"Ponte gafas, el VIH no se ", lema del concurso del Día Mundial de lucha frente al SIDA 2013

Boletín semanal para profesionales sanitarios de la Secretaría General de Calidad, Innovación y Salud Pública de la Consejería de Igualdad, Salud y Políticas Sociales

1 de Diciembre, Día Mundial de la lucha frente al SIDA 2013

Boletín semanal para profesionales sanitarios de la Secretaría General de Calidad, Innovación y Salud Pública de la Consejería de Igualdad, Salud y Políticas Sociales

Evaluación económica de la monoterapia con tocilizumab frente a adalimumab en artritis reumatoide.

BACKGROUND Tocilizumab (TCZ) was superior to adalimumab (ADA), as monotherapy, in reducing signs and symptoms of adult rheumatoid arthritis (RA) when methotrexate (MTX) treatment is poorly tolerated or inappropriate. The aim of the study was to analyze the cost-effectiveness of TCZ vs ADA in these patients. METHODS Economic evaluation of the cost per response or remission of TCZ vs ADA from ADACTA (time horizon: 24 weeks). Clinical response criteria ACR or disease remission criteria, DAS28. PERSPECTIVE National Health System. The costs included (acquisition, administration and monitoring of medicines; € 2012) were obtained from Spanish sources. Simple univariate sensitivity analyzes were performed. RESULTS ACR20, ACR50 and ACR70 response rates with TCZ and ADA were obtained in 65% and 49.4% (p <0.01), 47.2% and 27.8% (p <0.01); and 32.5% and 17.9% (p <0.01) of patients, respectively. DAS28 remission occurred in 39.9% and 10.5%, respectively (p <0.0001). The cost per response was lower with TCZ than with ADA (ACR20: € 8,105 and € 11,553; ACR50: € 11,162 and € 20,529; ACR70: € 16,211 and € 31,882) respectively. The cost of DAS28 remission was € 13,204 and € 54,352, respectively. Treatment with TCZ was dominant (more effective, with lower costs vs ADA) in all scenarios analyzed. CONCLUSIONS According to this analysis, in Spain TCZ monotherapy is an efficient strategy vs ADA for treating RA patients intolerant to MTX or in which there is inappropriate response.

Estudio comparativo de la respuesta inflamatoria peritoneal en la gastrectomía por cáncer: abordaje abierto frente abordaje laparoscópico.

Introducción Estudios en colecistectomías y cáncer colorrectal demostraron que la laparoscopia genera menor respuesta inflamatoria sistémica. Escasos trabajos en cáncer gástrico evalúan el impacto inflamatorio en laparoscopia y emplean metodología deficiente. Hipótesis Demostrar mediante el estudio de tejido peritoneal la menor respuesta inflamatoria(protein-arrays) en pacientes gastrectomizados por laparoscopia vs. vía abierta. Material y métodos 26 pacientes: laparoscópica (12) vs. abierta (14); 2010-2012. Resultados Basados en TNF muestran incremento similar de respuesta a la agresión quirúrgica (aunque hubo diferencias en valores finales en ambos abordajes). Conclusiones Resultados preliminares apuntan hacia conclusiones estadísticamente significativas que apoyen nuestra hipótesis: menor respuesta inflamatoria en laparoscopia y correlación con datos clínicos.

Niveles de anticuerpos bactericidas frente a meningococo C tras la vacunación de niños de 2 a 6 años de edad en Andalucía.

BACKGROUND In 1997, 18.5% of the cases of Meningococcal Disease caused b serogroup C in Andalusia were children between 2 and 4 years of age; ages where the initial immune response and the duration of the capsular A + C meningococcal polysaccharide vaccine is less than in older age groups. Research was designed in order to measure the immune response produced by this vaccine in children from 2 to 6 years of age and to compare it with the natural immunity present in unvaccinated children. METHODS I. Dual monitoring study: a) groups of children vaccinated previously and control groups, b) groups of children who were going to be vaccinated, for pre and post-vaccination (1, 6 and 12 months) analysis and a control group. II. The bactericidal activity was measured according to the standardised protocol of the CDC with regard to the strain of N. meningitidis C-11. The sera with bactericidal activity (TAB) > 1:8 were considered to be protective. RESULTS 1 and 2 months following vaccination, the proportion of TAB > 1:8 was significantly higher than that of the control group (65.6% and 73% in comparison to 2.2% and 12%). In the pre-vaccine and post-vaccine (after 6, 7, 12 and 13 months) verification, no significant difference between vaccinated individuals and controls was observed. CONCLUSIONS The differences between vaccinated and unvaccinated individuals 1 and 2 months following vaccination indicate seroconversion in the vaccinated individuals. For the age group of between 2 to 6 years of age, the bactericidal activity acquired decline quickly, as, after 6 months, differences between this group and the control group are no longer observed.

La Unión Europea frente a Darfur una vez más: EUFOR Chad/RCA

Los estados europeos se han mostrado impotentes ante el conflicto que asola Sudán, ejemplificado por la catástrofe humanitaria de Darfur. La creciente presión para “hacer algo” llegó a los despachos de los ministros de exteriores europeos hace cuatro años y desde entonces, tanto a nivel unilateral como europeo se han desarrollado diferentes (y fracasadas) iniciativas. A nivel de la PESD, por ejemplo, la Unión puso en marcha en coordinación con la OTAN, la operación de apoyo a la misión de la Unión Africana en Darfur, la operación AMIS II, pero pronto se vio desbordada por las dimensiones del conflicto. Este fracaso ha obligado a la Unión a ocupar un lugar protagonista en este conflicto imposible de desligar del enfrentamiento de Sudán con Chad, a través de la operación EUFOR Chad/RCA. Sin embargo, esta nueva operación se está convirtiendo en la última pesadilla europea en el terreno de la PESD. El complejo contexto bélico a escala regional así como las dificultades para construir una operación europea a gran escala han puesto en evidencia las diferencias entre socios europeos sobre el deber de intervenir en el conflicto de Darfur, así como las lagunas en la estrategia europea hacia un conflicto tan grave como el que asola el triángulo formado por Sudán, Chad y la República Centroafricana (RCA).

Alcon, sive de morte Dametae, id est Henrici III. Francorum Regis, carmen pastorale : authore D. Petremot, olim supplicum libellorum Magistro.

Mazarinaeus

Valoración de la Situación Actual de la Infancia frente a la Pobreza y Desigualdad Económica

Especial XXII Congreso Español de Pediatría Social

Efectividad comparativa del seguimiento remoto a personas con marcapasos cardíacos frente al convencional: calidad de vida a los 6 meses.

BACKGROUND The use of remote follow-up (RF) of people with pacemakers (PM) is limited in comparison to the hospital modality (HS), being still poor the scientific evidence that shows their comparative effectiveness. The aim of this study was to compare the quality of life in individuals with different modalities of follow-up. METHODS Controlled, not randomized nor masked clinical trial, with data collection at pre and post-implantation of pacemakers during the 6 months follow-up. All patients over 18 years-old who were implanted a PM during the study period were selected (n = 83), and they were assigned to RF (n = 30) or HF (n = 53) groups according to their personal characteristics and patient's preferences. Baseline characteristics and number of visits to the hospital were analysed, the EuroQol-5D (EQ5D) questionnaire was administered to evaluate the health-related quality of life, and Duke Activity Status Index (DASI) to assess the functional capacity. RESULTS There were no significant differences between both groups in relation to the baseline analysis, EQ5D (RF:0.7299; HF:0.6769) and DASI (RF:21.41; HF:19.99). At 6 months the quality of life was improved in both groups (EQ5D RF:0.8613; HF:0.8175; p = 0,439) still without significant differences between them. DASI score was similar to baseline (20.51 vs 21.80). RF group performed less transmissions/visits per patient (1.57) than hospital group (1.96; relative reduction 31%; p = 0.015). CONCLUSIONS Remote follow-up of people with pacemakers might be considered as an equivalent option to the hospital follow-up in relation to the quality of life and it reduces the number of hospital visits.

Mecanismos da linha de frente e orientações empresariais: tradução, adaptação e validação de uma escala

O trabalho de linha de frente das empresas pode ser observado como uma luta de três frentes. O cliente exige atenção e qualidade de serviço, de um lado, a organização exige eficiência e produtividade, de outro, e o pessoal da linha de frente é metaforicamente apanhado no centro. Essa abordagem surgiu como um tema relevante para Marinova, Ye e Singh (2008), que desenvolveram uma escala que avalia esses elementos por meio de cinco dimensões: duas orientações (produtividade e qualidade) e três mecanismos (autonomia, coesão e feedback). O objetivo principal neste artigo foi adaptar a escala e verificar se ela pode ser utilizada no Brasil. Para isso, ela foi submetida a tradução e validação semântica, adaptação ao contexto de pesquisa e validação estatística. A escala foi aplicada em 105 estudantes de graduação e pós-graduação, e seus resultados foram estatisticamente satisfatórios, validando a versão brasileira da escala.

Petrus de Alvernia, de motibus animalium, de longit. et brev. vite (5v), de morte et vita (7v), de juventute et senecta (9), de respiratione (12).

Pour gardes, fragments de comptes de la ville de Paris en 1365.