Journal of Clinical Medicine最新文献

{"title":"Internalised Stigma, Self-Esteem and Perceived Social Support as Psychosocial Predictors of Quality of Life in Adult Patients with Schizophrenia.","authors":"Corina Gagiu, Vlad Dionisie, Mihnea Costin Manea, Doina Carmen Mazilu, Mirela Manea","doi":"10.3390/jcm13226959","DOIUrl":"https://doi.org/10.3390/jcm13226959","url":null,"abstract":"<p><p><b>Background:</b> Schizophrenia is a chronic and severe mental illness that ultimately leads to reduced quality of life (QoL). Over the years, QoL has emerged as an important outcome in the treatment of schizophrenia patients, but the role of psychosocial variables in determining QoL is still ambiguous. Therefore, in the present research, demographic, clinical and psychosocial variables were examined for their influence on QoL. <b>Methods:</b> We conducted a prospective and cross-sectional study on a sample of 139 patients with schizophrenia (72.7% females, age 48.17 ± 10.22) attending an outpatient service. QoL was measured using Schizophrenia Quality of Life Revision-4 (SQLR4) and internalised stigma, self-esteem, perceived social support, resilience and coping mechanisms were assessed using a battery of standardized self-report scales. <b>Results:</b> Female patients and those less adherent to treatment had reduced cognition and vitality QoL. The worst QoL in all domains was observed in patients with a younger age at illness onset and with six or more hospitalizations. Regression analysis indicated that reduced self-esteem, perceived social support, a larger number of hospitalization and increased internalised stigma predicted poorer overall QoL and accounted for 44.9% in the variance in SQLSR4 global score (adjusted R² = 0.449, <i>p</i> = 0.046). <b>Conclusions:</b> Routine assessment of internalised stigma, self-esteem and perceived social support, in addition to demographic and clinical variables and addressing possible deficits in these areas through personalized intervention, could improve QoL in schizophrenia patients.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"13 22","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Greater Tuberosity Healing Rate and Clinical Results Following RSA Are Similar for Two Fracture-Specific Implant Systems.","authors":"Dani Rotman, Omer Avraham, Yariv Goldstein, Efi Kazum, Jorge Rojas Lievano, Ofir Chechik, Eran Maman","doi":"10.3390/jcm13226967","DOIUrl":"https://doi.org/10.3390/jcm13226967","url":null,"abstract":"<p><p><b>Background:</b> Various fracture-specific reverse shoulder arthroplasty (RSA) systems exist on the market. We set out to examine whether the type of prosthesis used and the means of fixation (cemented or non-cemented) influenced the rate of tuberosity healing or the functional outcome of the operation. <b>Methods:</b> This retrospective cohort multicenter study included 146 patients who underwent RSA for an acute three- or four-part proximal humerus fracture and had a minimum follow-up of one year. Six fellowship-trained surgeons at two different centers performed all operations. The implants were either Tornier Aequalis or Depuy Delta Xtend, both fracture-specific Grammont-style systems. <b>Results:</b> The mean age ± standard deviation (SD) was 76 ± 7 years, and 83% of patients were female. The mean ± SD follow-up time was 30 ± 31 months. The Aequalis prosthesis was used in 82 patients (56%), and the Delta Xtend in 64 patients (44%). A total of 105 RSAs (72%) were cemented. Tuberosity healing rate was similar for the two implant systems (71% Aequalis vs. 82% Delta Xtend, <i>p</i> = 0.15) and for the cemented or non-cemented, respectively (73% cemented vs. 83% non-cemented, <i>p</i> = 0.22). There was no significant difference in the motion and functional outcomes between the two implant systems in this study. <b>Conclusions:</b> RSA for complex PHF in the elderly has similar short-term results, regardless of the type of fracture-specific implant or the fixation technique (cemented vs. cementless).</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"13 22","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Myocardial Protection in Minimally Invasive Cardiac Surgeries: A Network Comparison of Del Nido, Histidine-Tryptophan-Ketoglutarate, and Blood Cardioplegia.","authors":"Sadeq Al-Hasan-Al-Saegh, Sho Takemoto, Stefano Benenati, Saeed Shafiei, Senol Yavuz, Mattia Galli, Florian Helms, Lukman Amanov, Nunzio Davide De Manna, Saeed Torabi, Jan Karsten, Jan Dieter Schmitto, Fabio Ius, Tim Kaufeld, Jawad Salman, Aron-Frederik Popov, Bastian Schmack, Arjang Ruhparwar, Alina Zubarevich, Alexander Weymann","doi":"10.3390/jcm13226977","DOIUrl":"https://doi.org/10.3390/jcm13226977","url":null,"abstract":"<p><p><b>Background/Objectives</b>: The optimal choice of cardioplegia solution in minimally invasive cardiac surgeries (MICS) remains debated, as prolonged myocardial protection is essential to avoid interruptions to the surgical flow, which can prolong aortic cross-clamp time and cardiopulmonary bypass time, especially in the constrained surgical field. We conducted a network meta-analysis to evaluate the safety and efficacy of the del Nido (DN), histidine-tryptophan-ketoglutarate (HTK), blood cardioplegia (BC), and St. Thomas' (STH) solutions in MICS. <b>Methods</b>: Medical electronic databases were thoroughly searched without time restrictions, including all types of studies except for study protocols and animal research. The final search was completed in June 2024. Subsequently, a network meta-regression was performed on both primary and secondary endpoints, utilizing R (The R Foundation for Statistical Computing, version 3.6.2) for the analysis. Meta-analyses were carried out using Review Manager software. <b>Results</b>: A total of 15 studies, enrolling 2282 patients, were included in the analysis. None of the comparisons showed statistically significant differences in in-hospital mortality between the four cardioplegia solutions (BC vs. HTK, OR: 3.21, 95% CI: 0.13-80.84; DN vs. HTK, OR: 1.42, 95% CI: 0.28-7.23; STH vs. HTK, OR: 1.25, 95% CI: 0.19-8.20). <b>Conclusions</b>: In this network meta-analysis of cardioplegia solutions in MICS, no significant differences were observed in major clinical outcomes across the solutions. Cardioplegia solutions that provide long-lasting myocardial protection with a single dose, such as DN and HTK, were found to be safely applied in MICS. DN was associated with shorter CPB times and HTK was associated with shorter hospital stays, though these differences may not have clinical implications.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"13 22","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiological Approach to Assessment of Lower-Limb Alignment-Coronal and Transverse Plane Analysis.","authors":"Anna Michalska-Foryszewska, Piotr Modzelewski, Katarzyna Sklinda, Bartosz Mruk, Jerzy Walecki","doi":"10.3390/jcm13226975","DOIUrl":"https://doi.org/10.3390/jcm13226975","url":null,"abstract":"<p><p>Lower-limb alignment deformities constitute a significant clinical concern, as they can lead to serious complications, including progressive degenerative diseases and disabilities. Rotational deformities may give rise to conditions such as joint arthrosis, patellar instability, and the degeneration of the patellofemoral cartilage. Therefore, a comprehensive evaluation of lower-limb alignment is essential for the effective patient management, preoperative planning, and successful correction of these deformities. The primary assessment method employs full-length standing radiographs in the anteroposterior (AP) projection, which facilitates accurate measurements of the anatomical and mechanical axes of the lower limb, including angles and deviations. The outcomes of this analysis are vital for the meticulous planning of osteotomy and total knee arthroplasty (TKA). In addition, computed tomography (CT) provides a specialized approach for the precise evaluation of femoral and tibial rotation. In this area, there are potential opportunities for the implementation of AI-based automated measurement systems.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"13 22","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Multiparametric and Biparametric Magnetic Resonance Imaging in Bladder Cancer Staging: Prospective Observational Study and Analysis of Radiologist Learning Curve.","authors":"F Piramide, M Sica, G Fondello, G Mesterca, L Ferrando, N Ziani, M Ortenzi, G Grosso, B Desana, P Frattoni, S De Cillis, A Piana, D Amparore, E Checcucci, C Fiori, S Cirillo, F Porpiglia, M Manfredi","doi":"10.3390/jcm13226955","DOIUrl":"https://doi.org/10.3390/jcm13226955","url":null,"abstract":"<p><p><b>Background</b>: Nowadays, thanks to the introduction of the VI-RADS scoring system, mpMRI has shown promising results in pre-TURBT assessment of muscular invasiveness of BCa, even if its application in everyday practice is still limited. This might be due to a lack in the literature about the learning curve of radiologists and about the characteristics of the exam. With the aim to reduce scan time and patient discomfort while maintaining diagnostic accuracy, bpMRI has been introduced as a possible alternative to mpMRI in this group of patients. This study reports a single-center experience using mpMRI and the VI-RADS scoring system to differentiate NMIBC from MIBC. The primary aim of the study is to assess diagnostic accuracy of mpMRI using the VI-RADS scoring system. The secondary aim is to evaluate the learning curve of an experienced mpMRI radiologist. Additionally, we perform a retrospective assessment of the same group of patients evaluating only DWIs and T2-weighted images, as they underwent bpMRI, to compare the performance of mpMRI and bpMRI. <b>Materials and Methods:</b> From 11/2021 to 11/2023, patients with suspected newly diagnosed BCa were enrolled in this prospective study. All patients underwent mpMRI prior to TURBT in a highly specialized radiology center for MRI. According to VI-RADS, a cutoff of ≥3 was assumed to define MIBC. Histological TURBT reports were compared with preoperative VI-RADS scores to assess the accuracy of mpMRI in discriminating between NMIBC and MIBC. Furthermore, to assess the learning curve of the reading radiologist we analyzed the rate of patients correctly classified as MIBC at MRI. Finally, we evaluated the performance of a hypothetic biparametric MRI in classifying our cohort according to VI-RADS score and compared it with mpMRI performance by using DeLong's test. Data analysis was performed using Jamovi software v.2.3 and R software v.4.2.1. <b>Results:</b> A total of 133 patients were enrolled. mpMRI showed sensitivity and specificity of 86% (95% confidence interval [CI]: 64-97) and 95% (95% CI: 89-98), respectively. The learning curve analysis of the reading radiologist showed that the rate of patients correctly classified as MIBC rapidly increases reaching its plateau after 40 cases. The hypothetic bpMRI showed a sensitivity of 76% (95% CI: 53-92) and a specificity of 93% (95% CI: 86-97), with no significant difference with mpMRI performance (<i>p</i> = 0.10). <b>Conclusions:</b> Our study confirms the effectiveness of MRI, particularly with the VI-RADS scoring system, in differentiating NMIBC from MIBC. The learning curve analysis underscores the importance of radiologist training in optimizing diagnostic accuracy. Future research should focus on enhancing the sensitivity of bpMRI and further validating these findings in larger and multicentric studies.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"13 22","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Denervation of the Patella During Knee Arthroplasty: An Updated Systematic Global Review.","authors":"Kennedy Nkachukwu, Amanda Alejo, Jeffrey Toman, Jalal Jwayyed, Justin Iwuagwu, Andrew Alejo","doi":"10.3390/jcm13226942","DOIUrl":"https://doi.org/10.3390/jcm13226942","url":null,"abstract":"<p><p><b>Background:</b> Total knee arthroplasty is a widely endorsed surgical intervention, extensively recognized within the orthopedic field for its efficacy in significantly reducing pain and enhancing overall mobility in patients suffering from advanced stages of osteoarthritis. Despite a general consensus on the core procedural steps, the rapid advancements in implant technology and the nuanced techniques in knee reconstruction have inevitably introduced subtle variations in surgical approaches. These variations often emerge due to individual surgeon preferences, their unique expertise, and comfort levels with specific techniques. Anterior knee pain, however, remains a frequent postoperative complication, likely attributed to the extensive and complex innervation of the patella. To address this challenge, some surgeons have adopted patellar denervation, hypothesizing that by reducing nerve signaling from the patellar region, patients may experience a measurable decrease in pain. <b>Methods:</b> A systematic search was performed to include eight recent level I studies to analyze this issue. <b>Results:</b> Of the eight reviews, there were four strong studies that concluded patellar denervation helps decrease anterior knee pain in the acute period, but this may not last long term. The other four papers did not show a difference in anterior knee pain after denervation. <b>Conclusions:</b> This review synthesizes and critically analyzes the current body of literature, aiming to provide clinicians with evidence-based insights into the potential benefits and limitations of incorporating patellar denervation into their surgical especially during the acute post-operative period.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"13 22","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Celiac Disease and Inflammatory Cardiomyopathies: Exploring the Heart-Gut Axis.","authors":"Lucia Ilaria Birtolo, Gianluca Di Pietro, Riccardo Improta, Paolo Severino, Endrit Shahini, Carmine Dario Vizza","doi":"10.3390/jcm13226936","DOIUrl":"https://doi.org/10.3390/jcm13226936","url":null,"abstract":"<p><p><b>Background</b>: Celiac disease (CD) is associated with an increased risk of cardiovascular (CV) events, especially inflammatory heart diseases. We aimed to gather evidence on the association between CD and inflammatory CV diseases, including pericarditis and myocarditis, and the underlying pathophysiological mechanisms. <b>Methods</b>: The PubMed, Scopus, and Google Scholar databases were searched for studies assessing the prevalence and the long-term outcomes of patients with CD and inflammatory CV diseases. <b>Result</b>: Ten studies (nine case series/reports and one prospective observational study) covering a total of 22 patients, including 9 women (41%) and 13 men (59%), were evaluated. The median age was 23 (IQR, 12-41) years. A total of 6 patients had recurrent pericarditis, while 16 patients had celiac-related myocarditis (11 patients presented with heart failure and 5 with arrhythmia). A strict gluten-free diet (GFD) alone was effective in 87.5% of cases (4/6 for pericarditis and 10/16 for myocarditis). All patients with pericarditis achieved complete resolution of symptoms. Conversely, heart function was restored in 81% of patients with myocarditis. Only one patient died. <b>Conclusions</b>: Myocarditis and/or pericarditis, especially if recurrent, may complicate CD in pediatric and adult subjects due to an autoimmune reaction involving the pericardium/myocardium and the small intestine.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"13 22","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Five Pillars of Acute Right Ventricular Heart Failure Therapy: Can We Keep the Pediment in Balance?","authors":"Antoniu Octavian Petriş, Călin Pop, Diana Carmen Cimpoeşu","doi":"10.3390/jcm13226949","DOIUrl":"https://doi.org/10.3390/jcm13226949","url":null,"abstract":"<p><p>Acute right ventricular heart failure (aRHF), a long-neglected aspect of heart disease, has recently gained attention due to an improved understanding of its pathophysiology and the development of tailored therapeutic strategies. The therapeutic approach is now built on several pillars that aim to support the stable clinical condition of the patient, starting with the central pillar of etiological or specific therapy and extending to various aspects related to hemodynamic support, ventilation support, fluid optimization, and, when necessary, advanced resources such as right ventricular assist devices (e.g., extracorporeal membrane oxygenation-ECMO, Impella RP, or ProtekDuo). This five-pillar approach summarizes the different facets of contemporary treatment for aRHF, although some aspects related to their use are still being clarified.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"13 22","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Local Excision (ELE) with Knife-Assisted Resection (KAR) Techniques Followed by Adjuvant Radiotherapy and/or Chemotherapy for Invasive (T1bsm2,3/T2) Early Rectal Cancer: A Multicenter Retrospective Cohort.","authors":"George Tribonias, Apostolis Papaefthymiou, Petros Zormpas, Stefan Seewald, Maria Zachou, Federico Barbaro, Michel Kahaleh, Gianluca Andrisani, Shaimaa Elkholy, Mohamed El-Sherbiny, Yoriaki Komeda, Raghavendra Yarlagadda, Georgios Tziatzios, Kareem Essam, Hany Haggag, Gregorios Paspatis, Georgios Mavrogenis","doi":"10.3390/jcm13226951","DOIUrl":"https://doi.org/10.3390/jcm13226951","url":null,"abstract":"<p><p><b>Background:</b> Resected rectal polyps with deep invasion into the submucosa (pT1b-sm2,3) or the muscle layer (pT2) are currently confronted with surgery due to non-curative resection. <b>Aims:</b> We evaluated the efficacy, safety, and locoregional control of adjuvant radiotherapy (RT) and/or chemotherapy (CT) following endoscopic KAR (knife-assisted resection) in patients with invasive early rectal cancers who are unwilling or unsuitable for additional surgical resection. <b>Methods:</b> Fifty-one patients with early rectal cancers, pT1b or pT2, underwent post-resection adjuvant RT and/or CT in 15 centers worldwide. \"En bloc\" macroscopic resection, R0 resection, recurrence rate, and adverse events following resection and adjuvant therapy were recorded in a multicenter retrospective cohort study. <b>Results:</b> Diagnostic staging (38/51, 75%) was the main reason for ELE. Macroscopic \"en bloc\" resection was demonstrated in 50/51 (98%), with an average follow-up of 20.6 months. Endoscopic recurrence occurred in 7/51 (13.7%) of patients, with mean time for diagnosis of recurrence at 8.9 months. Adjuvant therapy consisted of RT in 49.0% (25/51), CT in 11.8% (6/51), and combined CRT in 39.2% (20/51) of the cases. Perforation, severe post-procedural bleeding, and incontinence were the most frequent complications. The absence of superficial ulceration was associated with macroscopic complete resection, while the lesions with lower budding stage, clear lateral margins, lesion size < 40 mm, and needle-type knife used were associated with less endoscopic recurrencies. <b>Conclusions:</b> Our data investigated adjuvant RT and/or CT after endoscopic KAR of infiltrative rectal cancers (pT1bsm2,3-pT2) as being safe and effective for locoregional control and providing a non-surgical treatment option for patients with a non-curative resection.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"13 22","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two Handheld Retinograph Devices Evaluated by Ophthalmologists and an Artificial Intelligence Algorithm.","authors":"Pedro Romero-Aroca, Benilde Fontoba-Poveda, Eugeni Garcia-Curto, Aida Valls, Julián Cristiano, Monica Llagostera-Serra, Cristian Morente-Lorenzo, Isabel Mendez-Marín, Marc Baget-Bernaldiz","doi":"10.3390/jcm13226935","DOIUrl":"https://doi.org/10.3390/jcm13226935","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Telemedicine in diabetic retinopathy (RD) screening is effective but does not reach the entire diabetes population. The use of portable cameras and artificial intelligence (AI) can help in screening diabetes. <b>Methods:</b> We evaluated the ability of two handheld cameras, one based on a smartphone and the other on a smartscope, to obtain images for comparison with OCT. Evaluation was carried out in two stages: the first by two retina specialists and the second using an artificial intelligence algorithm that we developed. <b>Results:</b> The retina specialists reported that the smartphone images required mydriasis in all cases, compared to 73.05% of the smartscope images and 71.11% of the OCT images. Images were ungradable in 27.98% of the retinographs with the smartphone and in 7.98% with the smartscope. The detection of any DR using the AI algorithm showed that the smartphone obtained lower recall values (0.89) and F1 scores (0.89) than the smartscope, with 0.99. Low results were also obtained using the smartphone to detect mild DR (146 retinographs), compared to using the smartscope (218 retinographs). <b>Conclusions:</b> we consider that the use of handheld devices together with AI algorithms for reading retinographs can be useful for DR screening, although the ease of image acquisition through small pupils with these devices needs to be improved.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"13 22","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}