ABSTRACT
PURPOSE: Timely screening and treatment are essential for preventing diabetic retinopathy blindness. Improving screening workflows can reduce waiting times for specialist evaluation and thus enhance patient outcomes. This study assessed different screening approaches in a Brazilian public healthcare setting. METHODS: This retrospective study evaluated a telemedicine-based diabetic retinopathy screening implemented during the COVID-19 pandemic and compared it with in-person strategies. The evaluation was conducted from the perspective of a specialized referral center in an urban area of Central-West Brazil. In the telemedicine approach, a trained technician would capture retinal images by using a handheld camera. These images were sent to specialists for remote evaluation. Patient variables, including age, gender, duration of diabetes diagnosis, diabetes treatment, comorbidities, and waiting time, were analyzed and compared. RESULTS: In total, 437 patients with diabetes mellitus were included in the study (mean age: 62.5 ± 11.0 years, female: 61.7%, mean diabetes duration: 15.3 ± 9.7 years, insulin users: 67.8%). In the in-person assessment group, the average waiting time between primary care referral and specialist evaluation was 292.3 ± 213.9 days, and the referral rate was 73.29%. In the telemedicine group, the average waiting time was 158.8 ± 192.4 days, and the referral rate was 29.38%. The telemedicine approach significantly reduced the waiting time (p<0.001) and significantly lowered the referral rate (p<0.001). CONCLUSION: The telemedicine approach significantly reduced the waiting time for specialist evaluation in a real-world setting. Employing portable retinal cameras may address the burden of diabetic retinopathy, especially in resource-limited settings.
Subject(s)
COVID-19 , Diabetic Retinopathy , Telemedicine , Humans , Diabetic Retinopathy/diagnosis , Female , Male , Retrospective Studies , Telemedicine/methods , Middle Aged , Brazil , Aged , Referral and Consultation , Mass Screening/methods , Pandemics , SARS-CoV-2 , Time Factors , AdultABSTRACT
A sarcoidose é uma doença granulomatosa sistêmica, de etiologia ainda desconhecida. Essa doença pode acometer qualquer órgão, mas afeta principalmente pulmão e gânglios linfáticos intratorácicos. Em apenas 10% dos casos existe envolvimento extra torácico. O envolvimento articular é raro e pode-se dividir em agudo e crônico. As articulações mais afetadas na sarcoidose são as dos joelhos, punho, cotovelo e articulações das mãos e pés. Neste estudo iremos descrever um caso de um paciente com sarcoidose envolvendo a articulação sacriilíaca. O acometimento dessa região é bem raro e existem poucos casos relatados na literatura
Sarcoidosis is a systemic granulomatous disease of unknown etiology. This disease can affect any organ, but prefers lung and intra thoracic lymph nodes. In just 10% of cases there is extra thoracic involvement. Joint involvement is rare and can be divided into acute and chronic involvment. The most affected joints are the knees, wrist, elbow, and joints of the hands and feet. Herein we describe a case of a patient with sarcoidosis involving the sacriiliac joint. The involvement of this region is very rare and there are few cases reported in the literature
ABSTRACT
A sarcoidose é uma doença granulomatosa sistêmica, de etiologia ainda desconhecida. Essa doença pode acometer qualquer órgão, mas afeta principalmente pulmão e gânglios linfáticos intratorácicos. Em apenas 10% dos casos existe envolvimento extra torácico. O envolvimento articular é raro e pode-se dividir em agudo e crônico. As articulações mais afetadas na sarcoidose são as dos joelhos, punho, cotovelo e articulações das mãos e pés. Neste estudo iremos descrever um caso de um paciente com sarcoidose envolvendo a articulação sacriilíaca. O acometimento dessa região é bem raro e existem poucos casos relatados na literatura
Sarcoidosis is a systemic granulomatous disease of unknown etiology. This disease can affect any organ, but prefers lung and intra thoracic lymph nodes. In just 10% of cases there is extra thoracic involvement. Joint involvement is rare and can be divided into acute and chronic involvment. The most affected joints are the knees, wrist, elbow, and joints of the hands and feet. Herein we describe a case of a patient with sarcoidosis involving the sacriiliac joint. The involvement of this region is very rare and there are few cases reported in the literature
