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Vol. 30, nº 05. Mapeado de líneas y grupos de I+D+I en salud pública en Andalucía: área de vigilancia y sistemas inteligentes.
No full textEnfermedades de Declaración Obligatoria por provincias. Semana 04/2025 y acumulado desde la semana 01/2025. Datos provisionales. Incluye además el artículo titulado “Mapeado de líneas y grupos de I+D+I en salud pública en Andalucía: área de vigilancia y sistemas inteligentes”, de “Cristina Medina Prado, Virginia Nieto Guerrero y Belén Jiménez Ojeda”.N
Implementing Holistic Care in Isolated Patients During COVID-19 Pandemic: A Case Study Using Nursing Outcomes (NOC) and Interventions (NIC) Classifications.
No full textThe most effective strategy against SARS-Cov-2 virus spread is therapeutic isolation. Consequences of this measure are the presence of anxiety and depression. Therefore, it is the nurse's responsibility to identify strategies to implement humanized and holistic care in order to avoid physical and mental consequences of isolation
Vol. 30, nº 37. Botulismo, enfermedad poco común, pero potencialmente grave.
No full textEnfermedades de Declaración Obligatoria por provincias. Semana 39/2025 y acumulado desde la semana 01/2025. Datos provisionales. Incluye además el artículo titulado “Botulismo, enfermedad poco común, pero potencialmente grave”, de “Servicio de Vigilancia y Salud Laboral”.Ye
Vol. 30, nº 23. Desafíos globales, soluciones locales: estrategias y resiliencia en salud pública para afrontar las amenazas sanitarias del presente y del futuro en Andalucía.
No full textEnfermedades de Declaración Obligatoria por provincias. Semana 24/2025 y acumulado desde la semana 01/2025. Datos provisionales. Incluye además el artículo titulado “Desafíos globales, soluciones locales: estrategias y resiliencia en salud pública para afrontar las amenazas sanitarias del presente y del futuro en Andalucía”, de “Elena Mª Gras García, Alejandra Gutiérrez Armesto, Nicola Larusso”.Ye
Vol. 30, nº 26. Oportunidades perdidas y diagnostico tardío de VIH en el distrito de salud Málaga-Valle del Guadalhorce.
No full textEnfermedades de Declaración Obligatoria por provincias. Semana 27/2025 y acumulado desde la semana 01/2025. Datos provisionales. Incluye además el artículo titulado “Oportunidades perdidas y diagnostico tardío de VIH en el distrito de salud Málaga-Valle del Guadalhorce”, de “Mishel Renata Heredia Ruiz, María Ángeles Fernández Gómez”.Ye
Vol. 30, nº 04. Atención y seguimiento de las agresiones sexuales en un área de gestión sanitaria: papel de los servicios de medicina preventiva en Andalucía.
No full textEnfermedades de Declaración Obligatoria por provincias. Semana 03/2025 y acumulado desde la semana 01/2025. Datos provisionales. Incluye además el artículo titulado “Atención y seguimiento de las agresiones sexuales en un área de gestión sanitaria: papel de los servicios de medicina preventiva en Andalucía”, de “Jorge González Acosta, Ana María Muñoz Martínez, Isabel Pozo Jiménez, Manuel Suárez Vázquez, Álvaro Tejero González, Miguel Daniel Vila Alba, Consuelo Jiménez Castillo, Javier Jiménez Moreno, Juan Antonio Córdoba Doña”.N
Vol. 30, nº 17. Situación epidemiológica de la tuberculosis en el distrito sanitario poniente de Almería: funciones del equipo de atención a los usuarios con TBC.
No full textEnfermedades de Declaración Obligatoria por provincias. Semana 17/2025 y acumulado desde la semana 01/2025. Datos provisionales. Incluye además el artículo titulado “Situación epidemiológica de la tuberculosis en el distrito sanitario poniente de Almería: funciones del equipo de atención a los usuarios con TBC", de “Romero García Leticia, Gimeno Mora Rosario, Archilla Castillo Mónica, Rueda Nieto Senay, Fernández Humanes Vanesa”.N
Comparative clinical outcomes of acenocoumarol versus direct oral anticoagulants (DOACs) and warfarin in patients with atrial fibrillation: real-world-evidence (SIESTA-A study)
No full textThe study protocol was submitted to the Spanish Agency of Medicines and Medical Devices (AEMPS, Spanish acronym) and classified as an observational study (AEMPS reference number: 0004–2022-OBS; 12 January 2022).
The author(s) declare that financial support was received for the research and/or publication of this article. This work was supported by the Andalusian Public Foundation for Health Research Management in Seville (FISEVI) of the Andalusian Ministry of Health (AP-0222-2019 and AP-0379-2023-C4-F2) and by the Instituto de Salud Carlos III (PI20/01281), Spanish Ministry of Health (co-financed by the European Regional Development Funds).Objective: The aim of this study was to evaluate the effectiveness and safety of direct oral anticoagulants (DOACs: dabigatran, rivaroxaban, apixaban and edoxaban) and warfarin versus acenocoumarol in patients with atrial fibrillation under real-world clinical practice conditions.
Methods: This was a retrospective, real-world data-based study. The data source was the Andalusian Population Health Database. The study covered the period from January 2012 to December 2020. Effectiveness outcomes were defined as the identification of a first occurrence of ischaemic or bleeding events, or all-cause mortality. The statistical analysis included crude incidence analysis, survival models: Kaplan-Meier curves, propensity score matched pairs analysis, Fine-Gray model, and Cox regression analysis adjusted for possible confounding.
Results: A total of 150,949 patients were included. The mean age of the cohort was 74 years (48.2% female). The mean follow-up time was 3.3 years. The combined effectiveness endpoint of ischaemic events (transient ischaemic attack, systemic embolism, pulmonary embolism, or ischaemic stroke) showed the following results compared to acenocoumarol: warfarin (RR:1.06; 95%CI 0.93–1.22); dabigatran (RR:1.17; 95%CI 1.02–1.33); rivaroxaban (RR:1.15; 95%CI 1.05–1.26); apixaban (RR: 0.96; 95%CI 0.87–1.07) and edoxaban (RR: 1.10; 95%CI 0.79–1.51). Compared to acenocoumarol, the risk of all-cause mortality was lower for dabigatran, rivaroxaban and apixaban (RR:0.77; 95%CI 0.72–0.82; RR:0.79; 95%CI 0.76–0.83; RR:0.85; 95%CI 0.81–0.89, respectively) and higher for warfarin (RR:1.12; 95%CI 1.05–1.20). An increased risk of gastrointestinal bleeding was observed with dabigatran (RR:1.36; 95%CI 1.09–1.70) and a lower risk with rivaroxaban (RR:0.84; 95%CI 0.72–0.98). All 4 DOACs showed a lower risk of intracranial bleeding compared to acenocoumarol. Warfarin carried a higher risk of both gastrointestinal bleeding (RR:1.64; 95%CI 1.31–2.06) and intracranial bleeding (RR:1.61; 95%CI 1.22–2.13) compared to acenocoumarol. An unadjusted analysis of matched groups in a multivariate Cox regression analysis yielded similar results for combined effectiveness and safety outcomes compared to acenocoumarol.
Conclusion: Although DOACs were clearly associated with a lower risk of intracranial bleeding compared to acenocoumarol, our data did not reveal a significant reduction in thromboembolic events. Warfarin was found to be both less effective and less safe than acenocoumarol.Andalusian Public Foundation for Health Research Management in Seville (FISEVI) of the Andalusian Ministry of Health (AP-0222-2019 and AP-0379-2023-C4-F2)Instituto de Salud Carlos III (PI20/01281), Spanish Ministry of Health (co-financed by the European Regional Development Funds)Ye
A Framework for Considering the Role of the Public Sector in R&D of Health Technology
No full textThe development of health technologies involves complex, costly, and risky investments, with significant contributions from both public and private sectors. Recent EU pharmaceutical directives propose transparency on public funding to aid pricing negotiations and affordability. However, questions remain regarding how public investments should be measured and their influence on pricing and reimbursement (P&R) decisions. In this paper, we characterise public sector institutions as "payers," "R&D investors," and "regulators". Through a myriad of agencies and decisions, these institutions directly, indirectly or sometime unexpectedly influence risk and return on private research and development (R&D) through P&R, direct investments, and regulatory policy. P&R decisions by payers for innovative therapies influence risk and expected return of future R&D. Value-based pricing offers a more reliable signal of payers' priorities than cost-plus or (international) reference pricing. For greatest impact, public R&D investment should be directed to areas where markets are deficient, such as basic science, translational research, real-world studies, and towards emerging fields like AI and gene editing that will play an increasing role in healthcare and drug development. Applied R&D should be conducted on a financially sustainable basis. Licensing arrangements can be used to recover those investments, while promoting spillover benefits to wider society. Market access regulators are aware of the need for scrupulous transparency and neutrality, but other public sector actors (payers and R&D investors) also must recognise their policies affect the level playing field.Ye
Vol. 30, nº 28. Hepatitis A en Andalucía: año 2024.
No full textEnfermedades de Declaración Obligatoria por provincias. Semana 29/2025 y acumulado desde la semana 01/2025. Datos provisionales. Incluye además el artículo titulado “Hepatitis A en Andalucía: año 2024”, de “Servicio de Vigilancia y Salud Laboral”.Ye