Browsing by Author "Lobo, Manuel Duarte"
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- Advancing Precision in Physical Education and Sports SciencePublication . Lobo, Manuel Duarte; Tavares, Sérgio Miravent; Garcia, Manuel B.; Almeida, RuiThis 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.
- Early detection of metastatic disease through screening ultrasoundPublication . Vaz, Bruna; Miravent, Sérgio; Gomes, Carla; Gago, Rui; Lobo, Manuel Duarte; Almeida, RuiScreening ultrasound is crucial in emergency care, providing precise guidance for patients in various situations. Its versatility, real-time imaging, and lack of radiation make it invaluable, especially in settings lacking diagnostic resources and specialized expertise. The widespread use of screening ultrasound among health professionals, regardless of their level of sonographic expertise, emphasizes the need for them to manage clinical uncertainties as part of their daily practice." This article emphasizes the crucial role of screening ultrasound, especially in acute abdomen cases. Its integration alongside conventional radiology significantly improves clinical orientation, facilitating prompt treatment decisions and specialist referrals. In a specific case, we reviewed screening ultrasound images, basic abdominal X-rays, and Computed Tomography scans alongside clinical reports to assess initial evaluations made at a peripheral emergency service. Our patient presented with acute abdominal symptoms, revealing suspected liver metastases, free fluid, and signs of intestinal obstruction on ultrasound. These findings were confirmed through Computed Tomography at a referral hospital, showing ultrasound's role in prompt patient triage and transfer. Operator skill is crucial, but comprehensive training minimizes errors. Screening sonography may revolutionize patient safety saving time by detecting pathologies early, preventing overcrowding in emergency departments of reference hospitals. The ultrasonographic detection of images suspected to be metastases is a common occurrence in hospital settings where various advanced diagnostic means, and medical specialties are present. However, the detection of suspicious images of metastases in a pre-hospital context is innovative and provides clinicians with a much better understanding of the patient's clinical landscape.
- Pre-hospital detection of intrahepatic biliary duct dilatation: Recognizing the abundance of vessels in the liverPublication . Miravent, Sérgio; Lobo, Manuel Duarte; Almeida, RuiDiagnosing and confirming intrahepatic biliary duct dilation (IHBDD) involves a coordinated effort across multiple medical spe cialties, 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 identifi cation of imaging findings that help differentiate simple biliary colic from clinical cases that should be prompt referral to the reference hos pital and without unnecessary delays or resource expenditure. The eti ology 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 imaging.
- Pre-hospital Identification of a Giant Bladder Calculus through Screening Sonography: A Case ReportPublication . Miravent, Sérgio; Gomes, Carla Marisa; Simãozinho, Paula; Vaz, Bruna; Lobo, Manuel Duarte; Almeida, RuiIntroduction: Screening ultrasound proves to be remarkably beneficial in pre-hospital settings, particularly in geographically remote areas with technological constraints and no medical specialties. Urological pathology has a high frequency of occurrence in the emergency department and is part of the wide range of occurrences that can benefit from this ultrasound screening as a clinical guide for patients. Case Presentation: In this case, a patient experiencing lower abdominal pain and symptoms of renal colic sought assistance at a basic emergency service facility. Utilizing a renal screening ultrasound executed by a sonographer, the clinical team identified images indicative of a significant bladder calculus. Subsequently, the patient was referred to a referral hospital for a comprehensive evaluation by medical specialties. Conclusion: The images obtained in both health units exhibited congruence, indicating that the screening ultrasound, while not intended to replace the specialized orthodox ultrasound executed by a radiologist, served as a crucial tool for diagnostic presumption, providing consistency in clinical decision-making for referring patients. This capability allowed emergency physicians to promptly transfer a patient requiring urgent further investigation to a referral hospital with compelling and substantiated data. This shift in the approach to patient triage in a remote setting could enhance patient safety.
- 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.