Desarrollo de un sistema convertidor de protocolos para comunicación inalámbrica vía GSM.

Proyecto de Graduación (Licenciatura en Ingeniería Electrónica). Instituto Tecnológico de Costa Rica. Escuela de Ingeniería Electrónica, 2010.Este documento describe el proceso de investigación e implementación de un sistema de comunicaciones inalámbricas de larga distancia que se utilizó para conectar la plataforma de redes inalámbricas de sensores CRTECMote, con cualquier punto de interés; mediante una red de área amplia (Wide Area Network o WAN, de su traducción al inglés). Los procedimientos seguidos para la ejecución del proyecto se basaron en una amplia investigación sobre protocolo USB y dispositivos de comunicación inalámbrica de tipo GSM. Producto de esta investigación, se desarrollaron rutinas de diseño de sistemas con las cuales se logró administrar un dispositivo de comunicaciones inalámbricas de tipo USB-GSM mediante un controlador de tipo USB. En base de la administración del dispositivo de comunicaciones USB-GSM, se creó un sistema que permitió enviar cadenas de información por medio del sistema de mensajes cortos de texto. El canal de transmisión de la información se creó a través de una línea de telefonía celular conectada al servicio de última generación 3G brindado por el Instituto Costarricense de Electricidad. La aplicación diseñada en este proyecto, cumplió los requerimientos de bajo consumo de potencia y transmisión eficiente de la información, lo cual la convierte en una aplicación de gran utilidad en los sistemas de monitoreo de redes inalámbricas de sensores. La importancia de este proyecto es la de brindar un servicio de comunicación de la información contenida en una red de sensores; es por esto, que la solución de este problema llega a solventar la necesidad de transmitir información de carácter importante de una forma rápida y confiable

“Desarrollo tecnológico de un sistema de adquisición de datos ambientales para su uso en proyectos de investigación científica: Arquitectura abierta CRTECMote”

Proyectos de investigación (Código: 5402-1360-2201) Instituto Tecnológico de Costa Rica. Escuela de Ingeniería Electrónica, 2010El avance en el desarrollo de la microelectrónica y las teorías de sistemas han hecho posible el diseño de complejos sistemas de monitorización con un mayor nivel de integración y una mayor eficiencia en el consumo energético. Gracias a esto, se ha logrado el desarrollo de tecnologías móviles que abren una ventana de oportunidad a aquellos proyectos que se habían visto limitados desde un punto de vista tecnológico. Los países desarrollados han hecho una gran inversión en el desarrollo de tecnologías portátiles o móviles para aplicaciones militares, sin embargo, en el contexto de la realidad nacional, el enfoque que se ha dado a las tecnologías móviles va enfocado al desarrollo de sistemas de monitorización ambiental orientados a resolver tres problemáticas principales: la primera son las aplicaciones de monitorización y protección ambiental, la segunda aplicación es prevención de desastres mediante la predicción de problemas en la infraestructura nacional y la tercera es el desarrollo de indicadores de calidad de agua, con lo que se pretende mejorar la calidad de vida de los costarricenses. A inicios del 2009 se comenzó con el desarrollo de una plataforma tecnológica de arquitectura abierta que hiciera posible desarrollar herramientas para atacar las tres prioridades que se expusieron anteriormente, es por ello que CRTECMote viene a ser la respuesta natural que satisface las necesidades de un conjunto de investigadores en torno al desarrollo de sistemas de medición inteligentes, escalables y de bajo costo.Instituto Tecnológico de Costa Rica. Escuela de Ingeniería Electrónica

Association Between Preexisting Versus Newly Identified Atrial Fibrillation and Outcomes of Patients With Acute Pulmonary Embolism

Background Atrial fibrillation (AF) may exist before or occur early in the course of pulmonary embolism (PE). We determined the PE outcomes based on the presence and timing of AF. Methods and Results Using the data from a multicenter PE registry, we identified 3 groups: (1) those with preexisting AF, (2) patients with new AF within 2 days from acute PE (incident AF), and (3) patients without AF. We assessed the 90-day and 1-year risk of mortality and stroke in patients with AF, compared with those without AF (reference group). Among 16 497 patients with PE, 792 had preexisting AF. These patients had increased odds of 90-day all-cause (odds ratio [OR], 2.81; 95% CI, 2.33-3.38) and PE-related mortality (OR, 2.38; 95% CI, 1.37-4.14) and increased 1-year hazard for ischemic stroke (hazard ratio, 5.48; 95% CI, 3.10-9.69) compared with those without AF. After multivariable adjustment, preexisting AF was associated with significantly increased odds of all-cause mortality (OR, 1.91; 95% CI, 1.57-2.32) but not PE-related mortality (OR, 1.50; 95% CI, 0.85-2.66). Among 16 497 patients with PE, 445 developed new incident AF within 2 days of acute PE. Incident AF was associated with increased odds of 90-day all-cause (OR, 2.28; 95% CI, 1.75-2.97) and PE-related (OR, 3.64; 95% CI, 2.01-6.59) mortality but not stroke. Findings were similar in multivariable analyses. Conclusions In patients with acute symptomatic PE, both preexisting AF and incident AF predict adverse clinical outcomes. The type of adverse outcomes may differ depending on the timing of AF onset.info:eu-repo/semantics/publishedVersio

“Desarrollo tecnológico de un sistema de adquisición de datos ambientales para su uso en proyectos de investigación científica: Arquitectura abierta CRTECMote”

Proyectos de investigación (Código: 5402-1360-2201) Instituto Tecnológico de Costa Rica. Escuela de Ingeniería Electrónica, 2010El avance en el desarrollo de la microelectrónica y las teorías de sistemas han hecho posible el diseño de complejos sistemas de monitorización con un mayor nivel de integración y una mayor eficiencia en el consumo energético. Gracias a esto, se ha logrado el desarrollo de tecnologías móviles que abren una ventana de oportunidad a aquellos proyectos que se habían visto limitados desde un punto de vista tecnológico. Los países desarrollados han hecho una gran inversión en el desarrollo de tecnologías portátiles o móviles para aplicaciones militares, sin embargo, en el contexto de la realidad nacional, el enfoque que se ha dado a las tecnologías móviles va enfocado al desarrollo de sistemas de monitorización ambiental orientados a resolver tres problemáticas principales: la primera son las aplicaciones de monitorización y protección ambiental, la segunda aplicación es prevención de desastres mediante la predicción de problemas en la infraestructura nacional y la tercera es el desarrollo de indicadores de calidad de agua, con lo que se pretende mejorar la calidad de vida de los costarricenses. A inicios del 2009 se comenzó con el desarrollo de una plataforma tecnológica de arquitectura abierta que hiciera posible desarrollar herramientas para atacar las tres prioridades que se expusieron anteriormente, es por ello que CRTECMote viene a ser la respuesta natural que satisface las necesidades de un conjunto de investigadores en torno al desarrollo de sistemas de medición inteligentes, escalables y de bajo costo.Instituto Tecnológico de Costa Rica. Escuela de Ingeniería Electrónica

Clinical Presentation and Short- and Long-term Outcomes in Patients With Isolated Distal Deep Vein Thrombosis vs Proximal Deep Vein Thrombosis in the RIETE Registry

International audienceImportance: Insufficient data exist about the clinical presentation, short-term, and long-term outcomes of patients with isolated distal deep vein thrombosis (IDDVT), that is, thrombosis in infrapopliteal veins without proximal extension or pulmonary embolism (PE).Objective: To determine the clinical characteristics, short-term, and 1-year outcomes in patients with IDDVT and to compare the outcomes in unadjusted and multivariable adjusted analyses with patients who had proximal DVT.Design, setting, and participants: This was a multicenter, international cohort study in participating sites of the Registro Informatizado Enfermedad Tromboembólica (RIETE) registry conducted from March 1, 2001, through February 28, 2021. Patients included in this study had IDDVT. Patients with proximal DVT were identified for comparison. Patients were excluded if they had a history of asymptomatic DVT, upper-extremity DVT, coexisting PE, or COVID-19 infection.Main outcomes and measures: Primary outcomes were 90-day and 1-year mortality, 1-year major bleeding, and 1-year venous thromboembolism (VTE) deterioration, which was defined as subsequent development of proximal DVT or PE.Results: A total of 33 897 patients were identified with isolated DVT (without concomitant PE); 5938 (17.5%) had IDDVT (mean [SD] age, 61 [17] years; 2975 male patients [50.1%]), and 27 959 (82.5%) had proximal DVT (mean [SD] age, 65 [18] years; 14 315 male patients [51.2%]). Compared with individuals with proximal DVT, those with IDDVT had a lower comorbidity burden but were more likely to have had recent surgery or to have received hormonal therapy. Patients with IDDVT had lower risk of 90-day mortality compared with those with proximal DVT (odds ratio [OR], 0.47; 95% CI, 0.40-0.55). Findings were similar in 1-year unadjusted analyses (hazard ratio [HR], 0.52; 95% CI, 0.46-0.59) and adjusted analyses (HR, 0.72; 95% CI, 0.64-0.82). Patients with IDDVT had a lower 1-year hazard of VTE deterioration (HR, 0.83; 95% CI, 0.69-0.99). In 1-year adjusted analyses of patients without an adverse event within the first 3 months, IDDVT was associated with lower risk of VTE deterioration (adjusted HR, 0.48; 95% CI, 0.24-0.97). By 1-year follow-up, symptoms or signs of postthrombotic syndrome were less common in patients with IDDVT (47.6% vs 60.5%).Conclusions and relevance: Results of this cohort study suggest that patients with IDDVT had a less ominous prognosis compared with patients with proximal DVT. Such differences were likely multifactorial, including the differences in demographics, risk factors, comorbidities, particularly for all-cause mortality, and a potential association of thrombus location with VTE deterioration and postthrombotic syndrome. Randomized clinical trials are needed to assess the optimal long-term management of IDDVT

Real-Time Dissemination of Aggregate Data on Presentation and Outcomes of Patients With Venous Thromboembolism: The RIETE Infographics Project

In the current era of patient empowerment and precision medicine, access to timely information is critical to decision-making. Unfortunately, we currently lack patient-specific, real-time data about clinical presentation, risk of thrombotic or hemorrhagic events, key risk factors, and adverse outcomes in patients with venous thromboembolism (VTE). Accordingly, the Registro Informatizado Enfermedad TromboEmb\uf3lica (RIETE) investigators developed a tool to provide an open-source, real-time graphic representation of VTE-related data derived from over 90 000 patients with confirmed VTE. This information is intended to facilitate discussion in the informed decision-making process. The current article describes the aims, rationale, methods, and ongoing and future efforts of the real-time VTE infographics developed by the RIETE registry collaborators

Timing and characteristics of venous thromboembolism after noncancer surgery

Background: Venous thromboembolism (VTE) is a major cause of morbidity and mortality postoperatively. The use of pharmacologic prophylaxis is effective in reducing the incidence of VTE. However, the prophylaxis is often discontinued at hospital discharge, especially for those with benign disease. The implications of this practice are not known. We assessed the data from a large, ongoing registry regarding the time course of VTE and outcomes after noncancer surgery. Methods: We analyzed the RIETE (Computerized Registry on Venous Thromboembolism) registry, which includes data from consecutive patients with symptomatic confirmed VTE. In the present study, we focused on general surgical patients who had developed symptomatic postoperative VTE in the first 8 weeks after noncancer surgery. The main objective was to assess the interval between surgery and the occurrence of VTE. Additional variables included the clinical presentation associated with the event, the use of thrombosis prophylaxis, and unfavorable outcomes. Results: The data from 3296 patients were analyzed. The median time from surgery to the detection of VTE was 16 days (interquartile range, 8-30 days). Of the VTE events, 77% were detected after the first postoperative week and 27% after 4 weeks. Overall, 43.9% of the patients with VTE had received pharmacologic prophylaxis after surgery for a median of 8 days (interquartile range, 5-14 days), and three quarters of the VTE events were detected after pharmacologic prophylaxis had been discontinued. Overall, 54% of the patients with VTE had presented with pulmonary embolism. For 15% of the patients, the clinical outcome was unfavorable, including 4% who had died within 90 days. Conclusions: The risk of VTE after noncancer general surgery remains high for ≤2 months. More than one half of the patients had presented with symptomatic PE as the VTE event, and 15% had had unfavorable outcomes. Only 44% of these patients had received pharmacologic prophylaxis for around 1 week

Edoxaban for the Long-Term Therapy of Venous Thromboembolism: Should the Criteria for Dose Reduction be Revised?

Edoxaban is used for venous thromboembolism (VTE) treatment. Real-life data are lacking about its use in long-term therapy. We aimed to assess the efficacy and the safety of edoxaban for long-term VTE treatment in a real-life setting. Patients with VTE included in the Registro Informatizado Enfermedad TromboEmb\uf3lica (RIETE) registry, receiving edoxaban 60 or 30 mg daily were prospectively followed up to validate the benefit of using different dosages. The main outcome was the composite of VTE recurrences or major bleeding in patients with or without criteria for dose reduction. Multivariable analysis to identify predictors for the composite outcome was performed. From October 2015 to November 2019, 562 patients received edoxaban for long-term therapy. Most (94%) of the 416 patients not meeting criteria for dose reduction received 60 mg daily, and 92 patients meeting criteria (63%) received 30 mg daily. During treatment, two patients developed recurrent VTE, six had major bleeding and nine died (2 from fatal bleeding). Among patients not meeting criteria for dose reduction, those receiving 30 mg daily had a higher rate of the composite event (hazard ratio (HR) 8.37; 95% confidence interval (CI) 1.12\u201342.4) and a significant higher mortality rate (HR 31.1; 95% CI 4.63\u2013262) than those receiving 60 mg. Among patients meeting criteria for dose reduction, those receiving 60 mg daily had no events, and a nonsignificantly higher mortality rate (HR 5.04; 95% CI 0.54\u2013133) than those receiving 30 mg daily. In conclusion, edoxaban seems to be effective and safe for long-term VTE treatment in real life. Criteria for dose reduction should be reformulated