Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.505
Filtrar
1.
Circ Heart Fail ; 14(3): e007767, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33724883

RESUMEN

BACKGROUND: The expense of clinical trials mandates new strategies to efficiently generate evidence and test novel therapies. In this context, we designed a decentralized, patient-centered randomized clinical trial leveraging mobile technologies, rather than in-person site visits, to test the efficacy of 12 weeks of canagliflozin for the treatment of heart failure, regardless of ejection fraction or diabetes status, on the reduction of heart failure symptoms. METHODS: One thousand nine hundred patients will be enrolled with a medical record-confirmed diagnosis of heart failure, stratified by reduced (≤40%) or preserved (>40%) ejection fraction and randomized 1:1 to 100 mg daily of canagliflozin or matching placebo. The primary outcome will be the 12-week change in the total symptom score of the Kansas City Cardiomyopathy Questionnaire. Secondary outcomes will be daily step count and other scales of the Kansas City Cardiomyopathy Questionnaire. RESULTS: The trial is currently enrolling, even in the era of the coronavirus disease 2019 (COVID-19) pandemic. CONCLUSIONS: CHIEF-HF (Canagliflozin: Impact on Health Status, Quality of Life and Functional Status in Heart Failure) is deploying a novel model of conducting a decentralized, patient-centered, randomized clinical trial for a new indication for canagliflozin to improve the symptoms of patients with heart failure. It can model a new method for more cost-effectively testing the efficacy of treatments using mobile technologies with patient-reported outcomes as the primary clinical end point of the trial. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04252287.


Asunto(s)
Canagliflozina/uso terapéutico , Insuficiencia Cardíaca/tratamiento farmacológico , Inhibidores del Cotransportador de Sodio-Glucosa 2/uso terapéutico , Telemedicina , Actigrafía/instrumentación , Canagliflozina/efectos adversos , Método Doble Ciego , Tolerancia al Ejercicio/efectos de los fármacos , Monitores de Ejercicio , Insuficiencia Cardíaca/diagnóstico , Insuficiencia Cardíaca/fisiopatología , Humanos , Aplicaciones Móviles , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Recuperación de la Función , Inhibidores del Cotransportador de Sodio-Glucosa 2/efectos adversos , Volumen Sistólico/efectos de los fármacos , Telemedicina/instrumentación , Factores de Tiempo , Resultado del Tratamiento , Estados Unidos , Función Ventricular Izquierda/efectos de los fármacos
3.
JMIR Public Health Surveill ; 7(2): e24445, 2021 02 19.
Artículo en Inglés | MEDLINE | ID: mdl-33605883

RESUMEN

BACKGROUND: The COVID-19 pandemic has led to urgent calls for the adoption of telehealth solutions. However, public interest and demand for telehealth during the pandemic remain unknown. OBJECTIVE: We used an infodemiological approach to estimate the worldwide demand for telehealth services during COVID-19, focusing on the 50 most affected countries and comparing the demand for such services with the level of information and communications technology (ICT) infrastructure available. METHODS: We used Google Trends, the Baidu Index (China), and Yandex Keyword Statistics (Russia) to extract data on worldwide and individual countries' telehealth-related internet searches from January 1 to July 7, 2020, presented as relative search volumes (RSV; range 0-100). Daily COVID-19 cases and deaths were retrieved from the World Health Organization. Individual countries' ICT infrastructure profiles were retrieved from the World Economic Forum Report. RESULTS: Across the 50 countries, the mean RSV was 18.5 (SD 23.2), and the mean ICT index was 62.1 (SD 15.0). An overall spike in worldwide telehealth-related RSVs was observed from March 11, 2020 (RSV peaked to 76.0), which then tailed off in June-July 2020 (mean RSV for the period was 25.8), but remained higher than pre-March RSVs (mean 7.29). By country, 42 (84%) manifested increased RSVs over the evaluation period, with the highest observed in Canada (RSV=100) and the United States (RSV=96). When evaluating associations between RSV and the ICT index, both the United States and Canada demonstrated high RSVs and ICT scores (≥70.3). In contrast, European countries had relatively lower RSVs (range 3.4-19.5) despite high ICT index scores (mean 70.3). Several Latin American (Brazil, Chile, Colombia) and South Asian (India, Bangladesh, Pakistan) countries demonstrated relatively higher RSVs (range 13.8-73.3) but low ICT index scores (mean 44.6), indicating that the telehealth demand outstrips the current ICT infrastructure. CONCLUSIONS: There is generally increased interest and demand for telehealth services across the 50 countries most affected by COVID-19, highlighting the need to scale up telehealth capabilities, during and beyond the pandemic.


Asunto(s)
/terapia , Internacionalidad , Aceptación de la Atención de Salud/estadística & datos numéricos , Telemedicina/métodos , /prevención & control , Humanos , Pandemias/prevención & control , Pandemias/estadística & datos numéricos , Telemedicina/instrumentación , Telemedicina/estadística & datos numéricos
5.
JAMA Ophthalmol ; 139(3): 344-347, 2021 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-33443550

RESUMEN

Importance: The coronavirus disease 2019 pandemic illustrates the increasingly important role of telemedicine as a method of clinician-patient interaction. However, electronic applications (apps) for the testing of ophthalmology vital signs, such as visual acuity, can be published and used without any verification of accuracy, validity, or reliability. Objective: To reassess the accuracy of visual acuity-testing apps and assess their viability for telehealth. Design, Setting, and Participants: The US Apple App Store was queried for apps for visual acuity testing. Anticipated optotype size for various visual acuity lines were calculated and compared against the actual measured optotype size on 4 different Apple hardware devices. No human participants were part of this study. Main Outcomes and Measures: Mean (SD) errors were calculated per device and across multiple devices. Results: On iPhones, 10 apps met inclusion criteria, with mean errors ranging from 0.2% to 109.9%. On the iPads, 9 apps met inclusion criteria, with mean errors ranging from 0.2% to 398.1%. Six apps met criteria and worked on both iPhone and iPad, with mean errors from 0.2% to 249.5%. Of the 6 apps that worked across devices, the top 3 most accurate apps were Visual Acuity Charts (mean [SD] error, 0.2% [0.0%]), Kay iSight Test Professional (mean [SD] error, 3.5% [0.7%]), and Smart Optometry (mean [SD] error, 15.9% [4.3%]). None of the apps tested were ideal for telemedicine, because some apps displayed accurate optotype size, while others displayed the same letters on separate devices; no apps exhibited both characteristics. Conclusions and Relevance: Both Visual Acuity Charts and Kay iSight Test Professional had low mean (SD) errors and functionality across all tested devices, but no apps were suitable for telemedicine. This suggests that new and/or improved visual acuity-testing apps are necessary for optimal telemedicine use.


Asunto(s)
Aplicaciones Móviles , Optometría/instrumentación , Teléfono Inteligente , Telemedicina/instrumentación , Agudeza Visual , Humanos , Valor Predictivo de las Pruebas , Reproducibilidad de los Resultados
6.
Wilderness Environ Med ; 32(1): 102-111, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33423896

RESUMEN

Telemedicine potentially offers enormous value to expeditions to remote environments. For healthcare professionals, telemedicine can provide access to specialist advice. Where no healthcare professionals are present, telemedicine may be the sole source of expert care. This systematic review appraises and summarizes the current literature regarding telemedicine in patient management on expeditions to remote locations and identifies areas for future research. MEDLINE and EMBASE were systematically searched for relevant articles from 1980 through February 2018. Data were handled according to the PRISMA process and analyzed using type-specific critical appraisal checklists where possible. Two hundred twenty-five articles were identified, 33 of which were included in this systematic review. They encompassed a variety of remote environments, including maritime (13), polar (9), mountainous (5), jungle (1), and multiple austere environments (6). Although some environments were better reported than others, many overarching concepts were generalizable. Through channels of communication that included telephone, radio, videoconferencing, and email, telemedicine has been used effectively in a range of environments to initiate treatment, follow up with patients, and determine the appropriateness of evacuation. Telementoring, in which a remote expert guides a local care provider in performing a procedure or task, is a promising aspect of telemedicine that is currently being developed. As technology advances, the scope of telemedicine will continue to expand. However, each new telemedical development must be shown to do more than simply function in a remote environment. Instead, new technologies should be tested for improved patient, practitioner, or expedition outcomes, within a telemedical system.


Asunto(s)
Expediciones , Telemedicina/instrumentación , Telemedicina/métodos , Humanos , Comunicación por Videocoferencia , Medicina Silvestre
9.
Heart ; 107(5): 366-372, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33431425

RESUMEN

The incidence of heart failure (HF) remains high and patients with HF are at risk for frequent hospitalisations. Remote monitoring technologies may provide early indications of HF decompensation and potentially allow for optimisation of therapy to prevent HF hospitalisations. The need for reliable remote monitoring technology has never been greater as the COVID-19 pandemic has led to the rapid expansion of a new mode of healthcare delivery: the virtual visit. With the convergence of remote monitoring technologies and reliable method of remote healthcare delivery, an understanding of the role of both in the management of patients with HF is critical. In this review, we outline the evidence on current remote monitoring technologies in patients with HF and highlight how these advances may benefit patients in the context of the current pandemic.


Asunto(s)
Insuficiencia Cardíaca , Tecnología de Sensores Remotos , Telemedicina , /epidemiología , Control de Enfermedades Transmisibles , Insuficiencia Cardíaca/epidemiología , Insuficiencia Cardíaca/terapia , Humanos , Telemedicina/instrumentación , Telemedicina/métodos , Telemedicina/tendencias
11.
Clin Exp Dermatol ; 46(1): 145-146, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32754962

RESUMEN

The UK healthcare system, including skin cancer departments, has been profoundly affected by the COVID-19 pandemic. Despite service capacity and a worldwide increase in incidence, anecdotal reports suggest a decline in skin cancer diagnoses following COVID-19. To determine if there has been a decrease in skin cancer diagnosis in the UK in the COVID-19 era, we analysed data from the Northern Cancer Network from 23 March 2020 to 23 June 2020 and compared it with the same period in 2019 (pre-COVID). In the COVID period, there was a decrease of 68.61% in skin cancer diagnoses, from 3619 to 1136 (P < 0.01). Surprisingly, skin cancer waiting times were also reduced in the COVID period compared to the pre-COVID period (median of 8 and 12 days, respectively; P < 0.001). Collectively, these data highlight a statistically significant reduction in both skin cancer diagnoses and waiting times during the COVID period.


Asunto(s)
/epidemiología , Prestación de Atención de Salud/estadística & datos numéricos , Neoplasias Cutáneas/diagnóstico , /virología , Toma de Decisiones Clínicas , Humanos , Incidencia , Neoplasias Cutáneas/epidemiología , Telemedicina/instrumentación , Reino Unido/epidemiología
12.
ACS Nano ; 14(12): 16180-16193, 2020 12 22.
Artículo en Inglés | MEDLINE | ID: mdl-33314910

RESUMEN

The management of the COVID-19 pandemic has relied on cautious contact tracing, quarantine, and sterilization protocols while we await a vaccine to be made widely available. Telemedicine or mobile health (mHealth) is well-positioned during this time to reduce potential disease spread and prevent overloading of the healthcare system through at-home COVID-19 screening, diagnosis, and monitoring. With the rise of mass-fabricated electronics for wearable and portable sensors, emerging telemedicine tools have been developed to address shortcomings in COVID-19 diagnostics, monitoring, and management. In this Perspective, we summarize current implementations of mHealth sensors for COVID-19, highlight recent technological advances, and provide an overview on how these tools may be utilized to better control the COVID-19 pandemic.


Asunto(s)
/métodos , /terapia , Manejo de la Enfermedad , Telemedicina/métodos , Antígenos Virales/análisis , Técnicas Biosensibles/instrumentación , /virología , Trazado de Contacto/instrumentación , Humanos , Aplicaciones Móviles/provisión & distribución , Monitoreo Fisiológico/instrumentación , Monitoreo Fisiológico/métodos , Nanotecnología/instrumentación , Nanotecnología/métodos , Sistemas de Atención de Punto/organización & administración , Pruebas en el Punto de Atención/organización & administración , Cuarentena/organización & administración , Telemedicina/instrumentación
13.
Nephrol Nurs J ; 47(6): 529-536, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33377753

RESUMEN

Despite the increasing number of consumer-based mobile health applications (mHealth apps) for self-care, there is little research exploring consumers' experiences with mHealth apps. Health apps using mobile technology have the potential to provide a platform for kidney transplant recipients to monitor their self-care in real time. This study explored kidney transplant recipients' perceptions of the usefulness of mHealth apps and identified features that Kidney transplant recipients believe are important for using mHealth apps. A qualitative design was used to explore a purposive sample of adult kidney transplant recipients from a Midwest Transplant Program who used an mHealth app. Qualitative content data analysis revealed three themes participants found useful: health tracking (medication, nutrition, fluid intake, lab values, and activity), feedback (short personalized messages, positive awards using symbols, and color-coded bar graphs indicating normal and abnormal ranges), and usability (large font, words that everyone can understand, and all information stored in one area).


Asunto(s)
Teléfono Celular , Trasplante de Riñón , Aplicaciones Móviles , Autocuidado , Telemedicina/métodos , Adulto , Humanos , Entrevistas como Asunto , Monitoreo Fisiológico , Investigación Cualitativa , Telemedicina/instrumentación
14.
Arch. Soc. Esp. Oftalmol ; 95(12): 586-590, dic. 2020. tab
Artículo en Español | IBECS | ID: ibc-194908

RESUMEN

OBJETIVO: Reportar una experiencia piloto de atención por telemedicina en la especialidad de oftalmología, en el periodo de confinamiento por la pandemia por COVID-19. MÉTODOS: Estudio descriptivo. Se describen características demográficas y clínicas de pacientes atendidos en periodo de confinamiento de 10 semanas. Se evalúa la satisfacción de los pacientes y médicos participantes mediante una encuesta en línea. RESULTADOS: En las primeras 10 semanas, se realizaron 291 atenciones de telemedicina oftalmológica. Los principales motivos de consulta fueron afecciones inflamatorias de la superficie ocular y párpados (79,4%), seguido de requerimientos administrativos (6,5%), afecciones no inflamatorias de la superficie ocular (5,2%), sospecha de estrabismo (3,4%) y síntomas vitreorretinales (3,1%); 22 pacientes (7,5%) fueron derivados a atención presencial inmediata. El nivel de satisfacción con la prestación fue alto, tanto en médicos (100%), como en pacientes (93,4%). CONCLUSIONES: La atención oftalmológica por telemedicina en periodo de pandemia es un instrumento de utilidad para realizar un filtro de potenciales consultas presenciales, ya sea electivas o de urgencia, y para reducir potencialmente el riesgo de contagio por COVID-1


BACKGROUND: To report a pilot experience of telemedicine in ophthalmology in open-care modality (i.e. direct video call), in a confinement period due to the COVID-19 pandemic. METHODS: Descriptive study of the demographic and clinical characteristics of patients attended in a 10-week confinement period. Reported satisfaction of the participating patients and doctors was evaluated through an online survey. RESULTS: In the 10-week period, 291 ophthalmologic telemedicine consultations were performed. The main reasons for consultation were inflammatory conditions of the ocular surface and eyelids (79.4%), followed by administrative requirements (6.5%), non-inflammatory conditions of the ocular surface (5.2%), strabismus suspicion (3.4%) and vitreo-retinal symptoms (3.1%). According to previously defined criteria, 22 patients (7.5%) were referred to immediate face-to-face consultation. The level of satisfaction was high, both in doctors (100%) and in patients (93.4%). CONCLUSIONS: Open-care modality of telemedicine in ophthalmology during the pandemic period is a useful instrument to filter potential face-to-face consultations, either elective or emergency, and potentially reduce the risk of COVID-19 infection


Asunto(s)
Humanos , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Oftalmopatías/diagnóstico , Oftalmopatías/terapia , Telemedicina/instrumentación , Proyectos Piloto , Pandemias/prevención & control , Infecciones por Coronavirus/prevención & control , Neumonía Viral/prevención & control , Teleoftalmología , Betacoronavirus , Satisfacción del Paciente , Garantía de la Calidad de Atención de Salud/métodos , Garantía de la Calidad de Atención de Salud/estadística & datos numéricos
15.
Med. infant ; 27(2): 138-144, Diciembre 2020. ilus, Tab
Artículo en Español | LILACS, BINACIS, UNISALUD | ID: biblio-1150453

RESUMEN

Los Programas telemédicos entre unidades de cuidados intensivos han demostrado ser eficaces en el mundo. En Argentina realizamos el primer programa piloto entre una Unidad de Cuidados Intensivos Pediátricos de Buenos Aires (UCIP- BA) y Santiago del Estero (UCIP-S). En el presente trabajo describimos el desarrollo y la evaluación de una nueva modalidad de asistencia para el diagnóstico, tratamiento y seguimiento a distancia de los pacientes en UCIP. Se implementó un programa de atención sincrónica para pacientes internados y seleccionados por la UCIP-S. Se utilizó un sistema de videoconferencia y se realizó un seguimiento en conjunto de los pacientes. La evaluación se realizó con una encuesta de satisfacción de los usuarios. Ingresaron al estudio 29 pacientes, 72 % del sexo masculino. La edad promedio fue de 35 meses (2-168). El diagnóstico más frecuente fue shock séptico y el acompañamiento en el diagnóstico la conducta más frecuente. Solo cinco pacientes obitaron y se registraron 3 derivaciones al Hospital Garrahan. Se realizaron 155 teleconferencias y 396 consultas, con un tiempo promedio diario de 48 minutos, La media de seguimientos por pacientes fue de 20,6 días (2-107). Tele-UCI mejoró la capacidad de comprensión de la situación clínica (96%) y modificó la relación con la familia (65%). El modelo asistencial demostró un 88.5% de satisfacción. A través de estos resultados concluimos que según los profesionales participantes, Tele-UCI respaldó al equipo que se encarga del seguimiento diario de los pacientes, generando una disminución de traslados de pacientes (AU)


Telemedicine programs between intensive care units have proven effective worldwide. In Argentina we conducted the first pilot program between a Pediatric Intensive Care Unit in Buenos Aires (PICU- BA) and another in Santiago del Estero (PICU-S). In this study, we describe the development and evaluation of a new care modality for the diagnosis, treatment, and remote monitoring of patients in the PICU. A synchronous care program for inpatients selected by PICU-S was implemented. A videoconferencing system was used and patients were monitored together. The program was evaluated with a user satisfaction survey. Twenty-nine patients, 72% of the male sex, were included in the study. Mean age was 35 months (2-168). The most common diagnosis was septic shock and in the majority of cases the diagnosis was confirmed. Only five patients died and three were referred to Garrahan Hospital. Overall, 155 teleconferences and 396 consultations were conducted, with a mean daily time of 48 minutes. Mean monitoring time per patient was 20.6 days (2-107). Tele-ICU improved the ability to understand the clinical situation (96%) and changed the relationship with the family (65%). The care model showed an 88.5% satisfaction rate. Based on these results, we conclude that according to the participating professionals, TeleICU supported the team that is in charge of the daily monitoring of patients, leading to a decrease in patient transfers (AU)


Asunto(s)
Unidades de Cuidado Intensivo Pediátrico/tendencias , Telemedicina/instrumentación , Telemedicina/estadística & datos numéricos , Cuidados Críticos/métodos , Estudios Retrospectivos , Resultado del Tratamiento
17.
Sensors (Basel) ; 20(18)2020 Sep 11.
Artículo en Inglés | MEDLINE | ID: mdl-32932848

RESUMEN

The emerging wearable medical devices open up new opportunities for the provision of health services and promise to accelerate the development of novel telemedical services. The main objective of this study was to investigate the desirable features and applications of telemedical services for the Polish older adults delivered by wearable medical devices. The questionnaire study was conducted among 146 adult volunteers in two cohorts (C.1: <65 years vs. C.2: ≥65 years). The analysis was based on qualitative research and descriptive statistics. Comparisons were performed by Pearson's chi-squared test. The questionnaire, which was divided into three parts (1-socio-demographic data, needs, and behaviors; 2-health status; 3-telemedicine service awareness and device concept study), consisted of 37 open, semi-open, or closed questions. Two cohorts were analyzed (C.1: n = 77; mean age = 32 vs. C.2: n = 69; mean age = 74). The performed survey showed that the majority of respondents were unaware of the telemedical services (56.8%). A total of 62.3% of C.1 and 34.8% of C.2 declared their understanding of telemedical services. The 10.3% of correct explanations regarding telemedical service were found among all study participants. The most desirable feature was the detection of life-threatening and health-threatening situations (65.2% vs. 66.2%). The findings suggest a lack of awareness of telemedical services and the opportunities offered by wearable telemedical devices.


Asunto(s)
Telemedicina/instrumentación , Dispositivos Electrónicos Vestibles , Adulto , Anciano , Betacoronavirus , Estudios de Cohortes , Infecciones por Coronavirus/epidemiología , Femenino , Geriatría/instrumentación , Humanos , Masculino , Persona de Mediana Edad , Monitoreo Ambulatorio/instrumentación , Evaluación de Necesidades , Pandemias , Neumonía Viral/epidemiología , Polonia/epidemiología , Tecnología de Sensores Remotos/instrumentación , Encuestas y Cuestionarios , Tecnología Inalámbrica/instrumentación
18.
Biosens Bioelectron ; 169: 112617, 2020 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-32998066

RESUMEN

The outbreak of coronavirus disease (COVID-19) has caused a significant public health challenge worldwide. A lack of effective methods for screening potential patients, rapidly diagnosing suspected cases, and accurately monitoring of the epidemic in real time to prevent the rapid spread of COVID-19 raises significant difficulties in mitigating the epidemic in many countries. As effective point-of-care diagnosis tools, simple, low-cost and rapid sensors have the potential to greatly accelerate the screening and diagnosis of suspected patients to improve their treatment and care. In particular, there is evidence that multiple pathogens have been detected in sewage, including SARS-CoV-2, providing significant opportunities for the development of advanced sensors for wastewater-based epidemiology that provide an early warning of the pandemic within the population. Sensors could be used to screen potential carriers, provide real-time monitoring and control of the epidemic, and even support targeted drug screening and delivery within the integration of emerging mobile health (mHealth) technology. In this communication, we discuss the feasibility of an integrated point-of-care biosensor system with mobile health for wastewater-based epidemiology (iBMW) for early warning of COVID-19, screening and diagnosis of potential infectors, and improving health care and public health. The iBMW will provide an effective approach to prevent, evaluate and intervene in a fast, affordable and reliable way, thus enabling real-time guidance for the government in providing effective intervention and evaluating the effectiveness of intervention.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Técnicas Biosensibles/instrumentación , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Telemedicina/instrumentación , Monitoreo Epidemiológico Basado en Aguas Residuales , Diseño de Equipo , Estudios de Factibilidad , Humanos , Pandemias , Sistemas de Atención de Punto , Aguas del Alcantarillado/virología
19.
Acta Diabetol ; 57(12): 1493-1499, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32748176

RESUMEN

AIMS: To evaluate diabetic retinopathy (DR) screening with a portable handheld smartphone-based retinal camera and telemedicine in an urban primary healthcare setting and to evaluate the learning curve for image acquisition, performed by healthcare personnel without previous experience in retinal imaging. METHODS: This was a prospective study that enrolled patients with type 2 diabetes mellitus (T2DM) followed at a primary healthcare unit in São Paulo, Brazil. After a brief training in image acquisition, there was further continuous feedback given by a retina specialist during the remote image reading process. Each patient underwent two fundus and one anterior ocular segment images per eye, after mydriasis. Patients were classified according to the need of referral. RESULTS: A total of 627 adult individuals with T2DM underwent retinal evaluation. The population was composed by 63.2% female individuals, age median of 66 years, diabetes duration 10.7 ± 8.2 years and HbA1c 7.7 ± 1.9% (61 + 20.8 mmol/mol). The most prevalent associated comorbidities were arterial hypertension (80.3%) and dyslipidemia (50.2%). Referral decision was possible in 81.2% patients. Most patients had absent or non-referable DR; the main ocular media opacity detected was cataract. After the 7th day of image acquisition, the daily rate of patients whose images allowed clinical decision was maintained above 80%. A higher HbA1c was associated with referable DR. CONCLUSIONS: A low-cost DR screening strategy with a handheld device and telemedicine is feasible and has the potential to increase coverage of DR screening in underserved areas; the possibility of mobile units is relevant for DR screening in the context of COVID-19 pandemic. Daily rate of patients whose examinations allowed clinical decision. X-axis: day of examination; Y-axis: rate (%) of patients whose examinations allowed a clinical decision.


Asunto(s)
Retinopatía Diabética/diagnóstico , Tamizaje Masivo/métodos , Fotograbar/métodos , Retina/diagnóstico por imagen , Telemedicina/métodos , Adulto , Anciano , Brasil , Infecciones por Coronavirus/epidemiología , Diabetes Mellitus Tipo 2/complicaciones , Retinopatía Diabética/diagnóstico por imagen , Femenino , Humanos , Masculino , Tamizaje Masivo/instrumentación , Persona de Mediana Edad , Pandemias , Neumonía Viral/epidemiología , Prevalencia , Atención Primaria de Salud/métodos , Estudios Prospectivos , Derivación y Consulta , Teléfono Inteligente , Telemedicina/instrumentación
20.
Diabetes Res Clin Pract ; 168: 108379, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32853692
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...