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array:23 [ "pii" => "S030028962200566X" "issn" => "03002896" "doi" => "10.1016/j.arbres.2022.09.006" "estado" => "S300" "fechaPublicacion" => "2023-03-01" "aid" => "3179" "copyright" => "SEPAR" "copyrightAnyo" => "2022" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2023;59:169-70" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:18 [ "pii" => "S0300289622005804" "issn" => "03002896" "doi" => "10.1016/j.arbres.2022.09.016" "estado" => "S300" "fechaPublicacion" => "2023-03-01" "aid" => "3192" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2023;59:171" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "Left Radial Flap in the Treatment of Tracheo-Gastric Fistula" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "171" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 409 "Ancho" => 1005 "Tamanyo" => 57518 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Esophageal stent emerging above the main carina after rupture of the pars membranacea of the trachea (A); well-positioned radial myocutaneous flap with closed fistula. Hairs can be seen on its surface (B).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Alejandro Jove Lamas, José Cerón Navarro, Enrique Cases Viedma" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Alejandro" "apellidos" => "Jove Lamas" ] 1 => array:2 [ "nombre" => "José" "apellidos" => "Cerón Navarro" ] 2 => array:2 [ "nombre" => "Enrique" "apellidos" => "Cases Viedma" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289622005804?idApp=UINPBA00003Z" "url" => "/03002896/0000005900000003/v4_202401230711/S0300289622005804/v4_202401230711/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0300289622005671" "issn" => "03002896" "doi" => "10.1016/j.arbres.2022.09.007" "estado" => "S300" "fechaPublicacion" => "2023-03-01" "aid" => "3180" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2023;59:167-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case Report</span>" "titulo" => "Physiological Reconstruction of the Chest Wall Using a Dynamic 3D Titanium Custom-made Implant" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "167" "paginaFinal" => "168" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1406 "Ancho" => 2007 "Tamanyo" => 432675 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) 3D computed tomography reconstruction showing the radioinduced sternal sarcoma. (B) Customized dynamic titanium implant with sternoclavicular joint reconstruction. (C) Surgical resection specimen. (D) 3D computed tomography reconstruction showing correct positioning of the implant after surgery.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Sara Monge-Blanco, Francisco Javier de la Cruz-Lozano, Ana Isabel Blanco-Orozco" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Sara" "apellidos" => "Monge-Blanco" ] 1 => array:2 [ "nombre" => "Francisco Javier" "apellidos" => "de la Cruz-Lozano" ] 2 => array:2 [ "nombre" => "Ana Isabel" "apellidos" => "Blanco-Orozco" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289622005671?idApp=UINPBA00003Z" "url" => "/03002896/0000005900000003/v4_202401230711/S0300289622005671/v4_202401230711/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case Report</span>" "titulo" => "Digenic Inheritance in a Case of Pulmonary Arterial Hypertension Associated with Two Incidental Septal Defects and Multiple Thoracic Collaterals" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "169" "paginaFinal" => "170" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Alejandro Cruz-Utrilla, María Pilar Escribano Subias, Jair Antonio Tenorio Castaño, María Jesús del Cerro Marín" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Alejandro" "apellidos" => "Cruz-Utrilla" "email" => array:1 [ 0 => "acruzutrilla@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "María Pilar" "apellidos" => "Escribano Subias" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Jair Antonio" "apellidos" => "Tenorio Castaño" "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] ] ] 3 => array:3 [ "nombre" => "María Jesús" "apellidos" => "del Cerro Marín" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">f</span>" "identificador" => "aff0030" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">g</span>" "identificador" => "aff0035" ] ] ] ] "afiliaciones" => array:7 [ 0 => array:3 [ "entidad" => "Pulmonary Hypertension Unit, Cardiology Department, Hospital Universitario 12 de Octubre, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Centro de Investigación Biomédica en Red en Investigación Cardiovascular (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Instituto de Genética Médica y Molecular (INGEMM), Hospital Universitario La Paz, Madrid, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "CIBERER, Centro de Investigación en Red de Enfermedades Raras, Instituto de Salud Carlos III, Madrid, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "ITHACA, European Reference Network on Rare Congenital Malformations and Rare Intellectual Disability, Brussels, Belgium" "etiqueta" => "e" "identificador" => "aff0025" ] 5 => array:3 [ "entidad" => "Pediatric Cardiology Department, Ramón y Cajal University Hospital, Madrid, Spain" "etiqueta" => "f" "identificador" => "aff0030" ] 6 => array:3 [ "entidad" => "Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain" "etiqueta" => "g" "identificador" => "aff0035" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1506 "Ancho" => 2925 "Tamanyo" => 280509 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Panel A. Incidental atrial septal defect detected in TTE, showing right-to-left shunting (red arrow); Panel B. Small perimembranous ventricular septal defect (VSD) with Left-to-right shunting during systole (red arrow); Panels C and D. Reconstruction of some of the thoracic collaterals noticed in the mediastinum in the angiographic computed tomography (red arrows); Panel E. Genetic analysis and segregation study of first-degree relatives.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 10-year-old male with progressive dyspnea was diagnosed of Pulmonary Arterial Hypertension (PAH) related to a small atrial septal defect (ASD) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, panel A) and a restrictive perimembranous ventricular septal defect (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, panel B). The initial right heart catheterization demonstrated suprasystemic pulmonary artery pressure (138% of systemic pressures), right to left shunting (Qp/Qs 0.4), indexed pulmonary vascular resistance of 39<span class="elsevierStyleHsp" style=""></span>Wood Units/m<span class="elsevierStyleSup">2</span>, and a transpulmonary gradient of 76<span class="elsevierStyleHsp" style=""></span>mmHg. On triple sequential therapy with Tadalafil, Macitentan and subcutaneous Treprostinil, a Lenus implantable pump for intravenous Treprostinil was implanted at his 26 years. At that time, oral anticoagulation was also introduced. Despite progressive dilatation of the right chambers and persistent suprasystemic pulmonary pressures, the patient remained in functional class II until 28, when he was admitted due to an episode of life-threatening hemoptysis. After stabilization, a pulmonary angiography and an angio-CT were done, in which multiple thoracic collaterals were noticed (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, panels C and D). One bronchopulmonary collateral was actively bleeding, and an embolization was then performed. The patient responded favorably and was discharged, withdrawing Acenocoumarin. On maximum vasodilator therapy, without new hemoptysis episodes, the patient has remained at high-risk stratum. Nevertheless, considering the presence of multiple collaterals in the mediastinum and the pleura, the patient has recently been considered not candidate for bilateral lung transplantation or heart-lung transplantation at his 29 years of age.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Shortly after diagnosis, the index-case parents consented his inclusion in the Spanish Registry for pediatric pulmonary hypertension (REHIPED).<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> A genetic test was performed when he was 28, as part of a research study in patients in that registry, revealing two significant variants among candidate genes related with the development of PAH (<span class="elsevierStyleItalic">SMAD1</span> and <span class="elsevierStyleItalic">ABCC8</span>). Both variants were classified as likely pathogenic initially by the <span class="elsevierStyleItalic">in vitro</span> analysis.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> The evaluation of first-degree relatives revealed the presence of the <span class="elsevierStyleItalic">SMAD1</span> variant in the 30-year-old asymptomatic sister and the father of the index case. This last individual underwent an ASD closure at the age of 30 due to right chambers dilatation. After the segregation studies, the variant was maintained as likely pathogenic. The <span class="elsevierStyleItalic">ABCC8</span> was a rare <span class="elsevierStyleItalic">de novo</span> variant, not previously described in the literature, and not present in other first-degree relatives, which permitted in this case the reclassification of the variant as pathogenic (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, panel E).</p><p id="par0015" class="elsevierStylePara elsevierViewall">Genetic testing for PAH-associated candidate genes can be considered for patients with CHD and “out of proportion” PAH.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> The genetic background of such cases, in which the size of the defect unlikely explains the severity of vascular disease, should be taken into account, not only when shunt closure is considered or for genetic counseling, but also in the evaluation for lung transplantation. Certain mutations are associated with widespread collateral vessels.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> Specifically, <span class="elsevierStyleItalic">SOX17</span> variants have been related with PAH-CHD, with high prevalence of thoracic collaterals.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> Although genetics have not demonstrated a prognostic value in PAH, the presence of gene variants could be associated with specific phenotypes and management implications, as demonstrated in this rare case with a digenic inheritance.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Author contribution</span><p id="par0020" class="elsevierStylePara elsevierViewall">Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work: ACU, PES, JTC, MJC.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Drafting the work or revising it critically for important intellectual content: ACU, PES, JTC, MJC.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Final approval of the version to be published: ACU, PES, JTC, MJC.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: ACU, PES, JTC, MJC.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Funding</span><p id="par0045" class="elsevierStylePara elsevierViewall">This project was funded by project “Bases Genético-Moleculares de la Medicina de Precisión en la Hipertensión Arterial Pulmonar” and “Moving toward to a omic classification for pulmonary arterial hypertension”. <span class="elsevierStyleGrantSponsor" id="gs1">Instituto de Salud Carlos III</span>, <span class="elsevierStyleGrantSponsor" id="gs2">Ministerio de Economía y Competitividad</span>, <span class="elsevierStyleGrantSponsor" id="gs3">Gobierno de España</span>. Co-funded by “<span class="elsevierStyleGrantSponsor" id="gs4">Fondo Europeo de Desarrollo Regional</span>, Programa Operativo Crecimiento Inteligente 2014–2020” (<a href="https://www.isciii.es/Paginas/Inicio.aspx">https://www.isciii.es/Paginas/Inicio.aspx</a>). Award number: <span class="elsevierStyleGrantNumber" refid="gs4">PI 18/01233</span>, <span class="elsevierStyleGrantNumber" refid="gs4">PI21-01593</span>, and <span class="elsevierStyleGrantNumber" refid="gs4">PI21-01690</span>.</p><p id="par0055" class="elsevierStylePara elsevierViewall">A.C.U. holds a research-training contract “Rio Hortega” (<span class="elsevierStyleGrantNumber" refid="gs5">CM20/00164</span>) from the <span class="elsevierStyleGrantSponsor" id="gs5">Spanish Ministry of Science and Innovation</span> (Instituto de Salud Carlos III).</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Author contribution" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Funding" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1506 "Ancho" => 2925 "Tamanyo" => 280509 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Panel A. Incidental atrial septal defect detected in TTE, showing right-to-left shunting (red arrow); Panel B. Small perimembranous ventricular septal defect (VSD) with Left-to-right shunting during systole (red arrow); Panels C and D. Reconstruction of some of the thoracic collaterals noticed in the mediastinum in the angiographic computed tomography (red arrows); Panel E. Genetic analysis and segregation study of first-degree relatives.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Assessing pulmonary hypertensive vascular disease in childhood. Data from the Spanish registry" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.J. Del Cerro Marín" 1 => "A. Sabaté Rotés" 2 => "A. Rodriguez Ogando" 3 => "A. Mendoza Soto" 4 => "M. Quero Jiménez" 5 => "J.L. Gavilán Camacho" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/rccm.201406-1052OC" "Revista" => array:6 [ "tituloSerie" => "Am J Respir Crit Care Med" "fecha" => "2014" "volumen" => "190" "paginaInicial" => "1421" "paginaFinal" => "1429" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25379685" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Characterization of rare ABCC8 variants identified in Spanish pulmonary arterial hypertension patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Lago-Docampo" 1 => "J. Tenorio" 2 => "I. Hernández-González" 3 => "C. Pérez-Olivares" 4 => "P. Escribano-Subías" 5 => "G. Pousada" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/s41598-020-72089-1" "Revista" => array:5 [ "tituloSerie" => "Sci Rep" "fecha" => "2020" "volumen" => "10" "paginaInicial" => "15135" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32934261" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Genetic testing and blood biomarkers in paediatric pulmonary hypertension. Expert consensus statement on the diagnosis and treatment of paediatric pulmonary hypertension. The European Paediatric Pulmonary Vascular Disease Network, endorsed by ISHLT and DGPK" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Pattathu" 1 => "M. Gorenflo" 2 => "A. Hilgendorff" 3 => "J.W. Koskenvuo" 4 => "C. Apitz" 5 => "G. Hansmann" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/heartjnl-2014-307238" "Revista" => array:7 [ "tituloSerie" => "Heart" "fecha" => "2016" "volumen" => "102" "numero" => "Suppl 2" "paginaInicial" => "ii36" "paginaFinal" => "ii41" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27053696" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The role of genetics in pulmonary arterial hypertension associated with congenital heart disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Cruz-Utrilla" 1 => "N. Gallego" 2 => "T. Segura de la Cal" 3 => "J. Tenorio-Castaño" 4 => "F. Arribas-Ynsaurriaga" 5 => "P. Escribano Subias" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rec.2021.04.003" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Cardiol (Engl Ed)" "fecha" => "2021" "volumen" => "74" "paginaInicial" => "884" "paginaFinal" => "886" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33972189" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "An emerging phenotype of pulmonaryarterial hypertension patients carrying SOX17 variants" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D. Montani" 1 => "B. Lechartier" 2 => "B. Girerd" 3 => "M. Eyries" 4 => "M.R. Ghigna" 5 => "L. Savale" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/13993003.00656-2022" "Revista" => array:2 [ "tituloSerie" => "Eur Respir J" "fecha" => "2022" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/03002896/0000005900000003/v4_202401230711/S030028962200566X/v4_202401230711/en/main.assets" "Apartado" => array:4 [ "identificador" => "93865" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case reports" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000005900000003/v4_202401230711/S030028962200566X/v4_202401230711/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S030028962200566X?idApp=UINPBA00003Z" ]
