En el 2011 se desarrolló la primera versión del Diplomado en Informática Biomédica, del 17 de enero al 18 de Marzo del 2011.
En el programa contamos con la participación de 14 alumnos, 12 en la mención de Informática en Salud y 2 en la mención de Bioinformática, los cuales compartieron 7 semanas intensas de entrenamiento en las áreas más importantes de Informática Biomédica.
Entre nuestros alumnos tuvimos a profesionales de áreas diversas como Medicina (9), Ingienería (4) y Biología (1). Dos de nuestros alumnos, Osmán y Juan Guillermo, nos visitaron desde Venezuela y Colombia para llevar el Diplomado.
Las clases se desarrollaron con éxito durante las siete semanas, con un total de 73 profesores, 57 nacionales y 16 extranjeros (Argentina, Colombia, Chile, Estados Unidos, Inglaterra y México) tanto a nivel presencial como no presencial usando tecnologías de teleconferencia.
Como trabajo final del Diplomado, los alumnos presentaron propuestas de Investigación en Informática Biomédica, las cuales fueron evaluadas por el Comité Científico de QUIPU para recibir financiamiento.
Propuesta: Empowering diabetic patients and their caregivers using information technologies
Autores: Lupe Vidal, José Luis Rojas, Jorge Osada, Gustavo Donayre
Diabetes mellitus is a serious chronic disease. The global prevalence of diabetes is estimated at over 200 million. This figure has been predicted to reach 333 million by 2025 because of longer life expectancy, sedentary lifestyles and changing dietary patterns. Most diabetic patients over 50 years old have disabilities.
One of these complications is the diabetic foot, which can lead into limb amputation. This complication is highly disabling and preventable. Information and communication technologies (ICT) could play an important role in this group of patients. The emergence of new technologies such as SMS, Internet, email, etc. has the potential to greatly improve health service efficiency, expand or scale up treatment delivery to thousands of patients in developing countries, and improve patient outcomes.
Innovative interventions through mobile devices for chronic patients are being used around the world with quite success. However, the evidence from developed countries is very limited. In Peru, there is almost no literature about the use of technologies as a support for diabetes care. The proposed study is designed to evaluate a combined intervention using information technologies (IT) to improve diabetes care in patients and caregivers by empowering them using IT. We propose a two-phase study to evaluate the knowledge of Peruvian diabetic patients before and after an intervention based on IT and support by their caregivers. We expect toTuberculosis is one of the major public health problems in Peru. It is the third leading cause of death by specific causes of infectious disease group and the cumulative incidence was 96/100,000 in 2009. One of the factors limiting the control of Tuberculosis at all operational levels is the absence of an information system that allows health workers and patients, to track the treatment adherence and therefore taking appropriate decisions best suited to effectively reduce dropouts and failures and consequently cases of MDR tuberculosis and the need for retreatment. The current information system, which repeats 46% of data, is based on paper forms and its operation is cumbersome, fragmented, incomplete, and untimely adds work overload to the health care staff.
Propuesta: Improving Home blood pressure monitoring report: Closing physician-patient gap
Autores: Marcela Juárez, Javier Loza
Resumen: Every year in Peru, cardiovascular diseases cause more than 25 000 deaths and losses of 350 000 disability-adjusted life-years. Of these, hypertension is a leading cause: 23% of population older than 30 years is hypertensive, of which only 5% achieve disease control. A continuous blood pressure (BP) level of 130/80 or less is considered controlled because it prevents disabling events and mortality.
Multiple interventions for improving hypertension control rates have been tested. Of these strategies, home blood pressure monitoring (HBPM) achieved consistent success probably because of patient empowerment and better decision-support data which in turn could improve adherence and avoid therapeutic inertia. Both physicians and patients hold perceptive barriers towards HBPM; for example, measurement data transmission and handling has been reported as a source of preoccupation by health providers.
Based on these experiences, we intend to develop a remote support system for HBPM, enabling safe and timely registration and communication of monitoring information between health providers and patients.
The project consists of the following stages:
- A cross-sectional survey will measure HBPM process penetration within hypertensive population currently attending to a non-transmissible chronic diseases program of a health insurance company in Lima, Peru.
- A qualitative study with semi-structured interviews will explore facilitators and barriers towards HBPM process within studied hypertensive population and physicians.
- A system design process based on an iterative model will develop an automated mobile phone-based system in order to share HBPM monitoring data between health providers and patients, prototypes will be tested on a small sample of Every year in Peru, cardiovascular diseases cause more than 25 000 deaths and losses of 350 000 disability-adjusted life-years. Of these, hypertension is a leading cause: 23% of population older than 30 years is hypertensive, of which only 5% achieve disease control. A continuous blood pressure (BP) level of 130/80 or less is considered controlled because it prevents disabling events and mortality.
Propuesta: Implementation of an Automated System against vector-borne diseases in Venezuela
Autores: Osmán Argüello
The problem of Vector- borne Disease Surveillance deals with poor methodology transfer and analysis of data by health staff today.
The project objective is to demonstrate that the system can improve the epidemiological surveillance through information technologies with the use of mobile devices in rural areas using this new forms of data collection, information sharing and optimizing the response times of health personnel work in these areas.
The methodology will be qualitative and quantitative. The results we expect will be improved data collection time, transfer of collected information, analyzing and making sound decisions for epidemiological surveillance in rural areas.
This can effectively reduce the number of cases of vector-borne disease.
Propuesta: SInTB: The Electronic Health Record to fight against Tuberculosis in Peru
Autores: Hugo Juro, Román Edén, Javier Vargas, Jorge Nakachi.
Tuberculosis is one of the major public health problems in Peru. It is the third leading cause of death by specific causes of infectious disease group and the cumulative incidence was 96/100,000 in 2009. One of the factors limiting the control of Tuberculosis at all operational levels is the absence of an information system that allows health workers and patients, to track the treatment adherence and therefore taking appropriate decisions best suited to effectively reduce dropouts and failures and consequently cases of MDR tuberculosis and the need for retreatment. The current information system, which repeats 46% of data, is based on paper forms and its operation is cumbersome, fragmented, incomplete, and untimely adds work overload to the health care staff.
We think the use of Electronic Medical Record SInTB(EMR SInTB) will improve the quality of diagnosis, and the compliance of clinical check-ups of the TB patients within the established deadlines. A web-based information system can replace the need for keeping existing log books. The health care staff could have real time access to patient data through a computer or a mobile device and patients may even receive remainder messages on the need to go to the health establishment for regular check-ups. In Peru, there are experiences in implementing information systems to tuberculosis control (NETLAB and e-Chasqui), but they are limited to manage laboratory data or the patient care process for MDR TB cases.
We will make a qualitative and quantitative study in four Health Centers for primary care. In three that will receive the intervention and one that does will not receive the intervention. The qualitative study aims to measure the degree of acceptability of health personnel to EMR SInTB. The quantitative study will be quasi experimental. We will measure in a series time, the data quality and clinical outcomes, such as: completion of the assessment of weight and control BK or cases that initiated timely treatment. The measuring of indicators will be before and after of the intervention (EMR SInTB).
Propuesta: Mobile PHR as a way to share clinical information of diabetic patients
Autores: Juan Guillermo Bernal
The lack of information shared among patients with diabetes and their healthcare providers leads to insufficient control of the disease. PHR systems can provide assistance in solving this problem.
The perceptions of users are a key part in the success of a project in health that involves Information and Communication Technologies. This is why the main objective of this study is to evaluate the user perceptions to a mobile PHR system, to know which aspects should be covered by the application.
This evaluation will be conducted by a qualitative study, which can provide this information including system requirements. The development of the pilot application will be made following a methodology that involves users in each phase such as extreme programming, and a final evaluation of the functionality and usability will be conducted by a quantitative study with a descriptive and a comparative analysis.
We expect that knowing the perceptions and the real system requirements, the application can provide an effective way to share clinical information between the patients and their healthcare providers. We also expect that the application would constitute a means of empowerment of the patient to his health.
Propuesta: Applying bioinformatics for cysticercosis control
Autores: Hugo Valdivia, Ana Dávila
Taenia solium neurocysticercosis is the single major cause of acquired epilepsy and a major contributor to neurological pathology in most developing countries. T. solium infections are related to lack of adequate sanitary infrastructure and health education. The T. solium adult worm parasitizes the human intestine and causes taeniasis. Cysticercosis is the disease caused by the intermediate stage (the cyst) which parasites the pig and accidentally humans. In humans, the cyst infects mainly the central nervous system causing neurocysticercosis, a major public health problem in endemic areas of developing countries.
In developed countries, T. solium infections have been controlled through improvement in socioeconomic conditions, like sewage, sanitation systems and pig farming conditions; however these interventions are not feasible in developing countries with poor sanitary conditions and economic instability. Recent studies have shown that interrupting the life cycle of T. solium in any stage will reduce dramatically the infection rates in humans. A complementary intervention for the control of taeniasis/cysticercosis is the use of porcine vaccines. Oncosphere crude antigens, excretory/secretory antigens, or oncosphere derive recombinant proteins have been shown to be the most effective conferring protection against tapeworm intermediate stages.
Despite all the recent advances in cysticercosis, there is neither a vaccine available for commercial use nor a serologic diagnostic test adapted for field conditions. As well as in close organisms, in particular helminthes, genome sequences are not available. These species have been neglected from genome projects; despite they still represent public health problems in developing countries, and in particular in Peru. With the advancement of pyrosequencing, it is now possible to obtain full genome reads for an affordable price. By March 28th our group will receive the full T. solium raw genome sequence based on the 454 pyrosequencing reads, processed at the US-CDC.
Herein we pretend to use bioinformatics and immunoinformatics tools to analyze the T.solium genome and look for potential proteins and epitopes to be used as vaccine candidates for porcine cysticercosis. In addition we plan to obtain a set of molecular markers for T. solium genotyping to perform population epidemiological studies
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