RESUMO
Often described as a tool to build trust among stakeholders with divergent interests, blockchain technology has been of interest to many sectors since it was first used in 2008. Initially designed to record financial transactions between individuals, its applications have largely evolved with technological advances and the growing interest of international companies. In the healthcare sector, blockchain is interesting for many of its features: its immutability which makes it an excellent support for authenticating sensitive data such as clinical trials consents, the possibility of publishing smart contracts that automate and facilitate many processes or the constitution of a network that agrees on the state of the information. Much acclaimed, blockchain technology is still to be tested in real-life conditions and adapted to a particularly complex regulatory and economic context in the healthcare sector.
Assuntos
Registros Eletrônicos de Saúde , Setor de Assistência à Saúde , Invenções , Tecnologia Biomédica/métodos , Tecnologia Biomédica/organização & administração , Tecnologia Biomédica/tendências , Confidencialidade/tendências , Sistemas de Gerenciamento de Base de Dados/organização & administração , Sistemas de Gerenciamento de Base de Dados/normas , Sistemas de Gerenciamento de Base de Dados/tendências , Atenção à Saúde , Registros Eletrônicos de Saúde/organização & administração , Registros Eletrônicos de Saúde/normas , Registros Eletrônicos de Saúde/tendências , Setor de Assistência à Saúde/organização & administração , Setor de Assistência à Saúde/normas , Setor de Assistência à Saúde/tendências , Humanos , Inovação OrganizacionalRESUMO
Chronic myeloproliferative disorders (CMD) and Myelodisplastic Syndromes (MDS) represents a group of clonal pluripotent stem-cell pathologies. During their natural history, the clinical picture reveals both thrombosis and hemorrhage. The thrombosis could affect the microvessels, and also the large vessels, including even less usual territories (suprahepatic veins, porta vein, pulmonary vein). There are many factors contributing to thrombosis in myeloproliferative chronic disorders--the associated comorbidities, the numeric alterations of blood elements and also the disorders of the platelet's function. Thus, there were described quantitative and qualitative anomalies of platelet's receptors: GP Ib, GP IIb/IIIa, GP IV, GP VI, thrombopoietin receptor of the platelet cMPL, the increase of platelet activation; the increase of P selectin and thrombospondin and the increase on GP IIb/IIIa expression--they were all correlated with thrombosis. An important role has been attributed to JAK2 mutation, which affects the platelet receptor for thrombopoietin cMPL. Regarding the hemorrhage in chronic myeloproliferative syndrome, it is favored by many disorders in platelet's function, such as: the decrease of von Willebrand factor's receptor of the platelet, which leads to acquired Bernard Soulier syndrome; quantitative and qualitative disorders of dense granules of the platelet, decrease of the secretion and platelet aggregation after epinephrine, ADP and collagen stimulation. It was also described the acquired von Willebrand syndrome, most frequently type 2.