array:24 [
  "pii" => "S1695403315003550"
  "issn" => "16954033"
  "doi" => "10.1016/j.anpedi.2015.08.011"
  "estado" => "S300"
  "fechaPublicacion" => "2016-05-01"
  "aid" => "1954"
  "copyright" => "Asociación Española de Pediatría"
  "copyrightAnyo" => "2015"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "cita" => "An Pediatr (Barc). 2016;84:278-85"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 5521
    "formatos" => array:3 [
      "EPUB" => 124
      "HTML" => 4272
      "PDF" => 1125
    ]
  ]
  "Traduccion" => array:1 [
    "en" => array:19 [
      "pii" => "S2341287916300035"
      "issn" => "23412879"
      "doi" => "10.1016/j.anpede.2015.08.014"
      "estado" => "S300"
      "fechaPublicacion" => "2016-05-01"
      "aid" => "1954"
      "copyright" => "Asociación Española de Pediatría"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "fla"
      "cita" => "An Pediatr (Barc). 2016;84:278-85"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:2 [
        "total" => 2042
        "formatos" => array:3 [
          "EPUB" => 139
          "HTML" => 1381
          "PDF" => 522
        ]
      ]
      "en" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
        "titulo" => "Assessing the use of procalcitonin in the hospitalised young febrile infant"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "tieneResumen" => array:2 [
          0 => "en"
          1 => "es"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "278"
            "paginaFinal" => "285"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "es" => array:1 [
            "titulo" => "Valoraci&#243;n del uso de la procalcitonina en el lactante febril hospitalizado"
          ]
        ]
        "contieneResumen" => array:2 [
          "en" => true
          "es" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figure 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 2688
                "Ancho" => 1602
                "Tamanyo" => 227620
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">ROC curves for the assessment of possible or definite SBI by means of the WBC total&#44; band cell total&#44; CRP&#44; PCT&#44; PCR<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>PCT and lab-score&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "E&#46; Parada, O&#46; Calavia, M&#46; Dur&#225;n-Ball&#233;n, A&#46; Vasquez, R&#46; Ayats, N&#46; Ferr&#233;"
            "autores" => array:6 [
              0 => array:2 [
                "nombre" => "E&#46;"
                "apellidos" => "Parada"
              ]
              1 => array:2 [
                "nombre" => "O&#46;"
                "apellidos" => "Calavia"
              ]
              2 => array:2 [
                "nombre" => "M&#46;"
                "apellidos" => "Dur&#225;n-Ball&#233;n"
              ]
              3 => array:2 [
                "nombre" => "A&#46;"
                "apellidos" => "Vasquez"
              ]
              4 => array:2 [
                "nombre" => "R&#46;"
                "apellidos" => "Ayats"
              ]
              5 => array:2 [
                "nombre" => "N&#46;"
                "apellidos" => "Ferr&#233;"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "es" => array:9 [
          "pii" => "S1695403315003550"
          "doi" => "10.1016/j.anpedi.2015.08.011"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "es"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403315003550?idApp=UINPBA00005H"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287916300035?idApp=UINPBA00005H"
      "url" => "/23412879/0000008400000005/v1_201604260918/S2341287916300035/v1_201604260918/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S1695403315002817"
    "issn" => "16954033"
    "doi" => "10.1016/j.anpedi.2015.07.003"
    "estado" => "S300"
    "fechaPublicacion" => "2016-05-01"
    "aid" => "1909"
    "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "An Pediatr &#40;Barc&#41;. 2016;84:286-8"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 18966
      "formatos" => array:3 [
        "EPUB" => 140
        "HTML" => 17780
        "PDF" => 1046
      ]
    ]
    "es" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Carta cient&#237;fica</span>"
      "titulo" => "Mastocitosis cut&#225;nea difusa&#46; Presentaci&#243;n de 3 casos y revisi&#243;n de su manejo terap&#233;utico"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "286"
          "paginaFinal" => "288"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Diffuse cutaneous mastocytosis&#46; Presentation of 3 cases and therapeutic management review"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figura 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 2647
              "Ancho" => 1655
              "Tamanyo" => 265041
            ]
          ]
          "descripcion" => array:1 [
            "es" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">&#205;ndice de SCORMA<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>A&#47;5<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>5B<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>2C&#47;5&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "B&#46; Selva Folch, R&#46; L&#243;pez Almaraz, R&#46; S&#225;nchez Gonz&#225;lez, B&#46; Martinez de las Heras"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "B&#46;"
              "apellidos" => "Selva Folch"
            ]
            1 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "L&#243;pez Almaraz"
            ]
            2 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "S&#225;nchez Gonz&#225;lez"
            ]
            3 => array:2 [
              "nombre" => "B&#46;"
              "apellidos" => "Martinez de las Heras"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2341287916300059"
        "doi" => "10.1016/j.anpede.2015.07.030"
        "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/S2341287916300059?idApp=UINPBA00005H"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403315002817?idApp=UINPBA00005H"
    "url" => "/16954033/0000008400000005/v1_201604260918/S1695403315002817/v1_201604260918/es/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1695403315003562"
    "issn" => "16954033"
    "doi" => "10.1016/j.anpedi.2015.08.012"
    "estado" => "S300"
    "fechaPublicacion" => "2016-05-01"
    "aid" => "1955"
    "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "An Pediatr &#40;Barc&#41;. 2016;84:271-7"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 3422
      "formatos" => array:3 [
        "EPUB" => 125
        "HTML" => 2595
        "PDF" => 702
      ]
    ]
    "es" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
      "titulo" => "Pulsioximetr&#237;a frente al monitor de electrocardiograma para la determinaci&#243;n de la frecuencia card&#237;aca durante la reanimaci&#243;n del reci&#233;n nacido pret&#233;rmino"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "271"
          "paginaFinal" => "277"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Pulse oximetry versus electrocardiogram for heart rate assessment during resuscitation of the preterm infant"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figura 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 2001
              "Ancho" => 2216
              "Tamanyo" => 224905
            ]
          ]
          "descripcion" => array:1 [
            "es" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Comparaci&#243;n de valores fiables de frecuencia card&#237;aca &#40;FC&#41; medidos simult&#225;neamente por pulsioximetr&#237;a &#40;PO&#41; y monitor de electrocardiograma &#40;ECG&#41; durante la reanimaci&#243;n de 39 reci&#233;n nacidos pret&#233;rmino&#46;</p> <p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">S&#58; segundos&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "B&#46; Iglesias, M&#46;J&#46; Rodr&#237;guez, E&#46; Aleo, E&#46; Criado, G&#46; Herranz, M&#46; Moro, J&#46; Mart&#237;nez Orgado, L&#46; Arruza"
          "autores" => array:8 [
            0 => array:2 [
              "nombre" => "B&#46;"
              "apellidos" => "Iglesias"
            ]
            1 => array:2 [
              "nombre" => "M&#46;J&#46;"
              "apellidos" => "Rodr&#237;guez"
            ]
            2 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "Aleo"
            ]
            3 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "Criado"
            ]
            4 => array:2 [
              "nombre" => "G&#46;"
              "apellidos" => "Herranz"
            ]
            5 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Moro"
            ]
            6 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Mart&#237;nez Orgado"
            ]
            7 => array:2 [
              "nombre" => "L&#46;"
              "apellidos" => "Arruza"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2341287916300229"
        "doi" => "10.1016/j.anpede.2015.08.017"
        "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/S2341287916300229?idApp=UINPBA00005H"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403315003562?idApp=UINPBA00005H"
    "url" => "/16954033/0000008400000005/v1_201604260918/S1695403315003562/v1_201604260918/es/main.assets"
  ]
  "es" => array:19 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
    "titulo" => "Valoraci&#243;n del uso de la procalcitonina en el lactante febril hospitalizado"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "278"
        "paginaFinal" => "285"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "E&#46; Parada, O&#46; Calavia, M&#46; Dur&#225;n-Ball&#233;n, A&#46; Vasquez, R&#46; Ayats, N&#46; Ferr&#233;"
        "autores" => array:6 [
          0 => array:3 [
            "nombre" => "E&#46;"
            "apellidos" => "Parada"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          1 => array:4 [
            "nombre" => "O&#46;"
            "apellidos" => "Calavia"
            "email" => array:1 [
              0 => "olgacalavia&#64;gmail&#46;com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "M&#46;"
            "apellidos" => "Dur&#225;n-Ball&#233;n"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "A&#46;"
            "apellidos" => "Vasquez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "R&#46;"
            "apellidos" => "Ayats"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "N&#46;"
            "apellidos" => "Ferr&#233;"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Servicio de Pediatr&#237;a&#44; Hospital Universitari Joan XXIII de Tarragona&#44; Universidad Rovira i Virgili&#44; IISPV&#44; Tarragona&#44; Espa&#241;a"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Unidad de Pediatr&#237;a&#44; Facultad de Medicina y Cirug&#237;a&#44; Universidad Rovira i Virgili&#46; IISPV&#44; Tarragona&#44; Espa&#241;a"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Autor para correspondencia&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "en" => array:1 [
        "titulo" => "Assessing the use of procalcitonin in the hospitalised young febrile infant"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 2688
            "Ancho" => 1602
            "Tamanyo" => 243510
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Curvas ROC para la valoraci&#243;n de IBG posible o confirmada de n&#250;mero de leucocitos&#44; n&#250;mero de bandas&#44; PCR&#44; PCT&#44; PCR&#43;PCT y lab-score&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">La fiebre es una de las causas m&#225;s comunes de consulta pedi&#225;trica&#46; La gran mayor&#237;a de estos episodios son debidos a infecciones v&#237;ricas benignas y autolimitadas que no precisan tratamiento&#46; Sin embargo&#44; en los lactantes&#44; y especialmente en los menores de 3 meses&#44; esta fiebre puede representar una infecci&#243;n bacteriana grave &#40;IBG&#41; por lo que genera un n&#250;mero significativo de ingresos&#46; La evaluaci&#243;n del lactante febril supone un reto diagn&#243;stico que ha conducido al desarrollo de diferentes herramientas para intentar detectar los pacientes de mayor riesgo de IBG&#58; scores cl&#237;nicos como la escala de Yale<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">1</span></a>&#44; marcadores sangu&#237;neos valorados de forma aislada &#40;prote&#237;na C-reactiva &#91;PCR&#93;&#44; procalcitonina &#91;PCT&#93;&#44; interleucina-6&#44;&#8230;&#41; o combinada &#40;lab-score<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">2</span></a>&#41; as&#237; como combinaciones cl&#237;nico-anal&#237;ticas &#40;criterios de Rochester<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">3</span></a>&#41;&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">La PCT ofrece potenciales ventajas en el diagn&#243;stico precoz de infecci&#243;n bacteriana por su vida media m&#225;s corta y su elevaci&#243;n m&#225;s r&#225;pida&#44; y es aparentemente un marcador m&#225;s espec&#237;fico que la PCR en ni&#241;os con IBG<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">4</span></a>&#46; La mayor&#237;a de los estudios coinciden en que niveles bajos de PCT tienen un alto valor predictivo negativo &#40;VPN&#41; para la exclusi&#243;n de bacteriemia y en la &#250;ltima d&#233;cada se ha introducido en muchos protocolos de manejo del ni&#241;o con fiebre sin foco &#40;FSF&#41; en urgencias&#46; Sin embargo&#44; la PCT tiene tambi&#233;n falsos positivos y falsos negativos &#40;sensibilidad &#91;S&#93; entre el 70 y el 91&#37; y especificidad &#91;E&#93; entre 59 y 85&#37;<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">5&#8211;7</span></a>&#41;&#44; hecho que condiciona que las decisiones cl&#237;nicas no puedan basarse &#250;nicamente en este marcador&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">La utilidad de la PCT como marcador evolutivo ha sido validada en diferentes estudios en adultos y su uso para iniciar o suspender el tratamiento antibi&#243;tico en pacientes adultos parece seguro y eficaz&#44; contribuyendo a una reducci&#243;n importante del uso de antibi&#243;ticos<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">8&#44;9</span></a>&#46; Sin embargo&#44; hay pocos trabajos que eval&#250;en el resultado del uso rutinario de la PCT en la pr&#225;ctica cl&#237;nica &#40;indicaci&#243;n de ingreso&#44; repetici&#243;n de pruebas anal&#237;ticas&#44; uso de antibi&#243;ticos&#44; estancia hospitalaria&#41; y su coste en pediatr&#237;a&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Este trabajo pretende evaluar si la determinaci&#243;n de PCT ha cambiado en nuestro centro la valoraci&#243;n y el manejo del lactante febril hospitalizado&#44; as&#237; como comparar la S&#44; E&#44; valor predictivo positivo &#40;VPP&#41; y VPN de diferentes marcadores&#47;scores en esta poblaci&#243;n&#46; Tambi&#233;n eval&#250;a el coste a&#241;adido de PCR y PCT sobre los scores cl&#237;nico-anal&#237;ticos tradicionales&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material y m&#233;todos</span><p id="par0025" class="elsevierStylePara elsevierViewall">Estudio descriptivo retrospectivo de 2 periodos de tiempo&#58; enero-diciembre de 2009 &#40;periodo 1&#58; sin PCT&#41; y enero-diciembre de 2011 &#40;periodo 2&#58; uso rutinario de PCT&#41;&#46; El protocolo de manejo del lactante menor de 3 meses con fiebre fue el mismo durante los 2 periodos con la excepci&#243;n del uso rutinario de la PCT en el periodo 2&#58; para los lactantes de 1 a 3 meses con fiebre sin foco&#44; nuestro protocolo se basa en los criterios de Rochester&#59; para los neonatos el protocolo incluye anal&#237;tica de sangre&#44; orina y LCR&#44; Rx t&#243;rax si cl&#237;nica respiratoria&#44; ingreso y valoraci&#243;n de antibi&#243;ticos seg&#250;n cl&#237;nica y resultados&#59; y para los pacientes con diagn&#243;sticos espec&#237;ficos &#40;bronquiolitis&#44; infecci&#243;n de orina &#91;ITU&#93;&#44; neumon&#237;a&#44; etc&#46;&#41; se aplic&#243; el protocolo correspondiente&#46; No se a&#241;adi&#243; al protocolo ninguna recomendaci&#243;n sobre la valoraci&#243;n de la PCT&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Se incluy&#243; a los pacientes con edades entre 7 y 90 d&#237;as ingresados con fiebre &#40;definida como temperatura axilar igual o superior a 37&#44;5<span class="elsevierStyleHsp" style=""></span>&#176;C&#41; en un hospital universitario&#46; Se excluy&#243; a aquellos pacientes en los que no se realiz&#243; anal&#237;tica sangu&#237;nea&#46; Se recogieron los siguientes datos&#58; filiaci&#243;n&#44; cl&#237;nica&#44; hemograma&#44; PCR inicial y m&#225;xima&#44; PCT inicial y m&#225;xima&#44; sedimento de orina &#40;SO&#41;&#47;tira reactiva de orina &#40;TRO&#41;&#44; score de Rochester&#44; lab-score &#40;PCR<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>PCT<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>TRO&#41; calculado con anal&#237;tica inicial&#44; hemocultivo &#40;HC&#41;&#44; urocultivo &#40;UC&#41;&#44; estancia hospitalaria&#44; uso de antibi&#243;ticos y n&#250;mero de anal&#237;ticas solicitadas&#46; En casos seleccionados se dispuso tambi&#233;n de cultivo de l&#237;quido cefalorraqu&#237;deo &#40;LCR&#41;&#44; detecci&#243;n de virus respiratorios por reacci&#243;n en cadena de la polimerasa o ant&#237;geno VRS en aspirado nasofar&#237;ngeo y radiograf&#237;a de t&#243;rax&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Para la definici&#243;n de IBG se utilizaron los mismos criterios que Maniaci<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">10</span></a>&#44; en resumen&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">&#8226;</span><p id="par0040" class="elsevierStylePara elsevierViewall">I<span class="elsevierStyleUnderline">BG confirmada</span>&#58; si infecci&#243;n bacteriana focal en la exploraci&#243;n f&#237;sica &#40;diferente a otitis media&#41;&#44; bacteriemia&#44; ITU&#44; meningitis&#44; neumon&#237;a bacteriana o gastroenteritis bacteriana definidas respectivamente por&#58; HC positivo a un pat&#243;geno&#44; UC por sondaje con m&#225;s de 50&#46;000<span class="elsevierStyleHsp" style=""></span>UFC de un solo germen o entre 10&#46;000 y 49&#46;000 si adem&#225;s se acompa&#241;aba de SO patol&#243;gico &#40;&#62;5 leucocitos por campo&#41; o TRO patol&#243;gica &#40;nitritos o leucocitos positivos&#41;&#44; cultivo de LCR positivo o bacteriemia con pleocitosis en LCR&#44; cultivo positivo de l&#237;quido pleural o radiolog&#237;a compatible con neumon&#237;a bacteriana m&#225;s cultivo de esputo o HC positivo a un pat&#243;geno respiratorio y&#44; por &#250;ltimo&#44; coprocultivo positivo&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">&#8226;</span><p id="par0045" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleUnderline">IBG posible</span>&#58; si UC por sondaje con 10&#46;000-49&#46;000 UCF&#47;ml de un solo germen con SO y TRO normal o si radiolog&#237;a compatible con neumon&#237;a pero sin confirmaci&#243;n bacteriol&#243;gica en HC&#44; cultivo de esputo o l&#237;quido pleural&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">&#8226;</span><p id="par0050" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleUnderline">No IBG</span>&#58; En el resto de los casos&#46;</p></li></ul></p><p id="par0055" class="elsevierStylePara elsevierViewall">En el caso de UC con m&#250;ltiples g&#233;rmenes se consider&#243; como ITU confirmada si hab&#237;a &#62;50&#46;000<span class="elsevierStyleHsp" style=""></span>UFC de un germen predominante&#44; y como ITU posible si hab&#237;a 50&#46;000<span class="elsevierStyleHsp" style=""></span>UFC de varios g&#233;rmenes sin dominancia&#44; independientemente del resultado del SO&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Los datos sobre costes anal&#237;ticos se obtuvieron a partir del laboratorio de nuestro centro a fecha de diciembre de 2013&#58; hemograma&#58; 4&#44;29 euros&#47;determinaci&#243;n&#59; PCR&#58; 3&#44;68 euros&#47;determinaci&#243;n&#59; PCT&#58; 20&#44;15&#160;euros&#47;determinaci&#243;n&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Se realiz&#243; el an&#225;lisis de forma conjunta de todos los pacientes y tambi&#233;n por subgrupos&#58; pacientes con buen estado general&#44; pacientes con FSF&#44; pacientes con SO&#47;TRO normal y pacientes menores de un mes&#46; Se analiz&#243; la S&#44; E&#44; VPP y VPN de la PCT y PCR para diferentes puntos de corte &#40;PCT&#160;&#8805;&#160;0&#44;26&#59; &#8805;0&#44;5&#59; &#8805;1&#59; &#8805;2<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#59; PCR &#8805;&#160;1&#59; &#8805;2&#44;75&#59; &#8805;4&#59; &#8805;10<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41;&#44; criterios de Rochester<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">3</span></a>&#44; SO &#40;punto de corte&#58; &#8805;5 leucocitos&#47;campo y &#8805;10 leucocitos&#47;campo&#41; y lab-score &#40;punto de corte &#8805;&#160;3&#41;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">2&#44;11</span></a> para el diagn&#243;stico de IBG&#46; Para el c&#225;lculo del lab-score se utiliz&#243; el resultado del SO en el caso de que no se dispusiera del resultado de la TRO&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Se analiz&#243; si el uso sistem&#225;tico de la determinaci&#243;n de PCT hab&#237;a influido en el mayor&#47;menor uso de antibi&#243;ticos&#44; estancia hospitalaria y repetici&#243;n de anal&#237;ticas&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Se consider&#243; antibioticoterapia adecuada aquella situaci&#243;n en la que se prescribi&#243; antibi&#243;tico en pacientes con diagn&#243;stico de IBG &#40;posible o confirmada&#41; y la no prescripci&#243;n de antibi&#243;ticos en los pacientes no IBG&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Se recogieron los datos a partir de las historias cl&#237;nicas y registros del laboratorio en una hoja de c&#225;lculo &#40;Microsoft Office Excel 2007&#41; y se analizaron con el paquete estad&#237;stico SPSS 15&#46;0 para Windows&#46; Para la comparaci&#243;n de variables dicot&#243;micas se utiliz&#243; el test de chi-cuadrado y para la comparaci&#243;n de variables cuantitativas el test de Student o U de Mann-Whitney con niveles alfa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46; Se realizaron curvas ROC para la valoraci&#243;n del rendimiento de la PCR&#44; PCT y leucocitosis en el diagn&#243;stico de IBG posible o confirmada utilizando los datos obtenidos de los pacientes del periodo 2 con PCT disponible&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Resultados</span><p id="par0085" class="elsevierStylePara elsevierViewall">Se incluy&#243; a 220 pacientes&#58; 109 en el periodo 1 y 111 en el periodo 2&#59; en este segundo periodo solo se dispuso de resultado de PCT en 87 pacientes&#46; De los 220 pacientes&#44; 78 &#40;35&#44;4&#37;&#41; ten&#237;an menos de 30 d&#237;as de vida y 80 &#40;36&#44;4&#37;&#41; eran pacientes con FSF&#46; Las caracter&#237;sticas demogr&#225;ficas&#44; cl&#237;nicas y anal&#237;ticas iniciales se recogen en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#44; sin diferencias estad&#237;sticamente significativas entre los 2 periodos&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">Se diagnostic&#243; IBG en 85 pacientes &#40;38&#44;6&#37; del total de pacientes&#41;&#46; Aunque el porcentaje de pacientes ingresados con IBG &#40;posible o confirmada&#41; fue discretamente mayor en el periodo en que se dispuso de PCT &#40;37&#44;6&#37; en periodo 1 vs&#46; 40&#44;2&#37; en el periodo 2 en pacientes con PCT realizada&#41; la diferencia no fue significativa &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;59&#41;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">La prevalencia de IBG &#40;posible o confirmada&#41; fue similar en los pacientes con edades &#60;1&#160;mes y &#62;1&#160;mes &#40;39&#44;4 y 37&#44;5&#37; respectivamente&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;77&#41; y en la mayor&#237;a de casos se trat&#243; de ITU&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Un total de 42 de los pacientes del primer periodo y 28 de los pacientes con PCT disponible del segundo periodo eran menores de un mes&#46; La prevalencia de IBG posible o confirmada en este subgrupo de pacientes en los 2 periodos fue del 35&#44;5 y 39&#44;2&#37;&#44; respectivamente &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;76&#41;&#46; Tampoco hubo diferencias estad&#237;sticamente significativas en el uso de antibi&#243;ticos entre los 2 periodos &#40;66&#44;6 y 78&#44;6&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;28&#41;&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">El n&#250;mero de anal&#237;ticas realizadas y el porcentaje de pacientes que recibieron antibi&#243;ticos fueron similares en los 2 periodos &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46; Si comparamos la estancia entre los pacientes del periodo 1 y los pacientes del periodo 2 con PCT realizada &#40;media de 2&#44;6 y 2&#44;2 d&#237;as&#44; respectivamente&#41; la diferencia tampoco fue significativa &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;71&#41;&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> se detallan los diagn&#243;sticos de los pacientes con IBG posible o confirmada en los 2 periodos&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">De los 4 pacientes con bacteriemia &#40;1 en periodo pre-PCT y 3 en periodo 2 con PCT realizada&#41; todos ten&#237;an fiebre de menos de 12&#160;h de evoluci&#243;n&#46; Dos presentaban leucopenia&#44; todos ten&#237;an PCR superior a 1<span class="elsevierStyleHsp" style=""></span>mg&#47;dl &#40;concretamente 6&#44;9<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#59; 1&#44;4<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#59; 1&#44;5<span class="elsevierStyleHsp" style=""></span>mg&#47;dl y 8&#44;9<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41; y los valores de PCT fueron 0&#44;24<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#59; 0&#44;38<span class="elsevierStyleHsp" style=""></span>ng&#47;ml y 1&#44;07<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a> se muestran la S&#44; E&#44; VPP y VPN de los diferentes par&#225;metros cl&#237;nico-anal&#237;ticos &#40;con diferentes puntos de corte&#41; para el diagn&#243;stico de IBG posible o confirmada&#46; El criterio m&#225;s sensible fue el score de Rochester&#59; el m&#225;s espec&#237;fico&#44; valores de PCR&#160;&#8805;&#160;10<span class="elsevierStyleHsp" style=""></span>mg&#47;dl &#40;aunque &#62;1&#46;500 bandas&#47;mm<span class="elsevierStyleSup">3</span>&#44; PCT &#8805;2<span class="elsevierStyleHsp" style=""></span>ng&#47;ml o SO patol&#243;gico tuvieron especificidades muy similares&#41;&#46; El que mostr&#243; mejor VPP fue la PCR&#160;&#8805;&#160;10<span class="elsevierStyleHsp" style=""></span>mg&#47;dl &#40;100&#37;&#41; y el de mejor VPN los criterios de Rochester &#40;76&#44;8&#37;&#41;&#46; Los &#237;ndices de Youden m&#225;ximos fueron 0&#44;424 para una valor de PCR de 2&#44;35<span class="elsevierStyleHsp" style=""></span>mg&#47;dl y de 0&#44;345 para un valor de PCT 0&#44;351<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0125" class="elsevierStylePara elsevierViewall">Analizando el subgrupo de pacientes que ofrece m&#225;s dificultades en su manejo &#40;FSF y SO normal&#41; los resultados fueron similares &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#41;&#46; De los 24 pacientes con FSF y SO normal en los que se dispuso de PCR y PCT&#44; utilizando los valores propuestos en el &#171;lab score&#187;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">11</span></a> como punto de corte &#40;PCR &#8805;4<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#44; PCT &#8805;0&#44;5<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41;&#44; 2 de los 5 pacientes con IBG posible o confirmada ten&#237;an ambos marcadores negativos&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0130" class="elsevierStylePara elsevierViewall">En el subgrupo de pacientes menores de un mes &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>28&#41; el VPN de la PCT &#40;punto de corte 0&#44;5<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41; fue de 75&#37;&#58; de los 20 pacientes con PCT &#60;&#160;0&#44;5<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#44; 5 fueron diagnosticados de IBG&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Si consideramos solo los pacientes con FSF &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>80&#41;&#44; 35 pacientes &#40;43&#44;8&#37;&#41; ten&#237;an una IBG confirmada o posible &#40;94&#37; ITU&#41;&#46; Las caracter&#237;sticas cl&#237;nicas y anal&#237;ticas&#44; seg&#250;n tuvieran IBG o no&#44; se describen en la <a class="elsevierStyleCrossRef" href="#tbl0025">tabla 5</a>&#46; Los valores iniciales de PCR&#44; PCT y leucocitos y el valor m&#225;ximo de PCR fueron significativamente diferentes en los pacientes con IBG comparados con los no-IBG&#44; no as&#237; el valor m&#225;ximo de la PCT&#44; que fue similar en los 2 grupos&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0140" class="elsevierStylePara elsevierViewall">Recibieron antibioticoterapia adecuada el 72&#44;5&#37; de los pacientes del periodo 1 y el 73&#44;6&#37; de los pacientes en los que se dispuso de valor de PCT en el periodo 2&#44; sin que la diferencia fuera estad&#237;sticamente significativa&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">El coste anal&#237;tico de los pacientes en el periodo 2 fue el triple que en el periodo 1 &#40;11&#44;1 euros&#47;paciente de media &#40;SD 4&#44;95&#41; en el periodo 1 y 38&#44;7 euros &#40;SD 16&#41; en el periodo 2 con PCT&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;000&#41;&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a> se representan las curvas ROC obtenidas para la PCR&#44; PCT&#44; leucocitosis&#44; bandas&#44; PCR<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>PCT y lab-score&#46; El &#225;rea bajo la curva para la PCR fue superior a la de la PCT &#40;0&#44;752 y 0&#44;648 respectivamente&#41; pero esta diferencia no fue estad&#237;sticamente significativa &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;196&#41;&#46; El lab-score muestra un &#225;rea bajo la curva discretamente superior al uso de la PCR de forma aislada o junto con la PCT&#44; pero tampoco alcanza significaci&#243;n estad&#237;stica &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;399&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discusi&#243;n</span><p id="par0155" class="elsevierStylePara elsevierViewall">La PCT se introdujo en nuestro hospital en el a&#241;o 2010&#46; Inicialmente solo se solicitaba en casos seleccionados&#44; pero a partir de 2011 se pas&#243; a utilizar de forma rutinaria en la evaluaci&#243;n del lactante febril&#46; Los resultados de este estudio muestran que la utilizaci&#243;n rutinaria de PCT no ha cambiado el manejo de los pacientes menores de 3 meses hospitalizados&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">La mayor&#237;a de los estudios publicados en pediatr&#237;a sobre PCT se han realizado en pacientes con FSF en urgencias<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">5&#44;6&#44;12&#44;13</span></a>&#46; Estos estudios apoyan la utilidad de la PCT como marcador predictivo de enfermedad bacteriana potencialmente grave &#40;bacteriemia&#44; sepsis&#44; sepsis de origen urinario y neumon&#237;a grave&#41; en este escenario&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Los valores predictivos de la PCT que obtuvimos fueron significativamente diferentes a los publicados en series que inclu&#237;an pacientes menores de 36 meses tratados en urgencias<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">7</span></a>&#58; en nuestro estudio el VPN oscil&#243; entre 63 y 81&#37; para los diferentes puntos de corte de PCT &#40;0&#44;26<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#59; 0&#44;5<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#59; 1<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41;&#44; muy lejos de los valores cercanos al 100&#37; de otros estudios&#46; Esta diferencia podr&#237;a deberse a que nuestro trabajo incluye solo pacientes ingresados&#58; es una poblaci&#243;n seleccionada con una prevalencia de IBG superior a la de los estudios realizados en urgencias &#40;mayor porcentaje de pacientes con edades &#60;1&#160;mes&#44; no cumplir criterios de bajo riesgo de Rochester&#44; etc&#46;&#41;&#46; La prevalencia de IBG confirmada en nuestro estudio fue 31&#44;3&#37;&#44; similar al 26&#44;4&#37; del estudio de Bressan<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">11</span></a> pero claramente superior a la de estudios como el de Maniaci<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">10</span></a> &#40;9&#44;7&#37;&#41;&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">El estudio multic&#233;ntrico de Fern&#225;ndez-L&#243;pez<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">14</span></a> compara diferentes marcadores en 352 ni&#241;os de 1-36 meses de edad con FSF en urgencias y concluye que el mejor marcador es la PCT con un punto de corte de 0&#44;53<span class="elsevierStyleHsp" style=""></span>ng&#47;ml &#40;S<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>65&#44;5&#37;&#59; E&#61; 94&#44;3&#37;&#41;&#46; En nuestro estudio&#44; un punto de corte similar &#40;PCT 0&#44;5<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41; solo obtuvo una S del 41&#44;7&#37;&#44; y una E del 78&#44;4&#37;&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">En cuanto a la PCR&#44; observamos que con un punto de corte de 1<span class="elsevierStyleHsp" style=""></span>mg&#47;dl se alcanza una S del 70&#37; y un VPN del 75&#37; &#40;superior a lo que obtuvimos con la PCT&#41;&#44; aunque el VPP y la E fueron bajos &#40;75 y 58&#44;1&#37; respectivamente&#41;&#46; De hecho&#44; de los 12 pacientes ingresados con FSF&#44; SO normal y PCR<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>1<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#44; solo uno tuvo una IBG &#40;ITU&#41;&#44; con una PCT inicial de 0&#44;18<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#46; De los 24 pacientes con FSF y SO normal no hubo ning&#250;n caso de IBG posible o confirmada que tuviera PCR<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>1<span class="elsevierStyleHsp" style=""></span>mg&#47;dl y PCT<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#44;5<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">Analizando el lab-socre propuesto por Galetto-Lacour et al&#46; en 2008&#44; hemos obtenido valores similares a los publicados por Bressan<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">11</span></a> con S<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>45&#44;7&#37; y E<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>93&#44;9&#37; para un punto de corte de 3&#44; por lo que tampoco este score parece ofrecer ventajas claras sobre la PCR de forma aislada&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">En el metaan&#225;lisis publicado en 2010<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">5</span></a> se concluye que la principal virtud de la PCT es descartar la presencia de IBG&#46; Por lo tanto&#44; esperar&#237;amos encontrar o un menor n&#250;mero de ingresos o un mayor porcentaje de pacientes con diagn&#243;stico final de IBG en el periodo en el que se dispuso de PCT&#46; El hecho de que esto no suceda en nuestro estudio podr&#237;a atribuirse a un n&#250;mero insuficiente de pacientes para alcanzar significaci&#243;n estad&#237;stica o a la falta de confianza en este marcador de los pediatras que indicaron el ingreso&#58; 19 de los 87 pacientes ingresados durante el periodo 2 ten&#237;an FSF&#44; SO normal y valores de PCT<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;5<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">En los &#250;ltimos a&#241;os se han publicado m&#250;ltiples estudios en los que se determinan puntos de corte &#243;ptimos de la PCT para el diagn&#243;stico de IBG&#44; diferenciaci&#243;n entre enfermedad v&#237;rica y bacteriana y diferenciaci&#243;n entre infecci&#243;n bacteriana invasiva y no invasiva &#40;pielonefritis vs&#46; cistitis<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">15&#44;16</span></a>&#41;&#46; Estos puntos de corte oscilan entre 0&#44;12<span class="elsevierStyleHsp" style=""></span>ng&#47;ml y 1<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#46; Esta variabilidad puede contribuir en parte a la baja confianza absoluta en este marcador&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Buend&#237;a<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">17</span></a>&#44; a trav&#233;s del dise&#241;o de un modelo econ&#243;mico de costo-efectividad estructurado&#44; utilizando la t&#233;cnica de an&#225;lisis de decisiones&#44; compara la PCT&#44; la PCR y los criterios de Rochester para el diagn&#243;stico de IBG en el lactante menor de 3 meses y demuestra el mayor coste que implica la PCT&#46; En nuestro estudio objetivamos un coste anal&#237;tico 3 veces superior en el periodo en el que se solicit&#243; PCT en comparaci&#243;n con el primer periodo&#46; Dado que en ambos periodos no hay diferencias en el porcentaje de pacientes ingresados con diagn&#243;stico final de IBG y que el porcentaje de pacientes con antibi&#243;tico adecuado es similar&#44; no parece que en nuestro caso el uso de la PCT haya supuesto tampoco un ahorro&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Nuestros hallazgos tambi&#233;n coinciden con los resultados de otros estudios que valoran el efecto del uso de la PCT&#58; Lacroix<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">18</span></a> en el estudio prospectivo comparando el lab-score con los marcadores tradicionales &#40;PCR&#44; leucocitos y bandas&#41; no encuentra diferencias en la prescripci&#243;n de antibi&#243;ticos o ingreso hospitalario&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">El temor a que al ir a&#241;adiendo marcadores &#40;sin retirar los antiguos&#41; pueda condicionar un n&#250;mero superior de ingresos y tratamientos antibi&#243;ticos por hallarse elevado solo uno de los par&#225;metros &#40;es decir&#44; ingresar pacientes por PCT elevada exclusivamente&#41; no se confirm&#243; en nuestro estudio&#58; en el periodo 1 ingresaron 13 pacientes con FSF y bajo riesgo de IBG seg&#250;n los criterios de Rochester y 18 en el periodo 2 &#40;11&#44;9 vs&#46; 16&#44;2&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;36&#41;&#46; El n&#250;mero de pacientes con FSF&#44; bajo riesgo seg&#250;n criterios de Rochester y PCR inferior a 1<span class="elsevierStyleHsp" style=""></span>mg&#47;dl fue similar en ambos periodos &#40;9 y 10 pacientes&#44; respectivamente&#41;&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">Las debilidades de nuestro estudio son su naturaleza retrospectiva&#44; el reducido n&#250;mero de pacientes con FSF y el hecho de que pacientes considerados como no IBG recibieran tratamiento antibi&#243;tico&#44; sin poder garantizar en estos casos que no tuvieran IBG&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">A pesar de la menor calidad cient&#237;fica de los estudios retrospectivos&#44; consideramos que el evaluar y compartir los resultados de introducir nuevas herramientas diagn&#243;sticas en la pr&#225;ctica habitual es imprescindible para una buena pr&#225;ctica cl&#237;nica&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">En resumen&#44; en nuestro centro el empleo de la PCT en el manejo del lactante febril menor de 3 meses hospitalizado no result&#243; en una disminuci&#243;n del uso de antibi&#243;ticos&#44; n&#250;mero de anal&#237;ticas ni estancia hospitalaria&#46; Tampoco parece haber mejorado la selecci&#243;n de los pacientes que son ingresados &#40;&#37; IBG similar en el periodo en que se utiliz&#243; la PCT de forma rutinaria y en el periodo sin PCT&#41; aunque este dato deber&#237;a ser confirmado en un estudio prospectivo que asignara de forma aleatoria la realizaci&#243;n&#47;no realizaci&#243;n de PCT y valorara si hay diferencias en el porcentaje de pacientes que ingresan&#46;</p><p id="par0225" class="elsevierStylePara elsevierViewall">Los biomarcadores nos proporcionan una informaci&#243;n adicional a la valoraci&#243;n cl&#237;nica&#44; pero tambi&#233;n pueden suponer un coste a&#241;adido significativo&#44; no solo por el coste de la misma prueba sino porque puede inducir a realizar tratamientos o ingresos&#46; En el caso del lactante febril hospitalizado menor de 3 meses&#44; en el que la ITU es el principal diagn&#243;stico de IBG&#44; la introducci&#243;n de la PCT no parece haber tenido un impacto cl&#237;nico significativo en nuestro centro&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conflicto de intereses</span><p id="par0230" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:10 [
        0 => array:3 [
          "identificador" => "xres631253"
          "titulo" => "Resumen"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Introducci&#243;n"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Pacientes y m&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Conclusiones"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec644102"
          "titulo" => "Palabras clave"
        ]
        2 => array:3 [
          "identificador" => "xres631254"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Introduction"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "Materials and methods"
            ]
            2 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec644103"
          "titulo" => "Keywords"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introducci&#243;n"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Material y m&#233;todos"
        ]
        6 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Resultados"
        ]
        7 => array:2 [
          "identificador" => "sec0020"
          "titulo" => "Discusi&#243;n"
        ]
        8 => array:2 [
          "identificador" => "sec0025"
          "titulo" => "Conflicto de intereses"
        ]
        9 => array:1 [
          "titulo" => "Bibliograf&#237;a"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2015-05-25"
    "fechaAceptado" => "2015-08-19"
    "PalabrasClave" => array:2 [
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec644102"
          "palabras" => array:6 [
            0 => "Procalcitonina"
            1 => "Prote&#237;na-C reactiva"
            2 => "Lactantes"
            3 => "Hospitalizaci&#243;n"
            4 => "Infecci&#243;n bacteriana"
            5 => "Coste&#46;"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec644103"
          "palabras" => array:6 [
            0 => "Procalcitonin"
            1 => "C-reactive protein"
            2 => "Infants"
            3 => "Hospitalisation"
            4 => "Bacterial infection"
            5 => "Cost"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El uso de la procalcitonina &#40;PCT&#41; se ha generalizado en la evaluaci&#243;n del lactante febril en urgencias&#46; Este trabajo pretende evaluar si la introducci&#243;n de la PCT ha cambiado el manejo del lactante febril hospitalizado y el coste&#47;efectividad de dicho marcador&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Pacientes y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio retrospectivo comparando 2 periodos&#58; enero-diciembre de 2009 &#40;sin PCT&#41; y enero-diciembre de 2011 &#40;uso rutinario de PCT&#41;&#46; Se incluy&#243; a los pacientes de 7 a 90 d&#237;as de vida con fiebre ingresados en un hospital universitario y con anal&#237;tica realizada&#46; Se compararon porcentajes de infecci&#243;n bacteriana&#44; uso de antibi&#243;ticos&#44; estancia hospitalaria y coste anal&#237;tico&#46; Se evalu&#243; la PCT&#44; la prote&#237;na-C reactiva &#40;PCR&#41;&#44; recuento leucocitario&#44; score de Rochester y el lab-score propuesto por Galetto-Lacour para el diagn&#243;stico de infecci&#243;n bacteriana&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se incluy&#243; a 109 pacientes en el periodo 1 y 111 en el periodo 2 &#40;de los cuales en 87 se dispuso de valor de PCT&#41;&#46; La prevalencia de infecci&#243;n bacteriana&#44; uso de antibi&#243;ticos&#44; repetici&#243;n de anal&#237;ticas y estancia hospitalaria fue similar en los 2 periodos&#46; El coste anal&#237;tico fue significativamente superior en el segundo periodo&#46; La sensibilidad&#44; especificidad&#44; valor predictivo positivo y valor predictivo negativo de la PCR &#40;punto de corte 1<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41; fue 70&#44;6&#59; 58&#44;1&#59; 52&#44;6 y 75&#37; y de la PCT &#40;punto de corte 0&#44;5<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41; 41&#44;7&#59; 78&#44;4&#59; 57&#44;7 y 65&#44;6&#37;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El uso de la PCT no parece haber tenido un impacto significativo en el manejo del paciente hospitalizado&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Pacientes y m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The use of procalcitonin &#40;PCT&#41; in the evaluation of the febrile infant in the emergency care unit has been widespread&#46; The aim of this study is to assess whether the introduction of PCT has changed the management of hospitalised febrile infants and the cost&#47;effectiveness of this marker&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Materials and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A retrospective study was performed comparing 2 periods&#58; January-December 2009 &#40;without PCT&#41; and January-December 2011 &#40;routine use of PCT&#41;&#46; Infants aged 7 to 90 days with fever who were admitted to a university hospital and had a blood test performed were included in the study&#46; Bacterial infection rate&#44; antibiotic use&#44; hospitalisation days&#44; and analytical costs were compared&#46; Evaluations were made using PCT&#44; C-reactive protein &#40;CRP&#41;&#44; white cell count&#44; Rochester score&#44; and the lab-score proposed by Galetto-Lacour for the diagnosis of bacterial infection&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A total of 109 patients were included in period 1&#44; and 111 in period 2 &#40;87 of which had a PCT value&#41;&#46; The prevalence of bacterial infection&#44; use of antibiotics&#44; number of blood tests&#44; and days of hospital admission was similar in both periods&#46; The blood test cost was significantly higher in the second period&#46; Sensitivity&#44; specificity&#44; positive predictive value and negative predictive value&#160;were&#160;70&#46;6&#44; 58&#46;1&#44; 52&#46;6 and 75&#37;&#44; respectively for the CRP &#40;cut-off 1<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#41; and 41&#46;7&#59; 78&#46;4&#59; 57&#46;7&#44; and 65&#46;6&#37; for the PCT &#40;cut-off value 0&#46;5<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The use of PCT does not seem to have a significant impact on the management of the hospitalised febrile infant&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Materials and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusions"
          ]
        ]
      ]
    ]
    "multimedia" => array:6 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 2688
            "Ancho" => 1602
            "Tamanyo" => 243510
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Curvas ROC para la valoraci&#243;n de IBG posible o confirmada de n&#250;mero de leucocitos&#44; n&#250;mero de bandas&#44; PCR&#44; PCT&#44; PCR&#43;PCT y lab-score&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Tabla 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Periodo 1 n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>109&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Periodo 2 con PCT n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>87&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Varones&#58; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64 &#40;58&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">55 &#40;63&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;521&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Edad &#40;d&#237;as&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9-90&#59; 44&#44;0 &#40;23&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10-90&#59; 45 &#40;23&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;765&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Estancia &#40;d&#237;as&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1-13&#59; 5&#44;0 &#40;2&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2-11&#59; 4&#44;80 &#40;2&#44;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;594&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Fiebre &#60;24</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">h&#58; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">97 &#40;89&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">74 &#40;85&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;534&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Cl&#237;nica</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a><span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;507&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Respiratoria<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53 &#40;48&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36 &#40;41&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Cut&#225;nea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;1&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;5&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Gastrointestinal<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">d</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26 &#40;23&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;18&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Otra n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;1&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sin foco&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38 &#40;34&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35 &#40;40&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Leucocitos iniciales&#47;mm</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">3&#40;</span></span><a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">e</span></a><span class="elsevierStyleSup"><span class="elsevierStyleItalic">&#41;</span></span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#46;260 &#40;6&#46;553&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#46;034 &#40;5&#46;696&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;392&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Bandas iniciales&#47;mm</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">3&#40;</span></span><a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">e</span></a><span class="elsevierStyleSup"><span class="elsevierStyleItalic">&#41;</span></span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">144 &#40;524&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">73 &#40;173&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;195&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PCR inicial &#40;mg&#47;dl&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;3 &#40;4&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;73 &#40;3&#44;42&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;426&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PCT inicial &#40;ng&#47;ml&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;0 &#40;2&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Sedimento patol&#243;gico n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;16&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;18&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Bajo riesgo Rochester n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45 &#40;41&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39 &#40;44&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;618&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">N&#46;&#176; anal&#237;ticas&#47;paciente n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;893&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63 &#40;57&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53 &#40;60&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33 &#40;30&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25 &#40;28&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#62;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;11&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;10&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Antibioticoterapia</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">69 &#40;63&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57 &#40;65&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;748&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">ITU posible o confirmada</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33 &#40;30&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;32&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;774&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">IBG posible o confirmada</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41 &#40;37&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35 &#40;40&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;592&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">IBG confirmada</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26 &#40;23&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27 &#40;31&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;185&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1035621.png"
              ]
            ]
          ]
          "notaPie" => array:5 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Rango&#59; media &#40;DE&#41;&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Algunos pacientes tienen m&#225;s de un tipo de cl&#237;nica&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0015"
              "etiqueta" => "c"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Dificultad respiratoria&#44; tos o mucosidad de v&#237;as altas&#46;</p>"
            ]
            3 => array:3 [
              "identificador" => "tblfn0020"
              "etiqueta" => "d"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Diarrea o v&#243;mitos&#46;</p>"
            ]
            4 => array:3 [
              "identificador" => "tblfn0025"
              "etiqueta" => "e"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0025">Media &#40;DE&#41;&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas cl&#237;nicas y anal&#237;ticas en los 2 periodos</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "tbl0010"
        "etiqueta" => "Tabla 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Periodo 1 n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Periodo 2 con PCT n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Bacteriemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Enterococus</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">N&#46; meninigitidis</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">S&#46; agalactiae</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">S&#46; aureus</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Meningitis <span class="elsevierStyleItalic">E&#46; coli</span><span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>ITU&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>GEA <span class="elsevierStyleItalic">Campylobacter</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>ITU&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Neumon&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mastitis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Omfalitis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Otitis media supurada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1035623.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Diagn&#243;sticos de los pacientes con IBG posible o confirmada en los 2 periodos</p>"
        ]
      ]
      3 => array:7 [
        "identificador" => "tbl0015"
        "etiqueta" => "Tabla 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="middle" scope="col" style="border-bottom: 2px solid black">S en &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="middle" scope="col" style="border-bottom: 2px solid black">E en &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="middle" scope="col" style="border-bottom: 2px solid black">VPP en &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="middle" scope="col" style="border-bottom: 2px solid black">VPN en &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="middle" scope="col" style="border-bottom: 2px solid black">CPP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="middle" scope="col" style="border-bottom: 2px solid black">CPN&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="middle" scope="col" style="border-bottom: 2px solid black">Youden&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">Leucocitos &#40;&#60;5000 o &#62;15&#46;000&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">37&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">69&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">44&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">63&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">1&#44;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">Bandas &#40;&#62;1&#46;500&#47;mm<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">98&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">60&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">1&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">-0&#44;015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">Rochester&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">74&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">54&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">51&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">76&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">1&#44;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;47&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;289&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">Sedimento orina patol&#243;gico<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">39&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">97&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">91&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">69&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">15&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;364&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">Sedimento orina patol&#243;gico<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">43&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">92&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">80&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">70&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">5&#44;78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;61&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;363&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">PCR inicial &#40;&#8805; 1<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">70&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">58&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">52&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">75&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">1&#44;68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;287&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">PCR inicial &#40;&#8805; 2&#44;75<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">49&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">86&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">70&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">72&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">3&#44;53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;354&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">PCR inicial &#40;&#8805; 4<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">34&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">93&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">76&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">68&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">4&#44;87&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;271&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">PCR inicial &#40;&#8805; 10<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">9&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">62&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;094&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">PCT inicial &#40;&#8805; 0&#44;26<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41;<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">66&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">51&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">49&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">68&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">1&#44;36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;177&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">PCT inicial &#40;&#8805; 0&#44;5<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41;<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">41&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">78&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">57&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">65&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">1&#44;93&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;201&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">PCT inicial &#40;&#8805; 1<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41;<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">30&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">90&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">68&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">64&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">3&#44;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;208&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">PCT inicial &#40;&#8805; 2<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41;<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">19&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">98&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">87&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">63&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">9&#44;70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;174&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">Lab-score &#40;&#8805; 3&#41;<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">45&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">93&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">84&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">70&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">7&#44;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;396&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1035620.png"
              ]
            ]
          ]
          "notaPie" => array:3 [
            0 => array:3 [
              "identificador" => "tblfn0030"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0030">&#62;10 leucocitos&#47;campo en orina centrifugada&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0035"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0035">&#62;5 leucocitos&#47;campo en orina centrifugada&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0040"
              "etiqueta" => "c"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0040">Solo en periodo 2 con PCT disponible &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>87&#41;&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Sensibilidad&#44; especificidad&#44; valores predictivos&#44; coeficientes de probabilidad &#40;CP&#41; y &#237;ndices de Youden de diferentes par&#225;metros para IBG &#40;posible o confirmada&#41; en el conjunto de todos los pacientes &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>220&#41;</p>"
        ]
      ]
      4 => array:7 [
        "identificador" => "tbl0020"
        "etiqueta" => "Tabla 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">S en &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">E en &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">VPP en &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">VPN en &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">CPP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">CPN&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Leucocitos iniciales &#40;&#60;5&#46;000 o &#62;15&#46;000&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">73&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">75&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Bandas iniciales &#40;&#62;1&#46;500&#47;mm<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">70&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Rochester&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">58&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">80&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PCR inicial &#40;&#62;1<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">37&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">77&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PCR inicial &#40;&#62;4<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">97&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">83&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">77&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#44;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PCR inicial &#40;&#62;10<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">71&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PCT inicial &#40;&#62;0&#44;26<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41;<a class="elsevierStyleCrossRef" href="#tblfn0045"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">78&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PCT inicial &#40;&#62;0&#44;5<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">84&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">80&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PCT inicial &#40;&#62;1<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">89&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">81&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1035622.png"
              ]
            ]
          ]
          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0045"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0045">Solo en periodo 2 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>25&#41;&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Sensibilidad&#44; especificidad&#44; valores predictivos y coeficientes de probabilidad &#40;CP&#41; en pacientes con fiebre sin foco y sedimento de orina normal &#40;&#60;10 leucocitos&#47;campo&#41; para IBG posible o confirmada &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>61&#41;</p>"
        ]
      ]
      5 => array:7 [
        "identificador" => "tbl0025"
        "etiqueta" => "Tabla 5"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Valores de edad&#44; estancia&#44; leucocitos&#44; bandas&#44; PCR y PCT expresados como media &#40;DE&#41;&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No-IBG&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">IBG posible o confirmada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">N</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Varones&#58; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24 &#40;52&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24 &#40;70&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;097&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Edad &#40;d&#237;as&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">37&#44;8 &#40;23&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">46&#44;8 &#40;25&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;061&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Estancia &#40;d&#237;as&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#44;76 &#40;2&#44;39&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#44;12 &#40;1&#46;95&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;022&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Fiebre &#60;24</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">h&#58; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45 &#40;97&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31 &#40;91&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;177&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Leucocitos&#47;mm</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">3</span></span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;877 &#40;4&#46;979&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#46;496 &#40;7&#46;328&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;047&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Bandas&#47;mm</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">3</span></span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;95&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">87 &#40;168&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;031&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PCR inicial &#40;mg&#47;dl&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;02 &#40;1&#44;45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;69 &#40;4&#44;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#44;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PCR m&#225;xima &#40;mg&#47;dl&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;24 &#40;1&#44;63&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;97 &#40;4&#44;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#44;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PCT inicial &#40;ng&#47;ml&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0050"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;39 &#40;0&#44;46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;54 &#40;5&#44;66&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;031&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PCT m&#225;xima &#40;ng&#47;ml&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0055"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;09 &#40;2&#44;69&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#44;74 &#40;13&#44;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;094&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Sedimento patol&#243;gico n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;4&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;47&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#44;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Bajo riesgo Rochester n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26 &#40;56&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;17&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#44;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">N&#46;&#176; de anal&#237;ticas n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23 &#40;50&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22 &#40;58&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17 &#40;37&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;23&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#62;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;13&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;17&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Antibioticoterapia n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27 &#40;60&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34 &#40;97&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#44;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Antibi&#243;tico adecuado n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19 &#40;41&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#44;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">ITU posible o confirmada n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32 &#40;94&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#44;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">IBG confirmada n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27 &#40;79&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#44;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1035624.png"
              ]
            ]
          ]
          "notaPie" => array:2 [
            0 => array:3 [
              "identificador" => "tblfn0050"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0050">Total de 35 pacientes&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0055"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0055">Total de 39 pacientes&#58; en 4 pacientes no se dispon&#237;a de PCT inicial&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas de los pacientes con fiebre sin foco clasificados seg&#250;n IBG &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>80&#41;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliograf&#237;a"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:18 [
            0 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Observation scales to identify serious illness in febrile children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46;L&#46; McCarthy"
                            1 => "M&#46;R&#46; Sharpe"
                            2 => "S&#46;Z&#46; Spiesel"
                            3 => "T&#46;F&#46; Dolan"
                            4 => "B&#46;W&#46; Forsyth"
                            5 => "T&#46;G&#46; DeWitt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatrics&#46;"
                        "fecha" => "1982"
                        "volumen" => "70"
                        "paginaInicial" => "802"
                        "paginaFinal" => "809"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7133831"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A score identifying serious bacterial infections in children with fever without source"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46;G&#46; Lacour"
                            1 => "S&#46;A&#46; Zamora"
                            2 => "A&#46; Gervaix"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/INF.0b013e318168d2b4"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Infect Dis J&#46;"
                        "fecha" => "2008"
                        "volumen" => "27"
                        "paginaInicial" => "654"
                        "paginaFinal" => "656"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18536624"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Febrile infants at low risk for serious bacterial infection--an appraisal of the Rochester criteria and implications for management&#46; Febrile Infant Collaborative Study Group"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;A&#46; Jaskiewicz"
                            1 => "C&#46;A&#46; McCarthy"
                            2 => "A&#46;C&#46; Richardson"
                            3 => "K&#46;C&#46; White"
                            4 => "D&#46;J&#46; Fisher"
                            5 => "R&#46; Dagan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Pediatrics&#46;"
                        "fecha" => "1994"
                        "volumen" => "94"
                        "paginaInicial" => "390"
                        "paginaFinal" => "396"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8065869"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0886335009008578"
                          "estado" => "S300"
                          "issn" => "08863350"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Procalcitonin as a marker of severe bacterial infection in children in the emergency department"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;N&#46; Deis"
                            1 => "C&#46;B&#46; Creech"
                            2 => "C&#46;M&#46; Estrada"
                            3 => "T&#46;J&#46; Abramo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/PEC.0b013e3181c399df"
                      "Revista" => array:7 [
                        "tituloSerie" => "Pediatr Emerg Care&#46;"
                        "fecha" => "2010"
                        "volumen" => "26"
                        "paginaInicial" => "51"
                        "paginaFinal" => "60"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20065834"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0886335014017532"
                          "estado" => "S300"
                          "issn" => "08863350"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Exactitud del test de procalcitonina en el diagn&#243;stico de bacteriemia oculta en pediatr&#237;a&#58; revisi&#243;n sistem&#225;tica y metaan&#225;lisis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "P&#46; Mar&#237;n Reina"
                            1 => "I&#46; Ruiz Alc&#225;ntara"
                            2 => "S&#46; Vidal Mic&#243;"
                            3 => "J&#46;L&#46; L&#243;pez-Prats Lucea"
                            4 => "I&#46; Modesto"
                            5 => "V&#46; Alapont"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "An Pediatr&#237;a &#40;Barc&#41;&#46;"
                        "fecha" => "2003"
                        "volumen" => "2010"
                        "paginaInicial" => "403"
                        "paginaFinal" => "412"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of the test characteristics of procalcitonin to C-reactive protein and leukocytosis for the detection of serious bacterial infections in children presenting with fever without source&#58; A systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C-H&#46; Yo"
                            1 => "P-S&#46; Hsieh"
                            2 => "S-H&#46; Lee"
                            3 => "J-Y&#46; Wu"
                            4 => "S-S&#46; Chang"
                            5 => "K-C&#46; Tasi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.annemergmed.2012.05.027"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Emerg Med&#46;"
                        "fecha" => "2012"
                        "volumen" => "60"
                        "paginaInicial" => "591"
                        "paginaFinal" => "600"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22921165"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Procalcitonin in pediatrics"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "L&#46; Pacifico"
                            1 => "J&#46;F&#46; Osborn"
                            2 => "F&#46; Natale"
                            3 => "F&#46; Ferraro"
                            4 => "M&#46; De Curtis"
                            5 => "C&#46; Chiesa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Adv Clin Chem&#46;"
                        "fecha" => "2013"
                        "volumen" => "59"
                        "paginaInicial" => "203"
                        "paginaFinal" => "263"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23461137"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0002939408003401"
                          "estado" => "S300"
                          "issn" => "00029394"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Procalcitonin to initiate or discontinue antibiotics in acute respiratory tract infections"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Schuetz"
                            1 => "B&#46; M&#252;ller"
                            2 => "M&#46; Christ-Crain"
                            3 => "D&#46; Stolz"
                            4 => "M&#46; Tamm"
                            5 => "L&#46; Bouadma"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/14651858.CD007498.pub2"
                      "Revista" => array:5 [
                        "tituloSerie" => "Cochrane Database Syst Rev&#46;"
                        "fecha" => "2012"
                        "volumen" => "9"
                        "paginaInicial" => "CD007498"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22972110"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Soni NJ&#44; Samson DJ&#44; Galaydick JL&#44; Vats V&#44; Pitrak DL&#44; Aronson N&#46; Procalcitonin-guided antibiotic therapy&#46; Agency for Healthcare Research and Quality &#40;US&#41;&#59; 2012&#46;"
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Procalcitonin in young febrile infants for the detection of serious bacterial infections"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "V&#46; Maniaci"
                            1 => "A&#46; Dauber"
                            2 => "S&#46; Weiss"
                            3 => "E&#46; Nylen"
                            4 => "K&#46;L&#46; Becker"
                            5 => "R&#46; Bachur"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1542/peds.2007-3503"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatrics&#46;"
                        "fecha" => "2008"
                        "volumen" => "122"
                        "paginaInicial" => "701"
                        "paginaFinal" => "710"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18829791"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagnostic performance of the lab-score in predicting severe and invasive bacterial infections in well-appearing young febrile infants"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Bressan"
                            1 => "B&#46; Gomez"
                            2 => "S&#46; Mintegi"
                            3 => "L&#46; da Dalt"
                            4 => "D&#46; Blazquez"
                            5 => "I&#46; Olaciregui"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/INF.0b013e318266a9aa"
                      "Revista" => array:7 [
                        "tituloSerie" => "Pediatr Infect Dis J&#46;"
                        "fecha" => "2012"
                        "volumen" => "31"
                        "paginaInicial" => "1239"
                        "paginaFinal" => "1244"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22760529"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S088633500900861X"
                          "estado" => "S300"
                          "issn" => "08863350"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Systematic review and validation of prediction rules for identifying children with serious infections in emergency departments and urgent-access primary care"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Thompson"
                            1 => "A&#46; van den Bruel"
                            2 => "J&#46; Verbakel"
                            3 => "M&#46; Lakhanpaul"
                            4 => "T&#46; Haj-Hassan"
                            5 => "R&#46; Stevens"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Health Technol Assess Winch Engl&#46;"
                        "fecha" => "2012"
                        "volumen" => "16"
                        "paginaInicial" => "1"
                        "paginaFinal" => "100"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Procalcitonin to detect invasive bacterial infection in non-toxic-appearing infants with fever without apparent source in the emergency department"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Luaces-Cubells"
                            1 => "S&#46; Mintegi"
                            2 => "J-J&#46; Garc&#237;a-Garc&#237;a"
                            3 => "E&#46; Astobiza"
                            4 => "R&#46; Garrido-Romero"
                            5 => "J&#46; Velasco-Rodr&#237;guez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/INF.0b013e31824dacf4"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Infect Dis J&#46;"
                        "fecha" => "2012"
                        "volumen" => "31"
                        "paginaInicial" => "645"
                        "paginaFinal" => "647"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22333704"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Procalcitonin in pediatric emergency departments for the early diagnosis of invasive bacterial infections in febrile infants&#58; Results of a multicenter study and utility of a rapid qualitative test for this marker"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "Spanish Society of Pediatric Emergencies"
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Fern&#225;ndez Lopez"
                            1 => "C&#46; Luaces Cubells"
                            2 => "J&#46;J&#46; Garc&#237;a Garc&#237;a"
                            3 => "J&#46; Fern&#225;ndez Pou"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.inf.0000091360.11784.21"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Infect Dis J&#46;"
                        "fecha" => "2003"
                        "volumen" => "22"
                        "paginaInicial" => "895"
                        "paginaFinal" => "903"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14551491"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Serum procalcitonin level and other biological markers to distinguish between bacterial and aseptic meningitis in children&#58; A European multicenter case cohort study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46; Dubos"
                            1 => "B&#46; Korczowski"
                            2 => "D&#46;A&#46; Aygun"
                            3 => "A&#46; Martinot"
                            4 => "C&#46; Prat"
                            5 => "A&#46; Galetto-Lacour"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/archpedi.162.12.1157"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Pediatr Adolesc Med&#46;"
                        "fecha" => "2008"
                        "volumen" => "162"
                        "paginaInicial" => "1157"
                        "paginaFinal" => "1163"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19047543"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Association of procalcitonin with acute pyelonephritis and renal scars in pediatric UTI"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Leroy"
                            1 => "A&#46; Fernandez-Lopez"
                            2 => "R&#46; Nikfar"
                            3 => "C&#46; Romanello"
                            4 => "F&#46; Bouissou"
                            5 => "A&#46; Gervaix"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1542/peds.2012-2408"
                      "Revista" => array:7 [
                        "tituloSerie" => "Pediatrics&#46;"
                        "fecha" => "2013"
                        "volumen" => "131"
                        "paginaInicial" => "870"
                        "paginaFinal" => "879"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23629615"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0886335015001248"
                          "estado" => "S300"
                          "issn" => "08863350"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Costo-efectividad de la prote&#237;na c reactiva&#44; procalcitonina y escala de Rochester&#58; Tres estrategias diagn&#243;sticas para la identificaci&#243;n de infecci&#243;n bacteriana severa en lactantes febriles sin foco"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Buendia"
                            1 => "L&#46; Colantonio"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Value Health Reg Issues&#46;"
                        "fecha" => "2013"
                        "volumen" => "2"
                        "paginaInicial" => "375"
                        "paginaFinal" => "380"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Impact of the lab-score on antibiotic prescription rate in children with fever without source&#58; A randomized controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "L&#46; Lacroix"
                            1 => "S&#46; Manzano"
                            2 => "L&#46; Vandertuin"
                            3 => "F&#46; Hugon"
                            4 => "A&#46; Galetto-Lacour"
                            5 => "A&#46; Gervaix"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pone.0115061"
                      "Revista" => array:5 [
                        "tituloSerie" => "PloS One&#46;"
                        "fecha" => "2014"
                        "volumen" => "9"
                        "paginaInicial" => "e115061"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25503770"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "es"
  "url" => "/16954033/0000008400000005/v1_201604260918/S1695403315003550/v1_201604260918/es/main.assets"
  "Apartado" => array:4 [
    "identificador" => "14282"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Originales"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/16954033/0000008400000005/v1_201604260918/S1695403315003550/v1_201604260918/es/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403315003550?idApp=UINPBA00005H"
]
Compartir
Información de la revista

Estadísticas

Siga este enlace para acceder al texto completo del artículo

Original
Valoración del uso de la procalcitonina en el lactante febril hospitalizado
Assessing the use of procalcitonin in the hospitalised young febrile infant
E. Paradaa, O. Calaviaa,
Autor para correspondencia
olgacalavia@gmail.com

Autor para correspondencia.
, M. Durán-Balléna, A. Vasqueza, R. Ayatsa, N. Ferréb
a Servicio de Pediatría, Hospital Universitari Joan XXIII de Tarragona, Universidad Rovira i Virgili, IISPV, Tarragona, España
b Unidad de Pediatría, Facultad de Medicina y Cirugía, Universidad Rovira i Virgili. IISPV, Tarragona, España
Leído
15670
Veces
se ha leído el artículo
3355
Total PDF
12315
Total HTML
Compartir estadísticas
 array:24 [
  "pii" => "S1695403315003550"
  "issn" => "16954033"
  "doi" => "10.1016/j.anpedi.2015.08.011"
  "estado" => "S300"
  "fechaPublicacion" => "2016-05-01"
  "aid" => "1954"
  "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
  "copyrightAnyo" => "2015"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "cita" => "An Pediatr &#40;Barc&#41;. 2016;84:278-85"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 5521
    "formatos" => array:3 [
      "EPUB" => 124
      "HTML" => 4272
      "PDF" => 1125
    ]
  ]
  "Traduccion" => array:1 [
    "en" => array:19 [
      "pii" => "S2341287916300035"
      "issn" => "23412879"
      "doi" => "10.1016/j.anpede.2015.08.014"
      "estado" => "S300"
      "fechaPublicacion" => "2016-05-01"
      "aid" => "1954"
      "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "fla"
      "cita" => "An Pediatr &#40;Barc&#41;. 2016;84:278-85"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:2 [
        "total" => 2042
        "formatos" => array:3 [
          "EPUB" => 139
          "HTML" => 1381
          "PDF" => 522
        ]
      ]
      "en" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
        "titulo" => "Assessing the use of procalcitonin in the hospitalised young febrile infant"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "tieneResumen" => array:2 [
          0 => "en"
          1 => "es"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "278"
            "paginaFinal" => "285"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "es" => array:1 [
            "titulo" => "Valoraci&#243;n del uso de la procalcitonina en el lactante febril hospitalizado"
          ]
        ]
        "contieneResumen" => array:2 [
          "en" => true
          "es" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figure 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 2688
                "Ancho" => 1602
                "Tamanyo" => 227620
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">ROC curves for the assessment of possible or definite SBI by means of the WBC total&#44; band cell total&#44; CRP&#44; PCT&#44; PCR<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>PCT and lab-score&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "E&#46; Parada, O&#46; Calavia, M&#46; Dur&#225;n-Ball&#233;n, A&#46; Vasquez, R&#46; Ayats, N&#46; Ferr&#233;"
            "autores" => array:6 [
              0 => array:2 [
                "nombre" => "E&#46;"
                "apellidos" => "Parada"
              ]
              1 => array:2 [
                "nombre" => "O&#46;"
                "apellidos" => "Calavia"
              ]
              2 => array:2 [
                "nombre" => "M&#46;"
                "apellidos" => "Dur&#225;n-Ball&#233;n"
              ]
              3 => array:2 [
                "nombre" => "A&#46;"
                "apellidos" => "Vasquez"
              ]
              4 => array:2 [
                "nombre" => "R&#46;"
                "apellidos" => "Ayats"
              ]
              5 => array:2 [
                "nombre" => "N&#46;"
                "apellidos" => "Ferr&#233;"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "es" => array:9 [
          "pii" => "S1695403315003550"
          "doi" => "10.1016/j.anpedi.2015.08.011"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "es"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403315003550?idApp=UINPBA00005H"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287916300035?idApp=UINPBA00005H"
      "url" => "/23412879/0000008400000005/v1_201604260918/S2341287916300035/v1_201604260918/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S1695403315002817"
    "issn" => "16954033"
    "doi" => "10.1016/j.anpedi.2015.07.003"
    "estado" => "S300"
    "fechaPublicacion" => "2016-05-01"
    "aid" => "1909"
    "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "An Pediatr &#40;Barc&#41;. 2016;84:286-8"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 18966
      "formatos" => array:3 [
        "EPUB" => 140
        "HTML" => 17780
        "PDF" => 1046
      ]
    ]
    "es" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Carta cient&#237;fica</span>"
      "titulo" => "Mastocitosis cut&#225;nea difusa&#46; Presentaci&#243;n de 3 casos y revisi&#243;n de su manejo terap&#233;utico"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "286"
          "paginaFinal" => "288"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Diffuse cutaneous mastocytosis&#46; Presentation of 3 cases and therapeutic management review"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figura 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 2647
              "Ancho" => 1655
              "Tamanyo" => 265041
            ]
          ]
          "descripcion" => array:1 [
            "es" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">&#205;ndice de SCORMA<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>A&#47;5<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>5B<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>2C&#47;5&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "B&#46; Selva Folch, R&#46; L&#243;pez Almaraz, R&#46; S&#225;nchez Gonz&#225;lez, B&#46; Martinez de las Heras"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "B&#46;"
              "apellidos" => "Selva Folch"
            ]
            1 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "L&#243;pez Almaraz"
            ]
            2 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "S&#225;nchez Gonz&#225;lez"
            ]
            3 => array:2 [
              "nombre" => "B&#46;"
              "apellidos" => "Martinez de las Heras"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2341287916300059"
        "doi" => "10.1016/j.anpede.2015.07.030"
        "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/S2341287916300059?idApp=UINPBA00005H"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403315002817?idApp=UINPBA00005H"
    "url" => "/16954033/0000008400000005/v1_201604260918/S1695403315002817/v1_201604260918/es/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1695403315003562"
    "issn" => "16954033"
    "doi" => "10.1016/j.anpedi.2015.08.012"
    "estado" => "S300"
    "fechaPublicacion" => "2016-05-01"
    "aid" => "1955"
    "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "An Pediatr &#40;Barc&#41;. 2016;84:271-7"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 3422
      "formatos" => array:3 [
        "EPUB" => 125
        "HTML" => 2595
        "PDF" => 702
      ]
    ]
    "es" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
      "titulo" => "Pulsioximetr&#237;a frente al monitor de electrocardiograma para la determinaci&#243;n de la frecuencia card&#237;aca durante la reanimaci&#243;n del reci&#233;n nacido pret&#233;rmino"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "271"
          "paginaFinal" => "277"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Pulse oximetry versus electrocardiogram for heart rate assessment during resuscitation of the preterm infant"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figura 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 2001
              "Ancho" => 2216
              "Tamanyo" => 224905
            ]
          ]
          "descripcion" => array:1 [
            "es" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Comparaci&#243;n de valores fiables de frecuencia card&#237;aca &#40;FC&#41; medidos simult&#225;neamente por pulsioximetr&#237;a &#40;PO&#41; y monitor de electrocardiograma &#40;ECG&#41; durante la reanimaci&#243;n de 39 reci&#233;n nacidos pret&#233;rmino&#46;</p> <p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">S&#58; segundos&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "B&#46; Iglesias, M&#46;J&#46; Rodr&#237;guez, E&#46; Aleo, E&#46; Criado, G&#46; Herranz, M&#46; Moro, J&#46; Mart&#237;nez Orgado, L&#46; Arruza"
          "autores" => array:8 [
            0 => array:2 [
              "nombre" => "B&#46;"
              "apellidos" => "Iglesias"
            ]
            1 => array:2 [
              "nombre" => "M&#46;J&#46;"
              "apellidos" => "Rodr&#237;guez"
            ]
            2 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "Aleo"
            ]
            3 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "Criado"
            ]
            4 => array:2 [
              "nombre" => "G&#46;"
              "apellidos" => "Herranz"
            ]
            5 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Moro"
            ]
            6 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Mart&#237;nez Orgado"
            ]
            7 => array:2 [
              "nombre" => "L&#46;"
              "apellidos" => "Arruza"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2341287916300229"
        "doi" => "10.1016/j.anpede.2015.08.017"
        "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/S2341287916300229?idApp=UINPBA00005H"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403315003562?idApp=UINPBA00005H"
    "url" => "/16954033/0000008400000005/v1_201604260918/S1695403315003562/v1_201604260918/es/main.assets"
  ]
  "es" => array:19 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
    "titulo" => "Valoraci&#243;n del uso de la procalcitonina en el lactante febril hospitalizado"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "278"
        "paginaFinal" => "285"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "E&#46; Parada, O&#46; Calavia, M&#46; Dur&#225;n-Ball&#233;n, A&#46; Vasquez, R&#46; Ayats, N&#46; Ferr&#233;"
        "autores" => array:6 [
          0 => array:3 [
            "nombre" => "E&#46;"
            "apellidos" => "Parada"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          1 => array:4 [
            "nombre" => "O&#46;"
            "apellidos" => "Calavia"
            "email" => array:1 [
              0 => "olgacalavia&#64;gmail&#46;com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "M&#46;"
            "apellidos" => "Dur&#225;n-Ball&#233;n"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "A&#46;"
            "apellidos" => "Vasquez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "R&#46;"
            "apellidos" => "Ayats"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "N&#46;"
            "apellidos" => "Ferr&#233;"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Servicio de Pediatr&#237;a&#44; Hospital Universitari Joan XXIII de Tarragona&#44; Universidad Rovira i Virgili&#44; IISPV&#44; Tarragona&#44; Espa&#241;a"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Unidad de Pediatr&#237;a&#44; Facultad de Medicina y Cirug&#237;a&#44; Universidad Rovira i Virgili&#46; IISPV&#44; Tarragona&#44; Espa&#241;a"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Autor para correspondencia&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "en" => array:1 [
        "titulo" => "Assessing the use of procalcitonin in the hospitalised young febrile infant"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 2688
            "Ancho" => 1602
            "Tamanyo" => 243510
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Curvas ROC para la valoraci&#243;n de IBG posible o confirmada de n&#250;mero de leucocitos&#44; n&#250;mero de bandas&#44; PCR&#44; PCT&#44; PCR&#43;PCT y lab-score&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">La fiebre es una de las causas m&#225;s comunes de consulta pedi&#225;trica&#46; La gran mayor&#237;a de estos episodios son debidos a infecciones v&#237;ricas benignas y autolimitadas que no precisan tratamiento&#46; Sin embargo&#44; en los lactantes&#44; y especialmente en los menores de 3 meses&#44; esta fiebre puede representar una infecci&#243;n bacteriana grave &#40;IBG&#41; por lo que genera un n&#250;mero significativo de ingresos&#46; La evaluaci&#243;n del lactante febril supone un reto diagn&#243;stico que ha conducido al desarrollo de diferentes herramientas para intentar detectar los pacientes de mayor riesgo de IBG&#58; scores cl&#237;nicos como la escala de Yale<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">1</span></a>&#44; marcadores sangu&#237;neos valorados de forma aislada &#40;prote&#237;na C-reactiva &#91;PCR&#93;&#44; procalcitonina &#91;PCT&#93;&#44; interleucina-6&#44;&#8230;&#41; o combinada &#40;lab-score<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">2</span></a>&#41; as&#237; como combinaciones cl&#237;nico-anal&#237;ticas &#40;criterios de Rochester<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">3</span></a>&#41;&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">La PCT ofrece potenciales ventajas en el diagn&#243;stico precoz de infecci&#243;n bacteriana por su vida media m&#225;s corta y su elevaci&#243;n m&#225;s r&#225;pida&#44; y es aparentemente un marcador m&#225;s espec&#237;fico que la PCR en ni&#241;os con IBG<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">4</span></a>&#46; La mayor&#237;a de los estudios coinciden en que niveles bajos de PCT tienen un alto valor predictivo negativo &#40;VPN&#41; para la exclusi&#243;n de bacteriemia y en la &#250;ltima d&#233;cada se ha introducido en muchos protocolos de manejo del ni&#241;o con fiebre sin foco &#40;FSF&#41; en urgencias&#46; Sin embargo&#44; la PCT tiene tambi&#233;n falsos positivos y falsos negativos &#40;sensibilidad &#91;S&#93; entre el 70 y el 91&#37; y especificidad &#91;E&#93; entre 59 y 85&#37;<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">5&#8211;7</span></a>&#41;&#44; hecho que condiciona que las decisiones cl&#237;nicas no puedan basarse &#250;nicamente en este marcador&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">La utilidad de la PCT como marcador evolutivo ha sido validada en diferentes estudios en adultos y su uso para iniciar o suspender el tratamiento antibi&#243;tico en pacientes adultos parece seguro y eficaz&#44; contribuyendo a una reducci&#243;n importante del uso de antibi&#243;ticos<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">8&#44;9</span></a>&#46; Sin embargo&#44; hay pocos trabajos que eval&#250;en el resultado del uso rutinario de la PCT en la pr&#225;ctica cl&#237;nica &#40;indicaci&#243;n de ingreso&#44; repetici&#243;n de pruebas anal&#237;ticas&#44; uso de antibi&#243;ticos&#44; estancia hospitalaria&#41; y su coste en pediatr&#237;a&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Este trabajo pretende evaluar si la determinaci&#243;n de PCT ha cambiado en nuestro centro la valoraci&#243;n y el manejo del lactante febril hospitalizado&#44; as&#237; como comparar la S&#44; E&#44; valor predictivo positivo &#40;VPP&#41; y VPN de diferentes marcadores&#47;scores en esta poblaci&#243;n&#46; Tambi&#233;n eval&#250;a el coste a&#241;adido de PCR y PCT sobre los scores cl&#237;nico-anal&#237;ticos tradicionales&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material y m&#233;todos</span><p id="par0025" class="elsevierStylePara elsevierViewall">Estudio descriptivo retrospectivo de 2 periodos de tiempo&#58; enero-diciembre de 2009 &#40;periodo 1&#58; sin PCT&#41; y enero-diciembre de 2011 &#40;periodo 2&#58; uso rutinario de PCT&#41;&#46; El protocolo de manejo del lactante menor de 3 meses con fiebre fue el mismo durante los 2 periodos con la excepci&#243;n del uso rutinario de la PCT en el periodo 2&#58; para los lactantes de 1 a 3 meses con fiebre sin foco&#44; nuestro protocolo se basa en los criterios de Rochester&#59; para los neonatos el protocolo incluye anal&#237;tica de sangre&#44; orina y LCR&#44; Rx t&#243;rax si cl&#237;nica respiratoria&#44; ingreso y valoraci&#243;n de antibi&#243;ticos seg&#250;n cl&#237;nica y resultados&#59; y para los pacientes con diagn&#243;sticos espec&#237;ficos &#40;bronquiolitis&#44; infecci&#243;n de orina &#91;ITU&#93;&#44; neumon&#237;a&#44; etc&#46;&#41; se aplic&#243; el protocolo correspondiente&#46; No se a&#241;adi&#243; al protocolo ninguna recomendaci&#243;n sobre la valoraci&#243;n de la PCT&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Se incluy&#243; a los pacientes con edades entre 7 y 90 d&#237;as ingresados con fiebre &#40;definida como temperatura axilar igual o superior a 37&#44;5<span class="elsevierStyleHsp" style=""></span>&#176;C&#41; en un hospital universitario&#46; Se excluy&#243; a aquellos pacientes en los que no se realiz&#243; anal&#237;tica sangu&#237;nea&#46; Se recogieron los siguientes datos&#58; filiaci&#243;n&#44; cl&#237;nica&#44; hemograma&#44; PCR inicial y m&#225;xima&#44; PCT inicial y m&#225;xima&#44; sedimento de orina &#40;SO&#41;&#47;tira reactiva de orina &#40;TRO&#41;&#44; score de Rochester&#44; lab-score &#40;PCR<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>PCT<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>TRO&#41; calculado con anal&#237;tica inicial&#44; hemocultivo &#40;HC&#41;&#44; urocultivo &#40;UC&#41;&#44; estancia hospitalaria&#44; uso de antibi&#243;ticos y n&#250;mero de anal&#237;ticas solicitadas&#46; En casos seleccionados se dispuso tambi&#233;n de cultivo de l&#237;quido cefalorraqu&#237;deo &#40;LCR&#41;&#44; detecci&#243;n de virus respiratorios por reacci&#243;n en cadena de la polimerasa o ant&#237;geno VRS en aspirado nasofar&#237;ngeo y radiograf&#237;a de t&#243;rax&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Para la definici&#243;n de IBG se utilizaron los mismos criterios que Maniaci<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">10</span></a>&#44; en resumen&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">&#8226;</span><p id="par0040" class="elsevierStylePara elsevierViewall">I<span class="elsevierStyleUnderline">BG confirmada</span>&#58; si infecci&#243;n bacteriana focal en la exploraci&#243;n f&#237;sica &#40;diferente a otitis media&#41;&#44; bacteriemia&#44; ITU&#44; meningitis&#44; neumon&#237;a bacteriana o gastroenteritis bacteriana definidas respectivamente por&#58; HC positivo a un pat&#243;geno&#44; UC por sondaje con m&#225;s de 50&#46;000<span class="elsevierStyleHsp" style=""></span>UFC de un solo germen o entre 10&#46;000 y 49&#46;000 si adem&#225;s se acompa&#241;aba de SO patol&#243;gico &#40;&#62;5 leucocitos por campo&#41; o TRO patol&#243;gica &#40;nitritos o leucocitos positivos&#41;&#44; cultivo de LCR positivo o bacteriemia con pleocitosis en LCR&#44; cultivo positivo de l&#237;quido pleural o radiolog&#237;a compatible con neumon&#237;a bacteriana m&#225;s cultivo de esputo o HC positivo a un pat&#243;geno respiratorio y&#44; por &#250;ltimo&#44; coprocultivo positivo&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">&#8226;</span><p id="par0045" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleUnderline">IBG posible</span>&#58; si UC por sondaje con 10&#46;000-49&#46;000 UCF&#47;ml de un solo germen con SO y TRO normal o si radiolog&#237;a compatible con neumon&#237;a pero sin confirmaci&#243;n bacteriol&#243;gica en HC&#44; cultivo de esputo o l&#237;quido pleural&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">&#8226;</span><p id="par0050" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleUnderline">No IBG</span>&#58; En el resto de los casos&#46;</p></li></ul></p><p id="par0055" class="elsevierStylePara elsevierViewall">En el caso de UC con m&#250;ltiples g&#233;rmenes se consider&#243; como ITU confirmada si hab&#237;a &#62;50&#46;000<span class="elsevierStyleHsp" style=""></span>UFC de un germen predominante&#44; y como ITU posible si hab&#237;a 50&#46;000<span class="elsevierStyleHsp" style=""></span>UFC de varios g&#233;rmenes sin dominancia&#44; independientemente del resultado del SO&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Los datos sobre costes anal&#237;ticos se obtuvieron a partir del laboratorio de nuestro centro a fecha de diciembre de 2013&#58; hemograma&#58; 4&#44;29 euros&#47;determinaci&#243;n&#59; PCR&#58; 3&#44;68 euros&#47;determinaci&#243;n&#59; PCT&#58; 20&#44;15&#160;euros&#47;determinaci&#243;n&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Se realiz&#243; el an&#225;lisis de forma conjunta de todos los pacientes y tambi&#233;n por subgrupos&#58; pacientes con buen estado general&#44; pacientes con FSF&#44; pacientes con SO&#47;TRO normal y pacientes menores de un mes&#46; Se analiz&#243; la S&#44; E&#44; VPP y VPN de la PCT y PCR para diferentes puntos de corte &#40;PCT&#160;&#8805;&#160;0&#44;26&#59; &#8805;0&#44;5&#59; &#8805;1&#59; &#8805;2<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#59; PCR &#8805;&#160;1&#59; &#8805;2&#44;75&#59; &#8805;4&#59; &#8805;10<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41;&#44; criterios de Rochester<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">3</span></a>&#44; SO &#40;punto de corte&#58; &#8805;5 leucocitos&#47;campo y &#8805;10 leucocitos&#47;campo&#41; y lab-score &#40;punto de corte &#8805;&#160;3&#41;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">2&#44;11</span></a> para el diagn&#243;stico de IBG&#46; Para el c&#225;lculo del lab-score se utiliz&#243; el resultado del SO en el caso de que no se dispusiera del resultado de la TRO&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Se analiz&#243; si el uso sistem&#225;tico de la determinaci&#243;n de PCT hab&#237;a influido en el mayor&#47;menor uso de antibi&#243;ticos&#44; estancia hospitalaria y repetici&#243;n de anal&#237;ticas&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Se consider&#243; antibioticoterapia adecuada aquella situaci&#243;n en la que se prescribi&#243; antibi&#243;tico en pacientes con diagn&#243;stico de IBG &#40;posible o confirmada&#41; y la no prescripci&#243;n de antibi&#243;ticos en los pacientes no IBG&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Se recogieron los datos a partir de las historias cl&#237;nicas y registros del laboratorio en una hoja de c&#225;lculo &#40;Microsoft Office Excel 2007&#41; y se analizaron con el paquete estad&#237;stico SPSS 15&#46;0 para Windows&#46; Para la comparaci&#243;n de variables dicot&#243;micas se utiliz&#243; el test de chi-cuadrado y para la comparaci&#243;n de variables cuantitativas el test de Student o U de Mann-Whitney con niveles alfa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46; Se realizaron curvas ROC para la valoraci&#243;n del rendimiento de la PCR&#44; PCT y leucocitosis en el diagn&#243;stico de IBG posible o confirmada utilizando los datos obtenidos de los pacientes del periodo 2 con PCT disponible&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Resultados</span><p id="par0085" class="elsevierStylePara elsevierViewall">Se incluy&#243; a 220 pacientes&#58; 109 en el periodo 1 y 111 en el periodo 2&#59; en este segundo periodo solo se dispuso de resultado de PCT en 87 pacientes&#46; De los 220 pacientes&#44; 78 &#40;35&#44;4&#37;&#41; ten&#237;an menos de 30 d&#237;as de vida y 80 &#40;36&#44;4&#37;&#41; eran pacientes con FSF&#46; Las caracter&#237;sticas demogr&#225;ficas&#44; cl&#237;nicas y anal&#237;ticas iniciales se recogen en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#44; sin diferencias estad&#237;sticamente significativas entre los 2 periodos&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">Se diagnostic&#243; IBG en 85 pacientes &#40;38&#44;6&#37; del total de pacientes&#41;&#46; Aunque el porcentaje de pacientes ingresados con IBG &#40;posible o confirmada&#41; fue discretamente mayor en el periodo en que se dispuso de PCT &#40;37&#44;6&#37; en periodo 1 vs&#46; 40&#44;2&#37; en el periodo 2 en pacientes con PCT realizada&#41; la diferencia no fue significativa &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;59&#41;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">La prevalencia de IBG &#40;posible o confirmada&#41; fue similar en los pacientes con edades &#60;1&#160;mes y &#62;1&#160;mes &#40;39&#44;4 y 37&#44;5&#37; respectivamente&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;77&#41; y en la mayor&#237;a de casos se trat&#243; de ITU&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Un total de 42 de los pacientes del primer periodo y 28 de los pacientes con PCT disponible del segundo periodo eran menores de un mes&#46; La prevalencia de IBG posible o confirmada en este subgrupo de pacientes en los 2 periodos fue del 35&#44;5 y 39&#44;2&#37;&#44; respectivamente &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;76&#41;&#46; Tampoco hubo diferencias estad&#237;sticamente significativas en el uso de antibi&#243;ticos entre los 2 periodos &#40;66&#44;6 y 78&#44;6&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;28&#41;&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">El n&#250;mero de anal&#237;ticas realizadas y el porcentaje de pacientes que recibieron antibi&#243;ticos fueron similares en los 2 periodos &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46; Si comparamos la estancia entre los pacientes del periodo 1 y los pacientes del periodo 2 con PCT realizada &#40;media de 2&#44;6 y 2&#44;2 d&#237;as&#44; respectivamente&#41; la diferencia tampoco fue significativa &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;71&#41;&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> se detallan los diagn&#243;sticos de los pacientes con IBG posible o confirmada en los 2 periodos&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">De los 4 pacientes con bacteriemia &#40;1 en periodo pre-PCT y 3 en periodo 2 con PCT realizada&#41; todos ten&#237;an fiebre de menos de 12&#160;h de evoluci&#243;n&#46; Dos presentaban leucopenia&#44; todos ten&#237;an PCR superior a 1<span class="elsevierStyleHsp" style=""></span>mg&#47;dl &#40;concretamente 6&#44;9<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#59; 1&#44;4<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#59; 1&#44;5<span class="elsevierStyleHsp" style=""></span>mg&#47;dl y 8&#44;9<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41; y los valores de PCT fueron 0&#44;24<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#59; 0&#44;38<span class="elsevierStyleHsp" style=""></span>ng&#47;ml y 1&#44;07<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a> se muestran la S&#44; E&#44; VPP y VPN de los diferentes par&#225;metros cl&#237;nico-anal&#237;ticos &#40;con diferentes puntos de corte&#41; para el diagn&#243;stico de IBG posible o confirmada&#46; El criterio m&#225;s sensible fue el score de Rochester&#59; el m&#225;s espec&#237;fico&#44; valores de PCR&#160;&#8805;&#160;10<span class="elsevierStyleHsp" style=""></span>mg&#47;dl &#40;aunque &#62;1&#46;500 bandas&#47;mm<span class="elsevierStyleSup">3</span>&#44; PCT &#8805;2<span class="elsevierStyleHsp" style=""></span>ng&#47;ml o SO patol&#243;gico tuvieron especificidades muy similares&#41;&#46; El que mostr&#243; mejor VPP fue la PCR&#160;&#8805;&#160;10<span class="elsevierStyleHsp" style=""></span>mg&#47;dl &#40;100&#37;&#41; y el de mejor VPN los criterios de Rochester &#40;76&#44;8&#37;&#41;&#46; Los &#237;ndices de Youden m&#225;ximos fueron 0&#44;424 para una valor de PCR de 2&#44;35<span class="elsevierStyleHsp" style=""></span>mg&#47;dl y de 0&#44;345 para un valor de PCT 0&#44;351<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0125" class="elsevierStylePara elsevierViewall">Analizando el subgrupo de pacientes que ofrece m&#225;s dificultades en su manejo &#40;FSF y SO normal&#41; los resultados fueron similares &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#41;&#46; De los 24 pacientes con FSF y SO normal en los que se dispuso de PCR y PCT&#44; utilizando los valores propuestos en el &#171;lab score&#187;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">11</span></a> como punto de corte &#40;PCR &#8805;4<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#44; PCT &#8805;0&#44;5<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41;&#44; 2 de los 5 pacientes con IBG posible o confirmada ten&#237;an ambos marcadores negativos&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0130" class="elsevierStylePara elsevierViewall">En el subgrupo de pacientes menores de un mes &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>28&#41; el VPN de la PCT &#40;punto de corte 0&#44;5<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41; fue de 75&#37;&#58; de los 20 pacientes con PCT &#60;&#160;0&#44;5<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#44; 5 fueron diagnosticados de IBG&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Si consideramos solo los pacientes con FSF &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>80&#41;&#44; 35 pacientes &#40;43&#44;8&#37;&#41; ten&#237;an una IBG confirmada o posible &#40;94&#37; ITU&#41;&#46; Las caracter&#237;sticas cl&#237;nicas y anal&#237;ticas&#44; seg&#250;n tuvieran IBG o no&#44; se describen en la <a class="elsevierStyleCrossRef" href="#tbl0025">tabla 5</a>&#46; Los valores iniciales de PCR&#44; PCT y leucocitos y el valor m&#225;ximo de PCR fueron significativamente diferentes en los pacientes con IBG comparados con los no-IBG&#44; no as&#237; el valor m&#225;ximo de la PCT&#44; que fue similar en los 2 grupos&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0140" class="elsevierStylePara elsevierViewall">Recibieron antibioticoterapia adecuada el 72&#44;5&#37; de los pacientes del periodo 1 y el 73&#44;6&#37; de los pacientes en los que se dispuso de valor de PCT en el periodo 2&#44; sin que la diferencia fuera estad&#237;sticamente significativa&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">El coste anal&#237;tico de los pacientes en el periodo 2 fue el triple que en el periodo 1 &#40;11&#44;1 euros&#47;paciente de media &#40;SD 4&#44;95&#41; en el periodo 1 y 38&#44;7 euros &#40;SD 16&#41; en el periodo 2 con PCT&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;000&#41;&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a> se representan las curvas ROC obtenidas para la PCR&#44; PCT&#44; leucocitosis&#44; bandas&#44; PCR<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>PCT y lab-score&#46; El &#225;rea bajo la curva para la PCR fue superior a la de la PCT &#40;0&#44;752 y 0&#44;648 respectivamente&#41; pero esta diferencia no fue estad&#237;sticamente significativa &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;196&#41;&#46; El lab-score muestra un &#225;rea bajo la curva discretamente superior al uso de la PCR de forma aislada o junto con la PCT&#44; pero tampoco alcanza significaci&#243;n estad&#237;stica &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;399&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discusi&#243;n</span><p id="par0155" class="elsevierStylePara elsevierViewall">La PCT se introdujo en nuestro hospital en el a&#241;o 2010&#46; Inicialmente solo se solicitaba en casos seleccionados&#44; pero a partir de 2011 se pas&#243; a utilizar de forma rutinaria en la evaluaci&#243;n del lactante febril&#46; Los resultados de este estudio muestran que la utilizaci&#243;n rutinaria de PCT no ha cambiado el manejo de los pacientes menores de 3 meses hospitalizados&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">La mayor&#237;a de los estudios publicados en pediatr&#237;a sobre PCT se han realizado en pacientes con FSF en urgencias<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">5&#44;6&#44;12&#44;13</span></a>&#46; Estos estudios apoyan la utilidad de la PCT como marcador predictivo de enfermedad bacteriana potencialmente grave &#40;bacteriemia&#44; sepsis&#44; sepsis de origen urinario y neumon&#237;a grave&#41; en este escenario&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Los valores predictivos de la PCT que obtuvimos fueron significativamente diferentes a los publicados en series que inclu&#237;an pacientes menores de 36 meses tratados en urgencias<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">7</span></a>&#58; en nuestro estudio el VPN oscil&#243; entre 63 y 81&#37; para los diferentes puntos de corte de PCT &#40;0&#44;26<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#59; 0&#44;5<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#59; 1<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41;&#44; muy lejos de los valores cercanos al 100&#37; de otros estudios&#46; Esta diferencia podr&#237;a deberse a que nuestro trabajo incluye solo pacientes ingresados&#58; es una poblaci&#243;n seleccionada con una prevalencia de IBG superior a la de los estudios realizados en urgencias &#40;mayor porcentaje de pacientes con edades &#60;1&#160;mes&#44; no cumplir criterios de bajo riesgo de Rochester&#44; etc&#46;&#41;&#46; La prevalencia de IBG confirmada en nuestro estudio fue 31&#44;3&#37;&#44; similar al 26&#44;4&#37; del estudio de Bressan<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">11</span></a> pero claramente superior a la de estudios como el de Maniaci<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">10</span></a> &#40;9&#44;7&#37;&#41;&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">El estudio multic&#233;ntrico de Fern&#225;ndez-L&#243;pez<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">14</span></a> compara diferentes marcadores en 352 ni&#241;os de 1-36 meses de edad con FSF en urgencias y concluye que el mejor marcador es la PCT con un punto de corte de 0&#44;53<span class="elsevierStyleHsp" style=""></span>ng&#47;ml &#40;S<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>65&#44;5&#37;&#59; E&#61; 94&#44;3&#37;&#41;&#46; En nuestro estudio&#44; un punto de corte similar &#40;PCT 0&#44;5<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41; solo obtuvo una S del 41&#44;7&#37;&#44; y una E del 78&#44;4&#37;&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">En cuanto a la PCR&#44; observamos que con un punto de corte de 1<span class="elsevierStyleHsp" style=""></span>mg&#47;dl se alcanza una S del 70&#37; y un VPN del 75&#37; &#40;superior a lo que obtuvimos con la PCT&#41;&#44; aunque el VPP y la E fueron bajos &#40;75 y 58&#44;1&#37; respectivamente&#41;&#46; De hecho&#44; de los 12 pacientes ingresados con FSF&#44; SO normal y PCR<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>1<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#44; solo uno tuvo una IBG &#40;ITU&#41;&#44; con una PCT inicial de 0&#44;18<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#46; De los 24 pacientes con FSF y SO normal no hubo ning&#250;n caso de IBG posible o confirmada que tuviera PCR<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>1<span class="elsevierStyleHsp" style=""></span>mg&#47;dl y PCT<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#44;5<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">Analizando el lab-socre propuesto por Galetto-Lacour et al&#46; en 2008&#44; hemos obtenido valores similares a los publicados por Bressan<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">11</span></a> con S<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>45&#44;7&#37; y E<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>93&#44;9&#37; para un punto de corte de 3&#44; por lo que tampoco este score parece ofrecer ventajas claras sobre la PCR de forma aislada&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">En el metaan&#225;lisis publicado en 2010<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">5</span></a> se concluye que la principal virtud de la PCT es descartar la presencia de IBG&#46; Por lo tanto&#44; esperar&#237;amos encontrar o un menor n&#250;mero de ingresos o un mayor porcentaje de pacientes con diagn&#243;stico final de IBG en el periodo en el que se dispuso de PCT&#46; El hecho de que esto no suceda en nuestro estudio podr&#237;a atribuirse a un n&#250;mero insuficiente de pacientes para alcanzar significaci&#243;n estad&#237;stica o a la falta de confianza en este marcador de los pediatras que indicaron el ingreso&#58; 19 de los 87 pacientes ingresados durante el periodo 2 ten&#237;an FSF&#44; SO normal y valores de PCT<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;5<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">En los &#250;ltimos a&#241;os se han publicado m&#250;ltiples estudios en los que se determinan puntos de corte &#243;ptimos de la PCT para el diagn&#243;stico de IBG&#44; diferenciaci&#243;n entre enfermedad v&#237;rica y bacteriana y diferenciaci&#243;n entre infecci&#243;n bacteriana invasiva y no invasiva &#40;pielonefritis vs&#46; cistitis<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">15&#44;16</span></a>&#41;&#46; Estos puntos de corte oscilan entre 0&#44;12<span class="elsevierStyleHsp" style=""></span>ng&#47;ml y 1<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#46; Esta variabilidad puede contribuir en parte a la baja confianza absoluta en este marcador&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Buend&#237;a<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">17</span></a>&#44; a trav&#233;s del dise&#241;o de un modelo econ&#243;mico de costo-efectividad estructurado&#44; utilizando la t&#233;cnica de an&#225;lisis de decisiones&#44; compara la PCT&#44; la PCR y los criterios de Rochester para el diagn&#243;stico de IBG en el lactante menor de 3 meses y demuestra el mayor coste que implica la PCT&#46; En nuestro estudio objetivamos un coste anal&#237;tico 3 veces superior en el periodo en el que se solicit&#243; PCT en comparaci&#243;n con el primer periodo&#46; Dado que en ambos periodos no hay diferencias en el porcentaje de pacientes ingresados con diagn&#243;stico final de IBG y que el porcentaje de pacientes con antibi&#243;tico adecuado es similar&#44; no parece que en nuestro caso el uso de la PCT haya supuesto tampoco un ahorro&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Nuestros hallazgos tambi&#233;n coinciden con los resultados de otros estudios que valoran el efecto del uso de la PCT&#58; Lacroix<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">18</span></a> en el estudio prospectivo comparando el lab-score con los marcadores tradicionales &#40;PCR&#44; leucocitos y bandas&#41; no encuentra diferencias en la prescripci&#243;n de antibi&#243;ticos o ingreso hospitalario&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">El temor a que al ir a&#241;adiendo marcadores &#40;sin retirar los antiguos&#41; pueda condicionar un n&#250;mero superior de ingresos y tratamientos antibi&#243;ticos por hallarse elevado solo uno de los par&#225;metros &#40;es decir&#44; ingresar pacientes por PCT elevada exclusivamente&#41; no se confirm&#243; en nuestro estudio&#58; en el periodo 1 ingresaron 13 pacientes con FSF y bajo riesgo de IBG seg&#250;n los criterios de Rochester y 18 en el periodo 2 &#40;11&#44;9 vs&#46; 16&#44;2&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;36&#41;&#46; El n&#250;mero de pacientes con FSF&#44; bajo riesgo seg&#250;n criterios de Rochester y PCR inferior a 1<span class="elsevierStyleHsp" style=""></span>mg&#47;dl fue similar en ambos periodos &#40;9 y 10 pacientes&#44; respectivamente&#41;&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">Las debilidades de nuestro estudio son su naturaleza retrospectiva&#44; el reducido n&#250;mero de pacientes con FSF y el hecho de que pacientes considerados como no IBG recibieran tratamiento antibi&#243;tico&#44; sin poder garantizar en estos casos que no tuvieran IBG&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">A pesar de la menor calidad cient&#237;fica de los estudios retrospectivos&#44; consideramos que el evaluar y compartir los resultados de introducir nuevas herramientas diagn&#243;sticas en la pr&#225;ctica habitual es imprescindible para una buena pr&#225;ctica cl&#237;nica&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">En resumen&#44; en nuestro centro el empleo de la PCT en el manejo del lactante febril menor de 3 meses hospitalizado no result&#243; en una disminuci&#243;n del uso de antibi&#243;ticos&#44; n&#250;mero de anal&#237;ticas ni estancia hospitalaria&#46; Tampoco parece haber mejorado la selecci&#243;n de los pacientes que son ingresados &#40;&#37; IBG similar en el periodo en que se utiliz&#243; la PCT de forma rutinaria y en el periodo sin PCT&#41; aunque este dato deber&#237;a ser confirmado en un estudio prospectivo que asignara de forma aleatoria la realizaci&#243;n&#47;no realizaci&#243;n de PCT y valorara si hay diferencias en el porcentaje de pacientes que ingresan&#46;</p><p id="par0225" class="elsevierStylePara elsevierViewall">Los biomarcadores nos proporcionan una informaci&#243;n adicional a la valoraci&#243;n cl&#237;nica&#44; pero tambi&#233;n pueden suponer un coste a&#241;adido significativo&#44; no solo por el coste de la misma prueba sino porque puede inducir a realizar tratamientos o ingresos&#46; En el caso del lactante febril hospitalizado menor de 3 meses&#44; en el que la ITU es el principal diagn&#243;stico de IBG&#44; la introducci&#243;n de la PCT no parece haber tenido un impacto cl&#237;nico significativo en nuestro centro&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conflicto de intereses</span><p id="par0230" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:10 [
        0 => array:3 [
          "identificador" => "xres631253"
          "titulo" => "Resumen"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Introducci&#243;n"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Pacientes y m&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Conclusiones"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec644102"
          "titulo" => "Palabras clave"
        ]
        2 => array:3 [
          "identificador" => "xres631254"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Introduction"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "Materials and methods"
            ]
            2 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec644103"
          "titulo" => "Keywords"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introducci&#243;n"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Material y m&#233;todos"
        ]
        6 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Resultados"
        ]
        7 => array:2 [
          "identificador" => "sec0020"
          "titulo" => "Discusi&#243;n"
        ]
        8 => array:2 [
          "identificador" => "sec0025"
          "titulo" => "Conflicto de intereses"
        ]
        9 => array:1 [
          "titulo" => "Bibliograf&#237;a"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2015-05-25"
    "fechaAceptado" => "2015-08-19"
    "PalabrasClave" => array:2 [
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec644102"
          "palabras" => array:6 [
            0 => "Procalcitonina"
            1 => "Prote&#237;na-C reactiva"
            2 => "Lactantes"
            3 => "Hospitalizaci&#243;n"
            4 => "Infecci&#243;n bacteriana"
            5 => "Coste&#46;"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec644103"
          "palabras" => array:6 [
            0 => "Procalcitonin"
            1 => "C-reactive protein"
            2 => "Infants"
            3 => "Hospitalisation"
            4 => "Bacterial infection"
            5 => "Cost"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El uso de la procalcitonina &#40;PCT&#41; se ha generalizado en la evaluaci&#243;n del lactante febril en urgencias&#46; Este trabajo pretende evaluar si la introducci&#243;n de la PCT ha cambiado el manejo del lactante febril hospitalizado y el coste&#47;efectividad de dicho marcador&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Pacientes y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio retrospectivo comparando 2 periodos&#58; enero-diciembre de 2009 &#40;sin PCT&#41; y enero-diciembre de 2011 &#40;uso rutinario de PCT&#41;&#46; Se incluy&#243; a los pacientes de 7 a 90 d&#237;as de vida con fiebre ingresados en un hospital universitario y con anal&#237;tica realizada&#46; Se compararon porcentajes de infecci&#243;n bacteriana&#44; uso de antibi&#243;ticos&#44; estancia hospitalaria y coste anal&#237;tico&#46; Se evalu&#243; la PCT&#44; la prote&#237;na-C reactiva &#40;PCR&#41;&#44; recuento leucocitario&#44; score de Rochester y el lab-score propuesto por Galetto-Lacour para el diagn&#243;stico de infecci&#243;n bacteriana&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se incluy&#243; a 109 pacientes en el periodo 1 y 111 en el periodo 2 &#40;de los cuales en 87 se dispuso de valor de PCT&#41;&#46; La prevalencia de infecci&#243;n bacteriana&#44; uso de antibi&#243;ticos&#44; repetici&#243;n de anal&#237;ticas y estancia hospitalaria fue similar en los 2 periodos&#46; El coste anal&#237;tico fue significativamente superior en el segundo periodo&#46; La sensibilidad&#44; especificidad&#44; valor predictivo positivo y valor predictivo negativo de la PCR &#40;punto de corte 1<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41; fue 70&#44;6&#59; 58&#44;1&#59; 52&#44;6 y 75&#37; y de la PCT &#40;punto de corte 0&#44;5<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41; 41&#44;7&#59; 78&#44;4&#59; 57&#44;7 y 65&#44;6&#37;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El uso de la PCT no parece haber tenido un impacto significativo en el manejo del paciente hospitalizado&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Pacientes y m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The use of procalcitonin &#40;PCT&#41; in the evaluation of the febrile infant in the emergency care unit has been widespread&#46; The aim of this study is to assess whether the introduction of PCT has changed the management of hospitalised febrile infants and the cost&#47;effectiveness of this marker&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Materials and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A retrospective study was performed comparing 2 periods&#58; January-December 2009 &#40;without PCT&#41; and January-December 2011 &#40;routine use of PCT&#41;&#46; Infants aged 7 to 90 days with fever who were admitted to a university hospital and had a blood test performed were included in the study&#46; Bacterial infection rate&#44; antibiotic use&#44; hospitalisation days&#44; and analytical costs were compared&#46; Evaluations were made using PCT&#44; C-reactive protein &#40;CRP&#41;&#44; white cell count&#44; Rochester score&#44; and the lab-score proposed by Galetto-Lacour for the diagnosis of bacterial infection&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A total of 109 patients were included in period 1&#44; and 111 in period 2 &#40;87 of which had a PCT value&#41;&#46; The prevalence of bacterial infection&#44; use of antibiotics&#44; number of blood tests&#44; and days of hospital admission was similar in both periods&#46; The blood test cost was significantly higher in the second period&#46; Sensitivity&#44; specificity&#44; positive predictive value and negative predictive value&#160;were&#160;70&#46;6&#44; 58&#46;1&#44; 52&#46;6 and 75&#37;&#44; respectively for the CRP &#40;cut-off 1<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#41; and 41&#46;7&#59; 78&#46;4&#59; 57&#46;7&#44; and 65&#46;6&#37; for the PCT &#40;cut-off value 0&#46;5<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The use of PCT does not seem to have a significant impact on the management of the hospitalised febrile infant&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Materials and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusions"
          ]
        ]
      ]
    ]
    "multimedia" => array:6 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 2688
            "Ancho" => 1602
            "Tamanyo" => 243510
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Curvas ROC para la valoraci&#243;n de IBG posible o confirmada de n&#250;mero de leucocitos&#44; n&#250;mero de bandas&#44; PCR&#44; PCT&#44; PCR&#43;PCT y lab-score&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Tabla 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Periodo 1 n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>109&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Periodo 2 con PCT n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>87&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Varones&#58; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64 &#40;58&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">55 &#40;63&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;521&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Edad &#40;d&#237;as&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9-90&#59; 44&#44;0 &#40;23&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10-90&#59; 45 &#40;23&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;765&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Estancia &#40;d&#237;as&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1-13&#59; 5&#44;0 &#40;2&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2-11&#59; 4&#44;80 &#40;2&#44;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;594&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Fiebre &#60;24</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">h&#58; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">97 &#40;89&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">74 &#40;85&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;534&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Cl&#237;nica</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a><span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;507&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Respiratoria<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53 &#40;48&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36 &#40;41&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Cut&#225;nea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;1&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;5&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Gastrointestinal<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">d</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26 &#40;23&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;18&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Otra n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;1&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sin foco&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38 &#40;34&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35 &#40;40&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Leucocitos iniciales&#47;mm</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">3&#40;</span></span><a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">e</span></a><span class="elsevierStyleSup"><span class="elsevierStyleItalic">&#41;</span></span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#46;260 &#40;6&#46;553&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#46;034 &#40;5&#46;696&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;392&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Bandas iniciales&#47;mm</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">3&#40;</span></span><a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">e</span></a><span class="elsevierStyleSup"><span class="elsevierStyleItalic">&#41;</span></span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">144 &#40;524&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">73 &#40;173&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;195&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PCR inicial &#40;mg&#47;dl&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;3 &#40;4&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;73 &#40;3&#44;42&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;426&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PCT inicial &#40;ng&#47;ml&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;0 &#40;2&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Sedimento patol&#243;gico n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;16&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;18&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Bajo riesgo Rochester n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45 &#40;41&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39 &#40;44&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;618&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">N&#46;&#176; anal&#237;ticas&#47;paciente n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;893&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63 &#40;57&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53 &#40;60&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33 &#40;30&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25 &#40;28&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#62;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;11&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;10&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Antibioticoterapia</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">69 &#40;63&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57 &#40;65&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;748&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">ITU posible o confirmada</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33 &#40;30&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;32&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;774&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">IBG posible o confirmada</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41 &#40;37&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35 &#40;40&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;592&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">IBG confirmada</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26 &#40;23&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27 &#40;31&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;185&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1035621.png"
              ]
            ]
          ]
          "notaPie" => array:5 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Rango&#59; media &#40;DE&#41;&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Algunos pacientes tienen m&#225;s de un tipo de cl&#237;nica&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0015"
              "etiqueta" => "c"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Dificultad respiratoria&#44; tos o mucosidad de v&#237;as altas&#46;</p>"
            ]
            3 => array:3 [
              "identificador" => "tblfn0020"
              "etiqueta" => "d"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Diarrea o v&#243;mitos&#46;</p>"
            ]
            4 => array:3 [
              "identificador" => "tblfn0025"
              "etiqueta" => "e"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0025">Media &#40;DE&#41;&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas cl&#237;nicas y anal&#237;ticas en los 2 periodos</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "tbl0010"
        "etiqueta" => "Tabla 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Periodo 1 n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Periodo 2 con PCT n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Bacteriemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Enterococus</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">N&#46; meninigitidis</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">S&#46; agalactiae</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">S&#46; aureus</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Meningitis <span class="elsevierStyleItalic">E&#46; coli</span><span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>ITU&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>GEA <span class="elsevierStyleItalic">Campylobacter</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>ITU&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Neumon&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mastitis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Omfalitis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Otitis media supurada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1035623.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Diagn&#243;sticos de los pacientes con IBG posible o confirmada en los 2 periodos</p>"
        ]
      ]
      3 => array:7 [
        "identificador" => "tbl0015"
        "etiqueta" => "Tabla 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="middle" scope="col" style="border-bottom: 2px solid black">S en &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="middle" scope="col" style="border-bottom: 2px solid black">E en &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="middle" scope="col" style="border-bottom: 2px solid black">VPP en &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="middle" scope="col" style="border-bottom: 2px solid black">VPN en &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="middle" scope="col" style="border-bottom: 2px solid black">CPP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="middle" scope="col" style="border-bottom: 2px solid black">CPN&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="middle" scope="col" style="border-bottom: 2px solid black">Youden&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">Leucocitos &#40;&#60;5000 o &#62;15&#46;000&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">37&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">69&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">44&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">63&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">1&#44;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">Bandas &#40;&#62;1&#46;500&#47;mm<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">98&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">60&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">1&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">-0&#44;015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">Rochester&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">74&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">54&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">51&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">76&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">1&#44;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;47&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;289&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">Sedimento orina patol&#243;gico<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">39&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">97&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">91&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">69&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">15&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;364&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">Sedimento orina patol&#243;gico<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">43&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">92&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">80&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">70&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">5&#44;78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;61&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;363&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">PCR inicial &#40;&#8805; 1<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">70&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">58&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">52&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">75&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">1&#44;68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;287&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">PCR inicial &#40;&#8805; 2&#44;75<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">49&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">86&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">70&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">72&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">3&#44;53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;354&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">PCR inicial &#40;&#8805; 4<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">34&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">93&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">76&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">68&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">4&#44;87&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;271&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">PCR inicial &#40;&#8805; 10<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">9&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">62&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;094&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">PCT inicial &#40;&#8805; 0&#44;26<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41;<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">66&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">51&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">49&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">68&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">1&#44;36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;177&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">PCT inicial &#40;&#8805; 0&#44;5<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41;<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">41&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">78&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">57&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">65&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">1&#44;93&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;201&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">PCT inicial &#40;&#8805; 1<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41;<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">30&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">90&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">68&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">64&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">3&#44;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;208&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">PCT inicial &#40;&#8805; 2<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41;<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">19&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">98&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">87&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">63&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">9&#44;70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;174&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">Lab-score &#40;&#8805; 3&#41;<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">45&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">93&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">84&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">70&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">7&#44;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#44;396&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1035620.png"
              ]
            ]
          ]
          "notaPie" => array:3 [
            0 => array:3 [
              "identificador" => "tblfn0030"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0030">&#62;10 leucocitos&#47;campo en orina centrifugada&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0035"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0035">&#62;5 leucocitos&#47;campo en orina centrifugada&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0040"
              "etiqueta" => "c"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0040">Solo en periodo 2 con PCT disponible &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>87&#41;&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Sensibilidad&#44; especificidad&#44; valores predictivos&#44; coeficientes de probabilidad &#40;CP&#41; y &#237;ndices de Youden de diferentes par&#225;metros para IBG &#40;posible o confirmada&#41; en el conjunto de todos los pacientes &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>220&#41;</p>"
        ]
      ]
      4 => array:7 [
        "identificador" => "tbl0020"
        "etiqueta" => "Tabla 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">S en &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">E en &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">VPP en &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">VPN en &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">CPP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">CPN&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Leucocitos iniciales &#40;&#60;5&#46;000 o &#62;15&#46;000&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">73&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">75&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Bandas iniciales &#40;&#62;1&#46;500&#47;mm<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">70&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Rochester&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">58&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">80&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PCR inicial &#40;&#62;1<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">37&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">77&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PCR inicial &#40;&#62;4<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">97&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">83&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">77&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#44;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PCR inicial &#40;&#62;10<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">71&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PCT inicial &#40;&#62;0&#44;26<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41;<a class="elsevierStyleCrossRef" href="#tblfn0045"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">78&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PCT inicial &#40;&#62;0&#44;5<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">84&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">80&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PCT inicial &#40;&#62;1<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">89&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">81&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1035622.png"
              ]
            ]
          ]
          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0045"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0045">Solo en periodo 2 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>25&#41;&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Sensibilidad&#44; especificidad&#44; valores predictivos y coeficientes de probabilidad &#40;CP&#41; en pacientes con fiebre sin foco y sedimento de orina normal &#40;&#60;10 leucocitos&#47;campo&#41; para IBG posible o confirmada &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>61&#41;</p>"
        ]
      ]
      5 => array:7 [
        "identificador" => "tbl0025"
        "etiqueta" => "Tabla 5"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Valores de edad&#44; estancia&#44; leucocitos&#44; bandas&#44; PCR y PCT expresados como media &#40;DE&#41;&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No-IBG&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">IBG posible o confirmada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">N</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Varones&#58; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24 &#40;52&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24 &#40;70&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;097&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Edad &#40;d&#237;as&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">37&#44;8 &#40;23&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">46&#44;8 &#40;25&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;061&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Estancia &#40;d&#237;as&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#44;76 &#40;2&#44;39&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#44;12 &#40;1&#46;95&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;022&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Fiebre &#60;24</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">h&#58; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45 &#40;97&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31 &#40;91&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;177&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Leucocitos&#47;mm</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">3</span></span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;877 &#40;4&#46;979&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#46;496 &#40;7&#46;328&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;047&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Bandas&#47;mm</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">3</span></span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;95&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">87 &#40;168&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;031&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PCR inicial &#40;mg&#47;dl&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;02 &#40;1&#44;45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;69 &#40;4&#44;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#44;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PCR m&#225;xima &#40;mg&#47;dl&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;24 &#40;1&#44;63&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;97 &#40;4&#44;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#44;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PCT inicial &#40;ng&#47;ml&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0050"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;39 &#40;0&#44;46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;54 &#40;5&#44;66&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;031&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PCT m&#225;xima &#40;ng&#47;ml&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0055"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;09 &#40;2&#44;69&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#44;74 &#40;13&#44;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;094&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Sedimento patol&#243;gico n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;4&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;47&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#44;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Bajo riesgo Rochester n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26 &#40;56&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;17&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#44;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">N&#46;&#176; de anal&#237;ticas n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23 &#40;50&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22 &#40;58&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17 &#40;37&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;23&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#62;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;13&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;17&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Antibioticoterapia n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27 &#40;60&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34 &#40;97&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#44;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Antibi&#243;tico adecuado n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19 &#40;41&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#44;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">ITU posible o confirmada n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32 &#40;94&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#44;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">IBG confirmada n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27 &#40;79&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#44;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1035624.png"
              ]
            ]
          ]
          "notaPie" => array:2 [
            0 => array:3 [
              "identificador" => "tblfn0050"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0050">Total de 35 pacientes&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0055"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0055">Total de 39 pacientes&#58; en 4 pacientes no se dispon&#237;a de PCT inicial&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas de los pacientes con fiebre sin foco clasificados seg&#250;n IBG &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>80&#41;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliograf&#237;a"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:18 [
            0 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Observation scales to identify serious illness in febrile children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46;L&#46; McCarthy"
                            1 => "M&#46;R&#46; Sharpe"
                            2 => "S&#46;Z&#46; Spiesel"
                            3 => "T&#46;F&#46; Dolan"
                            4 => "B&#46;W&#46; Forsyth"
                            5 => "T&#46;G&#46; DeWitt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatrics&#46;"
                        "fecha" => "1982"
                        "volumen" => "70"
                        "paginaInicial" => "802"
                        "paginaFinal" => "809"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7133831"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A score identifying serious bacterial infections in children with fever without source"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46;G&#46; Lacour"
                            1 => "S&#46;A&#46; Zamora"
                            2 => "A&#46; Gervaix"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/INF.0b013e318168d2b4"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Infect Dis J&#46;"
                        "fecha" => "2008"
                        "volumen" => "27"
                        "paginaInicial" => "654"
                        "paginaFinal" => "656"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18536624"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Febrile infants at low risk for serious bacterial infection--an appraisal of the Rochester criteria and implications for management&#46; Febrile Infant Collaborative Study Group"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;A&#46; Jaskiewicz"
                            1 => "C&#46;A&#46; McCarthy"
                            2 => "A&#46;C&#46; Richardson"
                            3 => "K&#46;C&#46; White"
                            4 => "D&#46;J&#46; Fisher"
                            5 => "R&#46; Dagan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Pediatrics&#46;"
                        "fecha" => "1994"
                        "volumen" => "94"
                        "paginaInicial" => "390"
                        "paginaFinal" => "396"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8065869"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0886335009008578"
                          "estado" => "S300"
                          "issn" => "08863350"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Procalcitonin as a marker of severe bacterial infection in children in the emergency department"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;N&#46; Deis"
                            1 => "C&#46;B&#46; Creech"
                            2 => "C&#46;M&#46; Estrada"
                            3 => "T&#46;J&#46; Abramo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/PEC.0b013e3181c399df"
                      "Revista" => array:7 [
                        "tituloSerie" => "Pediatr Emerg Care&#46;"
                        "fecha" => "2010"
                        "volumen" => "26"
                        "paginaInicial" => "51"
                        "paginaFinal" => "60"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20065834"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0886335014017532"
                          "estado" => "S300"
                          "issn" => "08863350"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Exactitud del test de procalcitonina en el diagn&#243;stico de bacteriemia oculta en pediatr&#237;a&#58; revisi&#243;n sistem&#225;tica y metaan&#225;lisis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "P&#46; Mar&#237;n Reina"
                            1 => "I&#46; Ruiz Alc&#225;ntara"
                            2 => "S&#46; Vidal Mic&#243;"
                            3 => "J&#46;L&#46; L&#243;pez-Prats Lucea"
                            4 => "I&#46; Modesto"
                            5 => "V&#46; Alapont"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "An Pediatr&#237;a &#40;Barc&#41;&#46;"
                        "fecha" => "2003"
                        "volumen" => "2010"
                        "paginaInicial" => "403"
                        "paginaFinal" => "412"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of the test characteristics of procalcitonin to C-reactive protein and leukocytosis for the detection of serious bacterial infections in children presenting with fever without source&#58; A systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C-H&#46; Yo"
                            1 => "P-S&#46; Hsieh"
                            2 => "S-H&#46; Lee"
                            3 => "J-Y&#46; Wu"
                            4 => "S-S&#46; Chang"
                            5 => "K-C&#46; Tasi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.annemergmed.2012.05.027"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Emerg Med&#46;"
                        "fecha" => "2012"
                        "volumen" => "60"
                        "paginaInicial" => "591"
                        "paginaFinal" => "600"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22921165"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Procalcitonin in pediatrics"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "L&#46; Pacifico"
                            1 => "J&#46;F&#46; Osborn"
                            2 => "F&#46; Natale"
                            3 => "F&#46; Ferraro"
                            4 => "M&#46; De Curtis"
                            5 => "C&#46; Chiesa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Adv Clin Chem&#46;"
                        "fecha" => "2013"
                        "volumen" => "59"
                        "paginaInicial" => "203"
                        "paginaFinal" => "263"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23461137"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0002939408003401"
                          "estado" => "S300"
                          "issn" => "00029394"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Procalcitonin to initiate or discontinue antibiotics in acute respiratory tract infections"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Schuetz"
                            1 => "B&#46; M&#252;ller"
                            2 => "M&#46; Christ-Crain"
                            3 => "D&#46; Stolz"
                            4 => "M&#46; Tamm"
                            5 => "L&#46; Bouadma"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/14651858.CD007498.pub2"
                      "Revista" => array:5 [
                        "tituloSerie" => "Cochrane Database Syst Rev&#46;"
                        "fecha" => "2012"
                        "volumen" => "9"
                        "paginaInicial" => "CD007498"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22972110"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Soni NJ&#44; Samson DJ&#44; Galaydick JL&#44; Vats V&#44; Pitrak DL&#44; Aronson N&#46; Procalcitonin-guided antibiotic therapy&#46; Agency for Healthcare Research and Quality &#40;US&#41;&#59; 2012&#46;"
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Procalcitonin in young febrile infants for the detection of serious bacterial infections"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "V&#46; Maniaci"
                            1 => "A&#46; Dauber"
                            2 => "S&#46; Weiss"
                            3 => "E&#46; Nylen"
                            4 => "K&#46;L&#46; Becker"
                            5 => "R&#46; Bachur"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1542/peds.2007-3503"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatrics&#46;"
                        "fecha" => "2008"
                        "volumen" => "122"
                        "paginaInicial" => "701"
                        "paginaFinal" => "710"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18829791"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagnostic performance of the lab-score in predicting severe and invasive bacterial infections in well-appearing young febrile infants"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Bressan"
                            1 => "B&#46; Gomez"
                            2 => "S&#46; Mintegi"
                            3 => "L&#46; da Dalt"
                            4 => "D&#46; Blazquez"
                            5 => "I&#46; Olaciregui"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/INF.0b013e318266a9aa"
                      "Revista" => array:7 [
                        "tituloSerie" => "Pediatr Infect Dis J&#46;"
                        "fecha" => "2012"
                        "volumen" => "31"
                        "paginaInicial" => "1239"
                        "paginaFinal" => "1244"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22760529"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S088633500900861X"
                          "estado" => "S300"
                          "issn" => "08863350"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Systematic review and validation of prediction rules for identifying children with serious infections in emergency departments and urgent-access primary care"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Thompson"
                            1 => "A&#46; van den Bruel"
                            2 => "J&#46; Verbakel"
                            3 => "M&#46; Lakhanpaul"
                            4 => "T&#46; Haj-Hassan"
                            5 => "R&#46; Stevens"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Health Technol Assess Winch Engl&#46;"
                        "fecha" => "2012"
                        "volumen" => "16"
                        "paginaInicial" => "1"
                        "paginaFinal" => "100"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Procalcitonin to detect invasive bacterial infection in non-toxic-appearing infants with fever without apparent source in the emergency department"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Luaces-Cubells"
                            1 => "S&#46; Mintegi"
                            2 => "J-J&#46; Garc&#237;a-Garc&#237;a"
                            3 => "E&#46; Astobiza"
                            4 => "R&#46; Garrido-Romero"
                            5 => "J&#46; Velasco-Rodr&#237;guez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/INF.0b013e31824dacf4"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Infect Dis J&#46;"
                        "fecha" => "2012"
                        "volumen" => "31"
                        "paginaInicial" => "645"
                        "paginaFinal" => "647"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22333704"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Procalcitonin in pediatric emergency departments for the early diagnosis of invasive bacterial infections in febrile infants&#58; Results of a multicenter study and utility of a rapid qualitative test for this marker"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "Spanish Society of Pediatric Emergencies"
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Fern&#225;ndez Lopez"
                            1 => "C&#46; Luaces Cubells"
                            2 => "J&#46;J&#46; Garc&#237;a Garc&#237;a"
                            3 => "J&#46; Fern&#225;ndez Pou"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.inf.0000091360.11784.21"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Infect Dis J&#46;"
                        "fecha" => "2003"
                        "volumen" => "22"
                        "paginaInicial" => "895"
                        "paginaFinal" => "903"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14551491"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Serum procalcitonin level and other biological markers to distinguish between bacterial and aseptic meningitis in children&#58; A European multicenter case cohort study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46; Dubos"
                            1 => "B&#46; Korczowski"
                            2 => "D&#46;A&#46; Aygun"
                            3 => "A&#46; Martinot"
                            4 => "C&#46; Prat"
                            5 => "A&#46; Galetto-Lacour"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/archpedi.162.12.1157"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Pediatr Adolesc Med&#46;"
                        "fecha" => "2008"
                        "volumen" => "162"
                        "paginaInicial" => "1157"
                        "paginaFinal" => "1163"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19047543"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Association of procalcitonin with acute pyelonephritis and renal scars in pediatric UTI"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Leroy"
                            1 => "A&#46; Fernandez-Lopez"
                            2 => "R&#46; Nikfar"
                            3 => "C&#46; Romanello"
                            4 => "F&#46; Bouissou"
                            5 => "A&#46; Gervaix"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1542/peds.2012-2408"
                      "Revista" => array:7 [
                        "tituloSerie" => "Pediatrics&#46;"
                        "fecha" => "2013"
                        "volumen" => "131"
                        "paginaInicial" => "870"
                        "paginaFinal" => "879"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23629615"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0886335015001248"
                          "estado" => "S300"
                          "issn" => "08863350"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Costo-efectividad de la prote&#237;na c reactiva&#44; procalcitonina y escala de Rochester&#58; Tres estrategias diagn&#243;sticas para la identificaci&#243;n de infecci&#243;n bacteriana severa en lactantes febriles sin foco"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Buendia"
                            1 => "L&#46; Colantonio"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Value Health Reg Issues&#46;"
                        "fecha" => "2013"
                        "volumen" => "2"
                        "paginaInicial" => "375"
                        "paginaFinal" => "380"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Impact of the lab-score on antibiotic prescription rate in children with fever without source&#58; A randomized controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "L&#46; Lacroix"
                            1 => "S&#46; Manzano"
                            2 => "L&#46; Vandertuin"
                            3 => "F&#46; Hugon"
                            4 => "A&#46; Galetto-Lacour"
                            5 => "A&#46; Gervaix"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pone.0115061"
                      "Revista" => array:5 [
                        "tituloSerie" => "PloS One&#46;"
                        "fecha" => "2014"
                        "volumen" => "9"
                        "paginaInicial" => "e115061"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25503770"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "es"
  "url" => "/16954033/0000008400000005/v1_201604260918/S1695403315003550/v1_201604260918/es/main.assets"
  "Apartado" => array:4 [
    "identificador" => "14282"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Originales"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/16954033/0000008400000005/v1_201604260918/S1695403315003550/v1_201604260918/es/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403315003550?idApp=UINPBA00005H"
]
Información del artículo
ISSN: 16954033
Idioma original: Español
Datos actualizados diariamente
año/Mes Html Pdf Total
2024 Noviembre 15 11 26
2024 Octubre 119 42 161
2024 Septiembre 135 40 175
2024 Agosto 147 50 197
2024 Julio 119 28 147
2024 Junio 112 34 146
2024 Mayo 131 55 186
2024 Abril 104 38 142
2024 Marzo 85 24 109
2024 Febrero 110 31 141
2024 Enero 152 29 181
2023 Diciembre 137 12 149
2023 Noviembre 135 24 159
2023 Octubre 133 25 158
2023 Septiembre 116 24 140
2023 Agosto 96 24 120
2023 Julio 112 26 138
2023 Junio 117 28 145
2023 Mayo 126 23 149
2023 Abril 73 13 86
2023 Marzo 118 25 143
2023 Febrero 101 20 121
2023 Enero 95 16 111
2022 Diciembre 136 29 165
2022 Noviembre 180 41 221
2022 Octubre 134 52 186
2022 Septiembre 159 31 190
2022 Agosto 182 65 247
2022 Julio 155 56 211
2022 Junio 116 38 154
2022 Mayo 102 35 137
2022 Abril 176 32 208
2022 Marzo 206 56 262
2022 Febrero 192 34 226
2022 Enero 201 40 241
2021 Diciembre 138 46 184
2021 Noviembre 197 54 251
2021 Octubre 162 68 230
2021 Septiembre 130 47 177
2021 Agosto 114 55 169
2021 Julio 146 45 191
2021 Junio 89 40 129
2021 Mayo 130 61 191
2021 Abril 370 108 478
2021 Marzo 185 53 238
2021 Febrero 213 44 257
2021 Enero 144 49 193
2020 Diciembre 136 43 179
2020 Noviembre 134 45 179
2020 Octubre 158 29 187
2020 Septiembre 143 34 177
2020 Agosto 140 44 184
2020 Julio 123 38 161
2020 Junio 164 30 194
2020 Mayo 159 48 207
2020 Abril 141 42 183
2020 Marzo 136 44 180
2020 Febrero 172 32 204
2020 Enero 158 35 193
2019 Diciembre 153 24 177
2019 Noviembre 108 18 126
2019 Octubre 149 32 181
2019 Septiembre 194 37 231
2019 Agosto 136 35 171
2019 Julio 166 24 190
2019 Junio 139 27 166
2019 Mayo 250 32 282
2019 Abril 242 38 280
2019 Marzo 154 25 179
2019 Febrero 117 23 140
2019 Enero 136 28 164
2018 Diciembre 102 41 143
2018 Noviembre 175 39 214
2018 Octubre 265 24 289
2018 Septiembre 127 16 143
2018 Agosto 3 0 3
2018 Julio 4 0 4
2018 Junio 4 0 4
2018 Mayo 26 0 26
2018 Abril 77 0 77
2018 Marzo 47 0 47
2018 Febrero 52 0 52
2018 Enero 37 0 37
2017 Diciembre 38 0 38
2017 Noviembre 43 0 43
2017 Octubre 50 1 51
2017 Septiembre 33 0 33
2017 Agosto 42 0 42
2017 Julio 65 1 66
2017 Junio 43 19 62
2017 Mayo 66 31 97
2017 Abril 53 18 71
2017 Marzo 46 15 61
2017 Febrero 36 21 57
2017 Enero 31 11 42
2016 Diciembre 48 21 69
2016 Noviembre 61 41 102
2016 Octubre 93 38 131
2016 Septiembre 126 43 169
2016 Agosto 159 50 209
2016 Julio 103 51 154
2016 Junio 2 0 2
2016 Mayo 5 246 251
Mostrar todo

Siga este enlace para acceder al texto completo del artículo

Idiomas
Anales de Pediatría
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

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