Data from dental extraoral and cone beam computed tomography (CBCT) exposures in Portugal (2019) were gathered, and patient doses for standard adult exams were evaluated. In panoramic X-rays, 442 units (34% of the existing licensed units) were tested, with a third quartile value (PKA) of 82 mGy.cm2. For cephalometric radiography (88 units), the third quartile value (Ki) was 0.3 mGy for the posteroanterior projection and 0.2 mGy for lateral projection. In CBCT (69 units), the doses for the placement of an upper first molar implant were evaluated with a third quartile value (PKA) of 820 mGy.cm2. Due to the wide range of values (74–3687 mGy.cm2), the CBCT data were divided by FOV dimensions: for small FOV (average FOV of 7 ×8 cm), a value of 580 mGy.cm2 was obtained and for medium FOV (average FOV of 13 × 12 cm) a value of 1167 mGy.cm2. The number of annual panoramic X-rays made in Portugal was 208 per 1000 inhabitants, which is higher than the value for other countries.
Comprometimento e promoção do sono em unidades de terapia intensiva: revisão integrativa Sleep impairment and sleep promotion in intensive care units: an integrative review Comprometimiento y promoción del sueño en unidades de cuidados intensivos: revisión integradora
Introduction: Foreign body aspiration (FBA) is a potentially fatal paediatric emergency. Our objective was to highlight the importance of a multidisciplinary approach to difficult/doubtful diagnosis.
Case Report: 34-month-old girl referred for urgent rigid bronchoscopy after suspected metallic blade ingestion (found chewing on it). She had a previous recurrent history of wheezing. The physical examination revealed face/lip wounds, traces of powder on her teeth but no breathing difficulty. The plain X-Ray revealed radiopaque images of the upper pulmonary field and gastric chamber. In the absence of FBA clinical signs but considering a previous history of bronchial hyperresponsiveness, a direct digital radiographic study was performed. There were no images compatible with foreign bodies: the results were interpreted as artefacts and no bronchoscopy was performed.
Conclusions: A careful pre-anaesthetic evaluation, a high level of suspicion and excellent multidisciplinary communication led to the recognition of false radiologic findings. A conservative approach was followed and invasive procedures in a remote location, with high anaesthetic risk for the paediatric population were avoided.
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