Friday, December 31, 2010

Nasal Congestion Prior To Period

The crux of the matter.

would think that given the "waves" of graduates in medicine and the MIR finish in his pocket, could be a shortage of doctors ...

The reality is quite different: a shortage of doctors, more than a few specialties not others, and also a very unequal land distribution.

In Catalonia, without going any further, within a radius of 40 to 50 km from Barcelona, \u200b\u200bare some of the most advanced medical services in the world, a world reference ... however, moving away from this area, we will already have a shortage of doctors ... for example, to service the Central Catalunya, only 3 radiologists: and this has forced to deploy a teleradiology service.

In Balearic Islands, in the public offering there is not one allergist ...

And we could go shelling specialty by specialty ...

technologies associated with the concept of telemedicine can be mitigated depending on the specialty and the method these shortcomings ... but it is also true that normally associated with deployment of such expensive equipment or expensive.

The question might be: Is it possible to deploy telemedicine services "low-cost"? How contrasted efficiency and quality?

is a question I've been asking me for months ...

So when a few days ago, Maria José Alonso writing this tweet , I thought it would be worthwhile to reflect on teledermatology.

To begin with, since raw materials are the images, we can think of a store and forward model, ie no image transmission in real time, we are not making a teleconsultation.

Therefore, it could take a picture, store, send to a dermatologist, assess it and send back information and instructions or date and time for a more detailed exploration.

What additional information would need a dermatologist, addition to the photo in order to make the best score possible?

In terms of image, the various sources I consulted say that usually are used to store and forward chambers of resolutions between 4 and 8 megapixel ... therefore we could think of a smartphone with camera 4 Megapixel or higher, with 2G/3G data connection ... Do

cameras these smartphones are of sufficient quality? Because the optics of the camera phone is also important.

So many challenges ...
  • find a smartphone with enough resolution.
  • Make a comparative test with a conventional digital camera the same resolution and under the same conditions
  • information requirements necessary for the dermatologist can evaluate
To move forward (as I am rather of the tribe of the chip) I asked for help from a friend and dermatologist 2.0, José María Alonso, who has been given willingly to help.

:-) Stay tuned to your screens ...

Safety Valve In Pressure Cooker

PHR: in the way of city e-city.

One of the things that I like is that those who have asked questions and take nothing for granted ... and so it was that yesterday, during an exciting session of the laying of a washing machine, I had a conversation with a friend of mine doctor, which I used a term that she sounded unknown, PHR, an acronym for Personal Health Record .

The wikipedia link leaves the classical definition and model for the USA ...

But what do we mean and how they are orienting PHR deployments in Europe?

PHR would
personal history, one that corresponds and is maintained by the city ... that is, as an extension of the stewardship process with the clinician, the individual should be and must manage their health information and welfare.

The responsibility, therefore, is not only created a blog, a twitter account and search for health information criterion: the responsibility is 360 ° and extends to all aspects of health and wellness .. . and is not necessary that the citizens are sick to make use of it.

The personal history might think that is based only on clinical information repositories: they do not, the information that is in clinical repositories is one of the sources of a PHR, but not the only ...

I must say that a PHR in which leaving only a duplicate of the contents of a clinical repository does not add much value, that to me, I am a patient with type 2A cholesterol, 10mg atorvastatin prescription chronic 1-daily, which I know that I take, I displayed it, together with a history of my disease and prescription is not something that motivates me a lot, to put it mildly.

The PHR MUST bring a lot more, because it is oriented to the citizen: a study of Nike, the word most used in social networks is "I" and therefore any value personalized service that can link the PHR will be highly appreciated.

Thus, the citizen contributions can add regarding activities of daily living (ADL), or connect sensors (including non-prescription) and the Polar pulse scales or Bluetooth, to name two examples, for captured biometric data can be stored in the PHR, the association of these services.

thing is to store to store, if you do not have a clear return on value, not that it is too stimulating.

why the PHR should be combined with PGS type services (Patient Guidance Services), business intelligence services that are capable of, based on existing information in PHR, offering health advice ...

Suppose, for example, that the PHR is introduced our size, scale and Bluetooth (or manually) send our information weight: it can trigger a calculation of body mass index, and depending on the value and other parameters, to propose such a diet, a doctor's visit ...

Suppose, for example, I am a great lady :-) I practice Pilates, spinning, jogging, and more ... I have tachycardia and also ... the use of sensors heart during physical activity, which information would be stored in my PHR, along with the supervision of a cardiologist (who would have access to this information), allow better control of physical activity.

Suppose I am a teen with pheromones boiling :-), and probably is thinking about having my first sex ... a PHR with PGS can provide the information needed to practice safer sex so ... who says sex, says drugs, alcohol, piercings or tattoos ...

Suppose I am a diabetic with type 1 DM, with most Bluetooth glucose meter weight control and quizzes dedicated to control activities Daily life ... PHR again and again PGS can provide an added plus for quality of life in this kind of chronic patient.

Suppose I am a patient who wants to use the PHR to download medical reports have been generated in a center of the public ... prevent movement, a service much appreciated by the public.

Suppose I am a user of medical services related to private health care, either through mutual, whether private-private, although there is a high degree of consensus on the issue, if the center is connected to the public PHR and "incorporate" the most relevant data of the services provided ... and if the city itself may be incorporated.

In the case of health problems in the case of a shift away from the CCAA or the country, to have this service on mobile (and therefore is also mHealth PHR) can be a safety factor Added: our HC always travels with us and will be present wherever there is Internet connection.

are a few examples of the possibilities of this set of services: obviously may be some fear or apprehension about the access and registration of citizens to their PHR, but it is also true that until now in the process of opening of HC on a first visit, background are based solely on the information given orally (once in documentary form) the patient / citizen.

This is what comes ... this is the future: at least in Catalonia and Valencia and is in deployment phase, and Andalusia has also announced a similar deployment.

In Europe, only France has a public PHR ... in the UK have agreements with Google Health and Microsoft HealthVault , and in Germany the deployment of Microsoft HealthVault Siemens does, in this case acts as a VAR, under the name of ASSIGNIA .

You can see that trend. :-)

Wednesday, December 29, 2010

Men In Showers Quicktime

Year Honours 2010 in Medical Journal.

From a tweet Iñaki González and José María another Alonso I hear that " Medical Journal" has done me the honor, forgive the repetition, to include me in your Honor Roll of the Year 2010 (in today's edition, you will find inserted in the post, p. 42).

The truth is I do not know what to say ... a year ago at this time, was little known in the sector (only Rosa Taberner is a follower "fierce" from my second post: Rosa thanks !)...

I do not know if I deserve this award or not, but if I want to thank all those who have been following my odyssey on Twitter or Facebook, and especially Montse and Karla Carrasco Islands: without them this would never would have happened.

Thanks again to you all ... frankly do not know what to say.

Tuesday, December 28, 2010

Replacing Kohler Toilet Valve Fluidmaster

Ovum.

time ago I spoke to someone young and full of life, which had suffered Hodgkin lymphoma , and what would be the ideal process in which a patient would have a total control of their process to make decisions for themselves about their health, their life decisions.

There were two comments, one of Rosa Taberner and one of Dr. Cole , which made me think ... this post is as a compendium of reflections.

is true that at this time the patient does not have options to participate equally and in the process of deciding on the process, not just to be present in the context of a tumor board, and it is also true there are a number important for patients who are not prepared emotionally for it.

But we can not deny access to what I believe is a basic right ... What professional assistance, thus establishing who should be introduced into the chain of decisions, and who is not?

Give them the opportunity to participate in the decision chain, how can you ensure their emotional stability in the event of an adverse prognosis?

What would perhaps be more logical and legally acceptable is to leave the decision to the patient ...

But I suspect that in case of adverse prognosis would introduce an element evaluator, much as it pains me to use this expression.

We also have the problem of hypochondriacs "empowered" cyberchondriacs ... an estimated 20% of the English population corresponds to the profile, and according to this study Microsoft Research, some 160 million U.S. citizens.

How can we manage it?

I keep thinking.