Scientific Letter
Ascaris lumbricoides Through Pleural Biopsy Needle. A Rare Case of Intrapleural Ascariasis
Observación de Ascaris lumbricoides a través de una aguja de biopsia pleural. Un caso raro de ascariasis intrapleural
Tamer Elhadidy, Mohammed Elsayed Eldesoqy, Nesreen Elsayed Morsy, Heba Wagih Abdelwahab
, Mohamed Tohlob
Corresponding author
Chest Medicine Department, Mansoura University, Mansoura, Egypt
Read
6328
Timeswas read the article
2027
Total PDF
4301
Total HTML
Share statistics
array:24 [ "pii" => "S1579212916302671" "issn" => "15792129" "doi" => "10.1016/j.arbr.2016.11.005" "estado" => "S300" "fechaPublicacion" => "2017-03-01" "aid" => "1468" "copyright" => "SEPAR" "copyrightAnyo" => "2016" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2017;53:171-2" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1783 "formatos" => array:3 [ "EPUB" => 122 "HTML" => 1223 "PDF" => 438 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0300289616302514" "issn" => "03002896" "doi" => "10.1016/j.arbres.2016.08.014" "estado" => "S300" "fechaPublicacion" => "2017-03-01" "aid" => "1468" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2017;53:171-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3525 "formatos" => array:3 [ "EPUB" => 141 "HTML" => 2772 "PDF" => 612 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta científica</span>" "titulo" => "Observación de <span class="elsevierStyleItalic">Ascaris lumbricoides</span> a través de una aguja de biopsia pleural. Un caso raro de ascariasis intrapleural" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "171" "paginaFinal" => "172" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "<span class="elsevierStyleItalic">Ascaris lumbricoides</span> through pleural biopsy needle. A rare case of intrapleural ascariasis" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 938 "Ancho" => 612 "Tamanyo" => 52641 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Lombriz de <span class="elsevierStyleItalic">Ascaris</span> en la jeringa de la biopsia pleural.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Tamer Elhadidy, Mohammed Elsayed Eldesoqy, Nesreen Elsayed Morsy, Heba Wagih Abdelwahab, Mohammad Tohlob" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Tamer" "apellidos" => "Elhadidy" ] 1 => array:2 [ "nombre" => "Mohammed Elsayed" "apellidos" => "Eldesoqy" ] 2 => array:2 [ "nombre" => "Nesreen Elsayed" "apellidos" => "Morsy" ] 3 => array:2 [ "nombre" => "Heba Wagih" "apellidos" => "Abdelwahab" ] 4 => array:2 [ "nombre" => "Mohammad" "apellidos" => "Tohlob" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212916302671" "doi" => "10.1016/j.arbr.2016.11.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212916302671?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289616302514?idApp=UINPBA00003Z" "url" => "/03002896/0000005300000003/v4_201705130114/S0300289616302514/v4_201705130114/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1579212916302695" "issn" => "15792129" "doi" => "10.1016/j.arbr.2016.11.007" "estado" => "S300" "fechaPublicacion" => "2017-03-01" "aid" => "1467" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2017;53:172-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1756 "formatos" => array:3 [ "EPUB" => 144 "HTML" => 1045 "PDF" => 567 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>" "titulo" => "Molecular Testing of EGFR, EGFR Resistance Mutation, ALK and ROS1 Achieved by EBUS-TBNA in Chile" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "172" "paginaFinal" => "174" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Análisis moleculares de EGFR, mutación de resistencia al EGFR, ALK y ROS1 en muestras obtenidas mediante PATB-USEB en Chile" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Sebastián Fernandez-Bussy, Gonzalo Labarca, Yumay Pires, Iván Caviedes, Mauricio Burotto" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Sebastián" "apellidos" => "Fernandez-Bussy" ] 1 => array:2 [ "nombre" => "Gonzalo" "apellidos" => "Labarca" ] 2 => array:2 [ "nombre" => "Yumay" "apellidos" => "Pires" ] 3 => array:2 [ "nombre" => "Iván" "apellidos" => "Caviedes" ] 4 => array:2 [ "nombre" => "Mauricio" "apellidos" => "Burotto" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289616302502" "doi" => "10.1016/j.arbres.2016.08.013" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289616302502?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212916302695?idApp=UINPBA00003Z" "url" => "/15792129/0000005300000003/v1_201703240112/S1579212916302695/v1_201703240112/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1579212916303445" "issn" => "15792129" "doi" => "10.1016/j.arbr.2016.12.010" "estado" => "S300" "fechaPublicacion" => "2017-03-01" "aid" => "1434" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2017;53:170-1" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1704 "formatos" => array:3 [ "EPUB" => 139 "HTML" => 1028 "PDF" => 537 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>" "titulo" => "Pleural Effusion: A Rare Manifestation of Sarcoidosis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "170" "paginaFinal" => "171" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Derrame pleural: una presentación poco frecuente de sarcoidosis" ] ] "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" => 1524 "Ancho" => 1350 "Tamanyo" => 273612 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) PA chest radiograph. (B) Radiograph of lateral thorax, showing patchy alveolar infiltrates in the left middle and upper lobes. Predominantly right-sided bilateral pleural effusion. Hilar and mediastinal lymphadenopathy of pathological appearance. (C) Axial image of chest CT with intravenous contrast medium showing lymphadenopathy component in the mediastinal, bilateral hilar and periesophageal compartments. Bilateral alveolar involvement predominantly in the subpleural region of both bases, with accumulated nodal lesions and patchy air bronchogram in the subpleural region.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "María Fontecha Ortega, Sergio Julio Rodríguez Álvarez, Jose Luis García Satué" "autores" => array:3 [ 0 => array:2 [ "nombre" => "María" "apellidos" => "Fontecha Ortega" ] 1 => array:2 [ "nombre" => "Sergio Julio" "apellidos" => "Rodríguez Álvarez" ] 2 => array:2 [ "nombre" => "Jose Luis" "apellidos" => "García Satué" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289616302125" "doi" => "10.1016/j.arbres.2016.07.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289616302125?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212916303445?idApp=UINPBA00003Z" "url" => "/15792129/0000005300000003/v1_201703240112/S1579212916303445/v1_201703240112/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>" "titulo" => "<span class="elsevierStyleItalic">Ascaris lumbricoides</span> Through Pleural Biopsy Needle. A Rare Case of Intrapleural Ascariasis" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "171" "paginaFinal" => "172" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Tamer Elhadidy, Mohammed Elsayed Eldesoqy, Nesreen Elsayed Morsy, Heba Wagih Abdelwahab, Mohamed Tohlob" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Tamer" "apellidos" => "Elhadidy" ] 1 => array:2 [ "nombre" => "Mohammed Elsayed" "apellidos" => "Eldesoqy" ] 2 => array:2 [ "nombre" => "Nesreen Elsayed" "apellidos" => "Morsy" ] 3 => array:4 [ "nombre" => "Heba Wagih" "apellidos" => "Abdelwahab" "email" => array:1 [ 0 => "wagihheba84@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 4 => array:2 [ "nombre" => "Mohamed" "apellidos" => "Tohlob" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Chest Medicine Department, Mansoura University, Mansoura, Egypt" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Observación de <span class="elsevierStyleItalic">Ascaris lumbricoides</span> a través de una aguja de biopsia pleural. Un caso raro de ascariasis intrapleural" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 938 "Ancho" => 612 "Tamanyo" => 56311 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Ascaris worm in pleural biopsy syringe.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Ascariasis is the most common helminthic infection. However, helminthic involvement of the pleura is very rare. We report a case of an ascaris worm found in needle-guided pleural percutaneous aspiration.</p><p id="par0010" class="elsevierStylePara elsevierViewall">A 60 year-old male, smoker, presented with a 1-month history of dyspnea of gradual onset and progressive course, and hemoptysis. The condition was associated with anorexia, weight loss, and abdominal discomfort. Physical examination showed splenomegaly and normal temperature, with nolymphadenopathy or hepatomegaly. Respiratory examination showed dullness on percussion over the right and left lung base with decreased breath sounds. The rest of the examination was unremarkable. A chest radiograph showed bilateral pleural effusion and bilateral pulmonary infiltrates in both lung fields. A computed tomographic (CT) scan showed bilateral pleural effusion and bilateral consolidation involving upper lobes, middle lobe, and lingula (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). White cell count 96<span class="elsevierStyleHsp" style=""></span>000 with 75% eosinophils. Abdominal ultrasound showed splenomegaly with simple splenic cyst. Stool examination revealed amebiasis. A repeat stool examination showed ascaris ova. Based on the clinical and laboratory findings, diagnosis was ascaris infestation. Pleural biopsy was scheduled to diagnose chest pathology. An 8<span class="elsevierStyleHsp" style=""></span>cm long, grayish white worm was seen emerging from the pleural biopsy needle during percutaneous aspiration of pleural effusion (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). The worm was identified as <span class="elsevierStyleItalic">Ascaris lumbricoides</span>, so treatment with albendazole 400<span class="elsevierStyleHsp" style=""></span>mg for 3 days was started. Follow up CXR show marked improvement of pulmonary opacities and right sided pleural effusion with residual left pleural effusion.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Ascariasis is the most common helminthic infection, with an estimated worldwide prevalence of 25% (0.8–1.22 billion population).<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> Ascariasis is most prevalent in children living in tropical and developing countries, where it is perpetuated by contamination of soil by human feces or use of untreated feces as fertilizer.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> The adult worm resides in the gastrointestinal tract without causing any significant symptoms. However, when the environment in the intestines becomes unfavorable, such as with inflammation and obstruction, the ascaris will migrate to other less hostile environments, which can lead to serious intra-abdominal complications, such as biliary obstruction, cholangiohepatitis, liver abscess and pancreatitis.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> Two cases of pulmonary ascariasis in Austrian males have been reported. Both patients presented with dyspnea, nonproductive cough, fever, and eosinophilia (19% and 26%). One patient additionally had pulmonary infiltrates.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> A rare case of an ascaris worm emerging through an intercostal chest tube was reported by LONE et al., in 2010.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> Our case report concerns intrapleural ascariasis as a rare complication, and confirms the importance of awareness of this infestation.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Elhadidy T, Eldesoqy ME, Morsy NE, Abdelwahab HW, Tohlob M. Observación de <span class="elsevierStyleItalic">Ascaris lumbricoides</span> a través de una aguja de biopsia pleural. Un caso raro de ascariasis intrapleural. Arch Bronconeumol. 2017;53:171–172.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 496 "Ancho" => 1503 "Tamanyo" => 82326 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest CT of patient at time of presentation.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 938 "Ancho" => 612 "Tamanyo" => 56311 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Ascaris worm in pleural biopsy syringe.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Bethony" 1 => "S. Brooker" 2 => "M. Albonico" 3 => "S.M. Geiger" 4 => "A. Loukas" 5 => "D. Diemert" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0140-6736(06)68653-4" "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "2006" "volumen" => "367" "paginaInicial" => "1521" "paginaFinal" => "1532" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16679166" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Individual predisposition, household clustering and risk factors for human infection with <span class="elsevierStyleItalic">Ascaris lumbricoides:</span> new epidemiological insights" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Walker" 1 => "A. Hall" 2 => "M.G. Basáñez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1371/journal.pntd.0001047" "Revista" => array:5 [ "tituloSerie" => "PLoS Negl Trop Dis" "fecha" => "2011" "volumen" => "5" "paginaInicial" => "e1047" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21541362" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The intestinal nematodes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "E.K. Markell" 1 => "M. Voge" 2 => "D.T. John" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Medical parasitology" "paginaInicial" => "261" "paginaFinal" => "293" "serieFecha" => "1992" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intestinal complications of round worms in children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "N. Surendran" 1 => "M.O. Paulose" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Pediatr Surg" "fecha" => "1988" "volumen" => "23" "paginaInicial" => "931" "paginaFinal" => "935" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3236163" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ascaris through a chest tube: a rare presentation" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R.A. Lone" 1 => "M.L. Wani" 2 => "M. Manzoor" 3 => "M.L. Sharma" 4 => "G.N. Lone" 5 => "M. Shah" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ulus Travma Acil Cerrahi Derg" "fecha" => "2010" "volumen" => "16" "paginaInicial" => "183" "paginaFinal" => "184" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20517778" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005300000003/v1_201703240112/S1579212916302671/v1_201703240112/en/main.assets" "Apartado" => array:4 [ "identificador" => "49861" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Scientific letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005300000003/v1_201703240112/S1579212916302671/v1_201703240112/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212916302671?idApp=UINPBA00003Z" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 7 | 6 | 13 |
| 2024 October | 99 | 27 | 126 |
| 2024 September | 63 | 21 | 84 |
| 2024 August | 118 | 33 | 151 |
| 2024 July | 73 | 29 | 102 |
| 2024 June | 108 | 30 | 138 |
| 2024 May | 88 | 21 | 109 |
| 2024 April | 78 | 35 | 113 |
| 2024 March | 84 | 24 | 108 |
| 2024 February | 58 | 29 | 87 |
| 2023 November | 1 | 0 | 1 |
| 2023 March | 12 | 5 | 17 |
| 2023 February | 89 | 31 | 120 |
| 2023 January | 43 | 44 | 87 |
| 2022 December | 82 | 51 | 133 |
| 2022 November | 89 | 29 | 118 |
| 2022 October | 80 | 43 | 123 |
| 2022 September | 58 | 35 | 93 |
| 2022 August | 73 | 41 | 114 |
| 2022 July | 99 | 55 | 154 |
| 2022 June | 53 | 53 | 106 |
| 2022 May | 61 | 51 | 112 |
| 2022 April | 76 | 42 | 118 |
| 2022 March | 50 | 45 | 95 |
| 2022 February | 49 | 38 | 87 |
| 2022 January | 70 | 41 | 111 |
| 2021 December | 50 | 48 | 98 |
| 2021 November | 60 | 45 | 105 |
| 2021 October | 70 | 57 | 127 |
| 2021 September | 42 | 45 | 87 |
| 2021 August | 31 | 35 | 66 |
| 2021 July | 40 | 23 | 63 |
| 2021 June | 63 | 42 | 105 |
| 2021 May | 59 | 40 | 99 |
| 2021 April | 130 | 119 | 249 |
| 2021 March | 73 | 28 | 101 |
| 2021 February | 60 | 29 | 89 |
| 2021 January | 38 | 19 | 57 |
| 2020 December | 52 | 17 | 69 |
| 2020 November | 51 | 20 | 71 |
| 2020 October | 61 | 25 | 86 |
| 2020 September | 36 | 8 | 44 |
| 2020 August | 49 | 14 | 63 |
| 2020 July | 53 | 27 | 80 |
| 2020 June | 84 | 9 | 93 |
| 2020 May | 95 | 17 | 112 |
| 2020 April | 44 | 33 | 77 |
| 2020 March | 51 | 21 | 72 |
| 2020 February | 54 | 22 | 76 |
| 2020 January | 44 | 24 | 68 |
| 2019 December | 32 | 24 | 56 |
| 2019 November | 40 | 30 | 70 |
| 2019 October | 34 | 12 | 46 |
| 2019 September | 29 | 10 | 39 |
| 2019 August | 85 | 28 | 113 |
| 2019 July | 21 | 17 | 38 |
| 2019 June | 35 | 21 | 56 |
| 2019 May | 41 | 17 | 58 |
| 2019 April | 56 | 28 | 84 |
| 2019 March | 58 | 24 | 82 |
| 2019 February | 49 | 20 | 69 |
| 2019 January | 24 | 13 | 37 |
| 2018 December | 33 | 12 | 45 |
| 2018 November | 72 | 15 | 87 |
| 2018 October | 94 | 14 | 108 |
| 2018 September | 28 | 13 | 41 |
| 2018 May | 18 | 2 | 20 |
| 2018 April | 22 | 5 | 27 |
| 2018 March | 20 | 4 | 24 |
| 2018 February | 33 | 10 | 43 |
| 2018 January | 76 | 5 | 81 |
| 2017 December | 86 | 4 | 90 |
| 2017 November | 30 | 7 | 37 |
| 2017 October | 13 | 9 | 22 |
| 2017 September | 27 | 20 | 47 |
| 2017 August | 31 | 13 | 44 |
| 2017 July | 27 | 10 | 37 |
| 2017 June | 33 | 14 | 47 |
| 2017 May | 1 | 0 | 1 |
| 2017 April | 2 | 0 | 2 |
Show all
