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array:22 [ "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.. Todos los derechos reservados" "copyrightAnyo" => "2000" "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 ] ] "itemSiguiente" => array:18 [ "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." "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 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Feocromocitoma asociado a neoplasia endocrina múltiple 2A y esporádico: características diferenciales" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "405" "paginaFinal" => "409" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Distinctive clinic features of pheochromocytoma in the setting of multiple endocrine neoplasia 2A" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Albert Lecube, Cristina Hernández, Josep Oriola, José Luis Tovar, Enrique Gémar, Juan Antonio Baena, Jordi Mesa, Rafael Simó" "autores" => array:8 [ 0 => array:2 [ "nombre" => "Albert" "apellidos" => "Lecube" ] 1 => array:2 [ "nombre" => "Cristina" "apellidos" => "Hernández" ] 2 => array:2 [ "nombre" => "Josep" "apellidos" => "Oriola" ] 3 => array:2 [ "nombre" => "José" "apellidos" => "Luis Tovar" ] 4 => array:2 [ "nombre" => "Enrique" "apellidos" => "Gémar" ] 5 => array:2 [ "nombre" => "Juan" "apellidos" => "Antonio Baena" ] 6 => array:2 [ "nombre" => "Jordi" "apellidos" => "Mesa" ] 7 => array:2 [ "nombre" => "Rafael" "apellidos" => "Simó" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775300715752?idApp=UINPBA00004N" "url" => "/00257753/0000011500000011/v1_201307291745/S0025775300715752/v1_201307291745/es/main.assets" ] "es" => array:14 [ "idiomaDefecto" => true "titulo" => "Resistencias genotípicas a los fármacos antirretrovirales en fracasos terapéuticos con pautas de alta eficacia" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "401" "paginaFinal" => "404" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Félix Gutiérrez, José Moltó, Clara Escolano, A. Mora, Francisco Pasquau, Joan Gregori, Enrique. Nogueira" "autores" => array:7 [ 0 => array:4 [ "nombre" => "Félix" "apellidos" => "Gutiérrez" "email" => array:1 [ 0 => "fgutierrezr@medynet.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "José" "apellidos" => "Moltó" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Clara" "apellidos" => "Escolano" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "A." "apellidos" => "Mora" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "Francisco" "apellidos" => "Pasquau" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 5 => array:3 [ "nombre" => "Joan" "apellidos" => "Gregori" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 6 => array:3 [ "nombre" => "Enrique." "apellidos" => "Nogueira" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:5 [ 0 => array:3 [ "entidad" => "Unidad de Enfermedades Infecciosas. Servicio de Medicina Interna. Hospital General Universitario de Elche." "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Medicina Interna. Hospital Comarcal de la Marina Baja. Villajoyosa." "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Medicina Interna. Hospital Comarcal de la Vega Baja. Orihuela." "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Laboratorio de Diagnóstico Molecular DIENEI. Valencia." "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Departamento de Medicina. Universidad Miguel Hernández. Alicante." "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Dr. F. Gutiérrez Rodero. Unidad de Enfermedades Infecciosas. Hospital General Universitario de Elche. Huertos y Molinos, s/n. 03202 Elche. Alicante." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Genotypic resistance to antiretroviral drugs in patients with therapeutic failure to highly active antiretroviral therapy." ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2000-03-14" "fechaAceptado" => "2000-07-25" "PalabrasClave" => array:1 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec223092" "palabras" => array:4 [ 0 => "Resistencias genotípicas" 1 => "Infección por el virus de la inmunodeficiencia humana" 2 => "Terapia antirretroviral" 3 => "Fracaso del tratamiento" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Fundamento</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Caracterizar las mutaciones asociadas con resistencia en fracasos virológicos con tratamientos antirretrovirales de gran actividad (TARGA).</p> <span class="elsevierStyleSectionTitle">Métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio genotípico de la transcriptasa inversa y de la proteasa del VIH-1 en 33 pacien-tes con fracaso virológico, pese al buen cumplimiento del tratamiento.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se detectaron mutaciones en 32 de los 33 pacientes. En 27 (81,8%) se trataba de mutaciones primarias: en el gen de la transcriptasa inversa en 26 (78,8%) y en el de la protea-sa en 20 (60,6%). El 66,6% presentaba resistencias a dos fármacos y el 60,6% resistencias a fármacos de los dos principales grupos terapéuticos. En el momento del fracaso, el 72,7% de los pacientes recibía al menos un fármaco frente al que se identificaron genotipos resistentes; el 48,5%, dos fármacos, y el 21,2%, tres fármacos.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La mayoría de los pacientes que fracasan pese al buen cumplimiento del trata-miento con TARGA presentan genotípos virales resistentes. Puede estar constituyéndose un reservorio de VIH multirresistentes que puede comprometer en el futuro el éxito del tratamiento antirretroviral.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To assess genotypic resistance mutations in patients with virological failure with highly active antiretroviral therapy (HAART)</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Genotyping of reverse transcriptase (RT) and protease (PRO) HIV-1 genes were ca-rried out in 33 adherent patients failing on HAART.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Resistance mutations were found in 32 of the 33; 27 of them (81.8%) being primary mutations: 26 (78.8%) in the RT gene and 60 (60.6%) in the PRO gene. Overall, 66.6% had genotypic resistance to two drugs and 60.6% showed resistance to drugs belonging to the two main classes of antiretroviral drugs. At the time of treatment failure, 72.7% had on their thera-peutic regimen one antiretroviral drug to which they had resistance mutations, 48.5% had ge-notypic resistance to two drugs of the therapeutic regimen and 21.2% to three drugs.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Most adherent patients failing on HAART carry drug resistant genotypes. These pa-tients may constitute a reservoir of multidrug resistant HIV that may limit treatment options in the future.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias Bibliográficas" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:14 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "HIV, RNA and CD4 cell count response to protease inhibitor therapy in an ur-ban AIDS clinic: response to both initial and sal-vage therapy." "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Deeks" 1 => "F. Hecht" 2 => "M. Swanson" 3 => "T. Elbeik" 4 => "R. Loftus" 5 => "P. Cohen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Aids" "fecha" => "1999" "volumen" => "13" "paginaInicial" => "35" "paginaFinal" => "43" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Resistance, fitness, adherence and potency." "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M. Markowitz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Jama" "fecha" => "2000" "volumen" => "283" "paginaInicial" => "250" "paginaFinal" => "251" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10634342" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sexual transmission of an HIV-1 variant resistant to multiple reverse-transcriptase and protease inhibitors." "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Hecht" 1 => "R. Grant" 2 => "C. Petropoulos" 3 => "B. Dillon" 4 => "M.A. Chesney" 5 => "N. Hellman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJM199807303390504" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "1998" "volumen" => "339" "paginaInicial" => "307" "paginaFinal" => "311" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9682043" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long-read direct infrared sequencing of crude PCR products for prediction of resistance to HIV-1 reverse transcriptase and protease inhibitors." "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Zazzi" 1 => "M. Riccio" 2 => "G. Venturi" 3 => "M. Catucci" 4 => "L. Romano" 5 => "A. De Milito" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/BF02745858" "Revista" => array:6 [ "tituloSerie" => "Mol Biotechnol" "fecha" => "1998" "volumen" => "10" "paginaInicial" => "1" "paginaFinal" => "8" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9779418" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Human immunodeficiency virus reverse transcriptase and protease sequence database." "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R. Shafer" 1 => "D. Stevenson" 2 => "B. Chan" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Nucleic Acids Re-search" "fecha" => "1999" "volumen" => "27" "paginaInicial" => "348" "paginaFinal" => "352" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Introduction of HIV drug-resistance testing in clinical practice." "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R. Rodríguez-Rosado" 1 => "C. Briones" 2 => "V. Soriano" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Aids" "fecha" => "1999" "volumen" => "13" "paginaInicial" => "1007" "paginaFinal" => "1014" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10397528" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Antire-troviral drug resistance testing in adult HIV-1 in-fection. Recommendations of an international AIDS society-USA panel." "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.S. Hirsch" 1 => "F. Brun-Vézinet" 2 => "R.T. D’Aquila" 3 => "S.M. Hammer" 4 => "V.A. Johnson" 5 => "D.R. Kuritzkes" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Jama" "fecha" => "2000" "volumen" => "283" "paginaInicial" => "2417" "paginaFinal" => "2426" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10815085" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Drug-resistance genotyping in HIV-1 therapy: the VIRADAPT randomized controlled trial." "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Durant" 1 => "P. Clevenbergh" 2 => "P. Halfon" 3 => "P. Delgudice" 4 => "S. Porsin" 5 => "P. Simonet" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "1999" "volumen" => "353" "paginaInicial" => "2195" "paginaFinal" => "2199" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10392984" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence of genotipic resistance to nucleoside analogues in antire-troviral-naive and antiretroviral experienced HIV-infected patients in Spain." "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Gómez-Cano" 1 => "A. Rubio" 2 => "T. Puig" 3 => "M. Pérez-Olmeda" 4 => "L. Ruiz" 5 => "V. Soriano" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Aids" "fecha" => "1998" "volumen" => "12" "paginaInicial" => "1015" "paginaFinal" => "1020" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9662197" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence of genotypic resistance to nucleoside analogues and protease inhibitors in Spain." "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T. Puig" 1 => "M. Pérez-Olmeda" 2 => "A. Rubio" 3 => "L. Ruiz" 4 => "C. Brio-nes" 5 => "J.M. Franco" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Aids" "fecha" => "2000" "volumen" => "14" "paginaInicial" => "727" "paginaFinal" => "732" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10807196" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rapid decline in detectability of HIV-1 drug resistance mutations after stopping therapy." "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "H.L. Devereux" 1 => "M. Youle" 2 => "M.A. Johnson" 3 => "C. Loveday" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Aids" "fecha" => "1999" "volumen" => "13" "paginaInicial" => "123" "paginaFinal" => "127" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Impact of drug resistance mutations on virologic response to salvage therapy." "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Lorenzi" 1 => "M. Opravil" 2 => "B. Hirschel" 3 => "J. Chave" 4 => "H. Furrer" 5 => "H. Sax" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Aids" "fecha" => "1999" "volumen" => "13" "paginaInicial" => "17" "paginaFinal" => "21" ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Resistance profiles in patients with viral rebound on potent antirretroviral therapy." "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Cozzi" 1 => "C. Sabin" 2 => "S. Staszewski" 3 => "K. Hertogs" 4 => "A. Mü-ller" 5 => "H. Rabenau" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1086/315301" "Revista" => array:7 [ "tituloSerie" => "J Infect Dis" "fecha" => "2000" "volumen" => "181" "paginaInicial" => "1143" "paginaFinal" => "1147" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10720543" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0016508597003673" "estado" => "S300" "issn" => "00165085" ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "HIV-1 genotypic resistance patterns predicts response to saquinavirritonavir therapy in patients in whom previous pro-tease inhibitor therapy had failed." "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Zolopa" 1 => "R. Schafer" 2 => "A. Warford" 3 => "J. Montoya" 4 => "P. Hsu" 5 => "D. Katzenstein" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Intern Med" "fecha" => "1999" "volumen" => "131" "paginaInicial" => "813" "paginaFinal" => "821" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10610625" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/00257753/0000011500000011/v1_201307291745/S0025775300715740/v1_201307291745/es/main.assets" "Apartado" => array:4 [ "identificador" => "24087" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Original breve" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/00257753/0000011500000011/v1_201307291745/S0025775300715740/v1_201307291745/es/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775300715740?idApp=UINPBA00004N" ]
