{"id":16655,"date":"2021-02-24T09:13:53","date_gmt":"2021-02-24T08:13:53","guid":{"rendered":"https:\/\/idibell.cat\/?p=16655"},"modified":"2021-02-24T09:14:24","modified_gmt":"2021-02-24T08:14:24","slug":"medicina-digital-pel-seguiment-de-transplantaments-de-medulla-ossia-un-estudi-pilot-en-temps-de-covid19","status":"publish","type":"post","link":"https:\/\/idibell.cat\/2021\/02\/medicina-digital-pel-seguiment-de-transplantaments-de-medulla-ossia-un-estudi-pilot-en-temps-de-covid19\/","title":{"rendered":"Medicina digital pel seguiment de transplantaments de medul\u00b7la \u00f2ssia: Un estudi pilot en temps de COVID19"},"content":{"rendered":"<p>En aquests dies de pand\u00e8mia, es recomana disminuir el nombre de visites m\u00e8diques degut a l\u2019exc\u00e9s de feina de metges i metgesses i, el que \u00e9s m\u00e9s important, perqu\u00e8 els hospitals esdevenen focus d\u2019infecci\u00f3. Per aquest motiu, les visites no essencials queden posposades i per contra es fomenten els <strong>sistemes de telemedicina<\/strong>. Els controls m\u00e8dics a dist\u00e0ncia s\u00f3n especialment recomanats per persones immunodeficients, com per exemple els i les pacients que han rebut un <strong>transplantament de medul\u00b7la \u00f2ssia<\/strong>.<\/p>\n<p>S\u2019ha detectat un increment en la mortalitat per la COVID19 en pacients amb transplantaments<sup>1<\/sup>, per aix\u00f2 amb m\u00e9s motiu cal posar en marxa sistemes de telemedicina efectius. En aquest sentit, un projecte pioner en l\u2019\u00e0mbit de la <strong>medicina digital<\/strong> i la seva implementaci\u00f3, publicat a la revista m\u00e8dica (<a href=\"https:\/\/jmirpublications.com\/\"><em>JMIR<\/em><\/a>), demostra que el control domiciliari a dist\u00e0ncia \u00e9s factible i apropiat.<\/p>\n<p>\u201cPacients que hagin rebut un transplantament de medul\u00b7la \u00f2ssia recentment tenen un risc superior de patir complicacions greus en les primeres setmanes despr\u00e9s de l\u2019alta hospital\u00e0ria, especialment en temps de la pand\u00e8mia per la COVID19\u201d explica el <strong>Dr. Alberto Mussetti<\/strong>, investigador principal de l\u2019estudi pilot.<\/p>\n<p>La investigaci\u00f3, portada a terme a l\u2019Institut d\u2019Investigaci\u00f3 Biom\u00e8dica de Bellvitge (IDIBELL) i l\u2019Institut Catal\u00e0 d\u2019Oncologia (ICO), va registrar 21 pacients que havien rebut un transplantament de medul\u00b7la \u00f2ssia. Es van examinar a dist\u00e0ncia des de casa durant les dues setmanes posteriors a rebre l\u2019alta (del 30 d\u2019abril al 15 de juliol) amb l\u2019objectiu de detectar r\u00e0pidament problemes cl\u00ednics i alhora evitar visites presencials innecess\u00e0ries que podrien suposar contagis intra-hospitalaris.<\/p>\n<p>Els i les pacients van rebre equips m\u00e8dics per mesurar di\u00e0riament i de forma aut\u00f2noma les seves constants vitals (freq\u00fc\u00e8ncies card\u00edaca y respirat\u00f2ria, saturaci\u00f3 d\u2019oxigen, pressi\u00f3 arterial i temperatura). Tanmateix, van haver d\u2019omplir uns formularis sobre s\u00edmptomes f\u00edsics i psicol\u00f2gics cada dia. Totes aquestes dades les van anar enviant al moment mitjan\u00e7ant els seus tel\u00e8fons m\u00f2bils a trav\u00e9s de l\u2019aplicaci\u00f3 \u201c<em>Saludencasa<\/em>\u201d, desenvolupada per la <a href=\"https:\/\/www.fundaciontrilema.org\/fundacion\/\">Fundaci\u00f3 Trilema<\/a>. La aplicaci\u00f3 tamb\u00e9 oferia un servei de missatgeria per tal que els i les pacients es comuniquessin amb el personal sanitari sempre que aix\u00ed ho desitgessin.<\/p>\n<p>Tan sols 12 pacients van completar l\u2019estudi, principalment a causa de problemes t\u00e8cnics. No obstant, \u201cpels pacients que van completar l\u2019estudi, la experi\u00e8ncia va ser considerada positiva; a m\u00e9s a m\u00e9s, el sistema va permetre detectar r\u00e0pidament complicacions agudes, tant f\u00edsiques com psicol\u00f2giques\u201d especifica la <strong>Dra. Anna Sureda-Balari<\/strong>, coautora de l\u2019estudi. De forma autom\u00e0tica, l\u2019hospital va rebre tres alarmes: una per malestar emocional i dues per s\u00edmptomes f\u00edsics, com infecci\u00f3 i deshidrataci\u00f3. Nom\u00e9s dues persones van haver de ser reingressades a l\u2019hospital.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Cap a la implantaci\u00f3 de la medicina digital<\/strong><\/p>\n<p>De l\u2019estudi se\u2019n despr\u00e8n que noves i millors tecnologies poden ajudar a qu\u00e8 el telecontrol domiciliari sigui una realitat. Barreres tecnol\u00f2giques com m\u00f2bils incompatibles o falta d\u2019experi\u00e8ncia en l\u2019\u00fas d\u2019aplicacions m\u00f2bils expliquen que \u00fanicament un 57% de possibles participants fossin capa\u00e7os de completar l\u2019estudi. Aquest problema va ser m\u00e9s habitual en persones grans que viuen soles. Per tal de solucionar aquest problema, els i les investigadores creuen que es podrien recollir les dades dels equips m\u00e8dics de forma autom\u00e0tica. Tamb\u00e9 mencionen la possibilitat d\u2019oferir una formaci\u00f3 m\u00e9s \u00e0mplia en l\u2019\u00fas de les tecnologies que s\u00f3n requerides.<\/p>\n<p>Efectivament, el seg\u00fcent estudi que ja s\u2019est\u00e0 preparant, inclour\u00e0 l\u2019\u00fas d\u2019equips m\u00e8dics amb recollida i transmissi\u00f3 de dades automatitzada; a m\u00e9s, s\u2019incorporaran videotrucades d\u2019alta resoluci\u00f3. Amb tot aix\u00f2 es pret\u00e9n fer un pas m\u00e9s en la instauraci\u00f3 de la telemedicina digital pel control de pacients.<\/p>\n<p>&nbsp;<\/p>\n<p><em>L\u2019Institut d&#8217;Investigaci\u00f3 Biom\u00e8dica de Bellvitge (IDIBELL) \u00e9s un centre de recerca en biomedicina creat l\u2019any 2004. Est\u00e0 participat per l&#8217;Hospital Universitari de Bellvitge i l\u2019Hospital de Viladecans de l&#8217;Institut Catal\u00e0 de la Salut, l&#8217;Institut Catal\u00e0 d&#8217;Oncologia, la Universitat de Barcelona i l\u2019Ajuntament de l\u2019Hospitalet de Llobregat.<\/em><\/p>\n<p><em>L\u2019IDIBELL \u00e9s membre del Campus d&#8217;Excel\u00b7l\u00e8ncia Internacional de la Universitat de Barcelona HUBc i forma part de la instituci\u00f3 CERCA de la Generalitat de Catalunya. L&#8217;any 2009 es va convertir en un dels cinc primers centres d\u2019investigaci\u00f3 espanyols acreditats com a institut d\u2019investigaci\u00f3 sanit\u00e0ria per l\u2019Instituto de Salud Carlos III. A m\u00e9s, forma part del programa \u201cHR Excellence in Research\u201d de la Uni\u00f3 Europea i \u00e9s membre de EATRIS i REGIC. Des de l\u2019any 2018, l\u2019IDIBELL \u00e9s un Centro Acreditado de la Fundaci\u00f3n Cient\u00edfica AECC (FCAECC).<\/em><\/p>\n<p>&nbsp;<\/p>\n<ol>\n<li><em><a href=\"https:\/\/www.thelancet.com\/journals\/lanhae\/article\/PIIS2352-3026(20)30429-4\/fulltext\">Clinical characteristics and outcomes of COVID-19 in haematopoietic stem-cell transplantation recipients: an observational cohort study.<\/a> Akshay Sharma et al. 2021.<\/em><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Un estudi dels centres IDIBELL i ICO demostra que els sistemes de telemedicina poden ser aplicats per detectar complicacions inicials, f\u00edsiques i psicol\u00f2giques, despr\u00e9s d\u2019un transplantament de medul\u00b7la \u00f2ssia.<\/p>\n","protected":false},"author":8,"featured_media":16662,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"default","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"default","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center 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