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array:22 [ "pii" => "S0025775301717605" "issn" => "00257753" "doi" => "10.1016/S0025-7753(01)71760-5" "estado" => "S300" "fechaPublicacion" => "2001-01-01" "aid" => "71760" "copyright" => "Elsevier España, S.L.. Todos los derechos reservados" "copyrightAnyo" => "2001" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Med Clin. 2001;116:161-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 3463 "formatos" => array:3 [ "EPUB" => 11 "HTML" => 3218 "PDF" => 234 ] ] "itemSiguiente" => array:18 [ "pii" => "S0025775301717617" "issn" => "00257753" "doi" => "10.1016/S0025-7753(01)71761-7" "estado" => "S300" "fechaPublicacion" => "2001-01-01" "aid" => "71761" "copyright" => "Elsevier España, S.L." "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Med Clin. 2001;116:167-73" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1993 "formatos" => array:3 [ "EPUB" => 6 "HTML" => 1756 "PDF" => 231 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Originales</span>" "titulo" => "Diagnóstico y tratamiento de la tuberculosis en España: resultados del Proyecto Multicéntrico de Investigación en Tuberculosis (PMIT)" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "167" "paginaFinal" => "173" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Diagnosis and treatment of tuberculosis in Spain: results from the Multicenter Project for Tuberculosis Research (MPTR)" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Díez Ruiz-Navarro" "autores" => array:2 [ 0 => array:1 [ "colaborador" => "Grupo de Trabajo del PMIT" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Díez Ruiz-Navarro" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775301717617?idApp=UINPBA00004N" "url" => "/00257753/0000011600000005/v1_201307291416/S0025775301717617/v1_201307291416/es/main.assets" ] "es" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Originales</span>" "titulo" => "Estudio prospectivo de 221 neumonías adquiridas en la comunidad seguidas de forma ambulatoria. Etiología y evolución clinicorradiológica" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "161" "paginaFinal" => "166" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Francisco Javier Álvarez Gutiérrez, Daniel del Castillo Otero, Alberto García Fernández, Beatriz Romero Romero, Juan José del Rey Pérez, Gregorio Soto Campos, José Castillo Gómez" "autores" => array:7 [ 0 => array:4 [ "nombre" => "Francisco" "apellidos" => "Javier Álvarez Gutiérrez" "email" => array:1 [ 0 => "fag01se@nacom.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Daniel" "apellidos" => "del Castillo Otero" ] 2 => array:2 [ "nombre" => "Alberto" "apellidos" => "García Fernández" ] 3 => array:2 [ "nombre" => "Beatriz" "apellidos" => "Romero Romero" ] 4 => array:2 [ "nombre" => "Juan" "apellidos" => "José del Rey Pérez" ] 5 => array:2 [ "nombre" => "Gregorio" "apellidos" => "Soto Campos" ] 6 => array:2 [ "nombre" => "José" "apellidos" => "Castillo Gómez" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Unidad de Enfermedad Pulmonar Obstructiva Crónica e Infecciones Respiratorias. Centro de Especialidades Dr. Fleming. Unidad Médico-Quirúrgica de Enfermedades Respiratorias. Hospital Universitario Virgen del Rocío. Sevilla." ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondence: Avda. Alcalde Manuel del Valle. Edificio Cónsul, portal 6, 1.<span class="elsevierStyleSup">o</span> A. 41008 Sevilla." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Prospective study of 221 community acquired pneumonias followed up in an outpatient clinic. Etiology and clinical-radiological progression" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2000-03-20" "fechaAceptado" => "2000-07-25" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec220797" "palabras" => array:3 [ 0 => "Neumonía adquirida en la comunidad" 1 => "Etiología" 2 => "Tratamiento" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec220798" "palabras" => array:3 [ 0 => "Community acquired pneumonia" 1 => "Etiology" 2 => "Treatment" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Fundamento</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Se estudiaron de forma prospectiva las neumonías adquiridas en la comunidad seguidas en una consulta neumológica extrahospitalaria, con objeto de determinar la etiología, las características clinicorradiológicas y su evolución con unas pautas de actuación y tratamiento protocolizadas.</p> <span class="elsevierStyleSectionTitle">Pacientes y método</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se realizaron protocolos de evaluación clínica, diagnóstico etiológico por serología (en la primera visita y a las tres semanas) y, en los casos necesarios, por fibrobroncoscopia (cepillo microbiológico protegido), así como protocolos de evolución clínica y radiológica (hasta tres revisiones) tras pautas de tratamiento empírico previamente establecidos.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se incluyó inicialmente a 240 pacientes, siendo seguidos un total de 221 casos. Obtuvimos el diagnóstico etiológico en 86 pacientes (39%), siendo el germen más frecuente Coxiella burnetii (12,2%), seguido de Mycoplasma pneumoniae y Legionella pneumophila. Se diagnosticaron dos casos de Sptreptococcus pneumoniae. La forma de presentación radiológica más frecuente fue la condensación alveolar (86%). Se emplearon como tratamiento empírico inicial macrólidos (71%) o cefalosporinas de segunda generación (22%). La evolución clínica y radiológica fue satisfactoria en la mayoría de los pacientes, siendo necesario el ingreso hospitalario en dos casos (< 1% del total).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">En las neumonías adquiridas en la comunidad en régimen ambulatorio encontramos un elevado número de gérmenes «atípicos». En pacientes ambulatorios creemos apropiado el tratamiento empírico con macrólidos o cefalosporinas de segunda generación.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">All the community acquired pneumonia followed up in an outpatient clinic were prospectively studied in order to determine: etiology, clinical-radiological characteristics and its progression with diagnostic and therapeutic protocols.</p> <span class="elsevierStyleSectionTitle">Patients and method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">We arranged clinical evaluation protocols, etiological diagnosis by means of serology (in the first visit and three weeks later); and when necessary, by means of fiberbronchoscopy (protected microbiological brush), as well as clinical and radiological progression (up to three visits) after empirical treatment.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Initially, 240 patients were included, of which 221 were fully followed up. Etiological diagnosis was obtained in 86 patients (39%). The bacteria most frequently isolated was Coxiella burnetii (12.2%), followed up Mycoplasma pneumoniae and Legionella pneumophila. Two cases of Strepcococus pneumoniae were diagnosed. The most frequent radiological onset was alveolar infiltrate (86%). The initial empiric treatment were macrolids (71%) or second generation cephalosporines (22%). Most patients presented a favourable clinical and radiological progression. Only 2 patients needed admission to the hospital (< 1%).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">In community acquired pneumonias studied in our outpatient clinic we found a high number of «atipycal» agents. Treatment with macrolids or second generation cephalosporines are appropriate for these patients.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias Bibliográficas" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:23 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Neumonía comunitaria. Epidemiología. Factores de riesgo y pronóstico" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "I. Alfageme Michavila" 1 => "J. Muñoz Méndez" 2 => "I. 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