Augmented reality in health allows a real-time combination of images never before achieved, with new possibilities to diagnose diseases, which can increase accuracy in surgical procedures. That is, it can potentially improve patient quality of life.
In real time, the technology shows the material world overlayed with computer-made images, enabling greatly improved composite observations.
For this, smartphone cameras, tablets, smart glasses and even state-of-the-art helmets are used, so that the hands are unnecessary to command interfaces in systems and applications.
For instance, there is a strong trend to use Augmented Reality (AR) in this industry, according to the Journal of Med Internet Research (JMIR). Even with a still low use by doctors and institutions, there is an increasing number of applications of AR in medicine.
Learn about the advantages of using augmented reality in health and some cases of success.
Augmented reality X Virtual Reality
First, it’s important to understand the difference between augmented reality and Virtual Reality (VR).
AR, in its turn, integrates the physical and the virtual by overlaying computerized images in the real world, through software and devices. For example, the Google Glass app can be accessed from the user’s own mobile phone or tablet. There is also the famous game Pokémon Go, in which players searched for virtual Pokémon in real-world environments using the mobile phone camera.
Augmented reality in healthcare: advantages
Undoubtedly, there are numerous advantages of using AR in health. One of them is to ease access to the patient’s medical history in emergencies or on the surgery table, for example. Image overlaying may also more accurately ensure to locate an area of interest in surgical procedures, thus decreasing risk to the patient. In this case, it is possible to integrate imaging examinations and better see every detail of the organs in the preoperative care and, thus, have more success in surgery.
In fact, technology is a great ally of telemedicine. For example, specialists can instruct other doctors remotely in more complex operations. Another aspect is diagnostic medicine, because the patient can better understand the diagnosis and the recommended treatment.
AR has also been used in the digital screening of patients who have suffered accidents. In these cases, orthopedists help in the performance of arthroscopic surgeries on shoulders and in training interns and residents to carry out ultrasound examination at the care site.
Neurosurgery is one of the most advanced specialties in the use of AR, with reports of tumor resection, open neuro-vascular surgeries, spinal procedures, location of catheters or probes, cortical resection in epilepsy and aneurysms involving unusual trajectories or hidden ramifications.
In hospitals and clinics, the technology assists remote support by enabling on-site technicians and teams to receive specialized help needed for installation, setup, maintenance, troubleshooting, and repair of sensitive and specialized hospital equipment.
Teaching in medicine
Augmented Reality in healthcare allows seeing details of the human body and training procedures in a repetitive and precise way.
Student, imagine practicing surgery in a virtual environment? Stanford University has a simulator which allows the most complete training for the future surgeon.
For researchers, a three-dimensional virtual surgical environment can allow for enhanced preoperative planning and testing. It thus improves patient results, decreases complication rates and improves technical skills.
The Stanford Virtual Surgical Environment (VSE) is developed for rhinologic procedures. The technology allows the surgeon to interact with patient-specific three-dimensional reconstructions of nasal sinus CT data sets using a modified haptic interface device, triggering a virtual endoscope.
In Brazil, there are also options for simulators. For example, Eyesi is aimed at training intraocular cataract surgery and vitreo-retinal procedures. It presents performance score and evaluates tremor, movement accuracy and repetitiveness, among other analyzes. Thus, it is a good tool for resident practice to introduce new techniques in ophthalmic surgery.
There are also the da Vinci surgical systems for robotic surgery, already in the fourth generation. The technology carries out minimally invasive surgeries in different procedures. One of its tools is a console – inspired by flight simulators – in which doctors visualize the high-definition 3D images and make the operative movements with their own hands, which are transmitted to the robot.
Another application is training and retraining for students, residents and specialists in care or in the surgical center. Thus, it is possible to carry out an ethnographic analysis of the performance of the professional, who is alone during the procedure, through the capture of images by a camera installed on the site.
Augmented Reality solutions in healthcare
On the market, there are already quite interesting solutions of AR.
For example, the application EyeDecide allows you to see the eyeball from any angle just by directly touching the image generated on the tablet and rotating it with your finger. It is also possible to reduce, expand, move or make notes on the eye in almost any direction. All this assists to simulate various disorders and helps to diagnose more accurately.
The app Anatomy 4D makes it possible to explore more than two thousand anatomical structures. Undoubtedly, it helps students and medical colleges.
Even with all the advantages, augmented reality in health is still relatively new and is not heavily employed in the area. However, as it proves its value for the quality of patient care, soon AR technologies will be stronger in the medical industry.
Reviewed by Paulo Schor, ophthalmologist, associate professor and director of innovation of the Federal University of São Paulo (Unifesp) and collaborator of the Faculty of Medicine of the Albert Einstein Hospital.
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In early 2019, a colleague introduced the Phelcom Eyer smartdevice to ophthalmologist and retina specialist Gustavo Melo. Coupled to a smartphone, the device carries out high-quality fundus exams, in few minutes and without need of pupil dilation. It connects to an online platform, the Eyer Cloud, which allows remote diagnosis and assures safety to data stored in the cloud.
“I invested in this technology because I believed it would be a device that could revolutionize screening and diagnosis of diabetic retinopathy in the population not usually monitored with due regularity in eye offices,” he says.
Currently, Melo has performed more than two thousand exams with his two devices. One of them is used in an endocrinological clinic for screening patients with diabetes. “Those who have any changes are referred for detailed ophthalmic evaluation. Those with normal rates are reviewed annually, ” he explains.
Gustavo Melo, Ophthalmologist
The second Eyer is used to screen diabetic retinopathy in public health units in Aracaju (SE) and cities in the countryside, in voluntary actions through partnership with public managers. “The purpose is to be a continuous way to carry out early detection and awareness campaigns about the disease,” he says.
More than that, Melo reveals that he, in partnership with the ophthalmologist Fernando Malerbi, is developing a project to screen and treat diabetic retinopathy in the population of 13 inhabitants from Sergipe hinterland. The action will be a partnership of the American NGO Retina Global and Phelcom Technologies, startup responsible for Eyer.
“I think Eyer is a revolutionary milestone in primary care because it could change the way health managers prevent blindness due to diabetic retinopathy,” he says. For the ophthalmologist, using the equipment also in the Brazilian Unified Health System should reduce the evaluation cost per patient.
Phelcom Eyer
Image made by ophthalmologist Gustavo Melo with Eyer.
About the advantages of the technology, Melo reports that the easy handling, the high-quality images and the excellent cost-effectiveness. Regarding the EyerCloud online platform, the doctor points out the very user-friendly interface and extremely fast processing. “Perhaps this tool is one of Eyer’s best features,” he says.
Phelcom Eyer is integrated with Eyer Cloud and enables storing and managing patient exams. All data the equipment captures are automatically synchronized to the system, allowing a totally safe upload to the cloud.
Among the main functionalities are the possibility of sharing patient information with more than one clinic and visualize them in the same platform; locate patients by name or exam date; and create report templates from pre-made models available in the system.
In case of no internet access during the exam, images remain stored in the device and are sent to the cloud as soon as a connection is available.
The tool may be accessed in the device itself or via cellphone, tablet or computer.
Image made by ophthalmologist Gustavo Melo with Eyer.
About Phelcom’s slit lamp support, which allows attaching Eyer, the ophthalmologist says it greatly eases examinations performance by keeping the device static. And, with the new coronavirus pandemics, it also avoids contact of the operator’s hand with the patient’s skin.
“Eyer is a real game changer in the way diabetic retinopathy is detected and treated, as well as other retinal diseases,” Melo concludes.
Phelcom Technologies
Eyer is the first equipment of Phelcom Technologies, startup that unites technology and health, headquartered in São Carlos (SP). It manufactures wearable handheld devices with internet connection, aiming to democratize access to healthcare, offering better services, with a compact equipment, to more people.
Image made by ophthalmologist Gustavo Melo with Eyer.
Everyone already knows that cigarettes are bad for health. This includes the eyes. For example, smoke is a risk factor for various diseases such as dry eye syndrome, glaucoma, cataract, and age-related macular degeneration (AMD).
Learn more about the work that correlated cigarette and eyes, its results and next steps.
Cigarettes and eyes – the research
Scientists at Gifu Pharmaceutical University, in Japan, created cultures of cells from the epithelium of the human cornea and exposed part of them to an extract of cigarette smoke and PTA aerosol, which contained most of the ingredients inhaled by smokers.
After 24 hours, the number of dead cells in cultures exposed to smoke and aerosols was higher than compared to those that did not interact with the substances. Upon contact with cigarette components, the ferritin inside eye cells decomposes, releasing the stored iron.
Results
Exposure to the components of cigarette smoke accumulates iron, which kills cornea epithelium cells. The same reaction was observed with the aerosol produced by heated tobacco products (PTA). Although different from electronic cigarettes, these also require an electronic device for use and do not always come with nicotine.
Generally, cigarette smoke does not cause permanent problems. However, continuous exposure can cause corneal injury such as leukoma and even lead to blindness.
Despite the important results of the study on cigarettes and eyes, more research is still needed, especially in humans, to confirm the findings.
Information from Einstein Agency.
Reviewed by Paulo Schor, ophthalmologist, associate professor and director of innovation of the Federal University of São Paulo (Unifesp) and collaborator of the Faculty of Medicine of the Albert Einstein Hospital.
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Unfortunately, doctor and stress may walk side by side. The routine of these professionals is often quite troubled, with long days in different workplaces, several patients, relationship with suffering and death and difficult decision-making. The pandemics worsened this scenario, even more so for those who have been on the front line.
For example, a survey conducted by the Federal Council of Medicine (CFM), with 1.6 thousand doctors, from September to December 2020, revealed that the pandemics impacted the life of 96%, either increasing the level of stress (22.9%), generating a feeling of fear and panic (14.6%), reducing the time dedicated to family, meals and leisure (14.5%) or decreasing the time and quality of sleep (7.6%).
Therefore, it is essential to invest in building a balanced life. For this, we picked 8 tips on how to better manage stress in everyday life. Check it out!
1. Sleep tight
This tip is essential and also the most difficult to follow by doctors. Long working hours and even stress itself make it difficult to keep a good sleep routine. However, it is essential to prioritize good sleep, which is as fundamental for the body as healthy eating and the practice of physical exercises, for example.
Sleep deprivation deeply impacts health and generates stress due to the growth of cortisol and ACTH (adrenocorticotropic hormone) levels. It affects the cognitive system, increases irritability and anxiety, modifies the body’s immune response, collaborates for the emergence of diseases such as high blood pressure and diabetes and changes appetite. It also favors obesity, since it reduces the hormone that causes satiety (leptin) and stimulates the hormone that increases hunger (ghrelin).
Therefore, seek to sleep 7-8 hours a day. To do this, set schedules to create a routine and avoid electronic devices and stimulating food (sweets, coffee, soft drinks), coffee and alcoholic beverages two hours in advance.
2. Take balanced meals
Often, when we are stressed, we feel the need to consume food high in fat and/or sugar, in addition to alcohol. Instead of relaxing, we may face even more problems, such as agitation, overweight and obesity.
So invest in a healthy diet with more intake of greens, fruits, vegetables, white meat and water. For example, dark green vegetables, which are rich in vitamins, folic acid and fiber, and lean proteins, such as fish and poultry, contribute to reduce oxidation, which may be related to increased inflammation.
3. Do physical activities
So far, we have not spoken any news that you do not know already. But that doesn’t mean you can put it into practice, does it? Including physical exercises in everyday life can be challenging, but it is essential to keep the “doctor and stress” relationship more balanced.
Can you set 30 minutes a day? No? Then do it in 15 minutes. Regularity will increase endorphin production. If the activity is under sunlight, you will also have serotonin, which helps in mood and focus.
4. Organize your day
Not having an organized schedule causes even more stress, because you cannot identify daily priorities, nor which urgent tasks demand your attention. .
Being clear on which subjects are most important helps you keep control. So, before you start the day, set your tasks and remark your priorities.
5. Have moments of leisure
Feeling that life has become only work, family and personal obligations may demotivate you, cause sadness and even depression. That is why leisure moments are essential.
For example, if you like to hang out with family and friends, arrange dinners and visits. Also take some time for hobbies: reading, playing sports, watching films, marathoning series, playing with pets, etc.
It’s hard to imagine how to fit this into the routine, but try. Undoubtedly, stress will decrease by relaxing and focusing your attention on other things.
Meditation is proven to help reduce stress. By paying attention only to the present moment, mind and body connect, relaxing and slowing your thoughts.
The technique involves conscious breathing and the emptying of the mind. This does not mean that you will not think about anything during meditation, but that you should not cling to thoughts. Just watch them and let them pass.
There are guided meditations with various goals, such as relieving stress, increasing concentration, relaxing, etc. Currently, it is possible to watch some videos on YouTube or download applications for this purpose.
7. Mindfulness
Have you ever heard of mindfulness? The practice simply consists in being attentive of body and mind in the present moment. That is, neither remembering the past nor thinking about the future. Only in the present.
Are you having lunch? Pay attention exclusively to the food, chewing, flavors and textures. Talking to a friend? Practice active listening: focus entirely on what is being said, instead of just listening passively while you’re already working out the answer.
Going to play a sport? Notice the movements of the body and the sensations that the activity produces. Will you read or watch your favorite series? Just focus on that moment – say goodbye to scrolling the mobile screen on social networks while watching TV. Try your best to avoid your thoughts being in that conversation from last year or in the bill you need to pay tomorrow.
The technique has existed for 2,500 years and generates benefits such as reduced stress, increased focus and concentration at work, reduced emotional reactivity and improved cognitive flexibility, among others.
8. Seek professional help
In extreme cases of stress, seek professional help. The condition can worsen to anxiety, depression and burnout syndrome if you do not have the proper follow-up.
Take care of yourself too.
Reviewed by Paulo Schor, ophthalmologist, associate professor and director of innovation of the Federal University of São Paulo (Unifesp) and collaborator of the Faculty of Medicine of the Albert Einstein Hospital.
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Retinal neurons were first identified more than 100 years ago. But now scientists at the University of Utah in the United States have discovered a new type of retinal cell.
Published in the Proceedings of National Academy of Sciences, United States, the research found a hitherto unknown type of interneuron in the retina of mammals.
Learn more about the study, how it was conducted, and the next steps.
The research
In the central nervous system, a complex circuit of neurons communicates with each other to transmit sensory and motor information. “Interneurons” act as intermediaries in the communication chain.
Researchers at John A. Moran Eye Center of the University of Utah (USA) have identified a new type of interneuron in the mammalian retina. The new cell does not fit into the current five classes of retinal neurons: photoreceptors, horizontal cells, bipolar cells, amacrine cells and endogenous cells. This is due to differences presented in their morphology, physiology and genetic properties.
Thus, the scientists responsible for the discovery propose that this new type of cell should belong to a new class of retinal neurons.
The team dubbed the discovery a “bell cell” because of the hand-bell-like shape. The discovery unites two cell types, cones and rods, and does extra processing in the cells. Thus, they relay visual signals of both types of photoreceptor rods and photoreceptor cones in the retina, but their precise purpose is subject of ongoing research.
Experiments have shown that bell cells remain activated for an unusually long time – up to 30 seconds – in response to a 10-millisecond flashlight stimulus.
“In the brain, persistent firing cells are believed to be involved in memory and learning. Once campana cells have a similar behavior, we theorize that they could play a role in requesting a temporal ‘memory’ of a recent stimulation,” said research leader Ning Tian.
Undoubtedly, it is a great discovery that contributes directly to the search for a better understanding of the central nervous system, since it detects all classes of neurons and their connections.
Source: Medical Xpress
Reviewed by Paulo Schor, ophthalmologist, associate professor and director of innovation of the Federal University of São Paulo (Unifesp) and collaborator of the Faculty of Medicine of the Albert Einstein Hospital.
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Google is the most used search engine on the internet. There are 5.5 billion searches a day worldwide. In fact, the platform brings answers to countless and unimaginable types of questions.
In addition, it also takes the internet user wherever he/she wants. With Google My Business, companies can provide full address, opening hours, contacts and photos, among other information.
With a single click, your potential patients can find your clinic, know the services you offer and schedule an appointment. All this at no cost to you.
So how about attracting more customers using Google My Business for doctors? Learn more about the tool, how to register and the advantages for your business.
Google My Business for doctors – what is it?
Google My Business for doctors is a free and easy-to-use tool that enables offices, clinics, hospitals, laboratories and other healthcare institutions to manage their online presence on Google, including Search and Maps.
To do this, you can create a profile of your business with all the essential data. That way, when people search directly by your name or the office or by keywords related to your specialty, Google will show your professional profile.
Regarding keywords, the results presented by Google can be from the nearest locations or even from every city and in municipalities in the region.
Undoubtedly, having one-click access to all the information of your clinic is quite useful to patients. Will you make an appointment? Just “Google” and find the phone and service times. Is it the consultation date? Click on the address to open Maps right away.
In addition, it is possible to lure more customers. For example, when the internet user searches for “ophthalmologist in Vila Madalena”, Google will immediately show your clinic profile.
Another advantage is to increase interaction with your audience. The patient can call the registered number directly, send a message, leave comments or evaluate your office. And you can answer him/her, solving doubts or thanking the reviews.
By the way, evaluations help increasing your clinic reliability and increasingly rise your position on the search engine page. That is, the higher the chances of appearing in the first results on a keyword search. So, the better the “grades”, the more positive comments and interactions with the audience, the more your authority in the area grows.
This is because a good review and five stars, for example, helps to demonstrate your service excellence to potential customers. This influences their decision to schedule an appointment.
Reports are another benefit of Google My Business to doctors. The platform provides metrics such as number of followers and interactions on your profile through phone calls, visits to the registered site or route requests.
This way, you can know how customers research your business and where they come from, essential data for a more efficient digital marketing strategy.
Registering your office or medical clinic on Google My Business is easy. Read the step-by-step guide:
Create an email in Gmail;
Access Google website. At the top right, go to “Google Apps” and click ” My Business”;
To make sure there is no record of your business already, enter your name or that of the clinic. Then click ” Include your company on Google”;
Put the name and choose the business category;
Then allow the address to be included in Google Maps and direct searches;
Fill in the address fields;
Inform if you operate outside your workplace and the area you serve;
Include contact forms such as phone, website and email;
Upload images of your clinic. According to Google, Profiles with photos and videos receive 42% more route requests on Google Maps and 35% more clicks to access the site;
Confirm all data.
Finally, Google will send a code, by letter, to the address provided to confirm the veracity of the information registered. When you receive the letter, enter the code in the virtual area of Google My Business.
Ready! Your profile is up and visible to thousands of people who use Google.
Reviewed by Paulo Schor, ophthalmologist, associate professor and director of innovation of the Federal University of São Paulo (Unifesp) and collaborator of the Faculty of Medicine of the Albert Einstein Hospital.
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