Immunogenicity induced by the use of alternative vaccine platforms to deal with vaccine shortages in a low- to middle-income country: Results of two randomized clinical trials.

Background: Shortages of component two of Sputnik V vaccine (rAd5) are delaying the possibility of achieving full immunisation. The immunogenic response associated with the use of alternative schemes to complete the scheme was not explored.

Methods: We did two non-inferiority randomized clinical trials with outcomes measures blinded to investigators on adults aged 21-65 years, vaccinated with a single dose of rAd26 ≥ 30 days before screening and no history of SARS-CoV-2.

Evaluation of a COVID-19 Vaccine Campaign and SARS-CoV-2 Infection and Mortality Among Adults Aged 60 Years And Older in a Middle-Income Country.

Importance: Although there are reports of COVID-19 vaccine implementation in real-world populations, these come from high-income countries or from experience with messenger RNA technology vaccines. Data on outcomes of vaccine deployment in low- or middle-income countries are lacking.

Objective: To assess whether the pragmatic application of the 3 COVID-19 vaccines available in Argentina, 2 of which have no reports of evaluation in real-world settings to date, were associated with a reduction in morbidity, all-cause mortality, and mortality due to COVID-19.

[Implementation of telemedicine in the Americas: Barriers and facilitatorsBarreiras e facilitadores para a implementação da telemedicina nas Américas].

With millions of people in the world in situations of physical distancing because of COVID-19, information and communication technology (ICT) has become as one of the principal means of interaction and collaboration. The following advantages of ICT have been cited since the start of the new millennium: increased access to information and service delivery, educational strengthening, quality control of screening programs, and reduction of health care costs. In the case of telemedicine, however, a number of barriers-especially technological, human and social, psychosocial, anthropological, economic, and governance-related-have stood in the way of its adoption.

[Effect of statins on development of post thrombotic syndrome: cohort study].

Objetivo: Explorar la asociación entre consumo de estatinas (CE) y desarrollo de síndrome postrombótico (SPT).

MÉtodo: Cohorte retrospectiva con pacientes con primer episodio de trombosis venosa profunda (TVP) entre el 06/2006 y el 12/2017, incluidos en el Registro Institucional de Enfermedad TromboEmbólica (RIET) del Hospital Italiano de Buenos Aires. Se consideró exposición al CE entre los 30 días previos y hasta 180 días posterior al diagnóstico de TVP.

International Comparison of Six Basic eHealth Indicators Across 14 Countries: An eHealth Benchmarking Study.

Background: Many countries adopt eHealth applications to support patient-centered care. Through information exchange, these eHealth applications may overcome institutional data silos and support holistic and ubiquitous (regional or national) information logistics. Available eHealth indicators mostly describe usage and acceptance of eHealth in a country.

External validation of the unified model of information systems continuance (UMISC): An international comparison.

Context: The Unified Model of Information Systems Continuance (UMISC) is a metamodel for the evaluation of clinical information systems (CISs) that integrates constructs from five models that have previously been published in the literature. UMISC was developed at the Georges Pompidou University Hospital (HEGP) in Paris and was partially validated at the Saint Joseph Hospital Group (HPSJ), another acute care institution using the same CIS as HEGP.

Objective: The aim of this replication study was twofold: (1) to perform an external validation of UMISC in two different hospitals and country contexts: the Italian Hospital of Buenos Aires (HIBA) in Argentina and the Hospital Sirio Libanes in Sao Paulo, Brazil (HSL); (2) to compare, using the same evaluation model, the determinants of satisfaction, use, and continuance intention observed at HIBA and HSL with those previously observed at HEGP and HPSJ.

Workforce Development Strategy for Health Information System Implementation at the Public Health System of Buenos Aires.

One of the challenges of implementing health information and communication technology is the need for a skilled workforce that understands health care and ITC. There are also people and organizational challenges involved. This work describes the strategies to create such a workforce for the public network of healthcare facilities in the City of Buenos Aires, which include promoting the adoption of technologies and providing lines of contention for continuous training.

Development, Implementation and Preliminary Results of an Electronic Reminder for HIV Screening Using a Service Oriented Architecture.

30% of the Argentinian population and 58% of Plan de Salud HIBA patients are unaware of their HIV status. The Ministry of Health and US Preventive Service Task recommends physicians to assess HIV infection in persons aged 15 to 65. An HIV screening reminder integrated in an electronic health record (EHR) was created using FHIR to represent clinical information and CDS-Hooks to represent the exchange of information with a CDS service.

Face to Face Appointment vs. Telemedicine in First Time Appointment Orthopedic Oncology Patients: A Cost Analysis.

Medicine has evolved considerably in recent decades in part thanks to information and communication technologies in health (ICTs). However, face-to-face consultations continue to be the predominant model, since alternatives such as telemedicine are still the subject of debate. On the other hand, in some very specific specialties, centralization is relevant, mainly due to the low frequency and prevalence of diseases, as well as the need to have highly specialized professionals, causing problems in terms of accessibility and costs for the health system.

Infrastructure for Big Data in the Intensive Care Unit.

The Big Data paradigm can be applied in intensive care unit, in order to improve the treatment of the patients, with the aim of customized decisions. This poster is about the infrastructure necessary to built a Big Data system for the ICU. Together with the infrastructure, the conformation of a multidisciplinary team is essential to develop Big Data to use in critical care medicine.

Big Data in the ICU: Experience in the Hospital Italiano de Buenos Aires.

Intensive care represents the critical care setting of a hospital, where fundamental, precise, and fast decisions have to be made. These decisions will affect the outcome of the patients in a matter of few hours. The knowledge of the therapeutic interventions applied in this setting is evolving, thus the perspective of Big Data may provide a new paradigm in the ICU.

Bringing Knowledge to Users in One Click: Infobuttons in the Problem List of an EHR.

The infobuttons allows the solving of information needs. In our study, the use of Infobuttons is described, analyzing the number of queries to UpToDate® from the problem list of an Electronic Health Record. There were 26419 requests in 8 months.

Representation of People's Decisions in Health Information Systems.* A Complementary Approach for Understanding Health Care Systems and Population Health.

Objectives: In this study, we aimed: 1) to conceptualize the theoretical challenges facing health information systems (HIS) to represent patients' decisions about health and medical treatments in everyday life; 2) to suggest approaches for modeling these processes.

Methods: The conceptualization of the theoretical and methodological challenges was discussed in 2015 during a series of interdisciplinary meetings attended by health informatics staff, epidemiologists and health professionals working in quality management and primary and secondary prevention of chronic diseases of the Hospital Italiano de Buenos Aires, together with sociologists, anthropologists and e-health stakeholders.

Results: HIS are facing the need and challenge to represent social human processes based on constructivist and complexity theories, which are the current frameworks of human sciences for understanding human learning and socio-cultural changes.

Mild prolonged chronic hyponatremia and risk of hip fracture in the elderly.

Background: Hip fractures are among the most serious bone fractures in the elderly, producing significant morbidity and mortality. Several observational studies have found that mild hyponatremia can adversely affect bone, with fractures occurring as a potential complication. We examined if there is an independent association between prolonged chronic hyponatremia (>90 days duration) and risk of hip fracture in the elderly.

Inhospital mortality among clinical and surgical inpatients recently diagnosed with venous thromboembolic disease.

Venous thromboembolism (VTE) is the most common cause of preventable mortality in hospitalized patients, and pulmonary embolism is responsible for 5-10 % of all hospital deaths. To estimate the hospital mortality in hospitalized patients who developed VTE during hospitalization. Prospective cohort of all adult inpatients >17 years admitted to the hospital between August 2006 and August 2013, and follow-up until discharge to measure death.

Prognosis of patients with suspected pulmonary embolism in Buenos Aires: a prospective cohort study.

Background: The prognosis of patients with suspected pulmonary embolism (PE) in whom PE has been ruled out (RPE) is unclear. We aimed to evaluate survival and diagnosis of new cancer in suspected PE patients at follow up.

Methods: A prospective cohort study nested in a prospective Institutional Registry of Venous Thromboembolic Disease was performed between 2006 and 2011.

Nutritional Alert in hospitalized patients.

Unlabelled: The objective of the study is to assess a nutritional risk alert using an Informatics System in hospitalized patients versus the conventional methodology.

Method: We studied 400 medical patients at the Belgrano Hospital Critical Care Unit. We considered two groups of 200 patients.

Integrating personalized health information from MedlinePlus in a patient portal.

The objective of this paper is to describe the implementation and use of context aware information in Spanish from MedlinePlus embedded in a Patient Portal. Personalized information can help patients solve problems, make treatment decisions, gain confidence in their ability to care for themselves and communicate with providers. To integrate MedlinePlus information in our institutional PHR we used the HL7 Context-Aware Knowledge Retrieval Standard, also known as the Infobutton Standard.

The expectations of nurses about the implementation of a Barcoded Medication Administration System: a qualitative study.

The implementation of a health system like the Barcode Administration System (BCMA) often disrupts the workflow of nursing staff. Taking into account that system acceptance by nurses is one of the most important factors for successful implementation, this paper describes nurses' expectations regarding the introduction of BCMA. For this purpose, interviews were conducted with 18 nurses in different units of an academic medical center in Argentina.

Performance of the Wells score in patients with suspected pulmonary embolism during hospitalization: a delayed-type cross sectional study in a community hospital.

Introduction: The role of the Wells score for patients who develop signs and symptoms of pulmonary embolism (PE) during hospitalization has not been sufficiently validated. The aim of this study is to evaluate the performance of the Wells score for inpatients with suspected PE and to evaluate the prevalence of pulmonary embolism.

Materials And Methods: We conducted a cross sectional study nested in the prospective Institutional Registry of Thromboembolic Disease at Hospital Italiano de Buenos Aires from June 2006 to March 2011.

Factors associated with nonattendance at clinical medicine scheduled outpatient appointments in a university general hospital.

Introduction: Nonattendance at scheduled outpatient appointments for primary care is a major health care problem worldwide. Our aim was to estimate the prevalence of nonattendance at scheduled appointments for outpatients seeking primary care, to identify associated factors and build a model that predicts nonattendance at scheduled appointments.

Methods: A cohort study of adult patients, who had a scheduled outpatient appointment for primary care, was conducted between January 2010 and July 2011, at the Italian Hospital of Buenos Aires.

Developing and implementing an interoperable document-based electronic health record.

Health information exchange ensuring its authenticity and integrity is not a simple task. Many institutions have implemented different solutions to perform this exchange using partial or summary information, and rarely include metadata that establish the context in which they performed the primary data capture. In this setting, we proposed the creation of an alternative architecture, parallel, yet integrated with a traditional electronic health record, based on the relational data model.