Tuberculosis pulmonar y pleural diagnosticadas y tratadas en una unidad neumologica de un hospital general. Analisis de eficiencia
Lung and pleural tuberculosis diagnosed and treated in a chest service of a general hospital. Efficiency analysis
J.I. Garcia Del Palacio, A. Lopez Encuentra, J.M. Fernandez Sanchez-Alarcos, J.M. Ignacio Garcia, M.R. Melchor Iñiguez, P. Martin Escribano
Servicio de Neumología. Ciudad Sanitaria 1.° de Octubre. Madrid
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Morales Marin, R. Navarro Ivañez, B. Togores Solivellas, J. Gil Carbonell, V. Macian Gisbert, E. Benlloch Garcia, V. Marco Martinez" "autores" => array:7 [ 0 => array:2 [ "nombre" => "P." "apellidos" => "Morales Marin" ] 1 => array:2 [ "nombre" => "R." "apellidos" => "Navarro Ivañez" ] 2 => array:2 [ "nombre" => "B." "apellidos" => "Togores Solivellas" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Gil Carbonell" ] 4 => array:2 [ "nombre" => "V." "apellidos" => "Macian Gisbert" ] 5 => array:2 [ "nombre" => "E." "apellidos" => "Benlloch Garcia" ] 6 => array:2 [ "nombre" => "V." "apellidos" => "Marco Martinez" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289615322481?idApp=UINPBA00003Z" "url" => "/03002896/0000002000000003/v1_201509151156/S0300289615322481/v1_201509151156/es/main.assets" ] "es" => array:13 [ "idiomaDefecto" => true "titulo" => "Tuberculosis pulmonar y pleural diagnosticadas y tratadas en una unidad neumologica de un hospital general. Analisis de eficiencia" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "118" "paginaFinal" => "122" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "J.I. Garcia Del Palacio, A. Lopez Encuentra, J.M. Fernandez Sanchez-Alarcos, J.M. Ignacio Garcia, M.R. Melchor Iñiguez, P. Martin Escribano" "autores" => array:6 [ 0 => array:2 [ "nombre" => "J.I." "apellidos" => "Garcia Del Palacio" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Lopez Encuentra" ] 2 => array:2 [ "nombre" => "J.M." "apellidos" => "Fernandez Sanchez-Alarcos" ] 3 => array:2 [ "nombre" => "J.M." "apellidos" => "Ignacio Garcia" ] 4 => array:2 [ "nombre" => "M.R." "apellidos" => "Melchor Iñiguez" ] 5 => array:2 [ "nombre" => "P." "apellidos" => "Martin Escribano" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Neumología. Ciudad Sanitaria 1.° de Octubre. Madrid" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Lung and pleural tuberculosis diagnosed and treated in a chest service of a general hospital. Efficiency analysis" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "1983-07-11" "fechaAceptado" => "1983-12-06" "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Se han analizado 108 pacientes de tuberculosis pleuropulmonar tratados de forma inicial en una unidad neumológica de un hospital general. La población tuberculosa recibida en esta unidad tenía como característica especial un significativo porcentaje de enfermedades asociadas.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">En el 89% de los casos el tratamiento propuesto fue el ternario de 9 meses que incluye la rifampicina. El 55% de los pacientes efectuaron un inicial ingreso hospitalario.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se realizó un correcto tratamiento en dosis, combinación y tiempos totales, en el 89% de los casos. En el 8% se han efectuado tratamientos incorrectos, la mayoría (5,6%), no imputables a pacientes. En un 3% de casos no existían datos de seguimiento tras el diagnóstico.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La vigilancia toxicológica de la terapéutica ha sido efectuada en la mayoría, detectándose anormalidades enzimáticas hepáticas en un 5-8% de pacientes en los primeros ocho meses de tratamiento. La toxicidad inherente al tratamiento obligó en seis casos a cambio terapéutico, diferente al diseño inicial.</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A nuestro parecer no existen limitaciones teóricas ni prácticas al tratamiento de estos pacientes en un hospital general, habiéndose descartado la indiscriminada necesidad del ingreso hospitalario, pero considerando imprescindible el seguimiento de una norma terapéutica previamente admitida por todos los médicos qué se dedican al cuidado de estos pacientes, y que se base sobre datos seguros de curación en el tratamiento de la tuberculosis pleuropulmonar.</p></span>" ] "en" => array:1 [ "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">108 patients with pleuropulmonary tuberculosis initially treated in a chest Service of a general hospital were analyzed. The patients with tuberculosis treated in this Service had a significantly higher percentage of associated diseases.</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Treatment with three drugs for nine months including rifampicin was used in 89% of the cases. 55% of the patients were initially hospitalized.</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">89% of the cases followed corred treatment (dosage, combination of drugs, and total time of therapy). 8% of the patients followed and incorrect treatment and most of the times (5%) this was not due to the patients. Follow up data was not obtained after making the diagnosis in 3% of the patients.</p><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Surveillance to detect side effects of therapy was done in most of the patients and hepatic enzymatic abnormalities were detected in 5-8% of patients during the first 8 months of therapy. The initial therapeutical regimen had to be changed in 6 patients due to its toxicity.</p><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">We do not think that there are any theoretical or practical limitations to the treatment of these patients in a general hospital and we do not recommend the indiscriminate hospitalization of these patients but it is absolutely necessary to follow a therapeutical regimen accepted previously by all physicians taking care of these patients and based on reliable data on its success for curing pleuropulminary tuberculosis.</p></span>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografia" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:26 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 3 | 4 | 7 |
| 2024 October | 36 | 16 | 52 |
| 2024 September | 28 | 11 | 39 |
| 2024 August | 44 | 29 | 73 |
| 2024 July | 38 | 25 | 63 |
| 2024 June | 41 | 19 | 60 |
| 2024 May | 32 | 23 | 55 |
| 2024 April | 27 | 16 | 43 |
| 2024 March | 33 | 16 | 49 |
| 2024 February | 28 | 24 | 52 |
| 2023 March | 4 | 2 | 6 |
| 2023 February | 19 | 13 | 32 |
| 2023 January | 20 | 24 | 44 |
| 2022 December | 27 | 21 | 48 |
| 2022 November | 28 | 10 | 38 |
| 2022 October | 22 | 32 | 54 |
| 2022 September | 22 | 20 | 42 |
| 2022 August | 24 | 32 | 56 |
| 2022 July | 13 | 32 | 45 |
| 2022 June | 18 | 30 | 48 |
| 2022 May | 28 | 23 | 51 |
| 2022 April | 19 | 25 | 44 |
| 2022 March | 30 | 28 | 58 |
| 2022 February | 24 | 23 | 47 |
| 2022 January | 22 | 19 | 41 |
| 2021 December | 13 | 32 | 45 |
| 2021 November | 15 | 26 | 41 |
| 2021 October | 47 | 25 | 72 |
| 2021 September | 22 | 23 | 45 |
| 2021 August | 25 | 14 | 39 |
| 2021 July | 18 | 25 | 43 |
| 2021 June | 12 | 18 | 30 |
| 2021 May | 14 | 15 | 29 |
| 2021 April | 22 | 24 | 46 |
| 2021 March | 44 | 10 | 54 |
| 2021 February | 33 | 10 | 43 |
| 2021 January | 20 | 15 | 35 |
| 2020 December | 23 | 12 | 35 |
| 2020 November | 9 | 10 | 19 |
| 2020 October | 5 | 6 | 11 |
| 2020 September | 13 | 3 | 16 |
| 2020 August | 18 | 5 | 23 |
| 2020 July | 13 | 11 | 24 |
| 2020 June | 15 | 7 | 22 |
| 2020 May | 10 | 10 | 20 |
| 2020 April | 20 | 9 | 29 |
| 2020 March | 10 | 16 | 26 |
| 2020 February | 24 | 14 | 38 |
| 2020 January | 22 | 17 | 39 |
| 2019 December | 19 | 11 | 30 |
| 2019 November | 4 | 3 | 7 |
| 2019 October | 5 | 8 | 13 |
| 2019 September | 6 | 11 | 17 |
| 2019 August | 10 | 13 | 23 |
| 2019 July | 14 | 27 | 41 |
| 2019 June | 10 | 9 | 19 |
| 2019 May | 9 | 13 | 22 |
| 2019 April | 32 | 55 | 87 |
| 2019 March | 8 | 19 | 27 |
| 2019 February | 0 | 14 | 14 |
| 2019 January | 5 | 6 | 11 |
| 2018 December | 4 | 14 | 18 |
| 2018 November | 10 | 15 | 25 |
| 2018 October | 26 | 15 | 41 |
| 2018 September | 8 | 6 | 14 |
| 2018 May | 7 | 1 | 8 |
| 2018 April | 7 | 3 | 10 |
| 2018 March | 4 | 5 | 9 |
| 2018 February | 7 | 10 | 17 |
| 2018 January | 4 | 4 | 8 |
| 2017 December | 7 | 11 | 18 |
| 2017 November | 5 | 10 | 15 |
| 2017 October | 5 | 11 | 16 |
| 2017 September | 5 | 12 | 17 |
| 2017 August | 11 | 10 | 21 |
| 2017 July | 10 | 6 | 16 |
| 2017 June | 9 | 18 | 27 |
| 2017 May | 14 | 11 | 25 |
| 2017 April | 10 | 7 | 17 |
| 2017 March | 26 | 7 | 33 |
| 2017 February | 7 | 12 | 19 |
| 2017 January | 2 | 2 | 4 |
| 2016 December | 7 | 6 | 13 |
| 2016 November | 21 | 16 | 37 |
| 2016 October | 21 | 21 | 42 |
| 2016 September | 24 | 7 | 31 |
| 2016 August | 23 | 5 | 28 |
| 2016 July | 22 | 5 | 27 |
| 2016 June | 23 | 8 | 31 |
| 2016 May | 16 | 6 | 22 |
| 2016 April | 9 | 0 | 9 |
| 2016 March | 10 | 0 | 10 |
| 2016 February | 9 | 0 | 9 |
| 2016 January | 11 | 2 | 13 |
| 2015 December | 31 | 15 | 46 |
| 2015 November | 30 | 7 | 37 |
| 2015 October | 6 | 1 | 7 |
| 2015 September | 1 | 0 | 1 |
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