Cataract is one of the most frequent side effects on patients who undergo macular hole surgery. For some time now, specialists already indicate that multiple surgical procedure to correct the diseases.
Now, the simultaneous treatment of macular hole and cataract has received scientific approval after a study by the University of São Paulo (USP), campus of Ribeirão Preto (SP), which proved the effectiveness of the technique.
Details on research results and the benefits of this approval – for doctors, health institutions, the Brazilian Unified Health System, and the patient – follow below.
The research
Researchers divided 65 patients with macular hole in two groups. The first one, of 33 people, underwent the multiple surgery with both techniques. The other group, with 32 patients, underwent a single procedure of cataract correction after the first surgery.
This is the first prospective study in the world to evaluate the multiple surgeries in a single intervention.
Results
Twenty-seven patients who underwent only the macula correction surgery had cataract afterwards. Because of that, they needed a new surgery in less than one year. In general, they presented significant worsening in vision.
Patients from the first group improved their visual acuity, similar to those who underwent sequential surgery.
The results demonstrate effectiveness of joining both techniques in a single procedure.
Benefits
In most cases, cataract occurs only a few months after the macula surgery. Therefore, the multiple procedure, joining both techniques, is advantageous to doctors, hospitals, the Brazilian Unified Health System and the patient.
Offering a safer treatment, cost and time reduction and less suffering of the patient are some remarkable advantages.
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The search for a cure for diabetes is one of the main aspects of the health research sector. According to the World Health Organization (WHO), 422 million people suffer from the disease worldwide. It is also responsible for 1.6 million annual deaths.
Scientists at the University of Alberta, Canada, recently announced that they had discovered a possible solution for the problem. With a new stem cell process the team was able to transform the patient’s own blood into insulin-producing cells. The clinical research was carried out on mice. Learn more about the study, the results and next steps.
Research
Researchers at the University of Alberta in Canada are working with scientists from all around the world on a new stem cell technique.
The study basically turns the blood of patients with type 1 diabetes into insulin-producing cells .
To do this the team adapted the technique of the 2012 Nobel Prize winner in Physiology or Medicine, Shinya Yamanaka, for the treatment of diabetes. Yamanaka discovered how to reprogram skin cells, through the use of hormones and other growth factors, in induced pluripotent stem cells (iPSCs). These could be induced to become any type of cell.
The Canadian researchers took blood samples from patients and treated the cells with a cocktail of hormones and other growth factors to “go back in time” and induce them to become insulin-producing cells. Then, they transplanted into mice with type 1 diabetes.
Results
The new technique achieved a cure for diabetes in mice. If successful blood cell transplantation would overcome the challenges of islet transplantation, such as the need for anti-rejection drugs and lifelong insulin applications. The project leader is physician James Shapiro, who made history 20 years ago with the “Edmonton Protocol“. The procedure places new insulin-producing cells in the patient by transplanting islets harvested from pancreases of organ donors.
However, they have significant side effects, such as an increased risk of cancer and potentially fatal infections.
But this new research believes that using the patient’s own cells should eliminate the problem.
Now the hope is that it will also generate results in humans. However, there is still a long road ahead. Undoubtedly, further evaluations in animals are still needed to demonstrate that the procedure can be possible, safe and effective. Only then should the research test people.
Obstacles
Financing is one of the current biggest obstacles today to continue the work. But in an interview withCTV News Edmonton, Shapiro said there are volunteers working on raising $ 22 million by 2022.
Conclusion
Undoubtedly, if it works, the results of the research can be considered the next major advance in the treatment of diabetes. Even if the technique is successful there is a lot of work to be done in the areas of robotic engineering, artificial intelligence and stem cell science to improve the process and make it less laborious. Mass production of iPSC and personalized medications may occur for the patient to cure diabetes in the future.
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Have you ever thought that having an eyer handheld fundus camera in your clinic can be a real advantage?
After all, having quicker access to your patients’ fundus images can assist in early diagnosis, treatment initiation and monitoring various diseases: glaucoma, diabetic retinopathy and age-related macular degeneration (AMD).
However, the equipment is expensive. There are models up to BRL 100,000 on the market. In addition to the other devices your business needs, the investment can burden your budget. Even more for professionals beginning their careers. Given that scenario, a new alternative is available: Eyer handheld fundus camera. Connected to a smartphone, the technology captures high-quality images of the fundus and sends them to an online platform. It allows reporting the exam and filing the patients’ history, among other features.
Another advantage is the price: the equipment is up to 4 times cheaper than the conventional handheld fundus camera.
The technology is national and developed by the startup Phelcom Technologies headquartered in the countryside of Sao Paulo.
Next, learn more about Phelcom Eyer handheld fundus camera, its advantages, how the Eyer Cloud platform works and how the device has been used in research projects and social actions.
Phelcom Eyer handheld fundus camera
Released in 2019, Phelcom Eyer is a handheld fundus camera that works coupled to a smartphone with a high-resolution camera. The device captures high-quality images of the fundus, in a few minutes and without the need for pupil dilation. After that, the data is automatically sent to the Eyer Cloud online platform. It allows reporting the exam and storing patients’ history with total data security.
Check out all the features of the Eyer:
High quality
Phelcom’s patented technology allows high quality exams to be performed on a portable device integrated with the smartphone.
Telemedicine
Carried out exams are automatically synchronized with the internet and made available in the cloud, enabling remote diagnosis.
Embedded artificial intelligence
Eyer has intelligent functions to assist medical diagnosis and capture retinal exams.
Connectivity
The device is naturally connected because it is integrated with the smartphone. It eases sharing and accessing exam data in the cloud through the Eyer Cloud system.
Non-mydriatic
Eyers carries out retinal examinations at any location without the need to use eye drops for pupil dilation. It is more comfortable to the patient and provides a faster exam.
Autofocus
With the Autofocus function it is possible to compensate refractive errors in the range of -20D to + 20D. This allows retinal examinations with a high level of details.
Accessible
Eyer allows the democratization of access to retinal examination technology through innovative and more accessible business models.
Easy operation
Any minimally trained healthcare professional can use the equipment to perform high-quality retinal exams in less than 1 minute. It guarantees faster and more accurate diagnoses.
Panoramic
The Eyer generates panoramic exams with a more than 100 degree visual field. The device has internal fixation points that assist capturing and generating panoramics.
Portability
The portable device allows performing exams anywhere with remotely-issued diagnosis. This feature helps in the democratization of health, since 85% of Brazilian cities do not have access to specialists and devices that diagnose eye diseases.
Low cost
Portability and small size allow Eyer to have a much lower cost compared to traditional fundus cameras. Even with cutting-edge technologies applied to the device production.
Recently Phelcom also released a slit lamp holder to allow Eyer attachment to a tabletop. This way, it provides the experience of a tabletop retinograph by easing image capture without movement.
In addition, it helps to maintain social distance in care, since the professional does not need to touch the patient’s forehead as occurs in the traditional exam.
Eyer handheld fundus camera – advantages
Eyer offers state-of-the-art technology which makes the device one of the most modern portable fundus cameras for the prevention and diagnosis of vision-related diseases.
Learn about the advantages of the equipment below:
High-quality eye exam through a smartphone;
Accurate and quick diagnosis;
Lower cost compared to traditional retinographs;
Exams are possible in several locations due to portability;
Democratization of retinal exams, especially in places with low infrastructure of quality services in the area, such as doctors, health professionals, equipment, medicines etc;
Faster service through computerized systems integrated to an online platform with access via computers, smartphones and tablets;
Tests are easy to carry out in clinics and health centers;
Diagnosis made by specialists and reference professionals located anywhere in the world;
Reduction of attendance time and operational costs;
Decrease in the displacement of patients to hospitals and large urban centers;
Improvement in the quality of the reports issued;
Increase in prevention and early diagnosis of diseases such as diabetic retinopathy, glaucoma, cataract, macular degeneration, retinoblastoma, retinal detachment, premature retinopathy and blindness, inter alia.
Eyer handheld fundus camera – Eyer Cloud
Eyer Cloudis an online platform integrated with the Phelcom Eyer handheld fundus camera that allows you to store and manage patient exams. All data captured by the equipment is automatically synchronized with the system, allowing them to upload to the cloud with complete security.
Any health professional – without necessarily being a specialist – can carry out the exam in the field after a brief training. With the information available on the web, a doctor from anywhere in the world can diagnose.
In addition to ensuring data backup on a secure server, the user has all data organized in a friendly, functional and intuitive interface. Moreover, the platform can be accessed on the device itself or in a smartphone, tablet and computer.
If there is no internet access at the time of the exam the images are saved on the device and are sent to the cloud as soon as a connection is available.
Eyer handheld fundus camera – social actions
Currently there are several social actions that use the device to bring more health to the whole country.
This is the case of the project “Unidos pelo Diabetes em Ação”, in Itabuna (BA). The event gave rise to the collective task force “Unidos pelo Diabetes”that needed to be cancelled due to the pandemic. On the whole, 400 patients participated in the first phase. 100 of these had more severe diabetic retinopathy or macular edema.
The project used advanced technologies to ensure screening without agglomerations. Eyer was the main screening tool. “Phelcom was fundamental to the success of the project as it made the devices available, provided prior training, helped in the strategy of assembling reports using its Eyer Cloud program and made its team of engineers available for support during the action”, says Andrade. “In addition, in an innovative way in Brazil, it created an artificial intelligence algorithm to help sorting patients who would probably be serious and those without changes, easing the logistics through distance-reporting”, adds Andrade.
Expeditions
The expedition carried out by Barco Hospital São Francisco, in the region of the municipality of Terra Branca (PA),at the end of last year, also featured the Eyer. Ophthalmologist Mariana Lafetá, one of the volunteers on this trip, says that the equipment helped in the diagnosis of diseases such as cataracts, glaucoma and diabetic retinopathy, inter alia.
“It is easy to carry out the exams, take the photos, find them in the files and store them later. We can also send or print the images, which I think is very interesting, in addition to the easy access from anywhere with the internet connection ”, she analyzes. Ophthalmologist Fernando Korn Malerbi also used the Eyer on an expedition to three indigenous communities in the state of Mato Grossoearlier this year. The doctor evaluated 193 Indians. Diabetic retinopathy and cataracts figure among the main diseases found.
“The experience with the equipment was very good, mainly due to portability and ease of use”, he evaluates. He recalls that he has been involved in other projects with the Eyer handheld fundus camera for the diagnosis of diabetic retinopathy. “I believe that the Eyer is very relevant for this type of action, representing an important alternative for tracking populations that live in remote areas”, he concludes.
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Can you imagine regenerating the damaged optic nerve with gene therapy and being able to recover patients with glaucoma?
A research from the University of Cambridge (United Kingdom) has achieved promising results in this regard. Through gene therapy, scientists have rehabilitated damaged eye nerve fibers. The study was published recently in Nature Communications Journal.
Learn about details on the research: methodology, results and how important it may be, in the future, to treat glaucoma.
However, results are still initial and require further tests to determine an effective therapy for humans.
Research
Researchers from the University of Cambridge (UK) used a gene therapy technique to stimulate, in vitro, the increase and activity of the protruding protein in the eye and optic nerve.
First, the scientists cultivated the cells in laboratory. Then, laser-injured the nerve cells (axons). Finally, they introduced the gene and followed the changes with a microscope.
The study was carried out in mice.
Results
The scientists noticed that the more the protruding protein in these cells increased in number, the greater was the retinal neuron regeneration. More than improving the protein growth, it decreased the chance of nerve cell death.
The investigation showed an almost complete “protection” of the nerve cells growing in a cell culture of one of the guinea pigs.
This protein can help healing or, at least, reducing optic nerve damage. Thus, it may assist protection against glaucoma in the future.
It is worth mentioning that further tests are needed to determine an effective treatment for humans.
Conclusion
In fact, the gene therapy study results are promising. Especially because it seemed impossible to find a way to regenerate injured optic nerve in the past.
This research gives hope, however it still requires many tests on mice, primates and humans. Only then will an effective treatment be defined to reach the population within a few years. Nevertheless, the study is still a major breakthrough against glaucoma and other diseases that affect neurons such as Alzheimer.
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In fact, artificial intelligence in the diagnostic medicine has been showing positive and promising results. More than that, the development of more and more innovative software has been revolutionizing the sector by delivering more speed, precision, quality, accessibility and cost reduction to patients, professionals and institutions involved.
Undoubtedly, the use of computerized systems and computational symbols in the prediction and imitation of human behavior directly impacts the patient health and the cost reduction in treatments, among other numerous benefits.
Learn about 4 technologies that apply artificial intelligence in the diagnostic medicine: Eyer handheld fundus camera, remote reporting software, breast cancer genetic test and mammography software.
1. Eyer handheld fundus camera
The Eyer handheld fundus camera was one of the main equipments used in the project “Unidos pelo Diabetes em Ação, in Itabuna (BA), Brazil.
Connected to a smartphone, Eyer handheld fundus camera carries out high-quality retinal exams, in only a few minutes, with no need to dilate the pupil. Integrated with an online platform, the data is automatically sent and can be analyzed by a specialist anywhere in the world. That is, it allows remote diagnosis.
Learn about the equipment functionalities:
High-quality retinal exams by smartphone;
Accurate and fast diagnostics;
Lower cost compared to traditional fundus cameras;
Portability, which allows exams in several locations;
Democratization of Retina exams, mainly in places with low infrastructure of quality services in the area, such as doctors, health professionals, equipment, medicines, etc;
Faster service through computerized systems integrated to an online platform accessible through computers, smartphones and tablets;
Exams are easier to carry out in clinics and health centers;
Diagnosis made by specialists and leading professionals from anywhere in the world;
Reduction of service time and operational costs;
Decrease in the displacement of patients to hospitals and large urban centers;
Improvement in the quality of the issued reports;
No use of eye drops for pupil dilation;
Increased prevention and early diagnosis of diseases such as diabetic retinopathy, glaucoma, cataract, macular degeneration, retinoblastoma, retinal detachment, retinopathy of prematurity and blindness, inter alia.
In Brazil, the startup Phelcom Technologies offers the Phelcom Eyer handheld fundus camera . In addition, it also offers the online platform Eyer Cloud , which allows storing and managing patient exams. It ensures data backup on a secure server and the physician has all data organized in a friendly, functional and intuitive interface.
Remote reporting software
Some remote reporting software enable remote diagnosis and work with machine learning, an AI application. In Portuguese, the term means “machine learning”.
How does it work? Basically, it collects data, learns from it and improves automatically – without necessarily being programmed.
In the diagnostic medicine, the tool evaluates an extensive database of patients’ symptoms to find patterns for each illness. The software can check which disease the individual has, according to the evidence it presents.
There are some systems available in Brazil. Portal Telemedicina, for example, analytically compares face-to-face exams to similar cases in a database with 30 million images and exams.
The platform develops medical recommendations with reliable and accurate criteria when using Deep Learning. This method is based on complex algorithms that copies our brain neural net, giving the system an ability to detect medical findings at the superhuman level.
If the medical exam and the algorithm recommendation do not match, it sends the exam to three other specialists for a more detailed evaluation. The program even incorporates learning into each report issued, accumulating clinical repertoire in its database.
Another innovative aspect is its capacity to perform automatic exam screening allowing emergency cases to take priority in the doctor’s queue.
Software for mammography reports
Imagine accurately identifying the location of the breast with a suspicious change and, on top of that, easing the biopsy. Some artificial intelligence software are able to detect breast cancer more accurately.
One of them can predict unusual patterns of the mammography image and point out the region that demands further inquiry. American startup Dasa, in partnership with CureMetrix, created the algorithm.
Another software developed by Google may be the “second medical opinion” on the mammography. This is because the algorithm showed 11.5% more hits in relation to human analysis.
However, when evaluated by two doctors, humans show the same result as the machine. And, as it is common for two experts to analyze the image, Google tool can be the “second expert”.
Genetic testing – EndoPredict
Artificial intelligence in diagnostic medicine is also managing to predict the development of breast cancer and possible metastasis for the years to come.
The EndoPredict genetic test, for example, evaluates 12 tumor tissue genes related to the probability of recurrence. The result is a score that indicates whether the chance of the cancer to spread elsewhere in the body is high or low over the next ten years. Thus, it avoided chemotherapy in 70% of patients with negative nodules in clinical studies.
However, the test is indicated only for recent diagnoses of the disease and at an early stage. Moreover, positive for estrogen receptors and negative for HER2/neu protein.
The test is offered exclusively by GeneOne, Dasa genomics laboratory.
With more than 90,000 exam evaluations in the database, the AI has learned the subtle patterns in the breast tissue that are malignant tumor precursors.
The team model was significantly better at predicting risk than existing approaches. It accurately positioned 31% of all cancer patients in its highest risk category, compared to only 18% of traditional models.
Conclusion
Artificial intelligence in diagnostic medicine will surely revolutionize the area and help doctors and health services to increase productivity and attend more people.
Undoubtedly, it is also essential to democratize access to healthcare. Mainly in places with low infrastructure of quality services in the area, such as doctors, health professionals, equipment, medicines etc;
In fact, intelligent algorithms will not replace doctors who specialize in this type of diagnosis. However, it can serve as support, offering safer and more accurate reports.
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Indeed, managing medical clinics can be a challenge for doctors. Office management involves various simultaneous responsibilities, such as organizing data, financial control, personnel administration, marketing and patient experience, inter alia.
As many specialists do not have technical knowledge in business administration, they may face difficulties in the area.
Therefore, it is critical to develop strategies that assure daily practicality and productivity in the already busy routine of those healthcare professionals. More than that, tools which help increase services and improve results.
Read below about the five best practices in administration of medical clinics.
Medical softwares for data organization and quick access
Nowadays, medical softwares help automating all the office internal processes. Storage of electronic records and data from doctors, as well as financial and administrative staff, are among their main functionalities.
This way, managing medical clinics becomes faster and more efficient. Thereafter, it also relieves professionals who work in various duties and office, besides studying.
For example, some programs even send reminders and ask to confirm the patient appointment. Undoubtedly, it is a great benefit, for it is frequent for the patient to miss an appointment.
Progresses on technology have changed service relations. Presently, the customer is a protagonist: he/she has more decision power in hands and demands optimal experience during the whole service process. Moreover, they influence consumption choices of friends, relatives and followers on the internet.
The patient also fits into this scenario. He/she goes through a journey before arriving at your office. There are, basically, five steps: symptoms identification, decision for setting an appointment, search for the best physician, healthcare service and its further evaluation.
It is, therefore, fundamental to understand and map the patient’s journey, in order to improve in-clinic experience. Consequently, it increases chances of acquiring more patients and building their loyalty.
In fact, they report easy-to-solve issues. Check out some actions that increase user satisfaction:
Possibility of setting appointments online;
Comfortable office;
Avoiding delays;
Setting a quality standard for services;
Reducing time of waiting between the patient’s journey steps;
Humanized service;
Investment in technologies for a more agile service and more assertive diagnostics.
Sound financial management
Undoubtedly, good financial management is one of the main requisites to avoid losses and decrease clinic costs. For that, it is necessary to develop an assertive planning of expenses and investments.
In this sense, it is important to recognize and measure resources involved in all areas of the clinic. Therefore, you will have available values at hand to decide what direction to take and how to apply each one of them efficiently.
Some tips to help you on this goal follow below:
Have a proper control of your cash flow;
Do not mix up personal and clinic accounts;
Automate internal processes;
Have a sound financial planning;
Follow expenses and incomes;
Use a good medical clinic management system.
People management
Recruiting and retaining talents is also a great challenge in medical clinic management. This area also needs close attention, since it is directly linked to the user experience, for example.
Therefore, some actions may help improving the staff work. Check them out:
Encourage participation in strategic matters
Give voice to employees. Create an environment where he/she not only feels safe to opine, but also motivated to debate key subjects.
Offer incentive programs
This, in fact, is one of the measures that help engagement and recruitment of good professionals. It may consist in money rewards or life experiences, as trips, for example, according to employee performance and results delivered.
Define a career plan
Career stagnation is one of the main de-motivations among professionals. Therefore, offer a clear and attractive career plan so that your staff knows about their chances of development.
Invest in training
Since the healthcare sector constantly evolves, it is essential that your employees receive training from your office. In addition, that tool improves motivation and service quality, once more with positive effects on patient experience.
Digital presence
The ascension of internet and social media makes it essential for trademarks and companies to be present and accessible for customers. That includes your office.
Most of the patients search the internet for information about services. Therefore, it is worth betting on a website for your clinic, as well as profiles in social media as Facebook and Instagram. After all, nowadays these are important communication tools to build user loyalty.
Undoubtedly, advertisement can be a powerful ally to increase your clinic visibility and create a confidence link with your patient.
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