Importancia del uso de sistemas de información en la automatización de historiales clínicos, una revisión sistemática / Importance of Use of Information Systems in the Automation of Medical Records, a Systematic Review

Los sistemas de información en los servicios de salud han contribuido en los procesos de automatización de historiales clínicos, desempeñando un papel importante en la atención médica. El objetivo de esta revisión ha sido identificar la importancia de los sistemas de información para la automatización de historiales clínicos y las herramientas usadas para su implementación. Se revisaron artículos de revistas indexadas en base de datos bibligráficas como: IEEE Digital Library, ScienceDirect, Scielo, Google Scholar con la finalidad de tener una mejor clasificación de información que aportara al desarrollo del contenido estudiado. Se identificó que los sistemas de información mejoran la comunicación médico-paciente, aceleran procesos de atención médica, reducen costos y tiempo. Los sistemas de información son importantes para la automatización de historiales clínicas, garantizado mejoras en el proceso de atención al paciente en los establecimientos de salud(AU)

Information systems in health services have contributed to the automation of medical records, playing an important role in medical care. The objective of this review was to identify the importance of information systems for the automation of medical records and the tools used for their implementation. Articles from journals indexed in bibliographic databases such as: IEEE Digital Library, ScienceDirect, Scielo, Google Scholar have been reviewed in order to have a better classification of information that contributes to the improvement of our interest topic. It has been identified that these information systems increase doctor-patient communication, speed up medical care processes, reduce costs and time. Information systems are important for the automation of medical records, guaranteeing advances in the patient care process in health establishments(AU)

Transhepatic Percutaneous Sustained Dilation with Multiple Catheters for the Management of Hepaticojejunostomy Benign Stricture.

Background: Benign biliary strictures (BBS) befall in ∼7%-23% after hepaticojejunostomy and in 0.3%-0.6% after cholecystectomies. Their treatment options include surgical, endoscopic, and percutaneous management. The percutaneous approach is an excellent mini-invasive option including balloon dilation, biodegradable stents, and sustained dilation, a procedure born endoscopically. However, when the endoscopic approach fails or it is not available, it is possible to perform it percutaneously. Aim: To estimate the technical and clinical success of sustained percutaneous dilation with multiple catheters (SPDMC) in hepaticojejunostomy strictures and the percentage of complications and recurrence. Materials and Methods: We conducted a retrospective study, from a prospective database from January 2010 to March 2019, of 17 patients with postoperative BBS who failed to percutaneous pneumatic balloon dilation and underwent SPDMC with a mean follow-up of 2 years. Results: Seventeen patients between 28 and 71 years of age underwent SPMDC with technical success of 100%; the average number of catheters used was 5.59 (95% confidence interval [CI] 5.12-6.06) achieving a dilatation diameter of 16.15 mm (95% CI 14.71-17.60), and the therapeutic success rate was 71%, with recurrences of stricture and complications of 29% and 18%, respectively. The mean time with SPMDC was 7.06 months (95% CI 5.56-8.56). The median follow-up after dilation was 16 months, with an average of 27.75 months (95% CI 14.15-41.34). Conclusion: SPMDC is a feasible technique with a high technical success rate, therapeutic success rate, and low morbidity and mortality.

Prediction of Symptomatic Vasospasm in Patients with Aneurysmal Subarachnoid Hemorrhage Using Early Transcranial Doppler.

BACKGROUND: Symptomatic vasospasm (sVSP) is a common complication during the course of aneurysmal subarachnoid hemorrhage (aSAH). We aimed to evaluate the efficacy and accuracy of transcranial Doppler ultrasound (TCD), performed within the first 3 days of aSAH to predict the development of sVSP. METHODS: We performed a retrospective analysis of our institutional prospectively collected database of patients with aSAH. Patients with aSAH and World Federation of Neurosurgical Societies (WFNS) grades I-III were included in the analysis. A receiver operating characteristic (ROC) curve was generated to determine cut-off values for mean flow velocities (MFVs) in the middle cerebral artery (MCA) and anterior cerebral artery (ACA) bilaterally to predict sVSP. RESULTS: Fifty-one patients were included in the study. Mean age was 49.8 ± 10.2 years, and 84.3% (43 patients) were women. The accuracy of measured MFVs to predict sVSP was 0.79 [95% confidence interval (CI), 0.69-0.89] and 0.77 (95% CI, 0.64-0.91) for the MCA and the ACA, respectively. In the MCA, an MFV ≥ 74 cm/s was significantly associated with a six-fold increased risk of sVSP, achieving sensitivity greater than 70%. In the ACA, an MFV ≥ 64 cm/s was significantly associated with a nine-fold increased risk of sVSP. CONCLUSION: Early TCD evaluation of MFVs in the MCA and ACA is a useful tool to predict the development of sVSP in patients with acute aSAH.

Regional status assessment of stony corals in the US Virgin Islands.

States may protect coral reefs using biological water quality standards outlined by the Clean Water Act. This requires biological assessments with indicators sensitive to human disturbance and regional, probability-based survey designs. Stony coral condition was characterized on a regional scale for the first time in the nearshore waters of the US Virgin Islands (USVI). Coral composition, abundance, size, and health were assessed at 66 stations in the St. Croix region in fall 2007 and at 63 stations in the St. Thomas and St. John region in winter 2009. Indicators were chosen for their sensitivity to human disturbance. Both surveys were probability-based (random) designs with station locations preselected from areas covered by hardbottom and coral reef substrate. Taxa richness was as high as 21 species but more than half the area of both regions exhibited taxa richness of <10 species in the 25 m(2) transect area. Coral density was as high as 5 colonies m(-2) but more than half the area of both regions had <2 colonies m(-2). Both regions showed similar dominant species based on frequency of occurrence and relative abundance. Because of large colony sizes, Montastrea annularis provided more total surface area and live surface area than more abundant species. The surveys establish baseline regional conditions and provide a foundation for long-term regional monitoring envisioned by the USVI Department of Planning and Natural Resources. The probabilistic sampling design assures the data can be used in Clean Water Act reporting.

Desarrollo y optimizacion de una metodologia multiresiduo por metodo Simplex para el analisis de plaguicidas en miel de abejas / Development and optimization of a multiresidue method for pesticide analysis in honey bee using Simplex method / Desenvlovimiento e otimização de uma metodologia de resíduos múltiplos para o método Simplex para a análise de pesticidas em abelhas

La aplicacion de plaguicidas en cultivos cercanos a las zonas de produccion apicola puede afectar la supervivencia de las abejas y la calidad de los productos derivados de la colmena; por tanto, es de gran importancia realizar estudios de residualidad de estos agroquimicos en mieles y otros productos apicolas. Para esto es indispensable desarrollar metodologias que permitan detectar y cuantificar la presencia de estos contaminantes en los productos apicolas. Este trabajo muestra los resultados del desarrollo y optimizacion de una metodologia multiresiduo para el analisis de 30 plaguicidas en miel de abejas (organoclorados, organofosforados y piretroides). El metodo consistio en una extraccion liquido-liquido, seguida de un paso de limpieza en fase solida usando una columna cargada con silica gel/florisil. El analisis de los plaguicidas fue realizado por cromatografia de gases con detectores de nitrogeno fosforo (NPD) y microcaptura electronica (μ-ECD). La optimizacion de las variables experimentales presentes en los pasos de pre-tratamiento, extraccion y limpieza se realizo mediante el empleo del metodo Simplex modificado. Con este fin, se escogieron 14 variables las cuales se optimizaron en 21 experimentos. Los resultados mostraron que los porcentajes de recuperacion obtenidos para la mayoria de los plaguicidas se encuentran entre 78.8% y 114.5%, con coeficientes de variacion inferiores al 20%.

Pesticide application near to beekeeping areas can affect the survival of the bees and the quality of the products derived of the hive, therefore it is of great importance to assess the residual of these agrochemicals in honey and other bee products. So many methods have been developed for determining pesticide residues in honey samples. Thus, a multi-residue method to determine 30 pesticides in honey bee (organochlorine, organophosphorus, and pyrethroids) has been developed and optimized. The method is based on a liquid-liquid extraction followed by a clean-up step on a silica gel/florisil solidphase column. Pesticides were determined by gas chromatography with micro-electron capture (μ-ECD) and nitrogen phosphorus detection (NPD). The optimization process was performed using the modified Simplex method, to make this 14 variables were chosen and the optimization was conducted in 21 experiments. The results indicated that the method show recoveries between 78.8 and 114.5% and coefficients of variation below 20%.

A aplicação de pesticidas em áreas de cultivo próximos a apicultura pode afetar a sobrevivência das abelhas e a qualidade dos produtos da colmeia, por isso é muito importante estudar o efeito residual destes produtos químicos no mel e outros produtos apícolas. Para isso é essencial para o desenvolvimento de metodologias para a análise de contaminantes em produtos de abelha. Este documento mostra os resultados para o desenvolvimento e optimização de um método de resíduos múltiplos para a análise de 30 pesticidas, incluindo pesticidas organoclorados, organofosforados e piretróides mel. O método consistiu em uma extracção líquido-líquido, seguido por uma etapa de limpeza, usando uma coluna de fase sólida, cheia de gel de sílica/florisil. Análise de pesticidas foi realizada por cromatografia gasosa com detector de nitrogênio e fósforo (NPD) e microcaptura eletrônico (μ-ECD). A optimização das variáveis experimentais presentes nas etapas de pré-tratamento, de extracção e limpeza foi efectuada por utilização do método simplex modificado. Para o efeito, foram escolhidas 14 variáveis que foram optimizadas em 21 experiências. Os resultados mostraram que as recuperações obtidas para a maioria dos pesticidas estão entre 78,8% e 114,5%, com coeficientes de variação inferiores a 20%.

Meningitis por Kluyvera sp. en una paciente con una derivación lumbo-peritoneal: reporte de un caso / Meningitis Kluyvera sp. in a patient with a lumboperitoneal derivation: report of a case

Describimos el caso de una paciente portadora de una derivación lumbo-peritoneal, que desarrolló una meningitis bacteriana en la cual Kluyvera sp. se aisló del líquido cefalorraquídeo. En nuestro conocimiento este es el primer caso reportado de infección del SNC por este microorganismo. Esta bacteria era sensible a cefalosporinas de tercera generación y se logró la resolución con Cefotaxime. El Género Kluyvera comprende tres especies infrecuentemente aisladas de muestras clínicas. Se puede asociar a infecciones desde leves a severas y posiblemente se favorece en un huésped inmunocomprometido.