Correspondence: Prof E. González Ochoa Instituto Pedro Kourí, Autopista Novia del Mediodía, km 6,5 La Lisa, La Habana, Cuba
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"cabecera" => "<span class="elsevierStyleTextfn">Original Articles</span>" "titulo" => "An Alternative for Improving the Diagnosis of Smear-Negative Tuberculosis and Other Bronchopulmonary Disorders in Cuba" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "604" "paginaFinal" => "610" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "José Sevy Court, Delfina Machado Molina, Luisa Armas Pérez, Mariana Peralta Pérez, Libertad Carreras Corzo, Reinaldo Sánchez de la Osa, Carmen Rosas Valladares, Edilberto González Ochoa" "autores" => array:8 [ 0 => array:3 [ "nombre" => "José Sevy" "apellidos" => "Court" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 1 => array:3 [ "nombre" => "Delfina Machado" "apellidos" => "Molina" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 2 => array:3 [ "nombre" => "Luisa Armas" "apellidos" => "Pérez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 3 => array:3 [ "nombre" => "Mariana Peralta" "apellidos" => "Pérez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 4 => array:3 [ "nombre" => "Libertad Carreras" "apellidos" => "Corzo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 5 => array:3 [ "nombre" => "Reinaldo Sánchez" "apellidos" => "de la Osa" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 6 => array:3 [ "nombre" => "Carmen Rosas" "apellidos" => "Valladares" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 7 => array:4 [ "nombre" => "Edilberto González" "apellidos" => "Ochoa" "email" => array:1 [ 0 => "ochoa@ipk.sld.cu" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Hospital Universitario Neumológico Benéfico Jurídico, La Habana, Cuba" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Grupo de Investigaciones y Vigilancia de Tuberculosis, Lepra e IRA, Instituto Pedro Kourí, La Habana, Cuba" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Prof E. González Ochoa Instituto Pedro Kourí, Autopista Novia del Mediodía, km 6,5 La Lisa, La Habana, Cuba" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2007-06-01" "fechaAceptado" => "2008-05-28" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec155078" "palabras" => array:4 [ 0 => "Tuberculosis" 1 => "Diagnosis" 2 => "Negative acid-fast bacillus smear" 3 => "Monitoring" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec155077" "palabras" => array:4 [ 0 => "Tuberculosis" 1 => "Diagnóstico" 2 => "Baciloscopia negativa" 3 => "Vigilancia" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">The diagnosis of tuberculosis in patients with negative acid-fast bacillus smears poses a challenge to both clinicians and public health authorities. In an attempt to aid diagnosis in such cases, an expert committee was established in the province of Ciudad de La Habana, Cuba in 1995. The aim of this study was to describe the progress of the committee's work and the corresponding results for the period 1996 through 2003.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">For each patient studied by the committee, we analyzed the following data: patient's residence and referring center, tentative diagnosis proposed by the attending physician, history of antibiotic treatment, and final diagnosis made by the committee.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Of the 1703 patients studied, 84.8% were from the province of Ciudad de La Habana, 48.4% were 55 years or older, and 63.8% were men. Between 2001 and 2003, 11.3% of patients were already on antituberculosis treatment when their case was studied by the committee. The corresponding percentage for 1996 through 2000 was 16.9% (<span class="elsevierStyleItalic">P=</span>.001). Active tuberculosis was confirmed in 43.1% of a total of 918 patients with full test results during the period 1996 through 2000 and in 52.2% of a total of 619 patients (52.2%) during the period 2001 through 2003 (<span class="elsevierStyleItalic">P</span><.001). Of 344 patients with suspected pulmonary tuberculosis and negative acid-fast bacillus smears between 2001 and 2003, 128 (37.2%) were diagnosed with active tuberculosis.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">These findings indicate that the work of the committee is viable, sustainable, and useful for preventing overdiagnosis and inappropriate treatment, and that it also serves an educational purpose.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">El diagnóstico de los pacientes con tuberculosis pulmonar y muestras negativas para bacilos ácido-alcohol resistentes (BAAR) representa un desafío clínico y de salud pública, por lo que en Ciudad de La Habana se creó en 1995 una comisión para esclarecer su diagnóstico. El objetivo de este estudio ha sido describir los progresos y resultados del trabajo de esta comisión entre 1996 y 2003.</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Se han analizado los datos recogidos de cada paciente presentado en las sesiones de la comisión: procedencia, diagnóstico de sospecha planteado por el médico que presentó el caso, antecedentes de tratamiento anterior con antibióticos y diagnóstico realizado por la comisión.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Del total de 1.703 pacientes presentados a esta comisión para esclarecer el diagnóstico, un 84,8% procedía de la Ciudad de La Habana, el 48,4% pertenecía al grupo de edad igual o mayor de 55 años y el 63,8% eran varones. El porcentaje de casos consultados con tratamiento específico contra la tuberculosis ya comenzado fue en 2001-2003 del 11,3%, y en el período 1996-2000, del 16,9% (p = 0,001). En 1986-2000, de 918 pacientes que completaron sus exámenes, tuvo diagnóstico final de tuberculosis activa un 43,1%, y en 2001-2003, el 52,2% de 619 (p = 0,000). De un total de 344 casos estudiados con sospecha de tuberculosis pulmonar con BAAR y cultivo negativos en 2001-2003, el diagnóstico se corroboró en 128 (37,2%).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Los resultados indican que el trabajo de la comisión es viable, sostenible y de utilidad porque evita el sobrediagnóstico y el tratamiento inapropiado, además de cumplir una función docente.</p>" ] ] "NotaPie" => array:1 [ 0 => array:1 [ "nota" => "<p class="elsevierStyleNotepara">Study conducted within the framework of a collaboration agreement with the Institute of Tropical Medicine in Antwerp, Belgium.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:34 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "World Health Organization" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:4 [ "titulo" => "The Global Plan To Stop Tuberculosis. 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Year/Month | Html | Total | |
---|---|---|---|
2024 November | 8 | 4 | 12 |
2024 October | 31 | 15 | 46 |
2024 September | 27 | 14 | 41 |
2024 August | 45 | 35 | 80 |
2024 July | 24 | 18 | 42 |
2024 June | 29 | 27 | 56 |
2024 May | 43 | 38 | 81 |
2024 April | 20 | 23 | 43 |
2024 March | 17 | 11 | 28 |
2024 February | 19 | 20 | 39 |
2023 March | 3 | 2 | 5 |
2023 February | 16 | 25 | 41 |
2023 January | 14 | 30 | 44 |
2022 December | 27 | 39 | 66 |
2022 November | 25 | 34 | 59 |
2022 October | 22 | 31 | 53 |
2022 September | 18 | 31 | 49 |
2022 August | 25 | 39 | 64 |
2022 July | 26 | 46 | 72 |
2022 June | 17 | 41 | 58 |
2022 May | 21 | 39 | 60 |
2022 April | 21 | 45 | 66 |
2022 March | 20 | 54 | 74 |
2022 February | 20 | 26 | 46 |
2022 January | 15 | 40 | 55 |
2021 December | 23 | 47 | 70 |
2021 November | 18 | 46 | 64 |
2021 October | 52 | 57 | 109 |
2021 September | 20 | 65 | 85 |
2021 August | 10 | 42 | 52 |
2021 July | 13 | 25 | 38 |
2021 June | 13 | 35 | 48 |
2021 May | 16 | 27 | 43 |
2021 April | 32 | 84 | 116 |
2021 March | 22 | 25 | 47 |
2021 February | 10 | 22 | 32 |
2021 January | 10 | 16 | 26 |
2020 December | 10 | 28 | 38 |
2020 November | 12 | 15 | 27 |
2020 October | 7 | 12 | 19 |
2020 September | 6 | 6 | 12 |
2020 August | 11 | 12 | 23 |
2020 July | 19 | 18 | 37 |
2020 June | 13 | 3 | 16 |
2020 May | 7 | 11 | 18 |
2020 April | 23 | 24 | 47 |
2020 March | 16 | 13 | 29 |
2020 February | 13 | 16 | 29 |
2020 January | 18 | 17 | 35 |
2019 December | 7 | 11 | 18 |
2019 November | 6 | 15 | 21 |
2019 October | 10 | 7 | 17 |
2019 September | 5 | 8 | 13 |
2019 August | 14 | 15 | 29 |
2019 July | 12 | 21 | 33 |
2019 June | 11 | 11 | 22 |
2019 May | 14 | 8 | 22 |
2019 April | 23 | 16 | 39 |
2019 March | 12 | 15 | 27 |
2019 February | 15 | 18 | 33 |
2019 January | 10 | 15 | 25 |
2018 December | 11 | 11 | 22 |
2018 November | 13 | 12 | 25 |
2018 October | 13 | 11 | 24 |
2018 September | 10 | 11 | 21 |
2018 May | 4 | 1 | 5 |
2018 April | 5 | 5 | 10 |
2018 March | 4 | 4 | 8 |
2018 February | 3 | 9 | 12 |
2018 January | 4 | 2 | 6 |
2017 December | 4 | 6 | 10 |
2017 November | 3 | 8 | 11 |
2017 October | 3 | 6 | 9 |
2017 September | 5 | 4 | 9 |
2017 August | 6 | 9 | 15 |
2017 July | 2 | 3 | 5 |
2017 June | 6 | 20 | 26 |
2017 May | 4 | 4 | 8 |
2017 April | 3 | 4 | 7 |
2017 March | 2 | 3 | 5 |
2017 February | 1 | 9 | 10 |
2017 January | 3 | 3 | 6 |
2016 December | 7 | 5 | 12 |
2016 November | 12 | 12 | 24 |
2016 October | 7 | 7 | 14 |
2016 September | 9 | 10 | 19 |
2016 August | 7 | 6 | 13 |
2016 July | 5 | 7 | 12 |
2016 June | 3 | 0 | 3 |
2016 May | 5 | 0 | 5 |
2016 April | 5 | 0 | 5 |
2016 March | 5 | 0 | 5 |
2016 February | 5 | 0 | 5 |
2016 January | 2 | 0 | 2 |
2015 December | 6 | 0 | 6 |
2015 November | 1 | 0 | 1 |
2015 October | 43 | 6 | 49 |
2015 September | 67 | 5 | 72 |
2015 August | 41 | 5 | 46 |
2015 July | 46 | 3 | 49 |
2015 June | 38 | 2 | 40 |
2015 May | 65 | 6 | 71 |
2015 April | 41 | 10 | 51 |
2015 March | 33 | 5 | 38 |
2015 February | 35 | 2 | 37 |
2015 January | 32 | 5 | 37 |
2014 December | 32 | 4 | 36 |
2014 November | 46 | 6 | 52 |
2014 October | 47 | 5 | 52 |
2014 September | 52 | 5 | 57 |
2014 August | 553 | 9 | 562 |
2014 July | 51 | 3 | 54 |
2014 June | 35 | 8 | 43 |
2014 May | 47 | 6 | 53 |
2014 April | 43 | 7 | 50 |
2014 March | 44 | 12 | 56 |
2014 February | 36 | 11 | 47 |
2014 January | 38 | 8 | 46 |
2013 December | 35 | 2 | 37 |
2013 November | 41 | 5 | 46 |
2013 October | 30 | 10 | 40 |
2013 September | 29 | 6 | 35 |
2013 August | 32 | 5 | 37 |
2013 July | 39 | 9 | 48 |
2013 June | 26 | 6 | 32 |
2013 May | 36 | 4 | 40 |
2013 April | 15 | 7 | 22 |
2013 March | 8 | 1 | 9 |