OnabotulinumtoxinA infiltration and nerve blocks in patients with headache and neuralgia: safety recommendations to prevent SARS-CoV-2 infection

array:23 ["pii" => "S217358082030105X" "issn" => "21735808" "doi" => "10.1016/j.nrleng.2020.05.010" "estado" => "S300" "fechaPublicacion" => "2020-06-01" "aid" => "1420" "copyrightAnyo" => "2020" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Neurologia. 2020;35:291-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0213485320301006" "issn" => "02134853" "doi" => "10.1016/j.nrl.2020.05.004" "estado" => "S300" "fechaPublicacion" => "2020-06-01" "aid" => "1420" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Neurologia. 2020;35:291-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "es" => array:12 [ "idiomaDefecto" => true "cabecera" => "Original" "titulo" => "Infiltración con onabotulinumtoxinA y bloqueos en el paciente con cefalea y neuralgia: recomendaciones de seguridad frente a la infección por SARS-CoV-2" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "291" "paginaFinal" => "294" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "OnabotulinumtoxinA infiltration and nerve blocks in patients with headache and neuralgia: safety recommendations to prevent SARS-CoV-2 infection" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "S. Santos-Lasaosa, J. Porta-Etessam" "autores" => array:2 [ 0 => array:2 [ "nombre" => "S." "apellidos" => "Santos-Lasaosa" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Porta-Etessam" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S217358082030105X" "doi" => "10.1016/j.nrleng.2020.05.010" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217358082030105X?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213485320301006?idApp=UINPBA00004N" "url" => "/02134853/0000003500000005/v1_202006200925/S0213485320301006/v1_202006200925/es/main.assets" ] ] "itemSiguiente" => array:20 [ "pii" => "S2173580820301012" "issn" => "21735808" "doi" => "10.1016/j.nrleng.2020.05.008" "estado" => "S300" "fechaPublicacion" => "2020-06-01" "aid" => "1418" "copyright" => "Sociedad Española de Neurología" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Neurologia. 2020;35:295-302" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Ischaemic stroke and SARS-CoV-2 infection: a causal or incidental association?" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "295" "paginaFinal" => "302" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Ictus isquémico e infección por SARS-CoV-2, ¿asociación casual o causal?" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1427 "Ancho" => 1508 "Tamanyo" => 132653 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Cerebral perfusion study showing hypoperfusion in the M2–M5 territories of the left middle cerebral artery, with increased mean transit time and no infarction (100% ischaemic penumbra)." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.M. Barrios-López, I. Rego-García, C. Muñoz Martínez, J.C. Romero-Fábrega, M. Rivero Rodríguez, J.A. Ruiz Giménez, F. Escamilla-Sevilla, A. Mínguez-Castellanos, M.D. Fernández Pérez" "autores" => array:9 [ 0 => array:2 [ "nombre" => "J.M." "apellidos" => "Barrios-López" ] 1 => array:2 [ "nombre" => "I." "apellidos" => "Rego-García" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Muñoz Martínez" ] 3 => array:2 [ "nombre" => "J.C." "apellidos" => "Romero-Fábrega" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "Rivero Rodríguez" ] 5 => array:2 [ "nombre" => "J.A." "apellidos" => "Ruiz Giménez" ] 6 => array:2 [ "nombre" => "F." "apellidos" => "Escamilla-Sevilla" ] 7 => array:2 [ "nombre" => "A." "apellidos" => "Mínguez-Castellanos" ] 8 => array:2 [ "nombre" => "M.D." "apellidos" => "Fernández Pérez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0213485320300955" "doi" => "10.1016/j.nrl.2020.05.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213485320300955?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173580820301012?idApp=UINPBA00004N" "url" => "/21735808/0000003500000005/v1_202006270652/S2173580820301012/v1_202006270652/en/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "OnabotulinumtoxinA infiltration and nerve blocks in patients with headache and neuralgia: safety recommendations to prevent SARS-CoV-2 infection" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "291" "paginaFinal" => "294" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "S. Santos-Lasaosa, J. Porta-Etessam" "autores" => array:2 [ 0 => array:3 [ "nombre" => "S." "apellidos" => "Santos-Lasaosa" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 1 => array:4 [ "nombre" => "J." "apellidos" => "Porta-Etessam" "email" => array:2 [ 0 => "jporta@yahoo.com" 1 => "jesusport@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Unidad de Cefaleas, Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Instituto de Investigación Sanitaria Aragón (IIS-Aragón), Zaragoza, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Cefaleas, Servicio de Neurología, Instituto de Investigación Sanitaria San Carlos, Hospital Clínico San Carlos, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Infiltración con onabotulinumtoxinA y bloqueos en el paciente con cefalea y neuralgia: recomendaciones de seguridad frente a la infección por SARS-CoV-2" ] ] "textoCompleto" => "IntroductionThe viral pneumonia outbreak that originated in Wuhan (China) in December 2019 has become a global pandemic. The World Health Organization declared the epidemic a public health emergency of international concern on 30 January 2020. In February 2020, the novel virus was officially denominated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with the associated disease being named COVID-19 (coronavirus disease 2019).<a class="elsevierStyleCrossRefs" href="#bib0070">1,2</a>The virus is transmitted through respiratory microdroplets, which are dispersed 1-2m when a person speaks or coughs. The virus is known to survive for an undetermined period of time on smooth surfaces, and as long as 72hours on plastic or stainless steel.<a class="elsevierStyleCrossRef" href="#bib0080">3</a> In Spain, hospitals were forced to modify their healthcare practices with the publication of Royal Decree 463/2020 of 14 March,<a class="elsevierStyleCrossRef" href="#bib0085">4</a> which declared a state of alarm for the management of the COVID-19 healthcare crisis.According to data from the Spanish migraine action plan (PALM study), approximately 12% of the general population (one-year prevalence) have migraine (18% of women and 8% of men). Chronic migraine affects 2.4% of the population, with rates depending on the geographical area and the methods used. This study was used to draft a national migraine map with data for each Autonomous Community, which showed significant geographic variations, ranging from 7.6% in Navarre to 18% in the Canary Islands.<a class="elsevierStyleCrossRef" href="#bib0090">5</a> Today, onabotulinumtoxinA (OnabotA) and anaesthetic nerve blocks are used to reduce the frequency of migraine attacks and number of headache days per month, and ultimately to improve patients’ quality of life.<a class="elsevierStyleCrossRef" href="#bib0095">6</a>In this article, we present a series of recommendations to ensure adequate safety for both staff and patients, which are based on the measures implemented in the Spanish healthcare system to prevent the spread of SARS-CoV-2, adapted to our professional setting. These recommendations may be modified according to each centre's needs and characteristics.We differentiate between measures related to patients and physicians, to the technique, to infrastructure (waiting room and consultation), and to healthcare management (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Measures related to patients and physiciansGiven the high transmissibility of SARS-CoV-2, a distance greater than 1.5m must be maintained to reduce the risk of infection. Examination of patients with headache requires a distance of less than 30cm, and even closer for certain procedures (direct ophthalmoscopy, palpation of cranial and cervical structures, etc.). As a result, these examinations present a risk and must be performed in accordance with the standard safety measures for these situations.<a class="elsevierStyleCrossRefs" href="#bib0100">7–9</a> Another key consideration is that the disease can be spread by healthcare professionals; therefore, prevention measures should be strictly observed.<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005">1.Given that the virus can be spread prior to symptom onset, and that many patients present few symptoms, all individuals should be considered as potential sources of infection.</li><li class="elsevierStyleListItem" id="lsti0010">2.It is advisable for patients to be evaluated prior to entering the consultation to screen for possible exposure to the virus through questions about fever, general discomfort, respiratory symptoms (dry cough, dyspnoea), ageusia, anosmia, diarrhoea, and headache, and whether patients have had close contact or live with any individual recently diagnosed or under quarantine for COVID-19 in the last 14 days.</li><li class="elsevierStyleListItem" id="lsti0015">3.Wherever possible, patients should attend consultations alone and wear disposable surgical face masks.</li><li class="elsevierStyleListItem" id="lsti0020">4.Physicians should wear hospital scrubs.</li><li class="elsevierStyleListItem" id="lsti0025">5.Gloves should be used in the examination of pericranial muscles, and the patient should be approached from the side. It is also essential to wear a face mask; the most recommended types are FFP2 masks without exhalation valves and FFP3 masks. If only disposable surgical masks are available, 2 should be worn. In high-risk patients, disposable gowns and protective plastic visors are also recommended. A personal protective suit and/or a surgical gown may be used.</li><li class="elsevierStyleListItem" id="lsti0030">6.It is essential to wash hands and change gloves between patients. Professionals must be careful not to touch any equipment with gloves that have been used for the procedure/examination.</li><li class="elsevierStyleListItem" id="lsti0035">7.All examination equipment must be disinfected with alcohol solution, or with soap and water if this is not available.</li></ul>Measures related to the techniqueWhen administering OnabotA or performing anaesthetic nerve blocks or dry needling, professionals should also follow these additional recommendations:<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0040">1.Plastic or methacrylate protective visors are recommended over goggles. As the virus is able to survive on plastic surfaces, these should be cleaned on both sides with disinfectant (e.g., alcohol) after each use.</li><li class="elsevierStyleListItem" id="lsti0045">2.Patients should be in the supine decubitus position and be approached from behind. If this is not possible, they should remain seated. In the first case, the paper or sheet on the bed should be replaced following the procedure.</li><li class="elsevierStyleListItem" id="lsti0050">3.The number of procedures performed in each consultation should be limited as far as possible, and those with the greatest level of evidence should be prioritised.</li></ul>Measures related to infrastructureThese recommendations may be generalised to all consultations and waiting rooms:<ul class="elsevierStyleList" id="lis0015"><li class="elsevierStyleListItem" id="lsti0055">1.Patients may be accompanied by a maximum of one person, where strictly necessary.</li><li class="elsevierStyleListItem" id="lsti0060">2.Individuals should be separated by a distance of 2m. Overcrowding of waiting rooms should be avoided.</li><li class="elsevierStyleListItem" id="lsti0065">3.All surfaces (doorknobs and handles, reception desks, telephones, computer equipment, pens, etc.) should be disinfected continuously.</li><li class="elsevierStyleListItem" id="lsti0070">4.It is important to display information notices about the hygiene measures recommended by the health ministry and workplace health and safety services.</li><li class="elsevierStyleListItem" id="lsti0075">5.Patients must enter the consultation alone and disinfect their hands with hydroalcoholic gel before and after the consultation. Gel dispensers should be placed in the waiting room for this purpose.</li></ul>Measures related to the management of headache unitsThere can be no doubt that the pandemic will lead to significant delays in the provision of care for our patients.<a class="elsevierStyleCrossRef" href="#bib0115">10</a> This makes it necessary to design strategies for the management of waiting lists, in accordance with care quality indicators for headache units<a class="elsevierStyleCrossRef" href="#bib0120">11</a>:<ul class="elsevierStyleList" id="lis0020"><li class="elsevierStyleListItem" id="lsti0080">1.In order to apply the measures described above, these patients should be grouped together in a single schedule.</li><li class="elsevierStyleListItem" id="lsti0085">2.Reconstituting OnabotA vials ahead of time, depending on the number of patient appointments, will enable reduction of consultation times.</li><li class="elsevierStyleListItem" id="lsti0090">3.Another highly practical consideration is the provision of information leaflets on the technique and the treatment for patients with de novo migraine to consult at home.</li><li class="elsevierStyleListItem" id="lsti0095">4.Teleconsultation and electronic communication (telephone, e-mail) will become essential tools in everyday practice.<a class="elsevierStyleCrossRef" href="#bib0125">12</a></li><li class="elsevierStyleListItem" id="lsti0100">5.Specialist nurses with training in the assessment and care of patients with headache unquestionably play a key role in these consultations.<a class="elsevierStyleCrossRef" href="#bib0130">13</a></li></ul>ConclusionsThe rapid spread of SARS-CoV-2 and the context of the pandemic will bring about a series of changes in the management of patients with migraine; fundamentally, this will involve the management of waiting lists and the implementation of new tools enabling integrated care within the framework of the safety regulations in force.OnabotulinumtoxinA and anaesthetic nerve blocks constitute the cornerstone of migraine management. Performing these procedures with the utmost care in order to ensure our patients’ safety, in observance of the regulations in force, requires great responsibility on the part of physicians.Conflicts of interestThe authors have no conflicts of interest to declare." "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres1355478" "titulo" => "Abstract" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1246343" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1355477" "titulo" => "Resumen" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0020" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0025" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0030" "titulo" => "Resultados" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1246344" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Measures related to patients and physicians" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Measures related to the technique" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Measures related to infrastructure" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Measures related to the management of headache units" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Conclusions" ] 10 => array:2 [ "identificador" => "sec0035" "titulo" => "Conflicts of interest" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2020-04-30" "fechaAceptado" => "2020-05-11" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1246343" "palabras" => array:5 [ 0 => "COVID-19" 1 => "Migraine" 2 => "Nerve block" 3 => "Infiltration" 4 => "OnabotulinumtoxinA" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1246344" "palabras" => array:5 [ 0 => "COVID-19" 1 => "Migraña" 2 => "Bloqueo" 3 => "Infiltración" 4 => "Onabotulinumtoxina" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "IntroductionThe COVID-19 pandemic has given rise to the need for changes in clinical practice, with new strategies to enable integrated care for patients with headache and neuralgia. Material and methodsGiven the high spreadability of SARS-CoV-2, new safety measures are required in such procedures as onabotulinumtoxinA infiltration and nerve blocks. ResultsWe present a series of recommendations based on the measures implemented to prevent infection in our healthcare system. We differentiate between measures related to patients and physicians, to technique, to infrastructure (waiting room and consultation), and to healthcare management." "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "IntroducciónLa infección por SARS-CoV-2 y la situación de pandemia hacen necesario un cambio en nuestra práctica clínica, en relación con la adopción de nuevas estrategias que permitan la asistencia integral de los pacientes con cefalea y neuralgia. Material y métodosAnte la elevada capacidad de transmisión del virus, determinados procedimientos, como la infiltración de onabotulinumtoxinA y la realización de bloqueos anestésicos, deben realizarse adoptando medidas que garanticen un nivel adecuado de seguridad. ResultadosNuestro objetivo es presentar una serie de recomendaciones basadas en las medidas establecidas por nuestro sistema sanitario para evitar el contagio. Diferenciaremos entre aquellas medidas relacionadas con el paciente y el facultativo, con la técnica, con la infraestructura (sala de espera y consulta) y con la gestión asistencial." "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0020" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0025" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0030" "titulo" => "Resultados" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Santos-Lasaosa S, Porta-Etessam J. Infiltración con onabotulinumtoxinA y bloqueos en el paciente con cefalea y neuralgia: recomendaciones de seguridad frente a la infección por SARS-CoV-2. Neurología. 2020;35:291–294." ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "OnabotA: onabotulinumtoxinA." "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=""><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">Measures related to patients and physicians \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">All individuals should be considered a potential source of infection. \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">All patients should be evaluated prior to consultation. \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">Patients should attend alone and wear disposable face masks. \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">Staff should wear hospital scrubs. \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">Staff should wear gloves and FFP2 masks without exhalation valves or FFP3 masks. If only disposable surgical masks are available, 2 should be worn. \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">Staff should wash hands and change gloves between patients. \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">Equipment must be disinfected with alcohol solution, or with soap and water if this is not available. \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"> \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">Measures related to the technique \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">Plastic or methacrylate protective visors should be used. \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">Patients should be in the supine decubitus position and approached from behind. \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">The number of procedures performed in each consultation should be limited. \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"> \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">Measures related to infrastructure \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">Patients should be accompanied by a maximum of one person, and only if strictly necessary. \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">A minimum distance of 2m between individuals should be observed. \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">All surfaces should be disinfected continuously. \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">Information notices about the recommended hygiene measures should be displayed. \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">Patients should wash their hands with hydroalcoholic gel before and after the consultation. \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"> \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">Measures related to the management of headache units \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">Patients should be grouped in the same schedule for performance of these procedures. \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">OnabotA vials should be reconstituted in advance. \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">Information leaflets should be provided. \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">Teleconsultation and communication by e-mail should be implemented. \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">Consultations should have specialised nurses. \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2327563.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Recommendations for advanced treatment of patients with migraine." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:13 [ 0 => array:3 [ "identificador" => "bib0070" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A novel coronavirus from patients with pneumonia in China, 2019" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N. Zhu" 1 => "D. Zhang" 2 => "W. Wang" 3 => "X. Li" 4 => "B. Yang" 5 => "J. Song" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMoa2001017" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2020" "volumen" => "382" "paginaInicial" => "727" "paginaFinal" => "733" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31978945" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0075" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "World Health Organization. Coronavirus disease (COVID-19) pandemic. Geneva: WHO. Available from <a target="_blank" href="https://www.who.int/emergencies/diseases/novel-coronavirus-2019">https://www.who.int/emergencies/diseases/novel-coronavirus-2019</a> [accessed 28.04.20]" ] ] ] 2 => array:3 [ "identificador" => "bib0080" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N. Van Doremalen" 1 => "T. Bushmaker" 2 => "D.H. Morris" 3 => "M.G. Holbrook" 4 => "A. Gamble" 5 => "B.N. Williamson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMc2004973" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2020" "volumen" => "382" "paginaInicial" => "1564" "paginaFinal" => "1567" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32182409" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0085" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Real Decreto 463/2020, de 14 de Mar, por el que se declara el estado de alarma para la gestión de la situación de crisis sanitaria ocasionada por el COVID-19. Available from: <a target="_blank" href="https://www.boe.es/eli/es/rd/2020/03/14/463">https://www.boe.es/eli/es/rd/2020/03/14/463</a> [accessed 28.04.20]" ] ] ] 4 => array:3 [ "identificador" => "bib0090" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "One-year prevalence of migraine in Spain: a nationwide population-based survey" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "Scientific Committee of the PALM Program" "etal" => false "autores" => array:6 [ 0 => "J. Matías-Guiu" 1 => "J. Porta-Etessam" 2 => "V. Mateos" 3 => "S. Díaz-Insa" 4 => "A. López-Gil" 5 => "C. Fernández" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/0333102410382794" "Revista" => array:6 [ "tituloSerie" => "Cephalalgia" "fecha" => "2011" "volumen" => "31" "paginaInicial" => "463" "paginaFinal" => "470" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20819843" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0095" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Migraña crónica" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A.L. Guerrero-Peral" 1 => "S. Díaz-Insa" 2 => "L. López mesonero" 3 => "A. Oterino Durán" 4 => "P. Irimia Sieira" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:5 [ "editores" => "D.Ezpeleta, P.Pozo-Rosich" "titulo" => "Guía oficial de práctica clínica en cefaleas" "paginaInicial" => "59" "paginaFinal" => "86" "serieFecha" => "2015" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0100" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pathogenicity and transmissibility of 2019-nCoV. A quick overview and comparison with other emerging viruses" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J. Chen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Microb Infect" "fecha" => "2020" "volumen" => "22" "paginaInicial" => "69" "paginaFinal" => "71" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0105" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Material y documentos sobre el lavado de manos" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Organización Mundial de la Salud" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:1 [ "fecha" => "2010" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0110" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19). Available from <a target="_blank" href="https://www.cdc.gov/coronavirus/2019-ncov/faq.html">https://www.cdc.gov/coronavirus/2019-ncov/faq.html#How-to-Protect-Yourself</a> [accessed 28.04.20]" ] ] ] 9 => array:3 [ "identificador" => "bib0115" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "La gestión de la asistencia neurológica en tiempos de la pandemia de COVID-19" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J. Matías-Guiu" 1 => "J. Porta-Etessam" 2 => "E. López-Valdés" 3 => "I. García-Morales" 4 => "A. Guerrero- Solá" 5 => "J.A. Matías-Guiu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.nrl.2020.04.001" "Revista" => array:2 [ "tituloSerie" => "Neurologia" "fecha" => "2020" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0120" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cartera de servicios y cuadro básico de indicadores de calidad para las unidades de cefalea: estudio de consenso" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "I. Carrillo" 1 => "P. Pozo-Rosich" 2 => "M. Guilabert" 3 => "M. Ignacio" 4 => "J. Pascual" 5 => "J. Porta-Etessam" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Neurol" "fecha" => "2019" "volumen" => "68" "paginaInicial" => "118" "paginaFinal" => "122" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30687919" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0125" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Correo electrónico de una consulta monográfica de cefaleas: experiencia durante cinco años" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.I. Pedraza" 1 => "S. Herrero-Velázquez" 2 => "L. López Mesonero" 3 => "M. Ruíz-Piñero" 4 => "A.L. Guerrero-Peral" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Neurol" "fecha" => "2015" "volumen" => "60" "paginaInicial" => "543" "paginaFinal" => "547" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26062826" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0130" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Quality assurance in specialized headache units in Spain: an observational prospective study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Pozo-Rosich" 1 => "A. Martínez-García" 2 => "J. Pascual" 3 => "E. Ignacio" 4 => "A.L. Guerrero-Peral" 5 => "J. Balseiro-Gómez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s10194-019-1020-1" "Revista" => array:5 [ "tituloSerie" => "J Headache Pain" "fecha" => "2019" "volumen" => "20" "paginaInicial" => "73" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31238877" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735808/0000003500000005/v1_202006270652/S217358082030105X/v1_202006270652/en/main.assets" "Apartado" => array:4 [ "identificador" => "9491" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original Articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735808/0000003500000005/v1_202006270652/S217358082030105X/v1_202006270652/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217358082030105X?idApp=UINPBA00004N"]

Statistics

Original article

Infiltración con onabotulinumtoxinA y bloqueos en el paciente con cefalea y neuralgia: recomendaciones de seguridad frente a la infección por SARS-CoV-2

S. Santos-Lasaosaa, J. Porta-Etessamb,

Corresponding author

jporta@yahoo.com
jesusport@gmail.com

Corresponding author.

a Unidad de Cefaleas, Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Instituto de Investigación Sanitaria Aragón (IIS-Aragón), Zaragoza, Spain

b Unidad de Cefaleas, Servicio de Neurología, Instituto de Investigación Sanitaria San Carlos, Hospital Clínico San Carlos, Madrid, Spain

Read

1877

Times
was read the article

431

Total PDF

1446

Total HTML

Share statistics

 array:23 [
  "pii" => "S217358082030105X"
  "issn" => "21735808"
  "doi" => "10.1016/j.nrleng.2020.05.010"
  "estado" => "S300"
  "fechaPublicacion" => "2020-06-01"
  "aid" => "1420"
  "copyrightAnyo" => "2020"
  "documento" => "article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "fla"
  "cita" => "Neurologia. 2020;35:291-4"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0213485320301006"
      "issn" => "02134853"
      "doi" => "10.1016/j.nrl.2020.05.004"
      "estado" => "S300"
      "fechaPublicacion" => "2020-06-01"
      "aid" => "1420"
      "documento" => "article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "fla"
      "cita" => "Neurologia. 2020;35:291-4"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:1 [
        "total" => 0
      ]
      "es" => array:12 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
        "titulo" => "Infiltraci&#243;n con onabotulinumtoxinA y bloqueos en el paciente con cefalea y neuralgia&#58; recomendaciones de seguridad frente a la infecci&#243;n por SARS-CoV-2"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:2 [
          0 => "es"
          1 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "291"
            "paginaFinal" => "294"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "OnabotulinumtoxinA infiltration and nerve blocks in patients with headache and neuralgia&#58; safety recommendations to prevent SARS-CoV-2 infection"
          ]
        ]
        "contieneResumen" => array:2 [
          "es" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "S&#46; Santos-Lasaosa, J&#46; Porta-Etessam"
            "autores" => array:2 [
              0 => array:2 [
                "nombre" => "S&#46;"
                "apellidos" => "Santos-Lasaosa"
              ]
              1 => array:2 [
                "nombre" => "J&#46;"
                "apellidos" => "Porta-Etessam"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S217358082030105X"
          "doi" => "10.1016/j.nrleng.2020.05.010"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217358082030105X?idApp=UINPBA00004N"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213485320301006?idApp=UINPBA00004N"
      "url" => "/02134853/0000003500000005/v1_202006200925/S0213485320301006/v1_202006200925/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S2173580820301012"
    "issn" => "21735808"
    "doi" => "10.1016/j.nrleng.2020.05.008"
    "estado" => "S300"
    "fechaPublicacion" => "2020-06-01"
    "aid" => "1418"
    "copyright" => "Sociedad Espa&#241;ola de Neurolog&#237;a"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Neurologia. 2020;35:295-302"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Ischaemic stroke and SARS-CoV-2 infection&#58; a causal or incidental association&#63;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "295"
          "paginaFinal" => "302"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Ictus isqu&#233;mico e infecci&#243;n por SARS-CoV-2&#44; &#191;asociaci&#243;n casual o causal&#63;"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig0005"
          "etiqueta" => "Fig&#46; 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1427
              "Ancho" => 1508
              "Tamanyo" => 132653
            ]
          ]
          "detalles" => array:1 [
            0 => array:3 [
              "identificador" => "at0005"
              "detalle" => "Fig&#46; "
              "rol" => "short"
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Cerebral perfusion study showing hypoperfusion in the M2&#8211;M5 territories of the left middle cerebral artery&#44; with increased mean transit time and no infarction &#40;100&#37; ischaemic penumbra&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "J&#46;M&#46; Barrios-L&#243;pez, I&#46; Rego-Garc&#237;a, C&#46; Mu&#241;oz Mart&#237;nez, J&#46;C&#46; Romero-F&#225;brega, M&#46; Rivero Rodr&#237;guez, J&#46;A&#46; Ruiz Gim&#233;nez, F&#46; Escamilla-Sevilla, A&#46; M&#237;nguez-Castellanos, M&#46;D&#46; Fern&#225;ndez P&#233;rez"
          "autores" => array:9 [
            0 => array:2 [
              "nombre" => "J&#46;M&#46;"
              "apellidos" => "Barrios-L&#243;pez"
            ]
            1 => array:2 [
              "nombre" => "I&#46;"
              "apellidos" => "Rego-Garc&#237;a"
            ]
            2 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Mu&#241;oz Mart&#237;nez"
            ]
            3 => array:2 [
              "nombre" => "J&#46;C&#46;"
              "apellidos" => "Romero-F&#225;brega"
            ]
            4 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Rivero Rodr&#237;guez"
            ]
            5 => array:2 [
              "nombre" => "J&#46;A&#46;"
              "apellidos" => "Ruiz Gim&#233;nez"
            ]
            6 => array:2 [
              "nombre" => "F&#46;"
              "apellidos" => "Escamilla-Sevilla"
            ]
            7 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "M&#237;nguez-Castellanos"
            ]
            8 => array:2 [
              "nombre" => "M&#46;D&#46;"
              "apellidos" => "Fern&#225;ndez P&#233;rez"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0213485320300955"
        "doi" => "10.1016/j.nrl.2020.05.002"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213485320300955?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173580820301012?idApp=UINPBA00004N"
    "url" => "/21735808/0000003500000005/v1_202006270652/S2173580820301012/v1_202006270652/en/main.assets"
  ]
  "en" => array:19 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
    "titulo" => "OnabotulinumtoxinA infiltration and nerve blocks in patients with headache and neuralgia&#58; safety recommendations to prevent SARS-CoV-2 infection"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "291"
        "paginaFinal" => "294"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "S&#46; Santos-Lasaosa, J&#46; Porta-Etessam"
        "autores" => array:2 [
          0 => array:3 [
            "nombre" => "S&#46;"
            "apellidos" => "Santos-Lasaosa"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          1 => array:4 [
            "nombre" => "J&#46;"
            "apellidos" => "Porta-Etessam"
            "email" => array:2 [
              0 => "jporta@yahoo.com"
              1 => "jesusport@gmail.com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              1 => array:2 [
                "etiqueta" => "&#42;"
                "identificador" => "cor0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Unidad de Cefaleas&#44; Servicio de Neurolog&#237;a&#44; Hospital Cl&#237;nico Universitario Lozano Blesa&#44; Instituto de Investigaci&#243;n Sanitaria Arag&#243;n &#40;IIS-Arag&#243;n&#41;&#44; Zaragoza&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Unidad de Cefaleas&#44; Servicio de Neurolog&#237;a&#44; Instituto de Investigaci&#243;n Sanitaria San Carlos&#44; Hospital Cl&#237;nico San Carlos&#44; Madrid&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Infiltraci&#243;n con onabotulinumtoxinA y bloqueos en el paciente con cefalea y neuralgia&#58; recomendaciones de seguridad frente a la infecci&#243;n por SARS-CoV-2"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The viral pneumonia outbreak that originated in Wuhan &#40;China&#41; in December 2019 has become a global pandemic&#46; The World Health Organization declared the epidemic a public health emergency of international concern on 30 January 2020&#46; In February 2020&#44; the novel virus was officially denominated severe acute respiratory syndrome coronavirus 2 &#40;SARS-CoV-2&#41;&#44; with the associated disease being named COVID-19 &#40;coronavirus disease 2019&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">1&#44;2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The virus is transmitted through respiratory microdroplets&#44; which are dispersed 1-2<span class="elsevierStyleHsp" style=""></span>m when a person speaks or coughs&#46; The virus is known to survive for an undetermined period of time on smooth surfaces&#44; and as long as 72<span class="elsevierStyleHsp" style=""></span>hours on plastic or stainless steel&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">3</span></a> In Spain&#44; hospitals were forced to modify their healthcare practices with the publication of Royal Decree 463&#47;2020 of 14 March&#44;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">4</span></a> which declared a state of alarm for the management of the COVID-19 healthcare crisis&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">According to data from the Spanish migraine action plan &#40;PALM study&#41;&#44; approximately 12&#37; of the general population &#40;one-year prevalence&#41; have migraine &#40;18&#37; of women and 8&#37; of men&#41;&#46; Chronic migraine affects 2&#46;4&#37; of the population&#44; with rates depending on the geographical area and the methods used&#46; This study was used to draft a national migraine map with data for each Autonomous Community&#44; which showed significant geographic variations&#44; ranging from 7&#46;6&#37; in Navarre to 18&#37; in the Canary Islands&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">5</span></a> Today&#44; onabotulinumtoxinA &#40;OnabotA&#41; and anaesthetic nerve blocks are used to reduce the frequency of migraine attacks and number of headache days per month&#44; and ultimately to improve patients&#8217; quality of life&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">6</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">In this article&#44; we present a series of recommendations to ensure adequate safety for both staff and patients&#44; which are based on the measures implemented in the Spanish healthcare system to prevent the spread of SARS-CoV-2&#44; adapted to our professional setting&#46; These recommendations may be modified according to each centre&#39;s needs and characteristics&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">We differentiate between measures related to patients and physicians&#44; to the technique&#44; to infrastructure &#40;waiting room and consultation&#41;&#44; and to healthcare management &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Measures related to patients and physicians</span><p id="par0030" class="elsevierStylePara elsevierViewall">Given the high transmissibility of SARS-CoV-2&#44; a distance greater than 1&#46;5<span class="elsevierStyleHsp" style=""></span>m must be maintained to reduce the risk of infection&#46; Examination of patients with headache requires a distance of less than 30<span class="elsevierStyleHsp" style=""></span>cm&#44; and even closer for certain procedures &#40;direct ophthalmoscopy&#44; palpation of cranial and cervical structures&#44; etc&#46;&#41;&#46; As a result&#44; these examinations present a risk and must be performed in accordance with the standard safety measures for these situations&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">7&#8211;9</span></a> Another key consideration is that the disease can be spread by healthcare professionals&#59; therefore&#44; prevention measures should be strictly observed&#46;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1&#46;</span><p id="par0035" class="elsevierStylePara elsevierViewall">Given that the virus can be spread prior to symptom onset&#44; and that many patients present few symptoms&#44; all individuals should be considered as potential sources of infection&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2&#46;</span><p id="par0040" class="elsevierStylePara elsevierViewall">It is advisable for patients to be evaluated prior to entering the consultation to screen for possible exposure to the virus through questions about fever&#44; general discomfort&#44; respiratory symptoms &#40;dry cough&#44; dyspnoea&#41;&#44; ageusia&#44; anosmia&#44; diarrhoea&#44; and headache&#44; and whether patients have had close contact or live with any individual recently diagnosed or under quarantine for COVID-19 in the last 14 days&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">3&#46;</span><p id="par0045" class="elsevierStylePara elsevierViewall">Wherever possible&#44; patients should attend consultations alone and wear disposable surgical face masks&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">4&#46;</span><p id="par0050" class="elsevierStylePara elsevierViewall">Physicians should wear hospital scrubs&#46;</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">5&#46;</span><p id="par0055" class="elsevierStylePara elsevierViewall">Gloves should be used in the examination of pericranial muscles&#44; and the patient should be approached from the side&#46; It is also essential to wear a face mask&#59; the most recommended types are FFP2 masks without exhalation valves and FFP3 masks&#46; If only disposable surgical masks are available&#44; 2 should be worn&#46; In high-risk patients&#44; disposable gowns and protective plastic visors are also recommended&#46; A personal protective suit and&#47;or a surgical gown may be used&#46;</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">6&#46;</span><p id="par0060" class="elsevierStylePara elsevierViewall">It is essential to wash hands and change gloves between patients&#46; Professionals must be careful not to touch any equipment with gloves that have been used for the procedure&#47;examination&#46;</p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">7&#46;</span><p id="par0065" class="elsevierStylePara elsevierViewall">All examination equipment must be disinfected with alcohol solution&#44; or with soap and water if this is not available&#46;</p></li></ul></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Measures related to the technique</span><p id="par0070" class="elsevierStylePara elsevierViewall">When administering OnabotA or performing anaesthetic nerve blocks or dry needling&#44; professionals should also follow these additional recommendations&#58;<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">1&#46;</span><p id="par0075" class="elsevierStylePara elsevierViewall">Plastic or methacrylate protective visors are recommended over goggles&#46; As the virus is able to survive on plastic surfaces&#44; these should be cleaned on both sides with disinfectant &#40;e&#46;g&#46;&#44; alcohol&#41; after each use&#46;</p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">2&#46;</span><p id="par0080" class="elsevierStylePara elsevierViewall">Patients should be in the supine decubitus position and be approached from behind&#46; If this is not possible&#44; they should remain seated&#46; In the first case&#44; the paper or sheet on the bed should be replaced following the procedure&#46;</p></li><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">3&#46;</span><p id="par0085" class="elsevierStylePara elsevierViewall">The number of procedures performed in each consultation should be limited as far as possible&#44; and those with the greatest level of evidence should be prioritised&#46;</p></li></ul></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Measures related to infrastructure</span><p id="par0090" class="elsevierStylePara elsevierViewall">These recommendations may be generalised to all consultations and waiting rooms&#58;<ul class="elsevierStyleList" id="lis0015"><li class="elsevierStyleListItem" id="lsti0055"><span class="elsevierStyleLabel">1&#46;</span><p id="par0095" class="elsevierStylePara elsevierViewall">Patients may be accompanied by a maximum of one person&#44; where strictly necessary&#46;</p></li><li class="elsevierStyleListItem" id="lsti0060"><span class="elsevierStyleLabel">2&#46;</span><p id="par0100" class="elsevierStylePara elsevierViewall">Individuals should be separated by a distance of 2<span class="elsevierStyleHsp" style=""></span>m&#46; Overcrowding of waiting rooms should be avoided&#46;</p></li><li class="elsevierStyleListItem" id="lsti0065"><span class="elsevierStyleLabel">3&#46;</span><p id="par0105" class="elsevierStylePara elsevierViewall">All surfaces &#40;doorknobs and handles&#44; reception desks&#44; telephones&#44; computer equipment&#44; pens&#44; etc&#46;&#41; should be disinfected continuously&#46;</p></li><li class="elsevierStyleListItem" id="lsti0070"><span class="elsevierStyleLabel">4&#46;</span><p id="par0110" class="elsevierStylePara elsevierViewall">It is important to display information notices about the hygiene measures recommended by the health ministry and workplace health and safety services&#46;</p></li><li class="elsevierStyleListItem" id="lsti0075"><span class="elsevierStyleLabel">5&#46;</span><p id="par0115" class="elsevierStylePara elsevierViewall">Patients must enter the consultation alone and disinfect their hands with hydroalcoholic gel before and after the consultation&#46; Gel dispensers should be placed in the waiting room for this purpose&#46;</p></li></ul></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Measures related to the management of headache units</span><p id="par0120" class="elsevierStylePara elsevierViewall">There can be no doubt that the pandemic will lead to significant delays in the provision of care for our patients&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">10</span></a> This makes it necessary to design strategies for the management of waiting lists&#44; in accordance with care quality indicators for headache units<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">11</span></a>&#58;<ul class="elsevierStyleList" id="lis0020"><li class="elsevierStyleListItem" id="lsti0080"><span class="elsevierStyleLabel">1&#46;</span><p id="par0125" class="elsevierStylePara elsevierViewall">In order to apply the measures described above&#44; these patients should be grouped together in a single schedule&#46;</p></li><li class="elsevierStyleListItem" id="lsti0085"><span class="elsevierStyleLabel">2&#46;</span><p id="par0130" class="elsevierStylePara elsevierViewall">Reconstituting OnabotA vials ahead of time&#44; depending on the number of patient appointments&#44; will enable reduction of consultation times&#46;</p></li><li class="elsevierStyleListItem" id="lsti0090"><span class="elsevierStyleLabel">3&#46;</span><p id="par0135" class="elsevierStylePara elsevierViewall">Another highly practical consideration is the provision of information leaflets on the technique and the treatment for patients with de novo migraine to consult at home&#46;</p></li><li class="elsevierStyleListItem" id="lsti0095"><span class="elsevierStyleLabel">4&#46;</span><p id="par0140" class="elsevierStylePara elsevierViewall">Teleconsultation and electronic communication &#40;telephone&#44; e-mail&#41; will become essential tools in everyday practice&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">12</span></a></p></li><li class="elsevierStyleListItem" id="lsti0100"><span class="elsevierStyleLabel">5&#46;</span><p id="par0145" class="elsevierStylePara elsevierViewall">Specialist nurses with training in the assessment and care of patients with headache unquestionably play a key role in these consultations&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">13</span></a></p></li></ul></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Conclusions</span><p id="par0150" class="elsevierStylePara elsevierViewall">The rapid spread of SARS-CoV-2 and the context of the pandemic will bring about a series of changes in the management of patients with migraine&#59; fundamentally&#44; this will involve the management of waiting lists and the implementation of new tools enabling integrated care within the framework of the safety regulations in force&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">OnabotulinumtoxinA and anaesthetic nerve blocks constitute the cornerstone of migraine management&#46; Performing these procedures with the utmost care in order to ensure our patients&#8217; safety&#44; in observance of the regulations in force&#44; requires great responsibility on the part of physicians&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conflicts of interest</span><p id="par0160" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:12 [
        0 => array:3 [
          "identificador" => "xres1355478"
          "titulo" => "Abstract"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Introduction"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Material and methods"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Results"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1246343"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres1355477"
          "titulo" => "Resumen"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Introducci&#243;n"
            ]
            1 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Material y m&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "Resultados"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec1246344"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Measures related to patients and physicians"
        ]
        6 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Measures related to the technique"
        ]
        7 => array:2 [
          "identificador" => "sec0020"
          "titulo" => "Measures related to infrastructure"
        ]
        8 => array:2 [
          "identificador" => "sec0025"
          "titulo" => "Measures related to the management of headache units"
        ]
        9 => array:2 [
          "identificador" => "sec0030"
          "titulo" => "Conclusions"
        ]
        10 => array:2 [
          "identificador" => "sec0035"
          "titulo" => "Conflicts of interest"
        ]
        11 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2020-04-30"
    "fechaAceptado" => "2020-05-11"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1246343"
          "palabras" => array:5 [
            0 => "COVID-19"
            1 => "Migraine"
            2 => "Nerve block"
            3 => "Infiltration"
            4 => "OnabotulinumtoxinA"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1246344"
          "palabras" => array:5 [
            0 => "COVID-19"
            1 => "Migra&#241;a"
            2 => "Bloqueo"
            3 => "Infiltraci&#243;n"
            4 => "Onabotulinumtoxina"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The COVID-19 pandemic has given rise to the need for changes in clinical practice&#44; with new strategies to enable integrated care for patients with headache and neuralgia&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Given the high spreadability of SARS-CoV-2&#44; new safety measures are required in such procedures as onabotulinumtoxinA infiltration and nerve blocks&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">We present a series of recommendations based on the measures implemented to prevent infection in our healthcare system&#46; We differentiate between measures related to patients and physicians&#44; to technique&#44; to infrastructure &#40;waiting room and consultation&#41;&#44; and to healthcare management&#46;</p></span>"
        "secciones" => array:3 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Material and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Introducci&#243;n</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La infecci&#243;n por SARS-CoV-2 y la situaci&#243;n de pandemia hacen necesario un cambio en nuestra pr&#225;ctica cl&#237;nica&#44; en relaci&#243;n con la adopci&#243;n de nuevas estrategias que permitan la asistencia integral de los pacientes con cefalea y neuralgia&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Material y m&#233;todos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Ante la elevada capacidad de transmisi&#243;n del virus&#44; determinados procedimientos&#44; como la infiltraci&#243;n de onabotulinumtoxinA y la realizaci&#243;n de bloqueos anest&#233;sicos&#44; deben realizarse adoptando medidas que garanticen un nivel adecuado de seguridad&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Resultados</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Nuestro objetivo es presentar una serie de recomendaciones basadas en las medidas establecidas por nuestro sistema sanitario para evitar el contagio&#46; Diferenciaremos entre aquellas medidas relacionadas con el paciente y el facultativo&#44; con la t&#233;cnica&#44; con la infraestructura &#40;sala de espera y consulta&#41; y con la gesti&#243;n asistencial&#46;</p></span>"
        "secciones" => array:3 [
          0 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Material y m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Resultados"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Santos-Lasaosa S&#44; Porta-Etessam J&#46; Infiltraci&#243;n con onabotulinumtoxinA y bloqueos en el paciente con cefalea y neuralgia&#58; recomendaciones de seguridad frente a la infecci&#243;n por SARS-CoV-2&#46; Neurolog&#237;a&#46; 2020&#59;35&#58;291&#8211;294&#46;</p>"
      ]
    ]
    "multimedia" => array:1 [
      0 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">OnabotA&#58; onabotulinumtoxinA&#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=""><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"><span class="elsevierStyleItalic">Measures related to patients and physicians</span>&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>All individuals should be considered a potential source of infection&#46;&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>All patients should be evaluated prior to consultation&#46;&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>Patients should attend alone and wear disposable face masks&#46;&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>Staff should wear hospital scrubs&#46;&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>Staff should wear gloves and FFP2 masks without exhalation valves or FFP3 masks&#46; If only disposable surgical masks are available&#44; 2 should be worn&#46;&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>Staff should wash hands and change gloves between patients&#46;&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>Equipment must be disinfected with alcohol solution&#44; or with soap and water if this is not available&#46;&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="elsevierStyleVsp" style="height:0.5px"></span>&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="elsevierStyleItalic">Measures related to the technique</span>&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>Plastic or methacrylate protective visors should be used&#46;&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>Patients should be in the supine decubitus position and approached from behind&#46;&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>The number of procedures performed in each consultation should be limited&#46;&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="elsevierStyleVsp" style="height:0.5px"></span>&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="elsevierStyleItalic">Measures related to infrastructure</span>&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>Patients should be accompanied by a maximum of one person&#44; and only if strictly necessary&#46;&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>A minimum distance of 2<span class="elsevierStyleHsp" style=""></span>m between individuals should be observed&#46;&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>All surfaces should be disinfected continuously&#46;&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>Information notices about the recommended hygiene measures should be displayed&#46;&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>Patients should wash their hands with hydroalcoholic gel before and after the consultation&#46;&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="elsevierStyleVsp" style="height:0.5px"></span>&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="elsevierStyleItalic">Measures related to the management of headache units</span>&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>Patients should be grouped in the same schedule for performance of these procedures&#46;&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>OnabotA vials should be reconstituted in advance&#46;&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>Information leaflets should be provided&#46;&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>Teleconsultation and communication by e-mail should be implemented&#46;&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>Consultations should have specialised nurses&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2327563.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Recommendations for advanced treatment of patients with migraine&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:13 [
            0 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A novel coronavirus from patients with pneumonia in China&#44; 2019"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46; Zhu"
                            1 => "D&#46; Zhang"
                            2 => "W&#46; Wang"
                            3 => "X&#46; Li"
                            4 => "B&#46; Yang"
                            5 => "J&#46; Song"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa2001017"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2020"
                        "volumen" => "382"
                        "paginaInicial" => "727"
                        "paginaFinal" => "733"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31978945"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "World Health Organization&#46; Coronavirus disease &#40;COVID-19&#41; pandemic&#46; Geneva&#58; WHO&#46; Available from <a target="_blank" href="https://www.who.int/emergencies/diseases/novel-coronavirus-2019">https&#58;&#47;&#47;www&#46;who&#46;int&#47;emergencies&#47;diseases&#47;novel-coronavirus-2019</a> &#91;accessed 28&#46;04&#46;20&#93;"
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46; Van Doremalen"
                            1 => "T&#46; Bushmaker"
                            2 => "D&#46;H&#46; Morris"
                            3 => "M&#46;G&#46; Holbrook"
                            4 => "A&#46; Gamble"
                            5 => "B&#46;N&#46; Williamson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMc2004973"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2020"
                        "volumen" => "382"
                        "paginaInicial" => "1564"
                        "paginaFinal" => "1567"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32182409"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Real Decreto 463&#47;2020&#44; de 14 de Mar&#44; por el que se declara el estado de alarma para la gesti&#243;n de la situaci&#243;n de crisis sanitaria ocasionada por el COVID-19&#46; Available from&#58; <a target="_blank" href="https://www.boe.es/eli/es/rd/2020/03/14/463">https&#58;&#47;&#47;www&#46;boe&#46;es&#47;eli&#47;es&#47;rd&#47;2020&#47;03&#47;14&#47;463</a> &#91;accessed 28&#46;04&#46;20&#93;"
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "One-year prevalence of migraine in Spain&#58; a nationwide population-based survey"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "Scientific Committee of the PALM Program"
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46; Mat&#237;as-Guiu"
                            1 => "J&#46; Porta-Etessam"
                            2 => "V&#46; Mateos"
                            3 => "S&#46; D&#237;az-Insa"
                            4 => "A&#46; L&#243;pez-Gil"
                            5 => "C&#46; Fern&#225;ndez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/0333102410382794"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cephalalgia"
                        "fecha" => "2011"
                        "volumen" => "31"
                        "paginaInicial" => "463"
                        "paginaFinal" => "470"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20819843"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Migra&#241;a cr&#243;nica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46;L&#46; Guerrero-Peral"
                            1 => "S&#46; D&#237;az-Insa"
                            2 => "L&#46; L&#243;pez mesonero"
                            3 => "A&#46; Oterino Dur&#225;n"
                            4 => "P&#46; Irimia Sieira"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:5 [
                        "editores" => "D&#46;Ezpeleta, P&#46;Pozo-Rosich"
                        "titulo" => "Gu&#237;a oficial de pr&#225;ctica cl&#237;nica en cefaleas"
                        "paginaInicial" => "59"
                        "paginaFinal" => "86"
                        "serieFecha" => "2015"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pathogenicity and transmissibility of 2019-nCoV&#46; A quick overview and comparison with other emerging viruses"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46; Chen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Microb Infect"
                        "fecha" => "2020"
                        "volumen" => "22"
                        "paginaInicial" => "69"
                        "paginaFinal" => "71"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Material y documentos sobre el lavado de manos"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "Organizaci&#243;n Mundial de la Salud"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:1 [
                        "fecha" => "2010"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Centers for Disease Control and Prevention&#46; Coronavirus Disease 2019 &#40;COVID-19&#41;&#46; Available from <a target="_blank" href="https://www.cdc.gov/coronavirus/2019-ncov/faq.html">https&#58;&#47;&#47;www&#46;cdc&#46;gov&#47;coronavirus&#47;2019-ncov&#47;faq&#46;html&#35;How-to-Protect-Yourself</a> &#91;accessed 28&#46;04&#46;20&#93;"
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "La gesti&#243;n de la asistencia neurol&#243;gica en tiempos de la pandemia de COVID-19"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46; Mat&#237;as-Guiu"
                            1 => "J&#46; Porta-Etessam"
                            2 => "E&#46; L&#243;pez-Vald&#233;s"
                            3 => "I&#46; Garc&#237;a-Morales"
                            4 => "A&#46; Guerrero- Sol&#225;"
                            5 => "J&#46;A&#46; Mat&#237;as-Guiu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.nrl.2020.04.001"
                      "Revista" => array:2 [
                        "tituloSerie" => "Neurologia"
                        "fecha" => "2020"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cartera de servicios y cuadro b&#225;sico de indicadores de calidad para las unidades de cefalea&#58; estudio de consenso"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "I&#46; Carrillo"
                            1 => "P&#46; Pozo-Rosich"
                            2 => "M&#46; Guilabert"
                            3 => "M&#46; Ignacio"
                            4 => "J&#46; Pascual"
                            5 => "J&#46; Porta-Etessam"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Neurol"
                        "fecha" => "2019"
                        "volumen" => "68"
                        "paginaInicial" => "118"
                        "paginaFinal" => "122"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30687919"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Correo electr&#243;nico de una consulta monogr&#225;fica de cefaleas&#58; experiencia durante cinco a&#241;os"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46;I&#46; Pedraza"
                            1 => "S&#46; Herrero-Vel&#225;zquez"
                            2 => "L&#46; L&#243;pez Mesonero"
                            3 => "M&#46; Ru&#237;z-Pi&#241;ero"
                            4 => "A&#46;L&#46; Guerrero-Peral"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Neurol"
                        "fecha" => "2015"
                        "volumen" => "60"
                        "paginaInicial" => "543"
                        "paginaFinal" => "547"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26062826"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Quality assurance in specialized headache units in Spain&#58; an observational prospective study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Pozo-Rosich"
                            1 => "A&#46; Mart&#237;nez-Garc&#237;a"
                            2 => "J&#46; Pascual"
                            3 => "E&#46; Ignacio"
                            4 => "A&#46;L&#46; Guerrero-Peral"
                            5 => "J&#46; Balseiro-G&#243;mez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s10194-019-1020-1"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Headache Pain"
                        "fecha" => "2019"
                        "volumen" => "20"
                        "paginaInicial" => "73"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31238877"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735808/0000003500000005/v1_202006270652/S217358082030105X/v1_202006270652/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "9491"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original Articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21735808/0000003500000005/v1_202006270652/S217358082030105X/v1_202006270652/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217358082030105X?idApp=UINPBA00004N"
]

Article information

ISSN: 21735808
Original language: English

DOI:10.1016/j.nrleng.2020.05.010

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 November	7	1	8
2024 October	14	1	15
2024 September	20	3	23
2024 August	38	2	40
2024 July	24	3	27
2024 June	15	4	19
2024 May	18	2	20
2024 April	24	4	28
2024 March	51	5	56
2024 February	29	6	35
2024 January	21	9	30
2023 December	23	11	34
2023 November	35	6	41
2023 October	40	5	45
2023 September	18	4	22
2023 August	26	9	35
2023 July	14	6	20
2023 June	19	4	23
2023 May	42	6	48
2023 April	39	11	50
2023 March	26	9	35
2023 February	24	3	27
2023 January	21	6	27
2022 December	16	11	27
2022 November	24	11	35
2022 October	28	14	42
2022 September	18	13	31
2022 August	27	11	38
2022 July	23	5	28
2022 June	30	4	34
2022 May	27	10	37
2022 April	32	8	40
2022 March	41	7	48
2022 February	32	10	42
2022 January	50	5	55
2021 December	40	7	47
2021 November	26	8	34
2021 October	56	11	67
2021 September	35	7	42
2021 August	20	9	29
2021 July	23	17	40
2021 June	19	12	31
2021 May	26	9	35
2021 April	63	23	86
2021 March	22	5	27
2021 February	23	8	31
2021 January	18	9	27
2020 December	18	10	28
2020 November	12	9	21
2020 October	12	10	22
2020 September	18	11	29
2020 August	26	14	40
2020 July	44	9	53
2020 June	9	14	23

Show all

Indexed in:

Follow us:

Statistics

Indexed in:

Follow us:

Statistics

Subscribe to our newsletter