Asunto(s)
Atención a la Salud/organización & administración , Planificación en Salud/organización & administración , Evaluación de Resultado en la Atención de Salud , Pediatras/provisión & distribución , Recursos Humanos/organización & administración , Adolescente , Niño , Preescolar , Europa (Continente) , Femenino , Encuestas de Atención de la Salud , Necesidades y Demandas de Servicios de Salud , Humanos , Lactante , Recién Nacido , Masculino , Atención Primaria de Salud/organización & administraciónRESUMEN
AIM AND METHOD: Short narrative overview based on regulations by law, individual experiences from daily practice and selected references from current literature. RESULTS (SELECTIVE CORNER POINTS): Information security and data protection are mandatory and indispensable elements by law of general, professional and social actions, which can be also considered substantial parts of quality management. Therefore, (general/abdominal) surgeon underlies it too. INFORMATION SECURITY: It comprises the protection of information of each type and origin - it serves the warranty of the basic aims such as confidentiality, integrity, availability and authenticity of information, which supports both aims of a clinician, patient safety and treatment effectiveness. DATA PROTECTION: It is considered a basic right to protect personal data against abusive processing - however, data security is not the primary aim, but rather the right for informational self-determination. IT EMERGENCY MANAGEMENT: It implies that in case of an IT emergency (released by a persisting system failure or cyberattack), logistic operations are transferred into previously defined emergency procedures well organized and possibly with no interruption - digital logistic operations become suddenly complete analogous processes, with exclusive responsibility of the single institutes and departments. CONCLUSION: Both sides benefit equally from a regular bilateral exchange between the surgeon and the information security and data protection officer and are able to ensure the common goals of patient safety and treatment effectiveness through a proportionate integration of information security and data protection into everyday clinical practice.
Asunto(s)
Confidencialidad , Cirujanos , Humanos , Seguridad ComputacionalRESUMEN
Evaluation of renal dysfunction includes estimation of glomerular filtration rate (eGFR) as the initial step and subsequent laboratory testing. We hypothesized that combined analysis of serum creatinine, myo-inositol, dimethyl sulfone, and valine would allow both assessment of renal dysfunction and precise GFR estimation. Bio-banked sera were analyzed using nuclear magnetic resonance spectroscopy (NMR). The metabolites were combined into a metabolite constellation (GFRNMR) using n = 95 training samples and tested in n = 189 independent samples. Tracer-measured GFR (mGFR) served as a reference. GFRNMR was compared to eGFR based on serum creatinine (eGFRCrea and eGFREKFC), cystatin C (eGFRCys-C), and their combination (eGFRCrea-Cys-C) when available. The renal biomarkers provided insights into individual renal and metabolic dysfunction profiles in selected mGFR-matched patients with otherwise homogenous clinical etiology. GFRNMR correlated better with mGFR (Pearson correlation coefficient r = 0.84 vs. 0.79 and 0.80). Overall percentages of eGFR values within 30% of mGFR for GFRNMR matched or exceeded those for eGFRCrea and eGFREKFC (81% vs. 64% and 74%), eGFRCys-C (81% vs. 72%), and eGFRCrea-Cys-C (81% vs. 81%). GFRNMR was independent of patients' age and sex. The metabolite-based NMR approach combined metabolic characterization of renal dysfunction with precise GFR estimation in pediatric and adult patients in a single analytical step.