array:25 [
  "pii" => "S2173511514000116"
  "issn" => "21735115"
  "doi" => "10.1016/j.rppnen.2013.10.011"
  "estado" => "S300"
  "fechaPublicacion" => "2014-01-01"
  "aid" => "184"
  "copyright" => "Sociedade Portuguesa de Pneumologia"
  "copyrightAnyo" => "2013"
  "documento" => "simple-article"
  "crossmark" => 0
  "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
  "subdocumento" => "cor"
  "cita" => "Rev Port Pneumol. 2014;20:52"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 2451
    "formatos" => array:3 [
      "EPUB" => 227
      "HTML" => 1414
      "PDF" => 810
    ]
  ]
  "Traduccion" => array:1 [
    "en" => array:20 [
      "pii" => "S087321591300127X"
      "issn" => "08732159"
      "doi" => "10.1016/j.rppneu.2013.10.003"
      "estado" => "S300"
      "fechaPublicacion" => "2014-01-01"
      "aid" => "184"
      "copyright" => "Sociedade Portuguesa de Pneumologia"
      "documento" => "simple-article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "cor"
      "cita" => "Rev Port Pneumol. 2014;20:52"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 4241
        "formatos" => array:3 [
          "EPUB" => 253
          "HTML" => 2868
          "PDF" => 1120
        ]
      ]
      "en" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
        "titulo" => "Video-mediastinoscopy is still the gold standard"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "paginas" => array:1 [
          0 => array:1 [
            "paginaInicial" => "52"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "pt" => array:1 [
            "titulo" => "A video-mediastinoscopia &#233; ainda o gold-standard"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "M&#46; Guerra"
            "autores" => array:1 [
              0 => array:2 [
                "nombre" => "M&#46;"
                "apellidos" => "Guerra"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2173511514000116"
          "doi" => "10.1016/j.rppnen.2013.10.011"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511514000116?idApp=UINPBA00004E"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S087321591300127X?idApp=UINPBA00004E"
      "url" => "/08732159/0000002000000001/v2_201509041402/S087321591300127X/v2_201509041402/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S217351151400013X"
    "issn" => "21735115"
    "doi" => "10.1016/j.rppnen.2013.09.005"
    "estado" => "S300"
    "fechaPublicacion" => "2014-01-01"
    "aid" => "187"
    "copyright" => "Sociedade Portuguesa de Pneumologia"
    "documento" => "simple-article"
    "crossmark" => 0
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "cor"
    "cita" => "Rev Port Pneumol. 2014;20:53-4"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2459
      "formatos" => array:3 [
        "EPUB" => 242
        "HTML" => 1444
        "PDF" => 773
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
      "titulo" => "Tuberculosis and TNF&#945; antagonists &#8211; What are we missing&#63;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "53"
          "paginaFinal" => "54"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Tuberculose e antagonistas do FNT&#945; &#8211; onde estamos a falhar&#63;"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "C&#46; Ribeiro, A&#46;M&#46; Correia, R&#46; Duarte"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Ribeiro"
            ]
            1 => array:2 [
              "nombre" => "A&#46;M&#46;"
              "apellidos" => "Correia"
            ]
            2 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Duarte"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0873215913001359"
        "doi" => "10.1016/j.rppneu.2013.09.002"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215913001359?idApp=UINPBA00004E"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217351151400013X?idApp=UINPBA00004E"
    "url" => "/21735115/0000002000000001/v1_201401230023/S217351151400013X/v1_201401230023/en/main.assets"
  ]
  "itemAnterior" => array:20 [
    "pii" => "S2173511514000177"
    "issn" => "21735115"
    "doi" => "10.1016/j.rppnen.2013.12.003"
    "estado" => "S300"
    "fechaPublicacion" => "2014-01-01"
    "aid" => "194"
    "copyright" => "Sociedade Portuguesa de Pneumologia"
    "documento" => "simple-article"
    "crossmark" => 0
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "cor"
    "cita" => "Rev Port Pneumol. 2014;20:51-2"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2952
      "formatos" => array:3 [
        "EPUB" => 248
        "HTML" => 1817
        "PDF" => 887
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letter to editor</span>"
      "titulo" => "Reply to &#8220;Obstructive sleep apnea prevalence and adverse respiratory events in surgical patients&#8221;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "51"
          "paginaFinal" => "52"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Resposta a &#8220;Preval&#234;ncia de apneia obstrutiva do sono e eventos respirat&#243;rios adversos em pacientes cir&#250;rgicos&#8221;"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Helder Pereira, Daniela Xar&#225;, J&#250;lia Mendon&#231;a, Alice Santos, Fernando Abelha"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "Helder"
              "apellidos" => "Pereira"
            ]
            1 => array:2 [
              "nombre" => "Daniela"
              "apellidos" => "Xar&#225;"
            ]
            2 => array:2 [
              "nombre" => "J&#250;lia"
              "apellidos" => "Mendon&#231;a"
            ]
            3 => array:2 [
              "nombre" => "Alice"
              "apellidos" => "Santos"
            ]
            4 => array:2 [
              "nombre" => "Fernando"
              "apellidos" => "Abelha"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0873215913001426"
        "doi" => "10.1016/j.rppneu.2013.12.002"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215913001426?idApp=UINPBA00004E"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511514000177?idApp=UINPBA00004E"
    "url" => "/21735115/0000002000000001/v1_201401230023/S2173511514000177/v1_201401230023/en/main.assets"
  ]
  "en" => array:14 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
    "titulo" => "Video-mediastinoscopy is still the gold standard"
    "tieneTextoCompleto" => true
    "saludo" => "Dear Editor&#44;"
    "paginas" => array:1 [
      0 => array:1 [
        "paginaInicial" => "52"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "M&#46; Guerra"
        "autores" => array:1 [
          0 => array:3 [
            "nombre" => "M&#46;"
            "apellidos" => "Guerra"
            "email" => array:1 [
              0 => "migueldavidguerra&#64;yahoo&#46;com"
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Servi&#231;o de Cirurgia Cardiotor&#225;cica&#44; Centro Hospitalar de Vila Nova de Gaia&#47;Espinho&#44; EPE&#44; Vila Nova de Gaia&#44; Portugal"
            "identificador" => "aff0005"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "A video-mediastinoscopia &#233; ainda o gold-standard"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We read with great interest the article by Bugalho et al&#46;&#44; entitled &#8220;Endobronchial ultrasound-guided transbronchial needle aspiration for lung cancer diagnosis and staging in 179 patients&#8221;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> as well as the editorial by Herth entitled &#8220;Access to the mediastinum&#8212;The standard has changed&#8221;&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">In fact&#44; for patients with lung cancer&#44; despite improvements in the accuracy of imaging modalities over the last decade&#44; invasive mediastinal lymph node staging remains necessary in cases of mediastinal lymph node enlargement&#44; positron emission tomography &#40;PET&#41; positive mediastinal and&#47;or hilar lymph nodes and&#47;or a centrally located tumor&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> For a long time&#44; cervical mediastinoscopy has been considered the gold standard in mediastinal staging&#44; given the high negative predictive value &#40;NPV&#41; if well performed&#46; However&#44; during the last decade&#44; oesophageal ultrasound-guided fine needle aspiration &#40;EUS-FNA&#41; followed by endobronchial ultrasound-guided transbronchial needle aspiration &#40;EBUS-TBNA&#41; has emerged as a minimally invasive alternative&#44; reducing the need for a cervical mediastinoscopy as a first-line staging procedure&#46; Nevertheless&#44; when the result of endoscopic staging appears negative&#44; a subsequent mediastinoscopy is currently recommended to exclude mediastinal lymph node metastases in patients with clinical suspicion&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> But&#44; since the sensitivity of EBUS-FNA seems to exceed that of mediastinoscopy&#44;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> there is a tendency to cut down on the need for surgical confirmation&#46; Accordingly&#44; in routine practice an additional mediastinoscopy is often regarded as overdone&#46; However&#44; only recently the combination of endosonography followed by mediastinoscopy was shown to be more accurate in mediastinal nodal staging than just mediastinoscopy alone&#46; In patients with non-small-cell lung cancer and an indication for mediastinal staging&#44; performing a cervical mediastinoscopy after a negative result of endosonography reduced the number of futile thoracotomies by 50&#37;&#46; Overall&#44; an average of 8&#46;8 patients had to undergo an additional mediastinoscopy to find one false-negative result of endosonography&#44; but when only patients with suspicious mediastinal lymph nodes on FDG-PET are taken into account&#44; this NNT comes down to 6&#46;1 patients&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">We agree with Dr&#46; Herth&#46; The standard has changed&#46; In fact&#44; EBUS and EUS should be used in conjunction with PET and considered as an alternative to mediastinoscopy&#46; However&#44; the gold standard is still video-mediastinoscopy&#44; because in patients with a high probability of mediastinal metastases&#44; a cervical mediastinoscopy should not be omitted after a negative result of endosonography&#44; not even when the aspirate seems representative&#44; based on the presence of a sufficient number and maturation of lymphocytes&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2013-09-26"
    "fechaAceptado" => "2013-10-01"
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:5 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Endobronchial ultrasound-guided transbronchial needle aspiration for lung cancer diagnosis and staging in 179 patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Bugalho"
                            1 => "D&#46; Ferreira"
                            2 => "R&#46; Barata"
                            3 => "C&#46; Rodrigues"
                            4 => "S&#46;S&#46; Dias"
                            5 => "F&#46; Medeiros"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.rppneu.2012.10.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Port Pneumol"
                        "fecha" => "2013"
                        "volumen" => "19"
                        "paginaInicial" => "192"
                        "paginaFinal" => "199"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23850376"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Access to the mediastinum&#8212;the standard has changed"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "F&#46;J&#46; Herth"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.rppneu.2013.07.001"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Port Pneumol"
                        "fecha" => "2013"
                        "volumen" => "19"
                        "paginaInicial" => "190"
                        "paginaFinal" => "191"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23993404"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "ESTS guidelines for preoperative lymph node staging for non-small cell lung cancer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; De Leyn"
                            1 => "D&#46; Lardinois"
                            2 => "P&#46;E&#46; van Schil"
                            3 => "R&#46; Rami-Porta"
                            4 => "B&#46; Passlick"
                            5 => "M&#46; Zielinski"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ejcts.2007.01.075"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Cardiothorac Surg"
                        "fecha" => "2007"
                        "volumen" => "32"
                        "paginaInicial" => "1"
                        "paginaFinal" => "8"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17448671"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Endobronchial ultrasound-guided transbronchial needle aspiration for staging of lung cancer&#58; a systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "P&#46; Gu"
                            1 => "Y&#46;Z&#46; Zhao"
                            2 => "L&#46;Y&#46; Jiang"
                            3 => "W&#46; Zhang"
                            4 => "Y&#46; Xin"
                            5 => "B&#46;H&#46; Han"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ejca.2008.11.043"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Cancer"
                        "fecha" => "2009"
                        "volumen" => "45"
                        "paginaInicial" => "1389"
                        "paginaFinal" => "1396"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19124238"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mediastinal staging in daily practice&#58; endosonography&#44; followed by cervical mediastinoscopy&#46; Do we really need both&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46;F&#46; Verhagen"
                            1 => "O&#46;C&#46; Schuurbiers"
                            2 => "M&#46;G&#46; Looijen-Salamon"
                            3 => "S&#46;M&#46; van der Heide"
                            4 => "H&#46;A&#46; van Swieten"
                            5 => "E&#46;H&#46; van der Heijden"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/icvts/ivt302"
                      "Revista" => array:6 [
                        "tituloSerie" => "Interact CardioVasc Thorac Surg"
                        "fecha" => "2013"
                        "volumen" => "17"
                        "paginaInicial" => "823"
                        "paginaFinal" => "828"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23838339"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735115/0000002000000001/v1_201401230023/S2173511514000116/v1_201401230023/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "20584"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Letters to the Editor"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21735115/0000002000000001/v1_201401230023/S2173511514000116/v1_201401230023/en/main.pdf?idApp=UINPBA00004E&text.app=https://journalpulmonology.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511514000116?idApp=UINPBA00004E"
]
Share
Journal Information

Statistics

Follow this link to access the full text of the article

Letter to the Editor
Video-mediastinoscopy is still the gold standard
A video-mediastinoscopia é ainda o gold-standard
M. Guerra
Serviço de Cirurgia Cardiotorácica, Centro Hospitalar de Vila Nova de Gaia/Espinho, EPE, Vila Nova de Gaia, Portugal
Read
912
Times
was read the article
487
Total PDF
425
Total HTML
Share statistics
 array:25 [
  "pii" => "S2173511514000116"
  "issn" => "21735115"
  "doi" => "10.1016/j.rppnen.2013.10.011"
  "estado" => "S300"
  "fechaPublicacion" => "2014-01-01"
  "aid" => "184"
  "copyright" => "Sociedade Portuguesa de Pneumologia"
  "copyrightAnyo" => "2013"
  "documento" => "simple-article"
  "crossmark" => 0
  "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
  "subdocumento" => "cor"
  "cita" => "Rev Port Pneumol. 2014;20:52"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 2451
    "formatos" => array:3 [
      "EPUB" => 227
      "HTML" => 1414
      "PDF" => 810
    ]
  ]
  "Traduccion" => array:1 [
    "en" => array:20 [
      "pii" => "S087321591300127X"
      "issn" => "08732159"
      "doi" => "10.1016/j.rppneu.2013.10.003"
      "estado" => "S300"
      "fechaPublicacion" => "2014-01-01"
      "aid" => "184"
      "copyright" => "Sociedade Portuguesa de Pneumologia"
      "documento" => "simple-article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "cor"
      "cita" => "Rev Port Pneumol. 2014;20:52"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 4241
        "formatos" => array:3 [
          "EPUB" => 253
          "HTML" => 2868
          "PDF" => 1120
        ]
      ]
      "en" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
        "titulo" => "Video-mediastinoscopy is still the gold standard"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "paginas" => array:1 [
          0 => array:1 [
            "paginaInicial" => "52"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "pt" => array:1 [
            "titulo" => "A video-mediastinoscopia &#233; ainda o gold-standard"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "M&#46; Guerra"
            "autores" => array:1 [
              0 => array:2 [
                "nombre" => "M&#46;"
                "apellidos" => "Guerra"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2173511514000116"
          "doi" => "10.1016/j.rppnen.2013.10.011"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511514000116?idApp=UINPBA00004E"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S087321591300127X?idApp=UINPBA00004E"
      "url" => "/08732159/0000002000000001/v2_201509041402/S087321591300127X/v2_201509041402/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S217351151400013X"
    "issn" => "21735115"
    "doi" => "10.1016/j.rppnen.2013.09.005"
    "estado" => "S300"
    "fechaPublicacion" => "2014-01-01"
    "aid" => "187"
    "copyright" => "Sociedade Portuguesa de Pneumologia"
    "documento" => "simple-article"
    "crossmark" => 0
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "cor"
    "cita" => "Rev Port Pneumol. 2014;20:53-4"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2459
      "formatos" => array:3 [
        "EPUB" => 242
        "HTML" => 1444
        "PDF" => 773
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
      "titulo" => "Tuberculosis and TNF&#945; antagonists &#8211; What are we missing&#63;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "53"
          "paginaFinal" => "54"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Tuberculose e antagonistas do FNT&#945; &#8211; onde estamos a falhar&#63;"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "C&#46; Ribeiro, A&#46;M&#46; Correia, R&#46; Duarte"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Ribeiro"
            ]
            1 => array:2 [
              "nombre" => "A&#46;M&#46;"
              "apellidos" => "Correia"
            ]
            2 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Duarte"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0873215913001359"
        "doi" => "10.1016/j.rppneu.2013.09.002"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215913001359?idApp=UINPBA00004E"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217351151400013X?idApp=UINPBA00004E"
    "url" => "/21735115/0000002000000001/v1_201401230023/S217351151400013X/v1_201401230023/en/main.assets"
  ]
  "itemAnterior" => array:20 [
    "pii" => "S2173511514000177"
    "issn" => "21735115"
    "doi" => "10.1016/j.rppnen.2013.12.003"
    "estado" => "S300"
    "fechaPublicacion" => "2014-01-01"
    "aid" => "194"
    "copyright" => "Sociedade Portuguesa de Pneumologia"
    "documento" => "simple-article"
    "crossmark" => 0
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "cor"
    "cita" => "Rev Port Pneumol. 2014;20:51-2"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2952
      "formatos" => array:3 [
        "EPUB" => 248
        "HTML" => 1817
        "PDF" => 887
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letter to editor</span>"
      "titulo" => "Reply to &#8220;Obstructive sleep apnea prevalence and adverse respiratory events in surgical patients&#8221;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "51"
          "paginaFinal" => "52"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Resposta a &#8220;Preval&#234;ncia de apneia obstrutiva do sono e eventos respirat&#243;rios adversos em pacientes cir&#250;rgicos&#8221;"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Helder Pereira, Daniela Xar&#225;, J&#250;lia Mendon&#231;a, Alice Santos, Fernando Abelha"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "Helder"
              "apellidos" => "Pereira"
            ]
            1 => array:2 [
              "nombre" => "Daniela"
              "apellidos" => "Xar&#225;"
            ]
            2 => array:2 [
              "nombre" => "J&#250;lia"
              "apellidos" => "Mendon&#231;a"
            ]
            3 => array:2 [
              "nombre" => "Alice"
              "apellidos" => "Santos"
            ]
            4 => array:2 [
              "nombre" => "Fernando"
              "apellidos" => "Abelha"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0873215913001426"
        "doi" => "10.1016/j.rppneu.2013.12.002"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215913001426?idApp=UINPBA00004E"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511514000177?idApp=UINPBA00004E"
    "url" => "/21735115/0000002000000001/v1_201401230023/S2173511514000177/v1_201401230023/en/main.assets"
  ]
  "en" => array:14 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
    "titulo" => "Video-mediastinoscopy is still the gold standard"
    "tieneTextoCompleto" => true
    "saludo" => "Dear Editor&#44;"
    "paginas" => array:1 [
      0 => array:1 [
        "paginaInicial" => "52"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "M&#46; Guerra"
        "autores" => array:1 [
          0 => array:3 [
            "nombre" => "M&#46;"
            "apellidos" => "Guerra"
            "email" => array:1 [
              0 => "migueldavidguerra&#64;yahoo&#46;com"
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Servi&#231;o de Cirurgia Cardiotor&#225;cica&#44; Centro Hospitalar de Vila Nova de Gaia&#47;Espinho&#44; EPE&#44; Vila Nova de Gaia&#44; Portugal"
            "identificador" => "aff0005"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "A video-mediastinoscopia &#233; ainda o gold-standard"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We read with great interest the article by Bugalho et al&#46;&#44; entitled &#8220;Endobronchial ultrasound-guided transbronchial needle aspiration for lung cancer diagnosis and staging in 179 patients&#8221;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> as well as the editorial by Herth entitled &#8220;Access to the mediastinum&#8212;The standard has changed&#8221;&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">In fact&#44; for patients with lung cancer&#44; despite improvements in the accuracy of imaging modalities over the last decade&#44; invasive mediastinal lymph node staging remains necessary in cases of mediastinal lymph node enlargement&#44; positron emission tomography &#40;PET&#41; positive mediastinal and&#47;or hilar lymph nodes and&#47;or a centrally located tumor&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> For a long time&#44; cervical mediastinoscopy has been considered the gold standard in mediastinal staging&#44; given the high negative predictive value &#40;NPV&#41; if well performed&#46; However&#44; during the last decade&#44; oesophageal ultrasound-guided fine needle aspiration &#40;EUS-FNA&#41; followed by endobronchial ultrasound-guided transbronchial needle aspiration &#40;EBUS-TBNA&#41; has emerged as a minimally invasive alternative&#44; reducing the need for a cervical mediastinoscopy as a first-line staging procedure&#46; Nevertheless&#44; when the result of endoscopic staging appears negative&#44; a subsequent mediastinoscopy is currently recommended to exclude mediastinal lymph node metastases in patients with clinical suspicion&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> But&#44; since the sensitivity of EBUS-FNA seems to exceed that of mediastinoscopy&#44;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> there is a tendency to cut down on the need for surgical confirmation&#46; Accordingly&#44; in routine practice an additional mediastinoscopy is often regarded as overdone&#46; However&#44; only recently the combination of endosonography followed by mediastinoscopy was shown to be more accurate in mediastinal nodal staging than just mediastinoscopy alone&#46; In patients with non-small-cell lung cancer and an indication for mediastinal staging&#44; performing a cervical mediastinoscopy after a negative result of endosonography reduced the number of futile thoracotomies by 50&#37;&#46; Overall&#44; an average of 8&#46;8 patients had to undergo an additional mediastinoscopy to find one false-negative result of endosonography&#44; but when only patients with suspicious mediastinal lymph nodes on FDG-PET are taken into account&#44; this NNT comes down to 6&#46;1 patients&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">We agree with Dr&#46; Herth&#46; The standard has changed&#46; In fact&#44; EBUS and EUS should be used in conjunction with PET and considered as an alternative to mediastinoscopy&#46; However&#44; the gold standard is still video-mediastinoscopy&#44; because in patients with a high probability of mediastinal metastases&#44; a cervical mediastinoscopy should not be omitted after a negative result of endosonography&#44; not even when the aspirate seems representative&#44; based on the presence of a sufficient number and maturation of lymphocytes&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2013-09-26"
    "fechaAceptado" => "2013-10-01"
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:5 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Endobronchial ultrasound-guided transbronchial needle aspiration for lung cancer diagnosis and staging in 179 patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Bugalho"
                            1 => "D&#46; Ferreira"
                            2 => "R&#46; Barata"
                            3 => "C&#46; Rodrigues"
                            4 => "S&#46;S&#46; Dias"
                            5 => "F&#46; Medeiros"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.rppneu.2012.10.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Port Pneumol"
                        "fecha" => "2013"
                        "volumen" => "19"
                        "paginaInicial" => "192"
                        "paginaFinal" => "199"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23850376"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Access to the mediastinum&#8212;the standard has changed"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "F&#46;J&#46; Herth"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.rppneu.2013.07.001"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Port Pneumol"
                        "fecha" => "2013"
                        "volumen" => "19"
                        "paginaInicial" => "190"
                        "paginaFinal" => "191"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23993404"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "ESTS guidelines for preoperative lymph node staging for non-small cell lung cancer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; De Leyn"
                            1 => "D&#46; Lardinois"
                            2 => "P&#46;E&#46; van Schil"
                            3 => "R&#46; Rami-Porta"
                            4 => "B&#46; Passlick"
                            5 => "M&#46; Zielinski"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ejcts.2007.01.075"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Cardiothorac Surg"
                        "fecha" => "2007"
                        "volumen" => "32"
                        "paginaInicial" => "1"
                        "paginaFinal" => "8"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17448671"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Endobronchial ultrasound-guided transbronchial needle aspiration for staging of lung cancer&#58; a systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "P&#46; Gu"
                            1 => "Y&#46;Z&#46; Zhao"
                            2 => "L&#46;Y&#46; Jiang"
                            3 => "W&#46; Zhang"
                            4 => "Y&#46; Xin"
                            5 => "B&#46;H&#46; Han"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ejca.2008.11.043"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Cancer"
                        "fecha" => "2009"
                        "volumen" => "45"
                        "paginaInicial" => "1389"
                        "paginaFinal" => "1396"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19124238"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mediastinal staging in daily practice&#58; endosonography&#44; followed by cervical mediastinoscopy&#46; Do we really need both&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46;F&#46; Verhagen"
                            1 => "O&#46;C&#46; Schuurbiers"
                            2 => "M&#46;G&#46; Looijen-Salamon"
                            3 => "S&#46;M&#46; van der Heide"
                            4 => "H&#46;A&#46; van Swieten"
                            5 => "E&#46;H&#46; van der Heijden"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/icvts/ivt302"
                      "Revista" => array:6 [
                        "tituloSerie" => "Interact CardioVasc Thorac Surg"
                        "fecha" => "2013"
                        "volumen" => "17"
                        "paginaInicial" => "823"
                        "paginaFinal" => "828"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23838339"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735115/0000002000000001/v1_201401230023/S2173511514000116/v1_201401230023/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "20584"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Letters to the Editor"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21735115/0000002000000001/v1_201401230023/S2173511514000116/v1_201401230023/en/main.pdf?idApp=UINPBA00004E&text.app=https://journalpulmonology.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511514000116?idApp=UINPBA00004E"
]
Article information
ISSN: 21735115
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 8 8 16
2024 October 24 30 54
2024 September 33 30 63
2024 August 48 31 79
2024 July 28 38 66
2024 June 27 19 46
2024 May 22 29 51
2024 April 23 25 48
2024 March 26 27 53
2024 February 21 27 48
2024 January 16 26 42
2023 December 13 22 35
2023 November 20 28 48
2023 October 15 33 48
2023 September 14 31 45
2023 August 17 13 30
2023 July 24 20 44
2023 June 16 14 30
2023 May 18 21 39
2023 April 12 15 27
Show all

Follow this link to access the full text of the article

Pulmonology

Are you a health professional able to prescribe or dispense drugs?