Tecnologia da informação em nefrologia / Information technology applied to nephrology

Este artigo apresenta uma revisão da literatura sobre as aplicações da tecnologia da informação em nefrologia. Caracterizamos as aplicações em bancos de dados, as iniciativas mais voltadas ao ensino e alguns exemplos de sistemas de apoio à decisão. Por fim, apresentamos as experiências de Telemedicina em nefrologia nitidamente voltadas ao suporte prestado à assistência dialítica à distância. Enfatizamos que a telesaúde pode ajudar na criação de um modelo assistencial descentralizado, voltado à prevenção, centrado na atenção básica como forma de combater a epidemia mundial de Doença Renal Crônica (DRC).

This article presents a literature review on the applications of information technology in nephrology. We characterize the applications in databases, most initiatives focused on education and some examples of decision support systems. Finally, we present the experiences of Telemedicine in Nephrology clearly geared to the support provided to assist dialysis distance. We emphasize that telehealth can help in creating a decentralized health care model, focused on prevention, focusing on primary care as a way to combat the worldwide epidemic of Chronic Kidney Disease (CKD).

History about the discovery of the renin-angiotensin system.

The history of the discovery of the renin-angiotensin system began in 1898 with the studies made by Tigerstedt and Bergman, who reported the pressor effect of renal extracts; they named the renal substance renin based on its origin. In 1934, Harry Goldblatt induced experimental hypertension in dogs by clamping a renal artery. About 1936, simultaneously in the Medical School of the University of Buenos Aires, Argentina, and in the Eli-Lilly Laboratories in Indianapolis, 2 independent groups of researchers, using the Goldblatt technique to produce experimental hypertension, demonstrated renal secretion of a pressor agent similar to renin. In the following years, both teams described the presence of a new compound in the renal vein blood of ischemic kidneys. This agent was extracted from blood with 70% acetone and had a short pressor effect. The final conclusion was that renin acted enzymatically on a plasma protein to produce the new substance. In Buenos Aires, it was called hypertensin; in the United States, angiotonin. In 1958, Eduardo Braun Menéndez from Argentina and Irving H. Page from the United States agreed to name it angiotensin.

Pre-Columbian medicine and the kidney.

Medicine in Mesoamerican cultures began in the year 1500 BC and ended with the conquest and destruction of Mexico-Tenochtitlan in 1521 by Spain. Mesoamerica started with the Olmec civilization followed by the Teoitihuacanes, Toltecs, and Mayas and perished with the Nahoa Empire. The medicine used by the Aztecs (ticiotl) is undoubtedly the sum of all Mesoamerican medicine. The medical history of the ticiotl was recovered in the years that followed the conquest from the works of Bernardino de Sahagún and Francisco Hernández and the Cruz-Badiano codex. All these works describe the use of plants and herbs in the treatment of diseases, including, edema, urinary retention, kidney stones, and podagra. The Aztec doctors (titicih) were also well acquainted with innumerable diseases and were excellent healers of wounds and fractures. The works of modern historians confirm the theory of the ticiotl medicine and its application by the titicih and define the differences between the hippocratic-galenic medicine and the ticiotl medicine. The latter used a complex and philosophically elaborated medical theory based on the polarity cold/warm, different from the four-humor theory. They demonstrate that every culture is capable to understand and 'invent' the meaning of disease and its cure, even when it is different from our modern medical views.