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array:23 [ "pii" => "S0025775301717642" "issn" => "00257753" "doi" => "10.1016/S0025-7753(01)71764-2" "estado" => "S300" "fechaPublicacion" => "2001-01-01" "aid" => "71764" "copyright" => "Elsevier España, S.L.. Todos los derechos reservados" "copyrightAnyo" => "2001" "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "Med Clin. 2001;116:182-5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1990 "formatos" => array:3 [ "EPUB" => 7 "HTML" => 1789 "PDF" => 194 ] ] "itemSiguiente" => array:18 [ "pii" => "S0025775301717654" "issn" => "00257753" "doi" => "10.1016/S0025-7753(01)71765-4" "estado" => "S300" "fechaPublicacion" => "2001-01-01" "aid" => "71765" "copyright" => "Elsevier España, S.L." "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "Med Clin. 2001;116:186-90" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1935 "formatos" => array:3 [ "EPUB" => 7 "HTML" => 1682 "PDF" => 246 ] ] "es" => array:8 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">ArtÍculo Especial</span>" "titulo" => "Final de la vida: ¿puede ser confortable?" 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"documento" => "simple-article" "crossmark" => 0 "subdocumento" => "edi" "cita" => "Med Clin. 2001;116:179-81" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1908 "formatos" => array:3 [ "EPUB" => 7 "HTML" => 1724 "PDF" => 177 ] ] "es" => array:8 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>" "titulo" => "Evaluación de la etiología y del abordaje terapéutico de la neumonía adquirida en la comunidad" "tienePdf" => "es" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "179" "paginaFinal" => "181" ] ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Torres Antoni, N. Soler" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Torres" "apellidos" => "Antoni" ] 1 => array:2 [ "nombre" => "N." "apellidos" => "Soler" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775301717630?idApp=UINPBA00004N" "url" => "/00257753/0000011600000005/v1_201307291416/S0025775301717630/v1_201307291416/es/main.assets" ] "es" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Nota ClÍnica</span>" "titulo" => "Exposición a <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> durante un viaje en autobús" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "182" "paginaFinal" => "185" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Francisco Extremera Montero, Rosa Moyano Acosta, Basilio Gómez Pozo, Pilar Bermúdez Ruiz, Julio López Méndez, Susana Aguilar Rivas, Javier Ingelmo Martín" "autores" => array:7 [ 0 => array:4 [ "nombre" => "Francisco" "apellidos" => "Extremera Montero" "email" => array:1 [ 0 => "frextmon@teleline.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" => "Rosa" "apellidos" => "Moyano Acosta" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Basilio" "apellidos" => "Gómez Pozo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Pilar" "apellidos" => "Bermúdez Ruiz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 4 => array:3 [ "nombre" => "Julio" "apellidos" => "López Méndez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 5 => array:3 [ "nombre" => "Susana" "apellidos" => "Aguilar Rivas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 6 => array:3 [ "nombre" => "Javier" "apellidos" => "Ingelmo Martín" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Centro de Salud Palma-Palmilla. Málaga" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Epidemiología. Distrito Sanitario de Málaga" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Microbiología. Hospital Regional Carlos Haya. Málaga" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Servicio de Medicina Preventiva. Hospital Clínico de Málaga" "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondence: Salvador Allende, 11, 9.<span class="elsevierStyleSup">o</span> B. 29017 Málaga." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Exposure to <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> during a bus travel" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2000-06-27" "fechaAceptado" => "2000-11-28" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras Clave" "identificador" => "xpalclavsec220807" "palabras" => array:3 [ 0 => "Tuberculosis" 1 => "Autobús escolar" 2 => "Estudio de contactos" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec220808" "palabras" => array:3 [ 0 => "Tuberculosis" 1 => "School bus" 2 => "Contact tracing" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Fundamento</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">En un brote de tuberculosis ocurrido en un instituto se valora la posible influencia de una excursión en autobús como causa de contagio entre un caso índice y los viajeros.</p> <span class="elsevierStyleSectionTitle">Población, pacientes y método</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio de contactos realizado al conductor, tres maestros y 49 alumnos que pertenecían a clases diferentes, y que viajaron de Málaga a Sierra Nevada en marzo de 1998. Se incluyó a todos los alumnos de las clases donde apareció algún caso de tuberculosis desde abril a diciembre de 1998 y a todos los profesores del instituto.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">En el instituto se estudió a un total de 232 alumnos, la prevalencia de infección fue del 35%, encontrando un total de 12 nuevos casos entre los alumnos. Ningún profesor de los 123 estudiados enfermó. De los que viajaron en autobús, dos profesores y 19 alumnos estaban infectados, y la prevalencia entre los alumnos fue del 46%; cinco de ellos estaban enfermos. La odds ratio de infección para los que tenían un compañero de clase con baciloscopia positiva fue de 5, 5. Independientemente, el viajar en autobús (con respecto a los que no viajaron) supuso una odds ratio de 3. 4. La mayoría de los viajeros infectados tenían relación de proximidad con el caso índice.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">En el brote de tuberculosis estudiado algunos de los alumnos enfermos e infectados no tenían ninguna relación de proximidad ni amistad con el caso índice en el instituto, por lo que parece confirmarse que para algunos alumnos la transmisión de la tuberculosis se produjo dentro del autobús.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">In an outbreak of tuberculosis that occurred in a school, we evaluated the possible transmission during a trip in an schoolbus as the cause of infection.</p> <span class="elsevierStyleSectionTitle">Subjects, patients and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Contact tracing of the driver, 3 teachers and 49 students from different grades who were travelling from Málaga to Sierra Nevada (Spain) in March 1998. All the students from the ten grades where any case of tuberculosis appeared from April to December 1998 and all the teachers of the school were included.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">At the school, 232 students were studied. The prevalence of the infection was 35%. A total of 12 new cases among the students were found. No teachers out of the 127 examined became ill. Out of the people who travelled by shool bus, 2 teachers and 19 students were infected, prevalence among students 46%; five of those become ill. The odds ratio of infection for those having a class mate with positive smears was 5, 5. On the other hand, the trip by bus (compared with those who did not take it) meant a odds ratio of 3, 4. Most of the infected travellers were sitting in the bus close to the index case.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">In this tuberculosis outbreak some of the students who became ill or infected were not near the index case nor friendly with him at class. Therefore is possible that in some cases tuberculosis was transmitted inside the bus.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias Bibliográficas" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:17 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tuberculosis. Una enfermedad especialmente contagiosa" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J. Mallolas" 1 => "E. 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