1016-53 An Inexpensive, Easy to Use and Highly Portable Quantitative Angiographic System

Ouantitative angiography is considered the ″gold standard″ for the assessment of coronary arterial dimensions. The presence in the actual systems of one or more disadvantages such as high cost, difficulty in usage and poor portability, have prevented the wide utilization of this method. To implement a similar system, the acquisition of the computer, software, digitizing board and cineprojector with CCD camera is usually required. We developed a system running on every Macintosh computer with only one special requirement, that of a commercially available slide scanner. A public domain software, NIH Image (written by Wayne Rasband) was modified and expanded to perform the following tasks: acquisition and storage of the digitized angiographic frames, automatic edge detection and measurements, and saving of the results in a text format file, readable from every database, spreadsheet or statistical package. Films (courtesy of Dr. Patrick W. Serruys, Rotterdam) of coronary phantoms with known size (0.5, 0.7, 1.0, 1.4, 1.9 mm) implanted in pigs, were used for system validation. The angiographic frames (24 × 18 mm) were digitized with a spatial resolution of 1850 pixels/inch (slide scanners with higher resolution are also available) and 256 gray levels. Using isocenter calibration, the measurements resulted in a correlation coefficient of 0.96 (y=0.86×+0.12), accuracy of –0.03 mm and precision of 0.15 mm. A correlation coefficient of 0.92 (y=0.67x+0.33), an accuracy of –0.03 mm and a precision of 0.23 mm were found using catheter calibration. With the same phantoms, the mean reproducibility was 0.08 mm for the interpolated reference diameter (RD), 0.03 mm for the minimal luminal diameter (MLD), 1.4% for the diameter stenosis (DS) and 0.6 mm for the lesion length. The variability of coronary measurements was also assessed in 23 patients who had 2 angiograms, a median of 21 days apart. The mean (±SD) of the difference between the 2 measurements was 0.09±0.28 mm for RD, 0.06±0.30 mm for MLD, 1.5±9.1% for DS, and 0.32±1.7 mm for lesion length. Less than 1 hour of training was needed for learning how to use this system efficiently

Telemedicine in primary health care, challenge or solution to the problem of medical visits, for family medicine clinics in rural areas!

Introduction: The pilot project in Ambulance of Family Medicine in Village of Kraishtë and Main Centre of Family Medicine in Lipjan: Telemedicine in primary healthcare for the quality of care in times at the time when there are no doctors at Ambulance of Family Medicine(AMF), patient communication through virtual platforms gained momentum in primary health care (PHC) during the COVID-19 pandemic. Thus, there is a need to know the satisfaction and quality of virtual visits through the technologies used and the impacts on people\u27s health. This study will reflect the experience so far in the use of telemedicine in the PHC in the Municipality of Lipjan as a demonstration centre supported by the Accessible Quality Health Care (AQH) project in Kosovo. Methods: This is a scoping review protocol developed according to data recorded in the used platform Hello Care, a patient and staff survey. Questionnaire reviews and meta-analysis of results for scoping reviews. The data are stored in the platform\u27s databases. Quantitative data are analysed using descriptive statistics, while thematic analysis will be done for qualitative data. Preliminary findings will be presented to stakeholders to identify missing studies and develop effective dissemination strategies. Results: Successfully calls:90, Missed calls: 185, Dropped calls: 8, Aborted calls: 4, phone interview with patient random calls: Very satisfied 34%, Satisfied 56%, Unsatisfied 8%, Very dissatisfied 0.5%, Neutral 1.5%. 4 Doctors who answered the call from the digital clinic participated in the interview. The results from the doctors\u27 interview: Is telemedicine a good way to provide remote services? Yes 75% and No 25%. Are there obstacles or difficulties in the internet network? Yes 100%, Difficulty in making a diagnosis decision? Yes 25% No 75%. Do you have difficulty in making a decision about prescribing therapy since the visit is virtual? No 75% Yes 25%. Telephone interviews with the patients after receiving the telemedicine treatment yielded the following results: Very satisfied 79%, Satisfied 12%, Not satisfied 7%, Not satisfied at all 2% Discussion: From these interviews, although still at the beginning of this project, we can conclude that digital clinics are the future of solving the problem of medical visits in places far from the main centre of family medicine, where there are clinics and nurses of family medicine, it can be an excellent choice for light occasions. However, more difficult cases should be seen by a doctor. Conclusion: Although it is only the beginning of this project, based on the initial results from these surveys, we can conclude that the medical staff and patients are satisfied with this method of communication when there is no possibility and staff for physical medical visits and the coverage is greater of patients in rural areas and faster where the doctor is not present every working day, such as the AMFs where they work according to U/A for POHC only twice a week. Ethics and dissemination: Results will be disseminated through publication in open access UBT scientific conferences, scientific events, and academic and community journals. Ethical approval has been obtained due to stakeholder consultation but will not involve direct patient participation