A New Multidisciplinary Home Care Telemedicine System to Monitor Stable Chronic Human Immunodeficiency Virus-Infected Patients: A Randomized Study

BACKGROUND: Antiretroviral therapy has changed the natural history of human immunodeficiency virus (HIV) infection in developed countries, where it has become a chronic disease. This clinical scenario requires a new approach to simplify follow-up appointments and facilitate access to healthcare professionals. METHODOLOGY: We developed a new internet-based home care model covering the entire management of chronic HIV-infected patients. This was called Virtual Hospital. We report the results of a prospective randomised study performed over two years, comparing standard care received by HIV-infected patients with Virtual Hospital care. HIV-infected patients with access to a computer and broadband were randomised to be monitored either through Virtual Hospital (Arm I) or through standard care at the day hospital (Arm II). After one year of follow up, patients switched their care to the other arm. Virtual Hospital offered four main services: Virtual Consultations, Telepharmacy, Virtual Library and Virtual Community. A technical and clinical evaluation of Virtual Hospital was carried out. FINDINGS: Of the 83 randomised patients, 42 were monitored during the first year through Virtual Hospital (Arm I) and 41 through standard care (Arm II). Baseline characteristics of patients were similar in the two arms. The level of technical satisfaction with the virtual system was high: 85% of patients considered that Virtual Hospital improved their access to clinical data and they felt comfortable with the videoconference system. Neither clinical parameters [level of CD4+ T lymphocytes, proportion of patients with an undetectable level of viral load (p = 0.21) and compliance levels >90% (p = 0.58)] nor the evaluation of quality of life or psychological questionnaires changed significantly between the two types of care. CONCLUSIONS: Virtual Hospital is a feasible and safe tool for the multidisciplinary home care of chronic HIV patients. Telemedicine should be considered as an appropriate support service for the management of chronic HIV infection. TRIAL REGISTRATION: Clinical-Trials.gov: NCT01117675.

Ampliación del puente de Son Espases. Palma de Mallorca (I. Baleares)

El proyecto “Nuevo Puente de Son Espases” describe una obra completa en el sentido exigido en el artículo 125 del Reglamento General de la Ley de Contratos de las Administraciones Públicas. Este proyecto describe una solución viaria para reducir sensiblemente los problemas de saturación de tránsito en el nudo entre la carretera de Valldemossa-Universidad (Ma-1110) y el Camí dels Reis. La obra consiste en la construcción de un viaducto que permite la continuidad de la carretera de Valldemossa-Universidad (Ma-1110) sin interrupción en la rotonda del nudo. Esto permitirá habilitar un acceso muy consistente al nuevo hospital de Son Espases y disminuir el tráfico provocado por la aparición del segundo cinturón de la ciudad. El proyecto se ha redactado en función de criterios y normativa técnica vigente, y de las indicaciones del promotor, el Consell de Mallorca,a disposición del cual se pone por si considera conveniente continuar su tramitación.

El Hospital General de Atocha de Madrid

El Hospital General de Atocha de Madrid