Caso Clínico/Clinical Case
Pneumonia por Pneumocystis e citomegalovírus no doente VIH – A propósito de dois casos clínicos
Pneumocystis and cytomegalovirus pneumonia in HIV patients – Two clinical cases
Sofia Lourenço1,
, Marta Amaral1, Raquel Almeida1, Paulo Marcelino2, Susan Marum2, M.ª Adelaide Milheiro3, Judite Oliveira4, Luís Mourão5
Corresponding author
sofilourenco@hotmail.com
Correspondência: Sofia Lourenço, Hospital de Curry Cabral, Unidade de Cuidados Intensivos, Rua da Beneficência, 8, 1069-166 Lisboa.
Correspondência: Sofia Lourenço, Hospital de Curry Cabral, Unidade de Cuidados Intensivos, Rua da Beneficência, 8, 1069-166 Lisboa.
1 Interna do Internato Complementar de Medicina Interna, Hospital de Curry Cabral, Unidade de Cuidados Intensivos
2 Assistente Hospitalar de Medicina Interna, subespecialista em Medicina Intensiva, Hospital de Curry Cabral, Unidade de Cuidados Intensivos
3 Assistente Hospitalar Graduado de Anatomia Patológica, Hospital de Curry Cabral, Unidade de Cuidados Intensivos
4 Assistente Hospitalar Graduado de Medicina Interna, Hospital de Curry Cabral, Unidade de Cuidados Intensivos
5 Assistente Hospitalar Graduado de Medicina Interna, Director de Serviço, Hospital de Curry Cabral, Unidade de Cuidados Intensivos
Read
7602
Timeswas read the article
3050
Total PDF
4552
Total HTML
Share statistics
array:24 [ "pii" => "S0873215915302245" "issn" => "08732159" "doi" => "10.1016/S0873-2159(15)30224-5" "estado" => "S350" "fechaPublicacion" => "2008-01-01" "aid" => "4" "copyright" => "Sociedade Portuguesa de Pneumologia/SPP" "copyrightAnyo" => "2008" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Rev Port Pneumol. 2008;14:151-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3641 "formatos" => array:3 [ "EPUB" => 228 "HTML" => 2023 "PDF" => 1390 ] ] "itemSiguiente" => array:19 [ "pii" => "S0873215915302257" "issn" => "08732159" "doi" => "10.1016/S0873-2159(15)30225-7" "estado" => "S350" "fechaPublicacion" => "2008-01-01" "aid" => "5" "copyright" => "Sociedade Portuguesa de Pneumologia/SPP" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Rev Port Pneumol. 2008;14:159-64" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2763 "formatos" => array:3 [ "EPUB" => 238 "HTML" => 1782 "PDF" => 743 ] ] "pt" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Caso Clínico/Clinical Case</span>" "titulo" => "Aspectos respiratórios da doença de Pompe: Relato de caso" "tienePdf" => "pt" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "pt" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "159" "paginaFinal" => "164" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Respiratory aspects of Pompe disease: Case report" ] ] "contieneResumen" => array:2 [ "pt" => true "en" => true ] "contienePdf" => array:1 [ "pt" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ewandro L.R. Moura, Thiago A. Jabuonski, Veronica M. Amado" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Ewandro L.R." "apellidos" => "Moura" ] 1 => array:2 [ "nombre" => "Thiago A." "apellidos" => "Jabuonski" ] 2 => array:2 [ "nombre" => "Veronica M." "apellidos" => "Amado" ] ] ] ] ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215915302257?idApp=UINPBA00004E" "url" => "/08732159/0000001400000001/v1_201509151510/S0873215915302257/v1_201509151510/pt/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0873215915302270" "issn" => "08732159" "doi" => "10.1016/S0873-2159(15)30227-0" "estado" => "S350" "fechaPublicacion" => "2008-01-01" "aid" => "7" "copyright" => "Sociedade Portuguesa de Pneumologia/SPP" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "pub" "cita" => "Rev Port Pneumol. 2008;14:167-70" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1711 "formatos" => array:3 [ "EPUB" => 217 "HTML" => 910 "PDF" => 584 ] ] "pt" => array:8 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Normas de Publicação/Instructions for Authors</span>" "titulo" => "Normas de publicação na Revista Portuguesa de Pneumologia" "tienePdf" => "pt" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "167" "paginaFinal" => "170" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Portuguese Journal of Pulmonology Instructions for authors" ] ] "contienePdf" => array:1 [ "pt" => true ] ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215915302270?idApp=UINPBA00004E" "url" => "/08732159/0000001400000001/v1_201509151510/S0873215915302270/v1_201509151510/pt/main.assets" ] "pt" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Caso Clínico/Clinical Case</span>" "titulo" => "Pneumonia por Pneumocystis e citomegalovírus no doente VIH – A propósito de dois casos clínicos" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "151" "paginaFinal" => "157" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Sofia Lourenço, Marta Amaral, Raquel Almeida, Paulo Marcelino, Susan Marum, M.ª Adelaide Milheiro, Judite Oliveira, Luís Mourão" "autores" => array:8 [ 0 => array:4 [ "nombre" => "Sofia" "apellidos" => "Lourenço" "email" => array:1 [ 0 => "sofilourenco@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "af0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cr0005" ] ] ] 1 => array:3 [ "nombre" => "Marta" "apellidos" => "Amaral" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "af0005" ] ] ] 2 => array:3 [ "nombre" => "Raquel" "apellidos" => "Almeida" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "af0005" ] ] ] 3 => array:3 [ "nombre" => "Paulo" "apellidos" => "Marcelino" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">2</span>" "identificador" => "af0010" ] ] ] 4 => array:3 [ "nombre" => "Susan" "apellidos" => "Marum" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">2</span>" "identificador" => "af0010" ] ] ] 5 => array:3 [ "nombre" => "M.ª" "apellidos" => "Adelaide Milheiro" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">3</span>" "identificador" => "af0015" ] ] ] 6 => array:3 [ "nombre" => "Judite" "apellidos" => "Oliveira" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">4</span>" "identificador" => "af0020" ] ] ] 7 => array:3 [ "nombre" => "Luís" "apellidos" => "Mourão" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">5</span>" "identificador" => "af0025" ] ] ] ] "afiliaciones" => array:5 [ 0 => array:3 [ "entidad" => "Interna do Internato Complementar de Medicina Interna, Hospital de Curry Cabral, Unidade de Cuidados Intensivos" "etiqueta" => "1" "identificador" => "af0005" ] 1 => array:3 [ "entidad" => "Assistente Hospitalar de Medicina Interna, subespecialista em Medicina Intensiva, Hospital de Curry Cabral, Unidade de Cuidados Intensivos" "etiqueta" => "2" "identificador" => "af0010" ] 2 => array:3 [ "entidad" => "Assistente Hospitalar Graduado de Anatomia Patológica, Hospital de Curry Cabral, Unidade de Cuidados Intensivos" "etiqueta" => "3" "identificador" => "af0015" ] 3 => array:3 [ "entidad" => "Assistente Hospitalar Graduado de Medicina Interna, Hospital de Curry Cabral, Unidade de Cuidados Intensivos" "etiqueta" => "4" "identificador" => "af0020" ] 4 => array:3 [ "entidad" => "Assistente Hospitalar Graduado de Medicina Interna, Director de Serviço, Hospital de Curry Cabral, Unidade de Cuidados Intensivos" "etiqueta" => "5" "identificador" => "af0025" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cr0005" "etiqueta" => "*" "correspondencia" => "<span class="elsevierStyleBold">Correspondência:</span> Sofia Lourenço, Hospital de Curry Cabral, Unidade de Cuidados Intensivos, Rua da Beneficência, 8, 1069-166 Lisboa." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Pneumocystis and cytomegalovirus pneumonia in HIV patients – Two clinical cases" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2007-06-28" "fechaAceptado" => "2007-09-12" "PalabrasClave" => array:2 [ "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras chave" "identificador" => "xpalclavsec570309" "palabras" => array:3 [ 0 => "Citomegalovírus" 1 => "pneumonia" 2 => "VIH" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec570308" "palabras" => array:3 [ 0 => "Cytomegalovirus" 1 => "pneumonia" 2 => "HIV" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<span id="as0005" class="elsevierStyleSection elsevierViewall"><p id="sp0005" class="elsevierStyleSimplePara elsevierViewall">Nos doentes com infecção pelo vírus da imunodeficiência humana (VIH) o citomegalovírus torna-se um agente de doença importante quando existe imunossupressão avançada. O seu papel como agente de doença pulmonar neste contexto tem sido amplamente debatido. Nos doentes com pneumocistose, a presença do citomegalovírus no pulmão não parece conferir pior prognóstico, excepto nos que recebem terapêutica adjuvante com corticóides.</p><p id="sp0010" class="elsevierStyleSimplePara elsevierViewall">Os autores apresentam dois casos de doentes com infecção VIH e imunossupressão avançada, admitidos na unidade de cuidados intensivos por insuficiência respiratória. Em ambos houve isolamento de <span class="elsevierStyleItalic">Pneumocystis jirovecii</span> no lavado broncoalveolar. Apesar da terapêutica instituída ambos vieram a falecer. A biópsia pulmonar <span class="elsevierStyleItalic">post mortem</span> mostrou, nos dois casos, a presença de <span class="elsevierStyleItalic">Pneumocystis</span> e inclusões por citomegalovírus. Perante este achado tecem-se algumas considerações sobre o papel do citomegalovírus como agente de pneumonia na SIDA e sobre o seu significado como co-infectante na pneumocistose, sobretudo nos casos de falência terapêutica.</p><p id="sp0015" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2008; XIV (1): 151-157</span></p></span>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="as0010" class="elsevierStyleSection elsevierViewall"><p id="sp0020" class="elsevierStyleSimplePara elsevierViewall">Cytomegalovirus is capable of causing disease in immunocompromised patients. In people infected by the Human Immunodeficiency Virus (HIV) it becomes an important agent when there is advanced immunosupression. Its role as a pulmonary pathogen in these patients has been questioned. In the case of pneumocystosis the presence of Cytomegalovirus doesn’t seem to worsen prognosis, except in cases where corticosteroids are used.</p><p id="sp0025" class="elsevierStyleSimplePara elsevierViewall">Authors present two cases of patients with HIV infection and advanced immunosupression who were admitted in the intensive care unit for respiratory failure. In both <span class="elsevierStyleItalic">Pneumocystis jirovecii</span> was isolated from bronco-alveolar lavage. Despite of therapy both patients died from refractory hypoxemia. Pulmonary biopsies performed post mortem revealed presence of Pneumocystis and Cytomegalovirus inclusion bodies. Considering this finding the role of Cytomegalovirus as a cause of pneumonia in AIDS is discussed, highlighting its impact on the outcome of patients with pneumocystosis, especially in cases of therapeutic failure.</p><p id="sp0030" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2008; XIV (1): 151-157</span></p></span>" ] ] "lecturaRecomendada" => array:1 [ 0 => array:3 [ "vista" => "all" "titulo" => "<span class="elsevierStyleSectionTitle" id="st0025">Bibliografia</span>" "seccion" => array:1 [ 0 => array:2 [ "vista" => "all" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bb0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "HIV disease: AIDS related disorders" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.S. Fauci" 1 => "H.C. Lane" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:5 [ "titulo" => "Harrison’s Principals of Internal Medicine" "paginaInicial" => "1076" "paginaFinal" => "1139" "edicion" => "16th edition" "serieFecha" => "2005" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bb0010" "etiqueta" => "2." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary Cytomegalovirus infection in immunocompromised patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "M. Tamm" 1 => "P. Traenkle" 2 => "B. Grilli" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Chest" "fecha" => "2001" "volumen" => "119" "paginaInicial" => "838" "paginaFinal" => "843" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11243966" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S019096221000318X" "estado" => "S300" "issn" => "01909622" ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bb0015" "etiqueta" => "3." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mills J" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M.A. Jacobson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Cytomegalovirus infection Clin Chest Med" "fecha" => "1988" "volumen" => "9" "numero" => "3" "paginaInicial" => "443" "paginaFinal" => "448" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2842110" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bb0020" "etiqueta" => "4." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prognostic markers of short-term mortality in AIDS-associated Pneumocystis carinii pneumonia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "T. Benfield" 1 => "J. Helweg-Larsen" 2 => "D. Bang" 3 => "J. Junge" 4 => "J. Lundgren" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "2001" "volumen" => "119" "paginaInicial" => "844" "paginaFinal" => "851" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11243967" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bb0025" "etiqueta" => "5." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary cytomegalovirus as a primary pulmonary pathogen in AIDS" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A.B. Waxman" 1 => "S.J. Goldie" 2 => "H. Brett-Smith" 3 => "R.A. Matthay" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "1997" "volumen" => "111" "paginaInicial" => "128" "paginaFinal" => "134" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8996006" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bb0030" "etiqueta" => "6." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary manifestations of HIV/AIDS" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "L. Huang" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:5 [ "titulo" => "Cecil Textbook of Medicine" "paginaInicial" => "2158" "paginaFinal" => "2168" "edicion" => "22nd edition" "serieFecha" => "2004" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bb0035" "etiqueta" => "7." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical features and outcomes of HIV-related cytomegalovirus pneumonia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "N. Salomon" 1 => "T. Gomez" 2 => "D.C. Perlman" 3 => "L. Laya" 4 => "C. Eber" 5 => "D. Mildvan" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "AIDS" "fecha" => "1997" "volumen" => "11" "numero" => "3" "paginaInicial" => "319" "paginaFinal" => "324" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9147423" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bb0040" "etiqueta" => "8." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Differences and similarities of cytomegalovirus and pneumocystis pneumonia in HIV-negative immunocompromised patientsthin section CT-morphology in the early phase of the disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.N. Vogel" 1 => "H. Brodoefel" 2 => "T. Hierl" 3 => "M.N. Vogel" 4 => "H. Brodoefel" 5 => "T. Hierl" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1259/0007-1285-64-767-1015" "Revista" => array:3 [ "tituloSerie" => "Br J Radiol" "fecha" => "2006" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1742581" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bb0045" "etiqueta" => "9." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cytomegalovirus disease in the era of highly active antiretroviral therapy (HAART)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C. Steininger" 1 => "E. Puchhammer-Stockl" 2 => "T. Popow-Kraupp" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jcv.2006.03.005" "Revista" => array:7 [ "tituloSerie" => "J Clin Virol" "fecha" => "2006" "volumen" => "37" "numero" => "1" "paginaInicial" => "1" "paginaFinal" => "9" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16675299" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bb0050" "etiqueta" => "10." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pneumocystis Workshop Participants. An Official ATS Workshop Summary: Recent Advances and Future Directions in Pneumocystis Pneumonia (PCP)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "L. Huang" 1 => "A. Morris" 2 => "A.H. Limper" 3 => "J.M.A.T.S. Beck" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1513/pats.200602-015MS" "Revista" => array:7 [ "tituloSerie" => "Proc Am Thorac Soc" "fecha" => "2006" "volumen" => "3" "numero" => "8" "paginaInicial" => "655" "paginaFinal" => "664" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17065370" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "pt" "url" => "/08732159/0000001400000001/v1_201509151510/S0873215915302245/v1_201509151510/pt/main.assets" "Apartado" => array:4 [ "identificador" => "43360" "tipo" => "SECCION" "pt" => array:2 [ "titulo" => "Casos Clínicos/Cases Reports" "idiomaDefecto" => true ] "idiomaDefecto" => "pt" ] "PDF" => "https://static.elsevier.es/multimedia/08732159/0000001400000001/v1_201509151510/S0873215915302245/v1_201509151510/pt/main.pdf?idApp=UINPBA00004E&text.app=https://journalpulmonology.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215915302245?idApp=UINPBA00004E" ]
Article information
ISSN: 08732159Original language: Portuguese
The statistics are updated each day
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 7 | 6 | 13 |
| 2024 October | 57 | 46 | 103 |
| 2024 September | 53 | 47 | 100 |
| 2024 August | 56 | 55 | 111 |
| 2024 July | 51 | 52 | 103 |
| 2024 June | 53 | 35 | 88 |
| 2024 May | 62 | 39 | 101 |
| 2024 April | 68 | 28 | 96 |
| 2024 March | 48 | 36 | 84 |
| 2024 February | 51 | 25 | 76 |
| 2024 January | 38 | 30 | 68 |
| 2023 December | 40 | 38 | 78 |
| 2023 November | 34 | 31 | 65 |
| 2023 October | 40 | 40 | 80 |
| 2023 September | 40 | 35 | 75 |
| 2023 August | 39 | 24 | 63 |
| 2023 July | 64 | 33 | 97 |
| 2023 June | 51 | 13 | 64 |
| 2023 May | 60 | 23 | 83 |
| 2023 April | 42 | 29 | 71 |
| 2023 March | 80 | 24 | 104 |
| 2023 February | 36 | 27 | 63 |
| 2023 January | 28 | 23 | 51 |
| 2022 December | 37 | 20 | 57 |
| 2022 November | 41 | 45 | 86 |
| 2022 October | 38 | 37 | 75 |
| 2022 September | 34 | 30 | 64 |
| 2022 August | 39 | 54 | 93 |
| 2022 July | 30 | 36 | 66 |
| 2022 June | 21 | 32 | 53 |
| 2022 May | 33 | 35 | 68 |
| 2022 April | 33 | 28 | 61 |
| 2022 March | 23 | 32 | 55 |
| 2022 February | 28 | 20 | 48 |
| 2022 January | 41 | 44 | 85 |
| 2021 December | 23 | 32 | 55 |
| 2021 November | 38 | 33 | 71 |
| 2021 October | 33 | 35 | 68 |
| 2021 September | 20 | 23 | 43 |
| 2021 August | 40 | 21 | 61 |
| 2021 July | 26 | 27 | 53 |
| 2021 June | 36 | 16 | 52 |
| 2021 May | 35 | 24 | 59 |
| 2021 April | 52 | 34 | 86 |
| 2021 March | 52 | 23 | 75 |
| 2021 February | 52 | 20 | 72 |
| 2021 January | 47 | 9 | 56 |
| 2020 December | 39 | 8 | 47 |
| 2020 November | 55 | 20 | 75 |
| 2020 October | 32 | 15 | 47 |
| 2020 September | 50 | 25 | 75 |
| 2020 August | 54 | 27 | 81 |
| 2020 July | 75 | 27 | 102 |
| 2020 June | 49 | 24 | 73 |
| 2020 May | 82 | 23 | 105 |
| 2020 April | 67 | 12 | 79 |
| 2020 March | 47 | 23 | 70 |
| 2020 February | 85 | 25 | 110 |
| 2020 January | 67 | 27 | 94 |
| 2019 December | 61 | 21 | 82 |
| 2019 November | 67 | 31 | 98 |
| 2019 October | 55 | 33 | 88 |
| 2019 September | 49 | 46 | 95 |
| 2019 August | 91 | 67 | 158 |
| 2019 July | 69 | 44 | 113 |
| 2019 June | 78 | 49 | 127 |
| 2019 May | 66 | 72 | 138 |
| 2019 April | 61 | 75 | 136 |
| 2019 March | 65 | 47 | 112 |
| 2019 February | 99 | 52 | 151 |
| 2019 January | 75 | 44 | 119 |
| 2018 December | 33 | 14 | 47 |
| 2018 November | 6 | 4 | 10 |
| 2018 October | 35 | 4 | 39 |
| 2018 September | 30 | 15 | 45 |
| 2018 August | 49 | 51 | 100 |
| 2018 July | 49 | 62 | 111 |
| 2018 June | 52 | 78 | 130 |
| 2018 May | 86 | 102 | 188 |
| 2018 April | 81 | 67 | 148 |
| 2018 March | 79 | 65 | 144 |
| 2018 February | 38 | 19 | 57 |
| 2018 January | 60 | 20 | 80 |
| 2017 December | 80 | 26 | 106 |
| 2017 November | 35 | 25 | 60 |
| 2017 October | 39 | 20 | 59 |
| 2017 September | 32 | 16 | 48 |
| 2017 August | 33 | 16 | 49 |
| 2017 July | 23 | 10 | 33 |
| 2017 June | 19 | 15 | 34 |
| 2017 May | 57 | 13 | 70 |
| 2017 April | 16 | 5 | 21 |
| 2017 March | 19 | 20 | 39 |
| 2017 February | 16 | 6 | 22 |
| 2017 January | 13 | 6 | 19 |
| 2016 December | 12 | 15 | 27 |
| 2016 November | 11 | 8 | 19 |
| 2016 October | 16 | 6 | 22 |
| 2016 September | 4 | 3 | 7 |
| 2016 August | 4 | 8 | 12 |
| 2016 July | 3 | 5 | 8 |
| 2016 June | 1 | 0 | 1 |
| 2016 May | 0 | 8 | 8 |
| 2016 April | 5 | 3 | 8 |
| 2016 March | 4 | 4 | 8 |
| 2016 February | 4 | 9 | 13 |
| 2016 January | 9 | 7 | 16 |
| 2015 December | 7 | 2 | 9 |
| 2015 November | 2 | 4 | 6 |
| 2015 October | 2 | 3 | 5 |
Show all
