ESALD - Artigos em revistas com arbitragem científica
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Browsing ESALD - Artigos em revistas com arbitragem científica by Field of Science and Technology (FOS) "Ciências Médicas"
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- Discrepancies between screening sonography and ultrasound in emergency department: A case reportPublication . Miravent, Sérgio; Figueiredo, Teresa; Donchenko, Inna; Cruz, Gualter; Almeida, Rui Pedro de; Lobo, ManuelIntroduction: 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.
- Effectiveness of ultrasound screening in right upper quadrant pain: A comparative study in a basic emergency servicePublication . Miravent, Sérgio; Figueiredo, Teresa; Jiménez, Carmen; Almeida, Rui Pedro de; Lobo, ManuelBackground 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.
- Point of care prehospital ultrasound in basic emergency services in PortugalPublication . Miravent, Sérgio; Lobo, Manuel; Almeida, Rui Pedro deBackground 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.
- Pre-hospital ultrasonography screening for biliary disease in remote settingsPublication . Miravent, Sérgio; Jimenez, Cármen; Lobo, Manuel; Figueiredo, Teresa; Almeida, Rui Pedro deScreening 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
- Renal screening sonography. A comparative study in a Portuguese basic emergency servicePublication . Miravent, Sérgio; Jiménez, Carmen; Barbancho, Narciso; Lobo, Manuel; Figueiredo, Teresa; Gomes, Carla; Ratusneac, Ion; Gonçalves, João Mário; Hasnas, Corina; Almeida, Rui Pedro deIntroduction: This study intends to compare the accuracy and pertinence of sonographic findings obtained by a sonographer in a Basic Emergency Service (BES) with the imaging findings at the Referral Hospital (RH). Methods: Thirty-one patients suspected of having renal pathology underwent initial renal sonography screening with sonographer reporting at the BES and were subsequently referred to the RH for additional imaging examinations. The results of both examinations were compared to verify whether the findings from the BES were confirmed by the radiologist in the RH and to ensure that the patient referrals from BES to RH were appropriate. Results: In our sample, most patients (80%) exhibited varying degrees of pyelocaliceal distension, with nearly half (48%) presenting obstructions. A strong association between the sonographic findings in the BES and the RH was found in the variables “Dilatation of pyelocaliceal system” (V=0.895; p=0.000), “Simple cystic formation” (V=0.878; p=0.000), respectively. There was a statistically significant correlation between BES and RH findings, indicating a strong association between these two variables respectively (k=0.890; p=0.000) and (k=0.870; p=0.000). In this research, an achieved sensitivity of 96% and a specificity of 85% were demonstrated in the identification of pyelocaliceal dilatation. Conclusion: Renal sonographer reporting screening successfully detected abnormalities in the urinary system of patients suspected of having renal colic. The sonographic data obtained at the BES demonstrated a strong correlation with the additional imaging findings from the RH in Portugal. These results suggest that Radiographers/Sonographers can have an important role in the preliminary assessment of urgent renal pathology in remote areas, contributing to a correct referral and early treatment.