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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="para0002" class="elsevierStylePara elsevierViewall">Cystic lung disease &#40;CLD&#41; encompasses a broad set of uncommon disorders that can represent a diagnostic challenge&#44; in part due to an increasing number of diseases with similar presentation&#46;<a class="elsevierStyleCrossRef" href="#bib0001"><span class="elsevierStyleSup">1</span></a> Hypersensitivity pneumonitis &#40;HP&#41; is a complex and heterogeneous interstitial lung disease &#40;ILD&#41; caused by an exaggerated immune response to an inhaled antigen in predisposed individuals&#46;<a class="elsevierStyleCrossRef" href="#bib0002"><span class="elsevierStyleSup">2</span></a></p><p id="para0003" class="elsevierStylePara elsevierViewall">Cysts have been reported in a small percentage of patients with non-fibrotic HP<a class="elsevierStyleCrossRef" href="#bib0003"><span class="elsevierStyleSup">3</span></a>&#59; they are typically few &#40;less than 5&#37; of lung parenchyma&#41;&#44; range from 3 to 25&#8239;mm in diameter and are associated with ground-glass opacities&#46; The cysts resemble those of lymphoid interstitial pneumonia and are presumably caused by partial bronchial obstruction due to peribronchiolar lymphocytic infiltrate present in patients with HP&#46;<a class="elsevierStyleCrossRef" href="#bib0004"><span class="elsevierStyleSup">4</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">5</span></a></p><p id="para0004" class="elsevierStylePara elsevierViewall">HP diagnosis is often difficult to achieve in part due to nonspecific clinical manifestations but also because radiological and histological patterns can mimic other interstitial and small airway disease&#46; Taking this into account&#44; a minority of patients may present thin-walled lung cysts as the main chest high-resolution computed tomography &#40;HRCT&#41; characteristic&#44; which requires a differential diagnosis with others CLDs&#46;</p><p id="para0005" class="elsevierStylePara elsevierViewall">We present a case of a 54-year-old women&#44; non-smoker&#44; who owned parakeets and goldfinches and lived near a square frequently occupied by pigeons&#59; her personal medical history included chronic kidney disease and dyslipidemia&#46;</p><p id="para0006" class="elsevierStylePara elsevierViewall">She was referred to our outpatient clinic complaining of fatigue and progressive dyspnea with moderate exertion in the previous year&#46; Chest HRCT showed bilateral multiple cysts predominantly in the pulmonary inferior lobes &#40;<a class="elsevierStyleCrossRef" href="#fig0001">Fig&#46; 1</a>A&#44;B&#41;&#44; some traction bronchiectasis and limited areas of emphysema and mosaic attenuation&#46; Serum specific IgGs were positive for parakeets and pigeons&#46; Complete autoimmune study and VEGF-D were normal&#46; Pulmonary function tests revealed FVC 89&#44;9&#37; and a severe-moderate decrease in DLCO &#40;DLCO 49&#44;4&#37;&#44; KCO of 57&#44;3&#37;&#41;&#46; Bronchoalveolar lavage with differential cell count showed 15&#37; of lymphocytes&#46; The nonspecific nature of these results combined with the possibility of other CLD&#44; like lymphocytic interstitial pneumonia&#44; prompted a request for a lung biopsy&#59; the histological examination revealed a cellular interstitial pneumonitis with peribronchiolar pattern and microgranulomas compatible with HP&#46;</p><elsevierMultimedia ident="fig0001"></elsevierMultimedia><p id="para0007" class="elsevierStylePara elsevierViewall">Once the diagnosis of HP was established&#44; the patient was advised to avoid any contact with possible allergens and inhaled corticosteroid and bronchodilators were prescribed&#46; Initially&#44; the patient improved and remained stable&#44; reporting only mild dyspnea &#40;mMRC 0-1&#41; during moderate&#47; hard exercises&#44; especially after being in the square and exposed to pigeons and other birds&#59; over time there was a substantial improvement in the respiratory functions tests&#44; with a FVC of 93&#37;&#44; a DLCO of 66&#37; and a KCO of 80&#37;&#46;</p><p id="para0008" class="elsevierStylePara elsevierViewall">After ten years the patient experienced clinical and functional worsening &#40;FVC 74&#37;&#44; DLCO 48&#37; and KCO 66&#37;&#41; and was put on oral corticosteroids &#40;prednisolone 5mg&#47;day&#41;&#44; with favorable response&#46;</p><p id="para0009" class="elsevierStylePara elsevierViewall">Currently&#44; the patient is clinically and functionally stable &#40;FVC 84&#37;&#44; DLCO 55&#37; and KCO 72&#37;&#41;&#59; although HRCT shows no changes regarding multiple cysts&#44; there are extensive areas with mosaic attenuation associated with ground glass opacities&#44; traction bronchiectasis and loss of lobar volume &#40;<a class="elsevierStyleCrossRef" href="#fig0001">Fig&#46; 1</a>C&#44;D&#41;&#46;</p><p id="para0010" class="elsevierStylePara elsevierViewall">Cystic lung diseases are increasingly recognized as a heterogeneous group of ILD with a broad spectrum of outcomes and consequences&#59; the widespread use of HRCT has had an important role in this increased knowledge and understanding&#46;<a class="elsevierStyleCrossRef" href="#bib0001"><span class="elsevierStyleSup">1</span></a> HP is a good prognosis disease often diagnosed by a combination of typical clinical history&#44; positive serum precipitins and a characteristic bronchoalveolar lavage&#46;<a class="elsevierStyleCrossRef" href="#bib0003"><span class="elsevierStyleSup">3</span></a> Cystic HP is a rare form of HP frequently associated with a challenging diagnosis<a class="elsevierStyleCrossRef" href="#bib0004"><span class="elsevierStyleSup">4</span></a>&#59; in these cases&#44; where there is an extensive overlap between clinical and radiographic features&#44; lung biopsy and histopathologic evaluation may be crucial to establishing a confident diagnosis&#46; Faced with this scenario it is important to weigh the need for a secure histopathological diagnosis against the risks of the medical procedure&#46; In recent years and in part due to an increasing demand for histological evaluations in patients with comorbid conditions&#44; poor overall health status&#44; physical frailty and a more severe degree of lung function impairment the role of transbronchial cryobiopsy &#40;TBLC&#41; in ILD patients has grown&#46; Nowadays&#44; compared to surgical lung biopsy&#44; TBLC offers a less invasive diagnostic method that is almost as accurate as surgical lung biopsy but has a better safety profile&#46;<a class="elsevierStyleCrossRef" href="#bib0006"><span class="elsevierStyleSup">6</span></a></p><p id="para0011" class="elsevierStylePara elsevierViewall">Furthermore&#44; and similar to other non-cystic forms of HP&#44; cystic HP can slowly progress over time&#44; especially the inflammatory-fibrotic component&#44; even after removing exposures and treating acute exacerbations&#59; interestingly&#44; the cystic component of the disease seems to remain stable&#46;</p><span id="sec0001" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0003">Funding</span><p id="para0012" class="elsevierStylePara elsevierViewall">This research did not receive any specific grant from funding agencies in the public&#44; commercial&#44; or not-for-profit sectors&#46;</p></span><span id="sec0002" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0004">Ethical considerations</span><p id="para0013" class="elsevierStylePara elsevierViewall">Written informed consent was obtained from the patient for publication of the article&#46;</p></span><span id="sec0002a" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0004a">CRediT authorship contribution statement</span><p id="para0013a" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">E&#46;M&#46; Tinoco&#58;</span> Writing &#8211; original draft&#44; Writing &#8211; review &#38; editing&#46; <span class="elsevierStyleBold">G&#46; Bermudo&#58;</span> Methodology&#44; Writing &#8211; review &#38; editing&#46; <span class="elsevierStyleBold">V&#46; Vicens-Zygmunt&#58;</span> Methodology&#44; Writing &#8211; review &#38; editing&#46; <span class="elsevierStyleBold">P&#46; Luburich&#58;</span> Writing &#8211; review &#38; editing&#46; <span class="elsevierStyleBold">R&#46; Llatj&#243;s&#58;</span> Writing &#8211; review &#38; editing&#46; <span class="elsevierStyleBold">M&#46; Molina-Molina&#58;</span> Writing &#8211; original draft&#44; Methodology&#44; Writing &#8211; review &#38; editing&#46;</p></span></span>"
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Letter to the Editor
Hypersensitivity pneumonitis, a differential diagnosis of cystic lung diseases
E.M. Tinocoa,
Corresponding author
, G. Bermudob, V. Vicens-Zygmuntb, P. Luburichc, R. Llatjósd, M. Molina-Molinab
a Pulmonology Department, Vila Nova de Gaia/Espinho Hospital Center, R. Conceição Fernandes S/N, Vila Nova de Gaia 4434-502, Portugal
b ILD Unit, Pulmonology Department, Bellvitge University Hospital-IDIBELL, Spain
c ILD Unit, Radiology Department, Bellvitge University Hospital-IDIBELL, Spain
d ILD Unit, Pathology Department, Bellvitge University Hospital-IDIBELL, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="para0002" class="elsevierStylePara elsevierViewall">Cystic lung disease &#40;CLD&#41; encompasses a broad set of uncommon disorders that can represent a diagnostic challenge&#44; in part due to an increasing number of diseases with similar presentation&#46;<a class="elsevierStyleCrossRef" href="#bib0001"><span class="elsevierStyleSup">1</span></a> Hypersensitivity pneumonitis &#40;HP&#41; is a complex and heterogeneous interstitial lung disease &#40;ILD&#41; caused by an exaggerated immune response to an inhaled antigen in predisposed individuals&#46;<a class="elsevierStyleCrossRef" href="#bib0002"><span class="elsevierStyleSup">2</span></a></p><p id="para0003" class="elsevierStylePara elsevierViewall">Cysts have been reported in a small percentage of patients with non-fibrotic HP<a class="elsevierStyleCrossRef" href="#bib0003"><span class="elsevierStyleSup">3</span></a>&#59; they are typically few &#40;less than 5&#37; of lung parenchyma&#41;&#44; range from 3 to 25&#8239;mm in diameter and are associated with ground-glass opacities&#46; The cysts resemble those of lymphoid interstitial pneumonia and are presumably caused by partial bronchial obstruction due to peribronchiolar lymphocytic infiltrate present in patients with HP&#46;<a class="elsevierStyleCrossRef" href="#bib0004"><span class="elsevierStyleSup">4</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">5</span></a></p><p id="para0004" class="elsevierStylePara elsevierViewall">HP diagnosis is often difficult to achieve in part due to nonspecific clinical manifestations but also because radiological and histological patterns can mimic other interstitial and small airway disease&#46; Taking this into account&#44; a minority of patients may present thin-walled lung cysts as the main chest high-resolution computed tomography &#40;HRCT&#41; characteristic&#44; which requires a differential diagnosis with others CLDs&#46;</p><p id="para0005" class="elsevierStylePara elsevierViewall">We present a case of a 54-year-old women&#44; non-smoker&#44; who owned parakeets and goldfinches and lived near a square frequently occupied by pigeons&#59; her personal medical history included chronic kidney disease and dyslipidemia&#46;</p><p id="para0006" class="elsevierStylePara elsevierViewall">She was referred to our outpatient clinic complaining of fatigue and progressive dyspnea with moderate exertion in the previous year&#46; Chest HRCT showed bilateral multiple cysts predominantly in the pulmonary inferior lobes &#40;<a class="elsevierStyleCrossRef" href="#fig0001">Fig&#46; 1</a>A&#44;B&#41;&#44; some traction bronchiectasis and limited areas of emphysema and mosaic attenuation&#46; Serum specific IgGs were positive for parakeets and pigeons&#46; Complete autoimmune study and VEGF-D were normal&#46; Pulmonary function tests revealed FVC 89&#44;9&#37; and a severe-moderate decrease in DLCO &#40;DLCO 49&#44;4&#37;&#44; KCO of 57&#44;3&#37;&#41;&#46; Bronchoalveolar lavage with differential cell count showed 15&#37; of lymphocytes&#46; The nonspecific nature of these results combined with the possibility of other CLD&#44; like lymphocytic interstitial pneumonia&#44; prompted a request for a lung biopsy&#59; the histological examination revealed a cellular interstitial pneumonitis with peribronchiolar pattern and microgranulomas compatible with HP&#46;</p><elsevierMultimedia ident="fig0001"></elsevierMultimedia><p id="para0007" class="elsevierStylePara elsevierViewall">Once the diagnosis of HP was established&#44; the patient was advised to avoid any contact with possible allergens and inhaled corticosteroid and bronchodilators were prescribed&#46; Initially&#44; the patient improved and remained stable&#44; reporting only mild dyspnea &#40;mMRC 0-1&#41; during moderate&#47; hard exercises&#44; especially after being in the square and exposed to pigeons and other birds&#59; over time there was a substantial improvement in the respiratory functions tests&#44; with a FVC of 93&#37;&#44; a DLCO of 66&#37; and a KCO of 80&#37;&#46;</p><p id="para0008" class="elsevierStylePara elsevierViewall">After ten years the patient experienced clinical and functional worsening &#40;FVC 74&#37;&#44; DLCO 48&#37; and KCO 66&#37;&#41; and was put on oral corticosteroids &#40;prednisolone 5mg&#47;day&#41;&#44; with favorable response&#46;</p><p id="para0009" class="elsevierStylePara elsevierViewall">Currently&#44; the patient is clinically and functionally stable &#40;FVC 84&#37;&#44; DLCO 55&#37; and KCO 72&#37;&#41;&#59; although HRCT shows no changes regarding multiple cysts&#44; there are extensive areas with mosaic attenuation associated with ground glass opacities&#44; traction bronchiectasis and loss of lobar volume &#40;<a class="elsevierStyleCrossRef" href="#fig0001">Fig&#46; 1</a>C&#44;D&#41;&#46;</p><p id="para0010" class="elsevierStylePara elsevierViewall">Cystic lung diseases are increasingly recognized as a heterogeneous group of ILD with a broad spectrum of outcomes and consequences&#59; the widespread use of HRCT has had an important role in this increased knowledge and understanding&#46;<a class="elsevierStyleCrossRef" href="#bib0001"><span class="elsevierStyleSup">1</span></a> HP is a good prognosis disease often diagnosed by a combination of typical clinical history&#44; positive serum precipitins and a characteristic bronchoalveolar lavage&#46;<a class="elsevierStyleCrossRef" href="#bib0003"><span class="elsevierStyleSup">3</span></a> Cystic HP is a rare form of HP frequently associated with a challenging diagnosis<a class="elsevierStyleCrossRef" href="#bib0004"><span class="elsevierStyleSup">4</span></a>&#59; in these cases&#44; where there is an extensive overlap between clinical and radiographic features&#44; lung biopsy and histopathologic evaluation may be crucial to establishing a confident diagnosis&#46; Faced with this scenario it is important to weigh the need for a secure histopathological diagnosis against the risks of the medical procedure&#46; In recent years and in part due to an increasing demand for histological evaluations in patients with comorbid conditions&#44; poor overall health status&#44; physical frailty and a more severe degree of lung function impairment the role of transbronchial cryobiopsy &#40;TBLC&#41; in ILD patients has grown&#46; Nowadays&#44; compared to surgical lung biopsy&#44; TBLC offers a less invasive diagnostic method that is almost as accurate as surgical lung biopsy but has a better safety profile&#46;<a class="elsevierStyleCrossRef" href="#bib0006"><span class="elsevierStyleSup">6</span></a></p><p id="para0011" class="elsevierStylePara elsevierViewall">Furthermore&#44; and similar to other non-cystic forms of HP&#44; cystic HP can slowly progress over time&#44; especially the inflammatory-fibrotic component&#44; even after removing exposures and treating acute exacerbations&#59; interestingly&#44; the cystic component of the disease seems to remain stable&#46;</p><span id="sec0001" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0003">Funding</span><p id="para0012" class="elsevierStylePara elsevierViewall">This research did not receive any specific grant from funding agencies in the public&#44; commercial&#44; or not-for-profit sectors&#46;</p></span><span id="sec0002" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0004">Ethical considerations</span><p id="para0013" class="elsevierStylePara elsevierViewall">Written informed consent was obtained from the patient for publication of the article&#46;</p></span><span id="sec0002a" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0004a">CRediT authorship contribution statement</span><p id="para0013a" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">E&#46;M&#46; Tinoco&#58;</span> Writing &#8211; original draft&#44; Writing &#8211; review &#38; editing&#46; <span class="elsevierStyleBold">G&#46; Bermudo&#58;</span> Methodology&#44; Writing &#8211; review &#38; editing&#46; <span class="elsevierStyleBold">V&#46; Vicens-Zygmunt&#58;</span> Methodology&#44; Writing &#8211; review &#38; editing&#46; <span class="elsevierStyleBold">P&#46; Luburich&#58;</span> Writing &#8211; review &#38; editing&#46; <span class="elsevierStyleBold">R&#46; Llatj&#243;s&#58;</span> Writing &#8211; review &#38; editing&#46; <span class="elsevierStyleBold">M&#46; Molina-Molina&#58;</span> Writing &#8211; original draft&#44; Methodology&#44; Writing &#8211; review &#38; editing&#46;</p></span></span>"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Multiple cystic lung disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "F&#46;A&#46; Ferreira Francisco"
                            1 => "A&#46; Soares Souza Jr"
                            2 => "G&#46; Zanetti"
                            3 => "E&#46; Marchiori"
                          ]
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                    ]
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                    0 => array:2 [
                      "doi" => "10.1183/16000617.0046-2015"
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                        "paginaInicial" => "552"
                        "paginaFinal" => "564"
                      ]
                    ]
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              "etiqueta" => "2"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Diagnosis&#44; course and management of hypersensitivity pneumonitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Hamblin"
                            1 => "H&#46; Prosch"
                            2 => "M&#46; Va&#353;&#225;kov&#225;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1183/16000617.0169-2021"
                      "Libro" => array:1 [
                        "fecha" => "2022"
                      ]
                    ]
                  ]
                ]
              ]
            ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Diagnosis of hypersensitivity pneumonitis in adults&#46; An official ATS&#47;JRS&#47;ALAT clinical practice guideline"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
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                            1 => "M&#46; Remy-Jardin"
                            2 => "C&#46;J&#46; Ryerson"
                            3 => "J&#46;L&#46; Myers"
                            4 => "M&#46; Kreuter"
                            5 => "M&#46; Vasakova"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/rccm.202005-2032ST"
                      "Revista" => array:7 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2020"
                        "volumen" => "202"
                        "numero" => "3"
                        "paginaInicial" => "e36"
                        "paginaFinal" => "e69"
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                  ]
                ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lung cysts in subacute hypersensitivity pneumonitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "T&#46; Franquet"
                            1 => "D&#46;M&#46; Hansell"
                            2 => "T&#46; Senbanjo"
                            3 => "M&#46; Remy-Jardin"
                            4 => "NL&#46; M&#252;ller"
                          ]
                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/00004728-200307000-00003"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Comput Assist Tomogr"
                        "fecha" => "2003"
                        "volumen" => "27"
                        "numero" => "4"
                        "paginaInicial" => "475"
                        "paginaFinal" => "478"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12886127"
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                          ]
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                    ]
                  ]
                ]
              ]
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              "etiqueta" => "5"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Cystic lung diseases&#58; algorithmic approach"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Raoof"
                            1 => "P&#46; Bondalapati"
                            2 => "R&#46; Vydyula"
                            3 => "J&#46;H&#46; Ryu"
                            4 => "N&#46; Gupta"
                            5 => "S&#46; Raoof"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.chest.2016.04.026"
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                        "numero" => "4"
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                          0 => array:2 [
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                      ]
                    ]
                  ]
                ]
              ]
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              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Complications and hospital admission in the following 90 days after lung cryobiopsy performed in interstitial lung disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Aburto"
                            1 => "J&#46; P&#233;rez-Izquierdo"
                            2 => "U&#46; Agirre"
                            3 => "I&#46; Barredo"
                            4 => "J&#46;J&#46; Echevarria-Uraga"
                            5 => "K&#46; Armendariz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.rmed.2020.105934"
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                        "tituloSerie" => "Respir Med"
                        "fecha" => "2020"
                        "volumen" => "165"
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ISSN: 25310437
Original language: English
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