Statistics

 array:24 [
  "pii" => "S0300289621003203"
  "issn" => "03002896"
  "doi" => "10.1016/j.arbres.2021.09.002"
  "estado" => "S300"
  "fechaPublicacion" => "2022-05-01"
  "aid" => "2914"
  "copyright" => "SEPAR"
  "copyrightAnyo" => "2021"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "sco"
  "cita" => "Arch Bronconeumol. 2022;58:435"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S0300289622002964"
    "issn" => "03002896"
    "doi" => "10.1016/j.arbres.2021.09.023"
    "estado" => "S300"
    "fechaPublicacion" => "2022-05-01"
    "aid" => "3066"
    "copyright" => "SEPAR"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "sco"
    "cita" => "Arch Bronconeumol. 2022;58:T435"
    "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" => " Visualization of the Pleural Space During a Flexible Bronchoscopy due to Bronchopleural Fistula"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:1 [
          "paginaInicial" => "T435"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Visualizaci&#243;n de cavidad pleural a trav&#233;s de broncoscopia flexible debido a gran f&#237;stula broncopleural"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Fig&#46; 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 522
              "Ancho" => 1300
              "Tamanyo" => 100030
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#41; Chest CT scan with cavitary lesion and pneumothorax associated with pleural drainage inside the pleural cavity &#40;note thickening of the visceral pleura&#41;&#46; &#40;B&#41; Endoscopic view of the Zephyr valve at the entrance to the right lower lobe&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Thais Beauperthuy Levy, Eduard Barrio Herraiz, Javier Fullana, Enrique Cases Viedma"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Thais Beauperthuy"
              "apellidos" => "Levy"
            ]
            1 => array:2 [
              "nombre" => "Eduard"
              "apellidos" => "Barrio Herraiz"
            ]
            2 => array:2 [
              "nombre" => "Javier"
              "apellidos" => "Fullana"
            ]
            3 => array:2 [
              "nombre" => "Enrique Cases"
              "apellidos" => "Viedma"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289622002964?idApp=UINPBA00003Z"
    "url" => "/03002896/0000005800000005/v2_202212170819/S0300289622002964/v2_202212170819/en/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S0300289622002952"
    "issn" => "03002896"
    "doi" => "10.1016/j.arbres.2021.08.027"
    "estado" => "S300"
    "fechaPublicacion" => "2022-05-01"
    "aid" => "3065"
    "copyright" => "SEPAR"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "sco"
    "cita" => "Arch Bronconeumol. 2022;58:T434"
    "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" => " The Spitting Stones&#58; A Case of Broncholithiasis"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:1 [
          "paginaInicial" => "T434"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "The spitting stones&#58; a prop&#243;sito de un caso de broncolitiasis"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Fig&#46; 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 871
              "Ancho" => 1000
              "Tamanyo" => 124877
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#41; Computed tomography with lung parenchymal window&#44; axial slice&#46; &#40;B&#41; Computed tomography with mediastinal window&#44; axial slice&#46; Cylindrical bronchiectasis predominantly in both lung bases&#44; containing multiple calcified hyperdense images consistent with broncholiths&#46; &#40;C&#41; A calcified&#44; rounded body with slightly irregular edges measuring 4<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>3<span class="elsevierStyleHsp" style=""></span>mm consistent with broncholith found in the bronchial aspiration tube&#46; &#40;D&#41; Same fresh specimen&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Anastasiya Torba, Violeta Esteban, Leyre Bouzas, Eusebi Chiner"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Anastasiya"
              "apellidos" => "Torba"
            ]
            1 => array:2 [
              "nombre" => "Violeta"
              "apellidos" => "Esteban"
            ]
            2 => array:2 [
              "nombre" => "Leyre"
              "apellidos" => "Bouzas"
            ]
            3 => array:2 [
              "nombre" => "Eusebi"
              "apellidos" => "Chiner"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289622002952?idApp=UINPBA00003Z"
    "url" => "/03002896/0000005800000005/v2_202212170819/S0300289622002952/v2_202212170819/en/main.assets"
  ]
  "asociados" => array:1 [
    0 => array:18 [
      "pii" => "S0300289622002964"
      "issn" => "03002896"
      "doi" => "10.1016/j.arbres.2021.09.023"
      "estado" => "S300"
      "fechaPublicacion" => "2022-05-01"
      "aid" => "3066"
      "copyright" => "SEPAR"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "sco"
      "cita" => "Arch Bronconeumol. 2022;58:T435"
      "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" => " Visualization of the Pleural Space During a Flexible Bronchoscopy due to Bronchopleural Fistula"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "paginas" => array:1 [
          0 => array:1 [
            "paginaInicial" => "T435"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "es" => array:1 [
            "titulo" => "Visualizaci&#243;n de cavidad pleural a trav&#233;s de broncoscopia flexible debido a gran f&#237;stula broncopleural"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Fig&#46; 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 522
                "Ancho" => 1300
                "Tamanyo" => 100030
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#41; Chest CT scan with cavitary lesion and pneumothorax associated with pleural drainage inside the pleural cavity &#40;note thickening of the visceral pleura&#41;&#46; &#40;B&#41; Endoscopic view of the Zephyr valve at the entrance to the right lower lobe&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Thais Beauperthuy Levy, Eduard Barrio Herraiz, Javier Fullana, Enrique Cases Viedma"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "Thais Beauperthuy"
                "apellidos" => "Levy"
              ]
              1 => array:2 [
                "nombre" => "Eduard"
                "apellidos" => "Barrio Herraiz"
              ]
              2 => array:2 [
                "nombre" => "Javier"
                "apellidos" => "Fullana"
              ]
              3 => array:2 [
                "nombre" => "Enrique Cases"
                "apellidos" => "Viedma"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289622002964?idApp=UINPBA00003Z"
      "url" => "/03002896/0000005800000005/v2_202212170819/S0300289622002964/v2_202212170819/en/main.assets"
    ]
  ]
  "es" => array:15 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Imagen Cl&#237;nica</span>"
    "titulo" => "Visualizaci&#243;n de cavidad pleural a trav&#233;s de broncoscopia flexible debido a gran f&#237;stula broncopleural"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:1 [
        "paginaInicial" => "435"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Thais Beauperthuy Levy, Eduard Barrio Herraiz, Javier Fullana, Enrique Cases Viedma"
        "autores" => array:4 [
          0 => array:4 [
            "nombre" => "Thais"
            "apellidos" => "Beauperthuy Levy"
            "email" => array:1 [
              0 => "thaiscarob@gmail.com"
            ]
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">1</span>"
                "identificador" => "fn0005"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Eduard"
            "apellidos" => "Barrio Herraiz"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">1</span>"
                "identificador" => "fn0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Javier"
            "apellidos" => "Fullana"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Enrique"
            "apellidos" => "Cases Viedma"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Servicio de Neumolog&#237;a&#44; Hospital Polit&#233;cnico y Universitario La Fe&#44; Valencia&#44; Espa&#241;a"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Neumolog&#237;a&#44; Hospital Universitario Arnau de Vilanova&#44; Valencia&#44; Espa&#241;a"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Autor para correspondencia&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "en" => array:1 [
        "titulo" => "Visualization of the Pleural Space During a Flexible Bronchoscopy due to Bronchopleural Fistula"
      ]
    ]
    "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" => 522
            "Ancho" => 1300
            "Tamanyo" => 100030
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A&#46; TC tor&#225;cica con neoplasia cavitada y neumot&#243;rax asociado con drenaje pleural en el interior de la cavidad pleural &#40;n&#243;tese el engrosamiento de la pleura visceral&#41;&#46; B&#46; Visi&#243;n endosc&#243;pica con la v&#225;lvula Zephyr en la entrada de l&#243;bulo inferior derecho&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Var&#243;n de 62 a&#241;os&#44; fumador &#40;&#237;ndice acumulado 45<span class="elsevierStyleHsp" style=""></span>a&#47;p&#41;&#44; EPOC y diagn&#243;stico reciente de carcinoma epidermoide de pulm&#243;n en el l&#243;bulo inferior derecho T4N2M0 &#40;estadio<span class="elsevierStyleHsp" style=""></span>IIIB&#41; en tratamiento con quimioterapia y radioterapia&#46; Ingresa por hidroneumot&#243;rax derecho y se coloca drenaje tor&#225;cico&#46; Mala evoluci&#243;n posterior&#44; desarrollando empiema por <span class="elsevierStyleItalic">Staphylococcus aureus</span> y fuga a&#233;rea persistente&#46; Se diagnostic&#243; como f&#237;stula broncopleural &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>A&#41; y se realiz&#243; tratamiento endosc&#243;pico mediante una v&#225;lvula endobronquial unidireccional tipo Zephyr en el l&#243;bulo inferior derecho&#46; A los 7<span class="elsevierStyleHsp" style=""></span>d&#237;as se reprodujo la fuga a&#233;rea&#44; por lo que se repiti&#243; la broncoscopia&#44; visualizando la v&#225;lvula en la entrada de la pir&#225;mide basal derecha desplazada en direcci&#243;n craneal&#44; siendo ineficaz &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>B&#41;&#44; motivo por el que se decidi&#243; extraer&#46; Distalmente a la v&#225;lvula se observ&#243; material fibrinoide y purulento que se retira y se accede a la cavidad pleural&#44; observando la pleura parietal y diafragm&#225;tica&#44; ambas engrosadas y de aspecto infiltrativo&#44; as&#237; como el drenaje tor&#225;cico normoposicionado &#40;<a class="elsevierStyleCrossRef" href="#sec0010">v&#237;deo</a>&#41;&#46; La f&#237;stula broncopleural tiene un pron&#243;stico ominoso &#40;mortalidad 0&#44;05-27&#37;&#41;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a>&#46; Los factores de riesgo m&#225;s importantes son la edad&#44; diabetes mellitus&#44; infecci&#243;n pulmonar necrosante&#44; EPOC&#44; toma de corticoides cr&#243;nicos o tratamiento quimiorradioter&#225;pico<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a>&#46; Aunque el tratamiento de elecci&#243;n es quir&#250;rgico&#44; pacientes no candidatos a cirug&#237;a estrictamente seleccionados pueden beneficiarse del tratamiento endosc&#243;pico&#46; En nuestro caso&#44; la situaci&#243;n de una infecci&#243;n aguda concomitante a la f&#237;stula genera controversia en la colocaci&#243;n de un dispositivo valvular endobronquial&#44; pero&#44; descartada la cirug&#237;a debido a las comorbilidades del paciente&#44; era la &#250;nica posibilidad terap&#233;utica disponible para&#44; una vez controlada la fuga a&#233;rea&#44; reiniciar el tratamiento quimiorradioter&#225;pico&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:3 [
        "etiqueta" => "1"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Ambos autores han contribuido por igual en la elaboraci&#243;n del art&#237;culo&#46;</p>"
        "identificador" => "fn0005"
      ]
    ]
    "apendice" => array:1 [
      0 => array:1 [
        "seccion" => array:1 [
          0 => array:4 [
            "apendice" => "<p id="par0015" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
            "etiqueta" => "Anexo A"
            "titulo" => "Material adicional"
            "identificador" => "sec0010"
          ]
        ]
      ]
    ]
    "multimedia" => array:2 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 522
            "Ancho" => 1300
            "Tamanyo" => 100030
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A&#46; TC tor&#225;cica con neoplasia cavitada y neumot&#243;rax asociado con drenaje pleural en el interior de la cavidad pleural &#40;n&#243;tese el engrosamiento de la pleura visceral&#41;&#46; B&#46; Visi&#243;n endosc&#243;pica con la v&#225;lvula Zephyr en la entrada de l&#243;bulo inferior derecho&#46;</p>"
        ]
      ]
      1 => array:5 [
        "identificador" => "upi0005"
        "tipo" => "MULTIMEDIAECOMPONENTE"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "Ecomponente" => array:3 [
          "fichero" => "mmc1.mp4"
          "ficheroTamanyo" => 20188601
          "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" => "Bibliograf&#237;a"
      "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" => "Bronchopleural fistula in the surgery of non-small cell lung cancer&#58; Incidence&#44; risk factors&#44; and management"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "H&#46; Sirbu"
                            1 => "T&#46; Busch"
                            2 => "I&#46; Aleksic"
                            3 => "W&#46; Schreiner"
                            4 => "O&#46; Oster"
                            5 => "H&#46; Dalichau"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Thorac Cardiovasc Surg&#46;"
                        "fecha" => "2001"
                        "volumen" => "7"
                        "paginaInicial" => "330"
                        "paginaFinal" => "336"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11888471"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Management of persistent air leaks"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "K&#46;C&#46; Dugan"
                            1 => "B&#46; Laxmanan"
                            2 => "S&#46; Murgu"
                            3 => "D&#46;K&#46; Hogarth"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.chest.2017.02.020"
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest&#46;"
                        "fecha" => "2017"
                        "volumen" => "152"
                        "paginaInicial" => "417"
                        "paginaFinal" => "423"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28267436"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "es"
  "url" => "/03002896/0000005800000005/v2_202212170819/S0300289621003203/v2_202212170819/es/main.assets"
  "Apartado" => array:4 [
    "identificador" => "93646"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Clinical Images&#47;Im&#225;genes cl&#237;nicas"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/03002896/0000005800000005/v2_202212170819/S0300289621003203/v2_202212170819/es/main.pdf?idApp=UINPBA00003Z&text.app=https://www.archbronconeumol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289621003203?idApp=UINPBA00003Z"
]