RESUMO
La fotografía de fibras clásica, usada tradicionalmente para identificar defectos en la capa de fibras nerviosas de la retina (CFNR), tiene un uso limitado debido a la necesidad de un equipo fotográfico específico y un técnico experto en la adquisición de esta clase de imágenes. El nuevo módulo MultiColor de la tomografía de coherencia óptica (OCT) SPECTRALIS®, utilizando 3 longitudes de onda diferentes simultáneamente, es capaz de proporcionar imágenes en las que se identifican las estructuras de la retina en diferente color según su profundidad. Nos propusimos realizar un pequeño estudio de concordancia para determinar la utilidad del nuevo software MultiColor frente a la fotografía de fibras tradicional en la identificación de defectos en la CFNR. La concordancia interobservador en la interpretación de imágenes MultiColor fue buena (κ=0,746; p<0,001); y se consiguieron identificar con MultiColor en torno al 70% de pacientes con glaucoma leve. Consideramos que el nuevo software MultiColor resulta útil en la evaluación de defectos de la CFNR, y es sencillo de realizar (AU)
The classical fibre photography traditionally used to identify defects in the retinal nerve fibre layer (RNFL), has been partially discontinued due to poor availability. The new MultiColour module of SPECTRALIS® Optical Coherence Tomography (OCT), using three different laser wavelengths simultaneously, can provide images that identify the structures of the retina in different colours according to their depth. A small concordance study was conducted to determine the usefulness of the new MultiColour software versus traditional fibre photography in identifying RNFL defects. The inter-observer agreement in the interpretation of MultiColour images was good (κ=.746; P<.001), as by using Multicolour they were able to identify around 70% of patients with mild glaucoma. It is believed that the new Multicolour software is useful in evaluating RNFL defects, and is easy to perform (AU)
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Retina/diagnóstico por imagem , Fibras Ópticas , Software , Glaucoma/diagnóstico por imagem , Tomografia de Coerência Óptica , Variações Dependentes do ObservadorRESUMO
The classical fibre photography traditionally used to identify defects in the retinal nerve fibre layer (RNFL), has been partially discontinued due to poor availability. The new MultiColour module of SPECTRALIS® Optical Coherence Tomography (OCT), using three different laser wavelengths simultaneously, can provide images that identify the structures of the retina in different colours according to their depth. A small concordance study was conducted to determine the usefulness of the new MultiColour software versus traditional fibre photography in identifying RNFL defects. The inter-observer agreement in the interpretation of MultiColour images was good (κ=.746; P<.001), as by using Multicolour they were able to identify around 70% of patients with mild glaucoma. It is believed that the new Multicolour software is useful in evaluating RNFL defects, and is easy to perform.
RESUMO
Objetivo: El tabaco es un factor de riesgo en la orbitopatía de Graves (GO) y es modificable. El consejo médico para dejar de fumar se ha incluido en todas las guías de práctica clínica de esta enfermedad, aunque su efectividad no ha sido evaluada. El objetivo de este estudio es conocer el cambio producido en el hábito tabáquico en pacientes con GO tras una recomendación verbal para dejar de fumar. Material y métodos: Se estudió una cohorte retrospectiva de pacientes con GO. Todos los pacientes recibieron consejo médico sobre la importancia de dejar de fumar en la primera consulta del oftalmólogo. Entre 2013 y 2014 se atendió a 33 pacientes en la consulta, que fueron preguntados sobre el cambio en su hábito tabáquico en 2015. La variable principal de estudio fue el número de cigarros fumados al día antes y después de las consultas en endocrinología y oftalmología. Aparte, se recogieron otros datos personales médicos y socioeconómicos. Resultados: El número medio de cigarros fumados fue de 13,6 (DE 9,66) y 6,3 (DE 7,73) antes y después de la primera consulta en oftalmología, respectivamente (test t pareado, p < 0,05). El 42,42% de los pacientes dejó de fumar y el 30,3% disminuyó el consumo de cigarrillos. Los pacientes que consiguieron dejar de fumar presentaban con mayor frecuencia formas de enfermedad de Graves activas y graves, tenían trabajos estables y estaban apoyados por sus familiares y amigos. Conclusión: Un consejo fuerte y firme recomendando dejar de fumar es efectivo en pacientes con GO. Esta enfermedad afecta seriamente la calidad de vida de los pacientes, lo que hace que sean más susceptibles de cambiar a la hora de modificar sus hábitos
Objective: Smoking is an important risk factor for Graves orbitopathy (GO) and it is modifiable. The advice to stop smoking has been included in all the clinical practice guidelines of GO. However, the effectiveness of this practice remains unknown. The purpose of this study is to assess the change in the smoking habit in patients affected with GO after an oral counselling for smoking cessation. Material and methods: A retrospective cohort of GO patients was studied. The patients received a significant oral counsel during the first consultation with the ophthalmologist. 33 GO patients were explored in the ophthalmology clinic during 2013 and 2014 and the study was done throughout a telephone questionnaire in 2015. The main outcome was the number of cigarettes smoked daily before and after consultation with the endocrinologist and the ophthalmologist. Other medical and socioeconomic factors were recorded. Results: The mean number of cigarettes that were smoked was 13.6 (SD 9.66) and 6.3 (SD 7.73) before and after the consultation done at the ophthalmology office (T-test paired, P = 0.0006). 42.42% achieved smoking cessation and 30.3% decreased their smoking habit. Patients who stopped smoking suffered usually from active and severe GO, had more stable jobs and received greater support from their relatives and friends. Conclusion: A firm and strong oral counsel held for smoke cessation was effective in GO patients. This disease deeply affects patients quality of life, making them more prone to change their habits
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Fumar Cigarros/prevenção & controle , Aconselhamento , Doença Catastrófica/terapia , Abandono do Hábito de Fumar , Fumar Cigarros/efeitos adversos , Hábitos , Educação de Pacientes como Assunto , Avaliação de Programas e Projetos de Saúde , Estudos Retrospectivos , Abandono do Hábito de Fumar/psicologia , Agentes de Cessação do Hábito de Fumar , Fatores Socioeconômicos , Inquéritos e Questionários , Produtos do Tabaco/estatística & dados numéricosRESUMO
OBJECTIVE: Smoking is an important risk factor for Graves orbitopathy (GO) and it is modifiable. The advice to stop smoking has been included in all the clinical practice guidelines of GO. However, the effectiveness of this practice remains unknown. The purpose of this study is to assess the change in the smoking habit in patients affected with GO after an oral counselling for smoking cessation. MATERIAL AND METHODS: A retrospective cohort of GO patients was studied. The patients received a significant oral counsel during the first consultation with the ophthalmologist. 33 GO patients were explored in the ophthalmology clinic during 2013 and 2014 and the study was done throughout a telephone questionnaire in 2015. The main outcome was the number of cigarettes smoked daily before and after consultation with the endocrinologist and the ophthalmologist. Other medical and socioeconomic factors were recorded. RESULTS: The mean number of cigarettes that were smoked was 13.6 (SD 9.66) and 6.3 (SD 7.73) before and after the consultation done at the ophthalmology office (T-test paired, P=0.0006). 42.42% achieved smoking cessation and 30.3% decreased their smoking habit. Patients who stopped smoking suffered usually from active and severe GO, had more stable jobs and received greater support from their relatives and friends. CONCLUSION: A firm and strong oral counsel held for smoke cessation was effective in GO patients. This disease deeply affects patients' quality of life, making them more prone to change their habits.
