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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Tuberculosis &#40;TB&#41; remains a major global health problem&#46; In 2012&#44; it was estimated that there were 8&#46;6 million of new TB cases &#40;1&#46;1 million attributed to HIV co-infection&#41; and 1&#46;3 million deaths due to the disease&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> In the last two decades active TB disease has globally decreased by 37&#37; in the community setting&#44;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> however this reduction is mainly in pulmonary tuberculosis &#40;PTB&#41;&#44; since the prevalence of extrapulmonary tuberculosis &#40;EPTB&#41; has remained stable&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> In 2012&#44; 0&#46;8 million &#40;16&#37;&#41; EPTB cases were notified worlwide&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> In Portugal this percentage is higher&#44; with 27&#37; of EPTB cases notified&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Contrary to what happens in PT &#40;where there have been numerous&#44; large studies&#41;&#44; research in EPTB is considerably smaller and has received less attention from public health entities&#46; This is probably due to the fact that most forms of EPTB do not contribute to the transmission of tuberculosis&#46; However&#44; EPTB significantly contributes to TB-related morbidity and may be a direct cause of complications&#44; sequelae and lifelong disabilities&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">There are many factors that may contribute to a delay in the diagnosis of EPTB&#46; EPTB has highly heterogeneous manifestation&#46; Therefore&#44; patients are often observed by different specialists&#44; with little experience in the diagnosis of tuberculosis&#46; Obtaining diagnostic samples can be another obstacle&#44; since it is often necessary to use invasive methods to obtain samples and laboratory diagnostic tests for the EPTB have lower yield in extrapulmonary samples&#46; The concepts inherent to EPTB treatment are similar to those of PTB&#44; however there are specific situations that require specific interventions such as corticosteroids as adjunctive therapy or extending the duration of treatment&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">It is clear that clinicians should be aware of the risks factors associated with this disease as this is the first step toward diagnosing EPTB&#46; The correctly and timely fashion in which the various forms of EPTB are diagnosed is crucial as it can minimize the morbidity and mortality of these patients&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">In order to identify the most common determinants associated with extrapulmonary involvement in tuberculosis patients&#44; a retrospective study was carried out between January&#47;2008 and January&#47;2012&#46; The study included all tuberculosis patients &#40;386&#41; followed at the Pulmonology Diagnostic Center of Vila Nova de Gaia&#44; Portugal&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">PTB diagnosis criteria were the existence of respiratory symptoms and isolation of <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> in samples of sputum and&#47;or bronchoalveolar lavage&#46; The criteria for EPTB diagnosis were the existence of suggestive clinical and radiological change as well as isolation in culture and&#47;or nucleic acid amplification tests for <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> in extrapulmonary samples and&#47;or existence of suggestive histological alterations &#40;granuloma and&#47;or caseation&#41;&#46; Patients with both PTB and EPTB were included in the group of EPTB&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">We analyzed demographics&#44; co-morbidities&#44; immunossuppressive therapies and existence of previous TB treatment&#46; Univariate and multivariate logistic regression were performed&#46; Odd-ratios and the associated 95&#37; confidence intervals were reported&#46; Statistical significance was reported for <span class="elsevierStyleItalic">p</span>-values &#60;0&#46;05&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="par0040" class="elsevierStylePara elsevierViewall">During the period studied&#44; 386 patients were included&#58; 260 PTB cases &#40;67&#46;4&#37;&#41; and 126 EPTB cases &#40;32&#46;6&#37;&#41;&#46; The most common forms of EPTB were lymphatic &#40;36&#46;5&#37;&#41;&#44; pleural &#40;34&#46;9&#37;&#41; and genitourinary &#40;7&#46;9&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; Of the 126 cases of EPTB&#44; 11 &#40;2&#46;8&#37;&#41; had concurrent PTB&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">The median age of EPTB patients was higher than PTB patients&#44; with a male&#58; female ratio of 1&#46;2 in EPTB vs 2&#46;0 in PTB &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; The comorbidities most frequently observed in both groups were HIV-coinfection and diabetes mellitus&#44; HIV positive being more prevalent in the EPTB &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;041&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">Previous history of TB was more common in PTB &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; The excessive use of alcohol was higher in patients with PTB &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;047&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Age over 40 years old &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;09&#44; 95&#37;CI&#58; 1&#46;29&#8211;3&#46;38&#41;&#44; female &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;63&#44; 95&#37;CI&#58; 1&#46;02&#8211;2&#46;6&#41; and HIV infection &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;72&#44; 95&#37;CI&#58; 1&#46;25&#8211;5&#46;93&#41; were independent risk factors for EPTB&#46; Previous liver disease was associated with peritoneal TB &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>22&#58;30&#44; 95&#37;CI&#58; 1&#46;89&#8211;263&#46;57&#41;&#46; Co-infection with HIV &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>12&#46;97&#44; 95&#37;CI&#58; 1&#46;71&#8211;48&#46;42&#41; and previous TB treatment &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7&#46;62&#44; 95&#37;CI&#58; 1&#46;00&#8211;57&#46;9&#41; were related with disseminated disease&#46; Alcoholism was associated with higher risk for PTB &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;22&#44; 95&#37;CI&#58; 1&#46;00&#8211;4&#46;95&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Discussion</span><p id="par0060" class="elsevierStylePara elsevierViewall">The incidence of EPTB observed in our study is similar to that observed in the literature&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#44;3</span></a> The studies by Garcia et al&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> and Fiske et al&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> showed similar common sites of EPTB&#44; lymphatic and pleural forms being the most frequent EPTB&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">In our study&#44; multivariable analyses demonstrated female sex and age as independent risk factors for EPTB&#46; Our findings are consistent with other studies that demonstrated an association between female sex<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#44;4&#44;5</span></a> and age<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> as risk factors for EPTB and alcoholism as a risk factor for PTB&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#44;5&#44;7</span></a> One suggested hypothesis to explain this association is that gender and alcoholism are associated with specific sociocultural behaviors that predispose males to greater alcoholic consumption with a consequently increased risk for PTB&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Patients with liver cirrhosis are likely to be susceptible to tuberculosis because of immune system dysfunction and Cho et al&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> found that patients with liver cirrhosis show extrapulmonary involvement more frequently with predominance of peritoneal tuberculosis&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Disseminated disease is related to an immunosuppressive state that can be justified by HIV co-infection and may lead to a reactivation of infection in patients with a tuberculosis history&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> Several studies confirm a clear association between HIV infection&#44; disseminated disease and EPTB&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4&#44;5&#44;9</span></a> Jones et al&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> showed that the smaller the number of CD4 cells the greater the incidence of EPTB in HIV positive patients&#44; demonstrating an inverse correlation between EPTB incidence and CD4 lymphocyte cell count&#46; The CD4 lymphocyte cell count was also relevant for the type of EPTB and Leeds et al&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> found that the most severe forms of EPTB correlate with CD4 &#60;100&#47;&#956;L&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Identification and understanding of the factors associated with EPTB as co-morbidities or sociocultural behaviors are essential to raise the level of suspicion&#44; which will allow the diagnosis of this pathology&#46; If risk factors are present and there is a high clinical suspicion&#44; authors advocate initiation of treatment in patients with a severe clinical status&#46; In spite of that&#44; etiologic research must be continued to obtain diagnostic samples&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Ethical disclosures</span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Protection of human and animal subjects</span><p id="par0085" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Confidentiality of data</span><p id="par0090" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Right to privacy and informed consent</span><p id="par0095" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Conflicts of interest</span><p id="par0100" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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        6 => array:3 [
          "identificador" => "sec0025"
          "titulo" => "Ethical disclosures"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Protection of human and animal subjects"
            ]
            1 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Confidentiality of data"
            ]
            2 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "Right to privacy and informed consent"
            ]
          ]
        ]
        7 => array:2 [
          "identificador" => "sec0045"
          "titulo" => "Conflicts of interest"
        ]
        8 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2014-03-25"
    "fechaAceptado" => "2014-06-16"
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        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec474575"
          "palabras" => array:3 [
            0 => "Extrapulmonar tuberculosis"
            1 => "Risk factors"
            2 => "HIV co-infection"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:1 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Tuberculosis &#40;TB&#41; remains a major global public health problem and 20&#37; of all cases are extrapulmonar&#46; The purpose of this study was to identify risk factors associated with extrapulmonar tuberculosis&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">We carried out a transversal study which included all patients with extrapulmonary tuberculosis registered in a TB reference center in northern Portugal&#44; between January 2008 and January 2012&#46; We evaluated demographic data&#44; comorbidities&#44; BCG vaccination and previous tuberculosis treatments&#46; Multivariable logistic regression was used to identify independent risk factors &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Among the 386 patients studied&#44; 260 &#40;67&#46;4&#37;&#41; had pulmonary tuberculosis &#40;PTB&#41; and 126 &#40;32&#46;6&#37;&#41; extrapulmonary TB &#40;EPTB&#41;&#46; Age over 40 years old &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;09&#59; 95&#37;CI&#58; 1&#46;29&#8211;3&#46;38&#41;&#44; female gender &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;63&#59; 95&#37;CI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;02&#8211;2&#46;6&#41; and HIV infection &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;72&#44; 95&#37;CI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;25&#8211;5&#46;93&#41; were independent risk factors for EPTB&#46; Alcoholism &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;22&#44; 95&#37;CI&#58; 1&#46;00&#8211;4&#46;95&#41; was associated with higher risk for PTB&#46; Previous liver disease &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>22&#46;30&#59; 95&#37;IC&#58; 1&#46;89&#8211;263&#46;57&#41; was an independent risk factor for peritoneal TB&#46; HIV co-infection &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>12&#46;97&#59; 95&#37;IC&#58; 1&#46;71&#8211;48&#46;42&#41; and the presence of previous TB treatment &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7&#46;62&#59; 95&#37;IC&#58; 1&#46;00&#8211;57&#46;9&#41; increase the risk of disseminated disease&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">We identified independent risk factors for EPTB&#46; Recognizing risk factors associated with EPTB is essential for suspicion of disease and may help make an accurate diagnosis&#46;</p></span>"
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            "titulo" => "Introduction"
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            "titulo" => "Methods"
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          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
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          3 => array:2 [
            "identificador" => "abst0020"
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                  <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
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                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Lymphatic</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&#46;5 &#40;46&#41;&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="top"><span class="elsevierStyleHsp" style=""></span>Extrathoracic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&#46;4 &#40;32&#41;&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="top"><span class="elsevierStyleHsp" style=""></span>Intrathoracic&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;1 &#40;14&#41;&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="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Pleural</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&#46;9 &#40;44&#41;&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="top"><span class="elsevierStyleItalic">Genitourinary</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;9 &#40;10&#41;&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="top"><span class="elsevierStyleItalic">Disseminated</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&#46;8 &#40;6&#41;&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="top"><span class="elsevierStyleItalic">Peritoneal</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&#46;0 &#40;5&#41;&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="top"><span class="elsevierStyleItalic">Osteoarticular</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;6 &#40;2&#41;&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="top"><span class="elsevierStyleItalic">Esophagus</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;8 &#40;1&#41;&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="top"><span class="elsevierStyleItalic">Larynx</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;8 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;8 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Distribution of extrapulmonary tuberculosis case by site of disease&#46;</p>"
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        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
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                  <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">Extrapulmonar TB&#37; &#40;<span class="elsevierStyleItalic">n</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">Pulmonar TB&#37; &#40;<span class="elsevierStyleItalic">n</span>&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>19&#46;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&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;006&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="top"><span class="elsevierStyleHsp" style=""></span>&#62;40 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">67&#46;5 &#40;85&#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&#46;8 &#40;140&#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&#46;012&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="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Gender</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">54&#46;0 &#40;68&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66&#46;5 &#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&#46;019&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="top"><span class="elsevierStyleHsp" style=""></span>Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">46&#46;0 &#40;58&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#46;5 &#40;87&#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" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Foreign origin</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;8 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#62;0&#46;05&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="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Co-morbidities</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>HIV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#46;8 &#40;20&#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&#46;2 &#40;24&#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&#46;041&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="top"><span class="elsevierStyleHsp" style=""></span>Diabetes mellitus&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;7 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#62;0&#46;05&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;8 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#62;0&#46;05&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="top"><span class="elsevierStyleHsp" style=""></span>Hepatic insufficiency&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;5 &#40;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">&#62;0&#46;05&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="top"><span class="elsevierStyleHsp" style=""></span>Renal insufficiency&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;6 &#40;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&#46;8 &#40;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">&#62;0&#46;05&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="top"><span class="elsevierStyleHsp" style=""></span>Silicosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;8 &#40;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&#46;8 &#40;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&#46;05&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="top"><span class="elsevierStyleHsp" style=""></span>Inflammatory joint disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;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&#46;4 &#40;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">&#62;0&#46;05&nbsp;\t\t\t\t\t\t\n
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          "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Comparison of extrapulmonary and pulmonary tuberculosis according to demographic&#44; life style and clinical characteristics&#46;</p>"
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        0 => array:2 [
          "identificador" => "bibs0005"
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            0 => array:3 [
              "identificador" => "bib0055"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Global tuberculosis report 2013"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "World Health Organization &#40;WHO&#41;"
                          ]
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                      "Libro" => array:3 [
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                      ]
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                      "WWW" => array:1 [
                        "link" => "http&#58;&#47;&#47;apps&#46;who&#46;int&#47;iris&#47;bitstream&#47;10665&#47;91355&#47;1&#47;9789241564656&#95;eng&#46;pdf"
                      ]
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              "identificador" => "bib0060"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology of extrapulmonary tuberculosis in the United States&#44; 1993&#8211;2006"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "H&#46;M&#46; Peto"
                            1 => "R&#46;H&#46; Pratt"
                            2 => "T&#46;A&#46; Harrington"
                            3 => "P&#46;A&#46; LoBue"
                            4 => "L&#46; Armstrong"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1086/605559"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Infect Dis"
                        "fecha" => "2009"
                        "volumen" => "49"
                        "paginaInicial" => "1350"
                        "paginaFinal" => "1357"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19793000"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "3"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Black race&#44; sex&#44; and extrapulmonary tuberculosis risk&#58; an observational study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "C&#46;T&#46; Fiske"
                            1 => "M&#46;R&#46; Griffin"
                            2 => "H&#46; Erin"
                            3 => "J&#46; Warkentin"
                            4 => "K&#46; Lisa"
                            5 => "P&#46;G&#46; Arbogast"
                            6 => "T&#46;R&#46; Sterling"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "BMC Infect Dis"
                        "fecha" => "2010"
                        "volumen" => "22"
                        "paginaInicial" => "10"
                        "paginaFinal" => "16"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Extrapulmonary tuberculosis&#58; epidemiology and risk factors"
                      "autores" => array:1 [
                        0 => array:2 [
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                          "autores" => array:6 [
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                            1 => "H&#46; &#193;lvarez-D&#237;az"
                            2 => "M&#46;V&#46; Lorenzo-Garc&#237;a"
                            3 => "A&#46; Mari&#241;o-Callejo"
                            4 => "&#193;&#46; Fern&#225;ndez-Rial"
                            5 => "P&#46; Sesma-S&#225;nchez"
                          ]
                        ]
                      ]
                    ]
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                    0 => array:2 [
                      "doi" => "10.1016/j.eimc.2011.03.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Enferm Infecc Microbiol Clin"
                        "fecha" => "2011"
                        "volumen" => "29"
                        "paginaInicial" => "502"
                        "paginaFinal" => "509"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21570159"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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                    0 => array:2 [
                      "titulo" => "Identification of risk factors for extrapulmonary tuberculosis"
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                        0 => array:2 [
                          "etal" => false
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                            0 => "Z&#46; Yang"
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                            2 => "F&#46; Wilson"
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                            4 => "A&#46;H&#46; Fowler"
                            5 => "C&#46;F&#46; Marrs"
                            6 => "M&#46;D&#46; Cave"
                            7 => "J&#46;H&#46; Bates"
                          ]
                        ]
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                    0 => array:2 [
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                        "tituloSerie" => "Clin Infect Dis"
                        "fecha" => "2004"
                        "volumen" => "38"
                        "paginaInicial" => "199"
                        "paginaFinal" => "205"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14699451"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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                      "titulo" => "Effects of gender and age on development of concurrent extrapulmonary tuberculosis in patients with pulmonary tuberculosis&#58; a population based study"
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                          "etal" => false
                          "autores" => array:8 [
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                            2 => "P&#46;L&#46; Lu"
                            3 => "C&#46;C&#46; Lai"
                            4 => "Y&#46;H&#46; Yang"
                            5 => "W&#46;R&#46; Lin"
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                          ]
                        ]
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                    ]
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                    0 => array:2 [
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                        "tituloSerie" => "PLoS ONE"
                        "fecha" => "2013"
                        "volumen" => "8"
                        "paginaInicial" => "e63936"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23717513"
                            "web" => "Medline"
                          ]
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                ]
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                            4 => "C&#46; Dye"
                          ]
                        ]
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                    ]
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                    0 => array:2 [
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                        "tituloSerie" => "BMC Public Health"
                        "fecha" => "2008"
                        "volumen" => "8"
                        "paginaInicial" => "289"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18702821"
                            "web" => "Medline"
                          ]
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                  ]
                ]
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Brief Communication
Who are the patients with extrapulmonary tuberculosis?
Inês Sanchesa,
Corresponding author
inesanches@portugalmail.pt

Corresponding author.
, Aurora Carvalhob,c, Raquel Duarteb,c,d,e
a Serviço de Pneumologia, Centro Hospitalar e Universitário de Coimbra- Hospital Geral, Coimbra, Portugal
b Centro de Diagnóstico Pneumológico de Vila Nova de Gaia, Vila Nova de Gaia, Portugal
c Serviço de Pneumologia, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
d Departamento de Epidemiologia, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
e Instituto de Saúde Publica, Universidade do Porto, Portugal
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Tuberculosis &#40;TB&#41; remains a major global health problem&#46; In 2012&#44; it was estimated that there were 8&#46;6 million of new TB cases &#40;1&#46;1 million attributed to HIV co-infection&#41; and 1&#46;3 million deaths due to the disease&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> In the last two decades active TB disease has globally decreased by 37&#37; in the community setting&#44;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> however this reduction is mainly in pulmonary tuberculosis &#40;PTB&#41;&#44; since the prevalence of extrapulmonary tuberculosis &#40;EPTB&#41; has remained stable&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> In 2012&#44; 0&#46;8 million &#40;16&#37;&#41; EPTB cases were notified worlwide&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> In Portugal this percentage is higher&#44; with 27&#37; of EPTB cases notified&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Contrary to what happens in PT &#40;where there have been numerous&#44; large studies&#41;&#44; research in EPTB is considerably smaller and has received less attention from public health entities&#46; This is probably due to the fact that most forms of EPTB do not contribute to the transmission of tuberculosis&#46; However&#44; EPTB significantly contributes to TB-related morbidity and may be a direct cause of complications&#44; sequelae and lifelong disabilities&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">There are many factors that may contribute to a delay in the diagnosis of EPTB&#46; EPTB has highly heterogeneous manifestation&#46; Therefore&#44; patients are often observed by different specialists&#44; with little experience in the diagnosis of tuberculosis&#46; Obtaining diagnostic samples can be another obstacle&#44; since it is often necessary to use invasive methods to obtain samples and laboratory diagnostic tests for the EPTB have lower yield in extrapulmonary samples&#46; The concepts inherent to EPTB treatment are similar to those of PTB&#44; however there are specific situations that require specific interventions such as corticosteroids as adjunctive therapy or extending the duration of treatment&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">It is clear that clinicians should be aware of the risks factors associated with this disease as this is the first step toward diagnosing EPTB&#46; The correctly and timely fashion in which the various forms of EPTB are diagnosed is crucial as it can minimize the morbidity and mortality of these patients&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">In order to identify the most common determinants associated with extrapulmonary involvement in tuberculosis patients&#44; a retrospective study was carried out between January&#47;2008 and January&#47;2012&#46; The study included all tuberculosis patients &#40;386&#41; followed at the Pulmonology Diagnostic Center of Vila Nova de Gaia&#44; Portugal&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">PTB diagnosis criteria were the existence of respiratory symptoms and isolation of <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> in samples of sputum and&#47;or bronchoalveolar lavage&#46; The criteria for EPTB diagnosis were the existence of suggestive clinical and radiological change as well as isolation in culture and&#47;or nucleic acid amplification tests for <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> in extrapulmonary samples and&#47;or existence of suggestive histological alterations &#40;granuloma and&#47;or caseation&#41;&#46; Patients with both PTB and EPTB were included in the group of EPTB&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">We analyzed demographics&#44; co-morbidities&#44; immunossuppressive therapies and existence of previous TB treatment&#46; Univariate and multivariate logistic regression were performed&#46; Odd-ratios and the associated 95&#37; confidence intervals were reported&#46; Statistical significance was reported for <span class="elsevierStyleItalic">p</span>-values &#60;0&#46;05&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="par0040" class="elsevierStylePara elsevierViewall">During the period studied&#44; 386 patients were included&#58; 260 PTB cases &#40;67&#46;4&#37;&#41; and 126 EPTB cases &#40;32&#46;6&#37;&#41;&#46; The most common forms of EPTB were lymphatic &#40;36&#46;5&#37;&#41;&#44; pleural &#40;34&#46;9&#37;&#41; and genitourinary &#40;7&#46;9&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; Of the 126 cases of EPTB&#44; 11 &#40;2&#46;8&#37;&#41; had concurrent PTB&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">The median age of EPTB patients was higher than PTB patients&#44; with a male&#58; female ratio of 1&#46;2 in EPTB vs 2&#46;0 in PTB &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; The comorbidities most frequently observed in both groups were HIV-coinfection and diabetes mellitus&#44; HIV positive being more prevalent in the EPTB &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;041&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">Previous history of TB was more common in PTB &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; The excessive use of alcohol was higher in patients with PTB &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;047&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Age over 40 years old &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;09&#44; 95&#37;CI&#58; 1&#46;29&#8211;3&#46;38&#41;&#44; female &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;63&#44; 95&#37;CI&#58; 1&#46;02&#8211;2&#46;6&#41; and HIV infection &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;72&#44; 95&#37;CI&#58; 1&#46;25&#8211;5&#46;93&#41; were independent risk factors for EPTB&#46; Previous liver disease was associated with peritoneal TB &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>22&#58;30&#44; 95&#37;CI&#58; 1&#46;89&#8211;263&#46;57&#41;&#46; Co-infection with HIV &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>12&#46;97&#44; 95&#37;CI&#58; 1&#46;71&#8211;48&#46;42&#41; and previous TB treatment &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7&#46;62&#44; 95&#37;CI&#58; 1&#46;00&#8211;57&#46;9&#41; were related with disseminated disease&#46; Alcoholism was associated with higher risk for PTB &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;22&#44; 95&#37;CI&#58; 1&#46;00&#8211;4&#46;95&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Discussion</span><p id="par0060" class="elsevierStylePara elsevierViewall">The incidence of EPTB observed in our study is similar to that observed in the literature&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#44;3</span></a> The studies by Garcia et al&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> and Fiske et al&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> showed similar common sites of EPTB&#44; lymphatic and pleural forms being the most frequent EPTB&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">In our study&#44; multivariable analyses demonstrated female sex and age as independent risk factors for EPTB&#46; Our findings are consistent with other studies that demonstrated an association between female sex<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#44;4&#44;5</span></a> and age<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> as risk factors for EPTB and alcoholism as a risk factor for PTB&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#44;5&#44;7</span></a> One suggested hypothesis to explain this association is that gender and alcoholism are associated with specific sociocultural behaviors that predispose males to greater alcoholic consumption with a consequently increased risk for PTB&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Patients with liver cirrhosis are likely to be susceptible to tuberculosis because of immune system dysfunction and Cho et al&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> found that patients with liver cirrhosis show extrapulmonary involvement more frequently with predominance of peritoneal tuberculosis&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Disseminated disease is related to an immunosuppressive state that can be justified by HIV co-infection and may lead to a reactivation of infection in patients with a tuberculosis history&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> Several studies confirm a clear association between HIV infection&#44; disseminated disease and EPTB&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4&#44;5&#44;9</span></a> Jones et al&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> showed that the smaller the number of CD4 cells the greater the incidence of EPTB in HIV positive patients&#44; demonstrating an inverse correlation between EPTB incidence and CD4 lymphocyte cell count&#46; The CD4 lymphocyte cell count was also relevant for the type of EPTB and Leeds et al&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> found that the most severe forms of EPTB correlate with CD4 &#60;100&#47;&#956;L&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Identification and understanding of the factors associated with EPTB as co-morbidities or sociocultural behaviors are essential to raise the level of suspicion&#44; which will allow the diagnosis of this pathology&#46; If risk factors are present and there is a high clinical suspicion&#44; authors advocate initiation of treatment in patients with a severe clinical status&#46; In spite of that&#44; etiologic research must be continued to obtain diagnostic samples&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Ethical disclosures</span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Protection of human and animal subjects</span><p id="par0085" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Confidentiality of data</span><p id="par0090" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Right to privacy and informed consent</span><p id="par0095" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Conflicts of interest</span><p id="par0100" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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    "pdfFichero" => "main.pdf"
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    "fechaRecibido" => "2014-03-25"
    "fechaAceptado" => "2014-06-16"
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            1 => "Risk factors"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Tuberculosis &#40;TB&#41; remains a major global public health problem and 20&#37; of all cases are extrapulmonar&#46; The purpose of this study was to identify risk factors associated with extrapulmonar tuberculosis&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">We carried out a transversal study which included all patients with extrapulmonary tuberculosis registered in a TB reference center in northern Portugal&#44; between January 2008 and January 2012&#46; We evaluated demographic data&#44; comorbidities&#44; BCG vaccination and previous tuberculosis treatments&#46; Multivariable logistic regression was used to identify independent risk factors &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Among the 386 patients studied&#44; 260 &#40;67&#46;4&#37;&#41; had pulmonary tuberculosis &#40;PTB&#41; and 126 &#40;32&#46;6&#37;&#41; extrapulmonary TB &#40;EPTB&#41;&#46; Age over 40 years old &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;09&#59; 95&#37;CI&#58; 1&#46;29&#8211;3&#46;38&#41;&#44; female gender &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;63&#59; 95&#37;CI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;02&#8211;2&#46;6&#41; and HIV infection &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;72&#44; 95&#37;CI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;25&#8211;5&#46;93&#41; were independent risk factors for EPTB&#46; Alcoholism &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;22&#44; 95&#37;CI&#58; 1&#46;00&#8211;4&#46;95&#41; was associated with higher risk for PTB&#46; Previous liver disease &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>22&#46;30&#59; 95&#37;IC&#58; 1&#46;89&#8211;263&#46;57&#41; was an independent risk factor for peritoneal TB&#46; HIV co-infection &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>12&#46;97&#59; 95&#37;IC&#58; 1&#46;71&#8211;48&#46;42&#41; and the presence of previous TB treatment &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7&#46;62&#59; 95&#37;IC&#58; 1&#46;00&#8211;57&#46;9&#41; increase the risk of disseminated disease&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">We identified independent risk factors for EPTB&#46; Recognizing risk factors associated with EPTB is essential for suspicion of disease and may help make an accurate diagnosis&#46;</p></span>"
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                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Lymphatic</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&#46;4 &#40;32&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#46;1 &#40;14&#41;&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="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Pleural</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&#46;9 &#40;44&#41;&nbsp;\t\t\t\t\t\t\n
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                  \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">Extrapulmonar TB&#37; &#40;<span class="elsevierStyleItalic">n</span>&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;006&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="top"><span class="elsevierStyleHsp" style=""></span>&#62;40 years&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53&#46;8 &#40;140&#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&#46;012&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66&#46;5 &#40;173&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">46&#46;0 &#40;58&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#46;5 &#40;87&#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" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Foreign origin</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&#46;0 &#40;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">3&#46;8 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#62;0&#46;05&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="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Co-morbidities</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>HIV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#46;8 &#40;20&#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&#46;2 &#40;24&#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&#46;041&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="top"><span class="elsevierStyleHsp" style=""></span>Diabetes mellitus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;3 &#40;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">7&#46;7 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#62;0&#46;05&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;8 &#40;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">3&#46;8 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#62;0&#46;05&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;4 &#40;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">1&#46;5 &#40;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">&#62;0&#46;05&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="top"><span class="elsevierStyleHsp" style=""></span>Renal insufficiency&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;6 &#40;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&#46;8 &#40;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">&#62;0&#46;05&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="top"><span class="elsevierStyleHsp" style=""></span>Silicosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;8 &#40;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&#46;8 &#40;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&#46;05&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;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&#46;4 &#40;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">&#62;0&#46;05&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="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Past history of pulmonary TB</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;6 &#40;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">8&#46;5 &#40;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#62;0&#46;05&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="top"><span class="elsevierStyleHsp" style=""></span>Complete treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57&#46;0 &#40;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">54&#46;5 &#40;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#62;0&#46;05&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="top"><span class="elsevierStyleHsp" style=""></span>Interrupted treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#46;0 &#40;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">4&#46;5 &#40;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">&#62;0&#46;05&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="top"><span class="elsevierStyleHsp" style=""></span>Unknown treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29&#46;0 &#40;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">40&#46;9 &#40;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">&#62;0&#46;05&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="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">BCG vaccine &#40;EPTB n</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">22&#59; PTB n</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">36&#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">95&#46;5 &#40;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">88&#46;9 &#40;32&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#62;0&#46;05&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;8 &#40;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 &#40;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">&#62;0&#46;05&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="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Habits</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Alcohol excessive use&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;3 &#40;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">13&#46;1 &#40;34&#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&#46;047&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;1 &#40;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">8&#46;5 &#40;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#62;0&#46;05&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;0 &#40;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">9&#46;2 &#40;24&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#62;0&#46;05&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="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Life-style factors</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Recluse&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;2 &#40;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">1&#46;9 &#40;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">&#62;0&#46;05&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;2 &#40;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">1&#46;2 &#40;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">&#62;0&#46;05&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="top"><span class="elsevierStyleHsp" style=""></span>Homelessness&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;8 &#40;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">2&#46;7 &#40;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">&#62;0&#46;05&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="top"><span class="elsevierStyleHsp" style=""></span>Unemployed&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#46;1 &#40;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">23&#46;1 &#40;60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#62;0&#46;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Comparison of extrapulmonary and pulmonary tuberculosis according to demographic&#44; life style and clinical characteristics&#46;</p>"
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                        0 => array:2 [
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                      "titulo" => "Epidemiology of extrapulmonary tuberculosis in the United States&#44; 1993&#8211;2006"
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                        0 => array:2 [
                          "etal" => false
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                            2 => "T&#46;A&#46; Harrington"
                            3 => "P&#46;A&#46; LoBue"
                            4 => "L&#46; Armstrong"
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                    0 => array:2 [
                      "doi" => "10.1086/605559"
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                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Identification of risk factors for extrapulmonary tuberculosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:8 [
                            0 => "Z&#46; Yang"
                            1 => "Y&#46; Kong"
                            2 => "F&#46; Wilson"
                            3 => "B&#46; Foxman"
                            4 => "A&#46;H&#46; Fowler"
                            5 => "C&#46;F&#46; Marrs"
                            6 => "M&#46;D&#46; Cave"
                            7 => "J&#46;H&#46; Bates"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1086/380644"
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                        "tituloSerie" => "Clin Infect Dis"
                        "fecha" => "2004"
                        "volumen" => "38"
                        "paginaInicial" => "199"
                        "paginaFinal" => "205"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14699451"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effects of gender and age on development of concurrent extrapulmonary tuberculosis in patients with pulmonary tuberculosis&#58; a population based study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:8 [
                            0 => "C&#46;Y&#46; Lin"
                            1 => "T&#46;C&#46; Chen"
                            2 => "P&#46;L&#46; Lu"
                            3 => "C&#46;C&#46; Lai"
                            4 => "Y&#46;H&#46; Yang"
                            5 => "W&#46;R&#46; Lin"
                            6 => "P&#46;M&#46; Huang"
                            7 => "Y&#46;H&#46; Chen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pone.0063936"
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                        "tituloSerie" => "PLoS ONE"
                        "fecha" => "2013"
                        "volumen" => "8"
                        "paginaInicial" => "e63936"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23717513"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
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              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Alcohol use as a risk factor for tuberculosis &#8211; a systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "K&#46; L&#246;nnroth"
                            1 => "B&#46;G&#46; Williams"
                            2 => "S&#46; Stadlin"
                            3 => "E&#46; Jaramillo"
                            4 => "C&#46; Dye"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1471-2458-8-289"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMC Public Health"
                        "fecha" => "2008"
                        "volumen" => "8"
                        "paginaInicial" => "289"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18702821"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical characteristics of tuberculosis in patients with liver cirrhosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "Y&#46;J&#46; Cho"
                            1 => "S&#46;M&#46; Lee"
                            2 => "C&#46;G&#46; Yoo"
                            3 => "Y&#46;W&#46; Kim"
                            4 => "S&#46;K&#46; Han"
                            5 => "Y&#46;S&#46; Shim"
                            6 => "J&#46;J&#46; Yim"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1440-1843.2007.01069.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Respirology"
                        "fecha" => "2007"
                        "volumen" => "12"
                        "paginaInicial" => "401"
                        "paginaFinal" => "405"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17539845"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Site of extrapulmonary tuberculosis is associated with HIV infection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "I&#46;L&#46; Leeds"
                            1 => "M&#46;J&#46; Magee"
                            2 => "E&#46;V&#46; Kurbatova"
                            3 => "C&#46; del Rio"
                            4 => "H&#46;M&#46; Blumberg"
                            5 => "M&#46;K&#46; Leonard"
                            6 => "C&#46;S&#46; Kraft"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/cid/cis303"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Infect Dis"
                        "fecha" => "2012"
                        "volumen" => "55"
                        "paginaInicial" => "75"
                        "paginaFinal" => "81"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22423123"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
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              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Relationship of the manifestations of tuberculosis to CD4 cell counts in patients with human immunodeficiency virus infection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "B&#46;E&#46; Jones"
                            1 => "S&#46;M&#46; Young"
                            2 => "D&#46; Antoniskis"
                            3 => "P&#46;T&#46; Davidson"
                            4 => "F&#46; Kramer"
                            5 => "P&#46;F&#46; Barnes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm/148.5.1292"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Rev Respir Dis"
                        "fecha" => "1993"
                        "volumen" => "148"
                        "paginaInicial" => "1292"
                        "paginaFinal" => "1297"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7902049"
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                ]
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ISSN: 21735115
Original language: English
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Pulmonology

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