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C y D) TAC de tórax donde se objetiva que dicha imagen quística condiciona atelectasia de gran parte del parénquima pulmonar del hemitórax derecho y desplazamiento del mediastino hacia la izquierda.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ana I. Córdoba Alonso, Maite Arlabán Carpintero, José M. Olmos Martínez" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Ana I." "apellidos" => "Córdoba Alonso" ] 1 => array:2 [ "nombre" => "Maite" "apellidos" => "Arlabán Carpintero" ] 2 => array:2 [ "nombre" => "José M." 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(D–F) PET/CT after administration of 18F-FDG. Mass in right upper lobe with large areas of necrosis and cavitation (A) with increased peripheral glucose metabolism (D). Lesion in the apex of the right ventricle (B and E, arrow) suggestive of cardiac metastasis. Image of peripheral base nodule containing air space in the right lower lobe (C, arrow) suggestive of pulmonary infarction. This lesion was metabolic on the PET/CT (F, arrow), and a hypermetabolic arterial embolism was observed in the feeding artery of that segment (E, gray arrow) consistent with tumor embolism.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Daniel Corominas, Ivan Vollmer, Pilar Paredes" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Daniel" "apellidos" => "Corominas" ] 1 => array:2 [ "nombre" => "Ivan" "apellidos" => "Vollmer" ] 2 => array:2 [ "nombre" => "Pilar" "apellidos" => "Paredes" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289617300182" "doi" => "10.1016/j.arbres.2017.01.008" "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/S0300289617300182?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917301702?idApp=UINPBA00003Z" "url" => "/15792129/0000005300000007/v1_201706290145/S1579212917301702/v1_201706290145/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1579212917301799" "issn" => "15792129" "doi" => "10.1016/j.arbr.2017.05.008" "estado" => "S300" "fechaPublicacion" => "2017-07-01" "aid" => "1498" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Bronconeumol. 2017;53:387-94" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2030 "formatos" => array:3 [ "EPUB" => 156 "HTML" => 1401 "PDF" => 473 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">SEPAR's voice</span>" "titulo" => "Guidelines for the Treatment of Smoking in Hospitalized Patients" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "387" "paginaFinal" => "394" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Normativa sobre tratamiento del tabaquismo en pacientes hospitalizados" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1875 "Ancho" => 2500 "Tamanyo" => 270559 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Algorithm 3: therapeutic intervention in hospitalized smokers. 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Córdoba Alonso, Maite Arlabán Carpintero, José M. Olmos Martínez" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Ana I." "apellidos" => "Córdoba Alonso" "email" => array:1 [ 0 => "acordoba@humv.es" ] "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" => "Maite Arlabán" "apellidos" => "Carpintero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "José M." "apellidos" => "Olmos Martínez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital Universitario Marqués de Valdecilla-IDIVAL, Universidad de Cantabria, Santander, Cantabria, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Cantabria, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Bulla pulmonar gigante sobreinfectada" ] ] "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" => 1696 "Ancho" => 2085 "Tamanyo" => 214257 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A and B) Standard posteroanterior and lateral chest radiographs showing cystic lesion with calcified walls occupying practically all the right hemithorax containing an air-fluid level. (C and D) Chest computed tomography, showing that the cystic lesion was causing atelectasis of a large part of the pulmonary parenchyma of the right hemithorax and left mediastinal shift.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 40-year-old man with no significant personal history consulted due to dyspnea and fever. Clinical laboratory tests showed leukocytosis with left shift and elevated acute phase reactants. Chest radiograph (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A and B) and computed tomography (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C and D) showed a cystic image with calcified walls and air-fluid level, occupying practically the entire right hemithorax, causing parenchymal atelectasis, and contralateral mediastinal shift. Treatment began with empirical antibiotics, and in view of the lack of response, the collection was drained by thoracotomy, with subsequent clinical improvement.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">A giant pulmonary bulla is defined as an air space in the lung, occupying over 30% of the hemithorax. Some risk factors include smoking, chronic obstructive pulmonary disease, and alpha-1 antitrypsin deficiency. One of the complications is superinfection, and various isolates have been reported (methicillin-resistant Staphylococcus aureus, Bacteroides, Pseudomonas aeruginosa, etc.).<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> Bronchoscopy is not routinely indicated.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> However, it is important to rule out a malignant etiology, autoimmune disease, primarily granulomatosis with polyangiitis, sarcoidosis, Sjögren syndrome, and pulmonary embolism. Drainage of the contents helps resolution, due to the poor penetration of antibiotics into the cavity.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a></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: Córdoba Alonso AI, Carpintero MA, Olmos Martínez JM. Bulla pulmonar gigante sobreinfectada. Arch Bronconeumol. 2017;53:395.</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" => 1696 "Ancho" => 2085 "Tamanyo" => 214257 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A and B) Standard posteroanterior and lateral chest radiographs showing cystic lesion with calcified walls occupying practically all the right hemithorax containing an air-fluid level. (C and D) Chest computed tomography, showing that the cystic lesion was causing atelectasis of a large part of the pulmonary parenchyma of the right hemithorax and left mediastinal shift.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fluid-containing emphysematous bullae: a spectrum of illness" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "D. Chandra" 1 => "S.R. Rose" 2 => "R.B. Carter" 3 => "D.M. Musher" 4 => "R.J. Hamill" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.00158807" "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "2008" "volumen" => "32" "paginaInicial" => "303" "paginaFinal" => "306" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18669786" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Management of a giant fluid-filled bulla by closed-chest thoracostomy tube drainage" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "L.S. Kirschner" 1 => "W. Stauffer" 2 => "C. Krenzel" 3 => "P.G. Duane" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "1997" "volumen" => "111" "paginaInicial" => "1772" "paginaFinal" => "1774" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9187211" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005300000007/v1_201706290145/S1579212917301696/v1_201706290145/en/main.assets" "Apartado" => array:4 [ "identificador" => "21342" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Clinical Image" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005300000007/v1_201706290145/S1579212917301696/v1_201706290145/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917301696?idApp=UINPBA00003Z" ]
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