Browsing by Author "Figueiredo, Teresa"
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- Assessment of Iodine Deficiency in Sao Tome e Principe ChildrenPublication . Serafim, Angela; Martins-Ferreira, Ana; Serafim, P.; Pedro, Paulo; Rodrigues, Celia; Coutinho, Miguel; Figueiredo, TeresaIntroduction: Iodine deficiency still constitutes one of the major public health problems in the world, having a serious social and economic impact. This global problem involves about 130 countries, including Sao Tome and Principe (STP). The aim of the present study was to determine the prevalence and distribution of iodine deficiency in male children within different host institutions of STP. Material and Methods: A descriptive, cross-sectional observational study was conducted with a non-probabilistic sample (for convenience) of 116 children. Children were aged from 6 to 17 years, with an overall mean age of 11.1 +/- 3.2 years. Iodine intake was evaluated in 6 districts of STP, through two indirect indices: (i) urine iodine (UI) determinations (ii) prevalence of goiter evaluated by cervical ultrasound. Results: The global median UI value was 109 mu g/L (P20: 78.2 mu g/Land P80: 140.3 mu g/L), with 16.4% of children <50 mu g/L and 40.5% <100 mu g/L. Considering children aged 6 - 12 years, 15.6% showed U1 <50 mu g / L, while in group aged 13-17 years this percentage increased to 17.9%. These values fulfill WHO criteria of sufficient region in iodine. On the other hand, the goiter prevalence against age was 29.7% and against Body Surface Area (BSA) was 44.6%, which is much higher than the cut-off established by the WHO (5%). Conclusion: The iodine deficiency and endemic goiter in STP are currently a public health problem. Therefore, it will be necessary to ensure that the interventions carried out are efficiently monitored, in order to eradicate endemic goiter, without risks of hyperthyroidism.
- Discrepancies between Screening Sonography and Ultrasound in Emergency Department - A case reportPublication . Miravent, Sérgio; Figueiredo, Teresa; Donchenko, Inna; Duarte Lobo, Manuel; Cruz, Gualter; Almeida, RuiIntroduction: 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; Lobo, Manuel; Figueiredo, Teresa; Jiménez, Carmen; Almeida, RuiBackground 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.
- Incidence and case-fatality from spontaneous intracerebral hemorrhage in a southern region of PortugalPublication . Nzwalo, Hipólito; Nogueira, Jerina; Félix, Catarina; Guilherme, Patrícia; Baptista, Alexandre; Figueiredo, Teresa; Ferreira, Fatima; Marreiros, Ana; Thomassen, Lars; Logallo, NicolaBackground: There is scarce information on incidence and case fatality of spontaneous intracerebral hemorrhage (SICH) in certain regions of the world, including in Europe. There is no community-based data on SICH in Southern Portugal. Aim: To determine the incidence and early case-fatality from SICH in Algarve, the southernmost region of Portugal. Methods: The recommended criteria for stroke incidence studies was used to identify cases of incident first-ever SICH from January 1st to December 31st 2015 in a subregion with 280,081 inhabitants. Crude incidence rates per age group and gender; standardized rates to the European population; and age adjusted case fatality rates were calculated. Results: Eighty-two first-ever cases of SICH (64.6% men) occurred. The mean age was 72.3 years (SD +/- 12.1); women were 3 years older than men on average and had more frequently lobar SICH. The crude annual incidence rate was 29.2/100,000 (95% CI 23.4- 38.6; p < 0.001); higher in men (39.7/100,000) than women (19.8/100,000). The standardized to the European population incidence was 15.1/100,000 (95% CI 3.6-18.9; p < 0.05); 26.9 and 10.9/100,000 for men and women respectively. The 30-day case-fatality was 40 % (95% CI 29-51) and increased steeply with age Conclusion: The incidence of SICH in Southern Portugal was high, but within the figures found in some parts of Europe. However, a marked predominance of males was found and the case-fatality rate was amongst the highest reported in western countries. (C) 2017 Elsevier B.V. All rights reserved.
- Pre-hospital ultrasonography screening for biliary disease in remote settingsPublication . Miravent, Sérgio; Jimenez, Cármen; Lobo, Manuel; Figueiredo, Teresa; Almeida, RuiScreening 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 gallbladder 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 complications. 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.
- Pre-hospital ultrasonography screening for biliary disease in remote settingsPublication . Miravent, Sérgio; Cármen Jimenez; Manuel Lobo; Figueiredo, Teresa; Almeida, RuiScreening 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 gallbladder 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 complications. 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 . Jiménez, Carmen; Barbancho, Narciso; Lobo, Manuel Duarte; João Mário Gonçalves; Corina Hasnas; Miravent, Sérgio; Figueiredo, Teresa; Almeida, Rui; Gomes, Carla Marisa; Ratusneac, IonRenal Point-of-Care Ultrasound (POCUS) is a screening modality that aids in clinical decision-making for patients with suspected renal colic. 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 sonography screening with POCUS 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, the majority of patients (80%) exhibited varying degrees of pyelocaliceal distension, with nearly half (48%) patients 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 = 0.00), ‘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). There was also a strong statistically significant correlation in the ultrasonographic findings between BES and RH performers (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 POCUS screening successfully detected abnormalities in the urinary system of patients suspected of having renal colic. The sonographic findings at the BES had a good correlation with the complementary imaging results obtained at 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.