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The chart shows the ratio of a journal's documents signed by researchers from more than one country; that is including more than one country address. Not every article in a journal is considered primary research and therefore "citable", this chart shows the ratio of a journal's articles including substantial research research articles, conference papers and reviews in three year windows vs. Ratio of a journal's items, grouped in three years windows, that have been cited at least once vs.

The purpose is to have a forum in which general doubts about the processes of publication in the journal, experiences and other issues derived from the publication of papers are resolved. For topics on particular articles, maintain the dialogue through the usual channels with your editor.

Year SJR 0.

Anaesthesia and Intensive Care Medicine

Citations per document. Cites Year Value External Cites per document 2. In general, they are useful for prognostic indexes, formulae related to analytical values and infusion dose titration. And even though there are apps for single calculations, most of them include various calculations—usually classified by organs or systems. Most apps provide precise and reliable results according to one of the few papers that put these medical calculators to the test.

They have a similar profile and are available in English language. However, MedCalc—of Swiss origin and developed by Dr. Pfiffner and Dr. Tschopp, stopped being free a long time ago, which has increased the number of downloads of the MDCalc app, commercialized by MD Aware as an app, even though it has an old tradition as an online calculator..

Antoni J. Now we will mention apps with summaries on topics, schemes, or diagnostic algorithms. They include information that even though could be presented in other formats that combine texts, and images, consultations are easier and user-friendlier in the format of an app.. It provides guides and diagnostic and therapeutic algorithms with general aspects over the use of antimicrobians, guides of empirically supported treatment and prevention manuals.

It also provides calculators capable of measuring infectious processes, web resources and access to the commission blog.. Sepsis Clinical Guide. It provides clinical information and tools used in the diagnosis and management of sepsis and septic shocks. This app is designed to be used by physicians and other healthcare providers managing critically ill patients.. It is a fee-for-service app and is in Spanish language.

It has a large database with specifics on action mechanisms, signs and symptoms, diagnosis, treatment and prognosis of poisonings..

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EchoCalc is basically a free ultrasound manual developed by the British Society of Echocardiography describing the different slices and normal values of ultrasound measurements.. Uptodate includes reviews of over 10, topics in constant discussion. Even though it requires subscription, the great variety of topics it includes, and its primarily practical and concise profile have made it a very popular app, and many health institutions that have already subscribed now offer access from their website..

Certain apps are also available including some of the aforementioned functionalities. Many all-in-one-apps include one more or less large database with different topics of discussion. It has numerous functions: pharmacopoeia, pharmacological interactions, disease thematic index, one system to be able to identify prescription tablets, one medical calculator, medical proceedings, etc.

Also, Medscape provides one specific version for intensive care medicine with clinical data, discussions, continuing medical education seminars, papers of interest, and news from different areas of interest of this or that medical specialty.. It requires prior registration. There is also a more complete fee-for-service app including guidelines on clinical practice, one manual with diseases and another manual on alternative medicine, the ICD classification, and treatment protocols on infectious diseases..

Omnio iOS and Android : it is an update of the famous Skyscape. Through one simple registration we will have easy and quick access to relevant medical information such as: medications guides, the Merck Manual, calculators, news, interaction analyser, and guidelines from the CDC, the American Diabetes Association and the National Comprehensive Cancer Network.. Its content is permanently updated, and has reliable sources such as the drug database designed by the Spanish General Council of Official Colleges of Pharmacists. Also, it has a profile based on our medical field by picking up relevant papers and information of interest..

Mobile devices, PDAs at the beginning and then smartphones like tablets, have always had the potential of storing large amounts of information such as books, notes, etc. However, this potential is more powerful in these tablets thanks to Internet connectivity and the functionality of app interaction—something of vital importance in a process of learning. Recent studies show that the students of medical schools and young attending physicians use these new technologies in over 75 per cent , and require apps for their academic training and clinical practice, 19 and this is the reason why many medical schools and residency programmes have replaced textbooks for electronic tablets in order to teach diagnoses, proceedings, and operations.

Diagnostic tool apps have been designed to achieve precise diagnoses and treatments. Many of these apps are versions of landmark medical books for the diagnosis of diseases. Most provide information on infectious diseases, laboratory values, pathogens, differential diagnoses, treatments, etc. There is an old study from that shows that the five most widely used apps on cases provide correct treatment recommendations in over 95 per cent of the cases. With over diseases, differential diagnoses, and interactive algorithms, it is particularly useful for both point-of-care and urgent situations..

And yet despite the fact that its use in controlled settings offered better results in CPR management, 24 no further studies have been conducted that would back up its clinical use.. The use of smartphones has proven benefitial in intensive care settings because of the reduced risk of medical errors following the immediate communication they provide with respect to pagers.

Whichever app we choose, they have improved communication in different settings such as the experiences published by surgeons, 26 transplant coordinators, 27 or emergency services. Smartphones and apps enable inter-patient communication through the use of regular apps, 29 or apps specifically developed for communication purposes without linguistic barriers, such as the Patient Communicator app by SCCM, created by the Society of Critical Care Medicine, that eliminates all linguistic barriers bidirectional communication in 19 different languages , while offering the possibility of choosing what part of your body hurts and what the intensity of sensations such as pain, itches, nausea, etc.

The collection of data from studies, clinical trials, etc. This has a real translation since one of the largest manufacturers of smartphones and software today—Apple Inc. Once authorized by the user, the apps operating under this platform available in appstore.

The Intensive Care Medicine Journal

All this with a very important focus on privacy, giving users absolute control of the information they have access to from each app and the visualization of data shared at anytime. Thanks to this technology, we can select more patients, conduct more efficient follow-ups, with fewer losses and lower costs, which empowers and gives more meaning to the studies already conducted.

From a more practical standpoint, we should talk about the ICU Trials app by ClinCalc iOS and Android —one quick-reference app for the intensive care physician, including short summaries and key points from the main clinical trials of Medicine.. It estimates derived values cardiac index, systolic volume index, peripheral vascular resistance, peripheral vascular resistance index , and tables and tendencies across time that grant us access to advanced monitoring with lower costs than that of specific monitors..

This app is still in the process of clinical validation though some studies have already validated it in simulation settings. Obviously, serious risks are associated with the use of these technologies in today's society of information.. Many times, the user does not even know how the app operates internally, what services it connects to, what the protocols it uses, etc. This is why its use is based on confidence only, which, obviously, is not enough for users or institutions to adopt these technologies without a strict review of security in data storage and transfer.

As a matter of fact, today there are apps that yet despite the fact that they are certified or endorsed by public services or scientific societies, are not as reliable as expected, as it shows one study conducted during 6 months among 79 apps with certifications of being clinically safe and trustworthy, according to the United Kingdom National Health Service that confirmed that 88 per cent of the apps transferred information online of which 66 per cent were not encrypted while per cent of the apps did not encrypt the personal information stored in the device 32 —a potential risk of exposing sensitive personal information..

In view of the above on the development of apps, the hallmark for generating trust both for users and the healthcare systems should be a clear policy of privacy and security for the management of data collected locally in the device that are transferred and stored remotely in public and private servers , while abiding by the applicable law in matters of privacy, ethical regulations, and needs for medical information.. Yet despite the fact that software programmes come with a number of processes and debuggers, the risks of malfuncioning, errors, etc.

This can be a vital risk for patients, as one study on apps for the resuscitation of burn-injured patients confirmed, where 13 out of the 32 apps analyzed showed errors in the estimation of fluid therapy with respect to the total body surface area burned. This is why institutions such as the European Commission and the U.

Food and Drug Administration FDA have taken measures and come up with a guide of recommendations for the industry that puts apps in the same level as any other drug or medical device. Due to the high levels of implementation of this technology, smartphones have turned into potential biological threats since they are carriers of pathogens in the clinical setting, as it has already been confirmed. Today, we do not know of any legislation, recommendation, or institutional protocol that can guarantee the proper cleaning of smartphones and other electronic devices to further avoid any bacterial contaminations.

As a matter of fact, the manufacturers of electronic devices explicitely warn against the use of aggressive products like the disinfectants used in the cleaning of surfaces.. At least for the time being, it seems reasonable to follow the directions on hand sanitation until new prevention strategies are implemented that take into account the use of these devices in clinical settings and keep the devices covered with disposable bags.

The use of different types of towels, not all of them allowed by the manufacturers of these devices though, has been a topic of discussion in certain pilot studies, 38 yet for now research in this field is insufficient.

Intensive Care Medicine

The development of waterproof, washable smartphones, or phones covered by antibacterial nanomaterials, and the use of ultraviolet radiation stand as the new measures in the fight against bacterial contamination.. This quick access to clinical history, including former health records, image modalities, etc. Not all are setbacks with these new technologies.

Portability: inherent to the very mobile device and providing a great deal of updated information and bedside care of optimal quality..

Segurity: debugged and verified apps provide further security to the process of drug titration and administration, to the performance of proceedings, etc.. User-friendliness: the familiarity that the routine use of the actual operating systems brings allows the development of intuitive, easy to use apps that require a short period of learning..

Networking access: The Internet powers mobile apps.. Data storage: even though it is one of the greatest threats to security, if done correctly data storage can be a great advancement for data access and preservation.. Also this translates into great advances and threats that should be considered challenges.. The use of apps and the interaction with the information collected by other health-related electronic registration systems will individualize and optimize both clinical practice, and the quality and efficiency of primary care..

The entities that develop these apps, the healthcare systems and scientific societies, should create a legal framework, a security framework and studies showing its efficiency so that they become useful, reliable, efficient, and certified tools within the healthcare systems Table Apps are becoming tools of the new technologies of information that have a great potential in all settings of the medical field, and offer promising opportunities to improve the scope and quality of the healthcare services..

We the authors declare that while conducting this paper there were no conflicts of interests linked whatsoever..

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