{"id":67536,"date":"2019-11-26T22:38:19","date_gmt":"2019-11-26T21:38:19","guid":{"rendered":"https:\/\/laindependent.cat\/salut-en-la-cruilla\/"},"modified":"2024-01-02T14:00:27","modified_gmt":"2024-01-02T13:00:27","slug":"salut-en-la-cruilla","status":"publish","type":"post","link":"https:\/\/laindependent.cat\/en\/salut-en-la-cruilla\/","title":{"rendered":"Salut a la cru\u00eflla"},"content":{"rendered":"

\u00a0<\/p>\n

<\/span><\/strong><\/p>\n

\u00a0<\/p>\n

Insuficients finances per a comprar inputs i equips, inestable disponibilitat de medicaments, endarreriment tecnol\u00f2gic i limitat acc\u00e9s a procediments m\u00e9s moderns i eficients.<\/span><\/strong><\/p>\n

<\/p>\n


Aquests s\u00f3n alguns\u00a0dels efectes que deixa el c\u00e8rcol econ\u00f2mic dels Estats Units<\/a> en els serveis de salut cubans.<\/span><\/p>\n

“Encara que els cirurgians estiguem preparats, perqu\u00e8 hem passat diversos entren<\/span>aments, a vegades tamb\u00e9 se’ns dificulta poder realitzar intervencions a causa d’aquestes limitacions”, assegura a SEMlac la doctora Yipsi Fern\u00e1ndez Santiesteban<\/strong>, cap del servei de Cirurgia de l’Hospital Germans Ameijeiras, en la capital cubana.<\/span><\/p>\n

L’especialista ho ha experimentat directament, perqu\u00e8 el 2018 va rebre entrenament a Espanya, espec\u00edficament per al tractament quir\u00fargic de c\u00e0ncer avan\u00e7at o carcinomatosis peritoneal, mitjan\u00e7ant una t\u00e8cnica que en el m\u00f3n es practica fa ja temps, per\u00f2 resulta nova per a Cuba.<\/span><\/p>\n

La literatura m\u00e8dica la descriu com una pr\u00e0ctica que permet destruir les c\u00e8l\u00b7lules cancer\u00edgenes microsc\u00f2piques que hagin quedat en l’abdomen despr\u00e9s de la realitzaci\u00f3 de la cirurgia i t\u00e8cnica espec\u00edfica per a tractar c\u00e0ncers d’afectaci\u00f3 abdominal com els d’ovari, g\u00e0stric, colorectal, primari del peritoneu, pseudomixoma peritoneal i ascites maligna.<\/span>
“Es tracta de procediments avan\u00e7ats de cirurgia citoreductora amb quimioter\u00e0pia intraperitoneal a altes temperatures, coneguda com Hipec, que permet una notable millora en el pron\u00f2stic i superviv\u00e8ncia dels pacients”, precisa.<\/span><\/p>\n

No obstant aix\u00f2, s\u00f3n poques les intervencions d’aquest tipus que s’han pogut realitzar en aquesta instituci\u00f3 m\u00e8dica, l’\u00fanica del pa\u00eds que les realitza.<\/span><\/p>\n

“Amb molt d’esfor\u00e7 es va comprar l’equip i ens preparem per a aix\u00f2, per\u00f2 els inputs per a sostenir aquesta activitat s\u00f3n molt cars. Ens hem vist limitats i nom\u00e9s hem aconseguit intervenir a tres pacients”, explica a SEMlac.<\/span><\/p>\n

La falta de suturadoras mec\u00e0niques, inputs i equips de protecci\u00f3 per a personal m\u00e8dic i pacients, que permetin una intervenci\u00f3 segura i efica\u00e7, han impedit el desenvolupament d’aquesta cirurgia complexa i l’atenci\u00f3 a persones que la necessiten. A aix\u00f2 s’hi uneix tamb\u00e9 limitacions amb medicaments m\u00e9s nous per a l’anest\u00e8sia.<\/span><\/p>\n

Altres cinc pacients amb c\u00e0ncer avan\u00e7at no van poder accedir per aix\u00f2 a aquesta mena d’operaci\u00f3. “Hem hagut d’anar enrere, al procediment antic de fer la citoreductora sense aquesta mena de complement”, comenta la cap del servei de Cirurgia.<\/span><\/p>\n

Enfrontar aquest tipus de situacions genera un altre problema que poques vegades es visibilitza, com l’estr\u00e8s i la pressi\u00f3 psicol\u00f2gica al fet que es veuen sotmesos especialistes de la salut.<\/span><\/p>\n

“Tot aix\u00f2 demanda esfor\u00e7os extra del personal m\u00e8dic i de les institucions de salut per a donar el millor servei. Sempre s’ofereixen les millors opcions als pacients”, assegura Fern\u00e1ndez Santiesteban.<\/span><\/p>\n

Tensions d’aquest tipus es viuen tamb\u00e9 entre pacients i especialistes d’Oncologia, per motius similars.<\/span><\/p>\n

“El bloqueig econ\u00f2mic i comercial dels Estats Units tamb\u00e9 impedeix l’estabilitat en la disponibilitat de medicaments per a malalties oncol\u00f2giques d’alta incid\u00e8ncia en la poblaci\u00f3 cubana”, refereix el doctor Noyde<\/strong> Batista<\/strong>, cap de serveis d’Oncologia tamb\u00e9 l’Hospital Germans Ameijeiras.<\/span><\/p>\n

Entre altres esmenta als inhibidors de Shake Point o la immunoter\u00e0pia en sentit general, amb grans aplicacions avui en pacients oncol\u00f2gics, i es refereix espec\u00edficament al Prembolizumab, de la farmac\u00e8utica The Mert.\u00a0<\/span>Aquest, en particular, s’empra en els tractaments del c\u00e0ncer de pulm\u00f3, amb alta mortalitat a Cuba; els limfomes i el c\u00e0ncer de bufeta.<\/span><\/p>\n

“No podem accedir al Prembolizumab perqu\u00e8 pertany a una casa farmac\u00e8utica estatunidenca i \u00e9s, a m\u00e9s, molt cost\u00f3s. Per la p\u00e8rdua que tenim di\u00e0riament al pa\u00eds, causada pel bloqueig, potser tampoc tenim diners per a comprar-lo”, explica el galeno.<\/span><\/p>\n

Entre abril de 2018 i mar\u00e7 de 2019, el perjudici al sector de la salut cub\u00e0 va ascendir a 104 milions 148.178 d\u00f2lars, xifra que supera en 6 milions 123.498 d\u00f2lars a la de l’any anterior, d’acord amb l’informe “Necessitat de posar fi al bloqueig econ\u00f2mic, comercial i financer impost pels Estats Units d’Am\u00e8rica contra Cuba”, presentat aquest any per Cuba en Nacions Unides.<\/span><\/p>\n

Aquest mateix informe resumeix una llista de contactes infructuosos fets amb diverses empreses estatunidenques per a la compra de f\u00e0rmacs nous en el tractament del c\u00e0ncer.<\/span><\/p>\n

Entre altres, s’esmenta la gesti\u00f3 sense resposta amb la farmac\u00e8utica Pfizer Inc. per a adquirir el Crizotinib, emprat en el c\u00e0ncer de pulm\u00f3; el Palbociclib, per a tractar el c\u00e0ncer de mama metast\u00e1sico hormonosensible, i el Sunitinib, \u00fanic medicament efica\u00e7 existent en el m\u00f3n per al tractament del c\u00e0ncer renal avan\u00e7at o amb met\u00e0stasi, del qual es diagnostiquen 20 casos anuals com a mitjana a l’Hospital “Germans Ameijeiras”.<\/span><\/p>\n

Un altre f\u00e0rmac d’alta demanda \u00e9s el Nivolumab, amb una \u00e0mplia gamma d’indicacions oncol\u00f2giques i entre els m\u00e9s nous en l’actualitat, per\u00f2 en tractar-se d’un medicament produ\u00eft per la Bristol-*Myers, tamb\u00e9 estatunidenca, no pot ser adquirit per cap entitat cubana.<\/span><\/p>\n

“No podem accedir tampoc tecnologies per al diagn\u00f2stic, sobretot de seq\u00fcenciaci\u00f3 massiva, per tractar-se d’equips de fabricants estatunidencs”, va agregar. “Realment es limita molt el desenvolupament de les especialitats i de l’atenci\u00f3 a pacients amb c\u00e0ncer”, va reiterar.<\/span><\/p>\n

“Malgrat tot, sempre busquem opcions i alternatives per a poder realitzar el millor tractament disponible i una bona atenci\u00f3. El que depengui del personal de la salut ser\u00e0 sempre en funci\u00f3 de brindar una atenci\u00f3 el m\u00e9s humana possible”, va concloure.<\/span><\/p>\n

\u00a0<\/p>\n

\u00a0\u00a0\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"

\u00a0 \u00a0 Insuficients finances per a comprar inputs i equips, inestable disponibilitat de medicaments, endarreriment tecnol\u00f2gic i limitat acc\u00e9s a procediments m\u00e9s moderns i eficients.<\/p>\n","protected":false},"author":50,"featured_media":36041,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[26461],"tags":[49289,47295],"class_list":["post-67536","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-terapies-alternatives","tag-sara-mas-3","tag-semlac-cuba"],"yoast_head":"\nSalut a la cru\u00eflla | La Independent<\/title>\n<meta name=\"description\" content=\"Insuficients finances per a comprar inputs i equips, inestable disponibilitat de medicaments, endarreriment tecnol\u00f2gic i limitat acc\u00e9s a procediments m\u00e9s moderns i eficients s\u00f3n alguns dels efectes que deixa el c\u00e8rcol econ\u00f2mic dels Estats Units en els 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