martes, 25 de enero de 2011

e-Health en Perú Promoviendo la Ciencia y Tecnología


                
IMIA-LAC Logo en Latinoamerica
                 Instituto de Medicina Tropical 
                  Alexander  von Humboldt

Fundación CTIC (Centro Tecnológico de la Información y Comunicación)
e-Health en Perú 

Promoviendo la Ciencia y  Tecnología
21 de enero del  2011
 Organiza:
Objetivos:
  1. - Actualizar al personal en el conocimiento
  2. - Fortalecer la red de sociedades de informática en Salud
  3. - Difundir el uso de Tecnologías de Información y Comunicación en América Latina y el 
       Caribe con el apoyo de la Asociación Internacional IMIA
Programa
HORA
ACTIVIDAD/CONTENIDO
RESPONSABLE
8:00 -8.30
Registro de asistencia
Organizadores
8:30 - 9:00
Inauguración
Eduardo Gotuzzo
DIRECTOR IMT AVH UPCH
9.00 - 9.30
Carola Lucay CossioPRESIDENTE  IMIA-LAC - CHILE
9.30 - 10.00
Augusto MelladoCONCYTEC
10.30 - 11.00
Claudia CordovaRED CLARA
11.00 - 11.30
CAFE  NET WORKING

11:30 -12:00
Salud móvil: Oportunidades y desafíos en salud materno-infantil
Walter CuriosoUPCH
 12:00 – 12:30
   Carolina Chang
ORAS - HIPOLITO UNANUE
12:30 – 13:00
Ana GrañaHOSPITAL CAYETANO HEREDIA
13:00 – 14:00
PREGUNTAS Y ALMUERZO
 14:00 – 14:30
Contribución de Perú al desarrollo de mHealth
Ernesto Gozzer
FASPA UPCH
14:30 – 15:00
Yolanda Rueda
ESPAÑA
15:00 – 15:30
Jesus PeinadoIMPACTA PERU
15:30 – 16:00
Erlinda Ramirez
HONDURAS
16:00 - 16: 30
Osman Arguello
VENEZUELA
16:30 - 17: 00
Lady MurrugarraIMT AVH UPCH
17:00
Creación de la Membresia en Perú                                                ¡  FOTOS  !                   
                                                                                                               

Clausura
Eduardo Gotuzzo
DIRECTOR IMT AVH UPCH

January 24, 2011: Call it a stunner. In an unexpected reversal of fortune, NASA's NanoSail-D spacecraft has unfurled a gleaming sheet of space-age fabric 650 km above Earth, becoming the first-ever solar sail to circle our planet.


January 24, 2011: Call it a stunner.
In an unexpected reversal of fortune, NASA's NanoSail-D spacecraft has unfurled a gleaming sheet of space-age fabric 650 km above Earth, becoming the first-ever solar sail to circle our planet.
"We're solar sailing!" says NanoSail-D principal investigator Dean Alhorn of the Marshall Space Flight Center in Huntsville, AL. "This is a momentous achievement."
Solar Sail Stunner (drag sail, 550px)
An artist's concept of a solar sail in Earth orbit. [larger image]
NanoSail-D spent the previous month and a half stuck inside its mothership, the Fast, Affordable, Science and Technology SATellite (FASTSAT). FASTSAT was launched in November 2010 with NanoSail-D and five other experiments onboard. High above Earth, a spring was supposed to push the breadbox-sized probe into an orbit of its own with room to unfurl a sail. But when the big moment arrived, NanoSail-D got stuck.
"We couldn't get out of FASTSAT," says Alhorn. "It was heart-wrenching—yet another failure in the long and troubled history of solar sails."
Team members began to give up hope as weeks went by and NanoSail-D remained stubbornly and inexplicably onboard. The mission seemed to be over before it even began.
And then came Jan. 17th. For reasons engineers still don't fully understand, NanoSail-D spontaneously ejected itself. When Alhorn walked into the control room and saw the telemetry on the screen, he says "I couldn't believe my eyes. Our spacecraft was flying free!"
Solar Sail Stunner (packet, 200px)
Click to listen to one of NanoSail-D's beacon packets recorded by radio amateur Henk Hamoen of the Netherlands. [audio]
The team quickly enlisted amateur radio enthusiasts Alan Sieg and Stan Sims at the Marshal Space Flight Center to try to pick up NanoSail-D's radio beacon.
"The timing could not have been better," says Sieg. "NanoSail-D was going to track right over Huntsville, and the chance to be the first ones to hear and decode the signal was irresistible."
Right before 5pm CST, they heard a faint signal. As the spacecraft soared overhead, the signal grew stronger and the operators were able to decode the first packet. NanoSail-D was alive and well.
"You could have scraped Dean off the ceiling. He was bouncing around like a new father," says Sieg.
The biggest moment, however, was still to come. NanoSail-D had to actually unfurl its sail. This happened on Jan. 20th at 9 pm CST.
Activated by an onboard timer, a wire burner cut the 50lb fishing line holding the spacecraft's panels closed; a second wire burner released the booms. Within seconds they unrolled, spreading a thin polymer sheet of reflective material into a 10 m2 sail.
Only one spacecraft has done anything like this before: Japan's IKAROS probe deployed a solar sail in interplanetary space and used it to fly by Venus in 2010. IKAROS is using the pressure of sunlight as its primary means of propulsion—a landmark achievement, which has encouraged JAXA to plan a follow-up solar sail mission to Jupiter later this decade.
NanoSail-D will remain closer to home. "Our mission is to circle Earth and investigate the possibility of using solar sails as a tool to de-orbit old satellites and space junk," explains Alhorn. "As the sail orbits our planet, it skims the top of our atmosphere and experiences aerodynamic drag. Eventually, this brings it down."
Indeed, mission planners expect NanoSail-D to return to Earth, meteor-style, in 70 to 120 days.
Solar Sail Stunner (lab, 550px)
The NanoSail-D team gathered around their sail after a successful laboratory deployment test: movie.
If this works, NanoSail-D could pave the way for a future clean-up of low-Earth orbit. Drag sails might become standard issue on future satellites. When a satellite's mission ends, it would deploy the sail and return to Earth via aerodynamic drag, harmlessly disintegrating in the atmosphere before it reaches the ground. Experts agree that something like this is required to prevent an exponential buildup of space junk around Earth.
Alhorn and colleagues will be monitoring NanoSail-D in the months ahead to see how its orbit decays. They'd also like to measure the pressure of sunlight on the sail, although atmospheric drag could overwhelm that effect.
No matter what happens next, NanoSail-D has already made history: It has demonstrated an elegant and inexpensive method for deploying sails and become the first sail to orbit Earth. Eventually, the team will diagnose the sail’s reluctance to leave FASTSAT—"and then we'll be batting a thousand," says Alhorn.
A follow-up story on Science@NASA will explain how sky watchers can track and photograph NanoSail-D before it returns to Earth. Stay tuned for "Solar Sail Flares."

Author: Dr. Tony Phillips | Credit: Science@NASA

Riesgo de hipoxemia postoperatoria en cirugía ortopédica ambulatoria en pacientes con apnea obstructiva del sueño: estudio observacional retrospectivo



Riesgo de hipoxemia postoperatoria en cirugía ortopédica ambulatoria en pacientes con apnea obstructiva del sueño: estudio observacional retrospectivo
Risk of postoperative hypoxemia in ambulatory orthopedic surgery patients with diagnosis of obstructive sleep apnea: a retrospective observational study.
Liu SS, Chisholm MF, John RS, Ngeow J, Ma Y, Memtsoudis SG.
Department of *Anesthesiology, Hospital for Special Surgery, Weill College of Medicine of Cornell University, 535 East 70th Street, New York, NY 10021, USA. liusp@hss.edu.
Patient Saf Surg. 2010 Jun 21;4(1):9. 

Abstract
BACKGROUND: It is unclear when it is safe to discharge patients with a diagnosis of Obstructive Sleep Apnea (OSA) after ambulatory surgical procedures due to concern for postoperative respiratory compromise and hypoxemia. Our OSA patients undergoing ambulatory-type orthopedic procedures are monitored overnight in the PACU, thus we reviewed patient records to determine incidence of complications. METHODS: Two hundred and six charts of patients with preoperative diagnosis of OSA based on ICD-9 codes were reviewed for outcomes including episodes of hypoxemia. Univariate analysis followed by logistic regression and propensity analysis was performed to determine independent risk factors for hypoxemia and association with adverse outcomes. RESULTS: The majority of patients had regional anesthesia (95%). Thirty four percent of patients had hypoxemia in the PACU. Initial risk factors for hypoxemia identified by univariate analysis were BMI >/= 35, increased age, history of COPD, upper extremity procedure, and use of peripheral nerve block. Independent risk factors identified by logistic regression were history of COPD (OR 3.64 with 95% CI 1.03-12.88) and upper extremity procedure (2.53, 1.36-4.68). After adjustment with propensity scores, adverse events were rare, and unplanned hospital admission after PACU stay was not increased with hypoxemia (11% vs 16%). CONCLUSIONS: Episodes of postoperative hypoxemia in OSA patients undergoing ambulatory surgery with regional anesthesia are not associated with increased adverse outcomes or unplanned hospital admission.

Atentamente
Anestesiología y Medicina del Dolor

La influencia de los niveles de hierro y los polimorfismos genéticos en el gen HFE en el riesgo de complicaciones postoperatorias después de la cirugía bariátrica: un estudio de cohorte prospectivo en 1.064 pacientes


La influencia de los niveles de hierro y los polimorfismos genéticos en el gen HFE en el riesgo de complicaciones postoperatorias después de la cirugía bariátrica: un estudio de cohorte prospectivo en 1.064 pacientes
The influence of iron status and genetic polymorphisms in the HFE gene on the risk for postoperative complications after bariatric surgery: a prospective cohort study in 1,064 patients
Glenn S Gerhard, Ravi Chokshi, Christopher D Still, Peter Benotti, G C Wood, Mollie Freedman-Weiss, Cody Rider and Anthony T Petrick.
Patient Safety in Surgery 2011, 5:1doi:10.1186/1754-9493-5-1


Abstract (provisional)
Background
Gastric bypass surgery is a highly effective therapy for long-term weight loss in severely obese patients, but carries significant perioperative risks including infection, wound dehiscence, and leaks from staple breakdown. Iron status can affect immune function and wound healing, thus may influence peri-operative complications. Common mutations in the HFE gene,the gene responsible for the iron overload disorder hereditary hemochromatosis, may impact iron status. Methods. We analyzed 1064 extremely obese Caucasian individuals who underwent open and laparoscopic Roux-en-Y gastric bypass surgery at the Geisinger Clinic. Serum iron, ferritin, transferrin, and iron binding capacity were measured pre-operatively. All patients had intra-operative liver biopsies and were genotyped for the C282Y and H63D mutations in the HFE gene. Associations between surgical complications and serum iron measures, HFE gene status, and liver iron histology were determined. Results. We found that increased serum iron and transferrin saturation were present in patients with any post-operative complication, and that increased serum ferritin was also increased in patients with major complications. Increased serum transferrin saturation was also associated with wound complications in open RYGB, and transferrin saturation and ferritin with prolonged lengths of stay. The presence of 2 or more HFE mutations was associated with overall complications as well as wound complications in open RYGB. No differences were found in complication rates between those with stainable liver iron and those without. Conclusion. Serum iron status and HFE genotype may be associated with complications following RYGB surgery in the extremely obese
  
 Paradoja de la obesidad y recuperación funcional en sobrevivientes a un primer infarto cerebral: estudio PREMIER
E. Chiquete, C. Cantú-Brito, J. Villarreal-Careaga, L.M. Murillo-Bonilla, R. Rangel-Guerra, C. León-Jiménez, A. Ochoa-Guzmán, A. Ramos-Moreno, A. Arauz, F. Barinagarrementería, A. Panduro, J.L. Ruiz-Sandoval
REV NEUROL 2010;51:705-713 

Introducción. Se denomina 'paradoja de la obesidad' al descenso del riesgo de muerte por enfermedad cardiovascular, con un índice de masa corporal (IMC) alto, aun cuando éste es un factor de riesgo para vasculopatía. Nuestro objetivo fue analizar la influencia de la obesidad en la recuperación funcional que sigue a un ictus isquémico. Pacientes y métodos. Analizamos 510 pacientes con un primer infarto cerebral, sin historia de ictus y sin recurrencia o muerte en 12 meses de seguimiento. A 501 sujetos sanos se les evaluó mediante bioimpedancia tetrapolar, para comparar el índice cintura/talla (ICT), perímetro abdominal e IMC en la discriminación de adiposidad, para aplicarlos a pacientes con ictus. Resultados. En individuos sanos, el ICT se desempeñó notablemente mejor que el IMC o el perímetro abdominal para identificar adiposidad corporal. En un modelo de riesgos proporcionales de Cox ajustado por múltiples covariables, la edad (riesgo relativo, RR = 1,11; intervalo de confianza del 95%, IC 95% = 1,08-1,14), puntuación de la National Institutes of Health Stroke Scale (RR = 1,03; IC 95% = 1,01-1,05) e ICT > 70 (RR = 2,44; IC 95% = 1,33-4,48) se asociaron a mayor riesgo de alcanzar una puntuación mayor o igual a 3 en la escala de Rankin modificada a los 12 meses, mientras que un IMC > 35 (RR = 0,33; IC 95% = 0,11-0,98) fue protector. Conclusión. El exceso de adiposidad, según el ICT, aumenta la probabilidad de discapacidad grave después del ictus. Dado que el IMC refleja también masa magra, es arriesgado concluir que existe un efecto protector de la obesidad en la recuperación del ictus, pero es posible que cierta masa corporal sea necesaria para prevenir una discapacidad grave 

Atentamente
Anestesiología y Medicina del Dolor