Hospital Universitario Severo Ochoa

<h3>Background and Importance</h3> The goal of pharmaceutical care is to provide patients with the support they need to ensure they can follow their treatment plan in a correct and safe manner. <h3>Aim and Objectives</h3> To analyse structured data collected from outpatients pharmaceutical care consultations. <h3>Material and Methods</h3> Observational, descriptive, retrospective study conducted in a secondary care hospital. All records of outpatient pharmaceutical care consultations between 2021 and 2024 were included. The following variables were collected from the electronic medical record: reason for consultation, service, type of drug and training for self-administration. <h3>Results</h3> A total of 4345 records were obtained: 22% belonged to internal medicine, 15% to oncology, 14% to dermatology and 13% to rheumatology departments. The reason for consultation was initiation of a new drug treatment in 2801 cases (64%): 38% biological drugs (BIO), 22% oral antineoplastic drugs (ANEO), and 11% antiretroviral therapy (ART). The breakdown by specialty was: dermatology (19%), oncology (18%), internal medicine (13%), and rheumatology (11%). Follow-up consultations accounted for 9% of the total. There were 238 consultations for drug interactions: 48% in patients with ANEO and 20% with ART. Adherence to treatment resulted in 227 consultations: 69% in patients with ART followed by 13% in patients with BIO. In 74 cases, consultations were due to treatment tolerance issues: 23% of patients were taking antifibrotics, 14% ART, and 14% ANEO. The remaining reasons accounted for 15%. Consultations relating to BIO occurred in 1515 cases. In 1066 cases, patients received training on how to use the delivery device. Only 3% consulted again due to problems with device management. Of the 879 consultations from patients with ART, 23% were related to PrEP and 18% to adherence problems. Of the 810 consultations related to ANEO, 14% were due to drug interactions. The remaining 26% corresponded to other drugs. <h3>Conclusion and Relevance</h3> This study shows that, within our population, the greatest demand for pharmaceutical care comes from patients undergoing BIO, followed by ART and ANEO. The most common reasons for consultation were initiating a new drug treatment, followed by follow-up consultations, drug interactions and adherence counselling. Self-administration training was provided in 25% of consultations. <h3>Conflict of Interest</h3> No conflict of interest

Malaria diagnosis plays a key role in case management, control, and elimination strategies. miLab™ is a digital microscopy with a fully integrated, sample-to-result approach, providing automated microscopic analysis of Plasmodium parasites and providing parasitemia levels of samples. It uses a deep learning model, a subfield of artificial intelligence (AI) that can differentiate from red blood cells that are infected with the malaria parasite from noninfected cells in blood smears. The aim of this study is to assess the performance of miLab™ microscopy for malaria diagnosis, in comparison with conventional microscopy and nested-multiplex malaria polymerase chain reaction (NM-PCR), in a malaria reference laboratory in a nonendemic country. From 2021 to 2024, 400 samples were analyzed prospectively using automated miLab™ microscopy, with NM-PCR and conventional microscopy as reference methods. The comparison between the miLab™ device and thin blood smear microscopy showed substantial concordance (90.8%), with a kappa coefficient of 0.8 and sensitivity and specificity values of 92.1% and 89.4%, respectively. The comparison of parasite density showed a significant correlation (correlation coefficient of 0.77), although the parasite counts estimated by the miLab™ device were 11.6% lower than those estimated by conventional microscopy. The sensitivity and specificity values of the miLab™ platform when compared with those obtained by NM-PCR were 62.8% and 95.4%, respectively; with a concordance value of 68.9% (kappa coefficient 0.4). Of P. falciparum infections identified by NM-PCR, 63.4% were accurately identified, and this figure increased to 95.7% if excluding negative results. One P. vivax, three P. ovale, and one P. malariae infections identified by NM-PCR were correctly classified by the miLab™ platform only after expert review of initial "review needed" results. miLab™ automated microscopy was as sensitive as conventional microscopy but without the need for expert microscopists and with shorter time to results. It is a valuable toolkit for malaria diagnosis in nonendemic settings; however, improvements are required in terms of species identification and parasite quantification.

Anal cancer mortality has increased across high-income countries, yet subnational patterns remain poorly characterized. This study provides the first comprehensive, sex-stratified, spatiotemporal analysis of anal cancer (ICD-10 C21) mortality in Spain from 1999 to 2023. We conducted an ecological, descriptive, province-level analysis of mortality using data from the National Institute of Statistics. Sex-stratified Bayesian hierarchical models were applied to estimate smoothed relative risks (RRs) by province and year, incorporating spatial, temporal, and interaction effects. Model selection was guided by the Deviance Information Criterion and Widely Applicable Information Criterion. Posterior probabilities (PP) were used to identify high-risk provinces (PP > 0.95). Among 160 candidate models, optimal structures differed by sex: males showed intrinsic Conditional Autoregressive (iCAR) spatial prior with RW1 temporal prior and Type IV interaction; females showed iCAR with RW2 temporal prior and Type III interaction. Mortality rose in both sexes: male RR increased steadily to 1.39 in 2023; female RR followed a nonlinear trajectory with delayed surge to 1.30. Variance decomposition indicated male mortality was mainly temporal (80.2%), female mortality largely spatial (58.1%). Male hotspots clustered in southern/insular provinces (e.g., Las Palmas RR=1.22, Cádiz 1.18, Valencia 1.18); female hotspots were more dispersed (e.g., Las Palmas 1.34, Málaga 1.33, Barcelona 1.26). Anal cancer mortality in Spain is rising, revealing persistent sex-specific and geographic inequalities beyond national temporal trends. Precision prevention-via gender-neutral HPV vaccination, targeted screening, and prioritization of hotspot provinces-is urgently needed.