Papers by Daniel Jose Igme Gomez
International medical case reports journal, 2017
Heparin-induced thrombocytopenia (HIT) can cause life-threatening complications following the adm... more Heparin-induced thrombocytopenia (HIT) can cause life-threatening complications following the administration of heparin. Discontinuation of all sources of heparin exposure and the use of alternative agents for anticoagulation are necessary when HIT is suspected or diagnosed. We present the successful use of bivalirudin anticoagulation in an adolescent patient during cardiopulmonary bypass who underwent both placement of a left ventricular assist device and subsequent heart transplantation within a 36-hour period. The pathophysiology and diagnosis of HIT are reviewed, previous reports of the use of direct thrombin inhibitors for cardiac surgery are presented, and potential dosing regimens for bivalirudin are discussed.
Artificial Organs, 2016
Outcomes for extracorporeal membrane oxygenation (ECMO) have been described for patients with sin... more Outcomes for extracorporeal membrane oxygenation (ECMO) have been described for patients with single ventricle physiology (SVP) undergoing cavopulmonary connection (Glenn procedure). An alternative surgical pathway for patients with SVP consists of an initial hybrid procedure followed by a comprehensive Stage II procedure. No data exist describing the outcomes of patients requiring ECMO after the comprehensive Stage II procedure. The goal of this study is to describe the outcomes for patients who required ECMO after the comprehensive Stage II procedure. Data from the Extracorporeal Life Support Organization (ELSO) registry from 2001 to 2015 for children undergoing the comprehensive Stage II procedure older than 3 months of age were retrospectively analyzed. Demographics and ECMO characteristics were recorded. A total of six children required ECMO support after the comprehensive Stage II procedure (2 males, 4 females). Four patients had the diagnosis of hypoplastic left heart syndrome and two patients had the diagnosis of an unbalanced atrioventricular septal defect. Bypass time was 242.8 ± 110.9 min and cross-clamp time was 91.2 ± 46.2 min for the surgical procedure. Weight was 5.8 ± 1.3 kg and age was 150.2 + 37.9 days at time of ECMO. ECMO duration was 276.0 ± 218.1 h. Complications during the ECMO run included hemorrhage in four patients (67%), renal dysfunction in two patients (33%), and neurologic injury in two patients (33%). Four patients (67%) were discharged alive after ECMO decannulation. Despite being a much more extensive surgical procedure, the morbidity and mortality after ECMO in patients undergoing the comprehensive Stage II procedure are similar to those in patients undergoing the Glenn procedure. If needed, ECMO support is reasonable for patients after the comprehensive Stage II procedure.
Journal of Intensive Care Medicine, 2016
Near-infrared spectroscopy (NIRS) is a noninvasive monitoring technique that measures regional ce... more Near-infrared spectroscopy (NIRS) is a noninvasive monitoring technique that measures regional cerebral oxygen saturation (rSO2). The primary aim was to compare the output of 2 NIRS-based cerebral oximetry devices, FORESIGHT (CAS Medical Systems Inc, Branford, Connecticut) and INVOS (Covidien, Boulder, Colorado), to venous oxygen saturations from the jugular venous bulb at cannulation and decannulation of the superior vena cava (SVC). Secondary objectives included evaluating correlations of cerebral saturation, as measured by the NIRS devices, with mean arterial blood pressure (MAP), measured by an invasive arterial line, and end-tidal CO2 (ETCO2). Near-infrared spectroscopy, MAP, and ETCO2 data were collected at 13 defined events during each case when hemodynamic instability was expected. At SVC cannulation and decannulation, a 0.1 mL sample of blood was collected from the jugular bulb by the surgeon using a long angiocatheter. The oxygen saturation of these blood samples was measured using an AVOX device and compared with contemporaneous readings from the NIRS probes. Mixed-effects linear regression was used to correlate MAP or ETCO2 with cerebral oxygen saturation (by NIRS) at each time point. Children undergoing cardiopulmonary bypass for congenital heart surgery (n = 34) were enrolled in the study. At SVC cannulation, both INVOS (r = .78) and FORESIGHT (r = .59) were correlated with AVOX data at P < .001, although the correlation with INVOS was significantly stronger (P = .003). At SVC decannulation, INVOS (r = .68; P < .001) and FORESIGHT (r = .60; P < .001) were similarly correlated with jugular venous rSO2. Correlations of rSO2 (by NIRS) with MAP and ETCO2 levels were stronger than correlations between rSO2 change and change in MAP or ETCO2. INVOS correlated more strongly than FORESIGHT with the jugular bulb rSO2 at SVC cannulation but may have underestimated oxygen saturation at low rSO2 values. Data from both NIRS devices were correlated with MAP and ETCO2 over the case duration.
Page 1. ABSTRACT This paper describes the development of a system for dexterous telemanipulation ... more Page 1. ABSTRACT This paper describes the development of a system for dexterous telemanipulation and presents the results of tests involving simple manipulation tasks. The user wears an instrumented glove augmented with an arm-grounded haptic feedback apparatus. ...
Dyna, Jul 1, 2008
RESUMEN: Las vibraciones excesivas o prolongadas en estructuras civiles, pueden producir molestia... more RESUMEN: Las vibraciones excesivas o prolongadas en estructuras civiles, pueden producir molestias en los usuarios y daños en elementos estructurales y no estructurales. Estas vibraciones están determinadas por los parámetros dinámicos (masa, rigidez y amortiguamiento), y es modificando estas características estructurales como se minimiza la respuesta de la edificación. La disminución de la respuesta estructural es el objetivo en el diseño sismo resistente, garantizando una adecuada resistencia, rigidez y ductilidad. En los últimos años se han propuesto alternativas para disminuir la vulnerabilidad estructural, entre ellas los sistemas de control activo, pasivo, híbrido y semiactivo; implementados en estructuras flexibles (rascacielos y puentes colgantes) en Japón y Estados Unidos. Este artículo incluye un breve resumen histórico del desarrollo de estos sistemas de control estructural y presenta el estado del arte y estado de la práctica de esta tecnología. Además, se describen las limitaciones y ventajas de los sistemas en el contexto del diseño y rehabilitación sismo resistente de estructuras.
Revista Ingenieria Y Competitividad, Jul 16, 2012
Efectos de la interacción humano-estructura en las propiedades dinámicas de una tribuna.
Obesity Surgery, 2010
Laparoscopic sleeve gastrectomy is a procedure for the management of morbid obesity, which usuall... more Laparoscopic sleeve gastrectomy is a procedure for the management of morbid obesity, which usually implies the placement of multiple trocars. It is now possible to perform procedures through smaller incisions, known as "invisible" or single port surgery. We describe the case of a transumbilical sleeve gastrectomy completed totally laparoscopically through a single port using a multichannel device.
Dyna, Feb 1, 2013
Recibido para revisar Octubre 16 de 2012, aceptado Diciembre 6 de 2012, versión final Diciembre 1... more Recibido para revisar Octubre 16 de 2012, aceptado Diciembre 6 de 2012, versión final Diciembre 12 de 2012 RESUMEN: En la actualidad, el incremento de la resistencia en nuevos materiales y las mayores luces entre apoyos hacen que los puentes peatonales sean más susceptibles a problemas de vibraciones excesivas. Infortunadamente las provisiones de las normas colombianas son limitadas para el diseño o rehabilitación de estas estructuras. En este artículo se presenta una clasificación de los puentes peatonales en Santiago de Cali que permite comparar efectos de la Interacción Humano-Estructura, aceleraciones máximas y frecuencias naturales, con los criterios de vibraciones para diseño especificados en las principales normas. Aunque en los 19 puentes estudiados no se superaron los límites de aceleraciones establecidas por las normas por una persona al caminar, 16 de los puentes presentaron vibraciones que generaron incomodidad en los peatones. En consecuencia, se recomienda que futuras normas colombianas establezcan valores límites de aceleraciones y frecuencias naturales en función del desempeño según niveles de comodidad y seguridad percibida por los peatones.
Dyna, Mar 2, 2010
RESUMEN: Las cimentaciones profundas son usadas con el fin de brindar estabilidad a una variedad ... more RESUMEN: Las cimentaciones profundas son usadas con el fin de brindar estabilidad a una variedad de estructuras tales como puentes, presas y edificaciones en condiciones donde las cimentaciones superficiales no la proporcionan. En consecuencia, ha surgido la necesidad de evaluar la calidad de este tipo de cimentaciones y descartar cualquier anomalía generada durante su proceso constructivo, motivo por el cual se han implementado los ensayos no destructivos, entre ellos la prueba de integridad de pilotes (PIT) que debido a sus bondades como lo son su rapidez y economía sumada a sus resultados, ha despertado el interés de los investigadores y constructores del medio. En el presente artículo se presentan aspectos generales de la prueba PIT y los resultados de su aplicación en once pilotes en una construcción cerca a la ciudad de Palmira, Colombia. Estos resultados fueron verificados mediante la excavación en dos pilotes en los que la PIT manifestó alguna anomalía, con lo cual se demostró la confiabilidad del método en la determinación de fallas en los elementos estructurales.
Lecture Notes in Computer Science, 2000
In this paper we show that Atanassov's Intuitionistic Fuzzy sets can be viewed as a classificatio... more In this paper we show that Atanassov's Intuitionistic Fuzzy sets can be viewed as a classification model, that can be generalized in order to take into account more classes than the three classes considered by Atanassov's (membership, non-membership and non-determinacy). This approach will imply, on one hand, to change the meaning of these classes, so each one will have a positive definition. On the other hand, this approach implies the possibility of a direct generalization for alternative logics and additional valuation states, being consistent with Atanassov's focuss. From this approach we shall stress the absence of any structure within those three valuation states in Atanassov's model. In particular, we consider this is the main cause of the dispute about Atanassov's model: acknowledging that the name intuitionistic is not appropriate, once we consider that a crisp direct graph is defined in the valuation space, formal differences with other three-state models will appear.
This paper investigates the use of arm-grounded force feedback applied to an operator's fingertip... more This paper investigates the use of arm-grounded force feedback applied to an operator's fingertips while performing telemanipulation tasks with a dexterous robot hand. The forces were applied by a cabledriven feedback device used in conjunction with an instrumented glove. Experiments were conducted to evaluate subjects' ability to discriminate between objects of different size and stiffness, and to regulate grasp forces. The results indicate that object size discrimination was comparable to using a conventional haptic feedback interface grounded to the environment, though still not as effective as direct human contact. The force regulation indicated that the user could maintain a fairly constant force, but was subject to some system noise. Discrimination of object stiffness was the most difficult task, due to the inherent compliances of the system and yielded a 75% success rate for distinguishing between compliant(150 N/m) and rigid objects.
2012 Pan American Health Care Exchanges, 2012
Electromyography is mainly used in the assessment of neuromuscular diseases such as muscular dyst... more Electromyography is mainly used in the assessment of neuromuscular diseases such as muscular dystrophy, myasthemia gravis or peripheral nerve disorders; however its direct relation with limb movement, muscle´s electrical signal accessibility (easy to acquire) and the need in our society to come up with rehabilitation oriented practical solutions make it an approachable and attractive option to develop useful control applications. In this project the forearm muscle signal is acquired through superficial electrodes and processed with a designed circuit in which signal amplification, filtering and other conditioning take place. All of these steps are conducive to obtain a final command so that the user can control the arm prototype at his will with just a tiny muscle contraction.
Lecture Notes in Physics, 1992
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Lecture Notes in Physics, 1992
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Papers by Daniel Jose Igme Gomez