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array:23 [ "pii" => "S0210480606735161" "issn" => "02104806" "doi" => "10.1016/S0210-4806(06)73516-1" "estado" => "S300" "fechaPublicacion" => "2006-01-01" "aid" => "73516" "copyright" => "Asociación Española de Urología (AEU)" "copyrightAnyo" => "2006" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2006;30:667-74" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1456 "formatos" => array:3 [ "EPUB" => 6 "HTML" => 867 "PDF" => 583 ] ] "itemSiguiente" => array:18 [ "pii" => "S0210480606735173" "issn" => "02104806" "doi" => "10.1016/S0210-4806(06)73517-3" "estado" => "S300" "fechaPublicacion" => "2006-01-01" "aid" => "73517" "copyright" => "Asociación Española de Urología (AEU)" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2006;30:675-83" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1290 "formatos" => array:3 [ "EPUB" => 4 "HTML" => 684 "PDF" => 602 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Litiasis urinaria en adultos con mielomeningocele" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "675" "paginaFinal" => "683" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Urinary calculi in myelomeningocele adults" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:2 [ 0 => array:2 [ "autoresLista" => "J. Salinas Casado" "autores" => array:1 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Salinas Casado" ] ] ] 1 => array:2 [ "autoresLista" => "F. Verdú Tartajo, F. Herranz Amo, J.M. Díez Cordero, R. Durán Merino, C. Hernández Fernández" "autores" => array:5 [ 0 => array:2 [ "nombre" => "F." "apellidos" => "Verdú Tartajo" ] 1 => array:2 [ "nombre" => "F." "apellidos" => "Herranz Amo" ] 2 => array:2 [ "nombre" => "J.M." "apellidos" => "Díez Cordero" ] 3 => array:2 [ "nombre" => "R." "apellidos" => "Durán Merino" ] 4 => array:2 [ "nombre" => "C." "apellidos" => "Hernández Fernández" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480606735173?idApp=UINPBA00004N" "url" => "/02104806/0000003000000007/v1_201304251821/S0210480606735173/v1_201304251821/es/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S021048060673515X" "issn" => "02104806" "doi" => "10.1016/S0210-4806(06)73515-X" "estado" => "S300" "fechaPublicacion" => "2006-01-01" "aid" => "73515" "copyright" => "Asociación Española de Urología (AEU)" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2006;30:661-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1537 "formatos" => array:3 [ "EPUB" => 5 "HTML" => 958 "PDF" => 574 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Resección transuretral de próstata bipolar vs monopolar: análisis peroperatorio de los resultados" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "661" "paginaFinal" => "666" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Bipolar Versus Monopolar Transurethral Resection Of The Prostate: Peroperative Analysis Of The Results" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.Mª. Abascal Junquera, L. Cecchini Rosell, C. Salvador Lacambra, R. Martos Calvo, A. Celma Domenech, J. Morote Robles" "autores" => array:6 [ 0 => array:2 [ "nombre" => "J.Mª." "apellidos" => "Abascal Junquera" ] 1 => array:2 [ "nombre" => "L." "apellidos" => "Cecchini Rosell" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Salvador Lacambra" ] 3 => array:2 [ "nombre" => "R." "apellidos" => "Martos Calvo" ] 4 => array:2 [ "nombre" => "A." "apellidos" => "Celma Domenech" ] 5 => array:2 [ "nombre" => "J." "apellidos" => "Morote Robles" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S021048060673515X?idApp=UINPBA00004N" "url" => "/02104806/0000003000000007/v1_201304251821/S021048060673515X/v1_201304251821/es/main.assets" ] "es" => array:13 [ "idiomaDefecto" => true "titulo" => "Validez de las pruebas utilizadas en el diagnóstico inicial y su concordancia con el diagnóstico final en pacientes con sospecha de hiperplasia benigna de próstata" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "667" "paginaFinal" => "674" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J. Carballido Rodríguez, X. Badia Llach, A. Gimeno Collado, L. Regadera Sejas, R. Dal-Ré Saavedra, M. Guilera Sardá" "autores" => array:6 [ 0 => array:3 [ "nombre" => "J." "apellidos" => "Carballido Rodríguez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] ] ] 1 => array:4 [ "nombre" => "X." "apellidos" => "Badia Llach" "email" => array:1 [ 0 => "mxbadia@hor-europe.co" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">**</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "cor0005" ] ] ] 2 => array:3 [ "nombre" => "A." "apellidos" => "Gimeno Collado" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">***</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "L." "apellidos" => "Regadera Sejas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">****</span>" "identificador" => "aff0020" ] ] ] 4 => array:3 [ "nombre" => "R." "apellidos" => "Dal-Ré Saavedra" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">****</span>" "identificador" => "aff0020" ] ] ] 5 => array:3 [ "nombre" => "M." "apellidos" => "Guilera Sardá" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">**</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Servicio Urología. Hospital Universitario Clínica Puerta de Hierro. Madrid" "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Health Outcomes Research Europe. Barcelona. Hospital Universitario Clínica Puerta de Hierro. Madrid" "etiqueta" => "<span class="elsevierStyleSup">**</span>" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Urología. Hospital General de la Mancha. Ciudad Real. Hospital Universitario Clínica Puerta de Hierro. Madrid" "etiqueta" => "<span class="elsevierStyleSup">***</span>" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Departamento Médico. GlaxoSmithKline. S.A. Hospital Universitario Clínica Puerta de Hierro. Madrid" "etiqueta" => "****" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "1" "correspondencia" => "Dr. X. Badia Health Outcomes Research Europe Avda. Diagonal 618, 1 C-D Barcelona 08021" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Validity Of Tests For Initial Diagnosis And Its Concordance With Final Diagnosis In Patients With Suspected Benign Prostatic Hyperplasia" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2006-04-05" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras claves" "identificador" => "xpalclavsec87946" "palabras" => array:3 [ 0 => "Hiperplasia benigna de próstata" 1 => "Diagnóstico" 2 => "Atención primaria" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec87945" "palabras" => array:3 [ 0 => "Benign prostatic hyperplasia" 1 => "Diagnosis" 2 => "Primary health care" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Determinar la validez de los métodos diagnósticos al alcance del primer escalón del nivel asistencial [historia clínica (HC), cuestionario I-PSS, tacto rectal (TR) y determinación del antígeno prostático específico (PSA)], para el diagnóstico de la hiperplasia benigna de próstata (HBP)</p> <span class="elsevierStyleSectionTitle">Población y Métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Participaron 363 pacientes atendidos en consultas externas de urología por sospecha de HBP. El diagnóstico inicial de HBP se fue realizando tras la aplicación secuencial de cada una de las siguientes pruebas: 1) HC 2) I-PSS 3) TR y 4) PSA. El diagnóstico emitido tras cada uno de los 4 pasos, se contrastó con el diagnóstico final (gold standard) tras la evaluación de sedimento urinario, volumen miccional residual y tamaño prostático por ecografía y flujometría urinaria. Se realizó un análisis descriptivo y se calculó la validez y concordancia entre cada paso diagnóstico y el gold standard</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La sensibilidad, especificidad, valor predictivo positivo y valor predictivo negativo del diagnóstico basado en HC+IPSS+ TR+PSA con respecto al diagnóstico final fueron 91%, 65%, 95% y 50% respectivamente. El porcentaje de acuerdo y el índice kappa entre ambos diagnósticos fueron 87,9% y 0,5, respectivamente</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La concordancia entre el diagnóstico inicial basada en la historia clínica, cuestionario I-PSS, TR y PSA, y el diagnóstico final de HBP es alta, lo que permite recomendar el uso del conjunto de estas pruebas accesibles en el primero de los escalones asistenciales no sólo como primer paso diagnóstico en los pacientes con sospecha de HBP, sino también como estrategia válida para evitar retrasos innecesarios en su manejo inicial y facilitar la adecuada derivación entre los niveles de atención primaria y especializada</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To assess the validity of diagnostic tools available at the primary care setting [medical history (MH), I-PSS questionnaire, digital rectal examination (DRE) and prostate specific antigen (PSA) evaluation] for the diagnosis of benign prostatic hyperplasia (BPH)</p> <span class="elsevierStyleSectionTitle">Subjects and Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">363 patients with suspected prostatic disease referred to urology outpatient clinics were included. For every subject initial BPH diagnosis was collected at each of the following sequential procedures: 1) MH; 2) I-PSS; 3) DRE; and 4) PSA. Each of these diagnostic decisions were compared to a final diagnosis (gold standard) reached after the addition of urinary sediment analysis, ultrasonographic assessment of residual volume and prostatic volume, and peak urinary flow measurement. A descriptive analysis was undertaken; validity and concordance between each diagnostic step and the gold standard was calculated</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Sensitivity, specificity, positive predictive value, and negative predictive value of diagnosis based on MH+IPSS+ DRE+PSA with respect to the gold standard were 91%, 65%, 95% and 50%, respectively. The percentage of agreement and kappa index between both diagnostic strategies were 87.9% and 0.5, respectively</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Concordance between BPH initial diagnosis based on MH+I-PSS+DRE+PSA and diagnosis based on a full range of tests was high, thus allowing recommending the use of this group of initial diagnostic procedures, which are available to the primary care physician, not only as a first diagnostic step in patients with suspected BPH, but also as a valid strategy to prevent unnecessary delay in its initial management and to facilitate appropriate referral from primary to specialized care</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:23 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." 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