income level of the country, and (2) to review the
evidence on the relationship of these three intervals with tumor stage at diagnosis and survival.
Materials and methods: We conducted a systematic review with meta-analysis following PRISMA 2020 guidelines (pre-registered protocol CRD42020200752). Following the Aarhus statement, studies were eligible if they reported data on the length of the patient (first symptom to first presentation to a healthcare professional), diagnostic (first presentation to diagnosis), or treatment (diagnosis
to start of treatment) intervals in adult patients diagnosed with primary oral cancer. The risk of bias was assessed with the Aarhus checklist.
Results: Twenty-eight studies reporting on 30,845 patients met the inclusion criteria. The pooled median duration of the patient interval was 47 days (95% CI = 31–73), k = 18, of the diagnosis interval 35 days (95% CI = 21–38),k = 11, and of the treatment interval 30 days (95% CI = 23–53), k = 19. In lower-income countries, the patient and treatment intervals were significantly longer, and longer patient intervals were related to later stage at diagnosis. In studies with a
lower risk of bias from high-income countries, longer treatment intervals were associated with lower survival rates.
Conclusion: Interval duration on the oral cancer care pathway is influenced by the socio-economic context and may have implications for patient outcomes.This work was supported by the Spanish Association Against Cancer [Asociación Española contra el Cáncer, PROYE20023SANC “High resolution study of social inequalities in cancer (HiReSIC)”], the Cancer Epidemiological Surveillance Subprogram of the CIBER of Epidemiology and Public Health and the Health Institute Carlos III (VICA), and the Health Institute Carlos III (PI18/01593 “Multilevel population-based study of socioeconomic inequalities in the geographical distribution of cancer incidence, mortality and net survival”). DP was supported by a Juan de la Cierva Fellowship from the Ministry of Science and the National Research Agency of Spain (MCIN/AEI, JC2019- 039691-I,Ye
Vol. 28, nº 27. Mortalidad durante los dos primeros años de la pandemia de Covid-19 en Andalucía
No full textEnfermedades de Declaración Obligatoria por provincias. Semana 26/2023 y acumulado desde semana 01/2023. Datos provisionales. Incluye además el artículo titulado "Mortalidad durante los dos primeros años de la pandemia de Covid-19 en Andalucía", de "Valme del Río García, Soledad Márquez Calderón".Ye
Vol. 28, nº 21. Escabiosis, un viejo amigo con una nueva mirada
No full textEnfermedades de Declaración Obligatoria por provincias. Semana XX/2022 y acumulado desde semana X/2022. Datos provisionales. Incluye además el artículo titulado 'xxxx', de xxxx.Enfermedades de Declaración Obligatoria por provincias. Semana 20/2023 y acumulado desde la semana 01/2023. Datos provisionales. Incluye además el artículo titulado “Escabiosis, un viejo amigo con una nueva mirada”, de Nuria López Ruiz, Unidad de Salud Pública, Epidemiología y Vigilancia de la Salud del Área de Gestión Sanitaria Campo de Gibraltar Este y Oeste
Vol. 28, nº 38. Enfermedad neumocócica invasora. Andalucía, año 2022
No full textEnfermedades de Declaración Obligatoria por provincias. Semana 37/2023 y acumulado desde la semana 01/2023. Datos provisionales. Incluye además el artículo titulado “Enfermedad neumocócica invasora. Andalucía, año 2022”, de “Virtudes Gallardo García, Nicola Lorusso”.Ye
Andalusian health centres committed against gender-based violence: an overview of 3 years of activity
No full textDentro del contexto español de las medidas y recomendaciones del Pacto de Estado contra la violencia de género, la Dirección General de Salud Pública y Ordenación Farmacéutica de Andalucía inició, en 2020, una estrategia pionera de acreditación de Centros Sanitarios Comprometidos contra la Violencia de Género. Este proyecto de acreditación ofrece a todos los centros sanitarios de Andalucía la oportunidad de: evaluar el grado de implantación de sus actuaciones en el abordaje de la violencia de género, identificar buenas prácticas y establecer medidas de mejora. El objetivo final persigue que todos los centros sanitarios incorporen medidas de calidad para la adecuada sensibilización, detección e intervención de posibles casos de violencia de género. Este artículo describe el inicio y desarrollo de esta iniciativa e incluye resultados de la evaluación llevada a cabo por el Instituto Andaluz de Administración Pública tras los primeros tres años de actividad. Además, proporciona ideas y sugerencias para su desarrollo en los años sucesivos, así como para su posible replicación en otros contextos.Within the framework of the Spanish measures and recommendations of the State Pact against gender-based violence, the General Directorate of Public Health of the Andalusian Government began, in 2020, a pioneering strategy for the accreditation of health centres committed against gender-based violence. This project offers all Health centres in Andalusia the opportunity to assess the degree of implementation of actions addressing gender-based violence and identifying good practices and improvement measures. The final goal is to incorporate quality measures towards the adequate awareness, detection and intervention concerning possible cases of gender-based violence. This article describes how this project evolved and is being developed. In addition, it includes the results from the evaluation carried out by the Andalusian Institute of Public Administration after the first three years of the project´s activity. Moreover, it provides suggestions and recommendations for further developments in the upcoming years and practical ideas for possible replication in other contexts.Proyecto financiado con fondos del Ministerio de Igualdad (Secretaría de Estado de Igualdad y contra la Violencia de Género) en el marco del Pacto de Estado contra la Violencia de Género, gestionados por la Dirección General de Salud Pública y Ordenación Farmacéutica de la Consejería de Salud y Consumo de la Junta de Andalucía.Ye
Vol. 28, nº 40. Programa de prevención de la infección VRS con Nirsevimab. Andalucía, campaña 2023-2024
No full textEnfermedades de Declaración Obligatoria por provincias. Semana 39/2023 y acumulado desde la semana 01/2023. Datos provisionales. Incluye además el artículo titulado “Programa de prevención de la infección VRS con Nirsevimab. Andalucía, campaña 2023-2024”, de “David Moreno, Javier Álvarez, Marta Bernal, Ignacio Salamanca de la Cueva, Inmaculada Martín, María Ángeles Onieva.”Ye
SEOM-GEMCAD-TTD clinical guidelines for the systemic treatment of metastatic colorectal cancer (2022)
No full textColorectal cancer (CRC) is the second leading cause of cancer deaths in Spain. Metastatic disease is present in 15-30% of patients at diagnosis and up to 20-50% of those with initially localized disease eventually develop metastases. Recent scientific knowledge acknowledges that this is a clinically and biologically heterogeneous disease. As treatment options increase, prognosis for individuals with metastatic disease has steadily improved over recent decades. Disease management should be discussed among experienced, multidisciplinary teams to select the most appropriate systemic treatment (chemotherapy and targeted agents) and to integrate surgical or ablative procedures, when indicated. Clinical presentation, tumor sidedness, molecular profile, disease extension, comorbidities, and patient preferences are key factors when designing a customized treatment plan. These guidelines seek to provide succinct recommendations for managing metastatic CRC.Ye
Midline incisional hernia guidelines: the European Hernia Society
No full textSince the introduction of anaesthesia by Morton in 1846, and as survivable abdominal surgery became more common, so did the incidence of incisional hernias. Since then, more than 4000 peer-reviewed articles have been published on the topic, many of which have tried to reduce the incidence or introduce techniques to improve outcomes from surgical repair. Despite this, the incidence of incisional hernias and the recurrence rates after repair remain high. A wide range of incisional hernia rates are reported. A meta-analysis including over 14 000 patients reported a weighted incidence of 12.8 per cent 2 years after a midline incision, and that one-third of patients with an incisional hernia undergo surgical repair. Recurrence rates after repair of incisional hernia range between 23 and 50 per cent, with increasing rates of complications and re-recurrence after each subsequent failed repair. Arguably, no other benign disease has seen so little improvement in terms of surgical outcome.Ye
Update of European Society of Clinical Microbiology and Infectious Diseases coronavirus disease 2019 guidelines: diagnostic testing for severe acute respiratory syndrome coronavirus 2
No full textSince the onset of COVID-19, several assays have been deployed for the diagnosis of SARS-CoV-2. The European Society of Clinical Microbiology and Infectious Diseases (ESCMID) published the first set of guidelines on SARS-CoV-2 in vitro diagnosis in February 2022. Because the COVID-19 landscape is rapidly evolving, the relevant ESCMID guidelines panel releases an update of the previously published recommendations on diagnostic testing for SARS-CoV-2. This update aims to delineate the best diagnostic approach for SARS-CoV-2 in different populations based on current evidence. An ESCMID COVID-19 guidelines task force was established by the ESCMID Executive Committee. A small group was established, half appointed by the chair, and the remaining selected with an open call. The panel met virtually once a week. For all decisions, a simple majority vote was used. A list of clinical questions using the population, intervention, comparison, and outcome (PICO) format was developed at the beginning of the process. For each PICO, 2 panel members performed a literature search focusing on systematic reviews with a third panellist involved in case of inconsistent results. The panel reassessed the PICOs previously defined as priority in the first set of guidelines and decided to address 49 PICO questions, because 6 of them were discarded as outdated/non-clinically relevant. The 'Grading of Recommendations Assessment, Development and Evaluation (GRADE)-adoption, adaptation, and de novo development of recommendations (ADOLOPMENT)' evidence-to-decision framework was used to produce the guidelines. After literature search, we updated 16 PICO questions; these PICOs address the use of antigen-based assays among symptomatic and asymptomatic patients with different ages, COVID-19 severity status or risk for severe COVID-19, time since the onset of symptoms/contact with an infectious case, and finally, types of biomaterials used.Ye
La monitorización proactiva de niveles de anti-TNF mejora el seguimiento de los pacientes pediátricos con enfermedad de Crohn.
Get PDFIntroduction and aims: The incidence of paediatric inflammatory bowel disease has increased in recent decades. The aim of the present study was to evaluate the role of proactive and serial monitoring of tumour necrosis factor (TNF) inhibitor levels to maintain clinical remission and mucosal healing in the follow-up of paediatric patients with Crohn disease (CD).Method: Prospective study that included all patients diagnosed with CD and treated with adali-mumab or infliximab between May 2015 and November 2020 who underwent serial and proactive monitoring of TNF inhibitor levels.Results: The study included 30 patients, 21 male (70%). The mean age at diagnosis was 11.3 years (SD, 2.0), the mean age at initiation of TNF inhibitors was 12.6 years (SD, 1.9) with a mean duration of follow-up of 27.1 +/- 9.1 months. Clinical remission was defined as a weighted Pediatric Crohn's Disease Activity Index (wPCDAI) of less than 12.5 and mucosal healing as a Mucosal Inflammation Non-invasive Index (MINI) of less than 8. During the follow-up, patients were in clinical remission in 87.1% of the visits, presented with mild disease in 11.4% and with moderate disease in 1.5%, and mucosal healing was assumed in 83% of the visits. The rates of clinical remission and mucosal healing at 1, 2, and 3 years of follow-up were 83.3%, 95.8%, 92.8%, and 86.7%, 87.5% and 85.7%, respectively. Conclusions: Proactive and serial monitoring of serum TNF inhibitor levels may make it possible for patients to maintain clinical remission and mucosal healing in the maintenance phase, with individualised optimization of the required dosage and minimization of secondary loss of response.(c) 2022 Asociacion Espanola de Pediatria. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)