Neumonía adquirida en la comunidad. Fiabilidad de los criterios para decidir tratamiento ambulatorio
Community acquired pneumonía. Reliability of outpatient treatment criteria
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Fiabilidad de los criterios para decidir tratamiento ambulatorio" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "74" "paginaFinal" => "79" ] ] "autores" => array:2 [ 0 => array:4 [ "autoresLista" => "R. Zalacain, N. Talayero, V. Achótegui, V. Sobradillo" "autores" => array:4 [ 0 => array:3 [ "nombre" => "R." "apellidos" => "Zalacain" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "N." "apellidos" => "Talayero" ] 2 => array:2 [ "nombre" => "V." "apellidos" => "Achótegui" ] 3 => array:2 [ "nombre" => "V." "apellidos" => "Sobradillo" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicios de Neumología, Hospital de Cruces. Barakaldo. Vizcaya" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "1" "correspondencia" => "Correspondencia: Servicio de Neumología. Hospital de Cruces. 48903 Cruces-Barakaldo. Vizcaya." ] ] ] 1 => array:3 [ "autoresLista" => "J. Corral, I. Barreña" "autores" => array:2 [ 0 => array:3 [ "nombre" => "J." "apellidos" => "Corral" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] ] ] 1 => array:3 [ "nombre" => "I." "apellidos" => "Barreña" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">**</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicios de Microbiología, Hospital de Cruces. Barakaldo. Vizcaya" "etiqueta" => "*" "identificador" => "aff0010" ] 1 => array:3 [ "entidad" => "Servicios de Urgencias. Hospital de Cruces. Barakaldo. Vizcaya" "etiqueta" => "**" "identificador" => "aff0015" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Community acquired pneumonía. Reliability of outpatient treatment criteria" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "1996-03-26" "fechaAceptado" => "1996-06-25" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec545634" "palabras" => array:2 [ 0 => "Neumonía adquirida en la comunidad" 1 => "Tratamiento ambulatorio" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec545635" "palabras" => array:2 [ 0 => "Community-acquired pneumonia" 1 => "Outpatient treatment" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El objetivo de este estudio ha sido verificar si los criterios para no ingresar a los pacientes con neumonía adquirida en la comunidad (NAC), diagnosticados en el servicio de urgencias, eran correctos, así como conocer las características clínicas, etiología y evolución de estas NAC.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Durante un año se hizo un estudio prospectivo, protocolizado de las NAC en pacientes adultos e inmunocompetentes, diagnosticados en el servicio de urgencias de nuestro hospital, que no requerían ingreso hospitalario según las recomendaciones de la Sociedad Española de Patología del Aparato Respiratorio (SEPAR). A todos los pacientes se les efectuó una anamnesis, radiografía de tórax y analítica general. Para el estudio microbiológico se emplearon hemocultivos y serología frente a <span class="elsevierStyleItalic">Legionella pneumophila, Mycoplasma pneumoniae, <span class="elsevierStyleItalic">Coxiella burnetii</span>, Chlamydia pneumoniae, Chlamydia psittaci</span> y virus influenza A y B. Los pacientes fueron tratados con eritromicina durante 14 días, y controlados por el neumólogo ambulatorio con visitas periódicas hasta la curación clínica y radiológica.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 106 pacientes. La edad media fue 36 ± 13 años. Sólo 3 sujetos requirieron el ingreso hospitalario con una buena evolución posterior. Los datos clínicos más relevantes fueron la fiebre, 106 (100%) y la tos, 83 (78%). En 46 (43,4%) la auscultación pulmonar fue normal. El diagnóstico microbiológico se consiguió en 28 pacientes (26,4%), siendo <span class="elsevierStyleItalic">Coxiella burnetii</span> el agente hallado en mayor número de casos, 19 (17,9%). La evolución fue muy buena, siendo la curación clínica mucho más rápida que la radiológica.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Los criterios recomendados por la SEPAR para el ingreso de pacientes con NAC son correctos. Las características clínicas de estos pacientes fueron inespecíficas, siendo destacable el elevado número de casos con exploración torácica normal. <span class="elsevierStyleItalic">Coxiella burnetii</span> fue el agente etiológico más frecuente. La evolución fue excelente tanto clínica como radiológicamente.</p></span>" ] "en" => array:1 [ "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To determine whether criteria for not admitting community-acquired pneumonia (CAP) patients diagnosed in the emergency room are appropriate, and to characterize the symptoms, etiology and course of CAP.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">This one-year prospective, protocol study of immunocompetent CAP patients diagnosed in the emergency room of our hospital enrolled patients not considered to require hospital admission according to the recommendations of the Spanish Society of Respiratory Disease (SEPAR). Medical histories, chest <span class="elsevierStyleSmallCaps">X</span>-rays and blood analysis were obtained for all patients. Blood cultures were analyzed for antibodies against <span class="elsevierStyleItalic">Legionella pneumophila, Mycoplasma pneumoniae, <span class="elsevierStyleItalic">Coxiella burnetii</span>, Chlamydia pneumoniae, Chlamydia psittaci</span> and influenza virus types A and B. The patients received erythromycin for 14 days and were regularly checked by the pulmonologist in the outpatient clinic until signs and symptoms had disappeared.</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">One hundred six patients were enrolled. Mean age was 36 ± 13 years. Only 3 patients had to be admitted to hospital, after which outcome was good. The main symptoms were fever (106, 100%) and cough (83, 78%). In 46 (43.4%) chest sounds were normal. Microbiologic diagnoses were achieved for 28 (26.4%) and <span class="elsevierStyleItalic">Coxiella burnetii</span> was the agent most often found (19, 17.9%). Outcome was good in all cases, with faster disappearance of symptoms than of radiological signs.</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The SEPAR criteria for admitting patients with CAP are appropriate. The clinical symptoms of such patients are non specific, a noteworthy finding being that many patients had normal chest sounds. <span class="elsevierStyleItalic">Coxiella burnetii</span> was the most common causative agent. Both clinical and radiological outcomes were excellent.</p></span>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:36 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 7 | 2 | 9 |
| 2024 October | 64 | 14 | 78 |
| 2024 September | 49 | 17 | 66 |
| 2024 August | 55 | 31 | 86 |
| 2024 July | 43 | 28 | 71 |
| 2024 June | 52 | 28 | 80 |
| 2024 May | 53 | 31 | 84 |
| 2024 April | 33 | 27 | 60 |
| 2024 March | 41 | 34 | 75 |
| 2024 February | 37 | 43 | 80 |
| 2024 January | 0 | 1 | 1 |
| 2023 December | 0 | 1 | 1 |
| 2023 November | 0 | 2 | 2 |
| 2023 October | 0 | 4 | 4 |
| 2023 September | 0 | 3 | 3 |
| 2023 July | 0 | 16 | 16 |
| 2023 June | 0 | 8 | 8 |
| 2023 May | 0 | 2 | 2 |
| 2023 March | 2 | 4 | 6 |
| 2023 February | 28 | 13 | 41 |
| 2023 January | 31 | 24 | 55 |
| 2022 December | 42 | 30 | 72 |
| 2022 November | 34 | 16 | 50 |
| 2022 October | 32 | 31 | 63 |
| 2022 September | 30 | 28 | 58 |
| 2022 August | 31 | 40 | 71 |
| 2022 July | 25 | 55 | 80 |
| 2022 June | 19 | 23 | 42 |
| 2022 May | 35 | 32 | 67 |
| 2022 April | 40 | 32 | 72 |
| 2022 March | 42 | 32 | 74 |
| 2022 February | 30 | 31 | 61 |
| 2022 January | 34 | 29 | 63 |
| 2021 December | 14 | 31 | 45 |
| 2021 November | 30 | 45 | 75 |
| 2021 October | 70 | 29 | 99 |
| 2021 September | 34 | 40 | 74 |
| 2021 August | 24 | 33 | 57 |
| 2021 July | 20 | 22 | 42 |
| 2021 June | 15 | 30 | 45 |
| 2021 May | 21 | 26 | 47 |
| 2021 April | 25 | 46 | 71 |
| 2021 March | 32 | 14 | 46 |
| 2021 February | 37 | 13 | 50 |
| 2021 January | 28 | 23 | 51 |
| 2020 December | 17 | 12 | 29 |
| 2020 November | 20 | 13 | 33 |
| 2020 October | 19 | 5 | 24 |
| 2020 September | 11 | 6 | 17 |
| 2020 August | 34 | 8 | 42 |
| 2020 July | 20 | 15 | 35 |
| 2020 June | 25 | 8 | 33 |
| 2020 May | 37 | 16 | 53 |
| 2020 April | 35 | 12 | 47 |
| 2020 March | 35 | 24 | 59 |
| 2020 February | 30 | 15 | 45 |
| 2020 January | 36 | 19 | 55 |
| 2019 December | 24 | 14 | 38 |
| 2019 November | 17 | 3 | 20 |
| 2019 October | 20 | 17 | 37 |
| 2019 September | 16 | 43 | 59 |
| 2019 August | 19 | 9 | 28 |
| 2019 July | 33 | 20 | 53 |
| 2019 June | 20 | 23 | 43 |
| 2019 May | 30 | 40 | 70 |
| 2019 April | 38 | 23 | 61 |
| 2019 March | 19 | 15 | 34 |
| 2019 February | 11 | 4 | 15 |
| 2019 January | 16 | 16 | 32 |
| 2018 December | 19 | 12 | 31 |
| 2018 November | 19 | 13 | 32 |
| 2018 October | 28 | 12 | 40 |
| 2018 September | 16 | 4 | 20 |
| 2018 May | 7 | 2 | 9 |
| 2018 April | 13 | 1 | 14 |
| 2018 March | 7 | 6 | 13 |
| 2018 February | 8 | 7 | 15 |
| 2018 January | 10 | 10 | 20 |
| 2017 December | 9 | 12 | 21 |
| 2017 November | 5 | 6 | 11 |
| 2017 October | 8 | 10 | 18 |
| 2017 September | 6 | 9 | 15 |
| 2017 August | 8 | 7 | 15 |
| 2017 July | 9 | 7 | 16 |
| 2017 June | 11 | 17 | 28 |
| 2017 May | 13 | 9 | 22 |
| 2017 April | 10 | 12 | 22 |
| 2017 March | 6 | 15 | 21 |
| 2017 February | 2 | 5 | 7 |
| 2017 January | 10 | 13 | 23 |
| 2016 December | 18 | 3 | 21 |
| 2016 November | 29 | 15 | 44 |
| 2016 October | 21 | 18 | 39 |
| 2016 September | 29 | 16 | 45 |
| 2016 August | 19 | 4 | 23 |
| 2016 July | 23 | 7 | 30 |
| 2016 June | 31 | 14 | 45 |
| 2016 May | 29 | 6 | 35 |
| 2016 April | 14 | 0 | 14 |
| 2016 March | 11 | 0 | 11 |
| 2016 February | 11 | 0 | 11 |
| 2016 January | 21 | 9 | 30 |
| 2015 December | 35 | 20 | 55 |
| 2015 November | 34 | 10 | 44 |
| 2015 October | 11 | 2 | 13 |
| 2015 September | 6 | 0 | 6 |
| 2015 August | 4 | 0 | 4 |
| 2015 June | 1 | 0 | 1 |
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