La historia clínica: con particular referencia a la historia clínica informatizada = The clinical history: with particular reference to the computerized clinical history

Disserta sobre o uso dos prontuários (história clínica) informatizados e o impacto das novas tecnologias em matéria de prova no processo civil. Aborda diversos aspectos processuais referentes à iniciativa, oferta, produção e avaliação probatória

El Derecho Argentino frente a la pandemia y post-pandemia COVID-19. TOMO III

La Facultad de Derecho de la Universidad Nacional de Córdoba no podía permanecer indolente frente a la conmoción que, durante este año 2020, ha provocado en el mundo la pandemia de COVID-19. Como comunidad educativa advertíamos que la prioridad máxima era lograr la continuidad de la labor de nuestra Casa de Estudios, para garantizar a nuestros alumnos del grado y del posgrado, el ejercicio de su derecho a estudiar, continuando y en algunos casos iniciando sus estudios, a pesar de las condiciones adversas que se vivían. Con esa finalidad convocamos a los profesores titulares de todas las cátedras y eméritos y consultos que quisieran hacerlo, a sumarse con sus aportes a esta construcción colectiva, que aborda los temas que nos ocupan desde las diversas perspectivas de las distintas áreas del mundo jurídico. Y la desinteresada respuesta positiva no se hizo esperar. Prueba de ello es este libro cuyas dimensiones, tanto en lo cuantitativo como en lo cualitativo, superaron las expectativas iniciales. La jerarquía de los autores que generosamente han participado con sus contribuciones, en algunos casos en forma individual y en otros acompañados por sus equipos de colaboradores, permiten prever que esta obra ha de brindar elementos de juicio de gran utilidad para continuar construyendo el mundo jurídico, dentro de la pandemia y después de ella.ÍNDICE GENERAL. TOMO III. DERECHO DE LOS RECURSOS NATURALES Y AMBIENTAL. "El Derecho Ambiental frente a la pandemia y post pandemia COVID-19 algunas perspectivas" por Aldo Novak. "Sustentabilidad y extractivismo: análisis crítico en contexto de pandemia" por Darío Ávila, María Laura Foradori y Soledad Graupera. II. "Género y ambiente: su inclusión en la agenda pública a partir del COVID-19" por Graciela Tronca María Cecilia Tello Roldán, María Eugenia Villalba y Candela González. DERECHO DE LA NAVEGACIÓN, TRANSPORTE Y COMUNICACIONES. "Derecho Aduanero. Derecho del turismo" por Giselle Javurek. Profesores: M. Soledad Pesqueira Nozikovsky, Ernesto Frontera Villamil, Juan Marcelo Cinalli y Hugo Rivarola. Adscriptos: Nelly Baigorria, Diego Cevallos, Victoria Ferronato, Maricel Freijo, M. Victoria Giubergia, Paula González Boarini,Guadalupe Hidalgo, Ignacio Latini Marramá, Iván Luna, Noelia I Mana, Dante Ariel Nuñez, Lucía Olivier y Erika Saimandi. DERECHO PROCESAL. "La justicia y el proceso judicial frente a la pandemia y post pandemia COVID-19" por Rosa A. Avila Paz de Robledo. Profesores: Mario R. Lescano, Mariano G. Lescano, Mariela Roldán, Carolina Vallania, Roxana Garay, y Santiago Molina Sandoval. "La Justicia y las personas en condiciones de vulnerabilidad frente a la Pandemia y Post Pandemia COVID-19" por Rosa A. Avila Paz de Robledo Federico M. Arce, Víctor Luna Cáceres, Horacio L. Cabanillas, Miriam Mabel Marchetti, Daniela Moyano Escalera, Eric A. Opl. "Acceso a la justicia en el COVID-19. Caso fortuito y la reforma procesal" por Cristina González de la Vega. "Nuevas tecnologías en la justicia civil de Córdoba en tiempos de pandemia COVID-19" por Leonardo González Zamar. "El proceso judicial en la época de la pandemia COVID-19. El Ministerio Público Fiscal en la oralidad" por Silvia Elena Rodríguez y Ariel Ksen. "Garantías judiciales en el COVID-19 desde la perspectiva del Sistema Interamericano de Derechos Humanos y del sistema jurídico argentino" por Diego Robledo. "La protección de datos personales en la nueva normalidad: salud pública y vigilancia digital" por María Cecilia Tello Roldan. "La emergencia sanitaria COVID-19 y la tecnología en los procesos de familia en la provincia de Córdoba" por Mariela Denise Antun y Sonia Elizabeth Cabral. "Justicia y pandemia: medidas implementadas en la justicia federal y provincial en el marco del COVID-19" por Adriana De Cicco, Ramón Agustín Ferrer Guillamondegui,Natalia Luna Jabase y Mauricio Zambiazzo. "La pandemia c 19 y el proceso judicial en Córdoba. Algunas reflexiones y las audiencias en el proceso penal" por Emilio Albarenga y Rodolfo Gaspar Lingua Rostagno. TEORÍAS DEL CONFLICTO Y DE LA DECISIÓN. MÉTODOS DERESOLUCIÓN DE CONFLICTOS. "Pensando con Morin en tiempos de incertidumbre. La noción de sujeto y la organización de los conocimientos" por Elena Garcia Cima de Esteve y Noemi G. Tamashiro de Higa. "El derecho argentino frente a la pandemia: los aportes desde la teoría del conflicto y los rad" por Daniel Gay Barbosa. "Estragos vs. orden jurídico: consenso superador para la protección de los derechos" por María Cristina Di Pietro. "El aislamiento y la resolución de conflictos. Raúl Álvarez" por Sergio Cattaneo. "El rol de mediador. Del amor en los tiempos del coronavirus" por Carla Saad y Leonardo Colazo. DERECHO POLITICO. "Pandemia. Decretos de necesidad y urgencia y constitución" por Jorge Edmundo Barbará. "La reformulación estatal en un escenario de globalización y pandemia" por Carlos Juárez Centeno. ECONOMIA. "Resolución de la CIDH 1/2020 “pandemia y derechos humanos en las Américas”. Una aproximación integral al documento emitido por la Comisión Interamericana de Derechos Humanos de la OEA" por Daniel Gattás. EDUCACION Y PANDEMIA. "Educación y pandemia. Introducción" por Graciela Ríos. "La política y el derecho educacional argentinos en tiempos de pandemia" por Claudia Giacobbe y María Florencia Blanco Pighi. "“Educar” en pandemia el acceso a la educación digital vs la desigualdad en tiempos de pandemia" por Noelia Nieva, Rosa Carnero, Florencia Pereyra y Lucas Cajeao. "Digitalización e igualdad educativa. ¿un equilibrio inestable? Un análisis de los espacios virtuales, las TIC y su necesidad en la educación básica a partir de la experiencia de emergencia sanitaria y confinamiento social" por Matías Parmigiani y Paula Gastaldi. ETICA Y DERECHO. "La pandemia como remedio de la política" por Hugo Omar Seleme. SOCIOLOGIA JURIDICA. "Pandemia COVID-19. Biopolítica y estado de excepción" por Martha Díaz de Landa.Fil: Novak, Aldo. Universidad Nacional de Córdoba. Facultad de Derecho; Argentina.Fil: Ávila, Darío. Universidad Nacional de Córdoba. Facultad de Derecho; Argentina.Fil: Foradori, María Laura. Universidad Nacional de Córdoba. Facultad de Derecho; Argentina.Fil: Graupera, Soledad. Universidad Nacional de Córdoba. Facultad de Derecho; Argentina.Fil: Tronca, Graciela. Universidad Nacional de Córdoba. Facultad de Derecho; Argentina.Fil: Tello Roldán, María Cecilia. Universidad Nacional de Córdoba. Facultad de Derecho; Argentina.Fil: Villalba, María Eugenia. Universidad Nacional de Córdoba. Facultad de Derecho; Argentina.Fil: González, Candela. Universidad Nacional de Córdoba. Facultad de Derecho; Argentina.Fil: Javurek, Giselle. Universidad Nacional de Córdoba. Facultad de Derecho; Argentina.Fil: Pesqueira Nozikovsky, M. Soledad. Universidad Nacional de Córdoba. Facultad de Derecho; Argentina.Fil: Frontera Villamil, Ernesto. Universidad Nacional de Córdoba. Facultad de Derecho; Argentina

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

International audienceBackground: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2–6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2–6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0-4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2-6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society