To study cases of foreign bodies (FB) in the tracheobronchial tree investigating the clinical and radiological FB characteristics, complications and endoscopic and surgical intervention. Medical and radiological records review of all FB aspiration cases treated at São Paulo State University Hospital over the last 30 years. One hundred and sixty-four FB cases were analyzed; 57% were male, 84% of these were under 16 years old. The most common clinical manifestations were coughing (68.3%) and choking (54.9%). The most common FBs were seeds (peanut, bean, maize) and also small metal or plastic objects. Radiography was normal in 21.3%, atelectasis was present in 40.9%, hyperinsufflation in 17.1% and the FB was radio-opaque in 20.7%. FB time in the bronchial tree varied from hours to years. The most serious complications, as fibroatelectasis and difficult resolution pneumonia, were caused by the long time that the FB remained in the bronchial tree. FB extraction was by endoscopy in 89% of cases, while 6% required surgical extraction or resection of destroyed part of lung, and 5% spontaneously eliminated the FB. There was no mortality in this series. Coughing and choking were the commonest clinical findings. Most FBs were dried seeds. Complications were due to delays in diagnosis, and most would not have existed if the doctor had given credence to the history. Radiography can be normal as most FBs are radiotransparent. FB extraction was by endoscopy, but a few cases required surgery and others were spontaneously eliminated.

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Of the various histological types, the most common was squamous cell carcinoma and the least common was large cell carcinoma. Most cases presented advanced stages at the moment of diagnosis, and less than 30% of the cases presented early stages. This accounts for the low survival rate and the small number of patients submitted to surgical treatment alone, the majority being submitted to chemotherapy alone.

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Oslerus osleri is a small nematode that infects the respiratory tract of domestic and wild canids and is responsible for causing chronic nodular tracheobronchitis. This paper aims to report a case of parasitism by O. osleri in a free-living maned wolf (Chrysocyon brachyurus) that was struck by a motor vehicle. Fecal samples were collected, and the presence of spiral larvae, with "S"-shaped tails, was observed on flotation. This characteristic was compatible with the Filaroididae Family larvae of O. osleri. Although the animal did not show clinical signs of respiratory system impairment, a tracheobronchoscopy was performed. Semitransparent nodules, 5 mm in diameter, containing adult parasites were observed in the third distal portion of the trachea, cranial to the carina. Larval morphological characteristics and the nodular locations were compatible with an O. osleri respiratory tract infection.

O objetivo deste trabalho foi desenvolver um indicador de dose eletrônico para a otimização da proteção radiológica no setor de Tomografia Computadorizada do Hospital das Clínicas de Botucatu. Foram estimadas doses efetivas utilizando o parâmetro DLP (do inglês Dose-Length Product). Estas doses efetivas foram comparadas com valores da literatura. O indicador de dose foi inserido no sistema de gestão hospitalar e contribuiu com o princípio da justificativa e proteção radiológica. Os valores de doses efetiva, para os protocolos da instituição são semelhantes aos referenciados na literatura, a maior diferença encontrada foi de 3,2%. O indicador de dose, carrega informações, sobre: a) dose acumulada pelo paciente em todos os exames de TC, b) O risco benefício de exames que envolvem radiação ionizante e c) um termo que representa a ciência do solicitante quanto à dose acumulada e o risco-benefício. Este estudo vem corroborar com o princípio da justificação junto ao solicitante do exame. Essa ferramenta, contribui para orientação da equipe médica sobre a indicação excessiva de um exame considerado com alta taxa de dose. Essa metodologia pode ser implementada em qualquer serviço que realiza exames, envolvendo radiações ionizantes promovendo a melhor relação risco-benefício para o paciente custobenefício para a instituição.

-This re t rospective study describes 14 cases of intercostal nerve mononeuropathy (INM) found in 5,560 electromyography (EMG) exams perf o rmed between January 1991 and June 2004 in our University Hospital. Medical charts of all patients with history of thoracic pain and EMG diagnosis of intercostal monon e u ropathy were reviewed. INM was detected in 14 patients; etiology was thoracic surg e ry in 6 (43%), post-herpetic neuropathy in 4 (28%), probable intercostal neuritis in 2 (14%), lung neoplasia in 1 (7%), and radiculopathy in 1 (7%). From this study, trauma and infection were the main etiologies in intercostal neuropathic pain development. Tricyclic antidepressants and anticonvulsants were the most common therapeutic drugs used.KEY WORDS: intercostal mononeuropathy, EMG, etiology. Mononeuropatia de nervo intercostal: estudo de 14 casosRESUMO -Este trabalho apresenta estudo re t rospectivo de 14 pacientes com mononeuropatia de nerv o i n t e rcostal (MNI), obtidos dentre 5.560 exames eletromiográficos, realizados de janeiro de 1991 até junho de 2004, em nosso Hospital Universitário. MNI foi encontrada em 14 pacientes, tendo como causas prováveis intervenções cirúrgicas torácicas em 6 (43%), neuropatia por herpes-zoster em 4 (28%), pro v á v e l neurite de nervo intercostal em 2 (14%), neoplasia pulmonar em 1 (7%) e radiculopatia em 1 (7%). As principais causas de MNI de nosso Serviço são similares às da literatura. Os antidepressivos tricíclicos e anticonvulsivantes foram os fármacos mais utilizados no controle da dor. PALAVRAS-CHAVE: mononeuropatia intercostal, EMG, etiologia.The first descriptions of intercostal nerve monon e u ropathy (INM) were re p o rted by USA army surgeons treating patients with chronic pain after t h oracotomy as a result of thoracic trauma during the Second World Wa r 1 . There is an estimated 11 to 8 0 % incidence of chronic pain after thoracotomy 2 , but c h ronic pain tends to reduce over time 3 . High doses of analgesics consumed during the first week a f t e r s u rg e rymay be a risk factor for pain after thoracotomy 3 . However, low-dose treatment of post-surgical pain induces the liberation of stress re l a t e d chemical mediators, which may cause pulmonary, c a rd i o v a s c u l a r, metabolic and neuro e n d o c h r i n e d i s t u r b a n c e s 4 . Despite these clinical problems, int e rcostal nerves have been transferred to the brachial plexus to treat traumatic brachial plexopathy with minimal effects on pulmonary function 5 . The first clinical descriptions related to Va r i c e l l a zoster were in the XIX century 6 . Infection by Va r icella zoster is also a common cause of INM 7 , usually presented as unilateral vesicular eruption in a b e l tlike distribution mainly on the thoracic sensory d e rmatomes, most cases preceded by pain and pare sthesias. The prognosis is usually good, most cases p resents complete re c o v e ryor significant impro v em e n t 7 . Atypical clinical presentations are described in imunosupressed patients 7 . The objective of o...

Small non-calcified benign nodules were much more frequent than malignant nodules. The best time for dynamic contrast-enhanced CT density analysis was 4 min postcontrast. As well as saving time and money, this simplified Swensen protocol with only precontrast and 4 min postcontrast phases also reduces patient exposure to ionizing radiation.