ABSTRACT
La teledermatología (TD) revoluciona la atención en dermatología, facilitando su acceso a regiones remotas. La TD asincrónica (TDA), utilizada para el diagnóstico dermatológico a través del envío de información mediante e-mail, ha sido implementada en forma limitada en Chile. El objetivo de este estudio fue analizar la efectividad y la satisfacción usuaria (SU) de la TDA en un centro de salud rural de Chile. Se diseño un sistema de teleconsultas, capacitando a los médicos generales en patología dermatológica más frecuente y se realizó contrarreferencia. Se analizaron 172 teleconsultas. Las patologías más frecuentes fueron: acné (11,1 por ciento), onicomicosis (8,7 por ciento), psoriasis (4,1 por ciento), dermatitis de contacto (4,1 por ciento) y verrugas (4,1 por ciento), Se encontró alta concordancia diagnóstica (CD) entre médicos generales y especialista (88,3 por ciento). La SU general alcanzó un 97 por ciento y se logró la resolución del 99,4 por ciento de las teleconsultas. La TDA permite proporcionar atención dermatológica a distancia, lo que permitiría favorecer a diversas localidades rurales de Chile.
Teledermatology (TD) revolutionizes the delivery of dermatology services by facilitating the access to specialist services at a distance. Asynchronous TD (ATD) is used for skin diseases diagnosis by sending information and images through e-mail. Its implementation in Chile has been limited. The purpose of this study was to analize the effectiveness and the user satisfaction (US) of the application of ATD in a rural helath center in Chile. A teleconsultation system was designed, primary care general practitioners were trained in dermatological diagnosis and implementation of the cross-refertence was developed. We assessed 172 teleconsultations. The most frequent pathologies were acne (11,1 percent), onychomycosis (8,7 percent), psoriasis (4,1 percent), contact dermatitis (4,1 percent) and warts (4,1 percent). The diagnosis concordance (DC) was 88,3 percent and the general US reached 97 percent. Diagnostic and therapeutic resolution was achieved in 99,4 percent of the teleconsultations. ATD was able to provide a distant dermatological assistance, helping several rural areas of Chile.
Subject(s)
Humans , Male , Adolescent , Adult , Female , Child, Preschool , Child , Middle Aged , Aged, 80 and over , Dermatology/methods , Skin Diseases/diagnosis , Patient Satisfaction , Telemedicine/methods , Chile , Remote Consultation/methods , Electronic Mail , Epidemiology, Descriptive , Skin Diseases/epidemiology , Health Services Accessibility , Pilot Projects , Rural HealthABSTRACT
Introducción: La psoriasis ha sido relacionada al aumento en el riesgo cardiovascular (CV). El Síndrome metabólico sería más prevalente en psoriáticos; sin embargo, se desconoce la realidad local. Objetivo: Determinar la presencia de Síndrome metabólico en pacientes con psoriasis leve a moderada en el Hospital Clínico de la Universidad de Chile. Pacientes y Métodos: Se realizó un estudio prospectivo en 214 psoriáticos adultos. Se definió Síndrome metabólico según criterios A TP III. Los resultados se compararon con estadísticas nacionales de prevalencia de Síndrome metabólico de lo OMS y publicaciones afines. Resultados: El Síndrome metabólico fue encontrado en el 71% de los psoriáticos examinados versus el 22,6% de población general. Los psoriáticos tuvieron una alta prevalencia de obesidad (70,6% vs 21,9%), hipercolesterolemia (239 mg/dL vs 186 mg/dL), hipertrigliceridemia (197 mg/dL) y aumento de la circunferencia abdominal (92 cm), además de alzas moderadas de la presión arterial y glicemia. Tabaquismo (40,2%) más prevalente que en la población general y sedentarismo (90,2%) con cifra similar a la población general. Conclusión: Los pacientes psoriáticos tienen una alta frecuencia de Síndrome metabólico. Este trabajo coincide con los datos publicados a nivel internacional.
Introduction: Psoriasis has been linked to on increase in cardiovascular risk (CV). Metabolic syndrome is more prevalent in psoriatic, however data on Chilean psoriasis patients hove not been reported. Objective: Study the prevalence of metabolic syndrome in patients with mild to moderate psoriasis attendees at Hospital Clínico of Universidad de Chile. Patients and methods: Descriptive study in 2 I 4 consecutive psoriasis patients. Metabolic syndrome was determined according to A TP III criteria. Data was compared with WHO notional statistics on prevalence of metabolic syndrome and related articles. Results: 71% of psoriasis patients had metabolic syndrome in comparison with 22.6% of general population. 70.6% were obese in contrast to 21,9% of the general population. The mean cholesterol level was 239 mg/dL vs. 186 mg/dL patients had elevated triglycerides (197 mg/dL) and increase of abdominal circumference (92 cm). Blood pressure, fasting blood sugar were moderately elevated. Smoking present in 40.2% was more frequent than in general population, and sedentarism (90.2%) was equally frequent. Conclusions: Psoriasis patients have a high prevalence of metabolic syndrome. This data is concurrent with results in international trials.
Subject(s)
Humans , Male , Adolescent , Adult , Female , Middle Aged , Psoriasis/epidemiology , Metabolic Syndrome/epidemiology , Body Mass Index , Chile/epidemiology , Cholesterol, HDL/blood , Cardiovascular Diseases/etiology , Blood Glucose/analysis , Hypertension/epidemiology , Hypertriglyceridemia/epidemiology , Prevalence , Prospective Studies , Risk Factors , Tobacco Use Disorder/epidemiologyABSTRACT
Background: A possible relationship has been reported between psoriasis and celiac disease, with common pathogenic mechanisms that may need further investigation. Aim: To investigate the presence of clinical and serological markers for celiac disease in a group of Chilean psoriatic patients. Material and methods: We included 80 psoriatic patients (42 males) aged 16 to 79 years, whose serum was tested for antitransglutaminase antibodies (ATGA) and antiendomysial antibodies (AEMA). Patients with weakly positive AEMA tests were also tested for antigliadin antibodies (AGA). Results: In six patients (7.5 percent), AEMA and AGA were positive and one patient was positive for ATGA. An upper gastrointestinal endoscopy and duodenal biopsy was offered to these six patients and five accepted the procedure. Only one had a pathological diagnosis of celiac disease. Conclusions: Only one of 80 patients with psoriasis had celiac disease (1.2 percent). Other four patients with positive serologic markers had a normal duodenal biopsy. This group of patients may have latent celiac disease and they should be followed up.