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Ensanchamiento generalizado de las metáfisis de los huesos largos, en copa, con desflecamiento de las mismas. Marcado ensanchamiento longitudinal de las fisis. Arqueamiento generalizado de las diáfisis de los huesos largos.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Patricia Rubio Sánchez, Marta Ferrer Lozano" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Patricia" "apellidos" => "Rubio Sánchez" ] 1 => array:2 [ "nombre" => "Marta" "apellidos" => "Ferrer Lozano" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S234128792400084X" "doi" => "10.1016/j.anpede.2024.03.029" "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/S234128792400084X?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403320304161?idApp=UINPBA00005H" "url" => "/16954033/0000009500000001/v1_202107030542/S1695403320304161/v1_202107030542/es/main.assets" ] ] "itemSiguiente" => array:18 [ "pii" => "S2341287924001169" "issn" => "23412879" "doi" => "10.1016/j.anpede.2024.03.050" "estado" => "S300" "fechaPublicacion" => "2024-04-01" "aid" => "3067" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "An Pediatr (Barc). 2024;100:e24-e25" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Images in Paediatrics</span>" "titulo" => "Diffuse subarachnoid haemorrhage with obstructive hydrocephalus in a 4-year-old girl" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "e24" "paginaFinal" => "e25" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hemorragia subaracnoidea difusa con hidrocefalia obstructiva en niña de 4 años" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 3574 "Ancho" => 1352 "Tamanyo" => 379811 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) The CT scan showed subarachnoid haemorrhage and obstructive hydrocephalus.</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Cerebral angiogram. Left vertebral artery series: (B) lateral view and (C) anteroposterior view. Giant fusiform aneurysm in the two lower thirds of the basilar artery. Treatment options like parent artery sacrifice or stent-assisted reconstruction were ruled out on account of the age of the patient and anatomical considerations.</p> <p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">T1-weighted and FLAIR (fluid-attenuated inversion recovery) MRI images: (D) and (E) immediate postoperative period, and (F) and (G) 6 months after surgery. The images show a progressive reduction of the aneurysmal pouch and partial resolution of mass effect and obstructive hydrocephalus.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ana Gutiérrez-Vélez, Clara Ferrero García-Loygorri, Mariano Del Valle Diéguez, Juan Vicente Darriba Alles" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Ana" "apellidos" => "Gutiérrez-Vélez" ] 1 => array:2 [ "nombre" => "Clara" "apellidos" => "Ferrero García-Loygorri" ] 2 => array:2 [ "nombre" => "Mariano" "apellidos" => "Del Valle Diéguez" ] 3 => array:2 [ "nombre" => "Juan Vicente" "apellidos" => "Darriba Alles" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1695403320305348" "doi" => "10.1016/j.anpedi.2020.11.030" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403320305348?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287924001169?idApp=UINPBA00005H" "url" => "/23412879/0000010000000004/v1_202404250845/S2341287924001169/v1_202404250845/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S2341287924000838" "issn" => "23412879" "doi" => "10.1016/j.anpede.2024.03.028" "estado" => "S300" "fechaPublicacion" => "2024-04-01" "aid" => "2967" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "An Pediatr (Barc). 2024;100:e19-e20" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Images in Paediatrics</span>" "titulo" => "Danger of bronchoaspiration in children's public spaces" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "e19" "paginaFinal" => "e20" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Peligro de broncoaspiración en lugares infantiles públicos" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 797 "Ancho" => 1501 "Tamanyo" => 124475 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0150" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">(a) Flexible bronchoscopy: foreign body (arrow) in the right bronchus (carina, asterisk). (b) Removed rubber fragment measuring 5<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>mm (L<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>H).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Maria Ballarà Petitbò, Antonio de Francisco Profumo, María Oviedo Gutiérrez, Andrea Soria Gondek" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Maria Ballarà" "apellidos" => "Petitbò" ] 1 => array:2 [ "nombre" => "Antonio" "apellidos" => "de Francisco Profumo" ] 2 => array:2 [ "nombre" => "María" "apellidos" => "Oviedo Gutiérrez" ] 3 => array:2 [ "nombre" => "Andrea" "apellidos" => "Soria Gondek" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1695403320302988" "doi" => "10.1016/j.anpedi.2020.08.010" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403320302988?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287924000838?idApp=UINPBA00005H" "url" => "/23412879/0000010000000004/v1_202404250845/S2341287924000838/v1_202404250845/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Images in Paediatrics</span>" "titulo" => "Vitamin D deficiency as cause of rickets in a patient of African origin" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "e21" "paginaFinal" => "e23" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Patricia Rubio Sánchez, Marta Ferrer Lozano" "autores" => array:2 [ 0 => array:4 [ "nombre" => "Patricia" "apellidos" => "Rubio Sánchez" "email" => array:1 [ 0 => "patrirub92@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Marta" "apellidos" => "Ferrer Lozano" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Pediatría, Hospital Infantil Universitario Miguel Servet, Zaragoza, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad Endocrinología, Servicio de Pediatría, Hospital Infantil 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" => "Raquitismo carencial en un paciente de raza negra" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1623 "Ancho" => 2092 "Tamanyo" => 214890 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Imaging features suggestive of rickets, with significant osteopenia and diaphyseal fracture in both fibulas associated with periosteal reaction. General long bone metaphyseal widening, cupping and fraying. Marked longitudinal widening of the growth plates. Generalised bowing of long bone diaphyses.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Rickets is a childhood disease characterised by deficient bone mineralization during growth. The most frequent cause is vitamin D deficiency and/or low dietary calcium intake.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">We present the case of a girl aged 2 years and 10 months of African descent brought in for assessment of bone deformities (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) and unstable gait, so that the patient required help walking. The relevant findings of the history-taking were exclusive breastfeeding through age 18 months followed by deficient supplementary feeding thereafter, without supplementation with vitamin D in the first year of life and prolonged periods inside the house. The patient exhibited a limp from the moment she started walking and refusal to walk due to pain. Since rickets was suspected, we performed laboratory tests (calcium, 8.4 mg/dL, phosphorus, 2.3 mg/dL, alkaline phosphatase, 2948 U/L; parathyroid hormone, 972.9 pg/mL, 25-hydroxyvitamin D < 10.8 ng/mL) and imaging tests that confirmed severe nutritional rickets (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Treatment started with administration of mega-doses of vitamin D, calcium and alfacalcidol, with subsequent administration of cholecalciferol and dietary changes, with clinical, radiological and laboratory improvement at the time of this writing (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). Testing of the mother and brother found deficient vitamin D levels.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">At present, nutritional rickets has been practically eradicated in developed countries, yet its incidence has been increasing, especially in the subset of immigrants with a dark phototype, so we would like to emphasise the importance of the early detection of risk factors, since delays in diagnosis and treatment in advanced cases can result in permanent bone deformities.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2020-07-17" "fechaAceptado" => "2020-09-07" "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2281 "Ancho" => 2092 "Tamanyo" => 348207 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Generalised deformities with epiphyseal widening in wrists and ankles, rachitic rosary, bowing of both femurs.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1623 "Ancho" => 2092 "Tamanyo" => 214890 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Imaging features suggestive of rickets, with significant osteopenia and diaphyseal fracture in both fibulas associated with periosteal reaction. General long bone metaphyseal widening, cupping and fraying. Marked longitudinal widening of the growth plates. Generalised bowing of long bone diaphyses.</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1974 "Ancho" => 2092 "Tamanyo" => 302774 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Clear radiological and deformity improvement, although some deformities remain due to the baseline severity, with persistent shortening of the lower body with coxa vara and genu valgum.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nutritional rickets around the world: an update" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A.L. Creo" 1 => "T.D. Thacher" 2 => "J.M. Pettifor" 3 => "M.A. Strand" 4 => "P.R. Fischer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1080/20469047.2016.1248170" "Revista" => array:7 [ "tituloSerie" => "Paediatr Int Child Health." "fecha" => "2017" "volumen" => "37" "numero" => "2" "paginaInicial" => "84" "paginaFinal" => "98" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27922335" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Global consensus recommendations on prevention and management of nutritional rickets" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F.M. Craig" 1 => "N. Shaw" 2 => "M. Kiely" 3 => "B.L. Specker" 4 => "T.D. Thacher" 5 => "K. Ozono" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Clin Endocrinol Metab." "fecha" => "2016" "volumen" => "101" "numero" => "2" "paginaInicial" => "394" "paginaFinal" => "415" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23412879/0000010000000004/v1_202404250845/S234128792400084X/v1_202404250845/en/main.assets" "Apartado" => array:4 [ "identificador" => "77701" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in Paediatrics" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23412879/0000010000000004/v1_202404250845/S234128792400084X/v1_202404250845/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S234128792400084X?idApp=UINPBA00005H" ]
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