Telemedicine consultation for emergency patients' attention: a clinical experience from a high complex university hospital from Latin America.

INTRODUCTION: As a result of the new coronavirus pandemic, a highly complex academic hospital in Latin America implemented a telemedicine service for the care of obstetric, pediatric, and adult patients. In 2020, regional emergency services collapsed due to the increase in demand for care, generating the need to open expansion services and seek strategies to provide timely care to consulting patients. OBJECTIVE: We retrospectively describe the clinical experience of patients who consulted the emergency department via telemedicine across a videoconference tool using digital platforms. METHODS: A descriptive study with retrospective data collection was conducted to describe the implementation of the teleconsultation care model for patients. We constructed the clinical process indicators to evaluate the model. RESULTS: A total of 4652 teleconsultations were registered. Telemedicine consultation was above 50% in the country and department and above 90% in Cali city. The average waiting time for care was estimated to be 1:59:52 h. A total of 275 patients were transferred to the emergency room after consultation. The principal reasons for consultation in the institutional telemedicine program were respiratory and gastrointestinal symptoms. Teleconsultations related to SARS-COV 2 infections reported 3775 patients (3127 with unidentified virus and 648 with the identified virus). CONCLUSIONS: Telemedicine is a tool that provides support and guidance to patients who consult emergency departments, reducing barriers to access health care and decreasing emergency department collapse.

Evaluation of reagentless pH modification for in situ ocean analysis: determination of dissolved inorganic carbon using mass spectrometry.

RATIONALE: In situ analytical techniques that require the storage and delivery of reagents (e.g., acidic or basic solutions) have inherent durability limitations. The reagentless electrolytic technique for pH modification presented here was developed primarily to ease and to extend the longevity of dissolved inorganic carbon (DIC) determinations in seawater, but can also be used for other analytical methods. DIC, a primary carbon dioxide (CO(2)) system variable along with alkalinity, controls seawater pH, carbonate saturation state, and CO(2) fugacity. Determinations of these parameters are central to an understanding of ocean acidification and global climate change. METHODS: Electrodes fabricated with electroactive materials, including manganese(III) oxide (Mn(2)O(3)) and palladium (Pd), were examined for potential use in electrolytic acidification. In-line acidification techniques were evaluated using a bench-top membrane introduction mass spectrometry (MIMS) setup to determine the DIC content of artificial seawater. Linear least-squares (LLSQ) calibrations for DIC concentration determinations over a range between 1650 and 2400 µmol kg(-1) were obtained, using both the novel electrolytic and conventional acid addition techniques. RESULTS: At sample rates of 4.5 mL min(-1), electrodes clad with Mn(2)O(3) and Pd were able to change seawater pH from 7.6 to 2.8 with a power consumption of less than 3 W. Although calibration curves were influenced by sampling rates at a flow of 4.5 mL min(-1), the 1σ measurement precision for DIC was of the order of ±20 µmol kg(-1). CONCLUSIONS: Calibrations obtained with the novel reagentless technique and the in-line addition of strong acid showed similar capabilities for DIC quantification. However, calculations of power savings for the reagentless technique relative to the mechanical delivery of stored acid demonstrated substantial advantages of the electrolytic technique for long-term deployments (>1 year).

Spectrometric determination of the refractive index of optical wave guiding materials used in lab-on-a-chip applications.

The design and optimization of light-based analytical devices often require optical characterization of materials involved in their construction. With the aim of benefiting lab-on-a-chip applications, a transmission spectrometric method for determining refractive indices, n, of transparent solids is presented here. Angular dependence of the reflection coefficient between material-air interfaces constitutes the basis of the procedure. Firstly, the method is studied via simulation, using a theoretical algorithm that describes the light propagation through the sample slide, to assess the potentially attainable accuracy. Simulations also serve to specify the angles at which measurements should be taken. Secondly, a visible light source and an optical fiber spectrometer are used to perform measurements on three commonly used materials in optical lab-on-a-chip devices. A nonlinear regression subroutine fits experimental data to the proposed theoretical model and is used to obtain n. Because the attainable precision using this method of refractive index determination is dictated by the uncertainty in the transmission measurements, the precision (with 95% confidence) for mechanically rigid samples, namely glass and poly(methyl methacrylate) (PMMA), is higher than those estimated for the elastomer sample (in-house-molded poly(dimethylsiloxane) (PDMS)). At wavelengths with the highest signal-to-noise ratio for the spectrometer setup, the estimated refractive indices were 1.43+/-0.05 (580 nm) for PDMS, 1.54+/-0.02 (546 nm) for glass, and 1.485+/-0.005 (656 nm) for PMMA. Accurate refractive index estimations with an average precision equal to 0.01 refractive index units (RIU) were obtained for PMMA and glass samples, and an average precision of 0.09 RIU for the PDMS molded slide between 550 and 750 nm was obtained.