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Evolución de los riesgos ambientales en el contexto de la crisis económica. Informe SESPAS 2014.

  • Ferran Ballester
  • Sabrina Llop
  • Xavier Querol
  • Ana Esplugues
This article aims to analyze the impact of the economic and financial crisis on environmental determinants of health. The World Health Organization estimates that between 13% and 27% of the disease burden in countries could be prevented by improving the environment. These effects are larger in vulnerable populations, especially among the poorest. In the last decade, outdoor air pollution (the most significant environmental health risk in most European countries) has declined, mostly due to the European policy of reducing emissions and to the decrease in activity following the economic crisis. During the last few years, this improvement in air quality has occurred simultaneously with a reduction in investment in environmental protection and could therefore be offset in the medium-term. The economic crisis has not reduced the trend for higher temperatures in Spain and Europe because climate change is a global phenomenon that is not directly related to local emissions. To reduce the risk of an increase in the health impact of environmental factors, certain key aspects should be considered, such as the need to maintain or develop adequate monitoring and control systems and the opportunity to implement policies that help improve the quality of the environment and reduce the vulnerability of different population groups in a cross-disciplinary framework of transparency and citizen participation.

Fingolimod: efectividad y seguridad en la practica clinica habitual. Estudio observacional, retrospectivo y multicentrico en la provincia de Alicante.

  • Mallada J
  • Perez-Carmona N
  • Berenguer-Ruiz L
  • Sanchez R
  • Martin-Gonzalez R
  • Sola-Martinez D
  • Mola S
  • Lopez-Arlandis JM
  • Vela-Yebra R
  • Gabaldon-Torres L
  • Freire-Alvarez E
  • Garcia-Escriva A
  • Perez A
INTRODUCTION: Post-authorisation studies are important to confirm whether the outcomes of clinical trials are reproduced in usual clinical practice. AIMS: To evaluate the effectiveness and safety of fingolimod in clinical practice in the province of Alicante. PATIENTS AND METHODS: A retrospective multi-centre study was conducted with remitting multiple sclerosis patients treated with fingolimod. Demographic, clinical and pharmacological data were collected. We report on the effectiveness of the drug -annualised relapse rate (ARR) and percentage of patients free from attacks- at one and at two years after treatment in relation to the previous year, and data concerning side effects are also provided. RESULTS: The sample consisted of 89 patients. Previous treatment was with immunomodulators (interferon beta or glatiramer acetate) in 54 patients and natalizumab in 32. Fifty patients changed due to failure with the immunomodulator and 31 owing to positive serology for JC virus (JCV+). Overall ARR decreased by 67.3% the first year (p < 0.0001) and by 84.1% the second (p = 0.0078). It diminished in patients with immunomodulator failure (85.6% the first year, p < 0.0001; 88.9% the second year, p = 0.0039) and increased in a non-significant manner in JCV+ patients in the first year. The percentage of patients free from relapses in the overall population increased from 32.6% to 68.1% in the first year (p < 0.0019) and to 82.6% in the second (p = 0.0215). This increase was not observed in JCV+ patients. Side effects were reported by 13 patients, which led to the drug being withdrawn in two of them. CONCLUSION: In clinical practice in the province of Alicante, levels of effectiveness and safety of fingolimod proved to be slightly higher than those found in clinical trials.

Bronchial Microbiome In Severe Persistent Oral Corticosteroid-Dependent Asthma

  • Millares, L
  • Bermudo, G
  • Garcia-Nunez, M
  • Grimau, C
  • Martinez-Lopez, N
  • Perez-Brocal, V
  • Domingo, C
  • Monso, E

Circulating exosomes in obstructive sleep apnoea syndrome (OSAS) in adults

  • Puertas, F
  • Atienzar, S
  • Serrano, G
  • Sancho-Pelluz, J
  • Roquet-Jalmar, P
  • Asencio-Guerra, A
  • Romero, F


  • Cejalvo, M
  • Panero, M
  • Ribas, P
  • Jarque, I
  • Lopez, A
  • Perez, P
  • Avaria, A
  • Castillo, I
  • Guinot, M
  • Beltran, S
  • Gascon, A
  • Montava, A
  • Teruel, A
  • Arnao, M
  • Lorente, P
  • Ruiz, M
  • Ibanez, F
  • Villarrubia B
  • Sanchez, J
  • Ferrer, R
  • Fernandez, P
  • Blanes M
  • Mauricio, A
  • Conesa, V
  • de la Rubia, J

Variabilidad en las recomendaciones para el abordaje clínico de la osteoporosis.

  • Sanfélix-Genovés J
  • Catalá-López F
  • Sanfélix-Gimeno G
  • Hurtado I
  • Peiró S
Analysis of the variability in the recommendations of the main guidelines and clinical documents for the management of osteoporosis.

Riesgo cardiovascular asociado al consumo de antiinflamatorios no esteroideos: estudio de cohortes retrospectivo en un área de salud, 2008-2012.

  • Sánchez Serrano JL
  • Tenias Burillo JM
  • Arias Arias Á
  • Muñoz Carreras MI
  • Valenzuela Gámez JC
Since the clinical trial VIGOR, in which the use of rofecoxib was proved to be connected to a larger number of cardiovascular accidents, an increase of cardiovascular diseases connected to the use of non Steroidal Anti-Inflammatory Drugs has been observed. This study intends to evaluate cardiovascular impact related to the use of non steroidal anti-inflammatory drugs in a Health Care Area in Castilla La Mancha (Spain).

Asociación entre la exposición laboral a factores psicosociales y la existencia de trastornos musculoesqueléticos en personal de enfermería: revisión sistemática y meta-análisis.

  • Ballester Arias AR
  • García AM
There is scientific evidence that psychosocial factors are significantly associated with discomfort and / or pain musculoskeletal complaints in nursing staff. The objective of the research was to analyze the association between occupational exposure to psychosocial factors at work and musculoskeletal damage in nursing staff.

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