Smart glasses evaluation during the COVID-19 pandemic: First-use on Neurointerventional procedures.

The COVID-19 pandemic is rapidly transforming the healthcare system, with telemedicine, or virtual health, being one of the key drivers of the change. Smart glasses have recently been introduced to the public and have generated interest with healthcare professionals as demonstrated by their early adoption in clinics and hospitals. Observing procedures is essential for young interventionalist-in-training, but sometimes it is difficult for them to be able to get the volume of exposure to procedures that they need. Here, we report the first experience using smart glasses for Neurointerventional procedures, highlighting potential benefits and limitations during different scenarios including invitro and life cases. This field is novel, innovative, and may have potential to improve both patient care and patient safety in other health care settings.

Measurement of the anterior chamber depth and ocular axial length: transpalpebral B-mode ultrasound using an 18-MHz linear probe compared with the IOL Master 500.

AIMS: To determine the reliability of transpalpebral ultrasound in B-mode (B-TUS) with a high-resolution linear probe (18 MHz) in estimating both the ocular anterior chamber depth (ACD) and axial length (AL), as well as its agreement with the IOL Master 500 optical biometer. MATERIAL AND METHODS: Cross-sectional study on 82 eyes of 41 volunteers with no history of eye disease. ACD and AL were determined using B-TUS and the IOL Master 500. The agreement between the two tech-niques and the variability of B-TUS (inter- and intra-observer) were analyzed with the Bland-Altman method. To this end, the mean difference between measures±1.96 SD was calculated to determine the limits of agreement (LoA). RESULTS: The mean difference±1.96SD between B-TUS and the IOL Master 500 was -0.41±0.25mm for ACD (p<0.001) and -0.48±0.45 mm for AL (p<0.001). The maximum variability for B-TUS (average±1.96SD) was 0.00±0.35 mm at the inter-observer level for AL, and 0.00±0.18mm at the intra-observer level for AL. CONCLUSION: The determination of ACD and AL by B-TUS has a good re-liability and variability, in line with other sonographic techniques. However, it systematically provides smaller measurements than those obtained with the IOL Master 500, similar to the conventional ultrasound techniques. B-TUS could be useful in the assessment and follow-up of a wide range of ophthalmic diseases, in which a high accuracy in ACD and AL is not determinant.

Ocular biometry through fully refocused steady-state magnetic resonance imaging sequence: reliability and agreement with the IOLMaster® 500.

PURPOSE: To evaluate the reliability and agreement between Fully Refocused Steady-State magnetic resonance sequences (FRSS) and the IOLMaster® 500 optical biometer for measuring anterior chamber depth (ACD) and axial length (AL). METHODS: In a sample of 32 healthy volunteers, separate observers measured the ACD and AL of both eyes using both techniques (inter-method) and through repeated FRSS measurements (interobserver) and by the same observer (intraobserver). We employed the Bland-Altman method to determine the agreement between FRSS and partial coherence interferometry (using the IOLMaster®) and the interobserver and intraobserver variability, providing the limits of agreement (LoA, or mean difference ± 1.96 SD). Correlation coefficients and intraclass correlation coefficients were also provided. RESULTS: For ACD measurements with FRSS in pseudo-color scale, we obtained an LoA of 0.016 ± 0.266 mm compared with partial coherence interferometry. For AL with FRSS in greyscale, the LoA was 0.019 ± 0.383 mm. Maximum interobserver variability showed a - 0.036 ± 0.247 mm LoA for ACD with FRSS in pseudo-color scale. Maximum intraobserver variability was 0.000 ± 0.157 mm LoA for AL with FRSS in greyscale. CONCLUSIONS: ACD and AL measurements using FRSS sequencing present high LoA and reliability when compared with partial coherence interferometry using the IOLMaster® 500. The results were better for FRSS in pseudo-color scale in ACD determination and for FRSS in greyscale in AL determination. FRSS would not be recommended for IOL power calculation due to variability of AL measurement.

Elevated D-Dimer and acute pulmonary embolism in COVID-19 patients / Dímero-D elevado y tromboembolismo pulmonar agudo en pacientes con COVID-19

INTRODUCTION: It has been determined that patients with SARS-CoV-2 infection and severe pneumonia with elevated D-dimer values ​​can develop acute pulmonary thromboembolism (APE) as a complication, being one of the causes related to mortality in this group of patients. METHODS: A retrospective analysis of 12 patients diagnosed with SARS-CoV-2 infection with high clinical suspicion of APE confirmed by computed tomography pulmonary angiopgraphy (CTPA) was performed and the described findings are described. RESULTS: 12 patients with diagnosis of severe pneumonia, elevated D-dimer 9.2 μg / ml (1.4 - ˃20 μg / mL) and confirmation of SARS-CoV-2 infection through real-time reverse transcription polymerasa chain reaction (RT-PCR). APEs were observed mainly in segmental arteries (75%) and main arteries (25%). Pneumonia with patched areas of bilateral ground glass opacities was observed in 100% of the sample as a typical finding of SARS-CoV-2 infection. CONCLUSION: SARS-CoV-2 infection is related to elevation of D-dimer and APE. The CTPA determines the diagnosis, severity and timely management (anticoagulation) of patients with APE. Therefore CTPA should be considered in all patients with elevated D-dimer or clinical worsening

INTRODUCCIÓN: Se ha determinado que los pacientes con infección por SARS-CoV-2 y neumonía severa con valores elevados de dímero-D, pueden desarrollar tromboembolismo pulmonar agudo (TEP) como complicación, siendo una de las causas relacionada con la mortalidad en este grupo de pacientes. MATERIAL Y MÉTODOS: Se realizó un análisis retrospectivo de 12 pacientes con diagnóstico de infección por SARS-CoV-2 con alta sospecha clínica de APE confirmado por angio tomografia computarizada (AngioTC) y se describen los hallazgos descritos. RESULTADOS: 12 pacientes con diagnóstico de neumonía severa, dímero-D elevado 9,2 μg/ml (1,4 - ˃20 μg/ml) y confirmación de infección de SARS-CoV-2 a través de reacción en cadena de polimerasa reversa (RT-PCR). Se objetivaron TEP principalmente en arterias segmentarias (75%) y arterias principales (25%). En el 100% de la muestra se objetivó neumonía con áreas parcheadas de vidrio deslustrado bilaterales como hallazgo típico de infección por SARS-CoV-2. CONCLUSIÓN: La infección por SARS-CoV-2 está relacionada con elevación del dímero-D y con TEP. La angioTC determina el diagnóstico, severidad y manejo oportuno (anticoagulación) de los pacientes con TEP. Por tanto el angioTC debe ser considerado en todos los pacientes con dímero-D elevado o empeoramiento clínico