Search

The drugs assessed by the Spanish Agency for Medicines and Health Products or European Medicines Agency made public in July and October 2020, and considered of interest to the healthcare professional, are reviewed. These are positive technical reports prior to the authorization and placing on the market of the product. [ABSTRACT FROM AUTHOR]

Background: Apixaban and rivaroxaban are two direct-acting oral anticoagulants (DOACs) recommended for thromboprophylaxis in cancer patients treated with chemotherapy in an ambulatory setting. We aimed to assess the cost-utility of thromboprophylaxis with apixaban and rivaroxaban vs no thromboprophylaxis in ambulatory cancer patients starting chemotherapy with an intermediate-to-high risk of venous thromboembolism (VTE), Khorana score ≥ 2 points., Methods: A cost-effectiveness analysis was performed from the perspective of Spain's National Health System (NHS) using an analytical decision model in the short-term (180 days) and a Markov model in the long-term (5 years). Transition probabilities were obtained from randomized, double-blind, placebo-controlled clinical trials of apixaban and rivaroxaban in adult ambulatory patients with cancer at risk for VTE, treated with chemotherapy (AVERT and CASSINI trials). The costs (€2,021) were taken from Spanish sources. The utilities of the model were obtained through the EQ-5D questionnaire. Deterministic (base case) and probabilistic (second-order Monte Carlo simulation) analyses were conducted., Results: In the probabilistic sensitivity analysis, apixaban generated a cost per patient of €1,082 ± 187, with a 95% confidence interval (CI) of €713-1,442, while no prophylaxis produced a cost per patient of €1,146 ± 218, with a 95% CI of €700-1,491, with a saving of €64 per patient and a gain of 0.008 QALYs. Likewise, rivaroxaban provided a cost per patient of €993 ± 133, with a 95% CI of €748-1,310, while no prophylaxis produced a cost per patient of €872 ± 152, with a 95% CI of €602-1,250, with an additional expense of €121 per patient and a gain of 0.008 QALYs., Conclusions: In thromboprophylaxis of cancer patients, the use of apixaban and rivaroxaban generated similar costs compared to non-prophylaxis, without the difference found being statistically significant, with a clinically insignificant QALY gain.

In the present work, the analysis of seven fullerenes (C and C fullerenes and five functionalised fullerenes) has been performed in river samples collected in the vicinities of Barcelona (Catalonia, NE of Spain). The results of 48 samples (25 river waters, 12 river sediments and 11 wastewater effluents) are presented. Extracts of river water, river sediments and wastewater effluents were analysed by liquid chromatography (LC), using a pyrenylpropyl group bonded silica based column, coupled to a high-resolution mass spectrometer (HRMS), using a dual ion source, atmospheric pressure photoionisation/atmospheric pressure chemical ionisation source (APPI/APCI). The novel methodology presents good chromatographic separation, excellent selectivity and instrumental limits of quantification (ILOQ) in the femtogram order. Method limits of quantification (MLOQ) ranged from 2.9 to 17 pg/l and from 3.2 to 31 pg/l in surface waters and wastewaters, respectively. In wastewater effluents, the sums of C and C ranged from 0.5 to 9.3 ng/l. In surface waters, C fullerene was the most ubiquitous compound, being detected in 100 % of the samples in concentrations from 31 pg/l to 4.5 ng/l, while C concentrations ranged from less than the method limits of detection (MLOD) to 1.5 ng/l. The presence of fullerenes in both the large particulate (diameter Ø > 450 nm) and the colloidal ( Ø < 450 nm) fractions of surface waters should be noticed. In sediments, the concentrations of fullerenes were between the MLOD and 34.4 pg/g. In addition, nanoparticle tracking analysis (NTA) was used for the characterisation of water samples in terms of nanoparticle number concentration and size distribution. As far as our knowledge is concerned, this is the first time that NTA has been used for the characterisation of complex river waters with an environmental focus. [ABSTRACT FROM AUTHOR]

March H., Perarnau J. and Saurí D. Exploring the links between immigration, ageing and domestic water consumption: the case of the Metropolitan Area of Barcelona, Regional Studies. Mediterranean urban environments are increasingly undergoing structural or temporary episodes of water stress, which may lead to decreases in the use of water. Taking the Metropolitan Area of Barcelona (MAB) as a case study, this paper argues that socio-demographic factors may also contribute to explain decreases in per-capita urban consumption values. Using a generalized linear mixed model with panel data information for the period 2003–2007 for twenty-three municipalities of the Metropolitan Area of Barcelona, including the ten districts of Barcelona, an attempt is made to examine the role of immigration and ageing in explaining these reduced average consumptions per capita. March H., Perarnau J. et Saurí D. Examiner les liens entre l'immigration, le vieillissement et la consommation ménagère de l'eau: étude de cas de la zone métropolitaine de Barcelone, Regional Studies. Dans les milieux urbains méditerranéens, l'eau est soumise de plus en plus à des efforts pour des raisons structurelles ou à des périodes passagères, ce qui peut amener à une baisse de la consommation de l'eau. Se servant de la zone métropolitaine de Barcelone comme étude de cas, cet article affirme que des facteurs socio-démographiques pourraient aussi expliquer les baisses de la consommation urbaine par tête. A partir d'un modèle mixte linéaire généralisé employant des données provenant d'une enquête à échantillon permanent pour la période allant de 2003 à 2007 sur vingt-trois municipalités de la zone métropolitaine de Barcelone, y compris les dix districts de Barcelone, on cherche à examiner le rôle de l'immigration et du vieillissement afin d'expliquer les baisses de la consommation moyenne par tête. Consomamtion ménagère de l'eau?Immigration?Vieillissement de la population?Zone métropolitaine de Barcelone Modèles mixtes linéaires généralisés March H., Perarnau J. und Saurí D. Untersuchung der Zusammenhänge zwischen Immigration, Alterung und privatem Wasserverbrauch: eine Fallstudie des Großraums Barcelona, Regional Studies. Die Stadtgebiete des Mittelmeerraums leiden immer häufiger unter strukturellen oder temporären Episoden von Wassermangel, die zu einem verringerten Wasserverbrauch führen können. Anhand einer Fallstudie des Großraums Barcelona wird in diesem Beitrag argumentiert, dass soziodemografische Faktoren ebenfalls zu einer Erklärung des Rückgangs des Pro-Kopf-Verbrauchs in der Stadt beitragen könnten. Mit Hilfe eines generalisierten linearen Mischmodells mit Paneldaten für die 23 Gemeinden des Großraums Barcelona (einschließlich der zehn Distrikte von Barcelona) aus dem Zeitraum von 2003 bis 2007 wird versucht, die Rolle der Immigration und Alterung bei der Erklärung des gesunkenen durchschnittlichen Wasserverbrauchs pro Einwohner zu untersuchen. Privater Wasserverbrauch?Immigration?Altern der Bevölkerung?Großraum Barcelona?Generalisierte lineare Mischmodelle March H., Perarnau J. y Saurí D. Explorando las conexiones entre inmigración, envejecimiento, y consumo doméstico de agua: el caso del Área Metropolitana de Barcelona, Regional Studies. Los ambientes urbanos mediterráneos están sufriendo periodos más recurrentes de estrés hídrico que pueden llevar a disminuciones en el uso de agua. Seleccionando el Área Metropolitana de Barcelona (AMB) como caso de estudio, el artículo argumenta que algunos factores socio-demográficos pueden explicar también la disminución en el consumo doméstico de agua por capita. En este sentido, mediante el uso de Modelos Lineales Generalizados Mixtos y datos de 23 municipios para el periodo 2003–2007, el artículo examina el rol que la inmigración y el envejecimiento pueden tener en estas reducciones de consumo. Consumo doméstico de agua?Inmigración?Envejecimiento de la población?Área Metropolitana de Barcelona (AMB) Modelos lineales generalizados mixtos [ABSTRACT FROM PUBLISHER]

Aim: Recent studies have compared the efficacy and safety of direct-acting oral anticoagulants (DOAC) and low-molecular-weight heparin (LMWH) for cancer-associated venous thromboembolism (VTE). However, there is no available cost-effectiveness analysis comparing DOAC and LMWH. The study aimed to conduct a cost-effectiveness analysis of DOAC (apixaban, edoxaban, and rivaroxaban) vs. LMWH for the treatment of cancer-associated VTE in Spain from the Spanish healthcare system perspective., Methods: We developed a Markov model with a 12-month time horizon. The states included pulmonary embolism, deep vein thrombosis, major and non-major bleeding, chronic thromboembolic pulmonary hypertension, post-thrombotic syndrome, and death. The use of medical resources and drug costs were obtained from the 2021 Spanish Ministry of Health database, and the main references for obtaining the outcomes were derived from Caravaggio, Hokusai VTE Cancer, ADAM VTE, and SELECT-D trials. We performed a deterministic and probabilistic sensitivity analysis to validate the robustness. The Incremental Cost-Effectiveness Ratio (ICER) scores cost per life-year (€/LY) gained and cost per quality-adjusted life-year (€/QALY) gained., Results: The 12-month cost of DOAC was 1,994€ (apixaban 1,944€, edoxaban 1,968€, rivaroxaban 2,122€) and 2,152€ for LMWH. The amount of QALY for DOAC was 0.54 (apixaban 0.55, rivaroxaban 0.53, and edoxaban 0.52) and 0.53 for LMWH. We observed similar results for LYs. ICER scores in terms both of €/LY and €/QALY show that DOAC is dominant over LMWH and apixaban showed the best profile., Limitations: Our research is based on an indirect comparison of a short-term clinical trial., Conclusion: Our results suggest that DOAC is cost-effective and cost-saving compared to LMWH in treating VTE.

Pressurized irrigation networks require large amounts of energy for their operation which are linked to significant greenhouse gas (GHG) emissions. In recent years, several management strategies have been developed to reduce energy consumption in the agricultural sector. One strategy is the reduction of the water supplied for irrigation but implies a reduction in crop yields and farmer's profits. In this work, a new methodology is developed for sustainable management of irrigation networks considering environmental and economic criteria. The multiobjective non-dominated Sorting Genetic Algorithm (NSGA II) has been selected to obtain the optimum irrigation pattern that would reduce GHG emissions and increase profits. This methodology has been applied to Bembézar Margen Derecha (BMD) irrigation district (Spain). Irrigation patterns that reduce GHG emissions or increase actual profits are obtained. The best irritation pattern reduces the current GHG emissions in 8.56% with increases the actual profits in 14.56%. Thus, these results confirm that simultaneous improvements in environmental and economic factors are possible., (Copyright © 2013 Elsevier B.V. All rights reserved.)