Publications by authors named "Paula Otero"

32 Publications

Factors associated with mortality in patients hospitalized with COVID-19: A prospective cohort in a Peruvian national referral hospital.

Medwave 2021 Jul 5;21(6):e8231. Epub 2021 Jul 5.

Escuela de Medicina, Universidad Científica del Sur, Lima, Perú. ORCID: 0000-0001-6386-6643.

Objectives: To describe and assess clinical characteristics and factors associated with mortality in adult patients with COVID-19 admitted to a national referral hospital in Peru.

Methods: We conducted a prospective cohort study that included hospitalized patients older than 18 years with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection diagnosis. Patients with a positive rapid serological test on admission but no respiratory symptoms nor compatible images were excluded. We collected the data from clinical records.

Results: A total of 813 adults were included, 544 (66.9%) with confirmed COVID-19. The mean age was 61.2 years (standard deviation: 15.0), and 575 (70.5%) were male. The most frequent comorbidities were hypertension (34.1%) and obesity (25.9%). On admission, the most frequent symptoms were dyspnea (82.2%) and cough (53.9%). A total of 114 (14.0%) patients received mechanical ventilation, 38 (4.7%) were admitted to the intensive care unit, and 377 (46.4%) died. The requirement for ventilatory support, greater lung involvement, and inflammatory markers were associated with higher mortality. It was found that for every 10-year age increase, the risk of dying increased 32% (relative risk: 1.32; 95% confidence interval: 1.25 to 1.38). Those who were admitted to the intensive care unit and and were placed on mechanical ventilation had 1.39 (95% confidence interval: 1.13 to 1.69) and 1.97 (95% confidence interval: 1.69 to 2.29) times the risk of dying compared to those who did not, respectively.

Conclusion: We found a high mortality rate among hospitalized patients associated with older age, higher inflammatory markers, and greater lung involvement.
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http://dx.doi.org/10.5867/medwave.2021.06.8231DOI Listing
July 2021

The International Academy of Health Sciences Informatics (IAHSI): 2020 Report.

Yearb Med Inform 2021 Aug 21;30(1):8-12. Epub 2021 Apr 21.

Department of Health Informatics, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.

Objectives: To summarize the major activities of the International Academy of Health Sciences Informatics (IAHSI) in the 2020 time period and to welcome its 2020 Class of Fellows.

Method: Report from the members of the Academy's Board.

Results: Due to the SARS-CoV-2 pandemic, both Plenary meetings in 2020 had to be organized as virtual meetings. Scientific discussions, focusing on mobilizing computable biomedical knowledge and on data standards and interoperability formed major parts of these meetings. A statement on the use of informatics in pandemic situations was elaborated and sent to the World Health Organization. A panel on data standards and interoperability started its work. 34 Fellows were welcomed in the 2020 Class of Fellows so that the Academy now consists of 179 members.

Conclusions: There was a shift from supporting to strategic activities in the Academy's work. After having achieved organizational stability, the Academy can now focus on its strategic work and so on its main objective.
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http://dx.doi.org/10.1055/s-0041-1726479DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8416198PMC
August 2021

Belantamab mafodotin in combination with novel agents in relapsed/refractory multiple myeloma: DREAMM-5 study design.

Future Oncol 2021 06 8;17(16):1987-2003. Epub 2021 Mar 8.

Department of Medical Oncology, Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, MA 02215, USA.

Belantamab mafodotin (belamaf) is a BCMA-targeted antibody-drug conjugate recently approved as monotherapy for adults with relapsed/refractory multiple myeloma who have received ≥4 prior therapies. Belamaf binds to BCMA and eliminates myeloma cells by multimodal mechanisms of action. The cytotoxic and potential immunomodulatory properties of belamaf have led to novel combination studies with other anticancer therapies. Here, we describe the rationale and design of DREAMM-5, an ongoing Phase I/II platform study evaluating the safety and efficacy of belamaf combined with novel agents, including GSK3174998 (OX40 agonist), feladilimab (an ICOS; GSK3359609), nirogacestat (a gamma-secretase inhibitor; PF-03084014) and dostarlimab (a PD-1 blocker) versus belamaf monotherapy for patients with relapsed/refractory multiple myeloma. Clinical trial registration: NCT04126200 (ClinicalTrials.gov).
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http://dx.doi.org/10.2217/fon-2020-1269DOI Listing
June 2021

Information and communication technologies in neonatal health.

Rev Panam Salud Publica 2020 11;44:e123. Epub 2020 Nov 11.

Pan American Health Organization/World Health Organization Washington DC United States of America Pan American Health Organization/World Health Organization, Washington DC, United States of America.

Objectives: To identify scientific evidence on the use and results of information and communication technologies for the improvement of neonatal health in general or specific health problems or interventions, and to describe the type of intervention and its results.

Methods: A systematic review of the available evidence was performed. The search was carried out in peer-reviewed journals between January 1, 2008 and April 30, 2018, in English and Spanish. The searched key terms were (health informatics OR telemedicine OR mHealth) AND (newborn OR newborn care OR neonatal care).

Results: From a total of 305 articles initially identified, 10 articles fulfilled the inclusion criteria. The main domains of eHealth identified as applied to neonatal health were telemedicine (3 studies), eLearning (1 study) and mHealth (7 studies). Target population were health care providers or parents. The studies aimed at diagnosis, provision of health care and training, promoting adherence to interventions in parents or improving quality of care.

Conclusions: The use of eHealth in general and specifically focused on neonatal health shows important possibilities for development and expansion, given the advances and present needs, and should be considered a key tool for the reduction of inequalities.
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http://dx.doi.org/10.26633/RPSP.2020.123DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7655061PMC
November 2020

International Academy of Health Sciences Informatics (IAHSI): Strategy and Focus Areas, 1st Version.

Yearb Med Inform 2020 Aug 21;29(1):15-25. Epub 2020 Aug 21.

Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Germany.

Background: The International Academy of Health Sciences Informatics (IAHSI) is the Academy of the International Medical Informatics Association (IMIA). As an international forum for peers in biomedical and health informatics, the Academy shall play an important role in exchanging knowledge, providing education and training, and producing policy documents.

Objectives: A major priority of the Academy's activities in its inaugural phase was to define its strategy and focus areas in accordance with its objectives and to prioritize the Academy's work, which can then be transferred to respective taskforces.

Method: This document reflects the major outcomes of intensive discussions that occurred during 2019. It was presented at the Academy's 3rd Plenary on August 25th, 2019, in Lyon, France.

Results: Regardless of the 'living nature' of the strategy and focus areas document, it was concluded during the Plenary that the first version, which will be used as a base for decisions on the Academy's future activities, should be made available to a broad audience. Three out of eight 'Visions for IAHSI', presented in the IMIA Yearbook of Medical Informatics 2018, were identified as central for developing, implementing, and evaluating the Academy's strategic directions: (1) advise governments and organizations on developing health and health sciences through informatics, (2) stimulate progress in biomedical and health informatics research, education, and practice, and (3) share and exchange knowledge. Taskforces shall be implemented to work in the following areas, which were considered as priority themes: (1) artificial intelligence in health: future collaboration of entities with natural and with artificial intelligence in health care, and (2) current landscape of standards for digital health.

Conclusions: Taskforces are now being established. Besides specific key performance indicators, suggested for monitoring the work of theses taskforces, the strategy to monitor the progress of the Academy itself has to be measured by relevant and acceptable metrics.
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http://dx.doi.org/10.1055/s-0040-1701992DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7442516PMC
August 2020

The International Academy of Health Sciences Informatics (IAHSI): IMIAs Academy is Now Established and on Track.

Yearb Med Inform 2020 Aug 17;29(1):11-14. Epub 2020 Apr 17.

Clinical Informatics Center, University of Texas Southwestern Medical Center, Dallas, USA.

Objectives: To summarize the major activities of the International Academy of Health Sciences Informatics (IAHSI) from 2018 until 2019, and to provide an outline of actions planned for 2020.

Method: Reporting about these activities and actions by the members of the Academy's first Board.

Results: Academy bylaws were accepted by the Academy Plenary and the IMIA General Assembly on August 25th, 2019 and August 26th, 2019, respectively. Academy's strategy and focus areas were developed. Based on the Academy's eligibility criteria, the 2018/2019 Class made of 26 new Academy Fellows was elected. Future activities will concentrate on building taskforces for developing and implementing major Academy focus areas.

Conclusions: We are glad to report that the Academy is strong and thriving.
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http://dx.doi.org/10.1055/s-0040-1701971DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7442511PMC
August 2020

Comparison of Tracheal Intubation Conditions in Operating Room and Intensive Care Unit: A Prospective, Observational Study.

Anesthesiology 2018 08;129(2):321-328

From the Department of Anesthesiology and Intensive Care Medicine, Clinical University Hospital of Santiago, Spain.

What We Already Know About This Topic: WHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: Tracheal intubation is a common intervention in the operating room and in the intensive care unit. The authors hypothesized that tracheal intubation using direct laryngoscopy would be associated with worse intubation conditions and more complications in the intensive care unit compared with the operating room.

Methods: The authors prospectively evaluated during 33 months patients who were tracheally intubated with direct laryngoscopy in the operating room, and subsequently in the intensive care unit (within a 1-month time frame). The primary outcome was to compare the difference in glottic visualization using the modified Cormack-Lehane grade between intubations performed on the same patient in an intensive care unit and previously in an operating room. Secondary outcomes were to compare first-time success rate, technical difficulty (number of attempts, operator-reported difficulty, need for adjuncts), and the incidence of complications.

Results: A total of 208 patients met inclusion criteria. Tracheal intubations in the intensive care unit were associated with worse glottic visualization (Cormack-Lehane grade I/IIa/IIb/III/IV: 116/24/47/19/2) compared with the operating room (Cormack-Lehane grade I/IIa/IIb/III/IV: 159/21/16/12/0; P < 0.001). First-time intubation success rate was lower in the intensive care unit (185/208; 89%) compared with the operating room (201/208; 97%; P = 0.002). Tracheal intubations in the intensive care unit had an increased incidence of moderate and difficult intubation (33/208 [16%] vs. 18/208 [9%]; P < 0.001), and need for adjuncts to direct laryngoscopy (40/208 [19%] vs. 21/208 [10%]; P = 0.002), compared with the operating room. Complications were more common during tracheal intubations in the intensive care unit (76/208; 37%) compared with the operating room (13/208; 6%; P < 0.001).

Conclusions: Compared with the operating room, tracheal intubations in the intensive care unit were associated with worse intubation conditions and an increase of complications.
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http://dx.doi.org/10.1097/ALN.0000000000002269DOI Listing
August 2018

Female authorship in Latin American pediatric journals.

Arch Argent Pediatr 2017 Dec;115(6):580-583

Hospital General de Niños Pedro de Elizalde, Argentina.

Introduction: The participation of women in science increases every day. Here we estimated their participation in authorship in three Latin American pediatric journals indexed in PubMed.

Methods: All articles published in 2015 in the Archivos Argentinos de Pediatría, the Jornal de Pediatría and the Revista Chilena de Pediatría were identified, and the first and last authors and the total number of authors by sex were determined.

Results: A total of 329 articles were identified. Out of 1432 authors, 59.9% were women. Also, 54.4% of all first authors and 48% of last authors were women. No significant difference was observed in female authorship ratio among the three journals. Archivos Argentinos de Pediatría had a significantly lower number of women as first and last authors.

Conclusion: Women authorship ratio across three Latin American pediatric journals reached 59.9%. Their role as first or last authors was significantly lower in the Archivos Argentinos de Pediatría.
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http://dx.doi.org/10.5546/aap.2017.eng.580DOI Listing
December 2017

Sharenting... should children's lives be disclosed on social media?

Authors:
Paula Otero

Arch Argent Pediatr 2017 Oct;115(5):412-413

Subcomisión de Tecnologías de Información y Comunicación, Sociedad Argentina de Pediatría, Buenos Aires, Argentina.

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http://dx.doi.org/10.5546/aap.2017.eng.412DOI Listing
October 2017

How to Teach Health IT Evaluation: Recommendations for Health IT Evaluation Courses.

Stud Health Technol Inform 2017 ;243:3-7

University of Utah, Salt Lake City, Utah, USA.

Systematic health IT evaluation studies are needed to ensure system quality and safety and to provide the basis for evidence-based health informatics. Well-trained health informatics specialists are required to guarantee that health IT evaluation studies are conducted in accordance with robust standards. Also, policy makers and managers need to appreciate how good evidence is obtained by scientific process and used as an essential justification for policy decisions. In a consensus-based approach with over 80 experts in health IT evaluation, recommendations for the structure, scope and content of health IT evaluation courses on the master or postgraduate level have been developed, supported by a structured analysis of available courses and of available literature. The recommendations comprise 15 mandatory topics and 15 optional topics for a health IT evaluation course.
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April 2018

C-Methionine-PET in Multiple Myeloma: A Combined Study from Two Different Institutions.

Theranostics 2017 23;7(11):2956-2964. Epub 2017 Jul 23.

University Hospital Würzburg, Department of Hematology and Oncology, Würzburg, Germany.

C-methionine (MET) has recently emerged as an accurate marker of tumor burden and disease activity in patients with multiple myeloma (MM). This dual-center study aimed at further corroboration of the superiority of MET as positron emission tomography (PET) tracer for staging and re-staging MM, as compared to F-2`-deoxy-2`-fluoro-D-glucose (FDG). 78 patients with a history of solitary plasmacytoma (n=4), smoldering MM (SMM, n=5), and symptomatic MM (n=69) underwent both MET- and FDG-PET/computed tomography (CT) at the University Centers of Würzburg, Germany and Navarra, Spain. Scans were compared on a patient and on a lesion basis. Inter-reader agreement was also evaluated. In 2 patients, tumor biopsies for verification of discordant imaging results were available. MET-PET detected focal lesions (FL) in 59/78 subjects (75.6%), whereas FDG-PET/CT showed lesions in only 47 patients (60.3%; p<0.01), accordingly disease activity would have been missed in 12 patients. Directed biopsies of discordant results confirmed MET-PET/CT results in both cases. MET depicted more FL in 44 patients (56.4%; p<0.01), whereas in two patients (2/78), FDG proved superior. In the remainder (41.0%, 32/78), both tracers yielded comparable results. Inter-reader agreement for MET was higher than for FDG (κ = 0.82 vs κ = 0.72). This study demonstrates higher sensitivity of MET in comparison to standard FDG to detect intra- and extramedullary MM including histologic evidence of FDG-negative, viable disease exclusively detectable by MET-PET/CT. MET holds the potential to replace FDG as functional imaging standard for staging and re-staging of MM.
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http://dx.doi.org/10.7150/thno.20491DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5562228PMC
April 2018

[Electronic publishing brings good news to Archivos Argentinos de Pediatría].

Authors:
Paula Otero

Arch Argent Pediatr 2015 Dec;113(6):484

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http://dx.doi.org/10.5546/aap.2015.484DOI Listing
December 2015

[Use of electronic health record systems by office-based pediatricians].

Authors:
Paula Otero

Arch Argent Pediatr 2015 06;113(3):e169-70

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June 2015

Crowdfunding. A new option for funding health projects.

Authors:
Paula Otero

Arch Argent Pediatr 2015 Apr;113(2):154-7

Departamento de Pediatría, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires.

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http://dx.doi.org/10.5546/aap.2015.154DOI Listing
April 2015

Assessment of hospital daily cleaning practices using ATP bioluminescence in a developing country.

Braz J Infect Dis 2014 Nov-Dec;18(6):675-7. Epub 2014 Sep 1.

Infection Prevention and Control Committee, Hospital Clínico y Clínica UC Lira, Red de Salud, UC-CHRISTUS, Santiago, Chile; Department of Infectious Diseases, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. Electronic address:

Unlabelled: Visual assessment of surfaces may not be enough to document the level of cleanliness in the hospital setting. It is necessary to introduce quantitative methods to document the results of this practice.

Objective: To evaluate the efficacy of hospital terminal cleaning procedures, using an adenosine triphosphate (ATP) bioluminescence method in a teaching hospital.

Method: During 2008 we conducted an evaluation using ATP bioluminescence LIGHTNING MVP™ (Arquimed) of external and internal housekeeping service. After conducting an initial evaluation we implemented education of cleaning practices and finally we did a post intervention evaluation. Using chi-square method we compared prior versus after cleaning, quality of cleaning performed by external versus internal personnel, single versus double terminal cleaning procedures and prior versus after intervention. A finding of three RLU or less was considered a clean surface.

Results: We performed 198 evaluations in 33 patient units and nine OR. Internal personnel accomplished 25.37% of clean surfaces before and 80% after the education intervention (p=0.01). In contrast, external personnel obtained 68.8% before and 73.33% after intervention (p=0.3).

Conclusions: This study suggests that visual assessment is not enough to ensure quality of the process and it is necessary to document the level of cleanliness by quantitative methods.
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http://dx.doi.org/10.1016/j.bjid.2014.06.008DOI Listing
March 2015

Professional burnout in pediatric intensive care units in Argentina.

Arch Argent Pediatr 2012 Dec;110(6):466-73

Hospital Nacional de Pediatría Prof. Dr. Juan P. Garrahan, Ciudad Autónoma de Buenos Aires, Argentina.

Introduction: There is currently a deficiency of physicians in pediatric intensive care units (PICU). The cause of this deficit is multifactorial, although the burnout phenomenon has been described as relevant.

Objective: To analyze the situation of human resource in the pediatric intensive care units in Argentina and measure the level of burnout.

Methods: An observational cross-sectional study through surveys administered electronically; the Maslach Burnout Inventory was used. Physicians that work at public o private pediatric intensive care units in Argentina during at least 24 hours per week were invited to participate.

Results: A total of 162 surveys were completed (response rate 60%). We observed a high risk of burnout in emotional exhaustion in 40 therapists (25%), in fulfillment in 9 (6%), and depersonalization in 31 (19%). In combination, 66 professionals (41%) had a high risk of burnout to some extent; there were independent protective factors of this risk as to be certified in the specialty (ORA 0.38, 95% CI 0.19 to 0.75) and work in public sector PICU (ORA 0.31, 95% CI 0.15 to 0.65), while working more than 36 hours/week on duty increased the risk (ORA 1.94, 95% CI 1.1 to 3.85). Additionally, 31% said that they did not plan to continue working in intensive care, and 86% did not think to continue with on call duties in the following years. Over 60% of respondents reported that changes in professional practice (salary, staff positions, early retirement, fewer loads on call) could prolong the expectation of continuing activities in PICU.

Conclusions: A significant percentage of doctors working in the PICU of Argentina have a high risk of burnout syndrome and a low expectation of continuing in the field.
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http://dx.doi.org/10.5546/aap.2012.466DOI Listing
December 2012

[The challenge of scientific publications... how to remain chosen by readers].

Authors:
Paula Otero

Arch Argent Pediatr 2012 Oct;110(5):370-1

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http://dx.doi.org/10.5546/aap.2012.370DOI Listing
October 2012

[Advantages and risks associated with the use of electronic medical records].

Authors:
Paula Otero

Arch Argent Pediatr 2011 Dec;109(6):476-7

Departamento de Pediatría, Departamento de Informática en Salud, Comité de Seguridad del Paciente, Escuela de Medicina, Hospital Italiano de Buenos Aires.

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http://dx.doi.org/10.1590/S0325-00752011000600002DOI Listing
December 2011

[Facebook and Twitter, are they already in the pediatrician's office? Survey on the use of social networks].

Arch Argent Pediatr 2011 Oct;109(5):437-44

Sociedad Argentina de Pediatría.

The Web 2.0 has democratized the use of services and applications, being Facebook and Twitter its leading exponents and it even has been proposed that there exists a Medicine 2.0. A survey for professionals subscribed to discussion lists of Argentine Pediatric Society (SAP) and for visitors to the Website was carried out to know the use of Web 2.0. In 377 responses (76% pediatricians), 81.3% of users use Facebook and Twitter 16.5%. Facebook is used in an 85% for personal purposes, while the professional use of it is 41.2%. Pediatricians frequently use other web 2.0 applications such as YouTube (80.3%), sharing images (52.2%) and listening to Podcasts (34.8%). Around 50% of the professionasl surveyed showed interest in receiving information on the professional activites carried out by SAP. Clinicians should recognize these new tools to incorporate them into their professional activities.
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http://dx.doi.org/10.1590/S0325-00752011000500011DOI Listing
October 2011

[Full-text publication of abstracts presented at the 33th Argentinean pediatric meeting and non publication related factors].

Arch Argent Pediatr 2011 Feb;109(1):56-9

Hospital Italiano de Buenos Aires, Argentina.

Introduction: There is no information about non publication of research presented at scientific meetings in Argentina. We analyzed the full-text publication rate of abstracts presented at the 33° Argentinean Pediatric Congress (APC), time to achieve publication, and factors associated with publication or non-publication.

Methods: Survey-based cross-sectional study, including authors of abstracts presented at the 33° APC. The survey included age, gender, specialty and sub-specialty, professional area and reason of publication or non-publication.

Results: We randomly selected 140/894 presented abstracts. Only 16 abstracts (11.4%) were subsequently published in full, requiring 27±15 months. There were no association between full-text publication and author's characteristics. "Oral presentations" were more likely to be subsequently published (p= 0.018). In non published abstracts, 95% were not submitted by the author, more frequently because of "lack of time" (35.9%).

Conclusion: Only 11.4% of abstracts were subsequently published in full. Oral presentation was associated with a higher publication rate. Most frequent cause for non-publication was non submission due to lack of time.
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http://dx.doi.org/10.1590/S0325-00752011000100012DOI Listing
February 2011

[Greeting modalities preferred by patients in pediatric ambulatory setting].

Arch Argent Pediatr 2011 Feb;109(1):14-7

Servicio de Clínica Pediátrica, Departamento de Pediatría, Hospital Italiano de Buenos Aires, Argentina.

Introduction: The greeting is the first form of verbal and nonverbal communication and is a valuable tool to support the physician-patient relationship.

Objective: Assess parents and children preferences on how they want pediatricians greet and address them.

Material And Methods: Cross-sectional study. The population was persons accompanying patients (parents or guardians) between 1 month and 19 years old and patients older than 5 years old. A survey questionnaire was completed after the medical visit.

Results: A total of 419 surveys from patients' companions and 249 from pediatric patients were analyzed; 68% of the companions preferred the doctor addressed them by the first name, 67% liked to be greeted with a kiss on the cheek and 90% liked to be treated informally. Preferring to be greeted with a kiss on the cheek was associated in multivariate analysis with the companion was the mother, age younger than 39 years and longer time in knowing the pediatrician; 60% of the patients preferred to be addressed by their first name.

Conclusions: In the outpatient setting patients companions and patients themselves prefer to be addressed by their name informally and be greeted with a kiss on the cheek.
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http://dx.doi.org/10.1590/S0325-00752011000100005DOI Listing
February 2011

Mismatch between the prevalence of overweight and obese children and adolescents and recording in electronic health records: a cross-sectional study.

Inform Prim Care 2011 ;19(2):75-82

Department of Pediatrics, Section on Clinical Pediatrics, Hospital Italiano de Buenos Aires, Argentina.

Background: The prevalence of obesity has increased dramatically in recent years. An electronic health record (EHR) can be used to identify and manage overweight and obesity by providing timely information.

Objective: To estimate the prevalence of overweight and obesity using anthropometric data from an EHR and to compare it with the frequency of diagnoses of 'overweight' and 'obesity' registered by pediatricians.

Methods: Cross-sectional, descriptive analytical study from a sample of records from children aged between 2 and 19 years who had at least one well-child visit registered in the EHR over the 24-month period between 2007 and 2008. The record of a diagnosis of overweight or obesity by physicians was compared with estimations based on body mass index (BMI; World Health Organization Growth Reference Data).

Results: Of 14 743 patients aged 2-19 years, 22.1% were overweight and 9.8% were obese. By contrast, a diagnosis of overweight was registered in the EHR for 3.3% of patients, with a figure of 1.1% for obesity. The prevalence of overweight/obesity was lower in adolescents than in children and preschoolers. Based on BMI cut-off points, we found that only 11.5% of the overweight or obese patients had these diagnoses registered in the EHR. Referral to a nutritionist or endocrinolist, and the frequency of selected laboratory tests based on BMI categories vary between 11.8 and 52.5%.

Conclusion: An EHR can contribute to the identification of a population at risk when there is a sub-registry of these diagnoses by primary care physicians.
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http://dx.doi.org/10.14236/jhi.v19i2.798DOI Listing
May 2012

[What do they read when they read us? Opinion survey of readers of Archivos Argentinos de Pediatría].

Arch Argent Pediatr 2010 Dec;108(6):486-7, e1-6

Archivos Argentinos de Pediatría.

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http://dx.doi.org/10.1590/S0325-00752010000600002DOI Listing
December 2010

Building a health informatics workforce in developing countries.

Health Aff (Millwood) 2010 Feb;29(2):274-7

Oregon Health and Science University in Portland, OR, USA.

Information and communication technology can be used to improve the quality and safety of health care and to lower costs. But in both developed and developing countries, there is an inadequate supply of skilled individuals who have the technical skills to use this technology to improve health care. Some studies project workforce needs of tens of thousands in English-speaking developed countries, but it is not known what size workforce will be required in the developing world. It is important to identify and develop the skills, training, and competencies-consistent with local cultures, languages, and health systems-that will be needed to realize the full benefits of these technologies. We present a framework for answering these questions and for developing estimates of the size and scope of the workforce that may be needed.
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http://dx.doi.org/10.1377/hlthaff.2009.0883DOI Listing
February 2010

[Internet usage in households with children between 4 and 18 years old. Parent's supervision. Results of a national survey].

Arch Argent Pediatr 2009 Feb;107(1):30-6

Grupo de Informática, Sociedad Argentina de Pediatría.

Introduction: Internet has become, since its beginning, the ideal media for information access. Children and adolescents use it frequently, and they usually reach inappropriate material, and their parents are not aware of this situation. The objective of the study was to evaluate the family perception of the use at home of the Internet by children and adolescents.

Population, Material And Methods: A web survey coordinated by the Working Group of Medical Informatics at the Sociedad Argentina de Pediatría was conducted between 09/01/2007 and 03/01/2008, and evaluated the household characteristics (number of children and their age) and their user internet profile.

Results: The survey was completed by 857 of the 1055 registered users. A total of 1380 children and adolescents were included, 83.5% were from Argentina. 25.8% of the children informed the adults about an unpleasant experience while using the web, 30.8% of the adults did not know their child's online nickname and only 28.6% used parental control software. 53.4% of the surveyed individuals reported talking with their children about their online activities.

Conclusion: The results obtained from our survey show that children frequently have unpleasant experiences while using the web and there is very little supervision from parents, who underestimate the risk of the web access.
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http://dx.doi.org/10.1590/S0325-00752009000100008DOI Listing
February 2009

[Archivos: Medline database inclusion process].

Authors:
Paula Otero

Arch Argent Pediatr 2009 Feb;107(1):2-3

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http://dx.doi.org/10.1590/S0325-00752009000100002DOI Listing
February 2009

[Is data collection via web a valid methodology?].

Authors:
Paula Otero

Arch Argent Pediatr 2008 Oct;106(5):390-1

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http://dx.doi.org/10.1590/S0325-00752008000500003DOI Listing
October 2008

Medication errors in pediatric inpatients: prevalence and results of a prevention program.

Pediatrics 2008 Sep;122(3):e737-43

Hospital Italiano de Buenos Aires, School of Medicine, Department of Pediatrics, Gascon 450 (1181), Ciudad Autonoma de Buenos Aires, Argentina.

Objective: The objective of this study was to assess the prevalence and characteristics of medication errors in pediatric and neonatal inpatients and to measure the impact of interventions to reduce medication errors.

Methods: A preintervention and postintervention cross-sectional study was conducted of a sample of prescriptions that were ordered by physicians and medications that were administered by nurses to patients at the NICU, PICU, and general pediatric settings at the Hospital Italiano de Buenos Aires Department of Pediatrics in 2002 and 2004. Number and type of errors, time shift on which they occurred, and whether they had any kind of adverse event on the patient were recorded. Medication errors were stratified according to physicians' and nurses' status. Several interventions, including incorporating a positive safety culture without a punitive management of errors and specific prescribing and drug-administration recommendations were implemented between the 2 phases of the study.

Results: A total of 590 prescriptions and 1174 drug administrations for 95 patients in the first phase of the study and 1144 prescriptions with 1588 drug administrations for 92 patients in the second phase were evaluated. The prevalence of medication error rate in the second phase was 7.3% (199 of 2732) and 11.4% (201 of 1764) in the first phase. The risk difference was -4.1%.

Conclusions: The development of a program mainly centered on the promotion of a cultural change in the approach to medical errors can effectively diminish medication errors in neonates and children.
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http://dx.doi.org/10.1542/peds.2008-0014DOI Listing
September 2008

[Analysis of blood pressure measurement by pediatricians, in patients from 3 to 20 years of age in the electronic health record].

Arch Argent Pediatr 2008 Jun;106(3):226-30

Servicio de Clínica Pediátrica, Departamento de Pediatría, Hospital Italiano, Buenos Aires.

Introduction: Blood pressure measurement (BPM) is a recommended practice at least once a year for all of healthy children starting from 3 years old and before that age in population at risk. Pediatricians fulfilling of this recommendation is irregular. Objective. Identify the prevalence of records of BPM in a pediatric electronic health record (EHR) in patients from 3 to 20 years of age and the prevalence of records of hypertension (HBP) and prehypertension (preHBP) according to sex, age and percentile of height.

Population, Material And Methods: A cross-sectional and analytical study was conducted. 8140 patients from 3 to 20 years of age seen by their primary care physician at least in one opportunity between January and June 2005 were evaluated. Hypertension, prehypertension and normal BP was defined based on the recommendation published in Pediatrics 2004 Aug; 114: 555-76.

Results: 2.723 of the 8.140 patients had BP registered in the EHR (33.4%), 76% of the records were of normal BP, 17% of preHBP and 7% of HBP. The percentage of preHBP was significantly higher in males (21.7% vs. 13.4%) OR: 1.6 (IC 95% 1.3-1.9), but not in HBP (7.4% vs. 6.8%). 50% of the pediatricians registered 9% or less of their patients BP.

Conclusions: The prevalence of BPM was a third; there is a need of generating actions that stimulate this practice.
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http://dx.doi.org/10.1590/S0325-00752008000300007DOI Listing
June 2008

Analysis and redesign of a knowledge database for a drug-drug interactions alert system.

Stud Health Technol Inform 2007 ;129(Pt 2):885-9

Department of Medical Informatics, Hospital Italiano de Buenos Aires, Argentina.

Physicians tend to ignore drug-drug interactions alerts, this is due to the large amount of irrelevant interactions displayed and the interface in which these alerts are shown. The high rate of clinically inadequate alerts produce "alerts fatigue". This high number of incorrect alerts predisposes physicians to underestimate the electronic prescription systems as useful tools in their practice. We decided to analyze and redesign our drug-drug interactions alerting system knowledge database. In order to do so, we cleaned our knowledge database according to the clinical significance of drug-drug interactions. New drug interactions taxonomy was created in four levels based on clinical significance and the recommendations given in each single monograph of interaction. We proceeded to recategorize the alerts as Active, which present themselves to the physician interrupting the prescribing process, or Passive, which allow physicians to accept the recommendations, and adopt some action in order of minimizing the interaction risks.
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November 2007
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