ABSTRACT
BACKGROUND: Diabetic retinopathy (DR) is a leading cause of blindness. Our objective was to evaluate the performance of an artificial intelligence (AI) system integrated into a handheld smartphone-based retinal camera for DR screening using a single retinal image per eye. METHODS: Images were obtained from individuals with diabetes during a mass screening program for DR in Blumenau, Southern Brazil, conducted by trained operators. Automatic analysis was conducted using an AI system (EyerMaps™, Phelcom Technologies LLC, Boston, USA) with one macula-centered, 45-degree field of view retinal image per eye. The results were compared to the assessment by a retinal specialist, considered as the ground truth, using two images per eye. Patients with ungradable images were excluded from the analysis. RESULTS: A total of 686 individuals (average age 59.2 ± 13.3 years, 56.7% women, diabetes duration 12.1 ± 9.4 years) were included in the analysis. The rates of insulin use, daily glycemic monitoring, and systemic hypertension treatment were 68.4%, 70.2%, and 70.2%, respectively. Although 97.3% of patients were aware of the risk of blindness associated with diabetes, more than half of them underwent their first retinal examination during the event. The majority (82.5%) relied exclusively on the public health system. Approximately 43.4% of individuals were either illiterate or had not completed elementary school. DR classification based on the ground truth was as follows: absent or nonproliferative mild DR 86.9%, more than mild (mtm) DR 13.1%. The AI system achieved sensitivity, specificity, positive predictive value, and negative predictive value percentages (95% CI) for mtmDR as follows: 93.6% (87.8-97.2), 71.7% (67.8-75.4), 42.7% (39.3-46.2), and 98.0% (96.2-98.9), respectively. The area under the ROC curve was 86.4%. CONCLUSION: The portable retinal camera combined with AI demonstrated high sensitivity for DR screening using only one image per eye, offering a simpler protocol compared to the traditional approach of two images per eye. Simplifying the DR screening process could enhance adherence rates and overall program coverage.
ABSTRACT
Objective To report three cases of vein of Galen aneurysmalmalformation (VGAM) in pediatric patients treated at the hemodynamics lab of Hospital Santa Isabel (HSI) in Blumenau, state of Santa Catarina, Brazil, from 2006 to 2020. Clinical presentation, endovascular treatment, and postprocedure evolution to date are included. Case description Three children aged 5 to 12 months with cardiac, respiratory, or neurological damage in the neonatal stage, were referred to the neurosurgery service and diagnosed with VGAM. The three patients underwent endovascular embolization of themalformation, with different clinical evolution throughout outpatient follow-up. Conclusion Vein of Galen aneurysmal malformations are uncommon vascular abnormalities that, until the advent of endovascular embolization, were associated with high morbidity and mortality rates. Its prognosis is linked with initial clinic, early diagnosis, and timely surgical correction.
Subject(s)
Humans , Male , Female , Infant , Intracranial Aneurysm/surgery , Vein of Galen Malformations/surgery , Vein of Galen Malformations/physiopathology , Endovascular Procedures/methods , Prognosis , Intracranial Aneurysm/diagnostic imaging , Treatment Outcome , Embolization, Therapeutic/methods , Vein of Galen Malformations/diagnostic imagingABSTRACT
OBJETIVOS: Descrever características clínicas e epidemiológicas dos indivíduos recuperados da doença COVID-19 na cidade de Brusque, Santa Catarina, Brasil. MÉTODOS: Estudo observacional descritivo e retrospectivo de casos da COVID-19 compreendidas no período entre 27 de março de 2020 e 27 de maio de 2020. Foram revistos prontuários médicos de 104 indivíduos com diagnóstico laboratorial para SARS-CoV-2, analisando perfil clínico e epidemiológico, além de achados laboratoriais e de imagem e tratamento realizado. Foram utilizadas planilhas do Microsoft Excel, versão 2020, e software Statistical Package for the Social Sciences (SPSS®) versão 17.0 para obtenção de frequências e intervalos. RESULTADOS: A média de idade dos acometidos foi de 40,1 anos, 51% eram do sexo masculino, em 14,4% dos casos houve necessidade de internação hospitalar dos quais 54,3% destes apresentavam uma ou mais comorbidades pré-existentes. O sintoma mais comum na admissão foi tosse (85,6%) e o menos comum foi dor abdominal (3,5%). Dos tratamentos utilizados, os antibióticos foram prescritos em 45,2% dos casos, sendo a azitromicina a medicação mais prevalente (39,5%). CONCLUSÃO: A doença causada pelo novo coronavírus, COVID-19, na cidade de Brusque, acometeu faixa etária mais nova, com menor necessidade de internações hospitalares e complicações. Por ser uma doença nova, com diferentes formas de evolução e acometimento, a experiência e os resultados de cada cidade podem contribuir no tratamento e na prevenção da vida dos indivíduos.
OBJECTIVES: To describe the clinical and epidemiological characteristics of individuals recovered from COVID-19 disease in the city of Brusque, Santa Catarina, Brazil. METHODS: Descriptive and retrospective observational study of COVID-19 cases from March 27, 2020 to May 27, 2020. Medical records of individuals with laboratory diagnosis for new coronavirus (SARS-CoV-2) were reviewed, analyzing clinical profile and epidemiological, in addition to laboratory and imaging findings, treatment that was performed. Microsoft Excel spreadsheets, version 2020, and software Stastictical Package for the Social Sciences (SPSS®) version 17.0 were used to obtain frequencies and intervals. RESULTS: The average age of those affected was 40,1 years, 51% were male, in 14,4% of cases there was a need for hospitalization, of which 54,3% had one or more pre-existing comorbidities. The most common symptom on admission was cough (85,6%) and the least common was abdominal pain (3,5%). Of the treatments used, antibiotics were prescribed in 45,2% of cases, with azithromycin being the most prevalent medication (39,5%). CONCLUSION: The disease caused by the new coronavirus, COVID-19, in the city of Brusque, affected a younger age group, with lower rates of hospitalization and complications. As it is a new disease, with different forms of evolution and involvement, the experience and results of each city can contribute to the treatment and prevention of individuals' lives.
