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array:19 [ "pii" => "S002577530671884X" "issn" => "00257753" "doi" => "10.1157/13084870" "estado" => "S300" "fechaPublicacion" => "2006-02-18" "documento" => "article" "subdocumento" => "fla" "cita" => "Med Clin. 2006;126:211-3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 17913 "formatos" => array:3 [ "EPUB" => 7 "HTML" => 1286 "PDF" => 16620 ] ] "itemSiguiente" => array:15 [ "pii" => "S0025775306718851" "issn" => "00257753" "doi" => "10.1157/13084878" "estado" => "S300" "fechaPublicacion" => "2006-02-18" "documento" => "article" "subdocumento" => "fla" "cita" => "Med Clin. 2006;126:214-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2729 "formatos" => array:3 [ "EPUB" => 8 "HTML" => 2387 "PDF" => 334 ] ] "es" => array:7 [ "idiomaDefecto" => true "titulo" => "Prevención cardiovascular en atención primaria" "tienePdf" => "es" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "214" "paginaFinal" => "216" ] ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Pedro González-Santos" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Pedro" "apellidos" => "González-Santos" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775306718851?idApp=UINPBA00004N" "url" => "/00257753/0000012600000006/v0_201607111356/S0025775306718851/v0_201607111359/es/main.assets" ] "itemAnterior" => array:15 [ "pii" => "S0025775306718838" "issn" => "00257753" "doi" => "10.1157/13084869" "estado" => "S300" "fechaPublicacion" => "2006-02-18" "documento" => "article" "subdocumento" => "fla" "cita" => "Med Clin. 2006;126:206-10" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2890 "formatos" => array:3 [ "EPUB" => 7 "HTML" => 2456 "PDF" => 427 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Uso de bloqueadores beta en pacientes ancianos con insuficiencia cardíaca" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "206" "paginaFinal" => "210" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Use of betablockers in elderly patients with congestive heart failure" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Agustín Urrutia, Josep Lupón, Salvador Altimir, Beatriz González, Joan Herreros, Crisanto Díez, Ramón Coll, Vicente Valle, Celestino Rey-Joly" "autores" => array:9 [ 0 => array:2 [ "nombre" => "Agustín" "apellidos" => "Urrutia" ] 1 => array:2 [ "nombre" => "Josep" "apellidos" => "Lupón" ] 2 => array:2 [ "nombre" => "Salvador" "apellidos" => "Altimir" ] 3 => array:2 [ "nombre" => "Beatriz" "apellidos" => "González" ] 4 => array:2 [ "nombre" => "Joan" "apellidos" => "Herreros" ] 5 => array:2 [ "nombre" => "Crisanto" "apellidos" => "Díez" ] 6 => array:2 [ "nombre" => "Ramón" "apellidos" => "Coll" ] 7 => array:2 [ "nombre" => "Vicente" "apellidos" => "Valle" ] 8 => array:2 [ "nombre" => "Celestino" "apellidos" => "Rey-Joly" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775306718838?idApp=UINPBA00004N" "url" => "/00257753/0000012600000006/v0_201607111356/S0025775306718838/v0_201607111358/es/main.assets" ] "es" => array:12 [ "idiomaDefecto" => true "titulo" => "Revaluación del método estándar (criterios de Light) para identificar exudados pleurales" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "211" "paginaFinal" => "213" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "José M. Porcel, José M. Peña, Carmina Vicente de Vera, Aureli Esquerda" "autores" => array:4 [ 0 => array:4 [ "nombre" => "José M." "apellidos" => "Porcel" "email" => array:1 [ 0 => "jporcelp@yahoo.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "José M." "apellidos" => "Peña" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "affb" ] ] ] 2 => array:3 [ "nombre" => "Carmina" "apellidos" => "Vicente de Vera" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 3 => array:3 [ "nombre" => "Aureli" "apellidos" => "Esquerda" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "affc" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Interna. Hospital Universitario Arnau de Vilanova. Lleida. España" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] 1 => array:3 [ "entidad" => "Servicio de Nefrología. Hospital de Barbastro. Barbastro. Huesca. España" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "affb" ] 2 => array:3 [ "entidad" => "Servicio de Análisis Clínicos. Hospital Universitario Arnau de Vilanova. Lleida. España" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "affc" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "<span class="elsevierStyleSup">*</span>" "correspondencia" => "Correspondencia: Dr. J.M. Porcel. Servicio de Medicina Interna. Hospital Universitario Arnau de Vilanova. Avda. Alcalde Rovira Roure, 80. 25198 Lleida. España. jporcelp@yahoo.com" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Reappraisal of the standard method (Light's criteria) for identifying pleural exudates" ] ] "pdfFichero" => "2v126n06a90151398pdf001.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec690917" "palabras" => array:5 [ 0 => "Derrame pleural" 1 => "Exudado" 2 => "Trasudado" 3 => "Sensibilidad" 4 => "Especificidad" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec690918" "palabras" => array:5 [ 0 => "Pleural effusion" 1 => "Exudate" 2 => "Transudate" 3 => "Sensitivity" 4 => "Specificity" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Fundamento y objetivos</span><br/><p class="elsevierStylePara">Los criterios de Light se consideran el mejor método para diferenciar los exudados de los trasudados pleurales. Nos proponemos evaluar sus características operativas, así como las que resultan de eliminar el cociente de lactatodeshidrogenasa (LDH) entre líquido pleural y suero de los criterios originales (criterios de Light abreviados), en una serie amplia de pacientes. Asimismo buscamos la mejor combinación de parámetros bioquímicos del líquido pleural (entre ellas proteínas, LDH y colesterol), capaz de identificar exudados.</p><span class="elsevierStyleSectionTitle">Pacientes y método</span><br/><p class="elsevierStylePara">Se analizó retrospectivamente a 1.490 pacientes consecutivos con derrame pleural a quienes se había realizado una toracentesis. El diagnóstico final fue de exudado en 1.192 y de trasudado en 298. Se calcularon la sensibilidad, especificidad, área bajo la curva de eficacia diagnóstica y <span class="elsevierStyleItalic">odds ratio</span> tanto de parámetros individuales como combinados del líquido pleural.</p><span class="elsevierStyleSectionTitle">Resultados</span><br/><p class="elsevierStylePara">La sensibilidad y especificidad de los criterios de Light fueron del 97,5 y el 80%, respectivamente. Tanto los criterios de Light abreviados (sensibilidad del 95,4% y especificidad del 83,3%) como la combinación, con una regla en «o», de las proteínas y LDH del líquido pleural (sensibilidad del 95,4% y especificidad del 80,2%) tuvieron la misma capacidad discriminatoria que los criterios estándar.</p><span class="elsevierStyleSectionTitle">Conclusiones</span><br/><p class="elsevierStylePara">La identificación de los exudados pleurales se puede realizar con los criterios de Light abreviados cuando no se dispone del valor de la LDH sérica. Por otro lado, si la extracción sanguínea no es posible (circunstancia infrecuente), la combinación de proteínas y LDH pleurales serviría también como criterio diagnóstico alternativo a los criterios clásicos de Light.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Background and objectives</span><br/><p class="elsevierStylePara">Light's criteria remain the best method for separating pleural exudates from transudates. We assessed their operating characteristics, as well as those resulting from omitting the pleural fluid to serum lactate dehydrogenase (LDH) ratio from the original criteria (abbreviated Light criteria), in a large series of patients. We also searched for the best combination of pleural fluid parameters, including protein, LDH and cholesterol that identify exudates.</p><span class="elsevierStyleSectionTitle">Patients and method</span><br/><p class="elsevierStylePara">We conducted a retrospective study of 1,490 consecutive patients with pleural effusion who underwent a diagnostic thoracentesis. There were 1,192 exudates and 298 transudates. Sensitivity, specificity, area under ROC curve, and odds ratio for both individual and combined pleural fluid parameters were calculated.</p><span class="elsevierStyleSectionTitle">Results</span><br/><p class="elsevierStylePara">Light's criteria yielded 97.5% sensitivity and 80% specificity. Both abbreviated Light criteria (sensitivity: 95.4%; specificity: 83.3%) and the combined use in an «or» rule of pleural fluid protein and LDH (sensitivity: 95.4%; specificity: 80,2%) had similar discriminative properties than standard criteria.</p><span class="elsevierStyleSectionTitle">Conclusions</span><br/><p class="elsevierStylePara">Diagnostic separation of pleural effusions into exudates or transudates can be done effectively thorough the abbreviated Light criteria when the serum LDH value is not available. On the other hand, if venipuncture wants to be avoided (an unusual circumstance) the combination of pleural fluid protein and LDH represents an alternative to Light's criteria.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliograf¿a" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:9 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Evaluación diagnóstica del derrame pleural. Med Clin (Barc). 2004; 123:426-32." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Evaluación diagnóstica del derrame pleural." "idioma" => "es" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Porcel JM" 1 => "Rubio-Caballero M." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Med Clin (Barc). 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" "fecha" => "2003" "volumen" => "124" "paginaInicial" => "978" "paginaFinal" => "983" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12970026" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Diagnostic value of tests that discriminate between exudative and transudative pleural effusions. Chest. 1997; 111:970-80." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Diagnostic value of tests that discriminate between exudative and transudative pleural effusions." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Heffner JE" 1 => "Brown LK" 2 => "Barbieri CA." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Chest. " "fecha" => "1997" "volumen" => "111" "paginaInicial" => "970" "paginaFinal" => "980" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9106577" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/00257753/0000012600000006/v0_201607111356/S002577530671884X/v0_201607111358/es/main.assets" "Apartado" => array:4 [ "identificador" => "24087" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Original breve" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/00257753/0000012600000006/v0_201607111356/S002577530671884X/v0_201607111358/es/2v126n06a90151398pdf001.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S002577530671884X?idApp=UINPBA00004N" ]
