array:23 [ "pii" => "S0210480607736331" "issn" => "02104806" "doi" => "10.1016/S0210-4806(07)73633-1" "estado" => "S300" "fechaPublicacion" => "2007-01-01" "aid" => "73633" "copyright" => "Asociación Española de Urología (AEU)" "copyrightAnyo" => "2007" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2007;31:270-5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1270 "formatos" => array:3 [ "EPUB" => 9 "HTML" => 737 "PDF" => 524 ] ] "itemSiguiente" => array:18 [ "pii" => "S0210480607736343" "issn" => "02104806" "doi" => "10.1016/S0210-4806(07)73634-3" "estado" => "S300" "fechaPublicacion" => "2007-01-01" "aid" => "73634" "copyright" => "Asociación Española de Urología (AEU)" "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "Actas Urol Esp. 2007;31:276-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1551 "formatos" => array:3 [ "EPUB" => 8 "HTML" => 574 "PDF" => 969 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Condiloma acuminado extenso en pene tratado exitosamente con Imiquimod crema al 5%" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "276" "paginaFinal" => "278" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Extensive condyloma acuminata of the penis successfully treated with 5% imiquimod cream" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.R. Cortés, J. Arratia, R. Martínez, L. Gómez" "autores" => array:4 [ 0 => array:2 [ "nombre" => "J.R." "apellidos" => "Cortés" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Arratia" ] 2 => array:2 [ "nombre" => "R." "apellidos" => "Martínez" ] 3 => array:2 [ "nombre" => "L." "apellidos" => "Gómez" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480607736343?idApp=UINPBA00004N" "url" => "/02104806/0000003100000003/v1_201304251835/S0210480607736343/v1_201304251835/es/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S021048060773632X" "issn" => "02104806" "doi" => "10.1016/S0210-4806(07)73632-X" "estado" => "S300" "fechaPublicacion" => "2007-01-01" "aid" => "73632" "copyright" => "Asociación Española de Urología (AEU)" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2007;31:262-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 639 "formatos" => array:3 [ "EPUB" => 8 "HTML" => 241 "PDF" => 390 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Importancia de la nocturia y su impacto en la calidad del sueño y en la calidad de vida en el paciente con hiperplasia benigna de próstate" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "262" "paginaFinal" => "269" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Importance of nocturia and its impact on quality of sleep and quality of life in patient with benign prostatic hyperplasia." ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "C. Hernández Fernández, J. Ristol Pont, E. Estivill, J.E. Batista Miranda, M.A. López Aramburu" "autores" => array:5 [ 0 => array:2 [ "nombre" => "C." "apellidos" => "Hernández Fernández" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Ristol Pont" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Estivill" ] 3 => array:2 [ "nombre" => "J.E." "apellidos" => "Batista Miranda" ] 4 => array:2 [ "nombre" => "M.A." "apellidos" => "López Aramburu" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S021048060773632X?idApp=UINPBA00004N" "url" => "/02104806/0000003100000003/v1_201304251835/S021048060773632X/v1_201304251835/es/main.assets" ] "es" => array:14 [ "idiomaDefecto" => true "titulo" => "Influencia del proceso analítico en la aparición y desaparición de los espermatozoides del semen tras la vasectomía" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "270" "paginaFinal" => "275" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "M. Cháfer Rudilla, L. Navarro Casado, M. Belilty Araque, C. Andrés Fernández, M. Quintanilla Mata" "autores" => array:5 [ 0 => array:4 [ "nombre" => "M." "apellidos" => "Cháfer Rudilla" "email" => array:1 [ 0 => "mcharud@telefonica.net" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "L." "apellidos" => "Navarro Casado" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "M." "apellidos" => "Belilty Araque" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "C." "apellidos" => "Andrés Fernández" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "M." "apellidos" => "Quintanilla Mata" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Laboratorio de Análisis Clínicos. Complejo Hospitalario y Universitario de Albacete" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "1" "correspondencia" => "Correspondencia autor: Dra. M. Cháfer Rudilla Servicio de Análisis Clínicos. Compejo Hospitalario y Universitario de Albacete. Hermanos Falcó, 37. 02006 Albacete. Tel.: 967 597 100 Información artículo: Original - Esterilización" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Influence of the analytical process in the appearance and disappearance of the spermatozoa after vasectomy" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2006-09-01" "fechaAceptado" => "2007-02-01" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec88177" "palabras" => array:3 [ 0 => "Control de vasectomía" 1 => "Proceso analítico" 2 => "Espermatozoides residuales" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec88178" "palabras" => array:3 [ 0 => "Vasectomy assessment" 1 => "Analytical process" 2 => "Rare non motile sperm" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Evaluar si el proceso analítico puede justificar que en algunos pacientes se observen espermatozoides residuales en algunos de sus espermiogramas para el control de la vasectomía, pero no en todos</p> <span class="elsevierStyleSectionTitle">Material y métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se revisaron los controles de las vasectomías realizadas desde enero de 2002 a diciembre de 2004. Nuestro protocolo consiste en una adaptación a nuestro medio de las recomendaciones de la Sociedad Británica de Andrología para el control de la vasectomía y de la Organización Mundial de la Salud para el análisis seminal</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Durante los 3 años del estudio se ha intervenido a 984 pacientes de vasectomía y se recibieron una media de 2 muestras por paciente. En relación a la calidad de la fase preanalítica, 134 pacientes (9,4%) refirieron no haber recogido todo el eyaculado; los volúmenes de semen fueron inferiores a 2.0 mL en 269 especímenes (18,8%) y existían dudas de que los eyaculados fueran completos; en 11 casos, las condiciones preanalíticas fueron incorrectas: contenedores mal etiquetados, derramados o inadecuados. Con respecto a la fase analítica, en 432 eyaculados (30,5%) se encontraron alteraciones de la consistencia; 62 especímenes (4,3%) contenían abundantes células y obstruían la visualización microscópica. En cuanto a la fase postanalítica, 153 pacientes (20,9%) obtuvieron informes con resultados alternativos de azoospermia y de presencia de espermatozoides residuales.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Se produce un elevado porcentaje de incidencias en la fase preanalítica y la analítica en los controles de los pacientes vasectomizados. Estas condiciones inadecuadas pueden afectar los resultados y justificar que los espermatozoides residuales se observen o no en los eyaculados de algunos pacientes. Recomendamos realizar un mínimo de dos espermiogramas por paciente para asegurar su correcta evaluación. Proponemos informar los resultados negativos como un recuento inferior al límite de detección de nuestra técnica de manera similar a otras magnitudes del laboratorio para minimizar el efecto de la fluctuación de los recuentos en estos niveles tan bajos</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To evaluate if the analytical process might justify that in some patients rare non motile sperm might be seen in some but not all their post-vasectomy semen samples</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Post vasectomy ejaculates received in our Center from january 2002 to december 2004 were reviewed. We used our own guidelines for post vasectomy semen assessment based upon those of the British Andrology Society for the evaluation of post vasectomy semen samples and the World Health Organization guidelines for semen analysis</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">During the 3 years of follow up, 984 patients underwent vasectomy. We received 1.430 semen samples, 2 samples per patient on average. Regarding the pre analytical phase, 134 samples (9.4%) were not completely collected; ejaculate volumes of less than 2 mL were delivered by 269 patients (18.8%); in these cases, we were not sure whether the whole ejaculates were submitted; pre analytical conditions of 11 samples (0.8%) were inappropriate: incorrectly labeled, spilled, provided into inadequate containers' Regarding the analytical phase, 432 ejaculates (30.5%) were extremely viscous and sperm detection might have been affected; 62 semen samples (4.3%) contained many cells which obstructed the visualization of the entire microscopy field. Regarding the post analytical phase, 153 patients (20.9%) had alternative negative/positive results with rare non motile sperm</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">An elevated percentage of incidences involving both the pre analytical and the analytical phase were observed during post-vasectomy seminal analysis. Inadequate conditions may affect the results and justify that spermatozoa may be seen in some but not all the ejaculates of the same patient. We recommend that two semen samples per patient are required to ensure that he is correctly evaluated. We propose to report a negative result as a spermatozoa count bellow the detection limit of our analytical procedure similar to other laboratory magnitudes to minimize the effect of fluctuations in such a low count of rare non motile sperm</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fatherhood without apparent spermatozoa after vasectomy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.C. Smith" 1 => "D. Cranston" 2 => "T. O’Brien" 3 => "J. Guillebaud" 4 => "J. Hindmarsh" 5 => "A.G. Turner" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "1994" "volumen" => "344" "numero" => "8914" "paginaInicial" => "30" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7912302" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Persistence or reappearance of nonmotile sperm after vasectomy: does it have clinical consequences?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D.W. Knijff" 1 => "H.J. Vrijhof" 2 => "J. Arends" 3 => "R.A. Janknegt" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0015-0282(97)81920-6" "Revista" => array:8 [ "tituloSerie" => "Fertil Steril" "fecha" => "1997" "volumen" => "67" "numero" => "2" "paginaInicial" => "332" "paginaFinal" => "335" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9022612" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1201971209000745" "estado" => "S300" "issn" => "12019712" ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Temporary reappearance of sperm 12 months after vasectomy clearance" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "T.S. O´Brien" 1 => "D. Cranston" 2 => "P. Ashwin" 3 => "E. Turner" 4 => "I.Z. MacKenzie" 5 => "J. Guillebaud" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Br J Urol" "fecha" => "1995" "volumen" => "76" "numero" => "3" "paginaInicial" => "371" "paginaFinal" => "372" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7551849" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Protocolo para el control de la vasectomía" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Cháfer" 1 => "L. Navarro" 2 => "O. Fuster" 3 => "C. Andrés" 4 => "J. Vera" 5 => "J.P. Domínguez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Diag Biol" "fecha" => "2006" "volumen" => "55" "numero" => "1" "paginaInicial" => "55" "paginaFinal" => "59" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "British Andrology Society guidelines for the assessment of post vasectomy semen samples (2002" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P. Hancock" 1 => "E. McLaughlin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "J Clin Pathol" "fecha" => "2002" "volumen" => "55" "numero" => "11" "paginaInicial" => "812" "paginaFinal" => "816" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12401817" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "titulo" => "World Health Organization. Laboratory manual for the examination of human semen and sperm cervical mucus interaction, 4th ed. Cambridge" ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:1 [ "serieFecha" => "1999" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Earlier testing after vasectomy, based on the absence of motile sperm" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "I.S. Edwards" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Fertil Steril" "fecha" => "1993" "volumen" => "59" "numero" => "2" "paginaInicial" => "431" "paginaFinal" => "436" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8425641" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Review o current practice to establish success after vasectomy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "H.D. Bradshaw" 1 => "D.J. Rosario" 2 => "M.J. James" 3 => "N.R. Boucher" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1046/j.1365-2168.2001.01643.x" "Revista" => array:7 [ "tituloSerie" => "Br J Surg" "fecha" => "2001" "volumen" => "88" "numero" => "2" "paginaInicial" => "290" "paginaFinal" => "293" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11167883" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The longterm outcome following “special clearance” after vasectomy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A.H. Davies" 1 => "R.J. Sharp" 2 => "D. Cranston" 3 => "R.G. Mitchell" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "BR J Urol" "fecha" => "1990" "volumen" => "66" "numero" => "2" "paginaInicial" => "211" "paginaFinal" => "212" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2390708" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Semen analysis after vasectomy: when and how many?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C. Badrakumar" 1 => "N.K. Gogoi" 2 => "S.K. Sundaram" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "BJU Int" "fecha" => "2000" "volumen" => "86" "numero" => "4" "paginaInicial" => "479" "paginaFinal" => "481" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10971276" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/02104806/0000003100000003/v1_201304251835/S0210480607736331/v1_201304251835/es/main.assets" "Apartado" => array:4 [ "identificador" => "6429" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Original" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/02104806/0000003100000003/v1_201304251835/S0210480607736331/v1_201304251835/es/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480607736331?idApp=UINPBA00004N" ]
Journal Information
Influencia del proceso analítico en la aparición y desaparición de los espermatozoides del semen tras la vasectomía
Influence of the analytical process in the appearance and disappearance of the spermatozoa after vasectomy
M. Cháfer Rudillaa,1
, L. Navarro Casadoa, M. Belilty Araquea, C. Andrés Fernándeza, M. Quintanilla Mataa
Corresponding author
mcharud@telefonica.net
Correspondencia autor: Dra. M. Cháfer Rudilla Servicio de Análisis Clínicos. Compejo Hospitalario y Universitario de Albacete. Hermanos Falcó, 37. 02006 Albacete. Tel.: 967 597 100 Información artículo: Original - Esterilización
Correspondencia autor: Dra. M. Cháfer Rudilla Servicio de Análisis Clínicos. Compejo Hospitalario y Universitario de Albacete. Hermanos Falcó, 37. 02006 Albacete. Tel.: 967 597 100 Información artículo: Original - Esterilización
a Laboratorio de Análisis Clínicos. Complejo Hospitalario y Universitario de Albacete