Scientific Letter
Bronchiolitis Obliterans Following Hematopoietic Stem Cell Transplantation: Importance of Expiratory Computed Tomography
Bronquiolitis constrictiva tras trasplante de progenitores hematopoyéticos: importancia de la tomografía computarizada espiratoria
Read
4410
Timeswas read the article
1881
Total PDF
2529
Total HTML
Share statistics
array:24 [ "pii" => "S1579212917301106" "issn" => "15792129" "doi" => "10.1016/j.arbr.2017.04.003" "estado" => "S300" "fechaPublicacion" => "2017-06-01" "aid" => "1457" "copyright" => "SEPAR" "copyrightAnyo" => "2016" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2017;53:349-51" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1247 "formatos" => array:3 [ "EPUB" => 142 "HTML" => 746 "PDF" => 359 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0300289616302393" "issn" => "03002896" "doi" => "10.1016/j.arbres.2016.09.004" "estado" => "S300" "fechaPublicacion" => "2017-06-01" "aid" => "1457" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2017;53:349-51" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2175 "formatos" => array:3 [ "EPUB" => 115 "HTML" => 1453 "PDF" => 607 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta científica</span>" "titulo" => "Bronquiolitis constrictiva tras trasplante de progenitores hematopoyéticos: importancia de la tomografía computarizada espiratoria" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "349" "paginaFinal" => "351" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Bronchiolitis obliterans following hematopoietic stem cell transplantation: Importance of expiratory computed tomography" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1228 "Ancho" => 1500 "Tamanyo" => 211381 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A) Reconstrucción coronal minIP de la TC de tórax en inspiración, en la que se observa un parénquima pulmonar homogéneo con una atenuación uniforme. B) Reconstrucción coronal minIP de la TC de tórax en espiración, en la que se identifica un patrón en mosaico del parénquima pulmonar, apreciándose áreas geográficas de baja densidad (asterisco), que se alternan con otras zonas de mayor atenuación. Las áreas de baja densidad (que afectan especialmente al lóbulo inferior derecho y de forma parcheada al pulmón izquierdo) corresponden a zonas de atrapamiento aéreo, mientras que las áreas de mayor densidad corresponden a parénquima pulmonar normal. C) Reconstrucción axial minIP de TC de tórax en inspiración, en la que se observa un parénquima pulmonar homogéneo. D) Reconstrucción axial minIP de la TC de tórax en espiración, en la que se visualizan áreas geográficas de baja densidad (asteriscos) en relación con áreas de atrapamiento aéreo.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Luis Gorospe Sarasúa, Deisy Barrios-Barreto, Isabel García Gómez-Muriel, Anabelle Chinea-Rodríguez" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Luis" "apellidos" => "Gorospe Sarasúa" ] 1 => array:2 [ "nombre" => "Deisy" "apellidos" => "Barrios-Barreto" ] 2 => array:2 [ "nombre" => "Isabel" "apellidos" => "García Gómez-Muriel" ] 3 => array:2 [ "nombre" => "Anabelle" "apellidos" => "Chinea-Rodríguez" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212917301106" "doi" => "10.1016/j.arbr.2017.04.003" "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/S1579212917301106?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289616302393?idApp=UINPBA00003Z" "url" => "/03002896/0000005300000006/v2_201707150129/S0300289616302393/v2_201707150129/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1579212917301167" "issn" => "15792129" "doi" => "10.1016/j.arbr.2016.10.007" "estado" => "S300" "fechaPublicacion" => "2017-06-01" "aid" => "1493" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2017;53:351-2" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2059 "formatos" => array:3 [ "EPUB" => 146 "HTML" => 1474 "PDF" => 439 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>" "titulo" => "Diagnosis of <span class="elsevierStyleItalic">Actinomyces graevenitzii</span> Lung Infection Using Linear EBUS" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "351" "paginaFinal" => "352" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Diagnóstico mediante EBUS lineal de infección pulmonar por <span class="elsevierStyleItalic">Actinomyces graevenitzii</span>" ] ] "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" => 633 "Ancho" => 1000 "Tamanyo" => 73676 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">PET/CT with hypermetabolic focus in the right lower paratracheal lymph node station (4R).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Alberto Caballero Vázquez, Juan Jose Cruz Rueda, Julián Andrés Ceballos Gutierrez" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Alberto" "apellidos" => "Caballero Vázquez" ] 1 => array:2 [ "nombre" => "Juan Jose" "apellidos" => "Cruz Rueda" ] 2 => array:2 [ "nombre" => "Julián Andrés" "apellidos" => "Ceballos Gutierrez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289616302769" "doi" => "10.1016/j.arbres.2016.10.014" "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/S0300289616302769?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917301167?idApp=UINPBA00003Z" "url" => "/15792129/0000005300000006/v2_201707150125/S1579212917301167/v2_201707150125/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S157921291730109X" "issn" => "15792129" "doi" => "10.1016/j.arbr.2017.04.002" "estado" => "S300" "fechaPublicacion" => "2017-06-01" "aid" => "1450" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2017;53:348-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1178 "formatos" => array:3 [ "EPUB" => 122 "HTML" => 671 "PDF" => 385 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>" "titulo" => "Intraventricular Air Embolism Complicating Computed Tomography-Guided Pulmonary Aspiration Biopsy" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "348" "paginaFinal" => "349" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Embolia aérea intraventricular como complicación de una punción biopsia pulmonar guiada por tomografía computarizada" ] ] "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" => 575 "Ancho" => 1500 "Tamanyo" => 205912 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Right pneumothorax associated with left ventricular air embolism (arrow). (B) Drainage catheter in the pleural space (arrow) with resolution of right pneumothorax and air embolism.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Agustin Dietrich, Analía Vargas, David E. Smith, Alberto Domenech" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Agustin" "apellidos" => "Dietrich" ] 1 => array:2 [ "nombre" => "Analía" "apellidos" => "Vargas" ] 2 => array:2 [ "nombre" => "David E." "apellidos" => "Smith" ] 3 => array:2 [ "nombre" => "Alberto" "apellidos" => "Domenech" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289616302320" "doi" => "10.1016/j.arbres.2016.09.002" "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/S0300289616302320?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157921291730109X?idApp=UINPBA00003Z" "url" => "/15792129/0000005300000006/v2_201707150125/S157921291730109X/v2_201707150125/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>" "titulo" => "Bronchiolitis Obliterans Following Hematopoietic Stem Cell Transplantation: Importance of Expiratory Computed Tomography" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">To the Editor</span>," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "349" "paginaFinal" => "351" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Luis Gorospe Sarasúa, Deisy Barrios-Barreto, Isabel García Gómez-Muriel, Anabelle Chinea-Rodríguez" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Luis" "apellidos" => "Gorospe Sarasúa" "email" => array:1 [ 0 => "luisgorospe@yahoo.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" => "Deisy" "apellidos" => "Barrios-Barreto" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Isabel" "apellidos" => "García Gómez-Muriel" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Anabelle" "apellidos" => "Chinea-Rodríguez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Radiodiagnóstico, Hospital Universitario Ramón y Cajal, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Neumología, Hospital Universitario Ramón y Cajal, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Hematología, Hospital Universitario Ramón y Cajal, Madrid, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Bronquiolitis constrictiva tras trasplante de progenitores hematopoyéticos: importancia de la tomografía computarizada espiratoria" ] ] "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" => 1228 "Ancho" => 1500 "Tamanyo" => 211381 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) minIP coronal reconstruction of the chest inspiratory CT showing homogeneous pulmonary parenchyma with uniform attenuation. (B) minIP coronal reconstruction of chest expiratory CT, showing a mosaic pattern of the pulmonary parenchyma, with areas of low density (asterisk), alternating with areas of greater attenuation. Low density areas (affecting particularly the right lower lobe and the left lung in a patchy pattern) correspond to areas of air trapping, while the areas of greater density correspond to normal pulmonary parenchyma. (C) minIP axial reconstruction of the chest inspiratory CT showing homogeneous pulmonary parenchyma. (D) minIP axial reconstruction of chest expiratory CT, showing areas of low density (asterisks), related with areas of air trapping.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Bronchiolitis obliterans (BO) after hematopoietic stem cell transplantation (HSCT) is a serious, potentially fatal complication, which generally appears in the context of graft-vs-host disease (GVHD).<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1,2</span></a> The clinical presentation of BO after HSCT is non-specific, and no universal consensus is available on the diagnostic criteria of this entity, although imaging studies, particularly computed tomography (CT), dynamic inspiratory CT (iCT), and expiratory CT (eCT), are of growing diagnostic value in the detection of this complication.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">3,4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">We report the case of a 44-year-old woman with a history of acute myeloid leukemia, treated 6 months previously with unrelated donor HSCT, who consulted due to dyspnea and dry cough. As a complication of the HSCT, the patient had transitory cytomegalovirus viremia and cutaneous GVHD grade III, which responded favorably to treatment with corticosteroids. No parenchymal opacities were observed on chest radiograph, but chest iCT and eCT revealed a marked mosaic pattern in the pulmonary parenchyma in the expiratory phase, and multiple areas of air trapping were identified in both lungs (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>), while infectious complications were ruled out. Areas of air trapping on CT can be better viewed with the use of the minimum intensity projection (minIP), an algorithm for visualization of images that enhances areas of less attenuation. Lung function tests (LFT) showed a mild reduction (<20%) in forced expiratory volume in 1 second (FEV1) and increased residual volume (RV) (138%) with respect to pre-HSCT values. No changes were observed on fiberoptic bronchoscopy and bronchoalveolar lavage ruled out opportunistic infections. Given these findings, a diagnosis of BO was given, and the patient responded favorably to treatment with high-dose systemic corticosteroids (stabilization of functional tests).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">BO is the most common non-infectious complication of HSCT, and is usually diagnosed about 6–12 months post-transplantation.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> Some risk factors for the development of post-HSCT BO include age over 20 years, pre-HSCT airflow obstruction, the appearance of viral respiratory infections in the early post-transplantation months, but the most significant of all is the presence of chronic GVHD.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> Clinical presentation is often insidious, and symptoms are unspecific (cough, dyspnea), although 20% of patients can be asymptomatic. Long-term prognosis is generally poor, and the aim of treatment is to prevent progression of airflow obstruction. No universally accepted diagnostic criteria have been accepted for the diagnosis of post-HSCT BO, but the National Institutes of Health of the United States suggest the following criteria: (1) demonstrated airflow obstruction (FEV1/forced vital capacity [FVC]<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.7 and FEV1<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>75% predicted value); (2) evidence of air trapping on iCT and eCT, RV<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>120% predicted value, or histological confirmation of BO; and (3) absence of respiratory tract infection (clinically, radiologically, or microbiologically documented).<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> The most significant radiological finding of BO is the demonstration of air trapping on eCT (with respect to iCT), which has a sensitivity of 91% and 94% in some studies, respectively; these radiological changes can precede LFT changes.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2,3</span></a> We believe that dynamic CT (iCT and eCT) should be performed in all symptomatic HSCT patients for the early detection of BO, since this serious pulmonary complication cannot be detected on iCT alone.</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: Gorospe Sarasúa L, Barrios-Barreto D, García Gómez-Muriel I, Chinea-Rodríguez A. Bronquiolitis constrictiva tras trasplante de progenitores hematopoyéticos: importancia de la tomografía computarizada espiratoria. Arch Bronconeumol. 2017;53:349–351.</p>" ] ] "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" => 1228 "Ancho" => 1500 "Tamanyo" => 211381 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) minIP coronal reconstruction of the chest inspiratory CT showing homogeneous pulmonary parenchyma with uniform attenuation. (B) minIP coronal reconstruction of chest expiratory CT, showing a mosaic pattern of the pulmonary parenchyma, with areas of low density (asterisk), alternating with areas of greater attenuation. Low density areas (affecting particularly the right lower lobe and the left lung in a patchy pattern) correspond to areas of air trapping, while the areas of greater density correspond to normal pulmonary parenchyma. (C) minIP axial reconstruction of the chest inspiratory CT showing homogeneous pulmonary parenchyma. (D) minIP axial reconstruction of chest expiratory CT, showing areas of low density (asterisks), related with areas of air trapping.</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" => "Bronchiolitis obliterans following haematopoietic stem cell transplantation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.O. Soubani" 1 => "J.P. Uberti" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.00052806" "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "2007" "volumen" => "29" "paginaInicial" => "1007" "paginaFinal" => "1019" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17470622" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Late pulmonary complications after allogeneic hematopoietic stem cell transplantation: diagnosis, monitoring, prevention, and treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Bacigalupo" 1 => "J. Chien" 2 => "G. Barisione" 3 => "S. Pavletic" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/j.seminhematol.2011.10.005" "Revista" => array:6 [ "tituloSerie" => "Semin Hematol" "fecha" => "2012" "volumen" => "49" "paginaInicial" => "15" "paginaFinal" => "24" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22221781" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "High-resolution CT findings of bronchiolitis obliterans syndrome after hematopoietic stem cell transplantation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.L. Gunn" 1 => "J.D. Godwin" 2 => "J.P. Kanne" 3 => "M.E. Flower" 4 => "J.W. Chien" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/RTI.0b013e3181809df0" "Revista" => array:6 [ "tituloSerie" => "J Thorac Imaging" "fecha" => "2008" "volumen" => "23" "paginaInicial" => "244" "paginaFinal" => "250" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19204468" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "CT findings of late-onset noninfectious pulmonary complications in patients with pathologically proven graft-versus-host disease after allogeneic stem cell transplant" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "I. Song" 1 => "C.A. Yi" 2 => "J. Han" 3 => "D.H. Kim" 4 => "K.S. Lee" 5 => "T.S. Kim" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Am J Roentgenol" "fecha" => "2012" "volumen" => "199" "paginaInicial" => "581" "paginaFinal" => "587" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: VI. The 2014 Clinical Trial Design Working Group Report" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P.J. Martin" 1 => "S.J. Lee" 2 => "D. Przepiorka" 3 => "M.M. Horowitz" 4 => "J. Koreth" 5 => "G.B. Vogelsang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.bbmt.2015.05.004" "Revista" => array:6 [ "tituloSerie" => "Biol Blood Marrow Transplant" "fecha" => "2015" "volumen" => "21" "paginaInicial" => "1343" "paginaFinal" => "1359" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25985921" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005300000006/v2_201707150125/S1579212917301106/v2_201707150125/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/15792129/0000005300000006/v2_201707150125/S1579212917301106/v2_201707150125/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917301106?idApp=UINPBA00003Z" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 6 | 1 | 7 |
| 2024 October | 34 | 35 | 69 |
| 2024 September | 49 | 26 | 75 |
| 2024 August | 60 | 40 | 100 |
| 2024 July | 48 | 21 | 69 |
| 2024 June | 60 | 27 | 87 |
| 2024 May | 65 | 33 | 98 |
| 2024 April | 36 | 27 | 63 |
| 2024 March | 40 | 24 | 64 |
| 2024 February | 31 | 24 | 55 |
| 2024 January | 0 | 1 | 1 |
| 2023 March | 8 | 4 | 12 |
| 2023 February | 37 | 26 | 63 |
| 2023 January | 48 | 31 | 79 |
| 2022 December | 60 | 35 | 95 |
| 2022 November | 43 | 24 | 67 |
| 2022 October | 61 | 33 | 94 |
| 2022 September | 42 | 33 | 75 |
| 2022 August | 33 | 54 | 87 |
| 2022 July | 29 | 56 | 85 |
| 2022 June | 33 | 44 | 77 |
| 2022 May | 27 | 30 | 57 |
| 2022 April | 44 | 36 | 80 |
| 2022 March | 37 | 47 | 84 |
| 2022 February | 48 | 40 | 88 |
| 2022 January | 34 | 42 | 76 |
| 2021 December | 48 | 42 | 90 |
| 2021 November | 58 | 43 | 101 |
| 2021 October | 41 | 57 | 98 |
| 2021 September | 42 | 43 | 85 |
| 2021 August | 33 | 37 | 70 |
| 2021 July | 17 | 30 | 47 |
| 2021 June | 31 | 40 | 71 |
| 2021 May | 43 | 47 | 90 |
| 2021 April | 76 | 115 | 191 |
| 2021 March | 36 | 29 | 65 |
| 2021 February | 27 | 35 | 62 |
| 2021 January | 28 | 23 | 51 |
| 2020 December | 29 | 23 | 52 |
| 2020 November | 26 | 17 | 43 |
| 2020 October | 35 | 16 | 51 |
| 2020 September | 33 | 12 | 45 |
| 2020 August | 30 | 19 | 49 |
| 2020 July | 21 | 32 | 53 |
| 2020 June | 22 | 11 | 33 |
| 2020 May | 30 | 14 | 44 |
| 2020 April | 21 | 25 | 46 |
| 2020 March | 23 | 9 | 32 |
| 2020 February | 37 | 19 | 56 |
| 2020 January | 22 | 18 | 40 |
| 2019 December | 46 | 23 | 69 |
| 2019 November | 28 | 26 | 54 |
| 2019 October | 19 | 15 | 34 |
| 2019 September | 15 | 9 | 24 |
| 2019 August | 30 | 16 | 46 |
| 2019 July | 11 | 18 | 29 |
| 2019 June | 16 | 12 | 28 |
| 2019 May | 29 | 13 | 42 |
| 2019 April | 51 | 21 | 72 |
| 2019 March | 39 | 20 | 59 |
| 2019 February | 37 | 19 | 56 |
| 2019 January | 24 | 13 | 37 |
| 2018 December | 25 | 10 | 35 |
| 2018 November | 56 | 28 | 84 |
| 2018 October | 51 | 19 | 70 |
| 2018 September | 33 | 8 | 41 |
| 2018 May | 9 | 0 | 9 |
| 2018 April | 32 | 5 | 37 |
| 2018 March | 15 | 5 | 20 |
| 2018 February | 15 | 10 | 25 |
| 2018 January | 20 | 8 | 28 |
| 2017 December | 27 | 4 | 31 |
| 2017 November | 30 | 13 | 43 |
| 2017 October | 17 | 6 | 23 |
| 2017 September | 32 | 9 | 41 |
| 2017 April | 0 | 1 | 1 |
Show all
