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array:23 [ "pii" => "S030028962030291X" "issn" => "03002896" "doi" => "10.1016/j.arbres.2020.08.010" "estado" => "S300" "fechaPublicacion" => "2021-01-01" "aid" => "2610" "copyright" => "SEPAR" "copyrightAnyo" => "2020" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2021;57 Supl 1:68" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:18 [ "pii" => "S0300289620304014" "issn" => "03002896" "doi" => "10.1016/j.arbres.2020.10.018" "estado" => "S300" "fechaPublicacion" => "2021-01-01" "aid" => "2663" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2021;57 Supl 1:69" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "Multiple Reversed Halo Sign on Chest CT in COVID-19 Pneumonia" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "69" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Múltiples signos del halo invertido en la TC de tórax de una neumonía por COVID-19" ] ] "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" => 501 "Ancho" => 1250 "Tamanyo" => 121963 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Axial chest CT (A) and axial 3D volume-rendering (B) images revealed bilateral, multilobar peripherally located lesions with “multiple reversed halo sign” (arrows).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Serdar Aslan" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Serdar" "apellidos" => "Aslan" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289620304014?idApp=UINPBA00003Z" "url" => "/03002896/00000057000000S1/v1_202101190710/S0300289620304014/v1_202101190710/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0300289620302659" "issn" => "03002896" "doi" => "10.1016/j.arbres.2020.07.030" "estado" => "S300" "fechaPublicacion" => "2021-01-01" "aid" => "2588" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2021;57 Supl 1:67" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "Spontaneous Pneumomediastinum and Macklin Effect in COVID-19 Patients" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "67" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Neumomediastino espontáneo y efecto Macklin en pacientes con covid-19" ] ] "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" => 1103 "Ancho" => 955 "Tamanyo" => 152527 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Transverse CTPA images obtained with lung window setting shows multiple pulmonary parenchymal mainly peripheral ground glass opacities (red arrows). Bilateral varicose bronchiectasis (yellow arrows). (B) Maximum intensity projection (MIP) reconstructions images in axial plane shows filling defects (green circle) at the bifurcation level of the anterior segmental branch in right upper lobe compatible with pulmonary thromboembolism. (C–F) Transverse CT images with lung window (C and E) and reformatted Minimum intensity projection (MinIP) reconstructions (D and F) obtained at upper and medium mediastinic levels shows pulmonary interstitial emphysema with air tracking along the right peribronchovascular sheaths ((blue arrows). Central upper anterior right pneumomediastinum (green circles) secondary to a spontaneous barotrauma (Macklin effect). Multiple parenchymal ground glass opacities with prevalent peripheral distribution (red arrows). Bilateral varicose bronchiectasis (yellow arrows).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Salvatore Marsico, Luis Alexander Del Carpio Bellido, Flavio Zuccarino" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Salvatore" "apellidos" => "Marsico" ] 1 => array:2 [ "nombre" => "Luis Alexander" "apellidos" => "Del Carpio Bellido" ] 2 => array:2 [ "nombre" => "Flavio" "apellidos" => "Zuccarino" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289620302659?idApp=UINPBA00003Z" "url" => "/03002896/00000057000000S1/v1_202101190710/S0300289620302659/v1_202101190710/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "Pneumomediastinum: An Uncommon Complication of COVID-19 Pneumonia" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "68" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Marta Nobre Pereira, Rosário Blanco, Vanda Areias" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Marta" "apellidos" => "Nobre Pereira" "email" => array:1 [ 0 => "martapereira_15@hotmail.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" => "Rosário" "apellidos" => "Blanco" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Vanda" "apellidos" => "Areias" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Pulmonology Department, Centro Hospitalar Universitário do Algarve – Hospital de Faro, Portugal" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Internal Medicine Department, Centro Hospitalar Universitário do Algarve – Hospital de Faro, Portugal" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Neumomediastino: una complicación poco común de la neumonía por COVID-19" ] ] "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" => 957 "Ancho" => 900 "Tamanyo" => 110507 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest computerized tomography angiography: axial images (A–E) showing pneumomediastinum associated to mild subcutaneous emphysema and peripheral ground glass opacities, mostly in the lower lobes bilaterally, but also in the upper lobes; (F) coronal reconstruction showing pneumomediastinum.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 88-year-old male, non-smoker, without any underlying lung disease, was hospitalized due to COVID-19 pneumonia, with persistent fever and progressive fatigue. He started treatment with hydroxychloroquine, lopinavir/ritonavir, azithromycin and ceftriaxone, assuming bacterial co-infection. However, there was a radiological and analytical worsening. We switched antibiotherapy to ceftazidime and started corticosteroids, with further analytical and imaging improvement, but maintenance of hypoxemia. A chest CT angiography (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) was performed, revealing a pneumomediastinum. After three days of rest and oxygen therapy, patient's hypoxemia improved, with overall good clinical and imaging outcome, showing spontaneous resolution. Because no precipitating factors were identified, as severe cough, signs of respiratory distress, high flow oxygen therapy or ventilatory support, we assumed a pneumomediastinum as a complication of COVID-19 pneumonia. This can be related to an alveolar membrane damage and rupture caused by the disease, followed by air dissection through the bronchovascular sheath into the mediastinum.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">1,2</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Although a pneumomediastinum is a benign disease which only requires conservative treatment,<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> it is important to monitor it closely when associated to COVID-19, due to the possibility of disease worsening.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">1,2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">This is an interesting case because it seems to be an uncommon association,<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">1,2</span></a> although the overall incidence is yet unknown.</p></span>" "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" => 957 "Ancho" => 900 "Tamanyo" => 110507 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest computerized tomography angiography: axial images (A–E) showing pneumomediastinum associated to mild subcutaneous emphysema and peripheral ground glass opacities, mostly in the lower lobes bilaterally, but also in the upper lobes; (F) coronal reconstruction showing pneumomediastinum.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spontaneous pneumomediastinum occurring in the SARS-COV-2 infection" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Kolani" 1 => "H. Nawfal" 2 => "M. Haloua" 3 => "Y.A. Lamrani" 4 => "M. Boubbou" 5 => "M. Serraj" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "IDCases" "fecha" => "2020" "volumen" => "11" "paginaInicial" => "e00806" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "COVID-19 with spontaneous pneumothorax, pneumomediastinum and subcutaneous emphysema" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "W. Wang" 1 => "R. Gao" 2 => "Y. Zheng" 3 => "L. Jiang" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "J Travel Med" "fecha" => "2020" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/03002896/00000057000000S1/v1_202101190710/S030028962030291X/v1_202101190710/en/main.assets" "Apartado" => array:4 [ "identificador" => "21422" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Clinical Images / Imágenes clínicas" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/00000057000000S1/v1_202101190710/S030028962030291X/v1_202101190710/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S030028962030291X?idApp=UINPBA00003Z" ]
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