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- 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.
- 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.