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Original article
Characteristics and outcomes of hospitalized patients with Wilson’s disease in the United States: A national survey
Na Lia,
Corresponding author
Na.li@osumc.edu

Corresponding author.
, Somashekar G. Krishnaa, Alice Hintonb, Darwin L. Conwella, Khalid Mumtaza
a Division of Gastroenterology, Hepatology, & Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH, USA
b Division of Biostatistics, The Ohio State University, Columbus, OH, USA
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There have been a few published patient cohorts on WD worldwide &#91;<a class="elsevierStyleCrossRefs" href="#bib0040">8&#8211;14</a>&#93;&#46; For example&#44; the study from Austria analyzed 229 WD patients from 1961 to 2013 with mean observation period 14&#46;8 years &#91;<a class="elsevierStyleCrossRef" href="#bib0040">8</a>&#93;&#46; In this cohort&#44; 7&#46;4&#37; WD patients died&#44; among which 71&#37; of deaths were related to WD&#46; Cirrhosis at diagnosis was the best predictor of death and need for transplant&#46; Despite overall promising outcomes in WD&#44; there is limited knowledge on the outcomes of hospitalized patients with WD in the United States&#46; Hence&#44; we sought to investigate the inpatient outcomes including mortality among adult WD patients using a large national database in the United States&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">2</span><span class="elsevierStyleSectionTitle" id="sect0040">Materials and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">2&#46;1</span><span class="elsevierStyleSectionTitle" id="sect0045">Study population and covariates</span><p id="par0015" class="elsevierStylePara elsevierViewall">All data were extracted from the National Inpatient Sample &#40;NIS&#41; database between 2006 and 2011&#46; The NIS database is the largest publicly available all-payer inpatient healthcare database in the United States &#91;<a class="elsevierStyleCrossRef" href="#bib0075">15</a>&#93;&#46; The NIS database is a 20&#37; sample of discharges from all community hospitals participating in Healthcare Cost and Utilization Project &#40;HCUP&#41;&#44; representing more than 95&#37; of the U&#46;S&#46; population&#46; The NIS database contains un-weighted data from more than 7 million hospitalizations nationally every year&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">We queried the NIS database for hospital data on discharges with ICD-9-CM &#40;International Classification of Disease&#44; Ninth Revision&#44; Clinical Modification&#41; code of WD 275&#46;1 as either principle or secondary diagnosis in order to capture all the hospitalized WD patients&#46; NIS database cannot differentiate between newly diagnosed and established WD&#46; Discharges under the age of 18 were excluded to represent the adult patient population&#46; Discharges with a principal diagnosis or procedure related to pregnancy were further excluded&#46; Patient variables included age&#44; gender&#44; race&#44; median household income for patient&#8217;s zip code &#40;quartiles&#41;&#44; and insurance status&#46; Race was categorized as White&#44; Black&#44; Hispanic&#44; Asian&#44; and others&#46; Insurance status was categorized as Medicare&#44; Medicaid&#44; private insurance&#44; and others based on the primary payer listed on the discharge record&#46; Comorbidities for risk adjustment were derived from Agency for Healthcare Research and Quality &#40;AHRQ&#41; comorbidity measures based on the methods by Elixhauser et al&#46; Patients were stratified into a score of &#60;3 or &#8805;3 based on the number of comorbidities&#46; Hospital-related factors were hospital location &#40;urban&#44; rural&#41;&#44; hospital bed size &#40;large&#44; medium&#44; and small&#41;&#44; and hospital teaching status &#40;teaching&#44; non-teaching&#41;&#46; Hospital region was classified as Northeast&#44; Midwest&#44; South&#44; or West&#46; ICD-9 codes of all principle diagnoses were reviewed to determine admission etiologies &#40;Supplementary Table 1&#41;&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">This research protocol was deemed exempt from the Institutional Review Board of the Ohio State University because the data contained in the NIS database are not identifiable&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">2&#46;2</span><span class="elsevierStyleSectionTitle" id="sect0050">Statistical analysis</span><p id="par0030" class="elsevierStylePara elsevierViewall">All statistical calculations were conducted using SAS 9&#46;4 &#40;SAS Institute&#44; Cary&#44; NC&#41;&#46; Categorical variables were expressed as weighted frequency &#40;percentage&#41; and differences between groups were analyzed by &#967;<span class="elsevierStyleSup">2</span> tests&#46; Continuous variables were expressed as mean&#8239;&#177;&#8239;standard error &#40;SE&#41; and differences were analyzed with t tests&#46; Temporal trends were assessed using the Cochrane-Armitage trend test&#46; Statistical significance was defined as p value &#60;0&#46;05&#46; A multivariable logistic regression model was used to identify independent predictors for in-hospital mortality where results are presented with odds ratios &#40;OR&#41; and 95&#37; confidence intervals &#40;CI&#41;&#46; Terms included in the model were used by stepwise selection to determine the independent predictors of inpatient mortality among patients with WD&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Propensity score matching was further used to compare outcomes between patients with WD and other hospitalized patients&#46; Propensity scores were calculated using a multivariable logistic regression model for WD containing all demographic variables and 29 AHRQ comorbidities&#46; Patients in each group were then matched 1&#58;1 using a greedy matching algorithm with a caliper of 0&#46;2 times the standard deviation of the propensity scores&#46; A total of 1480 pairs were formed &#40;Supplementary Table 2&#41;&#46; In our original un-weighted sample there were 1838 discharges with WD&#46; Conditional logistic regression and paired <span class="elsevierStyleItalic">t</span>-test were used to evaluate the outcomes in the matched sample&#46; The study schema is outlined in <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">3</span><span class="elsevierStyleSectionTitle" id="sect0055">Results</span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">3&#46;1</span><span class="elsevierStyleSectionTitle" id="sect0060">Trend of hospitalization in WD patients</span><p id="par0040" class="elsevierStylePara elsevierViewall">There were an estimated total of 9046 hospitalizations for adult patients with WD between 2006 and 2011 in the United States&#46; There was an increasing trend of hospitalization for WD annually&#44; from 1145 cases &#40;40&#46;6 per 1&#44;000&#44;000 hospitalizations&#41; in 2006 to 1823 cases &#40;63&#46;4 per 1&#44;000&#44;000 hospitalizations&#41; in 2011&#44; p&#8239;&#60;&#8239;0&#46;001 &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">3&#46;2</span><span class="elsevierStyleSectionTitle" id="sect0065">Baseline characteristics and outcomes for patients with WD</span><p id="par0045" class="elsevierStylePara elsevierViewall">The baseline characteristics and outcomes for hospitalized patients with WD were described in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; The mean age of admission was 50&#46;4&#8239;&#177;&#8239;0&#46;6 years old&#46; Among the hospitalized patients&#44; 54&#46;23&#37; were female and 73&#46;35&#37; were White&#46; Majority of WD patients had Medicare and Private insurance&#46; WD patients were more likely admitted to large and teaching hospitals&#46; Additionally&#44; 38&#46;81&#37; of hospitalizations occurred in the South of the United States compared to other regions&#46; Almost half of hospitalized WD patients had an Elixhauser comorbidity index of more than 3&#46; A total of 233 &#40;2&#46;58&#37;&#41; patients with WD died during their hospitalizations between 2006 and 2011 &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; Mean length of stay was approximately 7&#8239;&#177;&#8239;0&#46;23 days with a cost of &#36;13&#44;999&#8239;&#177;&#8239;730 for each hospitalization&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">There were significant differences among comorbidities between patients with WD and without as shown in Supplementary Table 2&#46; Patients with WD had significantly higher prevalence of liver diseases &#40;20&#46;93&#37;&#41;&#44; neurological diseases &#40;10&#46;86&#37;&#41;&#44; psychosis &#40;7&#46;59&#37;&#41;&#44; and depression &#40;15&#46;45&#37;&#41; compared to non-WD patients&#46; Among hospitalized WD patients 8&#46;44&#37; reported alcohol abuse and 5&#46;78&#37; drug abuse&#46; Anemia &#40;25&#46;12&#37;&#41; and coagulopathy &#40;14&#46;82&#37;&#41; were also common in patients with WD&#46; In contrast&#44; hospitalized non-WD patients had significantly higher prevalence for cardiovascular disorders&#44; chronic lung disease&#44; diabetes&#44; hypertension&#44; malignancy&#44; and renal failure&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">3&#46;3</span><span class="elsevierStyleSectionTitle" id="sect0070">Principal diagnosis for admission in patients with WD</span><p id="par0055" class="elsevierStylePara elsevierViewall">There was a wide spectrum of principle diagnoses for hospitalization in patients with WD &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; The most common diagnosis for admissions in patients with WD was chronic liver disease which accounted for 8&#46;58&#37; of total admissions&#46; Most common chronic liver diseases were cirrhosis &#40;40&#46;00&#37;&#41; and hepatic encephalopathy &#40;38&#46;92&#37;&#41;&#46; Other leading diagnoses for admissions were WD &#40;6&#46;49&#37;&#41;&#44; infection &#40;5&#46;60&#37;&#41; including septicemia &#40;3&#46;10&#37;&#41; and pneumonia &#40;2&#46;50&#37;&#41;&#46; Among the full population of WD&#44; 1&#46;09&#37; of the patients had liver failure as their principle diagnosis&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">3&#46;4</span><span class="elsevierStyleSectionTitle" id="sect0075">Etiologies and predictors of inpatient mortality in WD patients</span><p id="par0060" class="elsevierStylePara elsevierViewall">A total of 43 patients with WD died during hospitalizations between 2006 and 2011 in the unweighted sample&#46; Most of the patients died due to liver-related cause &#40;30&#46;23&#37;&#41; followed by infections &#40;18&#46;60&#37;&#41;&#46; Independent predictors of inpatient mortality among patients with WD are shown in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46; For every 10-year increment of age&#44; there was increased risk of death during hospitalization &#40;OR&#58; 1&#46;48&#59; 95&#37; CI&#58; 1&#46;25&#8211;1&#46;75&#41;&#46; Other predictors of inpatient mortality in WD patients were acute respiratory failure &#40;OR&#58; 4&#46;53&#59; 95&#37; CI&#58; 2&#46;44&#8211;8&#46;42&#41;&#44; acute renal failure &#40;OR&#58; 4&#46;09&#59; 95&#37; CI&#58; 2&#46;19&#8211;7&#46;65&#41; and decompensated liver disease or hepatic failure &#40;OR&#58; 3&#46;37&#59; 95&#37; CI&#58; 1&#46;72&#8211;6&#46;59&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">3&#46;5</span><span class="elsevierStyleSectionTitle" id="sect0080">Propensity-score matched analysis for inpatient mortality</span><p id="par0065" class="elsevierStylePara elsevierViewall">Covariates in the propensity score analysis were all well balanced between the WD and non-WD groups except age &#40;Supplementary Table 3&#41;&#46; Inpatient mortality was lower in WD patients compared to matched non-WD patients &#40;2&#46;84&#37; vs&#46; 4&#46;67&#37;&#44; p&#8239;&#61;&#8239;0&#46;01&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46; There were no significant differences in length of stay&#44; or total cost between the two cohorts in the propensity-matched sample&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">4</span><span class="elsevierStyleSectionTitle" id="sect0085">Discussion</span><p id="par0070" class="elsevierStylePara elsevierViewall">We reported the outcomes of hospitalization in patients with WD in the United States based on analysis of the largest national inpatient database&#46; Our results showed an increasing annual trend of hospitalization in patients with WD from 2006 to 2011&#46; The leading causes for hospitalizations are chronic liver disease and infection&#46; Compared to general hospitalized patients&#44; WD patients had favorable survival&#46; Chronic organ system comorbidities &#40;respiratory&#44; renal&#44; and liver&#41; and advancing age are associated with increased mortality in patients with WD&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Despite being a rare disease with an estimated prevalence of 1 in 30&#44;000 &#91;<a class="elsevierStyleCrossRef" href="#bib0080">16</a>&#93;&#44; our study demonstrated an increased hospital utilization for WD&#46; The reason is likely multifactorial and may include the chronicity of disease&#44; increased awareness of the disease&#44; disease related complications&#44; and side effects related to medical therapy&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">The clinical manifestations and comorbidity profile of WD largely depend on the organs that are involved&#44; most commonly liver and brain&#46; Patients with WD often present with acute or chronic hepatitis&#44; cirrhosis&#44; liver failure&#44; or neuropsychiatric disorders &#91;<a class="elsevierStyleCrossRef" href="#bib0080">16</a>&#93;&#46; Our study also demonstrates significantly higher hepatic and neuropsychiatric comorbidities in hospitalized WD patients compared to general population&#46; In addition&#44; our study showed that liver disease is the leading cause of hospitalization and death among patients with WD&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Notably&#44; the prevalence of drug and alcohol abuse was almost 2 times higher in WD patients compared to hospitalized non-WD patients in the present study&#46; This finding is in line with the observation of increased substance and alcohol abuse in patients with mental disorders &#91;<a class="elsevierStyleCrossRef" href="#bib0085">17</a>&#93; and WD &#91;<a class="elsevierStyleCrossRef" href="#bib0090">18</a>&#93;&#46; One study from Serbia showed particularly high suicidal deaths in their WD cohort &#91;<a class="elsevierStyleCrossRef" href="#bib0055">11</a>&#93;&#46; Half of the subjects who committed suicide had no history of depression and were motivated by other suffering such as substance abuse and alcoholism &#91;<a class="elsevierStyleCrossRef" href="#bib0055">11</a>&#93;&#46; WD related neuropsychiatric disorders may also contribute to increased hospital utilization&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Infection&#44; particularly sepsis and pneumonia&#44; is one of the major contributors for admissions among WD patients in the present study&#46; Although immune system requires copper to perform several critical functions&#44; suppressed immune response is observed with excessive copper exposure in mice &#91;<a class="elsevierStyleCrossRef" href="#bib0095">19</a>&#44;<a class="elsevierStyleCrossRef" href="#bib0100">20</a>&#93; and healthy humans &#91;<a class="elsevierStyleCrossRef" href="#bib0105">21</a>&#93;&#46; Some studies also found impaired bactericidal activity and copper-induced inhibitory effect on cell-mediated immunity&#44; which was improved with D-penicillamine treatment in WD &#91;<a class="elsevierStyleCrossRef" href="#bib0110">22</a>&#44;<a class="elsevierStyleCrossRef" href="#bib0115">23</a>&#93;&#46; It is noteworthy that 2&#46;50&#37; of WD patients in our study are admitted for pneumonia&#44; which echoes Czlonkowska&#8217;s finding that pneumonia is a common complication in this population &#91;<a class="elsevierStyleCrossRef" href="#bib0050">10</a>&#93;&#46; Therefore&#44; early control of infection and preventive measures such as pneumococcal vaccination in patients with WD might be beneficial in reducing hospitalizations&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">There have been a few WD patient cohorts in the literature that reported the causes of death &#91;<a class="elsevierStyleCrossRef" href="#bib0040">8</a>&#44;<a class="elsevierStyleCrossRef" href="#bib0050">10</a>&#44;<a class="elsevierStyleCrossRef" href="#bib0055">11</a>&#93;&#46; Czlonkowska&#8217;s group from Poland showed 20 out of 164 WD patients died during 11-year follow-up &#91;<a class="elsevierStyleCrossRef" href="#bib0050">10</a>&#93;&#46; Almost half of the deaths were secondary to liver failure and ten of them also had pneumonia or sepsis&#46; Similarly&#44; large WD cohorts from Austria and Serbia also showed hepatic failure remain the leading cause of death &#91;<a class="elsevierStyleCrossRef" href="#bib0040">8</a>&#44;<a class="elsevierStyleCrossRef" href="#bib0055">11</a>&#93;&#46; Our study is in concordance with current literature&#46; In addition&#44; the present study shows that WD patients who presented with respiratory and renal failure also had increased mortality&#46; Respiratory failure&#44; as a result of severe hypokalemia related to renal tubular dysfunction has been reported in WD &#91;<a class="elsevierStyleCrossRef" href="#bib0120">24</a>&#93;&#46; Copper induced renal disturbances have long been described in WD &#91;<a class="elsevierStyleCrossRef" href="#bib0125">25</a>&#93;&#46; In addition&#44; therapeutic drugs like penicillamine&#44; and decompensated cirrhosis&#44; may also lead to renal dysfunction &#91;<a class="elsevierStyleCrossRef" href="#bib0130">26</a>&#93;&#46; Therefore&#44; early referral and comprehensive management of organ failures in a transplant center may be beneficial&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">The mortality of patients with WD ranges from 1&#46;8&#37; to 21&#46;1&#37; worldwide based on cohort studies &#91;<a class="elsevierStyleCrossRef" href="#bib0010">2</a>&#44;<a class="elsevierStyleCrossRefs" href="#bib0040">8&#8211;13</a>&#93;&#46; The inpatient mortality of WD was 2&#46;58&#37; in the current study&#46; Long-term survival of patients with WD in comparison to general populations has not been consistently reported&#46; Some studies showed comparable survival of WD patients to general population &#91;<a class="elsevierStyleCrossRef" href="#bib0010">2</a>&#44;<a class="elsevierStyleCrossRef" href="#bib0070">14</a>&#93;&#44; while others reported worse outcomes in WD &#91;<a class="elsevierStyleCrossRef" href="#bib0040">8</a>&#44;<a class="elsevierStyleCrossRef" href="#bib0050">10</a>&#93;&#46; Our study demonstrates the overall survival of WD is reassuring compared to their counterparts&#44; a cohort of non-WD patients with matched comorbidities instead of healthy population&#46; However&#44; it&#8217;s worth pointing out that our patients with WD are slightly &#40;2 years&#41; younger than those without despite propensity match&#46; The discrepancy of long-term survival in WD may include different patient population&#44; small sample size&#44; stage of the disease&#44; treatment response and compliance&#44; and advances in both medical and surgical treatments during long observation period&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Our study has several limitations which are inherent to the use of administrative data&#46; First&#44; the NIS database counts each single admission rather than individual patient&#46; In the study of a chronic disease&#44; the findings may be potentially skewed owing to the rate of re-admissions&#46; Second&#44; the data collection of NIS relies on accuracy of the ICD coding&#46; Third&#44; the NIS does not contain non-coded clinical data such as laboratory or medications&#46; Despite these limitations&#44; the NIS enhances statistical power by providing a large sample size to analyze outcomes of a rare disease&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">In conclusion&#44; our study demonstrates the clinical characteristics and outcomes among hospitalized patients with WD&#46; These findings add important knowledge to our understanding of the healthcare utilization and outcomes of this rare disease in the United States&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflict of interest</span><p id="par0115" class="elsevierStylePara elsevierViewall">The authors do not declare any conflict of interest&#46;</p></span></span>"
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              "titulo" => "Trend of hospitalization in WD patients"
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              "titulo" => "Propensity-score matched analysis for inpatient mortality"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction and Objectives</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Wilson&#8217;s disease &#40;WD&#41; is a rare genetic disorder characterized by excessive copper disposition predominantly in the liver and brain&#46; Hospitalization data on patients with WD are scarce&#46; Hence&#44; we sought to examine the inpatient characteristics and outcomes of patients with WD&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Patients and Methods</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">We utilized the National Inpatient Database &#40;2006&#8211;2011&#41; and analyzed all adult patients with a diagnosis of WD&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">There were 9046 hospitalizations during the study period&#46; The leading etiologies for admissions were chronic liver disease &#40;8&#46;58&#37;&#41;&#44; WD &#40;6&#46;49&#37;&#41; and infections &#40;septicemia 3&#46;10&#37; and pneumonia 2&#46;50&#37;&#41;&#46; The overall inpatient mortality rate for WD patients was 2&#46;58&#37;&#46; Independent predictors of mortality in WD patients were acute respiratory failure &#40;OR&#58; 4&#46;53&#59; 95&#37; CI&#58; 2&#46;44&#8211;8&#46;42&#41;&#44; acute renal failure &#40;OR&#58; 4&#46;09&#59; 95&#37; CI&#58; 2&#46;19&#8211;7&#46;65&#41;&#44; decompensated liver disease or liver failure &#40;OR&#58; 3&#46;37&#59; 95&#37; CI&#58; 1&#46;72&#8211;6&#46;59&#41;&#44; and advanced age &#40;every 10 year increase&#44; OR&#58; 1&#46;48&#59; 95&#37; CI&#58; 1&#46;25&#8211;1&#46;75&#41;&#46; Propensity-score matched analysis revealed better inpatient survival in WD patients compared to matched non-WD patients &#40;2&#46;84&#37; vs&#46; 4&#46;67&#37;&#44; p&#8239;&#61;&#8239;0&#46;01&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Our study demonstrated the clinical characteristics and outcomes of hospitalized patients with WD&#46; These findings add important knowledge to our understanding of the healthcare utilization and outcomes of this rare disease in the United States&#46;</p></span>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Wilson&#8217;s disease&#44; n&#8239;&#61;&#8239;9046 &#40;&#37;&#41;</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Age &#40;mean years&#44; SE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Gender&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">45&#46;77&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">54&#46;23&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Race&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">5632&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">73&#46;35&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Black&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">865&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">11&#46;26&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">698&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">9&#46;09&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Asian&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">167&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;18&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Other&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">316&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4&#46;12&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="3" align="left" valign="\n
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                  \t\t\t\t">Income &#40;National Quartile&#41;</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">28&#46;26&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Moderate&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2434&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">27&#46;76&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>High&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">24&#46;15&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Very High&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Type of insurance&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Medicare&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">39&#46;87&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Medicaid&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">33&#46;19&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Other&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">9&#46;50&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Location of hospital&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">87&#46;17&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Teaching Status&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Non-Teaching&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4071&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45&#46;79&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Teaching&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4820&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54&#46;21&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital size&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Small&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">936&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;53&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Medium&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1784&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#46;06&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Large&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6171&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">69&#46;41&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital region&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Northeast&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1518&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#46;78&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Midwest&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2351&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&#46;98&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>South&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3510&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">38&#46;81&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>West&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1667&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#46;43&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Elixhauser Comorbidity Index</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">903&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#46;98&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1546&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#46;09&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2173&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&#46;02&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8805;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4425&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48&#46;92&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Inpatient outcomes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mortality&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">233&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;58&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Length of Stay &#40;days&#44; SE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;95&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cost &#40;&#36;&#44; SE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;999&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">730&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                  \t\t\t\t\tvoid\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ICD-9 code&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Diagnosis&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Frequency&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">571&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Chronic liver disease or cirrhosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">788&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;58&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">572&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sequelae of chronic liver disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">275&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Wilson disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">597&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;49&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">038&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Septicemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">285&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;10&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">780&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">General symptoms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">263&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;86&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">996&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Complications peculiar to certain specific procedures&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">255&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;77&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">486&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pneumonia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">230&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;50&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">296&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Episodic mood disorder&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">222&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;42&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">584&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Acute kidney failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">197&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;14&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">V57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Care involving use of rehabilitation procedures&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">185&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;01&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                0 => "xTab2786353.png"
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        "descripcion" => array:1 [
          "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Top principle diagnoses for patients with Wilson&#8217;s disease in National Inpatient Sample &#40;2006&#8211;2011&#41;&#46;</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
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        "mostrarFloat" => true
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        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0025"
            "detalle" => "Table "
            "rol" => "short"
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">CI&#44; confidential interval&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Predictive factors&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">OR &#40;95&#37; CI&#41;</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age &#40;10 year increase&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;1&#46;25&#44; 1&#46;75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Acute respiratory failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;2&#46;44&#44; 8&#46;42&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Acute renal failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;2&#46;19&#44; 7&#46;65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Decompensated liver disease or liver failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;1&#46;72&#44; 6&#46;59&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                0 => "xTab2786355.png"
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          "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Logistic regression model for mortality among patients with Wilson&#8217;s disease in National Inpatient Sample &#40;2006&#8211;2011&#41;&#46;</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "tbl0020"
        "etiqueta" => "Table 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0030"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Non-Wilson&#8217;s disease n&#8239;&#61;&#8239;1480</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Wilson&#8217;s disease n&#8239;&#61;&#8239;1480</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mortality&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;67&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;84&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;01&nbsp;\t\t\t\t\t\t\n
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                    0 => array:2 [
                      "titulo" => "Pathogenesis of Wilson disease"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "I&#46;F&#46; Scheiber"
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                        "tituloSerie" => "Handb Clin Neurol"
                        "fecha" => "2017"
                        "volumen" => "142"
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                        "paginaFinal" => "55"
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28433109"
                            "web" => "Medline"
                          ]
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              "identificador" => "bib0010"
              "etiqueta" => "&#91;2&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Wilson disease&#58; clinical presentation&#44; treatment&#44; and survival"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "W&#46; Stremmel"
                            1 => "K&#46;W&#46; Meyerrose"
                            2 => "C&#46; Niederau"
                            3 => "H&#46; Hefter"
                            4 => "G&#46; Kreuzpaintner"
                            5 => "G&#46; Strohmeyer"
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.7326/0003-4819-115-9-720"
                      "Revista" => array:7 [
                        "tituloSerie" => "Ann Intern Med"
                        "fecha" => "1991"
                        "volumen" => "115"
                        "numero" => "9"
                        "paginaInicial" => "720"
                        "paginaFinal" => "726"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1929042"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
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              "identificador" => "bib0015"
              "etiqueta" => "&#91;3&#93;"
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                0 => array:2 [
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                          "autores" => array:1 [
                            0 => "P&#46; Ferenci"
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                        "link" => array:1 [
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28433100"
                            "web" => "Medline"
                          ]
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                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;M&#46; Walshe"
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                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Q J Med"
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                        "numero" => "7"
                        "paginaInicial" => "553"
                        "paginaFinal" => "555"
                      ]
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                          "autores" => array:4 [
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                        "link" => array:1 [
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                            "web" => "Medline"
                          ]
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                          "autores" => array:6 [
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                    0 => array:2 [
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                        "tituloSerie" => "Clin Gastroenterol Hepatol"
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                        "numero" => "4"
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                    0 => array:2 [
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                        "tituloSerie" => "Gut"
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                        "numero" => "1"
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                          0 => array:2 [
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                    0 => array:2 [
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                        "numero" => "6"
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                        "paginaFinal" => "703"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15742108"
                            "web" => "Medline"
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                        "tituloSerie" => "Eur J Neurol"
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                        "paginaFinal" => "857"
                        "link" => array:1 [
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                  "referenciaCompleta" => "&#40;NIS&#41;&#44; H&#46;N&#46;I&#46;S&#46; Healthcare Cost and Utilication Project &#40;HCUP&#41; Agency for Healthcare Research and Quality&#58; Rockville&#44; MD&#44; USA&#44; 2006&#44; 2007&#44; 2008&#44; 2009&#44; 2010&#44; 2011&#46;"
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "&#91;16&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Wilson&#8217;s disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46; Ala"
                            1 => "A&#46;P&#46; Walker"
                            2 => "K&#46; Ashkan"
                            3 => "J&#46;S&#46; Dooley"
                            4 => "M&#46;L&#46; Schilsky"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(07)60196-2"
                      "Revista" => array:7 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2007"
                        "volumen" => "369"
                        "numero" => "9559"
                        "paginaInicial" => "397"
                        "paginaFinal" => "408"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17276780"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "&#91;17&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comorbidity of mental disorders with alcohol and other drug abuse&#46; Results from the Epidemiologic Catchment Area &#40;ECA&#41; Study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46;A&#46; Regier"
                            1 => "M&#46;E&#46; Farmer"
                            2 => "D&#46;S&#46; Rae"
                            3 => "B&#46;Z&#46; Locke"
                            4 => "S&#46;J&#46; Keith"
                            5 => "L&#46;L&#46; Judd"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "1990"
                        "volumen" => "264"
                        "numero" => "19"
                        "paginaInicial" => "2511"
                        "paginaFinal" => "2518"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2232018"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "&#91;18&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Delusional disorder and alcohol abuse in a patient with Wilson&#8217;s disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46; Spyridi"
                            1 => "I&#46; Diakogiannis"
                            2 => "M&#46; Michaelides"
                            3 => "S&#46; Sokolaki"
                            4 => "A&#46; Iacovides"
                            5 => "G&#46; Kaprinis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.genhosppsych.2008.05.005"
                      "Revista" => array:7 [
                        "tituloSerie" => "Gen Hosp Psychiatry"
                        "fecha" => "2008"
                        "volumen" => "30"
                        "numero" => "6"
                        "paginaInicial" => "585"
                        "paginaFinal" => "586"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19061688"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "&#91;19&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Influence of the oral administration of excess copper on the immune response"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Pocino"
                            1 => "L&#46; Baute"
                            2 => "I&#46; Malave"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/0272-0590(91)90109-h"
                      "Revista" => array:7 [
                        "tituloSerie" => "Fundam Appl Toxicol"
                        "fecha" => "1991"
                        "volumen" => "16"
                        "numero" => "2"
                        "paginaInicial" => "249"
                        "paginaFinal" => "256"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2055356"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "&#91;20&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Elevated serum copper is associated with reduced immune response in aging mice"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "H&#46; Massie"
                            1 => "W&#46; Ofosu-Appiah"
                            2 => "V&#46; Aiello"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Gerontology"
                        "fecha" => "1993"
                        "volumen" => "39"
                        "numero" => "3"
                        "paginaInicial" => "136"
                        "paginaFinal" => "145"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "&#91;21&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of long-term&#44; high-copper intake on the concentrations of plasma homocysteine and B vitamins in young men"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "T&#46; Tamura"
                            1 => "J&#46;R&#46; Turnlund"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.nut.2004.05.011"
                      "Revista" => array:7 [
                        "tituloSerie" => "Nutrition"
                        "fecha" => "2004"
                        "volumen" => "20"
                        "numero" => "9"
                        "paginaInicial" => "757"
                        "paginaFinal" => "759"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15325682"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "&#91;22&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Immunological observations on patients with Wilson&#8217;s disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Czlonkowska"
                            1 => "B&#46; Milewski"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/0022-510x(76)90188-x"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Neurol Sci"
                        "fecha" => "1976"
                        "volumen" => "29"
                        "numero" => "2-4"
                        "paginaInicial" => "411"
                        "paginaFinal" => "421"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/978218"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "&#91;23&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The influence of prolonged treatment with D-penicillamine on the immune response in Wilson&#8217;s disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46; Czlonkowska"
                          ]
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/BF00607425"
                      "Revista" => array:7 [
                        "tituloSerie" => "Eur J Clin Pharmacol"
                        "fecha" => "1977"
                        "volumen" => "12"
                        "numero" => "4"
                        "paginaInicial" => "265"
                        "paginaFinal" => "271"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/590312"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "&#91;24&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Wilson&#8217;s disease presenting as respiratory failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46; Narayanan"
                            1 => "G&#46; Chetan"
                            2 => "S&#46; Mahadevan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/BF02758271"
                      "Revista" => array:7 [
                        "tituloSerie" => "Indian J Pediatr"
                        "fecha" => "2006"
                        "volumen" => "73"
                        "numero" => "7"
                        "paginaInicial" => "99"
                        "paginaFinal" => "100"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16444072"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0125"
              "etiqueta" => "&#91;25&#93;"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Renal function in Wilson&#8217;s disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Bearn"
                            1 => "T&#46; Y&#252;"
                            2 => "A&#46; Gutman"
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1172/JCI103506"
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                        "tituloSerie" => "J Clin Invest"
                        "fecha" => "1957"
                        "volumen" => "36"
                        "numero" => "7"
                        "paginaInicial" => "1107"
                        "paginaFinal" => "1114"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/13449163"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
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              "etiqueta" => "&#91;26&#93;"
              "referencia" => array:1 [
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                    0 => array:2 [
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
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                            1 => "R&#46; Goldman"
                            2 => "M&#46;H&#46; Maxwell"
                            3 => "H&#46; Latta"
                          ]
                        ]
                      ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/0002-9343(64)90096-8"
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                        "tituloSerie" => "Am J Med"
                        "fecha" => "1964"
                        "volumen" => "36"
                        "paginaInicial" => "330"
                        "paginaFinal" => "336"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14124700"
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es en pt

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

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

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos