array:24 [
  "pii" => "S1579212916302786"
  "issn" => "15792129"
  "doi" => "10.1016/j.arbr.2016.11.015"
  "estado" => "S300"
  "fechaPublicacion" => "2017-01-01"
  "aid" => "1406"
  "copyright" => "SEPAR"
  "copyrightAnyo" => "2016"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "sco"
  "cita" => "Arch Bronconeumol. 2017;53:3-4"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 1559
    "formatos" => array:3 [
      "EPUB" => 112
      "HTML" => 1078
      "PDF" => 369
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0300289616301776"
      "issn" => "03002896"
      "doi" => "10.1016/j.arbres.2016.06.001"
      "estado" => "S300"
      "fechaPublicacion" => "2017-01-01"
      "aid" => "1406"
      "copyright" => "SEPAR"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "sco"
      "cita" => "Arch Bronconeumol. 2017;53:3-4"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 4607
        "formatos" => array:3 [
          "EPUB" => 110
          "HTML" => 3226
          "PDF" => 1271
        ]
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
        "titulo" => "&#191;Qu&#233; ha cambiado en la neumon&#237;a adquirida en la comunidad en los &#250;ltimos a&#241;os&#63;"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "3"
            "paginaFinal" => "4"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "What has Changed in Community-Acquired Pneumonia in Recent Years&#63;"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Inmaculada Alfageme Michavila"
            "autores" => array:1 [
              0 => array:2 [
                "nombre" => "Inmaculada"
                "apellidos" => "Alfageme Michavila"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S1579212916302786"
          "doi" => "10.1016/j.arbr.2016.11.015"
          "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/S1579212916302786?idApp=UINPBA00003Z"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289616301776?idApp=UINPBA00003Z"
      "url" => "/03002896/0000005300000001/v1_201612310024/S0300289616301776/v1_201612310024/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S1579212916302750"
    "issn" => "15792129"
    "doi" => "10.1016/j.arbr.2016.11.012"
    "estado" => "S300"
    "fechaPublicacion" => "2017-01-01"
    "aid" => "1348"
    "copyright" => "SEPAR"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "sco"
    "cita" => "Arch Bronconeumol. 2017;53:5-6"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 1892
      "formatos" => array:3 [
        "EPUB" => 129
        "HTML" => 1381
        "PDF" => 382
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
      "titulo" => "Asbestos And The Law"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "5"
          "paginaFinal" => "6"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "La justicia y el amianto"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Gl&#242;ria Poyatos, Carmen Diego Roza"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "Gl&#242;ria"
              "apellidos" => "Poyatos"
            ]
            1 => array:2 [
              "nombre" => "Carmen"
              "apellidos" => "Diego Roza"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0300289616300059"
        "doi" => "10.1016/j.arbres.2016.02.012"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289616300059?idApp=UINPBA00003Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212916302750?idApp=UINPBA00003Z"
    "url" => "/15792129/0000005300000001/v1_201612310030/S1579212916302750/v1_201612310030/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1579212916302725"
    "issn" => "15792129"
    "doi" => "10.1016/j.arbr.2016.11.009"
    "estado" => "S300"
    "fechaPublicacion" => "2017-01-01"
    "aid" => "1465"
    "copyright" => "SEPAR"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "sco"
    "cita" => "Arch Bronconeumol. 2017;53:1-2"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 2654
      "formatos" => array:3 [
        "EPUB" => 150
        "HTML" => 2012
        "PDF" => 492
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
      "titulo" => "Bronchoscopic Thermal Vapour Ablation&#58; Hot Stuff to Treat Emphysema Patients&#33;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "1"
          "paginaFinal" => "2"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Ablaci&#243;n t&#233;rmica broncosc&#243;pica&#44; con vapor de agua&#44; en el tratamiento de pacientes con enfisema"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Arschang Valipour"
          "autores" => array:1 [
            0 => array:2 [
              "nombre" => "Arschang"
              "apellidos" => "Valipour"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0300289616302484"
        "doi" => "10.1016/j.arbres.2016.08.012"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289616302484?idApp=UINPBA00003Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212916302725?idApp=UINPBA00003Z"
    "url" => "/15792129/0000005300000001/v1_201612310030/S1579212916302725/v1_201612310030/en/main.assets"
  ]
  "en" => array:12 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
    "titulo" => "What has Changed in Community-Acquired Pneumonia in Recent Years&#63;"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "3"
        "paginaFinal" => "4"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "Inmaculada Alfageme Michavila"
        "autores" => array:1 [
          0 => array:3 [
            "nombre" => "Inmaculada"
            "apellidos" => "Alfageme Michavila"
            "email" => array:1 [
              0 => "Ialfageme&#64;separ&#46;es"
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Unidad de Gesti&#243;n Cl&#237;nica de Neumolog&#237;a&#44; Hospital Universitario Virgen de Valme&#44; Universidad de Sevilla&#44; Sevilla&#44; Spain"
            "identificador" => "aff0005"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "&#191;Qu&#233; ha cambiado en la neumon&#237;a adquirida en la comunidad en los &#250;ltimos a&#241;os&#63;"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Community-acquired pneumonia &#40;CAP&#41; can present with a wide range of symptoms&#44; ranging from a mild clinical syndrome to more severe forms that may need hospitalization and even admission to the intensive care unit &#40;ICU&#41;&#46; In individuals over 65 years of age&#44; it is one of the major causes of death and the greatest cause of death from infectious disease&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> The fact that it continues to be a problem is shown by a recent study that reports an increase of up to 8&#46;8&#37; in hospitalizations in recent years&#44; and increased rates of infection caused by enterobacteriaceae&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Since the appearance of influenza A and the routine use of molecular detection techniques&#44; more and more evidence is emerging on the role of viruses as etiological and&#47;or concomitant agents in CAP&#46; In general&#44; influenza A virus and respiratory syncytial virus are still the most common&#44; but the highly fatal coronavirus outbreaks in recent years and the zoonosis of the influenza virus suggest that we should be on the alert for these new emerging pathogens&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> Viral pneumonias have led to other complications such as obesity and pregnancy being added to the list of comorbidities included in risk scales as factors for severity in this type of pneumonia&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Risk evaluation has always focused on predicting in-hospital mortality&#46; However&#44; evidence suggests an increase in mortality at 30 days and even up to 5 years after CAP&#44; mainly due to heart diseases&#46; Readmission after CAP was also required in up to 18&#37; of cases&#44; either for the same pneumonia or for extrapulmonary &#40;primarily cardiovascular&#41; complications&#44;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> and reincorporation into activities of daily living was also delayed&#44; particularly in elderly patients&#46; Prognostic scales&#44; then&#44; should perhaps not be limited to evaluating short-term or in-hospital mortality&#44; but instead should be designed to predict other variables that are important in the survival and quality of life of CAP patients&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">These scales&#44; moreover&#44; cannot accurately predict the severity of the CAP&#44; or the most appropriate setting for treatment&#46; The most widely used scales&#44; such as the PSI and the CURB-65 or CRB-65&#44; are not useful for determining admission to the ICU&#44; and other evaluations&#44; including systolic blood pressure&#44; multilobar infiltrates&#44; albumin&#44; respiratory rate&#44; tachycardia&#44; confusion&#44; oxygen&#44; and pH &#40;SMARTCOP&#41; seem to be more useful for identifying patients who will need respiratory or hemodynamic support&#46; Along the same lines&#44; it would be relatively easy to add comorbidities and oxygen saturation to the previously used scales CURB-65 &#40;DS-CURB-65&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> In conventional scales&#44; age is one of the most weighted variables&#44; and this can distort the score&#58; one way to correct this in subjects over 76 years of age may be to incorporate SOAR &#40;oxygen saturation&#44; age and respiratory rate&#41;&#46; This approach has shown greater sensitivity for predicting mortality than the CRB-65&#44; but its specificity is low&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">In recent years&#44; the possibility of using biomarkers as predictors for mortality has been explored&#59; procalcitonin &#40;PCT&#41; has been one of the most widely studied markers&#44; with a low PCT on admission being associated with low mortality&#44; irrespective of PSI or CRB-65&#46; A great many others&#44; such as PaCO<span class="elsevierStyleInf">2</span>&#44; platelet count&#44; and proadrenomedullin&#44; have also been studied&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Comorbidities are known to impact the course and prognosis of CAP&#44; and the list is regularly reviewed&#46; Although COPD is not included in the most common scales&#44;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> it plays an undeniably important role&#44; since it can not only determine the course of the disease &#40;indeed COPD patients have higher PSI scores&#44; higher admission rates&#44; and higher 30 and 90-day mortality<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a>&#41;&#44; but can also induce an etiology involving difficult-to-treat bacteria such as <span class="elsevierStyleItalic">Pseudomonas aeruginosa</span> pneumonia&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">In addition to the impact of comorbidities on the initial evaluation of CAP&#44; the close relationship between cardiovascular complications and pneumonia during the acute phase and in the months following recovery must be taken into account&#46; The inclusion of heart function biomarkers seems to improve the reliability of standard prognostic scales&#46; However&#44; some cardiac events&#44; such as arrhythmias&#44; myocardial infarction&#44; previous decompensated heart failure or cardiac arrest&#44; both in the short and long term&#44;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> might justify the inclusion of new monitoring techniques during CAP&#44; such as heart monitoring or measures for the prevention of cardiovascular diseases&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">With regard to treatment&#44; it is clear that early administration of the shortest possible course of antibiotic therapy is essential&#46; Nevertheless&#44; 2 questions regarding the treatment of CAP are open to debate&#58; the use of macrolides and of corticosteroids&#46; The addition of macrolides to the treatment of non-severe CAP is still controversial&#44; although adding macrolides in severe pneumonia has clearly shown a reduction in mortality&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> This lack of a clear recommendation is further confounded by the potential risk of undesirable cardiovascular effects&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Despite important publications showing the potential benefit of the addition of corticosteroids in reducing the time needed to achieve clinical stability and in preventing antibiotic failure&#44; 2 metaanalyses have found that the addition of corticosteroids to CAP treatment does not reduce mortality in the general population&#46; However&#44; the addition of macrolides does shorten hospital stay and time to clinical stability&#44; and even prevents acute respiratory distress syndrome&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">The latest SEPAR guidelines on CAP were published over 6 years ago&#46; Evidence suggests that some aspects of our management of CAP should be modified&#44; so perhaps it is time for an update&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Alfageme Michavila I&#46; &#191;Qu&#233; ha cambiado en la neumon&#237;a adquirida en la comunidad en los &#250;ltimos a&#241;os&#63;&#46; Arch Bronconeumol&#46; 2017&#59;53&#58;3&#8211;4&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:10 [
            0 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Trends in hospitalizations for pneumonia among persons aged 65 years or older in the United States&#44; 1988&#8211;2002"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46;M&#46; Fry"
                            1 => "D&#46;K&#46; Shay"
                            2 => "R&#46;C&#46; Holman"
                            3 => "A&#46;T&#46; Curns"
                            4 => "L&#46;J&#46; Anderson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jama.294.21.2712"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2005"
                        "volumen" => "294"
                        "paginaInicial" => "2712"
                        "paginaFinal" => "2719"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16333006"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Increasing burden of community-acquired pneumonia leading to hospitalisation&#44; 1998&#8211;2014"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46;P&#46; Quan"
                            1 => "N&#46;J&#46; Fawcett"
                            2 => "J&#46;M&#46; Wrightson"
                            3 => "J&#46; Finney"
                            4 => "D&#46; Wyllie"
                            5 => "K&#46; Jeffery"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/thoraxjnl-2015-207688"
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax"
                        "fecha" => "2016"
                        "volumen" => "71"
                        "paginaInicial" => "535"
                        "paginaFinal" => "542"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26888780"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Revisi&#243;n sobre las infecciones no bacterianas del aparato respiratorio&#58; neumon&#237;as v&#237;ricas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;M&#46; Galv&#225;n"
                            1 => "O&#46; Rajas"
                            2 => "J&#46; Aspa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.arbres.2015.02.015"
                      "Revista" => array:7 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2015"
                        "volumen" => "51"
                        "paginaInicial" => "590"
                        "paginaFinal" => "597"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25957460"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0735675714008304"
                          "estado" => "S300"
                          "issn" => "07356757"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagnoses and timing of 30-day readmissions after hospitalization for heart failure&#44; acute myocardial infarction&#44; or pneumonia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46; Dharmarajan"
                            1 => "A&#46;F&#46; Hsieh"
                            2 => "Z&#46; Lin"
                            3 => "H&#46; Bueno"
                            4 => "J&#46;S&#46; Ross"
                            5 => "L&#46;I&#46; Horwitz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jama.2012.216476"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2013"
                        "volumen" => "309"
                        "paginaInicial" => "355"
                        "paginaFinal" => "363"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23340637"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessment of oxygenation and comorbidities improves outcome prediction in patients with community-acquired pneumonia with a low CRB-65 score"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Kolditz"
                            1 => "S&#46; Ewig"
                            2 => "H&#46; Schu¿tte"
                            3 => "N&#46; Suttorp"
                            4 => "T&#46; Welte"
                            5 => "G&#46; Rohde"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/joim.12349"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Intern Med"
                        "fecha" => "2015"
                        "volumen" => "278"
                        "paginaInicial" => "193"
                        "paginaFinal" => "202"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25597400"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Is COPD associated with increased mortality and morbidity in hospitalized pneumonia&#63; A systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "H&#46;L&#46; Jiang"
                            1 => "H&#46;X&#46; Chen"
                            2 => "W&#46; Liu"
                            3 => "T&#46; Fan"
                            4 => "G&#46;J&#46; Liu"
                            5 => "B&#46; Mao"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/resp.12597"
                      "Revista" => array:6 [
                        "tituloSerie" => "Respirology"
                        "fecha" => "2015"
                        "volumen" => "20"
                        "paginaInicial" => "1046"
                        "paginaFinal" => "1054"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26177049"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "COPD is associated with increased mortality in patients with community-acquired pneumonia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46;I&#46; Restrepo"
                            1 => "E&#46;M&#46; Mortensen"
                            2 => "J&#46;A&#46; Pugh"
                            3 => "A&#46; Anzueto"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Eu Respir J"
                        "fecha" => "2006"
                        "volumen" => "28"
                        "paginaInicial" => "346"
                        "paginaFinal" => "351"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardiac complications after community-acquired pneumonia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46;G&#46; Santos-Gallego"
                            1 => "J&#46;J&#46; Badimon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.amjcard.2015.10.048"
                      "Revista" => array:5 [
                        "tituloSerie" => "Am J Cardiol"
                        "fecha" => "2016"
                        "volumen" => "117"
                        "paginaInicial" => "310"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26639042"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Macrolides and mortality in critically ill patients with community-acquired pneumonia&#58; a systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "W&#46;I&#46; Sligl"
                            1 => "L&#46; Asadi"
                            2 => "D&#46;T&#46; Eurich"
                            3 => "L&#46; Tjosvold"
                            4 => "T&#46;J&#46; Marrie"
                            5 => "S&#46;R&#46; Majumdar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/CCM.0b013e3182a66b9b"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2014"
                        "volumen" => "42"
                        "paginaInicial" => "420"
                        "paginaFinal" => "432"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24158175"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Corticosteroid therapy for patients hospitalized with community-acquired pneumonia&#58; a systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46;A&#46; Siemieniuk"
                            1 => "M&#46;O&#46; Meade"
                            2 => "P&#46; Alonso-Coello"
                            3 => "M&#46; Briel"
                            4 => "N&#46; Evaniew"
                            5 => "M&#46; Prasad"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.7326/M15-0715"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Intern Med"
                        "fecha" => "2015"
                        "volumen" => "163"
                        "paginaInicial" => "519"
                        "paginaFinal" => "528"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26258555"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15792129/0000005300000001/v1_201612310030/S1579212916302786/v1_201612310030/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "46447"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Editorial"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005300000001/v1_201612310030/S1579212916302786/v1_201612310030/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212916302786?idApp=UINPBA00003Z"
]
Share
Journal Information

Statistics

Follow this link to access the full text of the article

Editorial
What has Changed in Community-Acquired Pneumonia in Recent Years?
¿Qué ha cambiado en la neumonía adquirida en la comunidad en los últimos años?
Inmaculada Alfageme Michavila
Unidad de Gestión Clínica de Neumología, Hospital Universitario Virgen de Valme, Universidad de Sevilla, Sevilla, Spain
Read
4566
Times
was read the article
1715
Total PDF
2851
Total HTML
Share statistics
 array:24 [
  "pii" => "S1579212916302786"
  "issn" => "15792129"
  "doi" => "10.1016/j.arbr.2016.11.015"
  "estado" => "S300"
  "fechaPublicacion" => "2017-01-01"
  "aid" => "1406"
  "copyright" => "SEPAR"
  "copyrightAnyo" => "2016"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "sco"
  "cita" => "Arch Bronconeumol. 2017;53:3-4"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 1559
    "formatos" => array:3 [
      "EPUB" => 112
      "HTML" => 1078
      "PDF" => 369
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0300289616301776"
      "issn" => "03002896"
      "doi" => "10.1016/j.arbres.2016.06.001"
      "estado" => "S300"
      "fechaPublicacion" => "2017-01-01"
      "aid" => "1406"
      "copyright" => "SEPAR"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "sco"
      "cita" => "Arch Bronconeumol. 2017;53:3-4"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 4607
        "formatos" => array:3 [
          "EPUB" => 110
          "HTML" => 3226
          "PDF" => 1271
        ]
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
        "titulo" => "&#191;Qu&#233; ha cambiado en la neumon&#237;a adquirida en la comunidad en los &#250;ltimos a&#241;os&#63;"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "3"
            "paginaFinal" => "4"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "What has Changed in Community-Acquired Pneumonia in Recent Years&#63;"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Inmaculada Alfageme Michavila"
            "autores" => array:1 [
              0 => array:2 [
                "nombre" => "Inmaculada"
                "apellidos" => "Alfageme Michavila"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S1579212916302786"
          "doi" => "10.1016/j.arbr.2016.11.015"
          "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/S1579212916302786?idApp=UINPBA00003Z"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289616301776?idApp=UINPBA00003Z"
      "url" => "/03002896/0000005300000001/v1_201612310024/S0300289616301776/v1_201612310024/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S1579212916302750"
    "issn" => "15792129"
    "doi" => "10.1016/j.arbr.2016.11.012"
    "estado" => "S300"
    "fechaPublicacion" => "2017-01-01"
    "aid" => "1348"
    "copyright" => "SEPAR"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "sco"
    "cita" => "Arch Bronconeumol. 2017;53:5-6"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 1892
      "formatos" => array:3 [
        "EPUB" => 129
        "HTML" => 1381
        "PDF" => 382
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
      "titulo" => "Asbestos And The Law"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "5"
          "paginaFinal" => "6"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "La justicia y el amianto"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Gl&#242;ria Poyatos, Carmen Diego Roza"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "Gl&#242;ria"
              "apellidos" => "Poyatos"
            ]
            1 => array:2 [
              "nombre" => "Carmen"
              "apellidos" => "Diego Roza"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0300289616300059"
        "doi" => "10.1016/j.arbres.2016.02.012"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289616300059?idApp=UINPBA00003Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212916302750?idApp=UINPBA00003Z"
    "url" => "/15792129/0000005300000001/v1_201612310030/S1579212916302750/v1_201612310030/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1579212916302725"
    "issn" => "15792129"
    "doi" => "10.1016/j.arbr.2016.11.009"
    "estado" => "S300"
    "fechaPublicacion" => "2017-01-01"
    "aid" => "1465"
    "copyright" => "SEPAR"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "sco"
    "cita" => "Arch Bronconeumol. 2017;53:1-2"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 2654
      "formatos" => array:3 [
        "EPUB" => 150
        "HTML" => 2012
        "PDF" => 492
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
      "titulo" => "Bronchoscopic Thermal Vapour Ablation&#58; Hot Stuff to Treat Emphysema Patients&#33;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "1"
          "paginaFinal" => "2"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Ablaci&#243;n t&#233;rmica broncosc&#243;pica&#44; con vapor de agua&#44; en el tratamiento de pacientes con enfisema"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Arschang Valipour"
          "autores" => array:1 [
            0 => array:2 [
              "nombre" => "Arschang"
              "apellidos" => "Valipour"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0300289616302484"
        "doi" => "10.1016/j.arbres.2016.08.012"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289616302484?idApp=UINPBA00003Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212916302725?idApp=UINPBA00003Z"
    "url" => "/15792129/0000005300000001/v1_201612310030/S1579212916302725/v1_201612310030/en/main.assets"
  ]
  "en" => array:12 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
    "titulo" => "What has Changed in Community-Acquired Pneumonia in Recent Years&#63;"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "3"
        "paginaFinal" => "4"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "Inmaculada Alfageme Michavila"
        "autores" => array:1 [
          0 => array:3 [
            "nombre" => "Inmaculada"
            "apellidos" => "Alfageme Michavila"
            "email" => array:1 [
              0 => "Ialfageme&#64;separ&#46;es"
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Unidad de Gesti&#243;n Cl&#237;nica de Neumolog&#237;a&#44; Hospital Universitario Virgen de Valme&#44; Universidad de Sevilla&#44; Sevilla&#44; Spain"
            "identificador" => "aff0005"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "&#191;Qu&#233; ha cambiado en la neumon&#237;a adquirida en la comunidad en los &#250;ltimos a&#241;os&#63;"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Community-acquired pneumonia &#40;CAP&#41; can present with a wide range of symptoms&#44; ranging from a mild clinical syndrome to more severe forms that may need hospitalization and even admission to the intensive care unit &#40;ICU&#41;&#46; In individuals over 65 years of age&#44; it is one of the major causes of death and the greatest cause of death from infectious disease&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> The fact that it continues to be a problem is shown by a recent study that reports an increase of up to 8&#46;8&#37; in hospitalizations in recent years&#44; and increased rates of infection caused by enterobacteriaceae&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Since the appearance of influenza A and the routine use of molecular detection techniques&#44; more and more evidence is emerging on the role of viruses as etiological and&#47;or concomitant agents in CAP&#46; In general&#44; influenza A virus and respiratory syncytial virus are still the most common&#44; but the highly fatal coronavirus outbreaks in recent years and the zoonosis of the influenza virus suggest that we should be on the alert for these new emerging pathogens&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> Viral pneumonias have led to other complications such as obesity and pregnancy being added to the list of comorbidities included in risk scales as factors for severity in this type of pneumonia&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Risk evaluation has always focused on predicting in-hospital mortality&#46; However&#44; evidence suggests an increase in mortality at 30 days and even up to 5 years after CAP&#44; mainly due to heart diseases&#46; Readmission after CAP was also required in up to 18&#37; of cases&#44; either for the same pneumonia or for extrapulmonary &#40;primarily cardiovascular&#41; complications&#44;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> and reincorporation into activities of daily living was also delayed&#44; particularly in elderly patients&#46; Prognostic scales&#44; then&#44; should perhaps not be limited to evaluating short-term or in-hospital mortality&#44; but instead should be designed to predict other variables that are important in the survival and quality of life of CAP patients&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">These scales&#44; moreover&#44; cannot accurately predict the severity of the CAP&#44; or the most appropriate setting for treatment&#46; The most widely used scales&#44; such as the PSI and the CURB-65 or CRB-65&#44; are not useful for determining admission to the ICU&#44; and other evaluations&#44; including systolic blood pressure&#44; multilobar infiltrates&#44; albumin&#44; respiratory rate&#44; tachycardia&#44; confusion&#44; oxygen&#44; and pH &#40;SMARTCOP&#41; seem to be more useful for identifying patients who will need respiratory or hemodynamic support&#46; Along the same lines&#44; it would be relatively easy to add comorbidities and oxygen saturation to the previously used scales CURB-65 &#40;DS-CURB-65&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> In conventional scales&#44; age is one of the most weighted variables&#44; and this can distort the score&#58; one way to correct this in subjects over 76 years of age may be to incorporate SOAR &#40;oxygen saturation&#44; age and respiratory rate&#41;&#46; This approach has shown greater sensitivity for predicting mortality than the CRB-65&#44; but its specificity is low&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">In recent years&#44; the possibility of using biomarkers as predictors for mortality has been explored&#59; procalcitonin &#40;PCT&#41; has been one of the most widely studied markers&#44; with a low PCT on admission being associated with low mortality&#44; irrespective of PSI or CRB-65&#46; A great many others&#44; such as PaCO<span class="elsevierStyleInf">2</span>&#44; platelet count&#44; and proadrenomedullin&#44; have also been studied&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Comorbidities are known to impact the course and prognosis of CAP&#44; and the list is regularly reviewed&#46; Although COPD is not included in the most common scales&#44;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> it plays an undeniably important role&#44; since it can not only determine the course of the disease &#40;indeed COPD patients have higher PSI scores&#44; higher admission rates&#44; and higher 30 and 90-day mortality<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a>&#41;&#44; but can also induce an etiology involving difficult-to-treat bacteria such as <span class="elsevierStyleItalic">Pseudomonas aeruginosa</span> pneumonia&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">In addition to the impact of comorbidities on the initial evaluation of CAP&#44; the close relationship between cardiovascular complications and pneumonia during the acute phase and in the months following recovery must be taken into account&#46; The inclusion of heart function biomarkers seems to improve the reliability of standard prognostic scales&#46; However&#44; some cardiac events&#44; such as arrhythmias&#44; myocardial infarction&#44; previous decompensated heart failure or cardiac arrest&#44; both in the short and long term&#44;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> might justify the inclusion of new monitoring techniques during CAP&#44; such as heart monitoring or measures for the prevention of cardiovascular diseases&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">With regard to treatment&#44; it is clear that early administration of the shortest possible course of antibiotic therapy is essential&#46; Nevertheless&#44; 2 questions regarding the treatment of CAP are open to debate&#58; the use of macrolides and of corticosteroids&#46; The addition of macrolides to the treatment of non-severe CAP is still controversial&#44; although adding macrolides in severe pneumonia has clearly shown a reduction in mortality&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> This lack of a clear recommendation is further confounded by the potential risk of undesirable cardiovascular effects&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Despite important publications showing the potential benefit of the addition of corticosteroids in reducing the time needed to achieve clinical stability and in preventing antibiotic failure&#44; 2 metaanalyses have found that the addition of corticosteroids to CAP treatment does not reduce mortality in the general population&#46; However&#44; the addition of macrolides does shorten hospital stay and time to clinical stability&#44; and even prevents acute respiratory distress syndrome&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">The latest SEPAR guidelines on CAP were published over 6 years ago&#46; Evidence suggests that some aspects of our management of CAP should be modified&#44; so perhaps it is time for an update&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Alfageme Michavila I&#46; &#191;Qu&#233; ha cambiado en la neumon&#237;a adquirida en la comunidad en los &#250;ltimos a&#241;os&#63;&#46; Arch Bronconeumol&#46; 2017&#59;53&#58;3&#8211;4&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:10 [
            0 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Trends in hospitalizations for pneumonia among persons aged 65 years or older in the United States&#44; 1988&#8211;2002"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46;M&#46; Fry"
                            1 => "D&#46;K&#46; Shay"
                            2 => "R&#46;C&#46; Holman"
                            3 => "A&#46;T&#46; Curns"
                            4 => "L&#46;J&#46; Anderson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jama.294.21.2712"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2005"
                        "volumen" => "294"
                        "paginaInicial" => "2712"
                        "paginaFinal" => "2719"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16333006"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Increasing burden of community-acquired pneumonia leading to hospitalisation&#44; 1998&#8211;2014"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46;P&#46; Quan"
                            1 => "N&#46;J&#46; Fawcett"
                            2 => "J&#46;M&#46; Wrightson"
                            3 => "J&#46; Finney"
                            4 => "D&#46; Wyllie"
                            5 => "K&#46; Jeffery"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/thoraxjnl-2015-207688"
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax"
                        "fecha" => "2016"
                        "volumen" => "71"
                        "paginaInicial" => "535"
                        "paginaFinal" => "542"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26888780"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Revisi&#243;n sobre las infecciones no bacterianas del aparato respiratorio&#58; neumon&#237;as v&#237;ricas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;M&#46; Galv&#225;n"
                            1 => "O&#46; Rajas"
                            2 => "J&#46; Aspa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.arbres.2015.02.015"
                      "Revista" => array:7 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2015"
                        "volumen" => "51"
                        "paginaInicial" => "590"
                        "paginaFinal" => "597"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25957460"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0735675714008304"
                          "estado" => "S300"
                          "issn" => "07356757"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagnoses and timing of 30-day readmissions after hospitalization for heart failure&#44; acute myocardial infarction&#44; or pneumonia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46; Dharmarajan"
                            1 => "A&#46;F&#46; Hsieh"
                            2 => "Z&#46; Lin"
                            3 => "H&#46; Bueno"
                            4 => "J&#46;S&#46; Ross"
                            5 => "L&#46;I&#46; Horwitz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jama.2012.216476"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2013"
                        "volumen" => "309"
                        "paginaInicial" => "355"
                        "paginaFinal" => "363"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23340637"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessment of oxygenation and comorbidities improves outcome prediction in patients with community-acquired pneumonia with a low CRB-65 score"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Kolditz"
                            1 => "S&#46; Ewig"
                            2 => "H&#46; Schu¿tte"
                            3 => "N&#46; Suttorp"
                            4 => "T&#46; Welte"
                            5 => "G&#46; Rohde"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/joim.12349"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Intern Med"
                        "fecha" => "2015"
                        "volumen" => "278"
                        "paginaInicial" => "193"
                        "paginaFinal" => "202"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25597400"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Is COPD associated with increased mortality and morbidity in hospitalized pneumonia&#63; A systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "H&#46;L&#46; Jiang"
                            1 => "H&#46;X&#46; Chen"
                            2 => "W&#46; Liu"
                            3 => "T&#46; Fan"
                            4 => "G&#46;J&#46; Liu"
                            5 => "B&#46; Mao"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/resp.12597"
                      "Revista" => array:6 [
                        "tituloSerie" => "Respirology"
                        "fecha" => "2015"
                        "volumen" => "20"
                        "paginaInicial" => "1046"
                        "paginaFinal" => "1054"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26177049"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "COPD is associated with increased mortality in patients with community-acquired pneumonia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46;I&#46; Restrepo"
                            1 => "E&#46;M&#46; Mortensen"
                            2 => "J&#46;A&#46; Pugh"
                            3 => "A&#46; Anzueto"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Eu Respir J"
                        "fecha" => "2006"
                        "volumen" => "28"
                        "paginaInicial" => "346"
                        "paginaFinal" => "351"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardiac complications after community-acquired pneumonia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46;G&#46; Santos-Gallego"
                            1 => "J&#46;J&#46; Badimon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.amjcard.2015.10.048"
                      "Revista" => array:5 [
                        "tituloSerie" => "Am J Cardiol"
                        "fecha" => "2016"
                        "volumen" => "117"
                        "paginaInicial" => "310"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26639042"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Macrolides and mortality in critically ill patients with community-acquired pneumonia&#58; a systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "W&#46;I&#46; Sligl"
                            1 => "L&#46; Asadi"
                            2 => "D&#46;T&#46; Eurich"
                            3 => "L&#46; Tjosvold"
                            4 => "T&#46;J&#46; Marrie"
                            5 => "S&#46;R&#46; Majumdar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/CCM.0b013e3182a66b9b"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2014"
                        "volumen" => "42"
                        "paginaInicial" => "420"
                        "paginaFinal" => "432"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24158175"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Corticosteroid therapy for patients hospitalized with community-acquired pneumonia&#58; a systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46;A&#46; Siemieniuk"
                            1 => "M&#46;O&#46; Meade"
                            2 => "P&#46; Alonso-Coello"
                            3 => "M&#46; Briel"
                            4 => "N&#46; Evaniew"
                            5 => "M&#46; Prasad"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.7326/M15-0715"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Intern Med"
                        "fecha" => "2015"
                        "volumen" => "163"
                        "paginaInicial" => "519"
                        "paginaFinal" => "528"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26258555"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15792129/0000005300000001/v1_201612310030/S1579212916302786/v1_201612310030/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "46447"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Editorial"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005300000001/v1_201612310030/S1579212916302786/v1_201612310030/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212916302786?idApp=UINPBA00003Z"
]
Article information
ISSN: 15792129
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 4 3 7
2024 October 46 17 63
2024 September 38 14 52
2024 August 69 41 110
2024 July 39 19 58
2024 June 73 29 102
2024 May 60 32 92
2024 April 55 28 83
2024 March 41 20 61
2024 February 36 26 62
2023 March 9 1 10
2023 February 63 39 102
2023 January 36 37 73
2022 December 59 37 96
2022 November 51 27 78
2022 October 53 45 98
2022 September 31 29 60
2022 August 43 42 85
2022 July 27 36 63
2022 June 38 36 74
2022 May 36 38 74
2022 April 36 25 61
2022 March 44 41 85
2022 February 43 27 70
2022 January 34 40 74
2021 December 36 45 81
2021 November 40 41 81
2021 October 40 47 87
2021 September 44 40 84
2021 August 22 47 69
2021 July 20 24 44
2021 June 33 29 62
2021 May 30 38 68
2021 April 97 95 192
2021 March 49 19 68
2021 February 21 18 39
2021 January 28 14 42
2020 December 23 17 40
2020 November 19 17 36
2020 October 21 15 36
2020 September 17 9 26
2020 August 27 12 39
2020 July 23 27 50
2020 June 30 1 31
2020 May 22 15 37
2020 April 38 24 62
2020 March 20 12 32
2020 February 23 19 42
2020 January 28 11 39
2019 December 27 14 41
2019 November 15 18 33
2019 October 17 9 26
2019 September 13 9 22
2019 August 29 18 47
2019 July 22 12 34
2019 June 12 15 27
2019 May 17 14 31
2019 April 20 12 32
2019 March 21 19 40
2019 February 22 23 45
2019 January 21 7 28
2018 December 20 12 32
2018 November 65 24 89
2018 October 94 34 128
2018 September 33 12 45
2018 May 29 2 31
2018 April 35 2 37
2018 March 47 4 51
2018 February 52 8 60
2018 January 107 5 112
2017 December 109 7 116
2017 November 14 5 19
2017 October 25 4 29
2017 September 22 9 31
2017 August 20 5 25
2017 July 22 5 27
2017 June 24 15 39
2017 May 42 11 53
2017 April 39 16 55
2017 January 1 0 1
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?