Corresponding author at: IRCCS Mondino Foundation, via Mondino 2, 27100 Pavia, Italy.
was read the article
array:24 [ "pii" => "S2531043721001203" "issn" => "25310437" "doi" => "10.1016/j.pulmoe.2021.06.002" "estado" => "S300" "fechaPublicacion" => "2021-11-01" "aid" => "1632" "copyright" => "Sociedade Portuguesa de Pneumologia" "copyrightAnyo" => "2021" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Pulmonol. 2021;27:566-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:19 [ "pii" => "S2531043721000933" "issn" => "25310437" "doi" => "10.1016/j.pulmoe.2021.04.004" "estado" => "S300" "fechaPublicacion" => "2021-11-01" "aid" => "1621" "copyright" => "Sociedade Portuguesa de Pneumologia" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Pulmonol. 2021;27:569-71" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:9 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Implementing nitrogen multiple breath washout as a clinical tool – A feasibility study" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "569" "paginaFinal" => "571" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Carolina Constant, Andreia Descalço, Ana Margarida Silva, Luísa Pereira, Celeste Barreto, Teresa Bandeira" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Carolina" "apellidos" => "Constant" ] 1 => array:2 [ "nombre" => "Andreia" "apellidos" => "Descalço" ] 2 => array:2 [ "nombre" => "Ana Margarida" "apellidos" => "Silva" ] 3 => array:2 [ "nombre" => "Luísa" "apellidos" => "Pereira" ] 4 => array:2 [ "nombre" => "Celeste" "apellidos" => "Barreto" ] 5 => array:2 [ "nombre" => "Teresa" "apellidos" => "Bandeira" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2531043721000933?idApp=UINPBA00004E" "url" => "/25310437/0000002700000006/v1_202111060605/S2531043721000933/v1_202111060605/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2531043721000805" "issn" => "25310437" "doi" => "10.1016/j.pulmoe.2021.03.004" "estado" => "S300" "fechaPublicacion" => "2021-11-01" "aid" => "1611" "copyright" => "Sociedade Portuguesa de Pneumologia" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Pulmonol. 2021;27:563-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:9 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Predictors of reduced 6-minute walk distance after COVID-19: a cohort study in Mexico" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "563" "paginaFinal" => "565" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A.W. Wong, S. López-Romero, E. Figueroa-Hurtado, S. Vazquez-Lopez, K.M. Milne, C.J. Ryerson, J.A. Guenette, A. Cortés-Telles" "autores" => array:8 [ 0 => array:2 [ "nombre" => "A.W." "apellidos" => "Wong" ] 1 => array:2 [ "nombre" => "S." "apellidos" => "López-Romero" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Figueroa-Hurtado" ] 3 => array:2 [ "nombre" => "S." "apellidos" => "Vazquez-Lopez" ] 4 => array:2 [ "nombre" => "K.M." "apellidos" => "Milne" ] 5 => array:2 [ "nombre" => "C.J." "apellidos" => "Ryerson" ] 6 => array:2 [ "nombre" => "J.A." "apellidos" => "Guenette" ] 7 => array:2 [ "nombre" => "A." "apellidos" => "Cortés-Telles" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2531043721000805?idApp=UINPBA00004E" "url" => "/25310437/0000002700000006/v1_202111060605/S2531043721000805/v1_202111060605/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Late-onset Pompe disease (LOPD): May axial myopathy influence respiratory dysfunction?" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "566" "paginaFinal" => "568" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Sabrina Ravaglia, Nicola Barbarito, Alberto Malovini, Serena Cirio, Anna Pichiecchio, Paola De Filippi, Cesare Danesino, Annalisa Carlucci" "autores" => array:8 [ 0 => array:4 [ "nombre" => "Sabrina" "apellidos" => "Ravaglia" "email" => array:1 [ 0 => "sabrina.ravaglia@mondino.it" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0001" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0001" ] ] ] 1 => array:3 [ "nombre" => "Nicola" "apellidos" => "Barbarito" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0002" ] ] ] 2 => array:3 [ "nombre" => "Alberto" "apellidos" => "Malovini" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0003" ] ] ] 3 => array:3 [ "nombre" => "Serena" "apellidos" => "Cirio" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0004" ] ] ] 4 => array:3 [ "nombre" => "Anna" "apellidos" => "Pichiecchio" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0001" ] ] ] 5 => array:3 [ "nombre" => "Paola" "apellidos" => "De Filippi" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0005" ] ] ] 6 => array:3 [ "nombre" => "Cesare" "apellidos" => "Danesino" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0005" ] ] ] 7 => array:3 [ "nombre" => "Annalisa" "apellidos" => "Carlucci" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0004" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">f</span>" "identificador" => "aff0006" ] ] ] ] "afiliaciones" => array:6 [ 0 => array:3 [ "entidad" => "IRCCS Mondino Foundation, Pavia, Italy" "etiqueta" => "a" "identificador" => "aff0001" ] 1 => array:3 [ "entidad" => "U.O. Pneumologia, Istituto Palazzolo, Fondazione Don Gnocchi, Milano, Italy" "etiqueta" => "b" "identificador" => "aff0002" ] 2 => array:3 [ "entidad" => "Laboratorio di Informatica e Sistemistica per la Ricerca Clinica, IRCCS Istituti Clinici Scientifici Salvatore Maugeri, Pavia, Italy" "etiqueta" => "c" "identificador" => "aff0003" ] 3 => array:3 [ "entidad" => "U.O. di Pneumologia Riabilitativa, IRCCS Istituti Clinici Scientifici Maugeri, Pavia, Italy" "etiqueta" => "d" "identificador" => "aff0004" ] 4 => array:3 [ "entidad" => "University of Pavia, Pavia, Italy" "etiqueta" => "e" "identificador" => "aff0005" ] 5 => array:3 [ "entidad" => "Dipartimento di Medicina e Chirurgia, Università degli Studi dell'Insubria, Varese – Como, Italy" "etiqueta" => "f" "identificador" => "aff0006" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0001" "etiqueta" => "⁎" "correspondencia" => "Corresponding author at: IRCCS Mondino Foundation, via Mondino 2, 27100 Pavia, Italy." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0002" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1371 "Ancho" => 3014 "Tamanyo" => 168776 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "alt0002" "detalle" => "Fig " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spara002" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Internal Oblique</span>, Multifidus and Longissimus muscles are positively correlated to ΔVC values. In particular, patients having MRI values ≥ 2 for these three parameters are characterized by a statistically significant increase in terms of ΔVC values with respect to those having MRI values ≤ 1 (<span class="elsevierStyleItalic">p</span> < 0.008).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0001" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0003">Clinical note</span><p id="para0002" class="elsevierStylePara elsevierViewall">Late-onset Pompe disease (LOPD) is an autosomal recessive disease caused by acid alpha–glucosidase deficiency. The phenotype is a progressive proximal myopathy. Respiratory failure is the main life-threatening complication, usually resulting from diaphragm weakness,<a class="elsevierStyleCrossRef" href="#bib0001"><span class="elsevierStyleSup">1</span></a> which may be independent of the severity of motor involvement. Screening for diaphragm function include the assessment of postural drop in forced vital capacity (FVC) moving from sitting to supine position (ΔVC),<a class="elsevierStyleCrossRef" href="#bib0002"><span class="elsevierStyleSup">2</span></a> and measurement of Maximal Inspiratory Pressure (MIP).</p><p id="para0003" class="elsevierStylePara elsevierViewall">We previously observed by <a href="http://www.ncbi.nlm.nih.gov/pubmed/27434783">Magnetic Resonance Imaging</a> (MRI) that axial muscles involvement (posterior trunk, abdominal wall) represents a feature peculiar to LOPD, otherwise uncommon in other myopathies. Axial involvement may be suspected in patients with chronic lumbar pain, hyper-lordosis, and abdominal prominence, but axial muscles are difficult to assess by clinical examination alone: thus, imaging fills a clinical need.<a class="elsevierStyleCrossRef" href="#bib0003"><span class="elsevierStyleSup">3</span></a> What is the clinical impact, if any, of axial muscles involvement? Are there any functional correlates, beyond lumbar pain and postural changes? Indeed, trunk muscles may be involved in respiration, with posterior muscles participating in inspiration, and anterior abdominal wall muscles contributing to forced expiration.<a class="elsevierStyleCrossRef" href="#bib0004"><span class="elsevierStyleSup">4</span></a> Our hypothesis is that axial involvement may be a sentinel sign of respiratory dysfunction, and that MRI of the axial muscles may represent an effective approach to screen for respiratory impairment in LOPD, to optimize pulmonary evaluation and treatment strategy for these individuals.</p><p id="para0004" class="elsevierStylePara elsevierViewall">We investigated prospectively 19 patients (8 females) aged 54.6 ± 18.2 years (range 25–76) with genetically confirmed LOPD. Clinical, demographic, genetic data are in <span class="elsevierStyleBold">Supplementary Table 1</span>.</p><p id="para0005" class="elsevierStylePara elsevierViewall">Muscle MRI was performed as previously described<a class="elsevierStyleCrossRef" href="#bib0003"><span class="elsevierStyleSup">3</span></a> by a 1.5T MRI scanner (1.5T Philips Intera and 1.5T Philips Ahieva XR Realeas) using T1-weighted spin-echo axial images from the mid-dorsal segment to the sacrum, using the same parameters (TR=300 ms, TE=10 ms, thickness =10 mm, matrix=640 × 640, in plane resolution 0.6 × 0.6 mm). Muscles were graded qualitatively according to the Mercuri score.<a class="elsevierStyleCrossRef" href="#bib0003"><span class="elsevierStyleSup">3</span></a> We considered two muscles of the posterior wall of the lower trunk (<span class="elsevierStyleItalic">Quadratus lumborum, Iliocostalis lumborum</span>), and seven anterior wall muscles (<span class="elsevierStyleItalic">Multifidus, Longissimus, Iliopsoas, Rectus abdominis, Transversus abdominis, Obliquus externus abdominis, Obliquus internus abdominis</span>). Two independent observers blinded to clinical data examined all scans.</p><p id="para0006" class="elsevierStylePara elsevierViewall">Respiratory assessment was performed within 48 h ofm MRI, according to standard guidelines.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">5</span></a> A postural drop of FVC (ΔVC) ≥30% was considered expression of diaphragmatic weakness;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">5</span></a> MIP was measured from the Functional Residual Capacity in the upright position; Maximal Expiratory Pressure (MEP) was measured at the Total Pulmonary Capacity. Both MIP and MEP were repeated at least three times or until two identical readings were obtained, with patients receiving strong verbal encouragement; the best value of both measurements was used.<a class="elsevierStyleCrossRef" href="#bib0006"><span class="elsevierStyleSup">6</span></a></p><p id="para0007" class="elsevierStylePara elsevierViewall">Deviations of quantitative variables from normality were calculated by the Shapiro-Wilk test (<span class="elsevierStyleItalic">p</span><0.05). Quantitative variables with normal distribution are described as mean ± standard deviation or by median (25th–75th percentiles) otherwise. To test for significant differences in terms of normally distributed variables between binary conditions we used the Welch's <span class="elsevierStyleItalic">t</span>-test, and the Wilcoxon rank-sum test to test for differences in terms of variables deviation from the normal. Pairwise correlations were estimated by the Spearman test, associations between categorical variables by the Fisher's exact test. The significance threshold was set to <span class="elsevierStyleItalic">p</span><0.008 based on the Bonferroni correction accounting for the number of muscles for which the MRI score was evaluated (α=0.05/6 tests). Univariate tests were applied to evaluate: a) significant correlations between MRI measurements and: MIP, MEP, FVC, ΔVC, FVC%; b) presence of significant associations between MRI measurements corresponding to the analyzed muscles and: Diaphragm ≥20 or Diaphragm ≥30. Statistical tests were performed by the R software v. 3.1.0 (<a href="http://www.r-project.org/">www.r-project.org/</a>).</p><p id="para0008" class="elsevierStylePara elsevierViewall">Summary statistics reporting the characteristics of the analyzed patients are in <span class="elsevierStyleBold">Supplementary Table 2</span> (quantitative variables) and <span class="elsevierStyleBold">3</span> (categorical variables). <a class="elsevierStyleCrossRef" href="#fig0001"><span class="elsevierStyleBold">Fig. 1</span></a> shows three different patterns of severity of trunk involvement. Involvement of the <span class="elsevierStyleItalic">Internal Oblique</span> and <span class="elsevierStyleItalic">Multifidus</span> correlated with worse MIP (rho=0.85, <span class="elsevierStyleItalic">p</span> = 0.004 and rho=0.75, <span class="elsevierStyleItalic">p</span> = 0.003 respectively). Similarly, <span class="elsevierStyleItalic">Internal Oblique, Multifidus</span> and <span class="elsevierStyleItalic">Longissimus</span> muscles were positively correlated with ΔVC values (rho=0.86, <span class="elsevierStyleItalic">p</span><0.001; rho=0.80, <span class="elsevierStyleItalic">p</span><0.001 and rho=0.73, <span class="elsevierStyleItalic">p</span><0.001 respectively) (<a class="elsevierStyleCrossRef" href="#fig0002"><span class="elsevierStyleBold">Fig. 2</span></a>). Increased MRI scores for <span class="elsevierStyleItalic">Multifidus</span> were associated with increased probability of diaphragm ≥20 (<span class="elsevierStyleItalic">p</span> = 0.006) and diaphragm ≥30 (<span class="elsevierStyleItalic">p</span> = 0.005). Similarly, higher MRI scores for <span class="elsevierStyleItalic">Longissimus</span> were associated with increased probability of diaphragm ≥30 (<span class="elsevierStyleItalic">p</span> = 0.002). A weaker but still consistent correlation was found with <span class="elsevierStyleItalic">Internal Oblique</span> (<span class="elsevierStyleItalic">p</span> = 0.015).</p><elsevierMultimedia ident="fig0001"></elsevierMultimedia><elsevierMultimedia ident="fig0002"></elsevierMultimedia><p id="para0009" class="elsevierStylePara elsevierViewall">Thus, posterior trunk atrophy was associated with decreased MIP, and both anterior and posterior trunk atrophy to postural drop; forced expiration (MEP) and upright FVC were not influenced by trunk muscles status. Indeed, posterior trunk muscles contribute to inspiration<a class="elsevierStyleCrossRef" href="#bib0004"><span class="elsevierStyleSup">4</span></a> and are thus expected to influence postural drop and MIP.</p><p id="para0010" class="elsevierStylePara elsevierViewall">The role of anterior/abdominal atrophy on postural drop may rather seem unexpected, given that abdominal muscles are essentially expiratory. We suggest that -in LOPD patients with diaphragm weakness- abdominal muscles may contribute to inspiration also, even during tidal breathing. At present, abdominal muscles contraction during expiration is conventionally regarded as beneficial to the act of breathing, because the consecutive rise in abdominal pressure induces diaphragm lengthening, placing diaphragm fibers on a more advantageous portion of their length-tension curve, and hence improving the force-generating ability of the diaphragm during the subsequent inspiration. Expiratory contraction of the abdominal muscles is a natural (automatic or spontaneous) component of the response of the normal respiratory system to greater than resting stimulation.<a class="elsevierStyleCrossRef" href="#bib0007"><span class="elsevierStyleSup">7</span></a> When normal subjects increase their ventilation or breathe against inspiratory mechanical loads, they recruit the abdominal muscles, particularly the transversus, during expiration<a class="elsevierStyleCrossRef" href="#bib0008"><span class="elsevierStyleSup">8</span></a>: the associated reduction in end-expiratory lung volume allows the increased work of breathing to be shared between the inspiratory and the expiratory muscles. It is possible that in LOPD patients with diaphragm weakness, this "automatic" response to the imbalance of the inspiratory load/capacity relationship is already triggered during resting breathing, even though it may be useless and induce additional energy expenditure.</p><p id="para0011" class="elsevierStylePara elsevierViewall">A limitation of our study is the lack of a control population. Further studies confirming our results are needed. Detection of axial involvement on MRI may be a warning sign of initial diaphragm weakness and respiratory dysfunction in clinostatism, since trunk weakness (and mainly abdominal weakness) is likely to impair the ability to compensate for diaphragmatic dysfunction in the supine position. Detection of trunk muscle damage by MRI may thus suggest the need of a closer respiratory follow-up or more extensive respiratory assessment, i.e. by polysomnography, even when upright FVC is still within normal ranges.</p></span><span id="sec0002" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0004">Declarations</span><p id="para0012" class="elsevierStylePara elsevierViewall">Ethics approval and consent to participate:</p><p id="para0013" class="elsevierStylePara elsevierViewall">The data collected are part of the regular follow-up of patients with Pompe disease. Data collection and consent to participate was approved by the Pavia Ethical Committee (IRCCS San Matteo Foundation), reference number p-20,160,022,743</p></span><span id="sec0003" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0005">Consent for publication</span><p id="para0014" class="elsevierStylePara elsevierViewall">All patients gave consent to collect their demographic and clinical data and to perform clinical and MRI investigations.</p></span><span id="sec0004" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0006">Availability of data and material</span><p id="para0015" class="elsevierStylePara elsevierViewall">Database of clinical data is available to any scientist wishing to use them (Sabrina.ravaglia@mondino.it)</p></span><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0007">Funding</span><p id="para0016" class="elsevierStylePara elsevierViewall">The work was supported by the Italian Ministry of Health funding, RC 2019; the funding body had no role in the study design and data collection and analysis.</p></span><span id="sec0007" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0009">Authors’ contribution</span><p id="para0018" class="elsevierStylePara elsevierViewall">The Author's contributions are as follows: AC, SR, CD: methodology, conceptualization of results, manuscript writing and editing; NB: interpretation of physiological data; CD, PdF: genetic analysis; AM statistical analysis; SC: respiratory examinations and acquisition of data; AP: muscle MRI. All Authors read and approved the final manuscript.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:8 [ 0 => array:2 [ "identificador" => "sec0001" "titulo" => "Clinical note" ] 1 => array:2 [ "identificador" => "sec0002" "titulo" => "Declarations" ] 2 => array:2 [ "identificador" => "sec0003" "titulo" => "Consent for publication" ] 3 => array:2 [ "identificador" => "sec0004" "titulo" => "Availability of data and material" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 5 => array:2 [ "identificador" => "sec0007" "titulo" => "Authors’ contribution" ] 6 => array:2 [ "identificador" => "xack566028" "titulo" => "Acknowledgements" ] 7 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2021-01-26" "fechaAceptado" => "2021-06-06" "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0001" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 563 "Ancho" => 3000 "Tamanyo" => 225776 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "alt0001" "detalle" => "Fig " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spara001" class="elsevierStyleSimplePara elsevierViewall">Muscle MRI with T1-w images at the level of the lumbar region showing three patients with different degrees of paraspinal muscle atrophy, in particular involving <span class="elsevierStyleItalic">Quadratus Lumborum, Multifidus, Longissimus</span> and <span class="elsevierStyleItalic">Iliocostalis Lumborum</span>. The first patient (A) shows a severe muscle atrophy, while the second (B) and the third (C) show respectively a moderate and a mild atrophy.</p>" ] ] 1 => array:8 [ "identificador" => "fig0002" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1371 "Ancho" => 3014 "Tamanyo" => 168776 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "alt0002" "detalle" => "Fig " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spara002" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Internal Oblique</span>, Multifidus and Longissimus muscles are positively correlated to ΔVC values. In particular, patients having MRI values ≥ 2 for these three parameters are characterized by a statistically significant increase in terms of ΔVC values with respect to those having MRI values ≤ 1 (<span class="elsevierStyleItalic">p</span> < 0.008).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "cebibsec1" "bibliografiaReferencia" => array:8 [ 0 => array:3 [ "identificador" => "bib0001" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Respiratory insufficiency and limb muscle weakness in adults with Pompe's disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N. Pellegrini" 1 => "P. Laforet" 2 => "D. Orlikowski" 3 => "M. Pellegrini" 4 => "C. Caillaud" 5 => "B. Eymard" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.05.00020005" "Revista" => array:7 [ "tituloSerie" => "Eur. Respir. J." "fecha" => "2005" "volumen" => "26" "numero" => "6" "paginaInicial" => "1024" "paginaFinal" => "1031" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16319331" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0002" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Supine fall in lung volumes in the assessment of diaphragmatic weakness in neuromuscular disorders" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Fromageot" 1 => "F. Lofaso" 2 => "D. Annane" 3 => "L. Falaize" 4 => "M. Lejaille" 5 => "B. Clair" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/apmr.2001.18053" "Revista" => array:7 [ "tituloSerie" => "Arch. Phys. Med. Rehabil." "fecha" => "2001" "volumen" => "82" "numero" => "1" "paginaInicial" => "123" "paginaFinal" => "128" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11239298" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0003" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Trunk muscle involvement in late-onset Pompe disease: study of thirty patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Alejaldre" 1 => "J. Díaz-Manera" 2 => "S. Ravaglia" 3 => "E.C. Tibaldi" 4 => "F. D'Amore" 5 => "G. Morís" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.nmd.2012.05.011" "Revista" => array:4 [ "tituloSerie" => "Neuromuscul. Disord." "fecha" => "2012" "paginaInicial" => "S148" "paginaFinal" => "S154" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0004" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Muscle testing and function" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "F.P. Kendall" 1 => "E.K. McCreary" 2 => "P.G. Provance" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:4 [ "edicion" => "4th Ed." "fecha" => "1993" "editorial" => "Williams and Wilkins" "editorialLocalizacion" => "Baltimore" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0005" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "ATS/ERS Statement on respiratory muscle testing" "autores" => array:1 [ 0 => array:2 [ "colaboracion" => "American Thoracic Society/European Respiratory Society" "etal" => false ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/rccm.166.4.518" "Revista" => array:7 [ "tituloSerie" => "Am. J. Respir. Crit. Care Med." "fecha" => "2002" "volumen" => "166" "numero" => "4" "paginaInicial" => "518" "paginaFinal" => "624" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12186831" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0006" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predicted normal values for maximal respiratory pressures in caucasian adults and children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S.H. Wilson" 1 => "N.T. Cooke" 2 => "R.H. Edwards" 3 => "S.G. Spiro" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/thx.39.7.535" "Revista" => array:7 [ "tituloSerie" => "Thorax" "fecha" => "1984" "volumen" => "39" "numero" => "7" "paginaInicial" => "535" "paginaFinal" => "538" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6463933" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0007" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Younes M. Determinants of thoracic excursions during exercise. In: Whipp BJ, Wasserman K, eds. <span class="elsevierStyleItalic">Exercise. Pulmonary physiology and pathophysiology</span>. Vol. 52. NewYork: Marcel Dekker; 1991; 1–65." ] ] ] 7 => array:3 [ "identificador" => "bib0008" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The behaviour of the abdominal muscles during inspiratory mechanical loading" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.G. Martin" 1 => "A. De Troyer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/0034-5687(82)90007-x" "Revista" => array:7 [ "tituloSerie" => "Respir. Physiol." "fecha" => "1982" "volumen" => "50" "numero" => "1" "paginaInicial" => "63" "paginaFinal" => "73" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6217533" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack566028" "titulo" => "Acknowledgements" "texto" => "<p id="para0020" class="elsevierStylePara elsevierViewall">Not applicable.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/25310437/0000002700000006/v1_202111060605/S2531043721001203/v1_202111060605/en/main.assets" "Apartado" => array:4 [ "identificador" => "72880" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/25310437/0000002700000006/v1_202111060605/S2531043721001203/v1_202111060605/en/main.pdf?idApp=UINPBA00004E&text.app=https://journalpulmonology.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2531043721001203?idApp=UINPBA00004E" ]
Year/Month | Html | Total | |
---|---|---|---|
2024 November | 8 | 8 | 16 |
2024 October | 41 | 44 | 85 |
2024 September | 42 | 42 | 84 |
2024 August | 54 | 53 | 107 |
2024 July | 58 | 41 | 99 |
2024 June | 65 | 35 | 100 |
2024 May | 121 | 29 | 150 |
2024 April | 57 | 35 | 92 |
2024 March | 60 | 29 | 89 |
2024 February | 51 | 32 | 83 |
2024 January | 45 | 33 | 78 |
2023 December | 24 | 23 | 47 |
2023 November | 53 | 45 | 98 |
2023 October | 34 | 30 | 64 |
2023 September | 46 | 33 | 79 |
2023 August | 51 | 20 | 71 |
2023 July | 41 | 30 | 71 |
2023 June | 42 | 18 | 60 |
2023 May | 67 | 44 | 111 |
2023 April | 60 | 15 | 75 |
2023 March | 75 | 24 | 99 |
2023 February | 40 | 22 | 62 |
2023 January | 41 | 29 | 70 |
2022 December | 83 | 36 | 119 |
2022 November | 70 | 32 | 102 |
2022 October | 127 | 43 | 170 |
2022 September | 91 | 47 | 138 |
2022 August | 73 | 43 | 116 |
2022 July | 48 | 47 | 95 |
2022 June | 39 | 37 | 76 |
2022 May | 64 | 42 | 106 |
2022 April | 55 | 43 | 98 |
2022 March | 55 | 57 | 112 |
2022 February | 47 | 42 | 89 |
2022 January | 56 | 57 | 113 |
2021 December | 88 | 88 | 176 |
2021 November | 160 | 74 | 234 |
2021 October | 71 | 70 | 141 |
2021 September | 41 | 47 | 88 |
2021 August | 49 | 49 | 98 |
2021 July | 68 | 41 | 109 |