RESUMO
Introduction: This study set out to examine the use of telehealth resources to tackle the coronavirus disease 2019 (COVID-19) pandemic in Latin America within the scope of national telehealth projects (NTPs). Methods: A qualitative study developed using ethnomethodology for appropriate understanding of how telehealth actions were carried out in practice during the COVID-19 pandemic within the scope of NTPs, in the following countries: Argentina, Colombia, Costa Rica, Ecuador, El Salvador, Guatemala, Honduras, Mexico, Peru, and Uruguay. The study was carried out from October to 2020 to March 2021. The number of participations in the discussion groups, formed by coordinating teams of NTPs, totaled 90. Results were described in the worksheet completed according to the script. Each country reviewed its respective data, three times on average, in an effort to clarify actions developed. Results: Three groups of countries were identified: (1) Countries with a telehealth background that used these resources to tackle COVID-19 and thereby refined telehealth activities. Countries with greater experience in NTP design, such as Mexico, Colombia, Peru, and Argentina, were able to use a wide range of telehealth activities to tackle the pandemic, with offers of teleconsultation, teleguidance, telemonitoring to patients, and training of health professionals; (2) Countries with some telehealth activities to address COVID-19. Uruguay, Ecuador, El Salvador, and Costa Rica; and (3) Countries with no evidence of telehealth resource use during the pandemic. Honduras and Guatemala. Discussion: Most NTPs in Latin America have improved their telehealth activities, contributing to address the COVID-19 pandemic in Latin America.
Assuntos
COVID-19 , Telemedicina , Humanos , América Latina/epidemiologia , Pandemias , COVID-19/epidemiologia , MéxicoRESUMO
The simultaneous measurement of soil water content and water table levels is of great agronomic and hydrological interest. Not only does soil moisture represent the water available for plant growth but also water table levels can affect crop productivity. Furthermore, monitoring soil saturation and water table levels is essential for an early warning of extreme rainfall situations. However, the measurement of these parameters employing commercial instruments has certain disadvantages, with a high cost of purchase and maintenance. In addition, the handling of commercial devices makes it difficult to adapt them to the specific requirements of farmers or decision-makers. Open-source IoT hardware platforms are emerging as an attractive alternative to developing flexible and low-cost devices. This paper describes the design of a datalogger device based on open-source hardware platforms to register water table levels and soil moisture data for agronomic applications. The paper begins by describing energy-saving and wireless transmission techniques. Then, it summarizes the linear calibration of the phreatimeter sensor obtained with laboratory and field data. Finally, it shows how non-linear machine-learning techniques improve predictions over classical tools for the moisture sensor (SKU: SEN0193).
Assuntos
Água Subterrânea , Solo , Calibragem , Água/análiseRESUMO
INTRODUCCIÓN: En el marco de la pandemia por COVID-19 y frente a la necesidad de capacitar a los equipos de salud para minimizar el impacto sanitario, el Ministerio de Salud de la Nación implementó un proyecto basado en la utilización de tecnologías de la información y comunicación, que reunió en un entorno de coordinación asistencial a equipos de establecimientos de todo el país y de la Sociedad Argentina de Terapia Intensiva. El objetivo del estudio fue describir el proceso y los resultados de la implementación de las Tele-Revistas realizadas entre el 2 de abril y el 21 de mayo de 2020. MÉTODOS: Se realizaron encuentros virtuales en tiempo real bajo el formato de Tele-Revistas en unidades de terapia intensiva, en los cuales se presentaron casos de COVID-19 mediante asistencia de expertos. La participación se ponderó a través de dos registros y la valoración de los participantes, mediante encuestas. Los temas recurrentes se compilaron a partir de informes semanales. RESULTADOS: Se realizaron 81 Tele-Revistas con 897 participantes, y se presentaron y discutieron 67 casos de COVID-19. Se generaron espacios de formación y aprendizaje colaborativo, que facilitaron el acceso a asesoramiento experto e integraron a los profesionales. Los actores involucrados evaluaron el proceso positivamente. DISCUSIÓN: Este enfoque, basado en la actualización continua de especialistas, contribuye a una atención integral que mejora el abordaje de pacientes críticos, brinda apoyo y fomenta el desarrollo de los talentos humanos en salud.
Assuntos
Telemedicina , Infecções por Coronavirus , Unidades de Terapia IntensivaRESUMO
INTRODUCCIÓN: La Dirección Nacional de Talento Humano y Conocimiento (DNTHyC) del Ministerio de Salud de la Nación se abocó a la planificación y gestión de la fuerza de trabajo en salud en Argentina durante la pandemia de la enfermedad por el nuevo coronavirus (COVID-19). Se detectaron cuatro problemas: escasez de profesionales en áreas críticas, vulnerabilidad del personal de salud, distribución desigual del conocimiento y falta de evidencia científica sobre el virus. El objetivo del artículo es describir el abordaje de la política de talento humano en la emergencia. MÉTODOS: Las políticas para dar respuesta fueron el incremento de la fuerza de trabajo disponible para la atención, la elaboración de un plan de cuidado de los trabajadores de la salud, la capacitación de los profesionales a cargo del manejo de la pandemia y la difusión y democratización del conocimiento. RESULTADOS: La fuerza de trabajo se incrementó en 15 200 profesionales. Se elaboraron programas con más de veinte universidades nacionales y más de 5000 estudiantes, y se creó el Plan Nacional de Cuidado de Trabajadores y Trabajadoras de la Salud, que llegó a más de 70 hospitales y más de 15 000 trabajadores. Se realizaron capacitaciones en línea y supervisión de servicios de terapias intensivas de todo el país mediante Tele-Revista, que alcanzó a 1200 profesionales. DISCUSIÓN: El aislamiento social, preventivo y obligatorio permitió encarar el trabajo necesario para alcanzar una dotación de personas, desarrollos tecnológicos y programas específicos que configuran una situación gobernable de la emergencia. No obstante, el nuevo virus y la crisis sanitaria derivada obligaron a repensar las condiciones de la formación de profesionales en Argentina
Assuntos
Recursos Humanos , Betacoronavirus , Política de SaúdeRESUMO
Digital Health is one of the three pillars for the effective implementation of Universal Health Coverage in Argentina. The Ministry of Health published the National Digital Health Strategy 2018-2024 in order to establish the conceptual guidelines for the design and development of interoperable health information systems as a state policy. The World Health Organization "National eHealth Strategy Toolkit", "Global Strategy on Digital Health" and other international and local evidence and expert recommendations were taken into account. The path to better healthcare involves adopting systems at the point of care, allowing for the primary recording of information and enabling information exchange through real interoperability. In that way, people, technology and processes will synergize to enhance integrated health service networks. In this paper, we describe the plan and the first two years of implementation of the strategy.
Assuntos
Sistemas de Informação em Saúde , Telemedicina , Argentina , Atenção à Saúde , Organização Mundial da SaúdeRESUMO
The Ministry of Health (MoH) stated the National Digital Health Strategy 2018-2024 in order to establish the conceptual guidelines for the design and development of interoperable health information systems. It included the creation of a National Digital Health Network, and a Citizen Health Portal to inform and empower patients about their rights. For instance, the Digital Vaccination Card is already available and has equal legal validity as its paper version. The platform also works as a personal privacy manager, to configure the consent for Health Information Exchange through the network, or to check the access logs. This paper outlines the implementation experience of this powerful tool at a national level.
Assuntos
Privacidade , Argentina , Troca de Informação em Saúde , HumanosRESUMO
The Ministry of Health (MoH) set the National Digital Health Strategy 2018-2024 as a state policy. It included a National TeleHealth Plan to enhance access and quality of healthcare in a wide territory like Argentina, leveraging more than 20 years of national telemedicine experiences and coordinating it with the territorial integrated health service networks proposed by the Universal Health Coverage strategy. In collaboration with the Ministry of Modernisation, the MoH developed and implemented a new TeleHealth Web Platform to perform eReferrals and eConsultations nationwide. This poster describes the first 2 months of usage.
Assuntos
Telemedicina , Argentina , Atenção à Saúde , Consulta RemotaRESUMO
BACKGROUND: Alpha-1-antitrypsin is a protein involved in avoidance of different processes that are seen in diabetic retinopathy pathogenesis. These processes include apoptosis, extracellular matrix remodeling and damage of vessel walls and capillaries. Furthermore, because of its anti-inflammatory effects, alpha-1-antitrypsin has been proposed as a possible therapeutic approach for diabetic retinopathy. Our group tested alpha-1-antitrypsin in a type 1 diabetes mouse model and observed a reduction of inflammation and retinal neurodegeneration. Thus, shedding light on the mechanism of action of alpha-1-antitrypsin at molecular level may explain how it works in the diabetic retinopathy context and show its potential for use in other retinal diseases. METHODS: In this work, we evaluated alpha-1-antitrypsin in an ARPE-19 human cell line exposed to high glucose. We explored the expression of different mediators on signaling pathways related to pro-inflammatory cytokines production, glucose metabolism, epithelial-mesenchymal transition and other proteins involved in the normal function of retinal pigment epithelium by RT-qPCR and Western Blot. RESULTS: We obtained different expression patterns for evaluated mediators altered with high glucose exposure and corrected with the use of alpha-1-antitrypsin. CONCLUSIONS: The expression profile obtained in vitro for the evaluated proteins and mRNA allowed us to explain our previous results obtained on mouse models and to hypothesize how alpha-1-antitrypsin hinder diabetic retinopathy progression on a complex network between different signaling pathways. GENERAL SIGNIFICANCE: This network helps to understand the way alpha-1-antitrypsin works in diabetic retinopathy and its scope of action.
Assuntos
Retinopatia Diabética/metabolismo , alfa 1-Antitripsina/metabolismo , alfa 1-Antitripsina/fisiologia , Animais , Apoptose/efeitos dos fármacos , Linhagem Celular , Retinopatia Diabética/patologia , Modelos Animais de Doenças , Glucose/metabolismo , Humanos , Inflamação/metabolismo , Camundongos , NF-kappa B/metabolismo , Retina/metabolismo , Epitélio Pigmentado da Retina/metabolismo , Epitélio Pigmentado da Retina/fisiologia , Transdução de Sinais/efeitos dos fármacos , Fator de Necrose Tumoral alfa/metabolismoRESUMO
PURPOSE: The objective is to analyze the antiangiogenic mechanism of suramab, a pharmaceutical compound of bevacizumab and suramin, in a rabbit model of corneal angiogenesis. MATERIAL AND METHODS: Corneal neovascularization was induced in four groups of six New Zealand White rabbits by applying a filter paper disk soaked in 1 M Na (OH) on the central cornea. Group one was treated after injury with intravenous suramab at a dose equivalent to 3 mg/kg of bevacizumab and 10 mg/kg of suramin. Group two was treated with intravenous bevacizumab (5 mg/kg). Group three was treated with 10 mg/kg of suramin while the control group received no treatment. Digital photographs were taken at days 9, 15, 21, and 35. Neovessel formation was quantified giving a 0-4 score to each quadrant according to the centripetal growth of the longest vessel (neovessel index, NVI). Animals were sacrificed at day 35. Corneas were processed for histology, immunohistochemistry, and Western-blot using primary antibodies against P2X2, basic fibroblast growth factor (bFGF), LYVE-1, PECAM-1, and vascular endothelial growth factor-A (VEGF-A). RESULTS: Suramab significantly reduced neovessel growth (mean NVI: 4.2) compared to bevacizumab (8.4), suramin (7.22), and control animals (12.2) at 35 days post-injury (p < 0.01). A lower protein expression of P2X2, bFGF, LYVE-1, PECAM-1, and VEGF-A was found in the cornea of suramab animals than in the other groups of animals. CONCLUSIONS: Joint downregulation of bFGF, P2X2, bFGF, and LYVE-1 constitutes a mechanism that induces greater and longer inhibition of corneal angiogenesis. Results might be relevant to ophthalmic care. Ocular administration of suramab is currently being investigated.
Assuntos
Bevacizumab/farmacologia , Córnea/patologia , Neovascularização da Córnea/tratamento farmacológico , Regulação para Baixo/efeitos dos fármacos , Fator 2 de Crescimento de Fibroblastos/biossíntese , Receptores Purinérgicos P2X2/biossíntese , Suramina/farmacologia , Animais , Western Blotting , Córnea/metabolismo , Neovascularização da Córnea/metabolismo , Neovascularização da Córnea/patologia , Modelos Animais de Doenças , Combinação de Medicamentos , Imuno-Histoquímica , CoelhosRESUMO
Background: The impact of tele-education for movement disorders on medical students is unknown. The present study had three objectives. First, to create a tele-education program for medical students in regions with limited access to movement disorders curricula. Second, to analyze the feasibility, satisfaction, and improvement of medical knowledge. Third, to assess the main reasons of medical students for attending this course. Methods: In 2016, a program was piloted in a low-middle income (Cameroon) and a middle-high income (Argentina) country. Medical students were offered a free movement disorder tele-education program (four medical schools in Argentina, and 1 medical school in Cameroon). Six real-time videoconferences covering hyperkinetic and hypokinetic movement disorders were included. Evaluations included attendance, pre- and post-medical knowledge, and satisfaction questionnaires. Results: The study included 151 undergraduate medical students (79.4% from Argentina, 20.6% from Cameroon). Feasibility was acceptable with 100% and 85.7% of the videoconferences completed in Argentina and Cameroon, respectively. Attendance was higher in Argentina compared to Cameroon (75% vs. 33.1%). According to student reports, the topics and innovative educational environment were the main reasons for attendance. Both groups ranked satisfaction as moderate to high, and medical knowledge improved similarly in both countries. Discussion: Tele-education can improve movement disorders knowledge in medical schools in high-middle and low-middle income countries lacking access to other educational opportunities.