Oftalmología

Oftalologo í a
  • 文章类型: Journal Article
    目的:数字化发展代表了眼科适应新护理模式的机会。本研究旨在了解大流行如何改变眼表专业眼科医生的临床实践和培训活动,以及分析新兴趋势和需求。
    方法:本研究通过在线调查进行。由3名专家组成的委员会制定了一份包含25个问题的问卷,其结构如下:1)参与者概况;2)大流行对患者管理和专业活动的影响;3)趋势和需求。
    结果:68名临床眼科医生参加。人们高度一致(90%)认为大流行推迟了眼科随访和诊断。参与者一致认为,干眼症患者的频率(75%),stye/chalazion(62%)和眼睑炎(60%)增加。28%的人说,对干眼症等病理的远程监测,青光眼,糖尿病,结膜炎,尿道疝,Styes,等。,将是常见的,尤其是在年轻人中。这在眼表的慢性或轻度病变中尤其相关,以及在白内障和糖尿病视网膜病变干预后患者的随访中。
    结论:在大流行期间,人们已经意识到某些眼表疾病的发病率增加。眼表慢性或轻度病变的远程随访需要为患者和医疗保健专业人员提供特定培训,除了筛选和转诊方案可以优化护理流程。
    OBJECTIVE: Digital evolution represents an opportunity for ophthalmology to adapt to new care models. This study aimed to find out how the pandemic has modified the clinical practice and training activities of the ophthalmologist specialised in ocular surface, as well as to analyse emerging trends and needs.
    METHODS: This study was carried out through an online survey. A committee of 3 specialists developed a questionnaire of 25 questions structured in: 1) Participant profile; 2) Impact of the pandemic on patient management and professional activities; 3) Trends and needs.
    RESULTS: 68 clinical ophthalmologists participated. There was a high degree of agreement (90%) that the pandemic has delayed ophthalmological follow-up visits and diagnosis. The participants agreed that the frequency of patients with dry eye disease (75%), stye/chalazion (62%) and blepharitis (60%) has increased. According to 28%, remote monitoring of pathologies such as dry eye, glaucoma, diabetes, conjunctivitis, hyposphagmas, styes, etc., will be common, especially in the young population. This will be especially relevant in chronic or mild pathologies of the ocular surface, and in the follow-up of patients after cataract and diabetic retinopathy interventions.
    CONCLUSIONS: During the pandemic, an increase in the incidence of certain ocular surface diseases has been perceived. The telematic follow-up of chronic or mild pathologies of the ocular surface entails the need to provide specific training for both the patient and the healthcare professional, in addition to screening and referral protocols that would optimise the flow of care.
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  • 文章类型: Observational Study
    目的:了解三级医院周围性面神经麻痹(PFP)患者的临床和流行病学特征。
    方法:这是一项在三级医疗中心接受治疗的PFP患者的回顾性观察性研究。我们收集了人口统计数据,病因学,偏侧性,复发,recovery,临床眼科,根据House-Brackmann(HB)量表,电生理测试,参加医疗服务,医学和外科治疗。
    结果:包括二百八十三个PFP,男性135人(48%),女性148人(52%)(p=0.47)。所有患者均有单侧受累。平均年龄为54±20岁。215例(76%)患者的主要病因是特发性。中位恢复时间为7周。190例(67%)患者完全恢复。一百七十(84%)特发性PFP患者完全恢复,非特发性PFP患者30例(16%)(p<0.01)。84%的患者为HBⅡ级,完全恢复,而HBVI级仅恢复了17%(p=0.003)。二百二十九名患者(81%)患有痛觉。大部分接受眼表护理治疗的有271例(96%)患者,其中249例(88%)患者接受口服皮质类固醇治疗。13例患者(5%)需要眼科手术。
    结论:PFP影响所有年龄范围,不偏爱性和单方面。其主要原因是特发性。在大多数情况下,恢复已完成,对轻度和特发性情感更有利。大多数只需要医疗。
    OBJECTIVE: To identify clinical and epidemiological characteristics of patients with peripheral facial palsy (PFP) at a tertiary care hospital.
    METHODS: This is a retrospective observational study of patients with PFP treated at a tertiary medical center. We gathered demographic data, etiology, laterality, recurrence, recovery, clinical ophthalmology, severity according to the House-Brackmann (HB) scale, electrophysiological tests, medical services attended, medical and surgical treatment.
    RESULTS: Two hundred and eighty-three PFP were included, 135 (48%) were men and 148 (52%) were women p = 0.47). All patients had unilateral involvement. The mean age was 54 ± 20 years. The main etiology was idiopathic in 215 (76%) patients. Median recovery time was 7 weeks. Recovery was complete in 190 (67%) patients. One hundred and seventy (84%) patients with idiopathic PFP had complete recovery, versus 30 (16%) patients with non-idiopathic PFP (p < 0.01). The 84% of patients with HB grade II, recovered completely, while with HB grade VI only 17% recovered (p = 0.003). Two hundred and twenty-nine patients (81%) had lagophthalmos. The majority received ocular surface care treatment in 271 (96%) patients and of these 249 (88%) patients received oral corticosteroid therapy. Thirteen patients (5%) required ophthalmologic surgery.
    CONCLUSIONS: PFP affects all age ranges, without predilection for sex and unilateral. Its main cause is idiopathic. Recovery is complete in most cases, being more favorable in mild and idiopathic affections. Most only require medical treatment.
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  • 文章类型: Journal Article
    目的:2013年,我们实施了用于诊断眼睑疾病(tele-liid)的异步远程医疗电路,将门诊基层医疗保健与医院的专家联系起来。这项研究的目的是评估远程医疗在初级保健团队诊断眼睑疾病中的应用,评估其有用性并分析三级医院的病理状况的流行病学,以及手术的需要。
    方法:这项研究是在西班牙公共卫生系统中进行的,在主要由加泰罗尼亚学院(ICS)和AlthaiaXarxa助理大学协助的农村地区。这是一个回顾展,对2013年至2019年进行的远程信息处理咨询的描述性分析。2018年至2019年的会诊进行了进一步的描述性回顾性前瞻性分析,以评估医院的病情。
    结果:在72%的远程会诊中避免了不必要的转诊。超过50%的初级保健医生使用远距眼睑。高达68%的转诊是由于眼睑肿瘤,50%需要手术18%,活检.此外,我们发现远程信息处理和面对面诊断之间有很高的可靠性.
    结论:应用于眼睑病理学的远程眼科学是改善获得专业护理并帮助解决病理状况的有用工具。避免了不必要的磋商,提高效率,在基层和医院护理方面。
    OBJECTIVE: In 2013 we implemented an asynchronous telemedicine circuit for the diagnosis of eyelid diseases (tele-eyelid), connecting the outpatient primary healthcare with the hospital\'s specialists. The purpose of this study is to assess the use of telemedicine in the diagnosis of eyelid diseases by primary care teams, to evaluate its usefulness and to analyse the epidemiology of the pathological conditions referred to the tertiary level hospital, as well as the need for surgery.
    METHODS: This study was carried out in the Spanish public health system, in a mainly rural area assisted by the Institut Català de la Salut (ICS) and Althaia Xarxa Assistencial Universitària de Manresa. This is a retrospective, descriptive analysis of the telematic consultations undertaken between 2013 and 2019. The consultations between 2018 and 2019 underwent a further descriptive retrospective-prospective analysis to assess the conditions referred to the hospital.
    RESULTS: Unnecessary referrals were avoided in 72% of telematic consultations. More than 50% of primary care practitioners used tele-eyelid. Up to 68% of the referrals were due to eyelid tumours, 50% needed surgery and 18%, a biopsy. Moreover, we found a high reliability between telematic and face-to-face diagnosis.
    CONCLUSIONS: Teleophthalmology applied to eyelid pathology is a useful tool to improve access to specialized care and helps solving pathological conditions. It avoids unnecessary consultations and increases efficiency, both in primary and hospital care.
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  • 文章类型: Journal Article
    OBJECTIVE: To determine the prevalence of ophthalmological emergency visits to two tertiary hospital in all age groups during years 2014 and 2015.
    METHODS: All patients who attended Ophthalmological Emergency Department from 1 January 2014 to 31 December 2015 were included in the study. The demographic variables studied were gender, age, place of origin, time of arrival, day of the week, month and year of the visit, the diagnosis, destination on discharge, total time of the visit and priority. Pathologies were categorised using codes from ICD-9, CM.
    RESULTS: A total of 39,869 visits were made between 2014 and 2015. Emergency consultations were more frequent among women, on Mondays, and from April to June. The mean age of the patients was 46.24years old, and 73.42% of visits were classified as non-emergencies. The most frequent pathology was conjunctivitis (17.28%), followed by keratitis (15.31%), and vitreous detachment (5.37%). The pathology that led to more hospital admissions was orbital cellulitis (23%). The majority of patients (94.85%) were sent to their place of residence after the visit.
    CONCLUSIONS: Given that the great majority of Ophthalmological Emergency visits are categorised as non-emergencies, measures need to be set up in order achieve a more effective care focused on emergency pathology without using unnecessary resources.
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