Indigenous Scientist: Digital & Health Science Transformation.

As an indigenous scientist, I have dedicated all my professional life to protecting people using informatics for public policy to the privacy of users, patients, clients, and citizens as a human right and obligation as part of the United Nations international development goals. I am reflecting on my earliest knowledge of the impact of data and information privacy on my journey as scientist. I was just a number out of many other numbers as a indigenous child. The aim of this paper is to share my own personal experience together with one of my students. Now working with data as a scientific task within the data modeling to measure poverty. As a datum with human value, I was a 1) Female child with young parents, 2) Low socioeconomic status & 3) Identified as an indigenous person within a minor language group. These three data descriptions described me as a person who needed protection of my human dignity and identity as a child, based on all the protocols of social services for providing help. In conclusion, as scientists, we need to remember when using client data in vulnerable contexts and protection of their privacy, due to the potential risk of active discrimination. Thanks to my extensive education in Australia, I became an outlying datum that deviated from the data modeling applied to me. Today, I work for Privacy digital standards to impact real life with respect to human dignity and obtain accurate scientific interpretations of human beings' realities.

Training on the Use of Technology to Collect Patient-Reported Outcome Data Electronically in Clinical Trials: Best Practice Recommendations from the ePRO Consortium.

Electronic capture of patient-reported outcome (PRO) data has many advantages over paper-based data collection. Regulatory agencies have consistently supported the use of electronic PRO (ePRO) data capture and recommended participant and site staff training on the correct use of electronic data capture systems. The objective of this paper is to outline best practice recommendations for training end users, including site staff and study participants, on the use of ePRO technology in clinical trials to enable consistent, accurate, and complete data collection. Site personnel should be trained on study-specific as well as technology-specific topics and be given instructions on whom to contact to obtain technical support. Optimal training takes place over time using multiple modalities, including hands-on, face-to-face training at an investigator meeting or directly in the clinical site; remote training via webinar or teleconference; interactive on-demand self-paced-training via e-learning modalities; and supplemented by proxy training performed by study clinical research associates. Like site personnel training, study participants should be provided with individual, hands-on training by site staff at the initiation of the trial and in conjunction with interactive electronic training modules that can be accessed on-demand throughout the duration of the trial. The recommendations put forth in this paper provide a structured framework for the training that site personnel and study participants need to optimize the advantages trials can gain from using ePRO data collection systems.

Biomateriales en tratamiento de dolor neuropático postexodoncia / Biomaterials in treatment of post-exodontia neuropathic pain

Los biomateriales son una herramienta usada frecuentemente en neurocirugía, traumatología y cirugía endoscópica, para reparar o reemplazar tejidos y sus funciones. Duragen es un injerto utilizado para la reparación de la duramadre en neurocirugía y beriplast es un sellador de fibrina usado para mejorar la hemostasia y sellado tisular. En el presente caso clínico se utilizaron estos biomateriales para tratar con éxito a una paciente con dolor neuropático refractario post exodoncia de diente 48.

Biomaterials are a usefull tool, used frecuentely in neurosurgery, traumatology and endoscopic surgery, for the repairment or replacement of tissues and there function. Duragen is a graft used to repair the dura mater in neurosurgery, beriplast is a fibrin sealant to treat bleeding and get tisular sealment. In the present clinical case, this material are used succesfuly to treat refractary post exodontia neuropathic pain.

Evaluación a largo plazo del impacto funcional y estructural de la arteria radial post acceso en intervencionismo coronario / Long term evaluation of functional and structural changes of the radial artery used as access for cardiac interventional procedures

Resumen: Antecedentes: El acceso radial es una alternativa aceptable y segura para procedimientos endovasculares. Sin embargo no existe una clara evaluación de la integridad de la arteria radial (AR) post procedimiento. Objetivo: Evaluar el impacto funcional y estructural a largo plazo de la punción y colocación del introductor vascular en arteria radial (AR) post intervencionismo coronario. Método: Se estudian 33 pacientes con cardiopatía coronaria a quienes se realizó coronadografía y/o angioplastía vía radial. A los 6-10 meses de seguimiento se analizó las características ecográficas funcionales y estructurales de la AR comparándola con la AR contralateral. Resultados: Con el seguimiento se observan 3 AR ocluidas (9 por ciento). No se encontró un aumento significativo del grosor de la pared a nivel distal (zona de punción), 0,36 +/- 0,22 vs 0,28 +/- 0,08mm; el diámetro fue similar a nivel distal 2,6 +/- 0,7mm vs 2,8 +/- 0,35mm (ns) y proximal 2,8 +/- 0,35 vs 2,5 +/- 0,7mm. No hay diferencia significativa en la velocidad peak sistólica (VPS), en la AR puncionada vs la control 54 +/- 16 vs 50 +/- 14 cm/seg ni en los índices de resistencia 0,83 +/- 0,1 vs 0,87 +/-0,1. Conclusiones: La utilización de la vía radial para intervencionismo coronario ocasiona en un bajo porcentaje la oclusión esta arteria. En las arterias que permanecen permeables no se encontró a largo plazo un impacto sobre las características estructurales ni funcionales.

Background: the radial artery is a common and safe access site for endovascular procedures. There has been no adequate evaluation of the radial artery integrity following the procedure. Aim: to evaluate the long term functional and structural status of the radial artery use for cardiac interventional procedures Methods: 33 patients with coronary artery disease had coronary angiography and/or PTCA using the radial artery approach. After 6-10 months the functional and structural status of the artery was evaluated by comparison to the contra lateral artery Results: Three (9 percent) arteries were occluded. No thickening of the arterial wall distal to the puncture site was observed. Diameters were 2.6 +/- 0.7 vs 2.8 +/- 0.35mm (punctured vs control) distally and 2.8 +/- 0.35 vs 2.5 +/- 0.7mm proximally. Respective peak systolic flow velocities were 54 +/- 16 vs 50 +/- 14 cm/sec (NS) and resistance indexes were 0.83+/-0.1 compared to 0.67+/-0.1 (NS) Conclusion: A low percent of radial arterial occlusion is observed following use of the radial artery following cardiovascular interventions. Patent arteries showed no structural or functional limitations at long term evaluation.

Complicaciones hemorrágicas del sistema nervioso central en pacientes hemofílicos / Hemorrhagic complications of the control nervous system in hemophilic patients

Se revisan las complicaciones hemorrágicas en el SNC sufridas por pacientes hemofílicos y estudiados en el Instituto de Neurocirugía Santiago, entre 1970-85. Destacan la gravedad de estos cuadros en contraste con la ausencia de antecedentes traumáticos o bien relacionados con traumatismos leves o medianos. La población más afectada es la de menores de 12 años. No es infrecuente la repetición de estos episodios en el mismo paciente. Se revisa el cuadro clínico de presentación y los métodos auxiliares de diagnóstico usados, destacando el importante papel que cabe en la actualidad a la TAC. Se revisan los tratamientos médicos y quirúrgicos efectuados, haciéndose hincapié en la necesidad de precocidad en la iniciación de los primeros. Finalmente, se insiste en la importancia que tiene en la prevención de complicaciones, una adecuada educación de los parientes y de los responsables de estos pacientes, así como la oportuna y adecuada clasificación de la hemofilia que padecen, para facilitar la iniciación precoz del tratamiento