Estudio multicéntrico y prospectivo de “educación y enseñanza” del procedimiento de inhalación en pacientes respiratorios (estudio Eden)
Multicenter prospective study of respiratory patient education and instruction in the use of inhalers (Eden study)
J. Ginera,
, V. Maciánb, C. Hernándezc, Grupo Eden *
Corresponding author
jginer@separ.es
Correspondencia: D. J. Giner. Departament de Pneumologia. Hospital de la Santa Creu i Sant Pau.Sant Antoni M. Claret, 165. 08025 Barcelona
Correspondencia: D. J. Giner. Departament de Pneumologia. Hospital de la Santa Creu i Sant Pau.Sant Antoni M. Claret, 165. 08025 Barcelona
Read
11505
Timeswas read the article
2963
Total PDF
8542
Total HTML
Share statistics
array:23 [ "pii" => "S0300289602752228" "issn" => "03002896" "doi" => "10.1016/S0300-2896(02)75222-8" "estado" => "S300" "fechaPublicacion" => "2002-07-01" "aid" => "75222" "copyright" => "Sociedad Española de Neumología y Cirugía Torácica" "copyrightAnyo" => "2002" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Arch Bronconeumol. 2002;38:300-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 8095 "formatos" => array:3 [ "EPUB" => 82 "HTML" => 6967 "PDF" => 1046 ] ] "itemSiguiente" => array:18 [ "pii" => "S030028960275223X" "issn" => "03002896" "doi" => "10.1016/S0300-2896(02)75223-X" "estado" => "S300" "fechaPublicacion" => "2002-07-01" "aid" => "75223" "copyright" => "Sociedad Española de Neumología y Cirugía Torácica" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Arch Bronconeumol. 2002;38:306-10" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 6377 "formatos" => array:3 [ "EPUB" => 71 "HTML" => 5612 "PDF" => 694 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Utilidad de la enseñanza del manejo del cartucho presurizado y el sistema Turbuhaler® en los pacientes hospitalizados" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "306" "paginaFinal" => "310" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Usefulness of teaching how to manag the pressurized canister and the Turbuhaler®system in hospitalized patients" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:2 [ 0 => array:2 [ "autoresLista" => "M. Haro Estarriol" "autores" => array:1 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Haro Estarriol" ] ] ] 1 => array:2 [ "autoresLista" => "C. Lázaro Castañer, C. Marín-Barnuevo, M.J. Andicoberry Martínez, M.D. Martínez Puerta" "autores" => array:4 [ 0 => array:2 [ "nombre" => "C." "apellidos" => "Lázaro Castañer" ] 1 => array:2 [ "nombre" => "C." "apellidos" => "Marín-Barnuevo" ] 2 => array:2 [ "nombre" => "M.J." "apellidos" => "Andicoberry Martínez" ] 3 => array:2 [ "nombre" => "M.D." "apellidos" => "Martínez Puerta" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S030028960275223X?idApp=UINPBA00003Z" "url" => "/03002896/0000003800000007/v1_201307081529/S030028960275223X/v1_201307081529/es/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0300289602752216" "issn" => "03002896" "doi" => "10.1016/S0300-2896(02)75221-6" "estado" => "S300" "fechaPublicacion" => "2002-07-01" "aid" => "75221" "copyright" => "Sociedad Española de Neumología y Cirugía Torácica" "documento" => "article" "crossmark" => 0 "subdocumento" => "edi" "cita" => "Arch Bronconeumol. 2002;38:297-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 9184 "formatos" => array:3 [ "EPUB" => 74 "HTML" => 8256 "PDF" => 854 ] ] "es" => array:7 [ "idiomaDefecto" => true "titulo" => "Terapia inhalada sin educación, un fracaso anunciado" "tienePdf" => "es" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "297" "paginaFinal" => "299" ] ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "F. Burgos" "autores" => array:1 [ 0 => array:2 [ "nombre" => "F." "apellidos" => "Burgos" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289602752216?idApp=UINPBA00003Z" "url" => "/03002896/0000003800000007/v1_201307081529/S0300289602752216/v1_201307081529/es/main.assets" ] "es" => array:13 [ "idiomaDefecto" => true "titulo" => "Estudio multicéntrico y prospectivo de “educación y enseñanza” del procedimiento de inhalación en pacientes respiratorios (estudio Eden)" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "300" "paginaFinal" => "305" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J. Giner, V. Macián, C. Hernández" "autores" => array:4 [ 0 => array:4 [ "nombre" => "J." "apellidos" => "Giner" "email" => array:1 [ 0 => "jginer@separ.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" => "V." "apellidos" => "Macián" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "C." "apellidos" => "Hernández" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:2 [ "colaborador" => "Grupo Eden" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "fn0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Hospital de la Santa Creu i Sant Pau. Barcelona" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Hospital Universitario La Fe. Valencia" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Hospital Clínic i Provincial. Barcelona" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Correspondencia: D. J. Giner. Departament de Pneumologia. Hospital de la Santa Creu i Sant Pau.Sant Antoni M. Claret, 165. 08025 Barcelona" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Multicenter prospective study of respiratory patient education and instruction in the use of inhalers (Eden study)" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec190561" "palabras" => array:4 [ 0 => "Educación" 1 => "Enseñanza" 2 => "Procedimiento de inha-lación" 3 => "Inhaladores" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec190562" "palabras" => array:4 [ 0 => "Education" 1 => "Teaching" 2 => "Inhalation procedure" 3 => "Inhalers" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El gran inconveniente de utilizar fármacos por vía inhalatoria es la deficiente técnica utilizada. Los objetivos del estudio fueron evaluar los conocimientos que sobre los dispositivos de inhalación tienen los pacientes que los utilizan y valorar el efecto sobre estos conocimientos de una sesión de instrucción en el uso de estos dispositivos de inhalación</p> <span class="elsevierStyleSectionTitle">Material y método</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio multicéntrico, prospectivo y descriptivo, pre y postintervención, sobre la eficacia de una sesión de instrucción en la técnica de utilización de los dispositivos de inhalación: cartucho presurizado (MDI), cámara de inhalación (IC), dispositivo de autodisparo Autohaler ® (AMDI) y dispositivos de polvo Turbuhaler ® (PST) y Accuhaler ® (PSA). Se estudiaron un total de 349 pacientes que utilizaban habitualmente dispositivos de inhalación para el tratamiento de su enfermedad respiratoria. Tras la evaluación de los conocimientos teóricos sobre la vía inhalatoria (comunes) y el dispositivo que utilizaban, así como de la técnica de inhalación con el dispositivo estudio, se instruyó al paciente en la técnica correcta y se evaluaron ambos conocimientos a los 2 y 8 meses de la intervención</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Los conocimientos teóricos comunes fueron de 3,2 (1) sobre 6 puntos y los del dispositivo de 2,7 (1) sobre 4 puntos y los prácticos de 77 (21) sobre 100 puntos. Tras la intervención todos los conocimientos teóricos y prácticos au-mentaron de forma estadísticamente significativa. Los co-munes fueron de 5,1 (1) a los 2 meses y de 5,2 (1) a los ocho; los del dispositivo, de 3,5 (0,6) y 3,6 (0,7), respectivamente, y los prácticos, de 95 (11) y 96 (11) a los 2 y 8 meses, respecti-vamente</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El estudio EDEN pone de manifiesto que los conocimientos sobre dispositivos de inhalación de los enfermos respiratorios, de una amplia muestra de la población de España, aunque son aceptables, pueden mejorar con un programa adecuado de enseñanza. Mediante un esquemaconsensuado de aprendizaje se consigue, además, una muy correcta utilización práctica de todos los dispositivos analizados. Creemos que de esta forma se consigue mejorar nota-blemente los síntomas y la calidad de vida de los enfermos respiratorios</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To evaluate patients' knowledge of the inhalers they use and to assess the effect of knowledge acquired in an instruction session on correct technique</p> <span class="elsevierStyleSectionTitle">Material and method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Multicentric, prospective, descriptive study before and after one instruction session dealing with the technique to apply in using an inhaler: a pressurized canister, an inhalation chamber Autohaler®, or one of two dry powder inhalers (the Turbuhaler® or the Accuhaler®). We studied 349 patients who used their inhalers regularly to treat their respiratory diseases. After assessing their theoretical knowledge of the airways (common), of the particular device they used, and their inhalation technique, we gave instruction in correct technique. Both types of knowledge were then evaluated 2 and 8 months after instruction</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Before instruction, common theoretical knowledge was 3.2 (1) on a 6-point scale and knowledge of the device used was 2.7(1) on a 4-point scale. Technique was assessed as 77 (21) on a 100-point scale. After instruction both theoretical knowledge and technique improved significantly. Common knowledge after instruction was assessed as 5.1 (1) at 2 months and 5.2 (1) at 8 months; knowledge of the inhaler was 3.5 (0.6) and 3.6 (0.7), respectively. Technique was assessed at 95 (11) and 96 (11) at 2 and 8 months, respectively</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The EDEN study demonstrates that knowledge of inhalers in a large sample of the population of respiratory disease patients in Spain, although acceptable, can be improved by an appropriate instruction program. After a standardized instruction program, correct use of all the inhalers studied was achieved. We believe that we thereby contribute to improving symptoms and quality of life of res-piratory disease patients</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "nota" => "<p class="elsevierStyleNotepara">Miembros grupo EDEN: M.C. Abadía (Hospital Clínico de Zaragoza), M. Díaz (Hospital de Cruces de Baracaldo), M. García (Hospital General Universitario de Murcia), M.T. Herrero (Hospital Clínic i Provincial de Barcelona), A. López (Hospital General Yagüe de Burgos), E. Martín (Hospital Virgen del Rocío de Sevilla), I. Martínez (Hospital 12 Octubre de Madrid), A. Mengibar (Hospital Clínico de Granada), C. Molins (Hospital Universitario la Fe de Valencia), A. Noguera (Hospital Son Dureta de Palma de Mallorca), B. Palacio (Hospital de la Princesa de Madrid), P. Pérez (Hospital General de Alicante), M.L. Vázquez (Hospital Juan Canalejo de La Coruña)</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:11 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "New trends in aerosol therapy: the clinician's view [editorial]" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J. Sanchis" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur Respir Rev" "fecha" => "1993" "volumen" => "4" "numero" => "8" "paginaInicial" => "106" "paginaFinal" => "107" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guía clínica para el diagnóstico y tratamiento de la enfermedad pulmonar obstructiva crónica" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.A. Barberá" 1 => "G. Peces-Barba" 2 => "A.G.N. Agustí" 3 => "J.L. Izquierdo" 4 => "E. Monsó" 5 => "T. Montemayor" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2001" "volumen" => "37" "paginaInicial" => "297" "paginaFinal" => "316" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11412529" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Recomendaciones para la utilización de fármacos inhalados" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "V. Plaza" 1 => "P. Casan" 2 => "A. De Diego" 3 => "F. Duce" 4 => "J.B. Gáldiz" 5 => "A. López Viña" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "1996" "volumen" => "32" "numero" => "Supl 1" "paginaInicial" => "8" "paginaFinal" => "9" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8653262" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Normativa sobre la utilización de fármacos inhalados" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Giner" 1 => "L.V. Basualdo" 2 => "P. Casan" 3 => "C. Hernández" 4 => "V. Macián" 5 => "I. Martínez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2000" "volumen" => "36" "paginaInicial" => "34" "paginaFinal" => "43" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10726183" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Asma bronquial y broncodilatadores en aerosol: Empleo correcto en nuestro medio" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A.G.N. Agustí" 1 => "P. Useti" 2 => "J. Roca" 3 => "J.M. Montserrrat" 4 => "R. Rodríguez-roisin" 5 => "A. Agustí-Vidal" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Clin (Barc)" "fecha" => "1983" "volumen" => "81" "paginaInicial" => "893" "paginaFinal" => "894" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pressurised aerosol inhalers. The cost of misues" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D. King" 1 => "S.M. Earnshaw" 2 => "J.C. Delane" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Br J Pract" "fecha" => "1991" "volumen" => "41" "paginaInicial" => "48" "paginaFinal" => "49" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Medical personnels knowledge of ability to use inhalating device. Metereddouse inhalers, spacing chambers, and brath-actuated dry powder inhalers" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "N.A. Hanania" 1 => "R. Wittman" 2 => "S. Kesten" 3 => "K.R. Chapman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "1994" "volumen" => "105" "paginaInicial" => "111" "paginaFinal" => "116" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8275720" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Conocimientos y destreza en el manejo del inhalador Turbuhaler por parte del personal sanitario" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "V. Plaza" 1 => "J. Giner" 2 => "J. Gómez" 3 => "P. Casan" 4 => "J. Sanchis" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "1997" "volumen" => "33" "paginaInicial" => "113" "paginaFinal" => "117" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9181982" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Medical personnel and patient skill in the use of metered dose inhalers: a multicentric study. CESEA Group" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "V. Plaza" 1 => "J. Sanchis" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Respiration" "fecha" => "1998" "volumen" => "65" "paginaInicial" => "195" "paginaFinal" => "198" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9670301" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Técnica de inhalación en los pacientes con enfermedades respiratorias crónicas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "F. Carrión" 1 => "M. Maya" 2 => "J. Fontana" 3 => "J. Díaz" 4 => "J. Martín" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2000" "volumen" => "36" "paginaInicial" => "236" "paginaFinal" => "240" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10916662" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11." "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Área de Enfermería y Fisioterapia. Educa y Enseña Sistemas de Inhalación [consultado 10/01/2000]. Disponible en: <a class="elsevierStyleInterRef" href="http://www.separ.es">http://www.separ.es</a>" ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/03002896/0000003800000007/v1_201307081529/S0300289602752228/v1_201307081529/es/main.assets" "Apartado" => array:4 [ "identificador" => "9277" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Originales" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000003800000007/v1_201307081529/S0300289602752228/v1_201307081529/es/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289602752228?idApp=UINPBA00003Z" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 7 | 1 | 8 |
| 2024 October | 40 | 50 | 90 |
| 2024 September | 43 | 27 | 70 |
| 2024 August | 47 | 42 | 89 |
| 2024 July | 44 | 28 | 72 |
| 2024 June | 57 | 34 | 91 |
| 2024 May | 49 | 39 | 88 |
| 2024 April | 44 | 37 | 81 |
| 2024 March | 37 | 45 | 82 |
| 2024 February | 42 | 41 | 83 |
| 2024 January | 1 | 3 | 4 |
| 2023 December | 0 | 1 | 1 |
| 2023 November | 0 | 9 | 9 |
| 2023 October | 0 | 6 | 6 |
| 2023 September | 0 | 3 | 3 |
| 2023 July | 0 | 6 | 6 |
| 2023 June | 0 | 12 | 12 |
| 2023 April | 0 | 1 | 1 |
| 2023 March | 2 | 7 | 9 |
| 2023 February | 23 | 30 | 53 |
| 2023 January | 18 | 31 | 49 |
| 2022 December | 33 | 38 | 71 |
| 2022 November | 37 | 39 | 76 |
| 2022 October | 28 | 75 | 103 |
| 2022 September | 19 | 43 | 62 |
| 2022 August | 40 | 48 | 88 |
| 2022 July | 28 | 45 | 73 |
| 2022 June | 24 | 55 | 79 |
| 2022 May | 35 | 54 | 89 |
| 2022 April | 57 | 45 | 102 |
| 2022 March | 55 | 50 | 105 |
| 2022 February | 40 | 35 | 75 |
| 2022 January | 37 | 49 | 86 |
| 2021 December | 20 | 55 | 75 |
| 2021 November | 28 | 56 | 84 |
| 2021 October | 39 | 77 | 116 |
| 2021 September | 29 | 54 | 83 |
| 2021 August | 26 | 48 | 74 |
| 2021 July | 20 | 25 | 45 |
| 2021 June | 31 | 58 | 89 |
| 2021 May | 30 | 41 | 71 |
| 2021 April | 49 | 126 | 175 |
| 2021 March | 50 | 58 | 108 |
| 2021 February | 36 | 19 | 55 |
| 2021 January | 36 | 31 | 67 |
| 2020 December | 37 | 28 | 65 |
| 2020 November | 26 | 30 | 56 |
| 2020 October | 26 | 23 | 49 |
| 2020 September | 22 | 22 | 44 |
| 2020 August | 31 | 6 | 37 |
| 2020 July | 38 | 31 | 69 |
| 2020 June | 20 | 14 | 34 |
| 2020 May | 32 | 25 | 57 |
| 2020 April | 26 | 19 | 45 |
| 2020 March | 21 | 35 | 56 |
| 2020 February | 29 | 26 | 55 |
| 2020 January | 47 | 29 | 76 |
| 2019 December | 51 | 30 | 81 |
| 2019 November | 19 | 17 | 36 |
| 2019 October | 13 | 13 | 26 |
| 2019 September | 18 | 24 | 42 |
| 2019 August | 22 | 19 | 41 |
| 2019 July | 24 | 27 | 51 |
| 2019 June | 28 | 27 | 55 |
| 2019 May | 43 | 44 | 87 |
| 2019 April | 38 | 27 | 65 |
| 2019 March | 35 | 25 | 60 |
| 2019 February | 23 | 23 | 46 |
| 2019 January | 12 | 28 | 40 |
| 2018 December | 26 | 24 | 50 |
| 2018 November | 36 | 23 | 59 |
| 2018 October | 45 | 15 | 60 |
| 2018 September | 24 | 5 | 29 |
| 2018 July | 2 | 0 | 2 |
| 2018 May | 16 | 2 | 18 |
| 2018 April | 8 | 12 | 20 |
| 2018 March | 10 | 11 | 21 |
| 2018 February | 8 | 9 | 17 |
| 2018 January | 12 | 10 | 22 |
| 2017 December | 16 | 26 | 42 |
| 2017 November | 15 | 18 | 33 |
| 2017 October | 11 | 27 | 38 |
| 2017 September | 8 | 24 | 32 |
| 2017 August | 15 | 24 | 39 |
| 2017 July | 9 | 18 | 27 |
| 2017 June | 25 | 41 | 66 |
| 2017 May | 25 | 33 | 58 |
| 2017 April | 31 | 17 | 48 |
| 2017 March | 15 | 33 | 48 |
| 2017 February | 16 | 36 | 52 |
| 2017 January | 19 | 14 | 33 |
| 2016 December | 38 | 27 | 65 |
| 2016 November | 63 | 48 | 111 |
| 2016 October | 55 | 37 | 92 |
| 2016 September | 51 | 43 | 94 |
| 2016 August | 51 | 21 | 72 |
| 2016 July | 68 | 10 | 78 |
| 2016 June | 63 | 16 | 79 |
| 2016 May | 68 | 7 | 75 |
| 2016 April | 48 | 2 | 50 |
| 2016 March | 47 | 5 | 52 |
| 2016 February | 51 | 7 | 58 |
| 2016 January | 46 | 17 | 63 |
| 2015 December | 40 | 22 | 62 |
| 2015 November | 39 | 9 | 48 |
| 2015 October | 102 | 1 | 103 |
| 2015 September | 98 | 0 | 98 |
| 2015 August | 95 | 0 | 95 |
| 2015 July | 74 | 0 | 74 |
| 2015 June | 93 | 0 | 93 |
| 2015 May | 119 | 0 | 119 |
| 2015 April | 109 | 0 | 109 |
| 2015 March | 92 | 0 | 92 |
| 2015 February | 76 | 0 | 76 |
| 2015 January | 69 | 0 | 69 |
| 2014 December | 59 | 0 | 59 |
| 2014 November | 100 | 0 | 100 |
| 2014 October | 96 | 0 | 96 |
| 2014 September | 83 | 0 | 83 |
| 2014 August | 64 | 0 | 64 |
| 2014 July | 69 | 0 | 69 |
| 2014 June | 82 | 0 | 82 |
| 2014 May | 103 | 0 | 103 |
| 2014 April | 87 | 0 | 87 |
| 2014 March | 126 | 0 | 126 |
| 2014 February | 74 | 0 | 74 |
| 2014 January | 82 | 0 | 82 |
| 2013 December | 62 | 0 | 62 |
| 2013 November | 69 | 0 | 69 |
| 2013 October | 78 | 0 | 78 |
| 2013 September | 69 | 0 | 69 |
| 2013 August | 60 | 0 | 60 |
| 2013 July | 74 | 0 | 74 |
| 2013 June | 43 | 0 | 43 |
| 2013 May | 60 | 0 | 60 |
| 2013 April | 40 | 0 | 40 |
| 2013 March | 18 | 0 | 18 |
| 2000 January | 2935 | 0 | 2935 |
Show all
