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array:23 [ "pii" => "S0025775300715752" "issn" => "00257753" "doi" => "10.1016/S0025-7753(00)71575-2" "estado" => "S300" "fechaPublicacion" => "2000-01-01" "aid" => "71575" "copyright" => "Elsevier España, S.L.. Todos los derechos reservados" "copyrightAnyo" => "2000" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Med Clin. 2000;115:405-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1734 "formatos" => array:3 [ "EPUB" => 8 "HTML" => 1587 "PDF" => 139 ] ] "itemSiguiente" => array:18 [ "pii" => "S0025775300715764" "issn" => "00257753" "doi" => "10.1016/S0025-7753(00)71576-4" "estado" => "S300" "fechaPublicacion" => "2000-01-01" "aid" => "71576" "copyright" => "Elsevier España, S.L." "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Med Clin. 2000;115:410-7" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1984 "formatos" => array:3 [ "EPUB" => 6 "HTML" => 1780 "PDF" => 198 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Evaluación de la comprensión de un nuevo modelo de prospecto del medicamento" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "410" "paginaFinal" => "417" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Assessment of the comprehension of a new rephrasing drug package inserts" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ángels Vidal Miquel, Francisca Ortín Font, Jaume Marrugat, Marco Pavesi" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Ángels" "apellidos" => "Vidal Miquel" ] 1 => array:2 [ "nombre" => "Francisca" "apellidos" => "Ortín Font" ] 2 => array:2 [ "nombre" => "Jaume" "apellidos" => "Marrugat" ] 3 => array:2 [ "nombre" => "Marco" "apellidos" => "Pavesi" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775300715764?idApp=UINPBA00004N" "url" => "/00257753/0000011500000011/v1_201307291745/S0025775300715764/v1_201307291745/es/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0025775300715740" "issn" => "00257753" "doi" => "10.1016/S0025-7753(00)71574-0" "estado" => "S300" "fechaPublicacion" => "2000-01-01" "aid" => "71574" "copyright" => "Elsevier España, S.L." "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Med Clin. 2000;115:401-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1381 "formatos" => array:3 [ "EPUB" => 5 "HTML" => 1240 "PDF" => 136 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Resistencias genotípicas a los fármacos antirretrovirales en fracasos terapéuticos con pautas de alta eficacia" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "401" "paginaFinal" => "404" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Genotypic resistance to antiretroviral drugs in patients with therapeutic failure to highly active antiretroviral therapy." ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Félix Gutiérrez, José Moltó, Clara Escolano, A. Mora, Francisco Pasquau, Joan Gregori, Enrique. Nogueira" "autores" => array:7 [ 0 => array:2 [ "nombre" => "Félix" "apellidos" => "Gutiérrez" ] 1 => array:2 [ "nombre" => "José" "apellidos" => "Moltó" ] 2 => array:2 [ "nombre" => "Clara" "apellidos" => "Escolano" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Mora" ] 4 => array:2 [ "nombre" => "Francisco" "apellidos" => "Pasquau" ] 5 => array:2 [ "nombre" => "Joan" "apellidos" => "Gregori" ] 6 => array:2 [ "nombre" => "Enrique." "apellidos" => "Nogueira" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775300715740?idApp=UINPBA00004N" "url" => "/00257753/0000011500000011/v1_201307291745/S0025775300715740/v1_201307291745/es/main.assets" ] "es" => array:14 [ "idiomaDefecto" => true "titulo" => "Feocromocitoma asociado a neoplasia endocrina múltiple 2A y esporádico: características diferenciales" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "405" "paginaFinal" => "409" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Albert Lecube, Cristina Hernández, Josep Oriola, José Luis Tovar, Enrique Gémar, Juan Antonio Baena, Jordi Mesa, Rafael Simó" "autores" => array:8 [ 0 => array:3 [ "nombre" => "Albert" "apellidos" => "Lecube" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "Cristina" "apellidos" => "Hernández" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Josep" "apellidos" => "Oriola" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "José" "apellidos" => "Luis Tovar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 4 => array:3 [ "nombre" => "Enrique" "apellidos" => "Gémar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 5 => array:3 [ "nombre" => "Juan" "apellidos" => "Antonio Baena" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 6 => array:3 [ "nombre" => "Jordi" "apellidos" => "Mesa" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 7 => array:4 [ "nombre" => "Rafael" "apellidos" => "Simó" "email" => array:1 [ 0 => "rsimo@hg.vhebron.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Sección de Endocrinología. Hospital General Vall d'Hebron." "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Hormonología.Hospital Clinic i Provincial. Barcelona." "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Nefrologia. Hospital General Vall d'Hebron." "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Unidad de Cirugía Endocrina. Hospital General Vall d'Hebron." "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Dr. R. Simó. Sección de Endocrinología. Hospital General Vall d'Hebron. Passeig Vall d'Hebron, 119-129. 08035 Barcelona." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Distinctive clinic features of pheochromocytoma in the setting of multiple endocrine neoplasia 2A" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "1999-11-11" "fechaAceptado" => "2000-07-12" "PalabrasClave" => array:1 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec223090" "palabras" => array:4 [ 0 => "Feocromocitoma" 1 => "Neoplasia endocrina múltiple tipo 2<span class="elsevierStyleSup">a</span>" 2 => "Hipertensión arterial" 3 => "Catecolaminas" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Fundamento</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Estudiar las características diferenciales entre el feocromocitoma en el contexto de una neoplasia endocrina múltiple 2A (MEN 2A) y el de presentación esporádica.</p> <span class="elsevierStyleSectionTitle">Pacientes y método</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron todos los pacientes diagnosticados de feocromocitoma esporádico (n = 29) y en el contexto de un MEN 2A (n = 16) entre 1976 y 1998 en un hospital de referencia. Se compararon las siguientes variables: edad en el momento del diagnóstico, síntomas, presencia y características de la hipertensión arterial, tamaño tumoral, localización y malignidad. También se evaluó el rendimiento de las pruebas diagnósticas.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">El feocromocitoma asociado al MEN 2A presentó una elevada prevalencia en este estudio (35,5%) y su diagnóstico se realizó a edades más tempranas que el feocromocitoma esporádico (29,1 [7,8] frente a 47,5 [10,9] años; p < 0,001). La elevada frecuencia de bilate-ralidad (el 81,25 frente al 3,44%; p < 0,001), la ausencia de síntomas (el 44 frente al 11%; p < 0,05) y el predominio de la hipertensión arterial en forma de crisis paroxística fueron las principales características que lo diferenciaron del feocromocitoma esporádico. Entre las pruebas diagnósticas cabe destacar la baja sensibilidad (60%) de la determinación de ácido vanilil-mandélico para el diagnóstico del feocromocitoma asociado al MEN 2A.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El feocromocitoma del MEN 2A se diagnostica a edades más tempranas y con frecuencia es bilateral y asintomático. Dada la alta prevalencia de MEN 2A en nuestra área, debería realizarse un estudio genético para descartarla en todo paciente con feocromocitoma, especialmente si es bilateral.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To study distinctive clinical features of pheochromocytoma in the setting of multiple endocrine neoplasia type 2A (MEN 2A) in comparison with sporadic pheochromocytoma.</p> <span class="elsevierStyleSectionTitle">Patients and method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">All patients diagnosed of sporadic pheochromocytoma (n = 29) and in the setting of MEN 2A (n = 16) between 1976 and 1998 in a tertiary hospital were included in the study. The following variables were compared: age at diagnosis, symptoms, presence and characteristics of hypertension, size of the tumor, localization and malignancy. The accuracy of diagnostic tests was also evaluated.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The pheochromocytoma associated to MEN 2A had a higher prevalence in our study (35.5%) and the diagnosis was performed earlier than for sporadic pheochromocytoma (29.1 [7.8] vs. 47,5 [10.9] years; p < 0.001). Other distinctive features in comparison with sporadic pheochromocytoma were: bilaterality (81.25 vs. 3.44%; p < 0.001), absence of symptoms (44 vs 11%; p < 0.05) and paroxysmal hypertension. Concerning the diagnostic tests, it must be noted the low sensitivity (60%) of vanillylmandelic acid in MEN 2A.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The pheochromocytoma in the setting of MEN 2A is diagnosed at younger age and frequently asymptomatic and bilateral. In view of the high prevalence of MEN 2A in our country, a genetic analysis should be performed in all patients with pheochromocytoma, especially when it is bilateral.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias BibliogrÁFicas" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:26 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "W.M. Manger" 1 => "R.W. Gifford" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:4 [ "titulo" => "Pheochromocytoma" "fecha" => "1977" "editorial" => "Springer-Verlag" "editorialLocalizacion" => "Nueva York" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2." 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