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array:23 [ "pii" => "S0025775303738676" "issn" => "00257753" "doi" => "10.1016/S0025-7753(03)73867-6" "estado" => "S300" "fechaPublicacion" => "2003-01-01" "aid" => "73867" "copyright" => "Elsevier España, S.L.. Todos los derechos reservados" "copyrightAnyo" => "2003" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Med Clin. 2003;121:95-7" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 4188 "formatos" => array:3 [ "EPUB" => 8 "HTML" => 3669 "PDF" => 511 ] ] "itemSiguiente" => array:18 [ "pii" => "S0025775303738688" "issn" => "00257753" "doi" => "10.1016/S0025-7753(03)73868-8" "estado" => "S300" "fechaPublicacion" => "2003-01-01" "aid" => "73868" "copyright" => "Elsevier España, S.L." "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Med Clin. 2003;121:98-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 6110 "formatos" => array:3 [ "EPUB" => 6 "HTML" => 5145 "PDF" => 959 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Tratamiento con fibrinolisis intrapleural del empiema y el derrame pleural complicado" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "98" "paginaFinal" => "99" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Treatment of empyema and complicated pleural effusion with intrapleural fibrinolysis" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Eduardo Montero Ruiz, Martín Daguerre Talou, Joaquín López Álvarez, Concepción Hernández Ahijado" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Eduardo" "apellidos" => "Montero Ruiz" ] 1 => array:2 [ "nombre" => "Martín" "apellidos" => "Daguerre Talou" ] 2 => array:2 [ "nombre" => "Joaquín" "apellidos" => "López Álvarez" ] 3 => array:2 [ "nombre" => "Concepción" "apellidos" => "Hernández Ahijado" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775303738688?idApp=UINPBA00004N" "url" => "/00257753/0000012100000003/v1_201307291536/S0025775303738688/v1_201307291536/es/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0025775303738664" "issn" => "00257753" "doi" => "10.1016/S0025-7753(03)73866-4" "estado" => "S300" "fechaPublicacion" => "2003-01-01" "aid" => "73866" "copyright" => "Elsevier España, S.L." "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Med Clin. 2003;121:89-94" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 4171 "formatos" => array:3 [ "EPUB" => 6 "HTML" => 3641 "PDF" => 524 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Correlación entre los valores de monóxido de carbono en el aire espirado y los sistemas de medición de dependencia nicotínica DSM-IV, test de Fagerström y ARUSMQ-9 en adolescentes fumadores" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "89" "paginaFinal" => "94" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Correlation between carbon-monoxide levels in exhaled air and nicotinedependence measurements systems (DSM-IV, fagerström test and ARU-SMQ-9) in adolescent smokers" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "María Lourdes Clemente Jiménez, Alfonso Pérez-Trullén, Encarnación Rubio Aranda, Rafael Marrón Tundidor, Inés Herrero Labarga" "autores" => array:5 [ 0 => array:2 [ "nombre" => "María" "apellidos" => "Lourdes Clemente Jiménez" ] 1 => array:2 [ "nombre" => "Alfonso" "apellidos" => "Pérez-Trullén" ] 2 => array:2 [ "nombre" => "Encarnación" "apellidos" => "Rubio Aranda" ] 3 => array:2 [ "nombre" => "Rafael" "apellidos" => "Marrón Tundidor" ] 4 => array:2 [ "nombre" => "Inés" "apellidos" => "Herrero Labarga" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775303738664?idApp=UINPBA00004N" "url" => "/00257753/0000012100000003/v1_201307291536/S0025775303738664/v1_201307291536/es/main.assets" ] "es" => array:14 [ "idiomaDefecto" => true "titulo" => "Morir en el hospital por enfermedad terminal no oncológica: análisis de la toma de decisiones" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "95" "paginaFinal" => "97" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Francesc Formiga, Victoria Vivanco, Yazz Cuapio, Josep Porta, Xavier Gómez-Batiste, Ramón Pujol" "autores" => array:6 [ 0 => array:4 [ "nombre" => "Francesc" "apellidos" => "Formiga" "email" => array:1 [ 0 => "fformiga@csub.scs.es" ] "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" => "Victoria" "apellidos" => "Vivanco" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Yazz" "apellidos" => "Cuapio" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Josep" "apellidos" => "Porta" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "Xavier" "apellidos" => "Gómez-Batiste" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 5 => array:3 [ "nombre" => "Ramón" "apellidos" => "Pujol" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "<span class="elsevierStyleItalic">UFISS de Geriatría. Servicio de Medicina Interna. Hospital Universitari de Bellvitge. L'Hospitalet de Llobregat. Barcelona</span>" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "<span class="elsevierStyleItalic">Servicio de Cuidados Paliativos. Institut Català d'Oncologia. L'Hospitalet de Llobregat. Barcelona. España</span>" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: F. Formiga. UFISS de Geriatría. Servicio de Medicina Interna. Hospital Universitari de Bellvitge. Feixa Llarga, s/n. 08907 L'Hospitalet de Llobregat. Barcelona. España." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Dying in the hospital from an end-stage non-oncologic disease: a decision making analysis" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2002-11-07" "fechaAceptado" => "2003-02-11" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec221815" "palabras" => array:3 [ 0 => "Paciente geriátrico" 1 => "Tratamiento paliativo" 2 => "Hospitalización" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec221814" "palabras" => array:3 [ 0 => "Elderly" 1 => "Palliative care" 2 => "Hospitalization" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Fundamento y objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Evaluar la toma de decisionespaliativas en personas ancianas fallecidasen un hospital de agudos por enfermedadescrónicas no oncológicas.</p> <span class="elsevierStyleSectionTitle">Pacientes y método</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se estudió a 293 pacientesde edad superior a 64 años fallecidos por demencia(46%), insuficiencia cardíaca (31%) oenfermedad pulmonar obstructiva crónica(23%) en fase terminal. Se investigó la existenciade órdenes escritas sobre reanimacióncardiopulmonar (RCP), graduación de actuaciones,información dada a la familia, retiradade la medicación habitual e inicio de tratamientofarmacológico paliativo.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">En el 37% de los casos existíanórdenes sobre RCP, en el 18% graduación deactuaciones y en el 57% información a la familia.En el 56% se retiró la medicación habitualy en el 65% se inició tratamiento paliativo.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Deben mejorarse la identificacióny el tratamiento paliativo de los pacientesancianos afectados de una enfermedad crónicano oncológica en fase terminal que se hallaningresados en un hospital de agudos.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Background and objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The aim of the studywas to evaluate palliative decision-making innon- oncological patients who died in an acutecare hospital.</p> <span class="elsevierStyleSectionTitle">Patients and method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">293 patients > 64 yearsold were analyzed. These patients sufferedfrom dementia (46%), end-stage congestiveheart failure (31%) and end-stage chronic obstructivepulmonary disease (23%). We evaluatedwritten information about: do not resuscitate(DNR) orders, graduation of therapeuticdecisions, information provided to relativesabout prognosis, total withdrawal of other drugtherapy and provision of terminal care.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">DNR orders were specified in 37% ofcases, graduation of therapeutic decisions in18% and knowledge of the prognosis by relativesin 57%. Drug withdrawal was carried outin 56% and palliative care in 65% patients.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Identification and provision of palliativecare, in an acute care hospital, of elderlypatients at their last admission prior todeath because of non-oncological end-stagediseases must be improved.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias Bibliográficas" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Actividad e idoneidad de los equipos geriátricos consultores hospitalarios en los cuidados paliativos" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L. Rexach" 1 => "C. Gutiérrrez" 2 => "M. 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"referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Perceptions by family members of the dying experience of older and serious ill patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Lynn" 1 => "J.M. Teno" 2 => "R.S. Phillips" 3 => "A.W. Wu" 4 => "N. Desbiens" 5 => "J. Harrold" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Intern Med" "fecha" => "1997" "volumen" => "126" "paginaInicial" => "97" "paginaFinal" => "106" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9005760" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10." 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