array:24 [
  "pii" => "S0300289618304630"
  "issn" => "03002896"
  "doi" => "10.1016/j.arbres.2018.11.018"
  "estado" => "S300"
  "fechaPublicacion" => "2019-08-01"
  "aid" => "2052"
  "copyright" => "SEPAR"
  "copyrightAnyo" => "2018"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "crp"
  "cita" => "Arch Bronconeumol. 2019;55:445-6"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 170
    "formatos" => array:3 [
      "EPUB" => 7
      "HTML" => 115
      "PDF" => 48
    ]
  ]
  "Traduccion" => array:1 [
    "en" => array:19 [
      "pii" => "S1579212919302083"
      "issn" => "15792129"
      "doi" => "10.1016/j.arbr.2018.11.023"
      "estado" => "S300"
      "fechaPublicacion" => "2019-08-01"
      "aid" => "2052"
      "copyright" => "SEPAR"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "crp"
      "cita" => "Arch Bronconeumol. 2019;55:445-6"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:2 [
        "total" => 24
        "formatos" => array:3 [
          "EPUB" => 5
          "HTML" => 11
          "PDF" => 8
        ]
      ]
      "en" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>"
        "titulo" => "Influenza and Pneumococcal Vaccination in Chronic Respiratory Patients &#8211; Are We in the Right Path&#63;"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "445"
            "paginaFinal" => "446"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "es" => array:1 [
            "titulo" => "Vacunaci&#243;n contra la gripe y el neumococo en pacientes con enfermedad respiratoria cr&#243;nica - &#191;estamos en el buen camino&#63;"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Rebeca Martins Natal, Lu&#237;s Vaz Rodrigues"
            "autores" => array:2 [
              0 => array:2 [
                "nombre" => "Rebeca"
                "apellidos" => "Martins Natal"
              ]
              1 => array:2 [
                "nombre" => "Lu&#237;s"
                "apellidos" => "Vaz Rodrigues"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S0300289618304630"
          "doi" => "10.1016/j.arbres.2018.11.018"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289618304630?idApp=UINPBA00003Z"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212919302083?idApp=UINPBA00003Z"
      "url" => "/15792129/0000005500000008/v2_201908080725/S1579212919302083/v2_201908080725/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S0300289619300109"
    "issn" => "03002896"
    "doi" => "10.1016/j.arbres.2018.12.011"
    "estado" => "S300"
    "fechaPublicacion" => "2019-08-01"
    "aid" => "2066"
    "copyright" => "SEPAR"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Arch Bronconeumol. 2019;55:446-7"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 90
      "formatos" => array:3 [
        "EPUB" => 18
        "HTML" => 56
        "PDF" => 16
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>"
      "titulo" => "Acute Respiratory Distress Syndrome Secondary to Histoplasmosis-induced Hemophagocytic Lymphohistiocytosis"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "446"
          "paginaFinal" => "447"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "S&#237;ndrome de distr&#233;s respiratorio agudo secundario a linfohistiocitosis hemofagoc&#237;tica inducida por histoplasmosis"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Fig&#46; 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 874
              "Ancho" => 2091
              "Tamanyo" => 114729
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest X-ray on admission and at 12-h follow-up&#46; &#40;A&#41; Bibasilar linear infiltrates seen on admission&#46; &#40;B&#41; Diffuse bilateral alveolar infiltrates with air bronchogram seen 12<span class="elsevierStyleHsp" style=""></span>h after admission&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Julio Arturo Huapaya, Elizabeth Yogiaveetil, Syed Qamer, Mary Sidawy, Eric Anderson"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "Julio Arturo"
              "apellidos" => "Huapaya"
            ]
            1 => array:2 [
              "nombre" => "Elizabeth"
              "apellidos" => "Yogiaveetil"
            ]
            2 => array:2 [
              "nombre" => "Syed"
              "apellidos" => "Qamer"
            ]
            3 => array:2 [
              "nombre" => "Mary"
              "apellidos" => "Sidawy"
            ]
            4 => array:2 [
              "nombre" => "Eric"
              "apellidos" => "Anderson"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S1579212919302095"
        "doi" => "10.1016/j.arbr.2018.12.025"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212919302095?idApp=UINPBA00003Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289619300109?idApp=UINPBA00003Z"
    "url" => "/03002896/0000005500000008/v2_201908080730/S0300289619300109/v2_201908080730/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S0300289619300924"
    "issn" => "03002896"
    "doi" => "10.1016/j.arbres.2019.02.009"
    "estado" => "S300"
    "fechaPublicacion" => "2019-08-01"
    "aid" => "2105"
    "copyright" => "SEPAR"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Arch Bronconeumol. 2019;55:443-4"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 264
      "formatos" => array:3 [
        "EPUB" => 6
        "HTML" => 168
        "PDF" => 90
      ]
    ]
    "es" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Carta cient&#237;fica</span>"
      "titulo" => "Importancia del manejo especializado en el destete prolongado"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "443"
          "paginaFinal" => "444"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "The Importance of Highly Specific Management in Prolonged Weaning"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figura 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1706
              "Ancho" => 2093
              "Tamanyo" => 179335
            ]
          ]
          "descripcion" => array:1 [
            "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Procedimiento de barrido para calcular el tiempo inspiratorio &#40;Ti&#41; neural&#46; A&#41;<span class="elsevierStyleHsp" style=""></span>Ti neural mayor que el Ti del ventilador&#44; objetiv&#225;ndose asincron&#237;a del tipo doble <span class="elsevierStyleItalic">trigger</span>&#46; B&#41;<span class="elsevierStyleHsp" style=""></span>Ti neural menor que el Ti del ventilador&#44; objetiv&#225;ndose asincron&#237;a del tipo inspiraci&#243;n prolongada&#46; C&#41;<span class="elsevierStyleHsp" style=""></span>Ti ajustado con correcto acoplamiento al ventilador&#46; D&#41;<span class="elsevierStyleHsp" style=""></span>Correlaci&#243;n lineal entre el Ti neural y Ti ajustado obtenido con el m&#233;todo de barrido&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Julia Herrero Huertas, Francisco Laso del Hierro, Fernando Pel&#225;ez Castro, Cristina Plaza Moreno, Ana Ampuero L&#243;pez, Mar&#237;a del Pilar Carballosa de Miguel, Sarah Heili Frades, Germ&#225;n Peces-Barba Romero"
          "autores" => array:8 [
            0 => array:2 [
              "nombre" => "Julia"
              "apellidos" => "Herrero Huertas"
            ]
            1 => array:2 [
              "nombre" => "Francisco"
              "apellidos" => "Laso del Hierro"
            ]
            2 => array:2 [
              "nombre" => "Fernando"
              "apellidos" => "Pel&#225;ez Castro"
            ]
            3 => array:2 [
              "nombre" => "Cristina"
              "apellidos" => "Plaza Moreno"
            ]
            4 => array:2 [
              "nombre" => "Ana"
              "apellidos" => "Ampuero L&#243;pez"
            ]
            5 => array:2 [
              "nombre" => "Mar&#237;a del Pilar"
              "apellidos" => "Carballosa de Miguel"
            ]
            6 => array:2 [
              "nombre" => "Sarah"
              "apellidos" => "Heili Frades"
            ]
            7 => array:2 [
              "nombre" => "Germ&#225;n"
              "apellidos" => "Peces-Barba Romero"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S1579212919301557"
        "doi" => "10.1016/j.arbr.2019.02.006"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212919301557?idApp=UINPBA00003Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289619300924?idApp=UINPBA00003Z"
    "url" => "/03002896/0000005500000008/v2_201908080730/S0300289619300924/v2_201908080730/es/main.assets"
  ]
  "en" => array:13 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>"
    "titulo" => "Influenza and Pneumococcal Vaccination in Chronic Respiratory Patients &#8211; Are We in the Right Path&#63;"
    "tieneTextoCompleto" => true
    "saludo" => "Dear Editor&#58;"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "445"
        "paginaFinal" => "446"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Rebeca Martins Natal, Lu&#237;s Vaz Rodrigues"
        "autores" => array:2 [
          0 => array:4 [
            "nombre" => "Rebeca"
            "apellidos" => "Martins Natal"
            "email" => array:1 [
              0 => "rebecanatal@gmail.com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Lu&#237;s"
            "apellidos" => "Vaz Rodrigues"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Sousa Martins Hospital&#44; Local Health Unit&#44; Guarda&#44; Portugal"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Faculty of Health Sciences&#44; University of Beira Interior&#44; Covilh&#227;&#44; Portugal"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Vacunaci&#243;n contra la gripe y el neumococo en pacientes con enfermedad respiratoria cr&#243;nica - &#191;estamos en el buen camino&#63;"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Chronic respiratory patients &#40;CRP&#41; are either more susceptible to develop infections&#44; or at increased risk of serious complications&#44; hospitalization&#44; long term use of drugs to treat infection&#44; and death&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Vaccination is still the best preventing method to reduce the burden of lower respiratory tract infections&#44; especially pneumonia&#44; in this set of patients&#46; Recommendations by the World Health Organization &#40;WHO&#41; for Influenza vaccination &#40;IV&#41; include CRP&#44; regardless of the age&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> For pneumococcal vaccination &#40;PV&#41;&#44; WHO position statement prioritizes high coverage of infants&#59; the benefits in adults are highlighted&#44; and studies have shown that the 13-valent conjugate vaccine &#40;PCV13&#41; vaccination in the elderly can induce an immune response against vaccine serotypes that is as good as or better than 23-valent polysaccharide vaccine &#40;PPV23&#41;&#46; PCV13 is safe and effective in preventing non-invasive and invasive pneumococcal pneumonia&#46;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2&#8211;4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Each country adapts these recommendations based on local epidemiological trends and social and financial circumstances&#46; In our clinical scenario IV is recommended for CRP with asthma under inhaled or systemic corticotherapy&#44; chronic obstructive lung disease &#40;COPD&#41;&#44; cystic fibrosis&#44; interstitial lung fibrosis&#44; pneumoconiosis and bronchopulmonary dysplasia with a cost ranging from 5&#46;84 to 6&#46;05 EUR &#40;with 37&#37; reimbursement upon medical prescription&#41;&#46; However&#44; it is only provided by the national health service for those with cystic fibrosis&#44; alpha-1 antitrypsin deficiency under replacement therapy&#44; interstitial lung disease &#40;ILD&#41; under immunosuppressive therapy&#44; neuromuscular diseases&#44; and for all inhabitants aged 65 or above&#46; Also in our clinical context PV has an average cost of 59&#46;11 EUR &#40;also with 37&#37; reimbursement&#41; and is recommended for those with chronic respiratory insufficiency&#44; COPD&#44; emphysema&#44; asthma under chronic inhaled or systemic corticotherapy&#44; bronchiectasis&#44; ILD&#44; cystic fibrosis&#44; pneumoconiosis&#44; neuromuscular diseases&#44; pulmonary arterial hypertension&#44; active neoplastic disease&#44; transplant receptor or in the waiting list&#44; and under immunosuppression&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The aim of our study was to ascertain the level of IV and PV coverage and its determinants&#44; as well as to identify the main reasons behind adherence to vaccination&#46; To do so&#44; we conducted a cross-sectional study based of the fulfillment of a questionnaire distributed to all CRP that attended our pulmonary outpatient clinic during nearly 5 months &#40;including the influenza vaccine season&#41;&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Of the total of 1362 patients that attended our clinic in the study period&#44; 201 patients &#40;14&#46;75&#37;&#41; answered the questionnaire&#58; 59&#46;7&#37; were men&#44; with mean age of 65&#46;3 years &#40;SD<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>15&#46;3&#41;&#59; 8&#37; were current and 36&#37; former smokers&#59; 81&#46;8&#37; had low vs&#46; 13&#46;1&#37; with medium and 5&#46;1&#37; with high educational status&#46; Major diagnosis registered were asthma &#40;31&#46;3&#37;&#41; followed by COPD &#40;28&#46;9&#37;&#41;&#44; ILD &#40;23&#46;4&#37;&#41; and lung cancer &#40;1&#46;0&#37;&#41;&#46; The overall coverage for IV and PV was 83&#46;5&#37; and 41&#46;9&#37;&#44; respectively&#46; For IV&#44; 65&#46;9&#37; were vaccinated that present season&#44; 63&#46;5&#37; in the previous one and 53&#46;9&#37; in any other season&#59; 60&#46;4&#37; had had been vaccinated in the last two seasons&#46; Among patients who received PV&#44; 75&#46;6&#37; have been vaccinated with PCV13 and 35&#46;4&#37; with PPV23&#46; Motivation towards vaccination was mainly due to previous medical recommendation &#40;96&#46;6&#37; for IV and 96&#46;1&#37; for PV&#41;&#44; followed by communication media &#40;3&#46;4&#37; for IV and 3&#46;9&#37; for PV&#41; and relatives&#8217; counseling &#40;1&#46;4&#37; and 0&#46;8&#37; for IV and PV&#44; respectively&#41;&#46; The chief hindrances towards vaccination were risk concerns &#40;54&#46;3&#37;&#41; and the possibility of acquiring flu regardless of vaccination &#40;28&#46;6&#37;&#41; for IV&#59; economical concerns &#40;39&#46;3&#37;&#41;&#44; followed by risk concerns &#40;25&#46;0&#37;&#41;&#44; fear of injections&#47;needles &#40;8&#46;9&#37;&#41; and difficult access to health care &#40;5&#46;4&#37;&#41; for PV&#46; Vaccination rates according to determinants in CRP are showed in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">Using a multivariable binary logistic regression model with forward elimination method&#44; IV coverage was independently associated with age &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;006&#41;&#58; patients aged &#8805;75 or 40&#8211;75 years were more likely to have IV coverage than patients aged &#60;40 years &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>9&#46;28&#59; 95&#37;CI&#44; 2&#46;09&#8211;41&#46;26&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;003 and OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6&#46;98&#59; 95&#37;CI&#44; 1&#46;92&#8211;25&#46;35&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;003&#44; respectively&#41;&#59; smoking history &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#41;&#58; current and former smokers were less likely to have IV coverage than non-smokers &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;09&#59; 95&#37;CI&#44; 0&#46;02&#8211;0&#46;40&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002 and OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;14&#59; 95&#37;CI&#44; 0&#46;04&#8211;0&#46;50&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;003&#44; respectively&#41;&#59; and gender&#58; women were less likely to have IV coverage than men &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;28&#59; 95&#37;CI&#44; 0&#46;09&#8211;0&#46;90&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;032&#41;&#46; For PV coverage no factors were significantly associated&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Comparing to European statistics&#44; where IV coverage in chronic medical conditions has a median rate of 50&#46;3&#37;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> and no data is available for PV coverage in adults&#44; these results are above average for IV coverage mainly in elder CRP &#40;where IV tends to be free of charge regardless of the clinical condition for people above 64 years&#41;&#46; Nevertheless&#44; both IV coverage in younger patients and overall PV coverage were considerably low&#46; The vaccination rate and the educational status are in agreement with the most prevalent educational level of our population&#44; unveiling a possible selection bias&#44; but also portraying our reality&#46; Further education on IV could be of benefit to resolve the main hindrance pointed out as the reason towards non-vaccination&#59; reimbursement issues should be discussed insofar PV non-vaccination&#44; since already 21 European member states offer one of the 2 conjugated pneumococcal vaccines for people 50 years of age and above and&#47;or for risk groups in certain age groups&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">This is the starting point of a prospective cohort study currently underway to evaluate the cost-effectiveness of both vaccines&#44; specially pneumococcal&#44; and to ascertain their impact on the number of infectious intercurrences&#44; use of antibiotics &#40;which and how long&#41;&#44; hospitalization and deaths&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">We expect&#44; given our current data and possibly with the results of our future investigation&#44; to increase the awareness of local physicians and administrative boards to this issue in order to develop strategies to re-enforce vaccination in CRP&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "multimedia" => array:1 [
      0 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Influenza vaccination &#40;IV&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Pneumococcal vaccination &#40;PV&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Total &#40;n</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">201&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">83&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Sex</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Age group</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#60;40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>40&#8211;74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">65&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8805;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Smoking history</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Smoker&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Former smoker&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Non-smoker&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">56&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Educational status</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Low&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">84&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Medium&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>High&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2099008.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Vaccination rates &#40;&#37;&#41;&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:5 [
            0 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vaccines against influenza WHO position paper &#8211; November 2012"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "World Health Organization"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Wkly Epidemiol Rec"
                        "fecha" => "2012"
                        "volumen" => "87"
                        "paginaInicial" => "461"
                        "paginaFinal" => "476"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23210147"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pneumococcal vaccines WHO position paper&#8212;2012"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "World Health Organization"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Wkly Epidemiol Rec"
                        "fecha" => "2012"
                        "volumen" => "87"
                        "paginaInicial" => "129"
                        "paginaFinal" => "144"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24340399"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Invasive pneumococcal disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "European Centre for Disease Prevention and Control"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:4 [
                        "titulo" => "ECDC&#46; Annual epidemiological report for 2016"
                        "fecha" => "2018"
                        "editorial" => "ECDC"
                        "editorialLocalizacion" => "Stockholm"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine among adults aged &#8805;65 years&#58; recommendations of the Advisory Committee on Immunization Practices &#40;ACIP&#41;"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "Centers for Disease Control and Prevention &#40;CDC&#41;"
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Tomczyk"
                            1 => "N&#46;M&#46; Bennett"
                            2 => "C&#46; Stoecker"
                            3 => "R&#46; Gierke"
                            4 => "M&#46;R&#46; Moore"
                            5 => "C&#46;G&#46; Whitney"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "MMWR Morb Mortal Wkly Rep"
                        "fecha" => "2014"
                        "volumen" => "63"
                        "paginaInicial" => "822"
                        "paginaFinal" => "825"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25233284"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Seasonal influenza vaccination in Europe&#46; Vaccination recommendations and coverage rates in the EU Member States for eight influenza seasons&#58; 2007&#8211;2008 to 2014&#8211;2015"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "European Centre for Disease Prevention and Control"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2017"
                        "editorial" => "ECDC"
                        "editorialLocalizacion" => "Stockholm"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/03002896/0000005500000008/v2_201908080730/S0300289618304630/v2_201908080730/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "49741"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Scientific Letters / Cartas cient&#237;ficas"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/03002896/0000005500000008/v2_201908080730/S0300289618304630/v2_201908080730/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289618304630?idApp=UINPBA00003Z"
]
Share
Journal Information

Statistics

Follow this link to access the full text of the article

Scientific Letter
Influenza and Pneumococcal Vaccination in Chronic Respiratory Patients – Are We in the Right Path?
Vacunación contra la gripe y el neumococo en pacientes con enfermedad respiratoria crónica - ¿estamos en el buen camino?
Rebeca Martins Natala,
Corresponding author
rebecanatal@gmail.com

Corresponding author.
, Luís Vaz Rodriguesa,b
a Sousa Martins Hospital, Local Health Unit, Guarda, Portugal
b Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
Read
2275
Times
was read the article
850
Total PDF
1425
Total HTML
Share statistics
 array:24 [
  "pii" => "S0300289618304630"
  "issn" => "03002896"
  "doi" => "10.1016/j.arbres.2018.11.018"
  "estado" => "S300"
  "fechaPublicacion" => "2019-08-01"
  "aid" => "2052"
  "copyright" => "SEPAR"
  "copyrightAnyo" => "2018"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "crp"
  "cita" => "Arch Bronconeumol. 2019;55:445-6"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 170
    "formatos" => array:3 [
      "EPUB" => 7
      "HTML" => 115
      "PDF" => 48
    ]
  ]
  "Traduccion" => array:1 [
    "en" => array:19 [
      "pii" => "S1579212919302083"
      "issn" => "15792129"
      "doi" => "10.1016/j.arbr.2018.11.023"
      "estado" => "S300"
      "fechaPublicacion" => "2019-08-01"
      "aid" => "2052"
      "copyright" => "SEPAR"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "crp"
      "cita" => "Arch Bronconeumol. 2019;55:445-6"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:2 [
        "total" => 24
        "formatos" => array:3 [
          "EPUB" => 5
          "HTML" => 11
          "PDF" => 8
        ]
      ]
      "en" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>"
        "titulo" => "Influenza and Pneumococcal Vaccination in Chronic Respiratory Patients &#8211; Are We in the Right Path&#63;"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "445"
            "paginaFinal" => "446"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "es" => array:1 [
            "titulo" => "Vacunaci&#243;n contra la gripe y el neumococo en pacientes con enfermedad respiratoria cr&#243;nica - &#191;estamos en el buen camino&#63;"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Rebeca Martins Natal, Lu&#237;s Vaz Rodrigues"
            "autores" => array:2 [
              0 => array:2 [
                "nombre" => "Rebeca"
                "apellidos" => "Martins Natal"
              ]
              1 => array:2 [
                "nombre" => "Lu&#237;s"
                "apellidos" => "Vaz Rodrigues"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S0300289618304630"
          "doi" => "10.1016/j.arbres.2018.11.018"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289618304630?idApp=UINPBA00003Z"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212919302083?idApp=UINPBA00003Z"
      "url" => "/15792129/0000005500000008/v2_201908080725/S1579212919302083/v2_201908080725/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S0300289619300109"
    "issn" => "03002896"
    "doi" => "10.1016/j.arbres.2018.12.011"
    "estado" => "S300"
    "fechaPublicacion" => "2019-08-01"
    "aid" => "2066"
    "copyright" => "SEPAR"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Arch Bronconeumol. 2019;55:446-7"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 90
      "formatos" => array:3 [
        "EPUB" => 18
        "HTML" => 56
        "PDF" => 16
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>"
      "titulo" => "Acute Respiratory Distress Syndrome Secondary to Histoplasmosis-induced Hemophagocytic Lymphohistiocytosis"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "446"
          "paginaFinal" => "447"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "S&#237;ndrome de distr&#233;s respiratorio agudo secundario a linfohistiocitosis hemofagoc&#237;tica inducida por histoplasmosis"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Fig&#46; 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 874
              "Ancho" => 2091
              "Tamanyo" => 114729
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest X-ray on admission and at 12-h follow-up&#46; &#40;A&#41; Bibasilar linear infiltrates seen on admission&#46; &#40;B&#41; Diffuse bilateral alveolar infiltrates with air bronchogram seen 12<span class="elsevierStyleHsp" style=""></span>h after admission&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Julio Arturo Huapaya, Elizabeth Yogiaveetil, Syed Qamer, Mary Sidawy, Eric Anderson"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "Julio Arturo"
              "apellidos" => "Huapaya"
            ]
            1 => array:2 [
              "nombre" => "Elizabeth"
              "apellidos" => "Yogiaveetil"
            ]
            2 => array:2 [
              "nombre" => "Syed"
              "apellidos" => "Qamer"
            ]
            3 => array:2 [
              "nombre" => "Mary"
              "apellidos" => "Sidawy"
            ]
            4 => array:2 [
              "nombre" => "Eric"
              "apellidos" => "Anderson"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S1579212919302095"
        "doi" => "10.1016/j.arbr.2018.12.025"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212919302095?idApp=UINPBA00003Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289619300109?idApp=UINPBA00003Z"
    "url" => "/03002896/0000005500000008/v2_201908080730/S0300289619300109/v2_201908080730/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S0300289619300924"
    "issn" => "03002896"
    "doi" => "10.1016/j.arbres.2019.02.009"
    "estado" => "S300"
    "fechaPublicacion" => "2019-08-01"
    "aid" => "2105"
    "copyright" => "SEPAR"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Arch Bronconeumol. 2019;55:443-4"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 264
      "formatos" => array:3 [
        "EPUB" => 6
        "HTML" => 168
        "PDF" => 90
      ]
    ]
    "es" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Carta cient&#237;fica</span>"
      "titulo" => "Importancia del manejo especializado en el destete prolongado"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "443"
          "paginaFinal" => "444"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "The Importance of Highly Specific Management in Prolonged Weaning"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figura 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1706
              "Ancho" => 2093
              "Tamanyo" => 179335
            ]
          ]
          "descripcion" => array:1 [
            "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Procedimiento de barrido para calcular el tiempo inspiratorio &#40;Ti&#41; neural&#46; A&#41;<span class="elsevierStyleHsp" style=""></span>Ti neural mayor que el Ti del ventilador&#44; objetiv&#225;ndose asincron&#237;a del tipo doble <span class="elsevierStyleItalic">trigger</span>&#46; B&#41;<span class="elsevierStyleHsp" style=""></span>Ti neural menor que el Ti del ventilador&#44; objetiv&#225;ndose asincron&#237;a del tipo inspiraci&#243;n prolongada&#46; C&#41;<span class="elsevierStyleHsp" style=""></span>Ti ajustado con correcto acoplamiento al ventilador&#46; D&#41;<span class="elsevierStyleHsp" style=""></span>Correlaci&#243;n lineal entre el Ti neural y Ti ajustado obtenido con el m&#233;todo de barrido&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Julia Herrero Huertas, Francisco Laso del Hierro, Fernando Pel&#225;ez Castro, Cristina Plaza Moreno, Ana Ampuero L&#243;pez, Mar&#237;a del Pilar Carballosa de Miguel, Sarah Heili Frades, Germ&#225;n Peces-Barba Romero"
          "autores" => array:8 [
            0 => array:2 [
              "nombre" => "Julia"
              "apellidos" => "Herrero Huertas"
            ]
            1 => array:2 [
              "nombre" => "Francisco"
              "apellidos" => "Laso del Hierro"
            ]
            2 => array:2 [
              "nombre" => "Fernando"
              "apellidos" => "Pel&#225;ez Castro"
            ]
            3 => array:2 [
              "nombre" => "Cristina"
              "apellidos" => "Plaza Moreno"
            ]
            4 => array:2 [
              "nombre" => "Ana"
              "apellidos" => "Ampuero L&#243;pez"
            ]
            5 => array:2 [
              "nombre" => "Mar&#237;a del Pilar"
              "apellidos" => "Carballosa de Miguel"
            ]
            6 => array:2 [
              "nombre" => "Sarah"
              "apellidos" => "Heili Frades"
            ]
            7 => array:2 [
              "nombre" => "Germ&#225;n"
              "apellidos" => "Peces-Barba Romero"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S1579212919301557"
        "doi" => "10.1016/j.arbr.2019.02.006"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212919301557?idApp=UINPBA00003Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289619300924?idApp=UINPBA00003Z"
    "url" => "/03002896/0000005500000008/v2_201908080730/S0300289619300924/v2_201908080730/es/main.assets"
  ]
  "en" => array:13 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>"
    "titulo" => "Influenza and Pneumococcal Vaccination in Chronic Respiratory Patients &#8211; Are We in the Right Path&#63;"
    "tieneTextoCompleto" => true
    "saludo" => "Dear Editor&#58;"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "445"
        "paginaFinal" => "446"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Rebeca Martins Natal, Lu&#237;s Vaz Rodrigues"
        "autores" => array:2 [
          0 => array:4 [
            "nombre" => "Rebeca"
            "apellidos" => "Martins Natal"
            "email" => array:1 [
              0 => "rebecanatal@gmail.com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Lu&#237;s"
            "apellidos" => "Vaz Rodrigues"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Sousa Martins Hospital&#44; Local Health Unit&#44; Guarda&#44; Portugal"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Faculty of Health Sciences&#44; University of Beira Interior&#44; Covilh&#227;&#44; Portugal"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Vacunaci&#243;n contra la gripe y el neumococo en pacientes con enfermedad respiratoria cr&#243;nica - &#191;estamos en el buen camino&#63;"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Chronic respiratory patients &#40;CRP&#41; are either more susceptible to develop infections&#44; or at increased risk of serious complications&#44; hospitalization&#44; long term use of drugs to treat infection&#44; and death&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Vaccination is still the best preventing method to reduce the burden of lower respiratory tract infections&#44; especially pneumonia&#44; in this set of patients&#46; Recommendations by the World Health Organization &#40;WHO&#41; for Influenza vaccination &#40;IV&#41; include CRP&#44; regardless of the age&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> For pneumococcal vaccination &#40;PV&#41;&#44; WHO position statement prioritizes high coverage of infants&#59; the benefits in adults are highlighted&#44; and studies have shown that the 13-valent conjugate vaccine &#40;PCV13&#41; vaccination in the elderly can induce an immune response against vaccine serotypes that is as good as or better than 23-valent polysaccharide vaccine &#40;PPV23&#41;&#46; PCV13 is safe and effective in preventing non-invasive and invasive pneumococcal pneumonia&#46;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2&#8211;4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Each country adapts these recommendations based on local epidemiological trends and social and financial circumstances&#46; In our clinical scenario IV is recommended for CRP with asthma under inhaled or systemic corticotherapy&#44; chronic obstructive lung disease &#40;COPD&#41;&#44; cystic fibrosis&#44; interstitial lung fibrosis&#44; pneumoconiosis and bronchopulmonary dysplasia with a cost ranging from 5&#46;84 to 6&#46;05 EUR &#40;with 37&#37; reimbursement upon medical prescription&#41;&#46; However&#44; it is only provided by the national health service for those with cystic fibrosis&#44; alpha-1 antitrypsin deficiency under replacement therapy&#44; interstitial lung disease &#40;ILD&#41; under immunosuppressive therapy&#44; neuromuscular diseases&#44; and for all inhabitants aged 65 or above&#46; Also in our clinical context PV has an average cost of 59&#46;11 EUR &#40;also with 37&#37; reimbursement&#41; and is recommended for those with chronic respiratory insufficiency&#44; COPD&#44; emphysema&#44; asthma under chronic inhaled or systemic corticotherapy&#44; bronchiectasis&#44; ILD&#44; cystic fibrosis&#44; pneumoconiosis&#44; neuromuscular diseases&#44; pulmonary arterial hypertension&#44; active neoplastic disease&#44; transplant receptor or in the waiting list&#44; and under immunosuppression&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The aim of our study was to ascertain the level of IV and PV coverage and its determinants&#44; as well as to identify the main reasons behind adherence to vaccination&#46; To do so&#44; we conducted a cross-sectional study based of the fulfillment of a questionnaire distributed to all CRP that attended our pulmonary outpatient clinic during nearly 5 months &#40;including the influenza vaccine season&#41;&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Of the total of 1362 patients that attended our clinic in the study period&#44; 201 patients &#40;14&#46;75&#37;&#41; answered the questionnaire&#58; 59&#46;7&#37; were men&#44; with mean age of 65&#46;3 years &#40;SD<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>15&#46;3&#41;&#59; 8&#37; were current and 36&#37; former smokers&#59; 81&#46;8&#37; had low vs&#46; 13&#46;1&#37; with medium and 5&#46;1&#37; with high educational status&#46; Major diagnosis registered were asthma &#40;31&#46;3&#37;&#41; followed by COPD &#40;28&#46;9&#37;&#41;&#44; ILD &#40;23&#46;4&#37;&#41; and lung cancer &#40;1&#46;0&#37;&#41;&#46; The overall coverage for IV and PV was 83&#46;5&#37; and 41&#46;9&#37;&#44; respectively&#46; For IV&#44; 65&#46;9&#37; were vaccinated that present season&#44; 63&#46;5&#37; in the previous one and 53&#46;9&#37; in any other season&#59; 60&#46;4&#37; had had been vaccinated in the last two seasons&#46; Among patients who received PV&#44; 75&#46;6&#37; have been vaccinated with PCV13 and 35&#46;4&#37; with PPV23&#46; Motivation towards vaccination was mainly due to previous medical recommendation &#40;96&#46;6&#37; for IV and 96&#46;1&#37; for PV&#41;&#44; followed by communication media &#40;3&#46;4&#37; for IV and 3&#46;9&#37; for PV&#41; and relatives&#8217; counseling &#40;1&#46;4&#37; and 0&#46;8&#37; for IV and PV&#44; respectively&#41;&#46; The chief hindrances towards vaccination were risk concerns &#40;54&#46;3&#37;&#41; and the possibility of acquiring flu regardless of vaccination &#40;28&#46;6&#37;&#41; for IV&#59; economical concerns &#40;39&#46;3&#37;&#41;&#44; followed by risk concerns &#40;25&#46;0&#37;&#41;&#44; fear of injections&#47;needles &#40;8&#46;9&#37;&#41; and difficult access to health care &#40;5&#46;4&#37;&#41; for PV&#46; Vaccination rates according to determinants in CRP are showed in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">Using a multivariable binary logistic regression model with forward elimination method&#44; IV coverage was independently associated with age &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;006&#41;&#58; patients aged &#8805;75 or 40&#8211;75 years were more likely to have IV coverage than patients aged &#60;40 years &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>9&#46;28&#59; 95&#37;CI&#44; 2&#46;09&#8211;41&#46;26&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;003 and OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6&#46;98&#59; 95&#37;CI&#44; 1&#46;92&#8211;25&#46;35&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;003&#44; respectively&#41;&#59; smoking history &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#41;&#58; current and former smokers were less likely to have IV coverage than non-smokers &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;09&#59; 95&#37;CI&#44; 0&#46;02&#8211;0&#46;40&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002 and OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;14&#59; 95&#37;CI&#44; 0&#46;04&#8211;0&#46;50&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;003&#44; respectively&#41;&#59; and gender&#58; women were less likely to have IV coverage than men &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;28&#59; 95&#37;CI&#44; 0&#46;09&#8211;0&#46;90&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;032&#41;&#46; For PV coverage no factors were significantly associated&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Comparing to European statistics&#44; where IV coverage in chronic medical conditions has a median rate of 50&#46;3&#37;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> and no data is available for PV coverage in adults&#44; these results are above average for IV coverage mainly in elder CRP &#40;where IV tends to be free of charge regardless of the clinical condition for people above 64 years&#41;&#46; Nevertheless&#44; both IV coverage in younger patients and overall PV coverage were considerably low&#46; The vaccination rate and the educational status are in agreement with the most prevalent educational level of our population&#44; unveiling a possible selection bias&#44; but also portraying our reality&#46; Further education on IV could be of benefit to resolve the main hindrance pointed out as the reason towards non-vaccination&#59; reimbursement issues should be discussed insofar PV non-vaccination&#44; since already 21 European member states offer one of the 2 conjugated pneumococcal vaccines for people 50 years of age and above and&#47;or for risk groups in certain age groups&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">This is the starting point of a prospective cohort study currently underway to evaluate the cost-effectiveness of both vaccines&#44; specially pneumococcal&#44; and to ascertain their impact on the number of infectious intercurrences&#44; use of antibiotics &#40;which and how long&#41;&#44; hospitalization and deaths&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">We expect&#44; given our current data and possibly with the results of our future investigation&#44; to increase the awareness of local physicians and administrative boards to this issue in order to develop strategies to re-enforce vaccination in CRP&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "multimedia" => array:1 [
      0 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Influenza vaccination &#40;IV&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Pneumococcal vaccination &#40;PV&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Total &#40;n</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">201&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">83&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Sex</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Age group</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#60;40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>40&#8211;74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">65&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8805;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Smoking history</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Smoker&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Former smoker&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Non-smoker&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">56&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Educational status</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Low&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">84&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Medium&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>High&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2099008.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Vaccination rates &#40;&#37;&#41;&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:5 [
            0 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vaccines against influenza WHO position paper &#8211; November 2012"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "World Health Organization"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Wkly Epidemiol Rec"
                        "fecha" => "2012"
                        "volumen" => "87"
                        "paginaInicial" => "461"
                        "paginaFinal" => "476"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23210147"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pneumococcal vaccines WHO position paper&#8212;2012"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "World Health Organization"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Wkly Epidemiol Rec"
                        "fecha" => "2012"
                        "volumen" => "87"
                        "paginaInicial" => "129"
                        "paginaFinal" => "144"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24340399"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Invasive pneumococcal disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "European Centre for Disease Prevention and Control"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:4 [
                        "titulo" => "ECDC&#46; Annual epidemiological report for 2016"
                        "fecha" => "2018"
                        "editorial" => "ECDC"
                        "editorialLocalizacion" => "Stockholm"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine among adults aged &#8805;65 years&#58; recommendations of the Advisory Committee on Immunization Practices &#40;ACIP&#41;"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "Centers for Disease Control and Prevention &#40;CDC&#41;"
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Tomczyk"
                            1 => "N&#46;M&#46; Bennett"
                            2 => "C&#46; Stoecker"
                            3 => "R&#46; Gierke"
                            4 => "M&#46;R&#46; Moore"
                            5 => "C&#46;G&#46; Whitney"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "MMWR Morb Mortal Wkly Rep"
                        "fecha" => "2014"
                        "volumen" => "63"
                        "paginaInicial" => "822"
                        "paginaFinal" => "825"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25233284"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Seasonal influenza vaccination in Europe&#46; Vaccination recommendations and coverage rates in the EU Member States for eight influenza seasons&#58; 2007&#8211;2008 to 2014&#8211;2015"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "European Centre for Disease Prevention and Control"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2017"
                        "editorial" => "ECDC"
                        "editorialLocalizacion" => "Stockholm"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/03002896/0000005500000008/v2_201908080730/S0300289618304630/v2_201908080730/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "49741"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Scientific Letters / Cartas cient&#237;ficas"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/03002896/0000005500000008/v2_201908080730/S0300289618304630/v2_201908080730/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289618304630?idApp=UINPBA00003Z"
]
Article information
ISSN: 03002896
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 7 2 9
2024 October 48 14 62
2024 September 47 10 57
2024 August 76 30 106
2024 July 50 23 73
2024 June 57 29 86
2024 May 76 26 102
2024 April 57 25 82
2024 March 46 17 63
2024 February 45 23 68
2023 March 9 4 13
2023 February 36 13 49
2023 January 36 19 55
2022 December 54 21 75
2022 November 59 19 78
2022 October 64 28 92
2022 September 46 38 84
2022 August 52 48 100
2022 July 36 47 83
2022 June 40 35 75
2022 May 41 31 72
2022 April 34 31 65
2022 March 33 37 70
2022 February 48 27 75
2022 January 42 26 68
2021 December 28 33 61
2021 November 37 34 71
2021 October 32 39 71
2021 September 22 27 49
2021 August 26 29 55
2020 October 0 2 2
2020 March 12 13 25
2020 February 26 14 40
2020 January 3 0 3
2019 December 1 1 2
2019 November 1 2 3
2019 October 2 2 4
2019 September 7 2 9
2019 August 75 18 93
2019 June 1 1 2
2019 January 13 10 23
Show all

Follow this link to access the full text of the article

Archivos de Bronconeumología

Are you a health professional able to prescribe or dispense drugs?