Compartir
array:23 [ "pii" => "S0014256511700078" "issn" => "00142565" "doi" => "10.1016/S0014-2565(11)70007-8" "estado" => "S300" "fechaPublicacion" => "2011-03-01" "aid" => "70007" "copyright" => "Elsevier España S.L." "copyrightAnyo" => "2011" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Rev Clin Esp. 2011;211 Supl 2:13-21" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 400 "formatos" => array:2 [ "HTML" => 275 "PDF" => 125 ] ] "itemSiguiente" => array:18 [ "pii" => "S001425651170008X" "issn" => "00142565" "doi" => "10.1016/S0014-2565(11)70008-X" "estado" => "S300" "fechaPublicacion" => "2011-03-01" "aid" => "70008" "copyright" => "Elsevier España S.L." "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Rev Clin Esp. 2011;211 Supl 2:22-30" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1845 "formatos" => array:2 [ "HTML" => 1670 "PDF" => 175 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Nuevos tratamientos en epoc</span>" "titulo" => "Inhibidores de la PDE4: roflumilast" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "22" "paginaFinal" => "30" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Phosphodiesterase-4 inhibitors: roflumilast" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.L. Izquierdo Alonso" "autores" => array:1 [ 0 => array:2 [ "nombre" => "J.L." "apellidos" => "Izquierdo Alonso" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S001425651170008X?idApp=WRCEE" "url" => "/00142565/00000211000000S2/v1_201302081053/S001425651170008X/v1_201302081053/es/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0014256511700066" "issn" => "00142565" "doi" => "10.1016/S0014-2565(11)70006-6" "estado" => "S300" "fechaPublicacion" => "2011-03-01" "aid" => "70006" "copyright" => "Elsevier España S.L." "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Rev Clin Esp. 2011;211 Supl 2:3-12" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 502 "formatos" => array:2 [ "HTML" => 344 "PDF" => 158 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Nuevos tratamientos en epoc</span>" "titulo" => "Impacto de las exacerbaciones en la evolución de la EPOC" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "3" "paginaFinal" => "12" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Impact of exacerbations on the clinical course of chronic obstructive pulmonary disease" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.J. Soler-Cataluña, M.A. Martínez-García, P. Catalán Serra, P. Román Sánchez" "autores" => array:4 [ 0 => array:2 [ "nombre" => "J.J." "apellidos" => "Soler-Cataluña" ] 1 => array:2 [ "nombre" => "M.A." "apellidos" => "Martínez-García" ] 2 => array:2 [ "nombre" => "P." "apellidos" => "Catalán Serra" ] 3 => array:2 [ "nombre" => "P." "apellidos" => "Román Sánchez" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256511700066?idApp=WRCEE" "url" => "/00142565/00000211000000S2/v1_201302081053/S0014256511700066/v1_201302081053/es/main.assets" ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Nuevos tratamientos en epoc</span>" "titulo" => "Complejidad de la EPOC. Tratamiento individualizado, nuevas aproximaciones, fenotipos, comorbilidades" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "13" "paginaFinal" => "21" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "J.C. Martín-Escudero" "autores" => array:1 [ 0 => array:3 [ "nombre" => "J.C." "apellidos" => "Martín-Escudero" "email" => array:1 [ 0 => "escudero@med.uva.es" ] ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Medicina Interna, Hospital Universitario Río Hortega, Valladolid, España" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Complexity in chronic obstructive pulmonary disease. Individualized treatment, new approaches, phenotypes and comorbidities" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec18126" "palabras" => array:3 [ 0 => "Enfermedad pulmonar obstructiva crónica" 1 => "Enfisema" 2 => "Bronquitis crónica" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec18127" "palabras" => array:3 [ 0 => "Chronic obstructive pulmonary disease" 1 => "Emphysema" 2 => "Chronic bronchitis" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La definición actual y los estadios de gravedad de la enfermedad pulmonar obstructiva crónica (EPOC) están excesivamente centrados en criterios sólo espirométricos. La medición de la obstrucción crónica al flujo aéreo y su grado de reversibilidad no está exenta de complejidad. La riqueza de matices de su etiología asociada al tabaco, la heterogeneidad de esta enfermedad sistémica cuya víctima principal es el pulmón, no se puede expresar sólo con el volumen espiratorio forzado en el primer segundo (FEV<span class="elsevierStyleInf">1</span>). Esta simplificación ha resultado útil durante un tiempo, pero la pérdida de matices clínicos en los grandes estudios supone una dificultad para interpretar sus resultados y sus conclusiones pierden validez externa. Aceptar la complejidad de la EPOC requiere sustituir el enfoque analítico centrado en el FEV<span class="elsevierStyleInf">1</span> por una multiperspectiva que integre otros aspectos en el análisis de los pacientes EPOC reales. La identificación y agrupación en subgrupos clínicamente significativos o “fenotipos EPOC”, pueden orientar el tratamiento de una forma más eficaz. Los pacientes con EPOC parecen fallecer antes por causas cardiovasculares o neoplasias, y más tarde, si las superan, por causas respiratorias. La comorbilidad se debe considerar y tratar para mejorar la supervivencia de los pacientes con EPOC. Ya no parece recomendable un tratamiento de la EPOC basado en escalones de función pulmonar. Las diversas opciones terapéuticas deben individualizarse en función de otras características del paciente.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The current definition and severity stages of chronic obstructive pulmonary disease (COPD) focus excessively on spirometric criteria alone. Measurement of chronic airflow obstruction and its degree of reversibility is complex. The etiology of this disease cannot be fully explained in relation to smoking and the heterogeneity of this systemic disease septiemthat affects mainly the lung cannot be expressed through forced expiratory volume in 1 second (FEV<span class="elsevierStyleInf">1</span>) alone. This simplification was useful for a period but the loss of clinical subtlety in large studies hampers interpretation of their results and their conclusions lose external validity. Accepting the complexity of COPD requires substituting the analytic focus centered on FEV<span class="elsevierStyleInf">1</span> for a multifaceted approach that integrates other aspects in the analysis of real COPD patients. Identifying and classifying clinically significant subgroups or “COPD phenotypes” may help to guide treatment more efficiently. In patients with COPD, mortality due to cardiovascular diseases or malignancies occurs earlier than that due to respiratory causes; that is, deaths from COPD occur in patients not succumbing to cardiovascular diseases or cancer. To prolong survival in these patients, comorbidity should be evaluated and treated. COPD treatment based on severity measured by lung function can no longer be recommended. The various therapeutic options should be individualized according to the patient's other characteristics.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:28 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K.F. Rabe" 1 => "S. Hurd" 2 => "A. Anzueto" 3 => "P.J. Barnes" 4 => "S.A. Buist" 5 => "P. Calverley" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/rccm.200703-456SO" "Revista" => array:6 [ "tituloSerie" => "Am J Respir Crit Care Med" "fecha" => "2007" "volumen" => "176" "paginaInicial" => "532" "paginaFinal" => "555" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17507545" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "committee members. ATS/ERS Task Force" "etal" => false "autores" => array:2 [ 0 => "B.R. Celli" 1 => "W. MacNee" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "2004" "volumen" => "23" "paginaInicial" => "932" "paginaFinal" => "946" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15219010" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guía clínica SEPAR-ALAT de diagnóstico y tratamiento de la EPOC" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Peces Barba" 1 => "J.A. Barberà" 2 => "A.G.N. Agustí" 3 => "C. Casanova" 4 => "A. Casas" 5 => "J.L. Izquierdo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2008" "volumen" => "44" "paginaInicial" => "271" "paginaFinal" => "281" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18448019" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Valoración de la EPOC: regreso al futuro" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J.L. Izquierdo Alonso" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.arbres.2009.11.009" "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2010" "volumen" => "46" "paginaInicial" => "53" "paginaFinal" => "55" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20092931" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chronic obstructive pulmonary disease phenotypes. The future of COPD" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.K. Han" 1 => "A. Agusti" 2 => "P.M. Calverley" 3 => "B.R. Celli" 4 => "G. Criner" 5 => "J.L. Curtis" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/rccm.200912-1843CC" "Revista" => array:6 [ "tituloSerie" => "Am J Respir Crit Care Med" "fecha" => "2010" "volumen" => "182" "paginaInicial" => "598" "paginaFinal" => "604" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20522794" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Characterisation of COPD heterogeneity in the ECLIPSE cohort" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Agusti" 1 => "P.M.A. Calverley" 2 => "B. Celli" 3 => "H.O. Coxson" 4 => "L.D. Edwards" 5 => "D.A. Lomas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1465-9921-11-122" "Revista" => array:5 [ "tituloSerie" => "Respiratory Research" "fecha" => "2010" "volumen" => "11" "paginaInicial" => "122" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20831787" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lung function testing in the elderly-can we still use FEV<span class="elsevierStyleInf">1</span>/FVC<70% as a criterion of COPD?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A. Medbø" 1 => "H. Melbye" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rmed.2006.11.019" "Revista" => array:6 [ "tituloSerie" => "Respir Med" "fecha" => "2007" "volumen" => "101" "paginaInicial" => "1097" "paginaFinal" => "1105" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17239575" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence of COPD in Spain: impact of undiagnosed COPD on quality of lyfe and daily life activities" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Miratvilles" 1 => "J.B. Soriano" 2 => "F. García-Río" 3 => "L. Muñoz" 4 => "E. Durán-Tauleria" 5 => "G. Sánchez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/thx.2009.115725" "Revista" => array:6 [ "tituloSerie" => "Thorax" "fecha" => "2009" "volumen" => "64" "paginaInicial" => "863" "paginaFinal" => "868" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19553233" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "References values for forced spirometry. Group of the European Community Respiratory Health Survey" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Roca" 1 => "F. Burgos" 2 => "J. Sunyer" 3 => "M. Sáez" 4 => "S. Chinn" 5 => "J.M. Antó" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "1998" "volumen" => "11" "paginaInicial" => "1354" "paginaFinal" => "1362" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9657579" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Debating the definitión of airflow obstrucción: time to move on?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.R. Miller" 1 => "O.F. Pedersen" 2 => "R. Pellegrino" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.00103309" "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "2009" "volumen" => "34" "paginaInicial" => "527" "paginaFinal" => "528" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19720804" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Implications of reversibility testing on prevalence and risk factors for chronic obstructive pulmonary disease: a community study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Johannessen" 1 => "E.R. Omenaas" 2 => "P.S. Bakke" 3 => "A. Gulsvik" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/thx.2005.043943" "Revista" => array:6 [ "tituloSerie" => "Thorax" "fecha" => "2005" "volumen" => "60" "paginaInicial" => "842" "paginaFinal" => "847" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16085729" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Interpretative strategies for lung function tests" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Pellegrino" 1 => "G. Viegi" 2 => "V. Brusasco" 3 => "R.O. Crapo" 4 => "F. Burgos" 5 => "R. Casaburi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.05.00035205" "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "2005" "volumen" => "26" "paginaInicial" => "948" "paginaFinal" => "968" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16264058" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bronchodilator responsiveness in patients with COPD" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D.P. Tashkin" 1 => "B. Celli" 2 => "M. Decramer" 3 => "D. Liu" 4 => "D. Burkhart" 5 => "C. Cassino" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.00129607" "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "2008" "volumen" => "31" "paginaInicial" => "742" "paginaFinal" => "750" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18256071" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Calverley" 1 => "J.A. Anderson" 2 => "B. Celli" 3 => "G.T. Ferguson" 4 => "C. Jenkins" 5 => "P.W. Jones" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMoa063070" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2007" "volumen" => "356" "paginaInicial" => "775" "paginaFinal" => "789" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17314337" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Is the short-term response to inhaled b-adrenergic agonist sensitive or specific for distinguishing between asthma and COPD?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S. Kesten" 1 => "A.S. Rebuck" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "1994" "volumen" => "105" "paginaInicial" => "1042" "paginaFinal" => "1045" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8162722" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib16" "etiqueta" => "16." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diferencias geográficas en la prevalencia de EPOC en España: relación con hábito tabáquico, tasas de mortalidad y otros determinantes" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.B. Soriano" 1 => "M. Miravitlles" 2 => "L. Borderías" 3 => "E. Durán-Tauleria" 4 => "F. García Río" 5 => "J. Martínez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.arbres.2010.06.008" "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2010" "volumen" => "46" "paginaInicial" => "522" "paginaFinal" => "530" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20832926" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib17" "etiqueta" => "17." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lung structure and function in cigarette smokers" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.C. Hogg" 1 => "J.L. Wright" 2 => "B.R. Wiggs" 3 => "H.O. Coxson" 4 => "A. Opazo Sáez" 5 => "P.D. Paré" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Thorax" "fecha" => "1994" "volumen" => "49" "paginaInicial" => "473" "paginaFinal" => "478" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8016769" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib18" "etiqueta" => "18." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Limited contribution of emphysema in advanced chronic obstructive pulmonary disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.F. Gelb" 1 => "M. Schein" 2 => "J. Kuei" 3 => "D.P. Tashkin" 4 => "N.L. Müller" 5 => "J.C. Hogg" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/ajrccm/147.5.1157" "Revista" => array:6 [ "tituloSerie" => "Am Rev Respir Dis" "fecha" => "1993" "volumen" => "147" "paginaInicial" => "1157" "paginaFinal" => "1161" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8484625" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib19" "etiqueta" => "19." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Centrilobular and panlobular emphysema in smokers. Two distinct morpho- logical and functional entities" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "W.D. Kim" 1 => "D. Eidelman" 2 => "J.L. Izquierdo" 3 => "H. Ghezzo" 4 => "M.P. Saetta" 5 => "M.G. Cosio" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/ajrccm/144.6.1385" "Revista" => array:6 [ "tituloSerie" => "Am Rev Respir Dis" "fecha" => "1991" "volumen" => "144" "paginaInicial" => "1385" "paginaFinal" => "1390" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1741553" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib20" "etiqueta" => "20." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "COPD, a multicomponent disease: implications for management" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A.G. Agusti" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rmed.2004.11.006" "Revista" => array:6 [ "tituloSerie" => "Respir Med" "fecha" => "2005" "volumen" => "99" "paginaInicial" => "670" "paginaFinal" => "682" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15878483" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib21" "etiqueta" => "21." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Roflumilast in symptomatic chronic obstructive pulmonary disease: two randomised clinical trials" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "for the M2-124 and M2-125 study groups" "etal" => false "autores" => array:6 [ 0 => "P.M.A. Calverley" 1 => "K.F. Rabe" 2 => "U.M. Goehring" 3 => "S. Kristiansen" 4 => "L.M. Fabbri" 5 => "F.J. Martínez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0140-6736(09)61255-1" "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "2009" "volumen" => "374" "paginaInicial" => "685" "paginaFinal" => "694" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19716960" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib22" "etiqueta" => "22." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "How representative are clinical study patients with asthma or COPD for a larger “real life” population of patients with obstructive lung disease?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "K. Herland" 1 => "J.P. Akselsen" 2 => "O.H. Skojønsberg" 3 => "L. Bjermer" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Respiratory Medicine" "fecha" => "2005" "volumen" => "99" "paginaInicial" => "11" "paginaFinal" => "19" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15672843" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib23" "etiqueta" => "23." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A new method of classifying prognostic comorbidity in longitudinal studies: development and validation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.E. Charlson" 1 => "P. Pompei" 2 => "K.L. Ales" 3 => "C.R.L. MacKenzie" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Chronic Dis" "fecha" => "1987" "volumen" => "40" "paginaInicial" => "373" "paginaFinal" => "383" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3558716" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib24" "etiqueta" => "24." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Estudio de las comorbilidades en pacientes hospitalizados por descompensación de la EPOC atendidos en los servicios de medicina interna. Estudio ECCO" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Almagro" 1 => "F. López García" 2 => "F.J. Cabrera" 3 => "L. Montero" 4 => "D. Morchón" 5 => "J. Díez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Clin Esp" "fecha" => "2009" "volumen" => "209" "paginaInicial" => "484" "paginaFinal" => "491" ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib25" "etiqueta" => "25." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long-term mortality follow-up of the ISOLDE participants: Causes of death during 13 years after trial completion" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "G. Bale" 1 => "P. Martínez-Camblor" 2 => "P.S. Burge" 3 => "J.B. Soriano" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rmed.2008.04.001" "Revista" => array:6 [ "tituloSerie" => "Respir Med" "fecha" => "2008" "volumen" => "102" "paginaInicial" => "1468" "paginaFinal" => "1472" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18620853" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib26" "etiqueta" => "26." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tratamiento individualizado de la EPOC: una propuesta de cambio" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M. Miravitlles" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0300-2896(09)72952-7" "Revista" => array:7 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2009" "volumen" => "45" "numero" => "Supl 5" "paginaInicial" => "27" "paginaFinal" => "34" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20116759" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib27" "etiqueta" => "27." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Impact of salmeterol/fluticasone propionate versus salmeterol on exacerbations in severe chronic obstructive pulmonary disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "P. Kardos" 1 => "M. Wencker" 2 => "T. Glaab" 3 => "C. Vogelmeier" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/rccm.200602-244OC" "Revista" => array:6 [ "tituloSerie" => "Am J Respir Crit Care Med" "fecha" => "2007" "volumen" => "175" "paginaInicial" => "144" "paginaFinal" => "149" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17053207" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib28" "etiqueta" => "28." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Eosinophilic airway inflammation and exacerbations of COPD: a randomised controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Siva" 1 => "R.H. Green" 2 => "C.E. Brightling" 3 => "M. Shelley" 4 => "B. Hargadon" 5 => "McKenna." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.00146306" "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "2007" "volumen" => "29" "paginaInicial" => "906" "paginaFinal" => "913" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17301099" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/00142565/00000211000000S2/v1_201302081053/S0014256511700078/v1_201302081053/es/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/00142565/00000211000000S2/v1_201302081053/S0014256511700078/v1_201302081053/es/main.pdf?idApp=WRCEE&text.app=https://revclinesp.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256511700078?idApp=WRCEE" ]
