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Patología crónica, fragilidad y funcionalidad en adultos mayores de Guadalajara. México
Chronic pathology, frailty, and functionality in older adults from Guadalajara. Mexico
Ana L. Salcedo Rocha, Javier E. García de Alba García
, Susana de la Rosa Hernández
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Unidad de investigación Social, Epidemiológica y de Servicios de Salud (UISESS), del Instituto Mexicano del Seguro Social (IMSS), Guadalajara, Jalisco, México
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México" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">Sr. Editor:</span>" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "511" "paginaFinal" => "513" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Ana L. Salcedo Rocha, Javier E. García de Alba García, Susana de la Rosa Hernández" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Ana L." "apellidos" => "Salcedo Rocha" ] 1 => array:4 [ "nombre" => "Javier E." "apellidos" => "García de Alba García" "email" => array:1 [ 0 => "Javier_91046@yahoo.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 2 => array:2 [ "nombre" => "Susana" "apellidos" => "de la Rosa Hernández" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Unidad de investigación Social, Epidemiológica y de Servicios de Salud (UISESS), del Instituto Mexicano del Seguro Social (IMSS), Guadalajara, Jalisco, México" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Autor para correspondencia." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Chronic pathology, frailty, and functionality in older adults from Guadalajara. Mexico" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">En nuestro medio se ha estudiado poco la relación entre DM2 y HAS con ciertas condiciones como fragilidad, funcionalidad y depresión, a las cuales se les atribuye incrementar el riesgo de morbilidad, hospitalización y mortalidad en los adultos mayores, sea de manera independiente o asociada<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a>.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Esta situación de riesgo es compleja debido a que en los padecimientos y las condiciones antes señaladas se pueden evidenciar durante o después de situaciones estresantes, que ponen de manifiesto la eficiencia de los aparatos y sistemas involucrados.</p><p id="par0015" class="elsevierStylePara elsevierViewall">En lo que se refiere a la depresión, en el caso de México, en adultos mayores, se reporta una prevalencia general de 9%, y hasta del 25% para personas marginadas<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a>.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Por lo anterior, nos propusimos determinar la prevalencia del síndrome de fragilidad bajo los criterios de Fried, la funcionalidad y el nivel de depresión en adultos mayores con hipertensión arterial o diabetes mellitus, usuarios de una clínica de medicina familiar, que cubre una gran área de estrato popular de la ciudad de Guadalajara, Jalisco.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Al efecto realizamos un diseño observacional mediante un estudio descriptivo y transversal en la Unidad de Medicina Familiar #3 (UMF) de Guadalajara, México, donde asisten 28.766 personas mayores de 60 años, usuarios de la consulta externa.</p><p id="par0030" class="elsevierStylePara elsevierViewall">La muestra fue calculada con un 95% de confianza y 80% de potencia, y se estimó en 200 personas, proporcional por grupos quinquenales de edad y sexo para cada uno de los 2 grupos de análisis: pacientes con diagnóstico médico de DM2 y de HTA, que consintieron informadamente participar. No se incluyeron pacientes con incapacidad cognitiva o física.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Se registraron datos sociodemográficos y relacionados con el síndrome de fragilidad de acuerdo a Fried<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">3,4</span></a>, las escalas: PASE y Calderón Narváez<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> (que mide ansiedad y depresión). Índices de: Katz y Lawton y Brody. El tiempo de aplicación promedio fue de 45<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleHsp" style=""></span>minutos.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Los cuestionarios que se registraron y analizaron con ayuda del programa SPSS 15 Evidenciaron, respectivamente, en los pacientes con DM2 y HAS, una edad promedio de 69,5 y 70,3 años; 53% y 64% fueron mujeres, 48% y 63% tuvieron escolaridad secundaria o superior (p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,05), 92% y 93% ingresaban 2 o menos salarios mínimos, además 53% y 57% estaban casados.</p><p id="par0045" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> se muestra respecto a la escala PASE que en DM2 hay más fragilidad ligada a la no actividad física, y en HTA más prefragilidad en personas que no hacen actividad física (p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,0000).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">Para la escala Katz hay menores frecuencias de independencia para ABVD en las personas frágiles, con DM2 (p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,001), y en la escala Lawton-Brody se observa más frecuencia de puntuaciones bajas para AIVD en personas frágiles con DM2 y en prefrágiles con HTA.</p><p id="par0055" class="elsevierStylePara elsevierViewall">En la Escala de depresión hay más frecuencia de ansiedad en las personas frágiles con DM2, y mayor depresión y ansiedad en las personas con HTA (p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,0000<span class="elsevierStyleBold">).</span></p><p id="par0060" class="elsevierStylePara elsevierViewall">En suma, el estudio evidencia en pacientes de estratos populares de Guadalajara, México, una prevalencia de fragilidad de 17% en el grupo con DM2, y 8% en pacientes con HTA.</p><p id="par0065" class="elsevierStylePara elsevierViewall">Se confirma la prevalencia de falta de ejercicio físico de 56% en el grupo con DM2 y 52,5% en el grupo con HTA.</p><p id="par0070" class="elsevierStylePara elsevierViewall">Se registran frecuencias de prefragilidad-fragilidad que sugieren poca prevención del síndrome, más evidente en el grupo con DM2.</p><p id="par0075" class="elsevierStylePara elsevierViewall">La prevalencia de incapacidad para ABVD (15% en grupo con DM2 y 20% en grupo con HTA) y de incapacidad para AIVD (de 83% en grupo DM2 y 90% en grupo HTA), así como la frecuencia de depresión-ansiedad (31% en DM2 y 40% en HTA) constituye una barrera para la prevención y la atención de la fragilidad en personas de estrato popular.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Financiación</span><p id="par0080" class="elsevierStylePara elsevierViewall">Este estudio fue apoyado por el Instituto Mexicano del Seguro Social: FIS/IMSS/PROT/PRIO/13/022 R-2012-785-099. 2013-TE.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Financiación" ] 1 => array:1 [ "titulo" => "Bibliografía" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:6 [ "identificador" => "tbl0005" "etiqueta" => "Tabla 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">En la Escala de Lawton-Brody<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>5 tendencia a desarrollar más actividades instrumentales.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Ans: ansiedad; Inc Lev: incapacidad leve; Inc Mod: incapacidad moderada; Inc Sev: incapacidad severa; Ind: independiente; Min: mínima; Norm: normal; Sev: severa.</p>" "tablatextoimagen" => array:4 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">GRUPO \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Diabetes Mellitus tipo 2 n=200</th><th class="td" title="table-head " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Hipertensión Arterial n=200</th></tr><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">ESCALAS \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Escala PASE</th><th class="td" title="table-head " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Escala PASE</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Actividad física \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No activ física \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Significancia \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Actividad física \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No activ física \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Significancia \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Frágil \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0 (0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">34 (17%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Ji<span class="elsevierStyleSup">2</span>=34.57<br>P<0.0000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6 (3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10(5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Ji<span class="elsevierStyleSup">2</span>=10.28<br>P=0.005 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pre frágil \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">50(25%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">35 (17.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">26(13%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">44(22%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">38(19%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">43(21.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">63(31.5% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">51(25.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">88 (44%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">112 (66%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">95(47.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">105(52.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">significancia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " colspan="6" align="center" valign="top">Ji<span class="elsevierStyleSup">2</span>= 0.4936, p= 0.4823</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">especificaciones \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1862345.png" ] ] 1 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">ESCALAS \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="5" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Escala Katz</th><th class="td" title="table-head " colspan="5" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Escala Katz</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Ind \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Inc Lev \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Inc<br>Mod \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Inc<br>Sev \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Significancia \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Ind \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Inc lev \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Inc<br>Mod \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Inc<br>Sev \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Significancia \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Frágil \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">19 (9.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6<br>(3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5<br>(2.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4<br>(2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " rowspan="3" align="left" valign="top">Ji<span class="elsevierStyleSup">2</span>=27.75<br>P=0.0001</td><td class="td" title="table-entry " align="left" valign="top">11<br>(5.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2<br>(1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2<br>(1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1<br>(0.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " rowspan="3" align="left" valign="top">Ji<span class="elsevierStyleSup">2</span>= 10.13<br>P=0.11</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pre frágil \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">74<br>(37%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6<br>(3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5<br>(2.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0<br>(0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">58<br>(29%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8<br>(4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2<br>(1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2<br>(1%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">67<br>(33.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8<br>(4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6<br>(3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0<br>(0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">102<br>(51%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8<br>(4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4<br>(2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0<br>(0%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">160<br>(80%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">20<br>(10%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">16<br>(8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4<br>(2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">171<br>(85.%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">18<br>(9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8<br>(4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3<br>(2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">significancia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " colspan="10" align="center" valign="top">Ji<span class="elsevierStyleSup">2</span>= 6.0977, p= 0.1070</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">especificaciones \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " colspan="10" align="center" valign="top">Ind= independiente, Inc Lev= incapacidad leve, Inc Mod= incapacidad moderada, Inc Sev= incapacidad severa</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1862347.png" ] ] 2 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">ESCALAS<br>VALOR \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="6" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Escala Lawton-Brody</th><th class="td" title="table-head " colspan="6" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Escala Lawton-Brody</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">4 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">5 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">6 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">7 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">8 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sig \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">4 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">5 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">6 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">7 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">8 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sig \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Frágil \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2<br>(1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3<br>(1.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2<br>(1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12<br>(6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15<br>(7.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " rowspan="3" align="left" valign="top">Ji<span class="elsevierStyleSup">2</span>=33.88<br>P<0.0000</td><td class="td" title="table-entry " align="left" valign="top">3<br>(0.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0<br>(0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0<br>(0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2<br>(1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">11<br>(6.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " rowspan="3" align="left" valign="top">Ji<span class="elsevierStyleSup">2</span>=26.17<br>P=0.001</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pre frágil \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0<br>(0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0<br>(0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5<br>(2.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">16<br>(8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">64<br>(32%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0<br>(0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2<br>(1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4<br>(2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8<br>(4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">56<br>(28%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0<br>(0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0<br>(0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2<br>(1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15<br>(7.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">64<br>(32%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0<br>(0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0<br>(0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12<br>(6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2<br>(1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">100<br>(50%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2<br>(1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3<br>(1.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9<br>(4.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">43<br>(21.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">143<br>(71.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3<br>(2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2<br>(1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">16<br>(8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12<br>(6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">167<br>(83% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">significancia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " colspan="12" align="center" valign="top">Ji<span class="elsevierStyleSup">2</span>= 22.13, p=0.0002</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">especificaciones \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " colspan="12" align="center" valign="top">Escala> 5 tendencia a desarrollar más actividades instrumentales</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1862348.png" ] ] 3 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">ESCALAS \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="5" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Escala de Depresión</th><th class="td" title="table-head " colspan="5" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Escala de Depresión</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Norm \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Min \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sev \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Ans \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Significancia \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Norm \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Min \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sev \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Ans \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Significancia \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Frágil \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4<br>(2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8<br>(4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0<br>(0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">22<br>(11%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " rowspan="3" align="left" valign="top">Ji<span class="elsevierStyleSup">2</span>=64.07<br>P<0.0000</td><td class="td" title="table-entry " align="left" valign="top">4<br>(2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6<br>(3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0<br>(0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6<br>(3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " rowspan="3" align="left" valign="top">Ji<span class="elsevierStyleSup">2</span>= 26.61<br>P<0.0002</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pre frágil \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">67<br>(33%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4<br>(2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0<br>(0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">14<br>(7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">32<br>(16%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">22<br>(11%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2<br>(1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">14<br>(7%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">68<br>(34%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5<br>2.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0<br>(0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8<br>(4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">85<br>(42.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">14<br>(7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2<br>(6.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13<br>(1%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">139<br>(69%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">17<br>(9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0<br>(0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">44<br>(22%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">121<br>(60%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">42<br>(21%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4<br>(2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">33<br>(17%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">significancia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " colspan="10" align="center" valign="top">Ji<span class="elsevierStyleSup">2</span>= 17.41, p= 0.0006</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">especificaciones \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " colspan="10" align="center" valign="top">Norm= Normal, Min= Mínima, Sev= Severa, Ans= Ansiedad</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1862346.png" ] ] ] ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Frailty prevalence and associated factors in the Mexican health and aging study: A comparison of the frailty index and the phenotype Exp" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C. Garcia Peña" 1 => "F. Avila" 2 => "J.A. Denc" 3 => "E. Gutierrez Robledo" 4 => "L.M. Perez Zepeda" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.exger.2016.03.016" "Revista" => array:5 [ "tituloSerie" => "Gerontol" "fecha" => "2016" "volumen" => "79" "paginaInicial" => "55" "paginaFinal" => "60" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Depresión y función cognitiva en adultos mayores de una comunidad urbano-marginal" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "T. Duran Badillo" 1 => "R.M. Aguilar" 2 => "M.L. Martinez" 3 => "T. Rodriguez" 4 => "G. Gutierrez" 5 => "L. Vazquez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Enferm Univ" "fecha" => "2013" "volumen" => "10" "paginaInicial" => "36" "paginaFinal" => "42" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalencia de fragilidad en una población urbana de mayores de 65 años y su relación con morbilidad y discapacidad" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M.V. Castell Alcalá" 1 => "A. Otero Puime" 2 => "M.T. Sánchez Santos" 3 => "A. Garrido Barral" 4 => "J.I. González Montalvo" 5 => "M.V. Zunzunegui" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.aprim.2009.09.024" "Revista" => array:6 [ "tituloSerie" => "Aten Primaria" "fecha" => "2010" "volumen" => "42" "paginaInicial" => "520" "paginaFinal" => "527" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20116137" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "M 146-56" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fraitly in older adults: Evidence for a phenotype" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L.P. Fried" 1 => "C.M. Tangen" 2 => "J. Walston" 3 => "A.B. Newman" 4 => "C. Hirsch" 5 => "J. Gottdiener" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "J Gerontol A Biol Sci Med Sci" "fecha" => "2001" "volumen" => "56" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cuestionario clínico para diagnosticar depresión" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "G. Calderón Narváez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Med IMSS" "fecha" => "1992" "volumen" => "30" "numero" => "5/6" "paginaInicial" => "377" "paginaFinal" => "380" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/02126567/0000005000000008/v2_201810020613/S0212656717307928/v2_201810020613/es/main.assets" "Apartado" => array:4 [ "identificador" => "37603" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Cartas al editor" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/02126567/0000005000000008/v2_201810020613/S0212656717307928/v2_201810020613/es/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0212656717307928?idApp=UINPBA00004N" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 3 | 1 | 4 |
| 2024 Octubre | 13 | 2 | 15 |
| 2024 Septiembre | 23 | 4 | 27 |
| 2024 Agosto | 24 | 4 | 28 |
| 2024 Julio | 13 | 3 | 16 |
| 2024 Junio | 14 | 4 | 18 |
| 2024 Mayo | 26 | 3 | 29 |
| 2024 Abril | 31 | 5 | 36 |
| 2024 Marzo | 40 | 8 | 48 |
| 2024 Febrero | 32 | 8 | 40 |
| 2024 Enero | 28 | 11 | 39 |
| 2023 Diciembre | 23 | 6 | 29 |
| 2023 Noviembre | 45 | 4 | 49 |
| 2023 Octubre | 46 | 13 | 59 |
| 2023 Septiembre | 26 | 4 | 30 |
| 2023 Agosto | 22 | 2 | 24 |
| 2023 Julio | 18 | 11 | 29 |
| 2023 Junio | 21 | 8 | 29 |
| 2023 Mayo | 52 | 14 | 66 |
| 2023 Abril | 20 | 10 | 30 |
| 2023 Marzo | 20 | 3 | 23 |
| 2023 Febrero | 13 | 3 | 16 |
| 2023 Enero | 15 | 7 | 22 |
| 2022 Diciembre | 15 | 7 | 22 |
| 2022 Noviembre | 35 | 8 | 43 |
| 2022 Octubre | 31 | 9 | 40 |
| 2022 Septiembre | 31 | 22 | 53 |
| 2022 Agosto | 42 | 8 | 50 |
| 2022 Julio | 29 | 11 | 40 |
| 2022 Junio | 30 | 17 | 47 |
| 2022 Mayo | 40 | 10 | 50 |
| 2022 Abril | 45 | 15 | 60 |
| 2022 Marzo | 38 | 20 | 58 |
| 2022 Febrero | 30 | 12 | 42 |
| 2022 Enero | 42 | 16 | 58 |
| 2021 Diciembre | 65 | 10 | 75 |
| 2021 Noviembre | 45 | 23 | 68 |
| 2021 Octubre | 43 | 26 | 69 |
| 2021 Septiembre | 33 | 15 | 48 |
| 2021 Agosto | 40 | 15 | 55 |
| 2021 Julio | 36 | 20 | 56 |
| 2021 Junio | 52 | 20 | 72 |
| 2021 Mayo | 49 | 27 | 76 |
| 2021 Abril | 116 | 76 | 192 |
| 2021 Marzo | 76 | 36 | 112 |
| 2021 Febrero | 64 | 20 | 84 |
| 2021 Enero | 78 | 22 | 100 |
| 2020 Diciembre | 64 | 18 | 82 |
| 2020 Noviembre | 52 | 18 | 70 |
| 2020 Octubre | 55 | 12 | 67 |
| 2020 Septiembre | 65 | 32 | 97 |
| 2020 Agosto | 48 | 18 | 66 |
| 2020 Julio | 25 | 14 | 39 |
| 2020 Junio | 30 | 22 | 52 |
| 2020 Mayo | 31 | 14 | 45 |
| 2020 Abril | 33 | 7 | 40 |
| 2020 Marzo | 33 | 17 | 50 |
| 2020 Febrero | 22 | 12 | 34 |
| 2020 Enero | 30 | 9 | 39 |
| 2019 Diciembre | 30 | 14 | 44 |
| 2019 Noviembre | 9 | 13 | 22 |
| 2019 Octubre | 27 | 9 | 36 |
| 2019 Septiembre | 17 | 8 | 25 |
| 2019 Agosto | 14 | 5 | 19 |
| 2019 Julio | 28 | 25 | 53 |
| 2019 Junio | 57 | 28 | 85 |
| 2019 Mayo | 161 | 27 | 188 |
| 2019 Abril | 65 | 23 | 88 |
| 2019 Marzo | 18 | 17 | 35 |
| 2019 Febrero | 20 | 13 | 33 |
| 2019 Enero | 12 | 6 | 18 |
| 2018 Diciembre | 13 | 9 | 22 |
| 2018 Noviembre | 25 | 17 | 42 |
| 2018 Octubre | 128 | 40 | 168 |
| 2018 Septiembre | 7 | 7 | 14 |
| 2018 Agosto | 1 | 5 | 6 |
| 2018 Julio | 3 | 7 | 10 |
| 2018 Junio | 2 | 11 | 13 |
| 2018 Mayo | 0 | 6 | 6 |
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