Resumen Introducción: la Telemedicina ofrece una herramienta poderosa, rentable y escalable que permite reducir las diferencias en el tratamiento del infarto agudo de miocardio entre países desarrollados y en vía de desarrollo. Métodos: se incorpora una estrategia en la que centros de salud en áreas remotas se conectaron estratégicamente a clínicas con salas de cateterismo 24/7. Expertos en Bogotá proporcionaron diagnóstico electrocardiográfico y tele-consulta para LATIN, activando el envío de ambulancias y la implementación de protocolos LATIN. Resultados: un total de 113 centros en Colombia se conectaron en red cubriendo un gran segmento de la población. De los 110.823 pacientes examinados, 1.014 (1%) fueron diagnosticados con infarto agudo de miocardio - ST. Un total de 472 (46%) pacientes se reperfundieron, la mayoría mediante intervención coronaria percutánea, 324 (68,6%). Las principales razones para el no tratamiento incluyeron rechazo de seguro médico, falta de unidades de cuidados intensivos y dolor torácico > 12 horas. El tiempo de diagnóstico fue de 5.5 con una precisión del 98%. Conclusiones: LATIN demuestra la posibilidad de crear una estrategia para tratar el infarto agudo de miocardio con base en la población y guiada por Telemedicina, la cual expande el acceso al tratamiento de emergencia en países en vía de desarrollo, en los cuales ésta adquiere importantes implicaciones en salud pública como una aproximación global al cuidado urgente de esta afección.

Abstract Introduction: Telemedicine offers a powerful and cost-effective tool that uses scales in order to reduce the differences in the treatment of acute myocardial infarction between the developed and developing countries. Methods: A strategy was used, in which health centres in remote areas were strategically connected to clinics with 24/7 catheter laboratories. Experts in Bogota provided the electrocardiographic diagnosis and tele-consultation using the Latin America Telemedicine Infarct Network (LATIN), activating the sending of ambulances, and the implementation of the LATIN protocols. Results: A total of 113 centres in Colombia were connected to a network covering a large segment of the population. Of the 110,823 patients examined, 1014 (1%) were diagnosed with an acute ST-myocardial infarction. A total of 472 (46%) of these patients were reperfused, with the majority (324, 68.6%) by means of percutaneous coronary intervention. The main reasons for non-treatment included refusal of medical insurance, lack of intensive care units, and chest pain > 12 hours. The time to diagnosis was 5.5 minutes with an accuracy of 98%. Conclusions: LATIN demonstrates the possibility of creating a strategy for treating acute myocardial infarction in a population base and guided by Telemedicine. This widens the access to emergency treatment in developing countries, where this acquires significant implications in public health, such as an overall approach to the urgent treatment of this condition.

RESUMO Objetivo: Avaliar os parâmetros biométricos oculares por meio da biometria óptica e observar uma possível diferença refratométrica esférica, assim como sua variação, baseada no cálculo pré-cirúrgico estimado e na refração esférica pós-cirurgia de catarata pela facoemulsificação com implante de lente intraocular (LIO). Métodos: Foram revisados 252 prontuários eletrônicos entre 2013 e 2014 dos quais foram selecionados 117 pacientes adultos (189 olhos) submetidos à facoemulsificação com implante de LIO dobrável pelo mesmo cirurgião e examinados através do IOLMaster® 500. O poder dióptrico da LIO foi calculado pela fórmula de Haigis. O teste de Wilcoxon foi empregado para testar a existência de diferença significativa (p<0,05) entre o grau esférico esperado (GEE) e o grau esférico final (GEF). Resultados: Foram operados 98 olhos direitos (OD) e 91 esquerdos (OE). Após calculada a variação entre o GEE e o GEF observou-se que 55% dos OD alcançaram resultados dentro de ± 0,5 dioptrias (D) e 89% resultados dentro de ± 1D. Quanto ao OE, 46% alcançaram resultados dentro de ± 0,5D e 78% dentro de ± 1D. Conclusão: A biometria óptica pode ser utilizada como um método confiável, previsível e reprodutível para que seja estimado o GEF de ambos olhos

ABSTRACT Objective: To assess ocular biometric parameters by optical biometry and to observe a possible spherical refractive difference, as well as its variation based on estimated preoperative calculation and the spherical refraction post cataract surgery by phacoemulsification with intraocular lens implant (IOL). Methods: After reviewing 252 electronic medical records between 2013 and 2014, 117 adult patients (189 eyes) were selected.The patients underwent phacoemulsification with foldable IOL implantation by the same surgeon and were examined by IOLMaster® 500.The IOL power was calculated using the Haigis formula.The Wilcoxon test was applied to identify the existence of significant differences (p<0.05) between the spherical expected refraction (SER) and the final spherical refraction (FSR) of the eyes. Results: There were operated 98 right eyes (OD) and 91 left (OS). A calculation of the variation between FSR and SER indicated that 55% of the OD reached results within ± 0.5 diopters (D) and 89% within ± 1D. With respect to OS, 46% achieved results within ± 0.5D and 78% within ± 1D. Conclusion: Optical biometry is a reliable, predictable and reproducible method to estimate the FSR of both eyes.