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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Foreign body &#40;FB&#41; aspiration in children is a common and potentially dangerous situation that can be associated to significant morbidity&#46;</p> <span class="elsevierStyleSectionTitle">Aims</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">To characterise the FB aspiration in children cases at the Hospital Pedi&#225;trico de Coimbra over a twenty five year period&#46;</p> <span class="elsevierStyleSectionTitle">Study design</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">This study was based on the retrospective analysis of all clinical files of children who were diagnosed with foreign body aspiration January 1982 to December 2006&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Foreign body aspiration was confirmed in 316 children&#46; The incidence was higher during the first twelve years of the study &#40;64&#37;&#41;&#46; Around two thirds of the children were male &#40;206&#41; and the sample was aged 6 months to 12 years&#46; Most children were younger than 3 years old &#40;83&#37;&#41;&#46; In 88&#37; of cases a choking episode was noticed while an early diagnosis &#40;&#60;24<span class="elsevierStyleHsp" style=""></span>h&#41; was obtained in only 39&#37;&#46; The most frequently described signs and symptoms were unilateral diminished breath sounds and cough&#46; In 7&#37; of cases no symptoms were described&#46; The most frequently recorded radiology finding was focal hyperinflation &#40;42&#37;&#41; and in 22&#37; the chest x-ray was unremarkable&#46; Treatment was exclusively by rigid bronchoscopy&#46; Complications related to the bronchoscopy removal were described in 22 cases&#46; Most aspirated FB were of vegetable origin &#40;75&#37;&#41;&#46; The majority of FB was lodged in the right bronchial tree&#46; Postremoval flexible bronchoscopy was performed in 116 cases&#46;</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">An unnoticed FB aspiration and absence of and&#47;or non-specific initial symptoms may contribute to a late diagnosis&#46; The significant reduction in the number of cases over the later years may be related to the implementation of preventive strategies&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Introdu&#231;&#227;o</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A aspira&#231;&#227;o de corpos estranhos &#40;CE&#41; em idade pedi&#225;trica &#233; uma situa&#231;&#227;o comum e potencialmente grave&#44; que pode estar associada a morbilidade significativa&#46;</p> <span class="elsevierStyleSectionTitle">Objectivos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Descrever as caracter&#237;sticas dos casos de aspira&#231;&#227;o de CE para a via a&#233;rea&#44; em crian&#231;as&#44; no Hospital Pedi&#225;trico de Coimbra&#44; num per&#237;odo de 25 anos&#46;</p> <span class="elsevierStyleSectionTitle">Material e m&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">An&#225;lise retrospectiva dos processos cl&#237;nicos das crian&#231;as com o diagn&#243;stico de aspi-ra&#231;&#227;o de CE&#44; durante o per&#237;odo de Janeiro de 1982 a Dezembro de 2006&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">O diagn&#243;stico de aspira&#231;&#227;o de CE foi confirmado em 316 crian&#231;as&#44; com uma maior incid&#234;ncia nos primeiros 12 anos do per&#237;odo de estudo &#40;64&#37;&#41;&#46; Cerca de 2&#47;3 das crian&#231;as eram do sexo masculino &#40;206&#41;&#44; com idades compreendidas entre os 6 meses e os 12 anos&#46; A maioria &#40;83&#37;&#41; tinha idade inferior a 3 anos&#46; Em 88&#37; dos casos havia hist&#243;ria de engasgamento&#44; tendo o diagn&#243;stico sido realizado precocemente &#40;&#60; 24<span class="elsevierStyleHsp" style=""></span>h&#41; em 39&#37;&#46; Os sinais e sintomas mais frequentemente encontrados foram&#58; assimetria do murm&#250;rio vesicular e tosse&#46; Constatou-se aus&#234;ncia de sintomas em 7&#37; dos casos&#46; A altera&#231;&#227;o radiol&#243;gica encontrada mais frequentemente foi hiperinsufla&#231;&#227;o localizada &#40;41&#37;&#41;&#59; em 22&#37; n&#227;o foi descrita altera&#231;&#227;o da radiografia de t&#243;rax&#46; O tratamento foi efectuado exclusivamente por broncoscopia r&#237;gida&#46; Foram descritos 22 casos de complica&#231;&#245;es da extrac&#231;&#227;o&#46; Os CE encontrados foram&#44; predominantemente&#44; de origem vegetal &#40;75&#37;&#41;&#46; A localiza&#231;&#227;o preferencial dos CE foi &#224; direita&#46; Foi realizada broncofibroscopia &#40;BF&#41; de revis&#227;o em 116 casos&#46;</p> <span class="elsevierStyleSectionTitle">Conclus&#227;o</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Um epis&#243;dio de aspira&#231;&#227;o de CE&#44; despercebido e&#47;ou subestimado&#44; bem como a aus&#234;ncia inicial de sintomas e&#47;ou a sua inespecificidade podem contribuir para um diagn&#243;stico tardio&#46; Houve uma not&#243;ria redu&#231;&#227;o dos casos de aspira&#231;&#227;o de CE na segunda metade da s&#233;rie&#44; que poder&#225; constituir um reflexo das estrat&#233;gias de preven&#231;&#227;o&#46;</p>"
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Vol. 14. Issue 6.
Pages 787-802 (November - December 2008)
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Vol. 14. Issue 6.
Pages 787-802 (November - December 2008)
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Foreign bodies in the airway: A quarter of a century's experience
Corpos estranhos na via aérea: Experiência de um quarto de século
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Juliana Roda1, Susana Nobre1, Jorge Pires2, M. Helena Estêvão3,
, Miguel Félix4
1 Serviço de Medicina Interna Complementar de Pediatria, Hospital Pediátrico de Coimbra, Centro Hospitalar de Coimbra / Resident, specialist training in Paediatrics, Hospital Pediátrico de Coimbra, Centro Hospitalar de Coimbra
2 Assistente Hospitalar. Chefe de Serviço de Pneumologia, Serviço de Pneumologia, Hospital Geral, Centro Hospitalar de Coimbra / Head, Pulmonology Service, Pulmonology Unit, Hospital Geral, Centro Hospitalar de Coimbra
3 Directora do Serviço de Medicina. Chefe de Serviço de Pediatria, Hospital Pediátrico de Coimbra, Centro Hospitalar de Coimbra / Head, Paediatrics Unit, Hospital Pediátrico de Coimbra, Centro Hospitalar de Coimbra
4 Assistente Graduado Hospitalar de Pediatria, Serviço de Medicina, Hospital Pediátrico de Coimbra, Centro Hospitalar de Coimbra / Paediatrics Consultant and Specialist, Serviço de Medicina, Hospital Pediátrico de Coimbra, Centro Hospitalar de Coimbra
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Article information
Abstract
Introduction

Foreign body (FB) aspiration in children is a common and potentially dangerous situation that can be associated to significant morbidity.

Aims

To characterise the FB aspiration in children cases at the Hospital Pediátrico de Coimbra over a twenty five year period.

Study design

This study was based on the retrospective analysis of all clinical files of children who were diagnosed with foreign body aspiration January 1982 to December 2006.

Results

Foreign body aspiration was confirmed in 316 children. The incidence was higher during the first twelve years of the study (64%). Around two thirds of the children were male (206) and the sample was aged 6 months to 12 years. Most children were younger than 3 years old (83%). In 88% of cases a choking episode was noticed while an early diagnosis (<24h) was obtained in only 39%. The most frequently described signs and symptoms were unilateral diminished breath sounds and cough. In 7% of cases no symptoms were described. The most frequently recorded radiology finding was focal hyperinflation (42%) and in 22% the chest x-ray was unremarkable. Treatment was exclusively by rigid bronchoscopy. Complications related to the bronchoscopy removal were described in 22 cases. Most aspirated FB were of vegetable origin (75%). The majority of FB was lodged in the right bronchial tree. Postremoval flexible bronchoscopy was performed in 116 cases.

Conclusion

An unnoticed FB aspiration and absence of and/or non-specific initial symptoms may contribute to a late diagnosis. The significant reduction in the number of cases over the later years may be related to the implementation of preventive strategies.

Key-words:
Foreign body
aspiration
paediatrics
bronchoscopy
airway
Resumo
Introdução

A aspiração de corpos estranhos (CE) em idade pediátrica é uma situação comum e potencialmente grave, que pode estar associada a morbilidade significativa.

Objectivos

Descrever as características dos casos de aspiração de CE para a via aérea, em crianças, no Hospital Pediátrico de Coimbra, num período de 25 anos.

Material e métodos

Análise retrospectiva dos processos clínicos das crianças com o diagnóstico de aspi-ração de CE, durante o período de Janeiro de 1982 a Dezembro de 2006.

Resultados

O diagnóstico de aspiração de CE foi confirmado em 316 crianças, com uma maior incidência nos primeiros 12 anos do período de estudo (64%). Cerca de 2/3 das crianças eram do sexo masculino (206), com idades compreendidas entre os 6 meses e os 12 anos. A maioria (83%) tinha idade inferior a 3 anos. Em 88% dos casos havia história de engasgamento, tendo o diagnóstico sido realizado precocemente (< 24h) em 39%. Os sinais e sintomas mais frequentemente encontrados foram: assimetria do murmúrio vesicular e tosse. Constatou-se ausência de sintomas em 7% dos casos. A alteração radiológica encontrada mais frequentemente foi hiperinsuflação localizada (41%); em 22% não foi descrita alteração da radiografia de tórax. O tratamento foi efectuado exclusivamente por broncoscopia rígida. Foram descritos 22 casos de complicações da extracção. Os CE encontrados foram, predominantemente, de origem vegetal (75%). A localização preferencial dos CE foi à direita. Foi realizada broncofibroscopia (BF) de revisão em 116 casos.

Conclusão

Um episódio de aspiração de CE, despercebido e/ou subestimado, bem como a ausência inicial de sintomas e/ou a sua inespecificidade podem contribuir para um diagnóstico tardio. Houve uma notória redução dos casos de aspiração de CE na segunda metade da série, que poderá constituir um reflexo das estratégias de prevenção.

Palavras-chave:
Corpo estranho
aspiração
pediatria
broncoscopia
vias aéreas
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Copyright © 2008. Sociedade Portuguesa de Pneumologia
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