Relación entre el tiempo de evolución de diabetes y las complicaciones posquirúrgicas de las apendicectomías. Hospital General Luis Vernaza, Enero 2010 - Diciembre 2011.

La apendicitis aguda es la patología más frecuente de tratamiento quirúrgico en la sala de urgencias de nuestra población y la diabetes es una enfermedad que cada día va en aumento por diferentes factores ambientales y mala práctica de hábitos. Estas dos patologías coinciden frecuentemente en el servicio de urgencias. No existen estudios que determinen si existe mayor probabilidad de apendicitis complicada cuando estamos frente a un paciente diabético con muchos años de evolución. Objetivo: Determinar si existe relación entre el tiempo de evolución de la diabetes mellitus con las complicaciones de la apendicectomía practicadas por apendicitis aguda. Metodología: Se elaborará un estudio descriptivo retrospectivo no experimental de pacientes diabéticos intervenidos quirúrgicamente por apendicitis aguda en el Hospital General Luis Vernaza entre enero 2010-diciembre 2011. Se investigó mediante el análisis del Chi cuadrado si existe alguna relación estadísticamente significativa entre el tiempo de evolución de la diabetes y las apendicitis complicadas. Resultados: Se obtuvo una muestra de 85 pacientes con el antecedente de diabetes que fueron sometidos a una apendicectomía. De estos hubo 65 pacientes a los cuales se les complicó su cuadro apendicular y 20 tuvieron una evolución totalmente favorable. La edad en el grupo de pacientes con apendicitis complicada con mayor número de casos fue entre 50-60 años (56.2%) y el sexo masculino obtuvo también un mayor porcentaje de presentación (75.36%). El tipo de complicación más frecuente fue la transoperatoria (52.31 %) de las fueron infecciones y dehiscencia de sutura. El CHI CUADRADO mostró una p< 0.05 entre el tiempo de evolución de la diabetes y la apendicitis complicada

Success stories in genomic medicine from resource-limited countries

In recent years, the translation of genomic discoveries into mainstream medical practice and public health has gained momentum, facilitated by the advent of new technologies. However, there are often major discrepancies in the pace of implementation of genomic medicine between developed and developing/resource-limited countries. The main reason does not only lie in the limitation of resources but also in the slow pace of adoption of the new findings and the poor understanding of the potential that this new discipline offers to rationalize medical diagnosis and treatment. Here, we present and critically discuss examples from the successful implementation of genomic medicine in resource-limited countries, focusing on pharmacogenomics, genome informatics, and public health genomics, emphasizing in the latter case genomic education, stakeholder analysis, and economics in pharmacogenomics. These examples can be considered as model cases and be readily replicated for the wide implementation of pharmacogenomics and genomic medicine in other resource-limited environments. © 2015 Mitropoulos et al

Success stories in genomic medicine from resource-limited countries

In recent years, the translation of genomic discoveries into mainstream medical practice and public health has gained momentum, facilitated by the advent of new technologies. However, there are often major discrepancies in the pace of implementation of genomic medicine between developed and developing/resource-limited countries. The main reason does not only lie in the limitation of resources but also in the slow pace of adoption of the new findings and the poor understanding of the potential that this new discipline offers to rationalize medical diagnosis and treatment. Here, we present and critically discuss examples from the successful implementation of genomic medicine in resource-limited countries, focusing on pharmacogenomics, genome informatics, and public health genomics, emphasizing in the latter case genomic education, stakeholder analysis, and economics in pharmacogenomics. These examples can be considered as model cases and be readily replicated for the wide implementation of pharmacogenomics and genomic medicine in other resource-limited environments

An appeal to the global health community for a tripartite innovation: an ‘‘Essential Diagnostics List,’’ ‘‘Health in All Policies,’’ and ‘‘See-Through 21st Century Science and Ethics"

Diagnostics spanning a wide range of new biotechnologies, including proteomics, metabolomics, and nanotechnology, are emerging as companion tests to innovative medicines. In this Opinion, we present the rationale for promulgating an ‘‘Essential Diagnostics List.’’ Additionally, we explain the ways in which adopting a vision for ‘‘Health in All Policies’’ could link essential diagnostics with robust and timely societal outcomes such as sustainable development, human rights, gender parity, and alleviation of poverty. We do so in three ways. First, we propose the need for a new, ‘‘see through’’ taxonomy for knowledge-based innovation as we transition from the material industries (e.g., textiles, plastic, cement, glass) dominant in the 20th century to the anticipated knowledge industry of the 21st century. If knowledge is the currency of the present century, then it is sensible to adopt an approach that thoroughly examines scientific knowledge, starting with the production aims, methods, quality, distribution, access, and the ends it purports to serve. Second, we explain that this knowledge trajectory focus on innovation is crucial and applicable across all sectors, including public, private, or public–private partnerships, as it underscores the fact that scientific knowledge is a co-product of technology, human values, and social systems. By making the value systems embedded in scientific design and knowledge co-production transparent, we all stand to benefit from sustainable and transparent science. Third, we appeal to the global health community to consider the necessary qualities of good governance for 21st century organizations that will embark on developing essential diagnostics. These have importance not only for science and knowledge based innovation, but also for the ways in which we can build open, healthy, and peaceful civil societies today and for future generations

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure &lt; 100 mmHg (n = 1127), estimated glomerular filtration rate &lt; 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

A Code of Ethics for Ethicists: What Would Pierre Bourdieu Say? Do Not Misuse Social Capital in the Age of Consortia Ethics

[No Abstract Available]Scientific and Technological Research Council of TurkeyTurkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK)This analysis represents the independent views of the authors and does not necessarily reflect the views or position of their affiliated institutions. Vural Ozdemir is the recipient of a senior interdisciplinary career support from the Scientific and Technological Research Council of Turkey

Democratizar el acceso y uso de la información como mecanismo de transparencia para los procesos de planificación territorial

La información territorial es un recurso clave para la planificación, sin embargo, esta no siempre está disponible y actualizada. En Ecuador, es frecuente que los Gobiernos Autónomos Descentralizados, las instituciones y la ciudadanía en general no puedan acceder a información oportuna y homogénea, dificultando así los procesos de planificación. En este trabajo se expone por qué la gestión de la información territorial necesaria y cómo la tecnología ayuda en este objetivo. Como una buena práctica se ha descrito el trabajo que ha desarrollado el Laboratorio Virtual de Ciudad y Territorio(LaVCiTe).Cuenc

Success stories in genomic medicine from resource-limited countries

In recent years, the translation of genomic discoveries into mainstream medical practice and public health has gained momentum, facilitated by the advent of new technologies. However, there are often major discrepancies in the pace of implementation of genomic medicine between developed and developing/resource-limited countries. The main reason does not only lie in the limitation of resources but also in the slow pace of adoption of the new findings and the poor understanding of the potential that this new discipline offers to rationalize medical diagnosis and treatment. Here, we present and critically discuss examples from the successful implementation of genomic medicine in resource-limited countries, focusing on pharmacogenomics, genome informatics, and public health genomics, emphasizing in the latter case genomic education, stakeholder analysis, and economics in pharmacogenomics. These examples can be considered as model cases and be readily replicated for the wide implementation of pharmacogenomics and genomic medicine in other resource-limited environments. © 2015 Mitropoulos et al