RESUMEN

Las serotecas son espacios destinados para el resguardo de Muestras Biológicas (MB) de procesos diagnósticos y científicos. El Instituto de Investigaciones en Ciencias de la Salud (IICS) cuenta con ocho congeladores de Ultra Baja Temperatura (UBT) distribuidos en dos serotecas. El sistema de monitoreo diseñado se evaluó durante cuatro meses, mientras registraba y enviaba alertas de tres UBT instalados en una de las serotecas y de su temperatura ambiente. Se recabó información de los usuarios respecto al rango de las temperaturas de cada UBT, tipo de MB almacenadas y su criterio de conservación. Se emplearon controladores de temperatura con sensores PT 100 conectados a un convertidor RS485/Ethernet en cada congelador. El sistema monitoreó, registró y alertó vía correo electrónico a los usuarios y técnicos biomédicos sobre los incidentes por temperaturas fuera del rango y falla de comunicación. En total se registraron 25 incidentes, 17 referentes al tiempo de apertura de puerta, 5 por temperatura elevada del ambiente y 3 por problemas en la conexión de red. La aplicación de la telemática fue determinante para monitorear en tiempo real las temperaturas de los congeladores UBT y del ambiente para garantizar que la cadena de frío no se vea afectada. De esta forma se cuenta con una herramienta que notifica a los usuarios de serotecas y biobancos los incidentes eléctricos o eventos que afecten el rango de temperatura necesario para la preservación de los materiales biológicos, permitiéndoles realizar una intervención oportuna y así garantizar la correcta preservación de las MB.

The serum banks are spaces used for the protection of Biological Samples (BS) of diagnostic and scientific processes. The Instituto de Investigaciones en Ciencias de la Salud (IICS) has eight Ultra Low Temperature (ULT) freezers distributed in two serum banks. The designed monitoring system was evaluated for four months, while recording and sending alerts of three ULTs installed in one of the serum banks and their ambient temperature. Information was collected from users regarding the temperature range of each ULT, type of stored BS and their conservation criteria. Temperature controllers with PT 100 sensors connected to an RS485/Ethernet converter were used in each freezer. The system monitored, recorded and alerted users and biomedical technicians via email about incidents due to temperatures outside the range and communication failure. In total, 25 incidents were recorded, 17 related to door opening time, 5 due to high ambient temperature and 3 due to network connection problems. The application of telematics was decisive in monitoring the temperatures of the ULT freezers and the environment in real time to ensure that the cold chain was not affected. In this way, there is a tool that notifies users of serum banks and biobanks of electrical incidents or events that affect the temperature range necessary for the preservation of biological materials, allowing them to perform a timely intervention and thus guaranteeing the correct preservation of the BS.

RESUMEN

INTRODUCTION AND OBJECTIVES: Implementation of a one-step strategy for diagnosis of active Hepatitis C virus (HCV) infection would encourage the early diagnosis and reduce the time to access antiviral treatments. The aim of this study was to evaluate the impact of a HCV one-step diagnosis compared to the traditional two-step protocol in terms of the time required for patients to be seen by specialists and the time taken to start antiviral treatment. MATERIAL AND METHODS: A comparative study was carried out to assess two diagnostic algorithms (one-step and two-step) for active HCV infection. Serological markers were quantified using the same serum sample to determine both anti-HCV antibodies (HCV-Ab) and HCV core antigen (HCV-cAg) by Architect i2000 SR kit. In this period, a multidisciplinary procedure was started for telematics referral of viremic patients. RESULTS: One-step approach reduced the time required for patient HCV diagnosis, referral to a specialist, access to treatment, and eliminated the loss of patients to follow-up. Significant differences were observed between one-step and two-step diagnosis methods in the time required for patients to be seen by a specialist (18 days [Interquartile range (IQR) = 14-42] versus 107 days [IQR = 62-148]) and for the initiation of treatment (54 days [IQR = 43-75] versus 200 days [IQR = 116-388]), mainly for patients with advanced fibrosis (35 days [IQR = 116-388] versus 126 days [IQR = 152-366]). CONCLUSIONS: Use of HCV-cAg has proven to be a useful tool for screening patients with active hepatitis C. The development of a multidisciplinary protocol for the communication of results improved the efficiency of the care process.

Asunto(s)

RESUMEN

A través de innovaciones tecnológicas basadas enlas tecnologías de la información y comunicación(TIC) pueden desarrollarse sistemas de telediagnósticoventajosos para mejorar la atención de lasalud de poblaciones remotas que no tienen accesoa los médicos especialistas. Este estudio realizadopor la Unidad de Telemedicina del Ministeriode Salud Pública y Bienestar Social (MSPBS) encolaboración con el Dpto. de Ingeniería Biomédicae Imágenes del Instituto de Investigaciones enCiencias de la Salud de la Universidad Nacional deAsunción (IICS-UNA) y la Universidad del PaísVasco (UPV/EHU) sirvió para evaluar la utilidadde un sistema de telediagnóstico en la salud pú-blica. Fueron analizados los resultados obtenidospor el sistema de telediagnóstico de 54 hospitalesregionales, distritales, especializados y centros desalud del MSPBS. Fueron realizados 182.406 diagnósticosremotos de enero del 2014 a noviembrede 2016 a través del sistema. Del total, el 37,32% (68.085) correspondieron a estudios de tomografía,62,00 % (113.059) a electrocardiografía(ECG), 0,68 % (1243) a electroencefalografía(EEG) y 0,01 % (19) a ecografía. Se observó unadiferencia importante en el coste de diagnóstico remotoen relación al diagnóstico “cara a cara”, enel análisis se incorporaron los costos de implantacióny mantenimiento de la TIC para el diagnósticoremoto y los costos de transporte, alimentación yoportunidad para el diagnóstico “cara a cara”. Lareducción del coste a través del diagnóstico remoto supone un beneficio importante para cada ciudadanodel interior del país toda vez que el costepromedio de diagnóstico remoto para cada hospitalsea igual o inferior al coste total del diagnósticocara a cara...

Through based on information and communicationtechnologies (ICT), advantageous telediagnosticsystems can be developed to improve the healthcare of remote populations that do not have accessto specialist doctors. This study was carried outby the Telemedicine Unit of the Ministry of PublicHealth and Social Welfare (MSPBS – acronym inspanish) in collaboration with the Department of Biomedical Engineering and Medical Imaging ofthe Institute of Research in Health Sciences of theNational University of Asunción (IICS-UNA acronymin spanish) and the University of the BasqueCountry (UPV / EHU acronym in spanish) servedto evaluate the utility of a telediagnostic system inpublic health. The results obtained by the telediagnosticsystem of 54 regional, district, specializedhospitals and health centers of the MoH (MSPBS)were analyzed. A total of 18.406 remote diagnoseswere performed from January 2014 to November2016 through the system. Of the total, 37.32%(68,085) corresponded to tomography studies(CT), 62.00% (113.059) to electrocardiography(ECG), 0.68% (1243) to electroencephalography(EEG) and 0.01% (19) to ultrasound. A significantdifference was observed in the cost of remote diagnosisin relation to the “face-to-face” diagnosis,in the analysis the costs of implementation andmaintenance of the ICT for the remote diagnosisand transport, feeding and opportunity costs forthe diagnosis “face to face” diagnosis,in the analysis the costs of implementation andmaintenance of the ICT for the remote diagnosisand transport, feeding and opportunity costs forthe diagnosis “face to face” were incorporatedinto the analysis. Reducing costs through remotediagnosis is an important benefit for every citizenof the interior of the country, since the average costof remote diagnosis for each hospital is equal toor less than the total cost of face-to-face diagnosis...

Asunto(s)