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array:23 [ "pii" => "S0300289624001716" "issn" => "03002896" "doi" => "10.1016/j.arbres.2024.05.010" "estado" => "S300" "fechaPublicacion" => "2024-10-01" "aid" => "3568" "copyright" => "SEPAR" "copyrightAnyo" => "2024" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2024;60:668-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:18 [ "pii" => "S0300289624002771" "issn" => "03002896" "doi" => "10.1016/j.arbres.2024.07.015" "estado" => "S300" "fechaPublicacion" => "2024-10-01" "aid" => "3631" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2024;60:670-1" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "A Giant Malignant Solitary Fibrous Tumor of the Pleura" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "670" "paginaFinal" => "671" ] ] "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" => 1178 "Ancho" => 1475 "Tamanyo" => 312021 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(a and b) A chest CT showed a 12<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>16<span class="elsevierStyleHsp" style=""></span>cm mass with compression of mediastinum. (c) Specimen after a left intrapericardial pneumonectomy with an en bloc resection of the 4–7th left ribs and a segment of diaphragm (L – lung, R – ribs, D – diaphram). (d) Closure of the wall defect using a 20<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>15<span class="elsevierStyleHsp" style=""></span>cm composite polyester mesh with collagen film (SYMBOTEX™).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Julio Ricardo Torres Bermúdez, Oriana Andreina Fernández González, Sebastian Sevilla López" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Julio Ricardo" "apellidos" => "Torres Bermúdez" ] 1 => array:2 [ "nombre" => "Oriana Andreina" "apellidos" => "Fernández González" ] 2 => array:2 [ "nombre" => "Sebastian" "apellidos" => "Sevilla López" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289624002771?idApp=UINPBA00003Z" "url" => "/03002896/0000006000000010/v1_202410020659/S0300289624002771/v1_202410020659/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0300289624001753" "issn" => "03002896" "doi" => "10.1016/j.arbres.2024.05.014" "estado" => "S300" "fechaPublicacion" => "2024-10-01" "aid" => "3572" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2024;60:666-7" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "Endobronchial Hamartoma Resected by Flexible Bronchoscopy: A Complex Approach" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "666" "paginaFinal" => "667" ] ] "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" => 1395 "Ancho" => 2000 "Tamanyo" => 359268 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A and B) Initial chest computed tomography revealing a lesion (red arrow) at the left main bronchial bifurcation; (C) air entrapment observed in the left lung during expiratory phase in chest computed tomography; (D) endoscopic view of the left main bronchus; (E) bronchial repermeabilization process using cryoablation and argon-plasma coagulation by flexible bronchoscopy; (F) endoscopic view of the left main bronchus after endoscopic resection; (G) endoscopic view inside left b6 segment showing a small remaining lesion (yellow arrow) at a b6 subdivision; (H) chest computed tomography follow-up, 1 month after endoscopic resection, identifying a residual endobronchial lesion (red arrow) at the left b6 segment; (I) endoscopic view of left b6 segment showing a growing lesion (yellow arrow), 2 months after endoscopic resection; (J) endoscopic view inside left b6 segment after the second endoscopic treatment; (K) endoscopic view of left b6 segment, 3 months after the first resection.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Joana Lourenço, Luís Rodrigues, Paulo Matos, Michele Santis, Amélia Estevão, Lourdes Barradas" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Joana" "apellidos" => "Lourenço" ] 1 => array:2 [ "nombre" => "Luís" "apellidos" => "Rodrigues" ] 2 => array:2 [ "nombre" => "Paulo" "apellidos" => "Matos" ] 3 => array:2 [ "nombre" => "Michele" "apellidos" => "Santis" ] 4 => array:2 [ "nombre" => "Amélia" "apellidos" => "Estevão" ] 5 => array:2 [ "nombre" => "Lourdes" "apellidos" => "Barradas" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289624001753?idApp=UINPBA00003Z" "url" => "/03002896/0000006000000010/v1_202410020659/S0300289624001753/v1_202410020659/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "The Effect of Bronchoscopic Lung Volume Reduction on Hemidiaphragm Excursion" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "668" "paginaFinal" => "669" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Sze Shyang Kho, Shan Khai Ing, Siew Teck Tie" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Sze Shyang" "apellidos" => "Kho" "email" => array:1 [ 0 => "khosze@moh.gov.my" ] "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" => "Shan Khai" "apellidos" => "Ing" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Siew Teck" "apellidos" => "Tie" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Division of Respiratory Medicine, Department of Medicine, Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Sarawak, Malaysia" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Respiratory Medicine Unit, Department of Internal Medicine, Sibu Hospital, Ministry of Health Malaysia, Sibu, Sarawak, Malaysia" "etiqueta" => "b" "identificador" => "aff0010" ] ] "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" => 1509 "Ancho" => 2255 "Tamanyo" => 336114 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">High-resolution CT thorax showing upper lobe predominant heterogeneous emphysema with centrilobular distribution in the right lung (<span class="elsevierStyleItalic">Panel A</span>) and complete fissure integrity (<span class="elsevierStyleItalic">Panel B</span>). Absence of collateral ventilation confirmed by occlusion of the right upper lobe ostium with the Chartis® balloon (<span class="elsevierStyleItalic">Panel C</span>). Deployment of three endobronchial valves in the anterior, posterior, and apical segments of the right upper lobe (<span class="elsevierStyleItalic">Panel D</span>).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Case</span><p id="par0005" class="elsevierStylePara elsevierViewall">A 56-year-old hypertensive gentleman with a 40 pack-year history of smoking was diagnosed with chronic obstructive pulmonary disease (COPD) characterized by GOLD-E and Grade 4 obstruction. Despite pulmonary rehabilitation and optimized inhaler therapy (<span class="elsevierStyleItalic">glycopyrronium/indacaterol/beclomethasone</span>), he remained symptomatic and primarily wheelchair-bound with modified medical research council (mMRC) scale of three and he could only walk for 80 meters on six-minute walking test (6MWT). He had three non-infective exacerbations requiring admission in the last twelve months. His forced expiratory volume in the first second (FEV<span class="elsevierStyleInf">1</span>) was 0.82<span class="elsevierStyleHsp" style=""></span>l (26% predicted) and forced vital capacity was 2.78<span class="elsevierStyleHsp" style=""></span>l (70% predicted), with an FEV<span class="elsevierStyleInf">1</span>/FVC ratio of 0.29. Plethysmography indicated severe air trapping [residual volume (RV) 192% predicted, total lung capacity (TLC) 100% predicted, RV/TLC ratio 0.55], and diffusing capacity for carbon monoxide (DLCO) of 43% predicted. Transthoracic echocardiography showed no pulmonary hypertension. Arterial blood gas analysis revealed hypoxemia (<span class="elsevierStyleItalic">p</span>O<span class="elsevierStyleInf">2</span> 72<span class="elsevierStyleHsp" style=""></span>mmHg) without hypercapnia (<span class="elsevierStyleItalic">p</span>CO<span class="elsevierStyleInf">2</span> 32<span class="elsevierStyleHsp" style=""></span>mmHg).</p><p id="par0010" class="elsevierStylePara elsevierViewall">Quantitative CT (QCT) thorax confirmed upper lobe-predominant, heterogeneous emphysema with an intact fissure (<span class="elsevierStyleItalic">98% completeness over right oblique fissure and 100% completeness over right horizontal fissure</span>) over the right lung (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, <span class="elsevierStyleItalic">Panel A & B</span>). Pre-procedure, right-hemi diaphragmatic excursion measured 3.35<span class="elsevierStyleHsp" style=""></span>cm with a sniff maneuver in 45° semi-recumbent position (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, <span class="elsevierStyleItalic">Panel E</span>). Under total intravenous anesthesia, three endobronchial valves were placed in the segmental bronchi of the right upper lobe after confirming no collateral ventilation (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, <span class="elsevierStyleItalic">Panels C & D</span>). Post-procedure, pneumothorax occurred within 24<span class="elsevierStyleHsp" style=""></span>h, necessitating an intercostal chest drain for 10 days. Patient was discharged uneventfully.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Two weeks post-procedure, right hemi-diaphragmatic excursion increased to 4.50<span class="elsevierStyleHsp" style=""></span>cm (+34%) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, <span class="elsevierStyleItalic">Panel F</span>; <a class="elsevierStyleCrossRef" href="#sec0025">Video 1</a>). A follow-up chest radiograph at one month showed complete collapse of the right upper lobe, accompanied by improvements in FVC (+1.05<span class="elsevierStyleHsp" style=""></span>l), FEV<span class="elsevierStyleInf">1</span> (+0.50<span class="elsevierStyleHsp" style=""></span>l), RV (−2.12<span class="elsevierStyleHsp" style=""></span>l), and a significant increase in 6MWT distance (+280<span class="elsevierStyleHsp" style=""></span>m). Clinically, the patient's mMRC scale improved to one, and he could engage in moderate physical activity.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Lung hyperinflation in severe COPD often leads to impaired respiratory muscle function, particularly the diaphragm, which will translate to significant functional limitation as diaphragm is the most important primary respiratory muscle.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> Bronchoscopic lung volume reduction (BLVR) using endobronchial valves is a minimally invasive procedure which is non inferior to lung volume reduction surgery.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a> While BLVR's impact on quality of life, lung function, and exercise capacity has been extensively studied, its effect on diaphragmatic motility remains less explored. However, assessment of diaphragm function via ultrasound can be operator-dependent with high variability, our case suggests that BLVR can potentially improve diaphragm mechanics. Therefore, further research to evaluate the utility of bedside ultrasound in assessing BLVR outcomes during both short and long-term follow-ups, especially its effect on diaphragmatic function, may be warranted.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Funding</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that no funding was received for the publication of this case.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Authors’ contribution</span><p id="par0030" class="elsevierStylePara elsevierViewall">SSK initiated the idea for manuscript submission and prepared the final copy of the manuscript. SSK, SKI acquired the clinical data. SSK performed the transthoracic ultrasound. SSK, SKI, STT were involved in the care of the patient. All authors have read and approved the final manuscript.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Conflicts of interest</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interests to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:5 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Case" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Funding" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Authors’ contribution" ] 3 => array:2 [ "identificador" => "sec0020" "titulo" => "Conflicts of interest" ] 4 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0045" class="elsevierStylePara elsevierViewall">The followings are the supplementary data to this article:<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>" "etiqueta" => "Appendix A" "titulo" => "Supplementary data" "identificador" => "sec0030" ] ] ] ] "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" => 1509 "Ancho" => 2255 "Tamanyo" => 336114 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">High-resolution CT thorax showing upper lobe predominant heterogeneous emphysema with centrilobular distribution in the right lung (<span class="elsevierStyleItalic">Panel A</span>) and complete fissure integrity (<span class="elsevierStyleItalic">Panel B</span>). Absence of collateral ventilation confirmed by occlusion of the right upper lobe ostium with the Chartis® balloon (<span class="elsevierStyleItalic">Panel C</span>). Deployment of three endobronchial valves in the anterior, posterior, and apical segments of the right upper lobe (<span class="elsevierStyleItalic">Panel D</span>).</p>" ] ] 1 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc1.mp4" "ficheroTamanyo" => 803978 "Video" => array:2 [ "flv" => array:5 [ "fichero" => "mmc1.flv" "poster" => "mmc1.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] "mp4" => array:5 [ "fichero" => "mmc1.m4v" "poster" => "mmc1.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] ] ] ] ] "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" => "Lung volume reduction for emphysema" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "P.L. Shah" 1 => "F.J. Herth" 2 => "W.H. van Geffen" 3 => "G. Deslee" 4 => "D.J. Slebos" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S2213-2600(16)30221-1" "Revista" => array:7 [ "tituloSerie" => "Lancet Respir Med" "fecha" => "2017" "volumen" => "5" "numero" => "2" "paginaInicial" => "147" "paginaFinal" => "156" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27693408" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lung volume reduction surgery <span class="elsevierStyleItalic">versus</span> endobronchial valves: a randomised controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.C. Buttery" 1 => "W. Banya" 2 => "R. Bilancia" 3 => "E. Boyd" 4 => "J. Buckley" 5 => "N.J. Greening" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Eur Respir J" "fecha" => "2023" "volumen" => "61" "numero" => "4" "paginaInicial" => "2202063" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/03002896/0000006000000010/v1_202410020659/S0300289624001716/v1_202410020659/en/main.assets" "Apartado" => array:4 [ "identificador" => "98298" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Cllinical Images" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000006000000010/v1_202410020659/S0300289624001716/v1_202410020659/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289624001716?idApp=UINPBA00003Z" ]
