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Browsing by Author "Miravent, Sérgio"

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  • Advancing precision in physical education and sports science: A review of medical imaging methods for assessing body composition
    Publication . Lobo, Manuel; Miravent, Sérgio; Almeida, Rui Pedro de; Garcia, Manuel
    This chapter provides an overview of the current state of medical imaging methods in body composition analysis. It advocates a holistic approach that combines the strengths of different approaches and addresses their limitations. We discuss the importance of using standardized protocols to improve the accuracy of body composition studies across populations and settings. By examining the capabilities and limitations of imaging modalities such as DEXA, MRI, CT, and ultrasound, we emphasize the need for a multidimensional approach to obtain body composition emphasis on complete understanding.
    2024Book part Restricted access Show more
  • Challenges in ultrasonography education and training: Building bridges for the professional practice of radiographer in Portugal
    Publication . Lobo, Manuel; Miravent, Sérgio
    Ultrasound for radiographers has faced several challenges in Portugal and is still seen as a very “grey” area for students, teachers, and professionals. In this chapter, the authors intend to make a brief overview of the history of ultrasound as well as its path in Portugal. There will be made a contextualization of the educational and professional framework, addressing the radiographers' possibilities and future challenges. It will be also highlighted the actual Radiographers role in ultrasound and will be made some suggestions of improvement to the future of this technique and the possible bridges between teaching and professional practice.
    2022Book part Restricted access Show more
  • Deteção precoce de doença metastática através de ecografia de triagem
    Publication . Vaz, Bruna; Miravent, Sérgio; Gomes, Carla; Gago, Rui; Lobo, Manuel; Almeida, Rui Pedro de
    A ecografia de triagem é crucial nos serviços de emergência, fornecendo orientação precisa para pacientes em diversas situações clínicas. A ecografia é móvel, produz imagens em tempo real e é isenta de radiação. É uma ferramenta apta para ambientes de meios tecnológicos limitados e ausência de médicos especialistas. O uso da ecografia de triagem entre profissionais de saúde, independentemente do seu nível de especialização em ultrassonografia, nasce da necessidade de responder a dúvidas clínicas concretas na prática quotidiana. Este artigo enfatiza o papel crucial da ecografia de triagem num caso de abdómen agudo. A sua integração com a radiologia convencional melhora significativamente a orientação clínica, facilitando decisões de tratamento e encaminhamentos à especialidade quando necessário. Neste caso específico, foram analisadas imagens de ecografia de triagem, radiografia abdominal e exame tomografia computorizada juntamente com relatórios clínicos para avaliar a orientação clínica dada num serviço de emergência básico periférico. O paciente em causa apresentava sintomas abdominais agudos, revelando suspeita de metástases hepáticas, líquido livre intraperitoneal e sinais de obstrução intestinal no exame de triagem ecográfica. Estes achados foram confirmados por tomografia computorizada no hospital de referência. A ecografia de triagem pode revolucionar a segurança do paciente, economizando tempo ao detetar precocemente patologias, prevenindo sobrelotação nos departamentos de emergência de hospitais centrais de referência. A deteção ultrassonográfica de imagens suspeitas de metástases é comum em ambientes hospitalares onde diversos meios diagnósticos avançados e especialidades médicas estão presentes. A utilização do ultrassom como ferramenta de triagem e orientação clínica de primeira linha em ambientes pré-hospitalares está em consonância com as estratégias médicas contemporâneas, que visam aprimorar a deteção e a intervenção precoces.
    2024Research article Open access Show more
  • Discrepancies between screening sonography and ultrasound in emergency department: A case report
    Publication . Miravent, Sérgio; Figueiredo, Teresa; Donchenko, Inna; Cruz, Gualter; Almeida, Rui Pedro de; Lobo, Manuel
    Introduction: This case report presents a discrepancy in sonographic findings between a screening sonography performed by a Sonographer in the Basic Emergency Service (BES) and a subsequent ultrasound performed by a Radiologist physician in a Referral Hospital (RH). The aim of this report is to discuss the possible reasons for the discrepancy and its implications for patient care. Case Presentation: A patient with a history of epigastric pain and vomiting underwent screening sonography in a BES, which suggested Intrahepatic Biliary Dilatation Duct (IHBD) and main pancreatic duct dilatation. The patient was subsequently referred to the RH for further evaluation. However, the Radiologist in the RH did not confirm any of the initial suspicions from BES through a normal ultrasound procedure. The discrepancy raises questions regarding the quality of the screening ultrasound, misinterpretation of the BES images, or the potential for ambiguity in the point of care ultrasound (POCUS) exam. Conclusion: The differences in sonographic findings between BES and RH, in this case, suggest that the improvement of the patient's clinical condition and therapeutic interventions may have contributed to the discrepancy. Further investigation and standardization of POCUS training and interpretation may improve diagnostic accuracy and patient outcomes.
    2023Journal article Open access Show more
  • Ecografia de triagem em contexto pré-hospitalar - Relato de caso
    Publication . Miravent, Sérgio; Jimenez, Cármen Jimenez; Lobo, Manuel; Almeida, Rui Pedro de
    Introdução: O presente caso clínico tem como objetivo evidenciar o papel crucial que a ecografia de triagem pode ter na orientação de doentes em contexto pré-hospitalar, onde não existem especialidades médicas, os recursos tecnológicos são escassos e a distância geográfica entre instituições de saúde e hospital central é considerável. Apresentação do caso clínico: Uma paciente com história de dor abdominal recorre ao Serviço de Urgência Básico, onde, entre outros exames disponíveis, foi submetida a uma ecografia de triagem, que revelou líquido livre nos recessos peritoneais. Posteriormente, a paciente foi encaminhada para o hospital de referência para uma maior investigação pelas respetivas especialidades. Conclusão: A doente realizou os exames apropriados e disponíveis no SUB, e a ecografia de triagem foi crucial na identificação de sinais clínicos que permitiram à médica de serviço fazer reencaminhamento da doente para o hospital de referência, com base na evidência imagiológica disponível.
    2024Journal article Open access Show more
  • Effectiveness of ultrasound screening in right upper quadrant pain: A comparative study in a basic emergency service
    Publication . Miravent, Sérgio; Figueiredo, Teresa; Jiménez, Carmen; Almeida, Rui Pedro de; Lobo, Manuel
    Background and Aims: The use of ultrasound screening is primarily facilitated by point‐of‐care ultrasound (POCUS) and its integration into healthcare systems is a result of the versatility of this imaging technique. This study intends to compare the accuracy and pertinence of sonographic findings obtained by a sonographer in a Basic Emergency Service (BES) with that of radiologists at referral hospital (RH) in Portugal. Methods: Twenty patients with right upper quadrant (RUQ) pain and suspected cholecystitis or biliary pathology underwent sonography screening using POCUS in the BES. They were then forwarded to the RH where a radiologist performed a conventional ultrasound exam on the same patients. The results of both exams were compared to determine if the findings obtained in the BES were confirmed by the radiologist in the RH. Results: In our sample, 60% of cases were related to biliary pathology, 20% were liver‐related, 10% had hepatopancreatic biliary etiology, and 10% had unknown etiology. A strong association between the sonographic findings in the BES and the RH was found in the variables “Sonographic Murphy sign” (V = 0.859; p = 0.001), “Cholelithiasis/Gallbladder sludge” (V = 0.840; p = 0.001), and “Intrahepatic biliary tract dilatation” (V = 0.717; p = 0.006). Adequate measures of agreement between the findings of the radiographer and radiologist were obtained for the “Sonographic Murphy sign” (k = 0.664; p = 0.001) and the presence of “Cholelithiasis/Gallbladder sludge” (k = 0.712; p = 0.000). Conclusion: Major biliary abnormalities were detected in patients with RUQ pain in BES using sonography. The correlation between the sonographic findings obtained by the sonographers at BES and those obtained by radiologists at the RH in Portugal was strong, showing that POCUS screening could be extended to other similar settings; however, more studies are needed.
    2022Research article Open access Show more
  • Emerging trends in ultrasound education and healthcare clinical applications: A rapid review
    Publication . Lobo, Manuel; Miravent, Sérgio; Almeida, Rui Pedro de
    In this chapter, the authors explore the transformation of ultrasound training in the digital era of higher education. As the digital landscape redefines access to information and learning modalities, this chapter critically examines the integration of innovative digital tools in ultrasound education. The authors focus on leveraging technologies like extended realities and simulations, alongside the practicality of mobile applications, to enhance the learning experience. The chapter underscores the importance of evolving educational systems to actively engage students in these advanced learning frameworks. It aims to stimulate a comprehensive discussion on effectively incorporating these technologies at the undergraduate level, evaluating their impact on student learning outcomes, and preparing future healthcare professionals for a technology-driven medical landscape. This review offers a forward-looking perspective on integrating cutting-edge digital tools in ultrasound education, signifying a shift towards more interactive, immersive, and effective learning experiences.
    2024Book part Restricted access Show more
  • Point of care prehospital ultrasound in basic emergency services in Portugal
    Publication . Miravent, Sérgio; Lobo, Manuel; Almeida, Rui Pedro de
    Background and Aims: The Point of Care Ultrasound and Point‐of‐Care Ultrasound in Resource‐Limited Settings are differentiated diagnostic methods using ultrasound, essential in urgent patients screening, allowing better guidance in the diagnostic process and therapeutic approach. This study intends to observe the impact of these techniques in two Basic Emergency Services (SUB) in Portugal. Methods: A longitudinal study was carried out in two remote locations in Portugal (SUB N and SUB S). Data were collected by trained radiographers in each location, and a total of 972 exams were considered. Imaging findings were documented by exam type, the exam normality and the resolution after exam. χ 2 and Cramer's V tests were performed to check significant correlations between the variables. Results: Regarding the type of echographic findings, 289 (29.7%) were considered normal, 628 (64.6%) were classified as abnormal and 55 (5.7%) were considered inconclusive. As for the type of resolution, 58% had local resolution, 24% were referred to a hospital emergency service and 18% referred to ambulatory care. Regarding the Location versus Resolution after exam versus Findings variables, it was verified a stronger statistically significant association for the exams considered “Abnormal” (Cramer´s V = 0.414; p < 0.001). In the variables Location versus Findings versus Resolution after exam, it was verified a stronger statistical significance for “Referral to Ambulatory” (Cramer V = 0.443; p < 0.001) although Referral for Hospital (Cramer V = 0.252; p = 0.003) or Local Resolution (Cramer V = 0.252; p < 0.001) also had a moderate association strength. Conclusion: Ultrasonography is a useful diagnostic tool for patients screening, having an influence on patient management in remote settings. Given the limited literature in Portugal about this matter, further research and literature will be needed to support and complement the results of this study.
    2022Research article Open access Show more
  • Pre-hospital detection of intrahepatic biliary duct dilatation: recognizing the abundance of vessels in the liver
    Publication . Miravent, Sérgio; Lobo, Manuel; Almeida, Rui Pedro de
    Diagnosing and confirming intrahepatic biliary duct dilation (IHBDD) involves a coordinated effort across multiple medical specialties, often relying on comprehensive blood analysis. However, the utility of screening ultrasound in detecting intrahepatic biliary dilation becomes particularly valuable in pre-hospital settings like our Basic Emergency Service, especially when access to alternative imaging techniques or detailed blood analyses are unavailable. Detecting the intrahepatic biliary dilation pattern through ultrasound is notably straightforward for a skilled sonographer. The presence of IHBDD can be efficiently identified during a screening ultrasound, allowing identification of imaging findings that help differentiate simple biliary colic from clinical cases that should be prompt referral to the reference hospital and without unnecessary delays or resource expenditure. The etiology of IHBDD is multifactorial1, and while its presentations may vary, the characteristic ultrasound pattern often involves the visualization of “extra vessels within the liver,” related to the distinctive “shotgun” sign2. This sign translates into the observation of dilated bile ducts exhibiting no flow on Doppler imaging3. In cases of extrahepatic obstruction, dilation of the common bile duct (CBD) may be evident. However, with intrahepatic obstruction, a normal CBD caliber can occur. Thus, the sonographer needs to diligently observe the signs outlined and typical sonographic landmarks to identify early indications of bile duct dilation within the innermost or regions of the liver.
    2024Research article Open access Show more
  • Pre-hospital ultrasonography screening for biliary disease in remote settings
    Publication . Miravent, Sérgio; Jimenez, Cármen; Lobo, Manuel; Figueiredo, Teresa; Almeida, Rui Pedro de
    Screening ultrasound, including Point of Care Ultrasonography (POCUS), is widely utilized for rapid clinical guidance in diverse healthcare settings. In this case report, a 34-year-old male with recurrent biliary colic symptoms underwent a Basic Emergency Service ultrasound, revealing a 13 mm gall bladder calculus and signs of inflammation, and was promptly referred to the hospital for further evaluation and treatment. Medical specialist confirmation at the hospital underscored the significance of early detection through POCUS. Despite inconclusive laboratory results, the detailed ultrasound assessment provided a comprehensive understanding, emphasizing the tool’s value in averting com plications. Thus, screening ultrasound played a pivotal role in justifying the hospital referral, showcasing its vital role in healthcare, especially in resource-limited settings. The judicious use of POCUS can lead to superior outcomes, avoiding unnecessary referrals for non-emergent cases
    2024Research article Open access Show more