Statistics

 array:23 [
  "pii" => "S2173574310700058"
  "issn" => "21735743"
  "doi" => "10.1016/S2173-5743(10)70005-8"
  "estado" => "S300"
  "fechaPublicacion" => "2010-01-01"
  "aid" => "70005"
  "copyright" => "Sociedad Española de Reumatología and Colegio Mexicano de Reumatología"
  "copyrightAnyo" => "2010"
  "documento" => "article"
  "crossmark" => 0
  "subdocumento" => "fla"
  "cita" => "Reumatol Clin. 2010;6:16-22"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 2646
    "formatos" => array:3 [
      "EPUB" => 43
      "HTML" => 1455
      "PDF" => 1148
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S217357431070006X"
    "issn" => "21735743"
    "doi" => "10.1016/S2173-5743(10)70006-X"
    "estado" => "S300"
    "fechaPublicacion" => "2010-01-01"
    "aid" => "70006"
    "copyright" => "Sociedad Española de Reumatología and Colegio Mexicano de Reumatología"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Reumatol Clin. 2010;6:23-36"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 2790
      "formatos" => array:3 [
        "EPUB" => 54
        "HTML" => 2108
        "PDF" => 628
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "Update of the Consensus Statement of the Spanish Society of Rheumatology on the management of biologic therapies in rheumatoid arthritis"
      "tienePdf" => "en"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "23"
          "paginaFinal" => "36"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Actualización del Documento de Consenso de la Sociedad Española de Reumatología sobre el uso de terapias biológicas en la artritis reumatoide"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Jesús Tornero Molina, Raimon Sanmartí Sala, Vicente Rodríguez Valverde, Emilio Martín Mola, José Luis Marenco de la Fuente, Isidoro González Álvaro, Santiago Muñoz Fernández, Juan Gómez-Reino Carnota, Luis Carreño Pérez, Enrique Batlle Gualda, Alejandro Balsa Criado, José Luis Andreu, José María Álvaro-Gracia, Juan Antonio Martínez López, Estíbaliz Loza Santamaría"
          "autores" => array:15 [
            0 => array:2 [
              "nombre" => "Jesús"
              "apellidos" => "Tornero Molina"
            ]
            1 => array:2 [
              "nombre" => "Raimon"
              "apellidos" => "Sanmartí Sala"
            ]
            2 => array:2 [
              "nombre" => "Vicente"
              "apellidos" => "Rodríguez Valverde"
            ]
            3 => array:2 [
              "nombre" => "Emilio"
              "apellidos" => "Martín Mola"
            ]
            4 => array:2 [
              "nombre" => "José Luis"
              "apellidos" => "Marenco de la Fuente"
            ]
            5 => array:2 [
              "nombre" => "Isidoro"
              "apellidos" => "González Álvaro"
            ]
            6 => array:2 [
              "nombre" => "Santiago"
              "apellidos" => "Muñoz Fernández"
            ]
            7 => array:2 [
              "nombre" => "Juan"
              "apellidos" => "Gómez-Reino Carnota"
            ]
            8 => array:2 [
              "nombre" => "Luis"
              "apellidos" => "Carreño Pérez"
            ]
            9 => array:2 [
              "nombre" => "Enrique"
              "apellidos" => "Batlle Gualda"
            ]
            10 => array:2 [
              "nombre" => "Alejandro"
              "apellidos" => "Balsa Criado"
            ]
            11 => array:2 [
              "nombre" => "José"
              "apellidos" => "Luis Andreu"
            ]
            12 => array:2 [
              "nombre" => "José"
              "apellidos" => "María Álvaro-Gracia"
            ]
            13 => array:2 [
              "nombre" => "Juan"
              "apellidos" => "Antonio Martínez López"
            ]
            14 => array:2 [
              "nombre" => "Estíbaliz"
              "apellidos" => "Loza Santamaría"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217357431070006X?idApp=UINPBA00004M"
    "url" => "/21735743/0000000600000001/v1_201305061603/S217357431070006X/v1_201305061603/en/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S2173574310700046"
    "issn" => "21735743"
    "doi" => "10.1016/S2173-5743(10)70004-6"
    "estado" => "S300"
    "fechaPublicacion" => "2010-01-01"
    "aid" => "70004"
    "copyright" => "Sociedad Española de Reumatología and Colegio Mexicano de Reumatología"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Reumatol Clin. 2010;6:11-5"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 2165
      "formatos" => array:3 [
        "EPUB" => 38
        "HTML" => 1325
        "PDF" => 802
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "Damage in Cuban patients with systemic lupus erythematosus. Relation with disease features"
      "tienePdf" => "en"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "11"
          "paginaFinal" => "15"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Daño en pacientes cubanos con lupus eritematoso sistémico. Relación con características de la enfermedad"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Miguel Estévez del Toro, Araceli Chico Capote, Rafael Hechavarría, Rosa Jiménez Paneque, Elena Kokuina"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "Miguel"
              "apellidos" => "Estévez del Toro"
            ]
            1 => array:2 [
              "nombre" => "Araceli"
              "apellidos" => "Chico Capote"
            ]
            2 => array:2 [
              "nombre" => "Rafael"
              "apellidos" => "Hechavarría"
            ]
            3 => array:2 [
              "nombre" => "Rosa"
              "apellidos" => "Jiménez Paneque"
            ]
            4 => array:2 [
              "nombre" => "Elena"
              "apellidos" => "Kokuina"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574310700046?idApp=UINPBA00004M"
    "url" => "/21735743/0000000600000001/v1_201305061603/S2173574310700046/v1_201305061603/en/main.assets"
  ]
  "en" => array:14 [
    "idiomaDefecto" => true
    "titulo" => "Fibromyalgia: Patient perception on their disease and health system. Qualitative research study"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "16"
        "paginaFinal" => "22"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "María José Escudero-Carretero, Noelia García-Toyos, María Ángeles Prieto-Rodríguez, Olivia Pérez-Corral, Joan Carles March-Cerdá, Manuela López-Doblas"
        "autores" => array:6 [
          0 => array:2 [
            "nombre" => "María José"
            "apellidos" => "Escudero-Carretero"
          ]
          1 => array:4 [
            "nombre" => "Noelia"
            "apellidos" => "García-Toyos"
            "email" => array:1 [
              0 => "noelia.garcia.easp@juntadeandalucia.es"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">¿</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          2 => array:2 [
            "nombre" => "Mar&#237;a &#193;ngeles"
            "apellidos" => "Prieto-Rodr&#237;guez"
          ]
          3 => array:2 [
            "nombre" => "Olivia"
            "apellidos" => "P&#233;rez-Corral"
          ]
          4 => array:2 [
            "nombre" => "Joan Carles"
            "apellidos" => "March-Cerd&#225;"
          ]
          5 => array:2 [
            "nombre" => "Manuela"
            "apellidos" => "L&#243;pez-Doblas"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:1 [
            "entidad" => "Escuela Andaluza de Salud P&#250;blica&#44; Campus Universitario de Cartuja&#44; Granada&#44; Spain"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Fibromialgia&#58; percepci&#243;n de pacientes sobre su enfermedad y el sistema de salud&#46; Estudio de investigaci&#243;n cualitativa"
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2008-12-05"
    "fechaAceptado" => "2009-04-22"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec112305"
          "palabras" => array:6 [
            0 => "Fibromyalgia"
            1 => "Patient expectation"
            2 => "Patient satisfaction"
            3 => "Qualitative analysis"
            4 => "Quality of health care"
            5 => "Professional-patient relationship"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec112306"
          "palabras" => array:6 [
            0 => "Fibromialgia"
            1 => "Expectativas de pacientes"
            2 => "Satisfacci&#243;n de pacientes"
            3 => "An&#225;lisis cualitativo"
            4 => "Calidad de la atenci&#243;n de salud"
            5 => "Relaciones profesional-paciente"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To know the experiences and expectations of persons with fibromyalgia towards the health system and its professionals&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Qualitative study with three focal groups&#46; The first focal group included patients with fibromyalgia&#44; 20 women and 1 man&#44; receiving care in the public health system&#44; with different assistance paths and progression&#46; Informed Consent was required&#46; Content analysis was done&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Patients describe a difficult experience&#44; with symptoms that may involve incapacity for daily activities&#46; Until knowing their diagnosis&#44; they feel a lack of understanding and also loneliness&#46; They develop different coping strategies&#44; as looking for information or association&#46; From the health system they expect&#58; attention and a fast diagnosis&#44; accessibility to consultations&#44; medical exams and therapies or an impulse for research&#46; They want trained professionals&#44; proactive attitudes&#44; interest&#44; empathy and information&#46;</p> <span class="elsevierStyleSectionTitle">Discussion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Qualitative methods seem suitable for delving into patient experience&#46; Health assistance must improve patients&#8217; quality of life&#44; facilitating their assistance process and offering companionship&#44; interest&#44; comprehension and support&#46;</p>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Conocer la experiencia y vivencia de personas con fibromialgia y sus expectativas sobre el sistema sanitario y sus profesionales&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Dise&#241;o cualitativo a trav&#233;s de grupos focales&#46; Se realizaron tres grupos&#44; uno con pacientes que pertenec&#237;an a asociaciones de fibromialgia&#46; Participaron 20 mujeres y 1 var&#243;n&#46; Se incluyeron personas que recib&#237;an atenci&#243;n en el sistema sanitario p&#250;blico&#44; con distintas trayectorias asistenciales y evoluci&#243;n&#46; Se pidi&#243; consentimiento informado&#46; An&#225;lisis de contenido&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Describen una vivencia dif&#237;cil con una sintomatolog&#237;a que puede ser incapacitante para las actividades cotidianas&#46; Hasta que reciben el diagn&#243;stico&#44; perciben incomprensi&#243;n y soledad&#46; Desarrollan distintas estrategias de afrontamiento&#44; como buscar informaci&#243;n o asociarse&#46; Esperan del sistema sanitario&#58; atenci&#243;n y diagn&#243;sticos &#225;giles&#44; acceso a consultas&#44; pruebas que necesiten y terapias beneficiosas o impulso a la investigaci&#243;n&#46; Quieren profesionales con formaci&#243;n para abordar la fibromialgia&#44; una actitud proactiva&#44; inter&#233;s&#44; empat&#237;a e informaci&#243;n&#46;</p> <span class="elsevierStyleSectionTitle">Discusi&#243;n</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La metodolog&#237;a cualitativa fue id&#243;nea para profundizar en la experiencia de pacientes&#46; La atenci&#243;n sanitaria debe dirigirse a mejorar su calidad de vida facilitando su proceso asistencial y ofreciendo acompa&#241;amiento&#44; inter&#233;s&#44; comprensi&#243;n y apoyo&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:32 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Consensus document on the diagnosis and treatment of fibromyalgia in Catalonia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Collado"
                            1 => "J&#46; Alijotas"
                            2 => "P&#46; Benito"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "2002"
                        "volumen" => "118"
                        "paginaInicial" => "745"
                        "paginaFinal" => "749"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fibromyalgia and its diagnosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; Andreu"
                            1 => "J&#46; Sanz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Clin Esp"
                        "fecha" => "2005"
                        "volumen" => "205"
                        "paginaInicial" => "333"
                        "paginaFinal" => "336"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16029760"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Scientific evidence of the psychological aspects in fibromyalgia&#46; Possibilities of intervention"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "V&#46; De Felipe"
                            1 => "B&#46; Castel Bernal"
                            2 => "J&#46; Vidal-Fuentes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Reumatol Clin"
                        "fecha" => "2006"
                        "volumen" => "2"
                        "paginaInicial" => "38"
                        "paginaFinal" => "43"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A reflection on fibromyalgia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; Ancochea Millet"
                            1 => "R&#46; Sed&#243; Fortuny"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Aten Primaria"
                        "fecha" => "2002"
                        "volumen" => "29"
                        "paginaInicial" => "562"
                        "paginaFinal" => "564"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12061988"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Consejer&#237;a de Salud Junta de Andaluc&#237;a&#46; Fibromialgia&#58; proceso asistencial integrado&#46; Sevilla&#58; Consejer&#237;a de Salud Junta de Andaluc&#237;a&#59; 2005&#46;"
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evidence in fibromyalgia treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Rivera"
                            1 => "C&#46; Alegre"
                            2 => "M&#46;B&#46; Nishishinya"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Reumatol Clin"
                        "fecha" => "2006"
                        "volumen" => "2"
                        "paginaInicial" => "34"
                        "paginaFinal" => "37"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fibromyalgia in 2002"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46; Rot&#233;s Querol"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Esp Reumatol"
                        "fecha" => "2005"
                        "volumen" => "32"
                        "paginaInicial" => "77"
                        "paginaFinal" => "81"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "bibliometric approach to research in fibromyalgia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "L&#46;A&#46; Merayo Alonso"
                            1 => "F&#46;J&#46; Garcia Cano"
                            2 => "L&#46; Rodriguez"
                            3 => "Franco A"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S1699-258X(07)73602-1"
                      "Revista" => array:6 [
                        "tituloSerie" => "Reumatol Clin"
                        "fecha" => "2007"
                        "volumen" => "3"
                        "paginaInicial" => "55"
                        "paginaFinal" => "62"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21794399"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Documento de la SER sobre tratamiento de la Fibromialgia&#46; Reumatismos&#46; 2005&#59; septiembre-octubre&#46;"
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Experience of fibromyalgia&#46; Qualitative study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46;C&#46; Raymond"
                            1 => "J&#46;B&#46; Brown"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Can Fam Physician"
                        "fecha" => "2000"
                        "volumen" => "46"
                        "paginaInicial" => "1100"
                        "paginaFinal" => "1106"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10845136"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Systematic review&#58; the diagnosis of fibromyalgia itself have any deleterious effect on prognosis&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "L&#46; Carmona"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S1699-258X(06)73022-4"
                      "Revista" => array:6 [
                        "tituloSerie" => "Reumatol Clin"
                        "fecha" => "2006"
                        "volumen" => "2"
                        "paginaInicial" => "52"
                        "paginaFinal" => "57"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21794304"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Study of quality of life of patients with fibromyalgia&#58; impact of a health education program"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "E&#46; Bosch Romero"
                            1 => "N&#46; S&#225;enz Moya"
                            2 => "M&#46; Valls Esteve"
                            3 => "S&#46; Vi&#241;olas Valer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Aten Primaria"
                        "fecha" => "2002"
                        "volumen" => "30"
                        "paginaInicial" => "16"
                        "paginaFinal" => "21"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12106575"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1699258X06730479"
                          "estado" => "S300"
                          "issn" => "1699258X"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Frequent users and difficult&#58; how do you feel treated by their doctors&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Arillo"
                            1 => "C&#46; Vilches"
                            2 => "M&#46; Major"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "An Sist Sanit Navar"
                        "fecha" => "2006"
                        "volumen" => "29"
                        "paginaInicial" => "47"
                        "paginaFinal" => "58"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16670729"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S073510970803934X"
                          "estado" => "S300"
                          "issn" => "07351097"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Principles of treatment&#44; coordination of medical care and patient education in fibromyalgia syndrome and chronic widespread"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Klemet"
                            1 => "W&#46; H&#228;user"
                            2 => "W&#46; Br&#252;ckl"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Shmerz"
                        "fecha" => "2008"
                        "volumen" => "22"
                        "paginaInicial" => "283"
                        "paginaFinal" => "294"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The doctor-patient relationship in the context of fibromyalgia&#46; Tribulations and proposals"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46; Mart&#237;nez Lavin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S1699-258X(07)73601-X"
                      "Revista" => array:6 [
                        "tituloSerie" => "Reumatol Clin"
                        "fecha" => "2007"
                        "volumen" => "3"
                        "paginaInicial" => "53"
                        "paginaFinal" => "54"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21794398"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Illness experience in fibromyalgia syndrome&#58; a metasynthesis of qualitative studies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; Sim"
                            1 => "S&#46; Madden"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.socscimed.2008.03.003"
                      "Revista" => array:6 [
                        "tituloSerie" => "Soc Sci Med"
                        "fecha" => "2008"
                        "volumen" => "67"
                        "paginaInicial" => "57"
                        "paginaFinal" => "67"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18423826"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Women&#39;s strategies for handling chronic muscle pain&#58; a qualitative study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46; Steihaug"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1080/02813430601016944"
                      "Revista" => array:6 [
                        "tituloSerie" => "Scand J Prim Health Care"
                        "fecha" => "2007"
                        "volumen" => "25"
                        "paginaInicial" => "44"
                        "paginaFinal" => "48"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17354159"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Patient power and control&#58; a study of women with uncertain illness trajectories"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "P&#46; Asbring"
                            1 => "A&#46;L&#46; N&#228;rv&#228;nen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/1049732303260682"
                      "Revista" => array:6 [
                        "tituloSerie" => "Qual Health Res"
                        "fecha" => "2004"
                        "volumen" => "14"
                        "paginaInicial" => "226"
                        "paginaFinal" => "240"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14768459"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Women&#39;s experiences of stigma in relation to chronic fatigue syndrome and fibromyalgia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "P&#46; Asbring"
                            1 => "A&#46;L&#46; N&#228;rv&#228;nen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Qual Health Res"
                        "fecha" => "2002"
                        "volumen" => "12"
                        "paginaInicial" => "148"
                        "paginaFinal" => "160"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11837367"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The discussion group&#46; A tool for research in primary care"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Buzzaqui Echevarr&#237;a"
                            1 => "J&#46; Selles Uris"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Aten Prim Form Contin Med"
                        "fecha" => "1997"
                        "volumen" => "4"
                        "paginaInicial" => "421"
                        "paginaFinal" => "433"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Focus groups as qualitative research technique in health&#58; design and implementation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46;M&#46; Calvente Garcia"
                            1 => "I&#46; Mateo Rodriguez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Aten Primaria"
                        "fecha" => "2000"
                        "volumen" => "25"
                        "paginaInicial" => "181"
                        "paginaFinal" => "186"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10730443"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Medical care for chronic disease&#58; reflections on the methodological procedures of a qualitative study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "F&#46;J&#46; Mercado"
                            1 => "E&#46; Alc&#225;ntara Hern&#225;ndez"
                            2 => "N&#46; Flores Lara"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Esp Salud P&#250;blica"
                        "fecha" => "2002"
                        "volumen" => "76"
                        "paginaInicial" => "461"
                        "paginaFinal" => "471"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12422421"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Qualitative research&#58; introducing focus groups"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46; Kitzinger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "1995"
                        "volumen" => "311"
                        "paginaInicial" => "299"
                        "paginaFinal" => "302"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7633241"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Total quality management services"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "V&#46;A&#46; Zeithaml"
                            1 => "A&#46; Parasuraman"
                            2 => "L&#46;L&#46; Berri"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "1993"
                        "editorial" => "Ediciones D&#237;az de Santos"
                        "editorialLocalizacion" => "Madrid"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Quality criteria in Qualitative Health Research &#40;ICS&#41;&#58; notes for a necessary debate"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "C&#46; Calder&#243;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Esp Salud P&#250;blica"
                        "fecha" => "2002"
                        "volumen" => "76"
                        "paginaInicial" => "473"
                        "paginaFinal" => "482"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12422422"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical and psychosocial characteristics of people with fibromyalgia&#46; Impact of diagnosis on their activities"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;C&#46; Ubago Linares"
                            1 => "I&#46; Ruiz P&#233;rez"
                            2 => "M&#46;J&#46; Bermejo Perez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Esp Salud P&#250;blica"
                        "fecha" => "2005"
                        "volumen" => "79"
                        "paginaInicial" => "683"
                        "paginaFinal" => "695"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16457060"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
              "etiqueta" => "27&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fibromyalgia&#58; a challenge for primary care"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Junyent Priu"
                            1 => "A&#46; Benavides Ruiz"
                            2 => "M&#46; Mu&#241;oz Borrell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Semergen"
                        "fecha" => "2005"
                        "volumen" => "31"
                        "paginaInicial" => "255"
                        "paginaFinal" => "258"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib28"
              "etiqueta" => "28&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of fibromyalgia syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D&#46;L&#46; Goldenberg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rheum Dis Clin N Am"
                        "fecha" => "1998"
                        "volumen" => "15"
                        "paginaInicial" => "61"
                        "paginaFinal" => "71"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib29"
              "etiqueta" => "29&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The care process of cancer&#58; needs and expectations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Suess"
                            1 => "J&#46;C&#46; March Cerd&#225;"
                            2 => "M&#46;A&#46; Rodr&#237;guez Prieto"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Oncology &#40;Barc&#41;"
                        "fecha" => "2006"
                        "volumen" => "29"
                        "paginaInicial" => "357"
                        "paginaFinal" => "367"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib30"
              "etiqueta" => "30&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Experiences&#44; expectations and demands for informal caregivers of patients in disease processes of long duration"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "E&#46; Gil Garcia"
                            1 => "M&#46; Escudero Carretero"
                            2 => "M&#46;A&#46; Rodr&#237;guez Prieto"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Enferm Clin"
                        "fecha" => "2005"
                        "volumen" => "15"
                        "paginaInicial" => "220"
                        "paginaFinal" => "226"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib31"
              "etiqueta" => "31&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Expectations held by type 1 and 2 diabetes mellitus patients and their relatives&#58; the importance of facilitating the health-care process"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;J&#46; Escudero-Carretero"
                            1 => "M&#46;A&#46; Prieto-Rodr&#237;guez"
                            2 => "I&#46; Fernandez-Fernandez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1369-7625.2007.00452.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Health Expect"
                        "fecha" => "2007"
                        "volumen" => "10"
                        "paginaInicial" => "337"
                        "paginaFinal" => "349"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17986070"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib32"
              "etiqueta" => "32&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Enfermedades cr&#243;nicas&#58; &#191;por qu&#233; seguimos esperando a Godot&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; J&#250;dez Guti&#233;rrez"
                            1 => "M&#46;T&#46; Mart&#237;nez Ros"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Aten Primaria"
                        "fecha" => "2006"
                        "volumen" => "38"
                        "paginaInicial" => "8"
                        "paginaFinal" => "18"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16790212"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735743/0000000600000001/v1_201305061603/S2173574310700058/v1_201305061603/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "17338"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Original Article"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21735743/0000000600000001/v1_201305061603/S2173574310700058/v1_201305061603/en/main.pdf?idApp=UINPBA00004M&text.app=https://reumatologiaclinica.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574310700058?idApp=UINPBA00004M"
]