Image in cardiology
Image of an extensive aneurysm in a young patient
Imagen de un aneurisma extenso en un paciente joven
Tatiana Chantal Castro-De la Torrea, Leticia Rodríguez-Mariscala, Martha A. Hernández-Gonzálezb, Sergio Solorioc,
Corresponding author
soloriosergio@aol.com
sergio.solorio@imss.gob.mx
Corresponding author at: Unidad de Investigagción, UMAE 1 Del Bajío León IMSS, Blvd Lopez Mateos esq Insurgentes SN, León Gto, Mexico CP 37320, Mexico. Tel.: +52 477 7174800x31788.
sergio.solorio@imss.gob.mx
Corresponding author at: Unidad de Investigagción, UMAE 1 Del Bajío León IMSS, Blvd Lopez Mateos esq Insurgentes SN, León Gto, Mexico CP 37320, Mexico. Tel.: +52 477 7174800x31788.
Read
2556
Timeswas read the article
656
Total PDF
1900
Total HTML
Share statistics
array:24 [ "pii" => "S1405994016300027" "issn" => "14059940" "doi" => "10.1016/j.acmx.2016.02.002" "estado" => "S300" "fechaPublicacion" => "2016-10-01" "aid" => "262" "copyright" => "Instituto Nacional de Cardiología Ignacio Chávez" "copyrightAnyo" => "2016" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Arch Cardiol Mex. 2016;86:374-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1092 "formatos" => array:3 [ "EPUB" => 51 "HTML" => 761 "PDF" => 280 ] ] "itemSiguiente" => array:19 [ "pii" => "S1405994016300349" "issn" => "14059940" "doi" => "10.1016/j.acmx.2016.05.003" "estado" => "S300" "fechaPublicacion" => "2016-10-01" "aid" => "279" "copyright" => "Instituto Nacional de Cardiología Ignacio Chávez" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Arch Cardiol Mex. 2016;86:376-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1392 "formatos" => array:3 [ "EPUB" => 42 "HTML" => 1006 "PDF" => 344 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>" "titulo" => "Unruptured sinus of Valsalva aneurysm presenting as NSTEMI" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "376" "paginaFinal" => "377" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "IAM sin elevación del segmento ST causado por aneurisma del seno de Valsalva" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1000 "Ancho" => 1012 "Tamanyo" => 60588 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Coronary angiography showing left main extrinsic compression from an ovoid-shaped structure with turbulent flow of dye inside (LM – left main coronary artery; SVA – sinus of Valsalva aneurysm).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Carlos Galvão Braga, Raymundo Ocaranza-Sánchez, Darío Durán-Muñoz, J. José Legarra-Calderón, José Ramón González-Juanatey" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Carlos Galvão" "apellidos" => "Braga" ] 1 => array:2 [ "nombre" => "Raymundo" "apellidos" => "Ocaranza-Sánchez" ] 2 => array:2 [ "nombre" => "Darío" "apellidos" => "Durán-Muñoz" ] 3 => array:2 [ "nombre" => "J. José" "apellidos" => "Legarra-Calderón" ] 4 => array:2 [ "nombre" => "José Ramón" "apellidos" => "González-Juanatey" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1405994016300349?idApp=UINPBA00004N" "url" => "/14059940/0000008600000004/v1_201611090122/S1405994016300349/v1_201611090122/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1405994016300647" "issn" => "14059940" "doi" => "10.1016/j.acmx.2016.06.004" "estado" => "S300" "fechaPublicacion" => "2016-10-01" "aid" => "293" "copyright" => "Instituto Nacional de Cardiología Ignacio Chávez" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Arch Cardiol Mex. 2016;86:367-73" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3562 "formatos" => array:3 [ "EPUB" => 65 "HTML" => 2713 "PDF" => 784 ] ] "es" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Artículo de opinión</span>" "titulo" => "El SPRINT en la práctica médica: ¿es momento de modificar el manejo de la hipertensión arterial en Latinoamérica?" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "367" "paginaFinal" => "373" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "SPRINT on clinical practice: It's time to change the management of arterial hypertension in Latin America?" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "José Kelvin Galvez-Olortegui, Yudy Condor-Rojas, Tomas Vladimir Galvez-Olortegui, Luis Camacho-Saavedra" "autores" => array:4 [ 0 => array:2 [ "nombre" => "José Kelvin" "apellidos" => "Galvez-Olortegui" ] 1 => array:2 [ "nombre" => "Yudy" "apellidos" => "Condor-Rojas" ] 2 => array:2 [ "nombre" => "Tomas Vladimir" "apellidos" => "Galvez-Olortegui" ] 3 => array:2 [ "nombre" => "Luis" "apellidos" => "Camacho-Saavedra" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1405994016300647?idApp=UINPBA00004N" "url" => "/14059940/0000008600000004/v1_201611090122/S1405994016300647/v1_201611090122/es/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in cardiology</span>" "titulo" => "Image of an extensive aneurysm in a young patient" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "374" "paginaFinal" => "375" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Tatiana Chantal Castro-De la Torre, Leticia Rodríguez-Mariscal, Martha A. Hernández-González, Sergio Solorio" "autores" => array:4 [ 0 => array:3 [ "nombre" => "Tatiana Chantal" "apellidos" => "Castro-De la Torre" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "Leticia" "apellidos" => "Rodríguez-Mariscal" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Martha A." "apellidos" => "Hernández-González" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:4 [ "nombre" => "Sergio" "apellidos" => "Solorio" "email" => array:2 [ 0 => "soloriosergio@aol.com" 1 => "sergio.solorio@imss.gob.mx" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Cardiología, UMAE 1 Bajío IMSS, León Gto, Mexico" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Cardiología, HGZ 21 IMSS, León Gto, Mexico" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Unidad de Investigación, UMAE 1 Bajío IMSS, León Gto, Mexico" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author at: Unidad de Investigagción, UMAE 1 Del Bajío León IMSS, Blvd Lopez Mateos esq Insurgentes SN, León Gto, Mexico CP 37320, Mexico. Tel.: +52 477 7174800x31788." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Imagen de un aneurisma extenso en un paciente joven" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 484 "Ancho" => 1800 "Tamanyo" => 114113 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Axis suprasternal echocardiogram, aortic arch and descending aorta is observed, with double-lumen image.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The acute aortic syndrome refers to a spectrum of life-threatening aortic emergencies. Acute aortic syndromes include non-traumatic entities as aortic dissection with an incidence of 80–90% of the cases, affecting 5–30 person-years, penetrating atherosclerotic ulcer with a incidence of 2.8% and intramural hematoma with incidence of 5–25%. Nowadays there are several imaging modalities for diagnosis, such as echocardiography, magnetic resonance imaging and computed tomography angiogram without let out the clinical characteristics and keep in mind differential diagnosis for initial suspicion (<a class="elsevierStyleCrossRefs" href="#fig0005">Figs. 1 and 2</a>).<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">1–3</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">We report the case of a hypertensive 42-year-old, with obesity and obstructive sleep apnea. He starts with oppressive chest pain with adrenergic discharge at rest, lasting 40<span class="elsevierStyleHsp" style=""></span>min, blood pressure was documented to 180/111, electrocardiogram with positive slope of the ST in aVR and V1 and negative troponin. The patient developed cardiogenic shock and death.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">4–7</span></a> Acute aortic syndrome should be identified early by clinical suspicion and supported by diagnostic studies to provide timely treatment because of its high mortality rate. Diagnostic imaging studies in clinical suspicion of dissection play an important role, such as confirmation of clinical suspicion, classification of dissection, localization of tears, assessment of extent of dissection and indicators of urgency.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">8</span></a></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical responsibilities</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0015" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Funding</span><p id="par0030" class="elsevierStylePara elsevierViewall">No endorsement of any kind received to conduct this study/article.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conflict of interest</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:3 [ "identificador" => "sec0005" "titulo" => "Ethical responsibilities" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0020" "titulo" => "Right to privacy and informed consent" ] ] ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Funding" ] 2 => array:2 [ "identificador" => "sec0030" "titulo" => "Conflict of interest" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-06-24" "fechaAceptado" => "2016-02-17" "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 484 "Ancho" => 1800 "Tamanyo" => 114113 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Axis suprasternal echocardiogram, aortic arch and descending aorta is observed, with double-lumen image.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2009 "Ancho" => 3333 "Tamanyo" => 551889 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">(A and B) Chest CT sagittal and axial scans showing aneurysmal dilatation with extravasation area, left pleural effusion. (C–E) Sagittal and coronal section showing double lumen from descending aorta to common iliac. (F) Digital reconstruction of aorta.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:8 [ 0 => array:3 [ "identificador" => "bib0045" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute aortic syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "I. Vilacosta" 1 => "J.A. San Ramon" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Heart" "fecha" => "2001" "volumen" => "85" "paginaInicial" => "265" "paginaFinal" => "268" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11179262" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0050" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute aortic syndromes: role of multi-detector row CT" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "L. Salvolini" 1 => "P. Renda" 2 => "D. Fiore" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ejrad.2007.09.020" "Revista" => array:6 [ "tituloSerie" => "Eur J Radiol" "fecha" => "2008" "volumen" => "65" "paginaInicial" => "350" "paginaFinal" => "358" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17997067" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0055" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The International Registry of Acute Aortic Dissection (IRAD): new insights into an old disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "P.G. Hagan" 1 => "C.A. Nienaber" 2 => "E.M. Isselbacher" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "JAMA" "fecha" => "2000" "volumen" => "283" "paginaInicial" => "897" "paginaFinal" => "903" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10685714" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0060" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Management of acute aortic syndromes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C.A. Nienaber" 1 => "J.T. Powell" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/eurheartj/ehr186" "Revista" => array:6 [ "tituloSerie" => "Eur Heart J" "fecha" => "2012" "volumen" => "33" "paginaInicial" => "26" "paginaFinal" => "35" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21810861" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0065" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Screening abdominal aorta aneurysm during echocardiography: literature review and proposal for a French nationwide study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "V. Aboyans" 1 => "S. Kownator" 2 => "M. Lafite" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.acvd.2010.06.003" "Revista" => array:6 [ "tituloSerie" => "Arch Cardiovasc Dis" "fecha" => "2010" "volumen" => "103" "paginaInicial" => "552" "paginaFinal" => "558" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21130969" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0070" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Interventional planning and assistance for ascending aorta dissections" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "C. Lohou" 1 => "P. Lubniewski" 2 => "N. Fetnaci" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "IRBM" "fecha" => "2013" "volumen" => "34" "paginaInicial" => "306" "paginaFinal" => "310" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0075" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute aortic dissection in blacks: insights from the International Registry of Acute Aortic Dissection" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "E. Bossone" 1 => "R.E. Pyeritz" 2 => "P. O’Gara" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.amjmed.2013.04.020" "Revista" => array:6 [ "tituloSerie" => "Am J Med" "fecha" => "2013" "volumen" => "126" "paginaInicial" => "909" "paginaFinal" => "915" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23953874" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0080" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The role of imaging in acute aortic syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "C.A. Nienaber" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Eur Heart J Cardiovasc Imaging" "fecha" => "2013" "volumen" => "14" "paginaInicial" => "15" "paginaFinal" => "23" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/14059940/0000008600000004/v1_201611090122/S1405994016300027/v1_201611090122/en/main.assets" "Apartado" => array:4 [ "identificador" => "14597" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Imágenes en cardiología" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/14059940/0000008600000004/v1_201611090122/S1405994016300027/v1_201611090122/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1405994016300027?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 3 | 1 | 4 |
| 2024 October | 13 | 8 | 21 |
| 2024 September | 8 | 3 | 11 |
| 2024 August | 12 | 4 | 16 |
| 2024 July | 17 | 6 | 23 |
| 2024 June | 9 | 3 | 12 |
| 2024 May | 11 | 2 | 13 |
| 2024 April | 14 | 9 | 23 |
| 2024 March | 17 | 5 | 22 |
| 2024 February | 18 | 4 | 22 |
| 2024 January | 14 | 1 | 15 |
| 2023 December | 11 | 12 | 23 |
| 2023 November | 24 | 7 | 31 |
| 2023 October | 13 | 2 | 15 |
| 2023 September | 21 | 5 | 26 |
| 2023 August | 7 | 1 | 8 |
| 2023 July | 23 | 2 | 25 |
| 2023 June | 24 | 3 | 27 |
| 2023 May | 45 | 4 | 49 |
| 2023 April | 17 | 1 | 18 |
| 2023 March | 22 | 0 | 22 |
| 2023 February | 12 | 4 | 16 |
| 2023 January | 14 | 3 | 17 |
| 2022 December | 14 | 3 | 17 |
| 2022 November | 30 | 12 | 42 |
| 2022 October | 13 | 4 | 17 |
| 2022 September | 19 | 6 | 25 |
| 2022 August | 31 | 11 | 42 |
| 2022 July | 25 | 9 | 34 |
| 2022 June | 22 | 21 | 43 |
| 2022 May | 11 | 7 | 18 |
| 2022 April | 16 | 12 | 28 |
| 2022 March | 31 | 10 | 41 |
| 2022 February | 38 | 3 | 41 |
| 2022 January | 36 | 8 | 44 |
| 2021 December | 30 | 8 | 38 |
| 2021 November | 20 | 9 | 29 |
| 2021 October | 60 | 8 | 68 |
| 2021 September | 31 | 6 | 37 |
| 2021 August | 28 | 10 | 38 |
| 2021 July | 26 | 6 | 32 |
| 2021 June | 17 | 5 | 22 |
| 2021 May | 27 | 12 | 39 |
| 2021 April | 20 | 13 | 33 |
| 2021 March | 18 | 5 | 23 |
| 2021 February | 17 | 5 | 22 |
| 2021 January | 17 | 13 | 30 |
| 2020 December | 18 | 7 | 25 |
| 2020 November | 17 | 10 | 27 |
| 2020 October | 19 | 6 | 25 |
| 2020 September | 21 | 11 | 32 |
| 2020 August | 18 | 9 | 27 |
| 2020 July | 20 | 11 | 31 |
| 2020 June | 12 | 9 | 21 |
| 2020 May | 13 | 9 | 22 |
| 2020 April | 5 | 1 | 6 |
| 2020 March | 22 | 4 | 26 |
| 2020 February | 16 | 7 | 23 |
| 2020 January | 14 | 4 | 18 |
| 2019 December | 25 | 4 | 29 |
| 2019 November | 6 | 4 | 10 |
| 2019 October | 10 | 1 | 11 |
| 2019 September | 16 | 3 | 19 |
| 2019 August | 10 | 1 | 11 |
| 2019 July | 16 | 5 | 21 |
| 2019 June | 37 | 9 | 46 |
| 2019 May | 136 | 7 | 143 |
| 2019 April | 43 | 10 | 53 |
| 2019 March | 7 | 10 | 17 |
| 2019 February | 7 | 2 | 9 |
| 2019 January | 5 | 3 | 8 |
| 2018 December | 7 | 6 | 13 |
| 2018 November | 13 | 8 | 21 |
| 2018 October | 21 | 10 | 31 |
| 2018 September | 14 | 0 | 14 |
| 2018 August | 7 | 2 | 9 |
| 2018 July | 12 | 5 | 17 |
| 2018 June | 8 | 1 | 9 |
| 2018 May | 6 | 1 | 7 |
| 2018 April | 7 | 1 | 8 |
| 2018 March | 7 | 0 | 7 |
| 2018 February | 4 | 1 | 5 |
| 2018 January | 12 | 2 | 14 |
| 2017 December | 5 | 3 | 8 |
| 2017 November | 9 | 2 | 11 |
| 2017 October | 7 | 2 | 9 |
| 2017 September | 13 | 3 | 16 |
| 2017 August | 9 | 1 | 10 |
| 2017 July | 17 | 3 | 20 |
| 2017 June | 13 | 15 | 28 |
| 2017 May | 18 | 4 | 22 |
| 2017 April | 23 | 3 | 26 |
| 2017 March | 22 | 77 | 99 |
| 2017 February | 19 | 6 | 25 |
| 2017 January | 22 | 1 | 23 |
| 2016 December | 42 | 8 | 50 |
| 2016 November | 64 | 31 | 95 |
| 2016 October | 10 | 5 | 15 |
| 2016 September | 7 | 4 | 11 |
| 2016 August | 3 | 4 | 7 |
| 2016 July | 0 | 4 | 4 |
Show all