Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 896
Filtrar
1.
Med Sci Monit ; 27: e931967, 2021 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-33980807

RESUMO

BACKGROUND The aim of this study was to evaluate the epidemiological features of the patients admitted to our emergency department (ED) during the COVID-19 pandemic in March, April, and May 2020, compare them with the patients in March, April, and May 2019, and to investigate the effect of various quarantine models. MATERIAL AND METHODS The records of 1206 eligible patients were reviewed. Age groups were divided according to their quarantine status. We recorded the reasons for patient presentation to the ED, the average number of patients in age groups according to quarantine days, and the problems reported by patients who presented to the ED according to quarantine days. RESULTS We enrolled 3016 of 3123 patients. The mean age was 36.4±17.3 years in 2019 and 37.8±16.4 years during the pandemic period (P=0.031). While 73.1% of the ED presentations were due to ocular trauma in 2019, it decreased to 70.7% in 2020. The proportion of those who presented to the ED during the weekend was 30.6% in 2019, but decreased to 23.9% in 2020 (<0.001). While 84.8% of trauma patients were ages 19-64 years in 2019, this rate increased to 88.9% during the pandemic (P=0.067). Non-trauma emergencies were more common than trauma emergencies in both periods in those over the age of 65 years. During the pandemic period, admissions to the ED were decreased in the quarantined age groups (P=0.001). CONCLUSIONS The changes in the number and characteristic of admissions for ophthalmic emergencies during the pandemic period may help planning allocation of healthcare personnel and resources in outpatient and emergency clinics.


Assuntos
COVID-19/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Oftalmologia/estatística & dados numéricos , Pandemias/estatística & dados numéricos , Quarentena/estatística & dados numéricos , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
2.
R I Med J (2013) ; 104(1): 61-64, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33517603

RESUMO

OBJECTIVE: To assess the impact of the COVID-19 pandemic and associated lockdowns on public interest in ophthalmology. METHODS: Search interest data for ophthalmic services and conditions were collected from January 1, 2019 to June 21, 2020. Temporal statistical analysis was used to identify significant trends. Weekly data on ophthalmic services and conditions search interest obtained from Google Trends were analyzed with analysis of variance testing and the generalized linear model based on dates. RESULTS: Ophthalmic services searches decreased after the first COVID-19 case in the country (p<0.001); ophthalmic services and conditions search interest also declined after the first COVID-19 case and lockdown orders in each state (p<0.001). Following the first in-state COVID-19 case, search interest in ophthalmic services fell more than for ophthalmic conditions (p=0.0088). Lockdown and COVID-19 had similar effects on ophthalmic services search interest (p=0.2246), but interest in ophthalmic conditions decreased more after lockdown than after the first in-state case (p<0.0001). CONCLUSIONS: Most of the decrease in search interest in ophthalmic services was associated with COVID-19 rather than lockdown orders, suggesting that public interest in ophthalmic care may be more sensitive to changes in the COVID-19 pandemic than lockdown orders.


Assuntos
COVID-19/epidemiologia , Oftalmopatias/epidemiologia , Comportamento de Busca de Informação , Oftalmologia , COVID-19/prevenção & controle , COVID-19/psicologia , Oftalmopatias/terapia , Humanos , Sistemas On-Line , Oftalmologia/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Quarentena
4.
PLoS One ; 15(10): e0239796, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33002074

RESUMO

Since the end of 2019, an outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), originating in the Chinese city of Wuhan has spread rapidly worldwide causing thousands of deaths. Coronavirus disease (COVID-19) is supported by SARS-CoV-2 and represents the causative agent of a potentially fatal disease that is of great global public health concern. Italy has been the first European country recording an elevated number of infected forcing the Italian Government to call for total lockdown. The lockdown had the aim to limit the spread of infection through social distancing. The purpose of this study is to analyze how the pandemic has affected the patient's accesses to the Ophthalmological Emergency Department of a tertiary referral center in central-northern Italy, during the lockdown period. The charts of all patients that came to the Emergency Department during the lockdown period (March 10 -May 4, 2020) have been retrospectively collected and compared with those in the same period of 2019 and the period from 15 January- 9 March 2020. A significant reduction of visits during the lockdown has been observed, compared with those of pre-lockdown period (reduction of 65.4%) and with those of the same period of 2019 (reduction of 74.3%). Particularly, during the lockdown, minor and not urgency visits decreased whereas the undeferrable urgency ones increased. These pieces of evidence could be explained by the fear of patients to be infected; but also revealed patients misuse of emergency services.


Assuntos
Infecções por Coronavirus/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Oftalmologia/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Centros de Atenção Terciária/estatística & dados numéricos , Adolescente , Adulto , Idoso , Betacoronavirus , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Classificação Internacional de Doenças , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Retrospectivos , Adulto Jovem
5.
Indian J Ophthalmol ; 68(11): 2391-2395, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33120625

RESUMO

Purpose: To evaluate the impact of 2019 COVID-19 pandemic, national lockdown, and unlocking on ophthalmic care provided by the government-funded apex health institute of India. Methods: Retrospective review of electronic medical records of all patients presenting to the ophthalmology department from March 23, 2020, to July 15, 2020, was compared with that from March 23, 2019, to July 15, 2019. The data between March 23, 2020, to May 31, 2020 (lockdown) and June 06, 2020, to July 15, 2020 (unlock) was compared separately. Parameters evaluated were age, gender, presenting complaints, final diagnosis, treatment advised, and surgical interventions. Results: During the lockdown, routine outpatient flow reduced by 97.14% (P < 0.001), the median age of presentation decreased to 29 years (55 years last year) and males increased by 4.7% (from 61.51% to 66.21%) in 2020. Emergency services decreased by 35.25%, percentage of children decreased by 4.28% (from 34.28% to 30%) and males increased by 13.53% (from 59.97% to 73.5%). Mechanical trauma, microbial keratitis, and conjunctivitis were the most common reasons for presentation. The former lessened by 41.75% while the latter two amplified by 1.25 times and 2 times, respectively. While sanitizer-associated chemical injury increased in proportion, endophthalmitis, and postoperative complications declined. The number of donor corneas collected and emergency therapeutic keratoplasties performed decreased by 99.61% and 92.39%, respectively (P < 0.001). During the unlocking phase, routine patient consultations were 71 ± 19/day, significantly lower than 978 ± 109/day of last year (P < 0.001). No voluntary eye donation was reported during this period. Conclusion: COVID-19 pandemic and national lockdown severely hampered the delivery of ophthalmic care by the apex-ophthalmic institute. Unlike anticipated, lifting of pandemic-associated lockdown served only minimally in improving patient inflow in its initial phases.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Atenção à Saúde/estatística & dados numéricos , Oftalmopatias/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Quarentena/estatística & dados numéricos , Centros de Atenção Terciária/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Bancos de Olhos/estatística & dados numéricos , Oftalmopatias/terapia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Oftalmologia/estatística & dados numéricos , Estudos Retrospectivos , Doadores de Tecidos/estatística & dados numéricos
7.
Pan Afr Med J ; 36: 163, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32952807

RESUMO

From an epidemic in December to a global pandemic in early March, COVID-19 arrived on Moroccan soil on March 2nd and ophthalmology consultations decreased considerably. The majority of ophthalmologists come to the fore to ensure continuity of care and emergency care following health regulations. We developed a questionnaire to collect information on the general approach of 35 ophthalmologists regarding the impact of COVID -19 on consultation activities. The results of the survey objectified that 88.57% of the ophthalmologists surveyed maintained their consultation activities; ¾ of them only treated urgent cases or patients whose condition required undelayed management. The majority of ophthalmologists reported a decrease in consultations of at least 90% compared to their standard workflow. Active ophthalmologists believe that the risk of being infected or infecting their patients and others ranges from medium to high in the majority of cases despite protective barrier gestures.


Assuntos
Infecções por Coronavirus/epidemiologia , Oftalmologistas/estatística & dados numéricos , Oftalmologia/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Encaminhamento e Consulta/estatística & dados numéricos , Adulto , Feminino , Pesquisas sobre Serviços de Saúde , Humanos , Pessoa de Meia-Idade , Marrocos/epidemiologia , Pandemias
8.
PLoS One ; 15(9): e0227783, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32925977

RESUMO

PURPOSE: To quantify differences in the age, gender, race, and clinical complexity of Medicare beneficiaries treated by ophthalmologists and optometrists in each of the United States. DESIGN: Cross-sectional study based on publicly accessible Medicare payment and utilization data from 2012 through 2017. METHODS: For each ophthalmic and optometric provider, demographic information of treated Medicare beneficiaries was obtained from the Medicare Provider Utilization and Payment Data from the Centers for Medicare and Medicaid Services (CMS) for the years 2012 through 2017. Clinical complexity was defined using CMS Hierarchical Condition Category (HCC) coding. RESULTS: From 2012 through 2017, ophthalmologists in every state treated statistically significantly older beneficiaries, with the greatest difference (4.99 years in 2014) between provider groups seen in Rhode Island. In most states there was no gender difference among patients treated by the providers but in 46 states ophthalmologists saw a more racially diverse group of beneficiaries. HCC risk score analysis demonstrated that ophthalmologists in all 50 states saw more medically complex beneficiaries and the differences were statistically significant in 47 states throughout all six years. CONCLUSIONS: Although there are regional variations in the characteristics of patients treated by ophthalmologists and optometrists, ophthalmologists throughout the United States manage older, more racially diverse, and more medically complex Medicare beneficiaries.


Assuntos
Oftalmopatias/terapia , Medicare/estatística & dados numéricos , Oftalmologia/estatística & dados numéricos , Optometria/estatística & dados numéricos , Demandas Administrativas em Assistência à Saúde/estatística & dados numéricos , Fatores Etários , Idoso , Grupos de Populações Continentais/estatística & dados numéricos , Estudos Transversais , Oftalmopatias/diagnóstico , Oftalmopatias/economia , Feminino , Humanos , Masculino , Medicare/economia , Oftalmologistas/economia , Oftalmologistas/estatística & dados numéricos , Oftalmologia/economia , Optometristas/economia , Optometristas/estatística & dados numéricos , Optometria/economia , Padrões de Prática Médica/economia , Fatores Sexuais , Estados Unidos
9.
Acta Med Port ; 33(10): 640-648, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-32914750

RESUMO

INTRODUCTION: The purpose of this study was to provide objective and real-life data concerning the impact of the COVID-19 pandemicon ophthalmology residency training in Portugal. MATERIAL AND METHODS: Descriptive survey-based study applied to current Portuguese ophthalmology residents (n = 80 eligible). RESULTS: Seventy-five residents participated (94% response rate). All except one (99%) admitted a change in their routine clinical practice during the pandemic, and most (89%) continued to be engaged in ophthalmology department duties. Twenty-five percent were deployed to COVID-19 units, which was combined with ophthalmological activities in about half of them (47%). A significant proportion of participants stated that they were enrolled in the following ophthalmological activities: emergency/inpatient care (87%), outpatient visits (73%; general 70% vs subspecialty 29%), and surgical procedures (64%). Twenty-five percent did not assist in any outpatient visits and 36% did not participate in any surgical procedures. On a scale from 1 (no impact) to 5 (maximum impact), most participants classified their perceived negative impact of the pandemic on the training program as 3 (24%), 4 (40%), or 5 (27%). Participants highly agreed with the extension of the residency program (80%) in order to to make up for training disruption. DISCUSSION: Most trainees provided ophthalmological care during the pandemic. However, those clinical activities were essentially related to general and emergency care. Surgical experience was significantly curtailed. As such, strategies are needed to guarantee a high-quality learning process. Further studies are required to develop an international perspective on how ophthalmology training programs have been affected so that educational organizations can make recommendations regarding standardized adjustments to training programs. CONCLUSION: The COVID-19 pandemic has significantly impacted the training of ophthalmology residents nationwide.


Assuntos
Infecções por Coronavirus/epidemiologia , Internato e Residência , Oftalmologistas , Oftalmologia/educação , Pneumonia Viral/epidemiologia , Adulto , Assistência Ambulatorial/estatística & dados numéricos , Betacoronavirus , Estudos Transversais , Serviços Médicos de Emergência/estatística & dados numéricos , Feminino , Humanos , Internato e Residência/estatística & dados numéricos , Masculino , Procedimentos Cirúrgicos Oftalmológicos/estatística & dados numéricos , Oftalmologia/estatística & dados numéricos , Pandemias , Portugal/epidemiologia , Inquéritos e Questionários/estatística & dados numéricos , Adulto Jovem
10.
Indian J Ophthalmol ; 68(8): 1540-1544, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32709770

RESUMO

Purpose: To evaluate the effect of COVID-19 pandemic and national lockdown on patient care at a tertiary-care ophthalmology institute. Methods: Records of all the patients who presented from March 25th to May 3rd, 2020 were scanned to evaluate the details regarding the presenting complaints, diagnosis, advised treatment and surgical interventions. Results: The number of outpatient department visits, retinal laser procedures, intravitreal injections and cataract surgeries during this lockdown decreased by 96.5%, 96.5%, 98.7% and 99.7% respectively compared from the corresponding time last year. Around 38.8% patients could be triaged as non-emergency cases based on history alone while 59.5% patients could be triaged as non-emergency cases after examination. Only eighty-four patients opted for video-consultation from April 15th to May 3rd, 2020. Nine patients presented with perforated corneal ulcer, but could not undergo penetrating keratoplasty due to the lack to available donor corneal tissue. One of these patients had to undergo evisceration due to disease progression. Two patients with open globe injury presented late after trauma and had to undergo enucleation. Around 9% patients could not undergo the advised urgent procedure due to logistical issues related to the lockdown. Conclusion: A significant number of patients could not get adequate treatment during the lockdown period. Hospitals need to build capacity to cater to the expected patient surge post-COVID-19-era, especially those requiring immediate in-person attention. A large number of patients can be classified as non-emergency cases. These patients need to be encouraged to follow-up via video-consultation to carve adequate in-person time for the high-risk patients.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Oftalmopatias/terapia , Oftalmologia/estatística & dados numéricos , Pandemias , Assistência ao Paciente/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Quarentena , Academias e Institutos/organização & administração , Academias e Institutos/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Serviços Médicos de Emergência/estatística & dados numéricos , Feminino , Hospitais Especializados/organização & administração , Hospitais Especializados/estatística & dados numéricos , Humanos , Índia/epidemiologia , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Oftalmologia/organização & administração , Estudos Retrospectivos , Centros de Atenção Terciária/estatística & dados numéricos
11.
Indian J Ophthalmol ; 68(8): 1546-1550, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32709772

RESUMO

Purpose: To find the clinical profile and prevalence of conjunctivitis and other ocular manifestations in mild COVID-19 positive patients in a nodal COVID-19 hospital. Methods: A retrospective cross-sectional, single-center study conducted in 127 mild cases of COVID-19 positive patients admitted between 27th March and 19th April 2020 in a tertiary care COVID-19 hospital in north India. From the hospital records, demographic data is collected. Ocular history and ocular examinations were done by face-to-face survey during ward rounds. Results: A total of 127 patients were included in the study with a median age of 38.8 years. Forty-eight (37.80%) patients had upper respiratory tract symptoms, 20 (15.75%) patients had systemic illness, 18 (14.17%) patients were using spectacles, and 50 (39.37%) patients had history of hand-eye contact. Out of 12 (9.45%) patients who had ocular complaints, 11 (8.66%) had ocular manifestation after admission. Among 11 patients, eight (6.29%) had conjunctival congestion. Three (3/8) patients had developed conjunctival congestion even before the manifestation of definite COVID-19 symptoms. Five patients (5/8) patients had no other associated ocular symptoms other than congestion. Six patients (6/8) had symptoms of upper respiratory tract infection. Conclusion: Mild conjunctivitis manifesting as conjunctival congestion is common and is one of the major ocular manifestations in COVID-19 positive patients even with milder disease.


Assuntos
Betacoronavirus , Conjuntivite Viral/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções Oculares Virais/epidemiologia , Hospitais Especializados/estatística & dados numéricos , Oftalmologia/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Conjuntivite Viral/diagnóstico , Infecções por Coronavirus/diagnóstico , Estudos Transversais , Infecções Oculares Virais/diagnóstico , Feminino , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Prevalência , Estudos Retrospectivos , Atenção Terciária à Saúde/estatística & dados numéricos
12.
J Fr Ophtalmol ; 43(7): 577-585, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32564983

RESUMO

This prospective observational cohort study is based on the first 500 patients who requested emergency teleconsultation during the initial days of the COVID-19 lockdown in Paris, France between 20 March and 10 April 2020. It is the first study to assess the utility of emergency teleophthalmology with a simple smartphone application or web browser and a webcam to manage emergency eye care in a population with sudden restricted access to ophthalmologists. In this study, every patient who asked for an ophthalmic emergency consultation in a single specialized center in Paris ('SOS Œil') first had to undergo a teleconsultation appointment to evaluate the indication for a physical consultation to preserve lockdown. Under medical advice only, a physical appointment was given within a day (if necessary). The aim of the study was to describe the population and diagnoses and evaluate the main judgment criteria, defined as the 'ability of teleconsultation to properly indicate a physical consultation for fair diagnosis and treatment in eye emergencies'. This organization has permitted physicians and patients to preserve social distancing while avoiding 3 or 4 physical consultations per person. Notably, 27% of teleconsultations were followed by a physical appointment. There was a mean 4.12-day delay between symptom apparition and consultation, and less than 1 day for traumas, superficial corneal foreign body and neuro-ophthalmological emergencies. There was a 96% sensitivity and 95% specificity to properly evaluate the indication of a physical consultation and only 1.0% misdiagnoses that lead to delayed care. Hence, teleconsultation maintained satisfactory healthcare access to patients with severe ophthalmological disorders while preserving social distancing and sanitary precautions. Therefore, teleconsultation may be seriously considered as a way to efficiently regulate ophthalmic emergencies, especially for patients with limited access to a specialist.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Oftalmologia/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Quarentena , Telemedicina/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Agendamento de Consultas , Criança , Pré-Escolar , Erros de Diagnóstico , Emergências/epidemiologia , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Oftalmologia/organização & administração , Pandemias , Paris/epidemiologia , Estudos Prospectivos , Sensibilidade e Especificidade , Distribuição por Sexo , Telemedicina/métodos , Adulto Jovem
13.
West Afr J Med ; 37(3): 221-224, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32476114

RESUMO

BACKGROUND: Ophthalmology consultations are more thorough on outpatient basis, but inpatient evaluation cannot be over looked especially in terms of care of patients admitted in other specialties. OBJECTIVES: This is to assess the profile of inpatient consultation and eye problems evaluated and managed by the ophthalmology department of the University of Benin Teaching Hospital, Benin City, Nigeria. METHODS: All consecutive inpatients who had ophthalmic consultations requested for by various departments in the hospital between July 2018 and June 2019. RESULTS: A total of 227 inpatient consultations with 217 diagnoses were seen. Most of the patients were between the ages of 20-39 years. The highest number of consults (50.7%) were received from the medical wards. The most common reasons for ophthalmic inpatient consultations were reduction in vision (26.7%), eye pain (19.9%) and ocular screening which was ocular examination for patients with raised intracranial pressure, hypertension, diabetes and glaucoma (15.4%). Based on subspecialties, anterior segment and cornea unit received the highest number of consults (41.9%) while retina/ uveitis received the highest (58.7%) number of screening consultation. CONCLUSION: Inpatient consultations is very useful to the patient and managing physician. Although a better knowledge in the identification of common ophthalmic conditions can help to reduce the number of inpatient consults from other medical specialties.


Assuntos
Pacientes Internados/estatística & dados numéricos , Oftalmologia/estatística & dados numéricos , Encaminhamento e Consulta/estatística & dados numéricos , Adulto , Oftalmopatias/diagnóstico , Oftalmopatias/epidemiologia , Humanos , Nigéria , Estudos Retrospectivos , Adulto Jovem
14.
Rev. cuba. oftalmol ; 33(2): e876, graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1139075

RESUMO

RESUMEN La historia de las pandemias y el hombre moderno han marcado un antes y un después en la medicina actual, como sucedió con la gripe española en el año 1918. La última registrada mundialmente es el Coronavirus, el cual -identificado como COVID-19 (por sus siglas en inglés), manifiesto por el agente viral SARS-CoV-2- desde su comienzo el 30 de diciembre del año 2019 guarda estrecha relación con la Oftalmología. El objetivo de esta investigación fue documentar la nueva evidencia científica relacionada con esta entidad y su manifestación ocular, mediante la revisión de la literatura comprendida del 1ro. de enero al 25 de abril del año 2020, con el uso de metabuscadores en inglés y en español. Dentro de los medios de transmisibilidad que han sido documentados, la sintomatología respiratoria es la más estudiada; sin embargo, existen manifestaciones oculares con la presencia del virus SARS-CoV-2 en la lagrima y en la conjuntiva de los pacientes infectados por COVID-19. El cuadro más característico se presenta con una conjuntivitis viral inespecífica. La tasa de mortalidad es un tema de especial relevancia. La estadística acumulada sugiere mayor letalidad y, por tanto, la necesidad de ejecutar medidas y acciones sociales para el control poblacional. La letalidad mundial en este momento es de 7,2 por ciento; en América Latina de 5,8 por ciento y en Cuba de 4,2 por ciento. El presente documento realiza un abordaje integral de la patología COVID-19 con respecto a las recomendaciones internacionales para el personal de Oftalmología y los centros oftalmológicos, así como acerca de los factores de riesgo, el cuadro clínico, los nuevos tratamientos y los reportes de estudios clínicos que se encuentran actualmente en fase de estudio(AU)


ABSTRACT The history of pandemics and modern man have marked a before and after in current medicine, as was the case with the Spanish flu in 1918. The last pandemic recorded worldwide is coronavirus, identified as COVID-19, caused by the viral agent SARS-CoV-2. From its onset on 30 December 2019 this disease has had a close connection to ophthalmology. The purpose of the study was to document the new scientific evidence about this condition and its ocular manifestation through a literature review covering the period extending from 1 January to 25 April 2020, using search terms in English and Spanish. Respiratory symptoms are among the transmission routes most commonly dealt with. However, some ocular manifestations are characterized by the presence of the SARS-CoV-2 virus in tears and in the conjunctiva of patients infected with COVID-19. The most typical manifestation is nonspecific viral conjunctivitis. Mortality rate is a topic of special relevance. The statistics accumulated suggest greater fatality and thus the need to implement social measures and actions aimed at population control. The current fatality rate is 7.2 percent worldwide, 5.8 percent in Latin America and 4.2 percent in Cuba. The present paper provides a comprehensive analysis of COVID-19 based on international recommendations for ophthalmology personnel and facilities, as well as the risk factors, clinical status, new treatments and reports about ongoing clinical studies(AU)


Assuntos
Humanos , Oftalmologia/estatística & dados numéricos , Conjuntivite Viral/etiologia , Infecções por Coronavirus/epidemiologia , Pandemias/história , Literatura de Revisão como Assunto , Relatório de Pesquisa
16.
Am J Ophthalmol ; 218: 156-163, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32446736

RESUMO

PURPOSE: The purpose was to assess differences in outpatient ophthalmologic usage based on patient characteristics such as race/ethnicity, income, insurance type, geographical region, and educational attainment. DESIGN: Retrospective cross-sectional study. METHODS: The Medical Expenditure Panel Survey (MEPS) is a nationally representative data set for the noninstitutionalized population cosponsored by the Agency for Healthcare Research. This study involved 183,054 MEPS respondents from 2007 to 2015. Primary outcome measure was patient utilization of outpatient ophthalmologic care. Secondary outcome measure was annual health care use and costs by patients in outpatient, inpatient, and the emergency department settings based on race. RESULTS: Overall, 21,673 participants self-reported an ophthalmologic condition, and 12,462 had at least 1 outpatient ophthalmologic visit. Hispanic (adjusted odds ratio [aOR] 0.72; P < .001) and black patients (aOR 0.74; P < .001) had fewer outpatient visits than their non-Hispanic white counterparts. Uninsured (aOR 0.41; P = .009) and Medicare/Medicaid (aOR 0.92; P < .001) patients had less outpatient care than their privately insured counterparts. Increasing income and education was associated with higher outpatient ophthalmologic care utilization. In the emergency department, non-Hispanic white patients had the least encounters (1.1 per 100 patients) and highest costs ($25,314.05) when compared to non-Hispanic black patients (3.2 encounters per 100 patients and $10,780.22 respectively) and Hispanic patients (2.2 encounters per 100 patients and $9,837.03 respectively). CONCLUSIONS: This study's findings demonstrate differences in outpatient ophthalmologic utilization based on demographic and socioeconomic characteristics. Concurrently, minority Americans had more ophthalmic emergency department visits but lower cost per visit. There is a need to further characterize these differences to predict future ophthalmologic care needs.


Assuntos
Assistência Ambulatorial/estatística & dados numéricos , Oftalmologia/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Classe Social , Adolescente , Adulto , Idoso , Assistência Ambulatorial/economia , Criança , Estudos Transversais , Feminino , Gastos em Saúde/estatística & dados numéricos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Seguro Saúde/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Oftalmologia/economia , Estudos Retrospectivos , Estados Unidos/epidemiologia , Adulto Jovem
17.
Acta Cir Bras ; 35(2): e202000207, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32320996

RESUMO

PURPOSE: To develop a database with social, demographic and professional information of all graduates of the two post-graduate programs in Ophthalmology of EPM-UNIFESP, including their opinions on quality, application, and contribution of the courses received in their professional careers. METHODS: The survey was conducted in the digital and physical archives of the University and by telephone contact. When the graduates' e-mails were all collected, the electronic questionnaire was applied. The responses were compiled. Descriptive analysis of the results obtained in this cross-sectional study was performed, and analyzed by the authors and by statistical professionals, through Excel graphs. RESULTS: The database suggests that most graduates were born and work in the state of São Paulo. A significant fraction of 66.77% is dedicated to academic work, but only 36.2% hold management positions. Most of them receive amounts of one to 56 minimum wages monthly. The main motivation was to improve their professional careers. CONCLUSION: For post-graduate programs, a database with information of its graduates can elucidate whether the goals were achieved based on the proposed teaching, as well as can generate reflections to improve the quality, the courses expectations and the vision that students have of the University.


Assuntos
Bases de Dados Factuais , Oftalmologia/educação , Estudantes de Medicina , Adulto , Idoso , Estudos Transversais , Bases de Dados Factuais/normas , Bases de Dados Factuais/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Oftalmologia/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Fatores Socioeconômicos , Estudantes de Medicina/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
20.
Am J Ophthalmol ; 211: 132-141, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31730839

RESUMO

PURPOSE: To perform a comprehensive analysis of characteristics of ophthalmology trials registered in ClinicalTrials.gov. DESIGN: Cross-sectional study. METHODS: All 4,203 ophthalmologic clinical trials registered on ClinicalTrials.gov between October 1, 2007, and April 30, 2018, were identified by using medical subject headings (MeSH). Disease condition terms were verified by manual review. Trial characteristics were assessed through frequency calculations. Hazard ratios and 95% confidence intervals were determined for characteristics associated with early discontinuation. RESULTS: The majority of trials were multiarmed (73.6%), single-site (69.4%), randomized (64.8%), and had <100 enrollees (66.3%). A total of 33% used a data-monitoring committee (DMC), and 50.6% incorporated blinding. Other groups (51.6%) were funded by industry, whereas 2.6% were funded by the US National Institutes of Health (NIH). NIH trials were significantly more likely to address oncologic (NIH = 15.5%, Other = 3%, Industry = 1.5%; P < 0.001) or pediatric disease (NIH = 20.9%, Other = 5.9%, Industry = 1.4%; P < 0.001). Industry-sponsored trials (69.6% of phase 3 trials) were significantly more likely to be randomized (Industry = 68.7%, NIH = 58.9%, Other = 60.8%; P < 0.001) and blinded (Industry = 57.2%, NIH = 42.7%, Other = 43.5%; P < 0.001). A total of 359 trials (8.5%) were discontinued early, and 530 trials (12.6%) had unknown status. Trials were less likely to be discontinued if funded by sources other than industry (hazard ratio [HR], 0.72; 95% confidence interval [CI], 0.55-0.95; P = 0.021) and/or had a DMC (HR, 0.71; 95% CI, 0.55-0.92; P = 0.010). CONCLUSIONS: Ophthalmology trials in the past decade reveal heterogeneity across study funding sources. NIH trials were more likely to support historically underfunded subspecialties, whereas Industry trials were more likely to face early discontinuation. These trends emphasize the importance of carefully monitored and methodologically sound trials with deliberate funding allocation.


Assuntos
Ensaios Clínicos como Assunto/estatística & dados numéricos , Bases de Dados Factuais/estatística & dados numéricos , Oftalmologia/estatística & dados numéricos , Sistema de Registros/estatística & dados numéricos , Projetos de Pesquisa , Ensaios Clínicos como Assunto/economia , Estudos Transversais , Financiamento Governamental/economia , Organização do Financiamento/economia , Pesquisa sobre Serviços de Saúde , Humanos , National Institutes of Health (U.S.)/estatística & dados numéricos , National Library of Medicine (U.S.)/estatística & dados numéricos , Oftalmologia/economia , Apoio à Pesquisa como Assunto/economia , Estados Unidos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...