Image in medicine
Complicated silicosis
Silicosis complicada
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=> "Jorge" "apellidos" => "Rodríguez-Sanz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Laura" "apellidos" => "Martín-Biel" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Ricardo" "apellidos" => "Gómez-Miranda" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Neumología, Hospital Universitario Miguel Servet, Zaragoza, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Radiodiagnóstico, Hospital Universitario Miguel Servet, Zaragoza, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Silicosis complicada" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1323 "Ancho" => 1917 "Tamanyo" => 327406 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">This is a 69-year-old patient with a history of bronchial asthma and complicated silicosis. He had worked in construction and metallurgy. In this case we present, in addition to radiological images, endoscopic images through a flexible bronchoscope, where we see extensive areas of blackish colouring in the bronchial mucosa (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, RLL: right lower lobe, LLL: left lower lobe, ML: middle lobe, RUL: right upper lobe, LUL: left upper lobe).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Silicosis is one of the oldest known occupational lung diseases and is classified as an interstitial disease. It is caused by chronic inhalation of silicon oxide. This silica, once inhaled, is phagocytosed by alveolar macrophages, activating and perpetuating the inflammatory process through inflammatory cytokines (TFN-α and IL-1), which are responsible for recruiting inflammatory cells to the alveolar wall. These cells release oxygen toxins and proteolytic enzymes that cause cellular damage and destruction of the extracellular matrix, leading to the fibrotic response of the lung parenchyma.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The risk of developing silicosis depends on several factors; magnitude of exposure, time of exposure (cumulative dose) and individual sensitivity (genetic and environmental factors). The clinical presentation can be chronic (simple, complicated and fibrosis), accelerated and acute silicosis, with the former being the most common. Time (years) since exposure to silica is key to differentiation. Thus, acute and accelerated forms are within 5–10 years after exposure, while chronic forms occur more than 10 years after exposure. In addition, complicated chronic forms are associated with impaired lung function, while simple chronic forms will have normal lung function.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Its diagnosis requires the presence of silica exposure, radiological findings and ruling out other pathologies. So far, there is no curative treatment, but comprehensive management strategies help to improve quality of life and delay deterioration.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interest</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1323 "Ancho" => 1917 "Tamanyo" => 327406 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000016100000004/v1_202308280911/S2387020623003091/v1_202308280911/en/main.assets" "Apartado" => array:4 [ "identificador" => "51820" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in medicine" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000016100000004/v1_202308280911/S2387020623003091/v1_202308280911/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020623003091?idApp=UINPBA00004N" ]
