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hoping to observe that these groups had different tomographic and&#47;or functional expressions&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and Methods</span><p id="par0010" class="elsevierStylePara elsevierViewall">This is an observational study involving retrospective cohorts&#46; We reviewed the medical records of all the patients hospitalized in the ILD clinic of the <span class="elsevierStyleItalic">Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas</span> &#40;INER&#41; &#40;Mexico&#41; between January 2012 and December 2014&#44; and of all of the outpatients attended to in the ILD unit of Hospital Mar&#237;a Ferrer &#40;HMF&#41; in Buenos Aires&#44; Argentina&#44; between January 2012 and June 2015&#46; The patients provided their written consent&#46; We included those patients with ILD who met the Kinder criteria for UCTD &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">3</span></a> We excluded patients who met the criteria for a defined CTD in accordance with the criteria of the American College of Rheumatology or for some other cause of known interstitial disease&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">We recorded demographic data &#40;age&#44; sex&#44; smoking behavior&#41;&#44; clinical findings &#40;respiratory signs&#47;symptoms and those associated with CTD&#41;&#44; data provided by the immunology laboratory &#40;ANA&#44; RF and anti-Ro&#47;SS-A&#44; anti-Jo-1&#44; anti-Scl-70&#44; anticentromere and anti-U1 ribonucleoprotein &#91;RNP&#93; antibodies&#41;&#44; data on respiratory function &#40;percentage of predicted forced vital capacity &#91;FVC&#37;&#93; and percentage of predicted diffusing capacity of the lung for carbon monoxide &#91;DLCO&#37;&#93; at baseline&#44; as well as changes in FVC&#37; during follow-up&#41;&#44; high-resolution computed tomography &#40;HRCT&#41; and surgical lung biopsy&#46; Follow-up included respiratory function test every 4&#8211;6<span class="elsevierStyleHsp" style=""></span>meses&#46; With respect to the clinical manifestations&#44; this being a retrospective study&#44; we analyzed those that are usually dealt with in visits to the pulmonologist specialized in ILD in the participating centers &#40;those included in the Kinder criteria&#41;&#46; Other more specific manifestations that require the presence of another specialist for their evaluation &#40;for example&#44; mechanic&#39;s hands or Gottron&#39;s papules&#41; were not analyzed&#46; Data related to treatment were also recorded&#46; In every case&#44; this was indicated by the treating physician according to his or her criteria&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Definition of the Variables</span><p id="par0020" class="elsevierStylePara elsevierViewall">Immunology laboratory&#58; the determination of the RF of the patients of the HMF was performed by nephelometry with a cut-off point of 35<span class="elsevierStyleHsp" style=""></span>U&#47;mL&#44; and in the INER by immunochemiluminescence with a cut-off point of 20<span class="elsevierStyleHsp" style=""></span>U&#47;mL&#46; Indirect immunofluorescence &#40;IIF&#41; was used to detect ANA&#44; with a cut-off titer of 1&#58;80&#46; The determination of anti-Ro&#47;SS-A&#44; anti-Jo-1&#44; anti-U1 RNP and anti-Scl-70 antibodies was done with the enzyme-linked immunosorbent assay &#40;ELISA&#41;&#44; with a cut-off value of 20<span class="elsevierStyleHsp" style=""></span>U&#47;mL&#46; Anticentromere antibody was measured using IIF&#44; with a cut-off titer of 1&#58;80&#46; Respiratory function tests&#58; spirometry&#44; plethysmography and DLCO measurements were performed at baseline and every 4&#8211;6<span class="elsevierStyleHsp" style=""></span>months in accordance with standardized acceptability and reproducibility criteria&#46;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">13&#8211;16</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">High-resolution computed tomography was performed with a slice width of 1<span class="elsevierStyleHsp" style=""></span>mm at intervals of 10<span class="elsevierStyleHsp" style=""></span>mm&#46; The results were evaluated by a radiologist who was an expert in interstitial disease&#46; The findings were classified according to standardized criteria as being typical of usual interstitial pneumonia &#40;UIP&#41;&#44; possible UIP and inconsistent with UIP&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">1</span></a> Lung biopsies were evaluated by a pathologist with experience in ILD&#46; The results were classified as indicative of UIP&#44; nonspecific interstitial pneumonia &#40;NSIP&#41;&#44; organizing pneumonia &#40;OP&#41;&#44; NSIP with OP&#44; lymphoid interstitial pneumonia &#40;LIP&#41; and unclassifiable ILD&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">2</span></a> The presence of lymphoid follicles&#44; follicular bronchiolitis&#44; pleural involvement and vascular involvement were also recorded&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">A multidisciplinary group defined a priori the signs that should be considered&#46; They consisted of a set of clinical manifestations &#40;Raynaud&#39;s phenomenon&#44; xerophthalmia or arthritis&#41;&#44; included in the criteria proposed by Kinder&#44; as being highly specific for CTD&#46; The patients who had at least one of them were considered to show <span class="elsevierStyleItalic">highly specific manifestations of CTD</span>&#46; <span class="elsevierStyleItalic">High titers of ANA</span> were considered to be those greater than 1&#58;320&#44; and the <span class="elsevierStyleItalic">patterns specific for ANA</span> were centromere&#44; cytoplasmic and nucleolar&#46; The choice of these ANA patterns as &#8220;specific&#8221; is linked to their strong association with CTD in which ILD constitutes a common manifestation&#44; which makes it less likely that the test results in a false positive&#46;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">17&#44;18</span></a> These 3 variables &#40;highly specific manifestations of CTD&#44; specific ANA patterns and a high ANA titer&#41; were considered to be major predictive variables&#46; We considered changes in the FVC&#37; over time and the HRCT pattern to be major outcome variables&#46; Sex and age were also evaluated&#46; These variables were chosen as they are characteristics that are expressed differently in an &#8220;IPF-like&#8221; disease and an inflammatory ILD associated with a CTD&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">5</span></a> Potential confounders were included in a multivariate analysis in the attempt to correct the effect of eventual selection biases&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Statistical Analysis</span><p id="par0035" class="elsevierStylePara elsevierViewall">The categorical variables were expressed in terms of frequency and the continuous variables as the mean and standard deviation &#40;SD&#41; or median and interquartile range &#40;IQR&#41;&#44; depending on whether or not there was a normal distribution&#44; respectively&#46; The univariate analysis was performed using the chi-square test&#44; Fisher&#39;s exact test&#44; Student&#39;s t test or Wilcoxon rank-sum test&#44; depending the type of variable&#46; Multiple logistic regression analysis was carried out to define the variables that were associated with the presence of a HRCT pattern that was inconsistent with UIP&#46; As covariates in the model&#44; we included the sex&#44; age under 60<span class="elsevierStyleHsp" style=""></span>years&#44; the presence of manifestations that were highly specific for CTD&#44; a specific ANA pattern and a high ANA titer&#46; The adjusted odds ratio &#40;OR&#41; and the 95&#37; confidence intervals &#40;CI&#41; were recorded&#46; Multiple linear regression was utilized to determine which variables were associated with changes in FVC&#37; over time&#46; As independent variables&#44; we included age over 60<span class="elsevierStyleHsp" style=""></span>years&#44; sex&#44; the presence of manifestations that were highly specific for CTD&#44; a specific ANA pattern&#44; high ANA titer&#44; the presence of a pattern that was inconsistent with UIP in the HRCT and whether or not the patient had received a specific treatment&#46; The <span class="elsevierStyleItalic">&#946;</span> coefficients and 95&#37; CI were recorded&#46; A <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05 was considered to indicate statistical significance&#46; The STATA 13&#46;0 software package was used for the statistical analysis&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Characteristics of the Cohorts</span><p id="par0040" class="elsevierStylePara elsevierViewall">We reviewed 648 medical records in the INER and 292 in HMF&#46; We included a total of 66 patients&#44; 21 men &#40;31&#46;82&#37;&#41;&#44; with a mean age &#40;SD&#41; of 57&#46;65<span class="elsevierStyleHsp" style=""></span>years &#40;12&#46;91&#41;&#46; The median &#40;IQR&#41; follow-up period was 35 weeks &#40;27&#8211;50&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The cohorts analyzed &#40;INER and HMF&#41; were different in terms of the proportion of patients who smoked &#40;33&#46;3&#37; vs 66&#46;6&#37;&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;011&#41; and in the presence of anti-Ro&#47;SS-A antibody &#40;4&#46;55&#37; vs 47&#46;62&#37;&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#44; of Raynaud&#39;s phenomenon &#40;6&#46;67&#37; vs 33&#46;33&#37;&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;005&#41;&#44; of xerophthalmia &#40;15&#46;56&#37; vs 42&#46;86&#37;&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;016&#41;&#44; of highly specific manifestations of CTD &#40;31&#46;11&#37; vs 71&#46;43&#37;&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;002&#41; and of HRCT findings inconsistent with UIP &#40;64&#46;44&#37; vs 85&#37; &#91;14&#46;29&#93;&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#44; respectively &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">The most common clinical manifestations were xerostomia &#40;40&#46;9&#37;&#41;&#44; weight loss &#40;38&#37;&#41; and symptoms of gastroesophageal reflux &#40;30&#46;3&#37;&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The most widespread serological finding was the presence of ANA &#40;87&#46;69&#37;&#41; at a titer higher than 1&#58;320 in 44&#37; of the cases&#46; The fine speckled pattern was that most frequently observed in IIF &#40;48&#46;12&#37;&#41;&#46; Anti-Ro&#47;SS-A antibody was tested in 43 patients&#44; and was positive in 11 &#40;25&#46;2&#37;&#41;&#44; whereas anti-Jo-1 antibody was positive in 7 &#40;23&#46;3&#37;&#41; of the 30 participants in whom it was requested&#46; All of the individuals tested for anti-Scl-70 and anti-U1-RNP antibodies were negative&#46; Surgical biopsy was performed in 15 patients &#40;22&#46;7&#37;&#41;&#46; The definitive diagnosis was UIP in 7 of them&#44; but diffuse lymphoid follicles were found in 3&#46; In 7 cases&#44; the diagnosis was NSIP &#40;in 3 combined with features of UIP and in 2 with OP&#41;&#46; Three biopsies were defined as &#8220;unclassifiable&#8221;&#46; The histological findings were involvement of arterioles in 5 biopsies&#44; follicular bronchiolitis in 2 and diffuse lymphoid follicles in 9&#46; In no case was there pleural involvement&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">With regard for therapy&#44; only 47 patients received a specific drug &#40;an immunosuppressive or antifibrotic agent&#41;&#46; The treatments most widely utilized were azathioprine in 23 &#40;48&#46;94&#37;&#41;&#44; mycophenolate mofetil in 14 &#40;29&#46;79&#37;&#41;&#44; methotrexate in 3 &#40;6&#46;38&#37;&#41;&#44; steroids alone in 3 &#40;6&#46;38&#37;&#41;&#44; cyclophosphamide in 2 &#40;4&#46;26&#37;&#41; and pirfenidone in 2 &#40;4&#46;26&#37;&#41;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Defining Patterns&#46; Univariate and Multivariate Analysis</span><p id="par0065" class="elsevierStylePara elsevierViewall">In the univariate analysis&#44; the patients with manifestations that were &#8220;highly specific for CTD&#8221; were younger &#40;mean 52 years &#91;SD 14&#46;58&#93; vs 62 years &#91;9&#46;46&#93;&#59; &#91;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;01&#93;&#41; and the proportion of men was lower &#40;10&#46;34&#37; vs 48&#46;65&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;01&#41;&#46; Although we observed no differences in the baseline FVC&#37; and DLCO&#37;&#44; the individuals with manifestations that were &#8220;highly specific for CTD&#8221; had a more favorable course in terms of the respiratory function test&#46; The change in the median &#40;IQR&#41; of FVC&#37; over time was 1 &#40;&#8722;1 to 10&#41; in the patients with manifestations that were &#8220;highly specific for CTD&#8221; vs &#8722;6 points &#40;&#8722;16 to &#8722;4&#41; in those in whom these manifestations were not encountered &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;01&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; It is important to clarify the fact that both groups &#40;with and without manifestations that were &#8220;highly specific for CTD&#8221;&#41; had similar median &#40;IQR&#41; follow-up periods &#40;34 weeks &#91;27&#8211;56&#93; vs 36 weeks &#91;27&#8211;50&#93;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;758&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">The presence or absence of high ANA titers or with a specific pattern was not associated with differences in terms of sex&#44; age&#44; frequency of manifestations that were &#8220;highly specific for CTD&#8221;&#44; functional data or that provided by HRCT&#46; In the multiple logistic regression analysis using HRCT pattern inconsistent with UIP as a dependent variable&#44; age under 60<span class="elsevierStyleHsp" style=""></span>years was the only variable that showed a statistically significant association&#44; with an OR &#40;95&#37;<span class="elsevierStyleHsp" style=""></span>CI&#41; of 11&#46;53 &#40;2&#46;7&#8211;47&#46;69&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46; In the multivariate analysis employing multiple linear regression&#44; the presence of manifestations that were &#8220;highly specific for CTD&#8221; was associated with an improvement in FVC&#37; values&#44; with a <span class="elsevierStyleItalic">&#946;</span> coefficient of 13&#46;25 &#40;95&#37;<span class="elsevierStyleHsp" style=""></span>CI&#44; 2&#46;41&#8211;24&#46;09&#41;&#44; this being the only independent variable to show a statistically significant association &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><elsevierMultimedia ident="tbl0025"></elsevierMultimedia></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Discussion</span><p id="par0075" class="elsevierStylePara elsevierViewall">In this report&#44; we found that the presence of at least 1 manifestation that was &#8220;highly specific for CTD&#8221; &#40;Raynaud&#39;s phenomenon&#44; xerophthalmia or arthritis&#41; was associated with a higher prevalence of women&#44; lower age at onset and a more favorable course in terms of changes in FVC&#37; over time&#44; which was confirmed after adjusting for potential confounders&#46; This profile differs from that classically observed in patients with IPF&#44; a disease in which there is a predominance of men&#44; advanced age and rapid functional deterioration&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">12</span></a> One datum to point out with respect to our results is the fact that there were significant clinical and radiological differences between the cohorts&#46; Although we do not have a definitive explanation for this finding&#44; it could be that the differences are related to the moment at which the patients are evaluated &#40;during a hospital stay in the INER and in the outpatient clinic in HMF&#41;&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">During the baseline evaluation of a patient with ILD&#44; the presence of clinical manifestations related to a CTD or a positive test for autoantibodies represents a dilemma for a physician&#44; who should decide whether to consider the patient a carrier of idiopathic ILD &#40;IPF&#41; and utilize antifibrotic agents&#44; or consider the case of a ILD associated with a CTD and administer immunosuppressive therapy&#46;<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">19&#44;20</span></a> The detection of clinical manifestations that can contribute to the differentiation of these phenotypes appears to be a relevant finding&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Our results support the proposals of other authors in terms of the impact of clinical manifestations on the course of this group of patients&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">5</span></a> The intersociety consensus recently published includes proposals for new classification criteria &#40;not yet validated&#41; in which the clinical manifestations occupy a specific domain &#40;together with a serological and a morphological domain&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">11</span></a> This consensus eliminates certain clinical manifestations included in previous criteria &#40;for example&#44; symptoms of gastroesophageal reflux&#44; weight loss&#41; and includes others with greater specificity&#44; such as Raynaud&#39;s phenomenon and arthritis&#46; The patients who meet the proposed criteria and do not satisfy those of a defined CTD have an &#8220;interstitial lung disease with autoimmune features&#8221;&#46; We believe that the objective of the results of our study are along the lines of that proposed in this consensus&#44; in the attempt to exclude highly sensitive manifestations that can mean the erroneous inclusion of individuals with IPF in the group of patients with ILD associated with CTD&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">With respect to the serological data&#44; neither the presence of high ANA titers nor the specific patterns according to IIF were helpful in differentiating between the groups presented in the hypothesis of this study&#46; This contrasts with findings reported by other groups&#44; which stress the role of the detection of autoantibodies in the evaluation of these patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">4&#44;21</span></a> We consider that the information provided by the immunology laboratory may be useful&#44; although we know that it can lead to false positives and negatives &#40;even more so in the use of techniques like IIF that depend on the observer&#41; and should be interpreted in accordance with the clinical setting in which it is obtained&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">In a recent article that involved patients with a diagnosis of &#8220;interstitial lung disease with autoimmune features&#8221; according to the abovementioned consensus&#44;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">11</span></a> it was observed that survival was better in those with a pattern not specific for UIP&#46; The authors stressed the importance of the tomographic and histological pattern&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">22</span></a> In our study&#44; the HRCT pattern did not differ among the subgroups evaluated&#46; We found no association with a better functional outcome when a &#8220;pattern inconsistent with UIP&#8221; was included as a covariate in the multivariate analysis of the change in FVC over time&#46; We point out the low prevalence in our cohort of the typical pattern of UIP according to HRCT findings in comparison with other reports&#46;<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">4&#44;22&#44;23</span></a> It could be that there has been a decrease in the strength of the study for detecting differences in the HRCT pattern when compared to the clinical manifestations&#44; immunology laboratory and functional outcome&#46; Our cohort came from 2 centers specialized in respiratory diseases&#44; with physicians who have extensive experience in the evaluation of patients with ILD and numbers of patients similar to those of other cohorts previously reported&#46; Thus&#44; we consider that our findings are representative and comparable to those of other articles&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Our study has certain limitations&#46; The patients were included on the basis of the medical records documented during hospital stays in one center &#40;INER&#41; and from an outpatient clinic in the other &#40;HMF&#41;&#46; This may constitute an important difference regarding the severity of the cases in the 2 centers&#44; which implies possible selection bias&#46; On the other hand&#44; as this is a retrospective study with data taken directly from the medical records&#44; the examination concerning the symptoms linked to CTD was not standardized&#44; leading to possible information bias&#46; The study also has limitations with respect to the evaluation of the features of autoimmune disease&#46; The clinical and serological variables taken into account were those proposed in the Kinder criteria&#46; Thus&#44; they exclude manifestations and serological findings specific for CTD&#44; such as mechanic&#39;s hands&#44; palmar telangiectasias&#44; Gottron&#39;s papules&#44; antisynthetase antibodies other than Jo-1 or anti-cyclic citrullinated peptide antibodies&#46; Many of these variables are now incorporated into the latest intersociety consensus and are valuable in the identification of patients with UCTD&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">11</span></a> Again&#44; we did not analyze the role of capillaroscopy or minor salivary gland biopsy in the evaluation of patients with ILD associated with UCTD&#44; as they are not included in the diagnostic criteria utilized&#46;<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">24&#44;25</span></a> Finally&#44; to evaluate the functional outcome&#44; we chose to study the change in FVC&#37; over time&#44; in the knowledge that it is not the best method in patients who have different follow-up periods&#46; The analysis of the time to event would have been a more accurate approach&#44; but we did not have access to the data necessary to carry it out&#46; While we consider that our study provides useful information&#44; and that it is in keeping with the latest intersociety consensus&#44; we believe that there is a need for prospective studies that evaluate survival and involve a larger number of patients to respond more conclusively to the question being proposed&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Ethical Disclosures</span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Protection of human and animal subjects</span><p id="par0105" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Confidentiality of data</span><p id="par0110" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Right to privacy and informed consent</span><p id="par0115" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Financing</span><p id="par0120" class="elsevierStylePara elsevierViewall">The present report has not received any type of funding&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Conflicts of Interest</span><p id="par0125" class="elsevierStylePara elsevierViewall">The authors declare they have no conflicts of interest&#46;</p></span></span>"
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          "titulo" => "Ethical Disclosures"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0050"
              "titulo" => "Protection of human and animal subjects"
            ]
            1 => array:2 [
              "identificador" => "sec0055"
              "titulo" => "Confidentiality of data"
            ]
            2 => array:2 [
              "identificador" => "sec0060"
              "titulo" => "Right to privacy and informed consent"
            ]
          ]
        ]
        9 => array:2 [
          "identificador" => "sec0065"
          "titulo" => "Financing"
        ]
        10 => array:2 [
          "identificador" => "sec0070"
          "titulo" => "Conflicts of Interest"
        ]
        11 => array:2 [
          "identificador" => "xack339329"
          "titulo" => "Acknowledgments"
        ]
        12 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2016-06-28"
    "fechaAceptado" => "2016-10-30"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec965928"
          "palabras" => array:5 [
            0 => "Interstitial lung diseases"
            1 => "Connective tissue diseases"
            2 => "Autoimmune diseases"
            3 => "Antinuclear antibodies"
            4 => "Raynaud phenomenon"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec965929"
          "palabras" => array:5 [
            0 => "Enfermedad pulmonar intersticial"
            1 => "Enfermedad del tejido conectivo"
            2 => "Enfermedades autoinmunes"
            3 => "Anticuerpos antinucleares"
            4 => "Fen&#243;meno de Raynaud"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To identify clinical or immunological features in patients with undifferentiated connective tissue disease &#40;UCTD&#41; associated interstitial lung disease &#40;ILD&#41;&#44; in order to group them and recognize different functional and high resolution computed tomography &#40;HRCT&#41; behavior&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Retrospective cohort study&#46; Patients meeting Kinder criteria for UCTD were included&#46; We defined the following predictive variables&#58; &#8216;highly specific&#8217; connective tissue disease &#40;CTD&#41; manifestations &#40;Raynaud&#39;s phenomenon&#44; dry eyes or arthritis&#41;&#44; high antinuclear antibody &#40;ANA&#41; titer &#40;above 1&#58;320&#41;&#44; and &#8216;specific&#8217; ANA staining patterns &#40;centromere&#44; cytoplasmic and nucleolar patterns&#41;&#46; We evaluated the following outcomes&#58; change in the percentage of the predicted forced vital capacity &#40;FVC&#37;&#41; during the follow-up period&#44; and HRCT pattern&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Sixty-six patients were included&#46; Twenty-nine &#40;43&#46;94&#37;&#41; showed at least one &#8216;highly specific&#8217; CTD manifestation&#44; 16 &#40;28&#46;57&#37;&#41; had a &#8216;specific&#8217; ANA staining pattern and 29 &#40;43&#46;94&#37;&#41; high ANA titer&#46; Patients with &#8216;highly specific&#8217; CTD manifestations were younger &#40;mean &#91;SD&#93; 52 years &#91;14&#46;58&#93; vs 62&#46;08 years &#91;9&#46;46&#93;&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#44; were more likely men &#40;10&#46;34&#37; vs 48&#46;65&#37;&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41; and showed a smaller decline of the FVC&#37; &#40;median &#91;interquartile range&#93; 1&#37; &#91;&#8722;1 to 10&#93; vs &#8722;6&#37; &#91;&#8722;16 to &#8722;4&#93;&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;006&#41;&#46; In the multivariate analysis&#44; the presence of highly specific manifestations was associated with improvement in the FVC&#37; &#40;<span class="elsevierStyleItalic">B coefficient</span> of 13&#46;25 &#91;95&#37; confidence interval&#44; 2&#46;41 to 24&#46;09&#93;&#41;&#46; No association was observed in relation to the HRCT pattern&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The presence of &#8216;highly specific&#8217; CTD manifestations was associated with female sex&#44; younger age and better functional behavior&#46; These findings highlight the impact of the clinical features in the outcome of patients with UCTD ILD&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objectives"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
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          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusion"
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      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Agrupar a los pacientes con enfermedad pulmonar intersticial &#40;EPI&#41; asociada a enfermedad indiferenciada del tejido conectivo &#40;EITC&#41; seg&#250;n la presencia o no de ciertas manifestaciones cl&#237;nicas o inmunol&#243;gicas&#44; esperando encontrar diferentes expresiones tomogr&#225;ficas o funcionales&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio de cohortes retrospectivas&#46; Se incluyeron pacientes que cumpl&#237;an criterios de Kinder para EITC&#46; Se consideraron variables predictoras&#58; manifestaciones &#171;altamente espec&#237;ficas de enfermedad del tejido conectivo &#40;ETC&#41;&#187; &#40;Raynaud&#44; xeroftalmia o artritis&#41;&#44; t&#237;tulos altos de anticuerpos antinucleares &#40;ANA&#41; &#40;mayores a 1&#58;320&#41; y patrones espec&#237;ficos de ANA &#40;centrom&#233;rico&#44; citopl&#225;smico y nucleolar&#41;&#46; El cambio en la capacidad vital forzada &#37; &#40;CVF&#37;&#41; en el tiempo y el patr&#243;n en TCAR fueron las variables de resultado estudiadas&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 66 pacientes&#46; Veintinueve presentaron al menos una manifestaci&#243;n &#171;altamente espec&#237;fica de ETC&#187; &#40;43&#44;94&#37;&#41;&#44; 16 ANA espec&#237;fico &#40;28&#44;57&#37;&#41; y 29 ANA alto t&#237;tulo &#40;43&#44;94&#37;&#41;&#46; Aquellos con manifestaciones &#171;altamente espec&#237;ficas de ETC&#187; presentaron menor frecuencia de sexo masculino &#40;10&#44;34&#37; vs 48&#44;65&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; menor edad en a&#241;os &#40;media 52 &#91;DE<span class="elsevierStyleHsp" style=""></span>14&#44;58&#93; vs 62&#44;08 &#91;9&#44;46&#93;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y menor mediana de declinaci&#243;n de CVF<span class="elsevierStyleHsp" style=""></span>&#37; &#40;1<span class="elsevierStyleHsp" style=""></span>&#91;RIC &#8722;1 a 10&#93; vs &#8722;6 &#91;RIC &#8722;16 a &#8722;4&#93;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;006&#41;&#46; En el an&#225;lisis de regresi&#243;n lineal m&#250;ltiple la presencia de manifestaciones &#171;altamente espec&#237;ficas de ETC&#187; se asoci&#243; con mejor&#237;a en CVF&#37; &#40;coeficiente B de 13&#44;25 &#91;IC 95&#37; 2&#44;41 a 24&#44;09&#93;&#41;&#46; No encontramos asociaciones en cuanto al patr&#243;n en TACAR&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La presencia de manifestaciones &#171;altamente espec&#237;ficas de ETC&#187; se asoci&#243; con sexo femenino&#44; menor edad al inicio y una evoluci&#243;n m&#225;s favorable en cuanto a la CVF&#37;&#44; lo cual evidencia el impacto de las manifestaciones cl&#237;nicas en la evoluci&#243;n de estos pacientes&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Objetivos"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "M&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as&#58; Alberti ML&#44; Paulin F&#44; Toledo HM&#44; Fern&#225;ndez ME&#44; Caro FM&#44; Rojas-Serrano J&#44; et al&#46; Enfermedad indiferenciada del tejido conectivo y enfermedad pulmonar intersticial&#58; intentando definir patrones&#46; Reumatol Clin&#46; 2018&#59;14&#58;75&#8211;80&#46;</p>"
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        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Diagnostic criteria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Presence of&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Symptoms associated with connective tissue disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">At least one of the following symptoms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46; Raynaud&#39;s phenomenon&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46; Arthralgia&#47;multiple joint swelling&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46; Photosensitivity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46; Unintentional weight loss&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46; Morning stiffness&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#46; Xerostom&#237;a or xerophthalmia &#40;sicca symptoms&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#46; Dysphagia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#46; Recurrent unexplained fever&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#46; Gastroesophageal reflux&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#46; Skin changes &#40;rash&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#46; Oral ulceration&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#46; Nonandrogenic alopecia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#46; Proximal muscle weakness&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Evidence of systemic inflammation in the absence of infection&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Positive findings for at least one of the following&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46; Antinuclear antibodies &#40;ANA&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46; Rheumatoid factor &#40;RF&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46; Anti-Scl-70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46; Anti Ro&#47;SS-A or La&#47;SS-B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46; Anti-Jo-1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#46; Erythrocyte sedimentation rate &#40;more than twice the normal value&#41;&#44; C reactive protein&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Kinder Criteria for Patients With Interstitial Lung Disease Associated With Undifferentiated Connective Tissue Disease&#46;</p>"
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        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
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          "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">ANA&#44; antinuclear antibodies&#59; CTD&#44; connective tissue disease&#59; DLCO&#44; diffusing capacity of the lung for carbon monoxide&#59; FVC&#44; forced vital capacity&#59; GER&#44; gastroesophageal reflux&#59; HMF&#44; Hospital Mar&#237;a Ferrer&#59; HRCT&#44; high-resolution computed tomography&#59; INER&#44; National Institute of Respiratory Diseases Ismael Cosio Villegas&#59; RF&#44; rheumatoid factor&#59; SD&#44; standard deviation&#59; UIP&#44; usual interstitial pneumonia&#46;</p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Data expressed as n &#40;&#37;&#41; or mean &#40;SD&#41;&#46;</p>"
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            0 => array:2 [
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">INER &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">HMF &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>66&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Demographic characteristics</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Men&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17 &#40;37&#46;78&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;19&#46;05&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21 &#40;31&#46;82&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Age at diagnosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57&#46;37 &#40;12&#46;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">58&#46;23 &#40;14&#46;61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57&#46;65 &#40;12&#46;91&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Smoking behavior<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;33&#46;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14 &#40;66&#46;67&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29 &#40;43&#46;94&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Immunology laboratory</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>ANA positive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">37 &#40;84&#46;09&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20 &#40;95&#46;24&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57 &#40;87&#46;69&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>RF positive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20 &#40;48&#46;78&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;42&#46;86&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29 &#40;46&#46;77&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>High ANA titer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17 &#40;37&#46;78&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;57&#46;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29 &#40;43&#46;94&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Specific ANA pattern&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;28&#46;57&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Clinical characteristics</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Raynaud&#39;s phenomenon<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;6&#46;67&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;33&#46;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;15&#46;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Xerophthalmia<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;15&#46;56&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;42&#46;86&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;24&#46;24&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Xerostom&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;33&#46;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;57&#46;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27 &#40;40&#46;91&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Arthritis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;13&#46;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;28&#46;57&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;18&#46;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Arthralgia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;26&#46;67&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;28&#46;57&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;27&#46;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Morning stiffness&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;8&#46; 89&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;6&#46;06&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>GER symptoms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;28&#46;89&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;33&#46;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20 &#40;30&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Weight loss&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19 &#40;42&#46;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;28&#46;57&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25 &#40;37&#46;88&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Photosensitivity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;2&#46;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;4&#46;76&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;3&#46;03&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dysphagia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;4&#46;44&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;3&#46;03&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Recurrent unexplained fever&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;11&#46;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;4&#46;76&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;9&#46;09&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Proximal muscle weakness&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;9&#46;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;3&#46;03&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Alopecia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Manifestations highly specific for CTD<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14 &#40;31&#46;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;71&#46;94&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29 &#40;43&#46;94&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Baseline respiratory function test</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>FVC &#40;predicted &#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60&#46;61 &#40;19&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64&#46;4 &#40;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61&#46;86 &#40;19&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>DLCO &#40;predicted &#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44&#46;36 &#40;23&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45&#46;85 &#40;18&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44&#46;94 &#40;21&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">HRCT pattern</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Typical UIP pattern&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;13&#46;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;14&#46;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;13&#46;64&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Pattern inconsistent with UIP<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29 &#40;64&#46;44&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;14&#46;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32 &#40;48&#46;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Cohort of Patients With Interstitial Lung Disease Associated With Undifferentiated Connective Tissue Disease&#44; HMF and INER&#46; Description of the Demographic&#44; Clinical&#44; Immunology Laboratory and Imaging Characteristics&#46; Comparison Between the Two Cohorts&#46;</p>"
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          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">CTD&#44; connective tissue disease&#59; DLCO&#44; diffusing capacity of the lung for carbon monoxide&#59; FVC&#44; forced vital capacity&#59; HMF&#44; Hospital Mar&#237;a Ferrer&#59; HRCT&#44; high-resolution computed tomography&#59; INER&#44; National Institute of Respiratory Diseases Ismael Cosio Villegas&#59; IQR&#44; interquartile range&#59; SD&#44; standard deviation&#59; UCTD&#44; undifferentiated connective tissue disease UIP&#44; usual interstitial pneumonia&#46;</p><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Data expressed as n &#40;&#37;&#41;&#44; mean &#40;SD&#41; or median &#40;IQR&#41;&#46;</p>"
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">UCTD with manifestations highly specific for CTD &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">UCTD without manifestations highly specific for CTD &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>37&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Men&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;10&#46;34&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;48&#46;65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52 &#40;14&#46;58&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62&#46;08 &#40;9&#46;46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Typical UIP pattern on HRCT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;10&#46;34&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;16&#46;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pattern on HRCT inconsistent with UIP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14 &#40;48&#46;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;48&#46;65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Baseline FVC &#40;predicted &#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">58 &#40;19&#46;78&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64&#46;97 &#40;18&#46;66&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Baseline DLCO &#40;predicted &#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43 &#40;19&#46;02&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">46&#46;38 &#40;23&#46;60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Difference between final and baseline FVC &#40;predicted &#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;&#8722; 1 to 10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722; 6 &#40;&#8722; 16 to &#8722; 4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Follow-up period in weeks&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34 &#40;27 to 56&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36 &#40;27 to 50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Cohort of Patients With Interstitial Lung Disease Associated With Undifferentiated Connective Tissue Disease&#44; HMF and INER&#46; Comparison Between Patients With and Without Manifestations &#8220;Highly Specific for Connective Tissue Disease&#8221;&#46;</p>"
        ]
      ]
      3 => array:8 [
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        "etiqueta" => "Table 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
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            "identificador" => "at4"
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">ANA&#44; antinuclear antibodies&#59; CI&#44; confidence interval&#59; CTD&#44; connective tissue disease&#59; HMF&#44; Hospital Mar&#237;a Ferrer&#59; INER&#44; National Institute of Respiratory Diseases Ismael Cosio Villegas&#59; OR&#44; odds ratio&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR &#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Manifestations &#8220;highly specific for CTD&#8221;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;35 &#40;0&#46;08&#8211;1&#46;46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">High ANA titer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;93 &#40;0&#46;24&#8211;3&#46;59&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;93&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Specific ANA pattern&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;82 &#40;0&#46;18&#8211;3&#46;64&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Men&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;90 &#40;0&#46;18&#8211;4&#46;43&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;90&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age under 60 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#46;53 &#40;2&#46;79&#8211;47&#46;69&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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        "descripcion" => array:1 [
          "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Cohort of Patients With Interstitial Lung Disease Associated With Undifferentiated Connective Tissue Disease&#44; HMF and INER&#46; Multiple Logistic Regression Analysis With High-Resolution Computed Tomography Pattern Inconsistent With Usual Interstitial Pneumonia as Dependent Variable&#46;</p>"
        ]
      ]
      4 => array:8 [
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        "etiqueta" => "Table 5"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
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            "identificador" => "at5"
            "detalle" => "Table "
            "rol" => "short"
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        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">ANA&#44; antinuclear antibodies&#59; CI&#44; confidence interval&#59; CTD&#44; connective tissue disease&#59; HMF&#44; Hospital Mar&#237;a Ferrer&#59; HRCT&#44; high-resolution computed tomography&#59; INER&#44; National Institute of Respiratory Diseases Ismael Cosio Villegas&#59; UIP&#44; usual interstitial pneumonia&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">&#946;</span> Coefficient&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95&#37; CI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Manifestations &#8220;highly specific for CTD&#8221;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#46;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;41 to 24&#46;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">High ANA titer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;8&#46;49 to 14&#46;37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Specific ANA pattern&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;2&#46;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;17&#46;06 to 12&#46;86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Men&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;10&#46;34 to 17&#46;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age over 60 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;10&#46;12 to 17&#46;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">HRCT pattern inconsistent with UIP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;9&#46;10 to 12&#46;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Received treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;7&#46;47 to 14&#46;79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab1703961.png"
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        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Cohort of Patients With Interstitial Lung Disease Associated With Undifferentiated Connective Tissue Disease&#44; HMF and INER&#46; Multiple Linear Regression Analysis With Change in the Forced Vital Capacity &#40;&#37;&#41; as Dependent Variable&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:25 [
            0 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An official ATS&#47;ERS&#47;JRS&#47;ALAT statement&#58; idiopathic pulmonary fibrosis&#58; evidence-based guidelines for diagnosis and management"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46; Raghu"
                            1 => "H&#46;R&#46; Collard"
                            2 => "J&#46;J&#46; Egan"
                            3 => "F&#46;J&#46; Martinez"
                            4 => "J&#46; Behr"
                            5 => "K&#46;K&#46; Brown"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/rccm.2009-040GL"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2011"
                        "volumen" => "183"
                        "paginaInicial" => "788"
                        "paginaFinal" => "824"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21471066"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An official American Thoracic Society&#47;European Respiratory Society statement&#58; update of the international multidisciplinary classification of the idiopathic interstitial pneumonias"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "W&#46;D&#46; Travis"
                            1 => "U&#46; Costabel"
                            2 => "D&#46;M&#46; Hansell"
                            3 => "T&#46;E&#46; King"
                            4 => "D&#46;A&#46; Lynch"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/rccm.201308-1483ST"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2013"
                        "volumen" => "188"
                        "paginaInicial" => "733"
                        "paginaFinal" => "748"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24032382"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
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Original Article
Undifferentiated Connective Tissue Disease and Interstitial Lung Disease: Trying to Define Patterns
Enfermedad indiferenciada del tejido conectivo y enfermedad pulmonar intersticial: intentando definir patrones
María Laura Albertia,
Corresponding author
, Francisco Paulina, Heidegger Mateos Toledob, Martín Eduardo Fernándeza, Fabián Matías Caroa, Jorge Rojas-Serranob, Mayra Edith Mejíab
a Hospital María Ferrer, Ciudad Autónoma de Buenos Aires, Argentina
b Instituto Nacional de Enfermedades Respiratorias (INER), Distrito Federal, Mexico
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The diagnosis of idiopathic interstitial pneumonia requires the exclusion of other known causes of interstitial lung disease &#40;ILD&#41;&#44; among them connective tissue diseases &#40;CTD&#41;&#46; The most conservative recommendations suggest the determination of rheumatoid factor &#40;RF&#41; and antinuclear antibodies &#40;ANA&#41; together with a questionnaire for the purpose of ruling out a CTD&#44; although it is considered that screening for the presence of other antibodies &#40;anti-Ro&#47;SS-A&#44; anti-La&#47;SS-B&#44; anti-Jo-1&#44; etc&#46;&#41; could be useful in selected cases&#46;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">1&#44;2</span></a> As a consequence of these recommendations&#44; it is common to encounter positive findings in the physical examination&#44; questionnaires and&#47;or immunology laboratory tests in patients that do not meet the classification criteria for a particular CTD&#44; but are diagnosed as having a syndrome that has had many names&#44; one of which is undifferentiated connective tissue disease &#40;UCTD&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">3</span></a> This disorder is characterized by a considerable heterogeneity in terms of the demographic&#44; clinical and morphological &#40;histological and tomographic&#41; characteristics as well as the outcome&#46;<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">4&#8211;8</span></a> The existence of highly sensitive classification criteria proposed by a number of authors has contributed to the heterogeneity&#46;<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">4&#44;5&#44;9&#44;10</span></a> An intersociety consensus was recently published that attempts to clarify the definition of this disorder referred to as &#8220;interstitial lung disease &#40;or interstitial pneumonia&#41; with autoimmune features&#8221;&#44; although the proposed criteria have not been validated&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">11</span></a> Beneath the hypothesis there is an underlying idea that this condition affects at least 2 different groups of patients&#46; First&#44; there would be a group of patients with inflammatory ILD&#44; associated with an incomplete CTD that might or might not be detected throughout the course of the disease&#46; Secondly&#44; there would be another group of patients with fibrotic ILD&#44; with a clinical profile similar to that of idiopathic pulmonary fibrosis &#40;IPF&#41;&#44; with false positive results according to the immunology laboratory&#44; accompanied by nonspecific extrapulmonary clinical manifestations that are prevalent in the general population&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">12</span></a> In this context&#44; the main objective of our study was to group the patients according to the presence or absence of certain clinical manifestations or immunological features&#44; hoping to observe that these groups had different tomographic and&#47;or functional expressions&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and Methods</span><p id="par0010" class="elsevierStylePara elsevierViewall">This is an observational study involving retrospective cohorts&#46; We reviewed the medical records of all the patients hospitalized in the ILD clinic of the <span class="elsevierStyleItalic">Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas</span> &#40;INER&#41; &#40;Mexico&#41; between January 2012 and December 2014&#44; and of all of the outpatients attended to in the ILD unit of Hospital Mar&#237;a Ferrer &#40;HMF&#41; in Buenos Aires&#44; Argentina&#44; between January 2012 and June 2015&#46; The patients provided their written consent&#46; We included those patients with ILD who met the Kinder criteria for UCTD &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">3</span></a> We excluded patients who met the criteria for a defined CTD in accordance with the criteria of the American College of Rheumatology or for some other cause of known interstitial disease&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">We recorded demographic data &#40;age&#44; sex&#44; smoking behavior&#41;&#44; clinical findings &#40;respiratory signs&#47;symptoms and those associated with CTD&#41;&#44; data provided by the immunology laboratory &#40;ANA&#44; RF and anti-Ro&#47;SS-A&#44; anti-Jo-1&#44; anti-Scl-70&#44; anticentromere and anti-U1 ribonucleoprotein &#91;RNP&#93; antibodies&#41;&#44; data on respiratory function &#40;percentage of predicted forced vital capacity &#91;FVC&#37;&#93; and percentage of predicted diffusing capacity of the lung for carbon monoxide &#91;DLCO&#37;&#93; at baseline&#44; as well as changes in FVC&#37; during follow-up&#41;&#44; high-resolution computed tomography &#40;HRCT&#41; and surgical lung biopsy&#46; Follow-up included respiratory function test every 4&#8211;6<span class="elsevierStyleHsp" style=""></span>meses&#46; With respect to the clinical manifestations&#44; this being a retrospective study&#44; we analyzed those that are usually dealt with in visits to the pulmonologist specialized in ILD in the participating centers &#40;those included in the Kinder criteria&#41;&#46; Other more specific manifestations that require the presence of another specialist for their evaluation &#40;for example&#44; mechanic&#39;s hands or Gottron&#39;s papules&#41; were not analyzed&#46; Data related to treatment were also recorded&#46; In every case&#44; this was indicated by the treating physician according to his or her criteria&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Definition of the Variables</span><p id="par0020" class="elsevierStylePara elsevierViewall">Immunology laboratory&#58; the determination of the RF of the patients of the HMF was performed by nephelometry with a cut-off point of 35<span class="elsevierStyleHsp" style=""></span>U&#47;mL&#44; and in the INER by immunochemiluminescence with a cut-off point of 20<span class="elsevierStyleHsp" style=""></span>U&#47;mL&#46; Indirect immunofluorescence &#40;IIF&#41; was used to detect ANA&#44; with a cut-off titer of 1&#58;80&#46; The determination of anti-Ro&#47;SS-A&#44; anti-Jo-1&#44; anti-U1 RNP and anti-Scl-70 antibodies was done with the enzyme-linked immunosorbent assay &#40;ELISA&#41;&#44; with a cut-off value of 20<span class="elsevierStyleHsp" style=""></span>U&#47;mL&#46; Anticentromere antibody was measured using IIF&#44; with a cut-off titer of 1&#58;80&#46; Respiratory function tests&#58; spirometry&#44; plethysmography and DLCO measurements were performed at baseline and every 4&#8211;6<span class="elsevierStyleHsp" style=""></span>months in accordance with standardized acceptability and reproducibility criteria&#46;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">13&#8211;16</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">High-resolution computed tomography was performed with a slice width of 1<span class="elsevierStyleHsp" style=""></span>mm at intervals of 10<span class="elsevierStyleHsp" style=""></span>mm&#46; The results were evaluated by a radiologist who was an expert in interstitial disease&#46; The findings were classified according to standardized criteria as being typical of usual interstitial pneumonia &#40;UIP&#41;&#44; possible UIP and inconsistent with UIP&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">1</span></a> Lung biopsies were evaluated by a pathologist with experience in ILD&#46; The results were classified as indicative of UIP&#44; nonspecific interstitial pneumonia &#40;NSIP&#41;&#44; organizing pneumonia &#40;OP&#41;&#44; NSIP with OP&#44; lymphoid interstitial pneumonia &#40;LIP&#41; and unclassifiable ILD&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">2</span></a> The presence of lymphoid follicles&#44; follicular bronchiolitis&#44; pleural involvement and vascular involvement were also recorded&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">A multidisciplinary group defined a priori the signs that should be considered&#46; They consisted of a set of clinical manifestations &#40;Raynaud&#39;s phenomenon&#44; xerophthalmia or arthritis&#41;&#44; included in the criteria proposed by Kinder&#44; as being highly specific for CTD&#46; The patients who had at least one of them were considered to show <span class="elsevierStyleItalic">highly specific manifestations of CTD</span>&#46; <span class="elsevierStyleItalic">High titers of ANA</span> were considered to be those greater than 1&#58;320&#44; and the <span class="elsevierStyleItalic">patterns specific for ANA</span> were centromere&#44; cytoplasmic and nucleolar&#46; The choice of these ANA patterns as &#8220;specific&#8221; is linked to their strong association with CTD in which ILD constitutes a common manifestation&#44; which makes it less likely that the test results in a false positive&#46;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">17&#44;18</span></a> These 3 variables &#40;highly specific manifestations of CTD&#44; specific ANA patterns and a high ANA titer&#41; were considered to be major predictive variables&#46; We considered changes in the FVC&#37; over time and the HRCT pattern to be major outcome variables&#46; Sex and age were also evaluated&#46; These variables were chosen as they are characteristics that are expressed differently in an &#8220;IPF-like&#8221; disease and an inflammatory ILD associated with a CTD&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">5</span></a> Potential confounders were included in a multivariate analysis in the attempt to correct the effect of eventual selection biases&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Statistical Analysis</span><p id="par0035" class="elsevierStylePara elsevierViewall">The categorical variables were expressed in terms of frequency and the continuous variables as the mean and standard deviation &#40;SD&#41; or median and interquartile range &#40;IQR&#41;&#44; depending on whether or not there was a normal distribution&#44; respectively&#46; The univariate analysis was performed using the chi-square test&#44; Fisher&#39;s exact test&#44; Student&#39;s t test or Wilcoxon rank-sum test&#44; depending the type of variable&#46; Multiple logistic regression analysis was carried out to define the variables that were associated with the presence of a HRCT pattern that was inconsistent with UIP&#46; As covariates in the model&#44; we included the sex&#44; age under 60<span class="elsevierStyleHsp" style=""></span>years&#44; the presence of manifestations that were highly specific for CTD&#44; a specific ANA pattern and a high ANA titer&#46; The adjusted odds ratio &#40;OR&#41; and the 95&#37; confidence intervals &#40;CI&#41; were recorded&#46; Multiple linear regression was utilized to determine which variables were associated with changes in FVC&#37; over time&#46; As independent variables&#44; we included age over 60<span class="elsevierStyleHsp" style=""></span>years&#44; sex&#44; the presence of manifestations that were highly specific for CTD&#44; a specific ANA pattern&#44; high ANA titer&#44; the presence of a pattern that was inconsistent with UIP in the HRCT and whether or not the patient had received a specific treatment&#46; The <span class="elsevierStyleItalic">&#946;</span> coefficients and 95&#37; CI were recorded&#46; A <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05 was considered to indicate statistical significance&#46; The STATA 13&#46;0 software package was used for the statistical analysis&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Characteristics of the Cohorts</span><p id="par0040" class="elsevierStylePara elsevierViewall">We reviewed 648 medical records in the INER and 292 in HMF&#46; We included a total of 66 patients&#44; 21 men &#40;31&#46;82&#37;&#41;&#44; with a mean age &#40;SD&#41; of 57&#46;65<span class="elsevierStyleHsp" style=""></span>years &#40;12&#46;91&#41;&#46; The median &#40;IQR&#41; follow-up period was 35 weeks &#40;27&#8211;50&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The cohorts analyzed &#40;INER and HMF&#41; were different in terms of the proportion of patients who smoked &#40;33&#46;3&#37; vs 66&#46;6&#37;&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;011&#41; and in the presence of anti-Ro&#47;SS-A antibody &#40;4&#46;55&#37; vs 47&#46;62&#37;&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#44; of Raynaud&#39;s phenomenon &#40;6&#46;67&#37; vs 33&#46;33&#37;&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;005&#41;&#44; of xerophthalmia &#40;15&#46;56&#37; vs 42&#46;86&#37;&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;016&#41;&#44; of highly specific manifestations of CTD &#40;31&#46;11&#37; vs 71&#46;43&#37;&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;002&#41; and of HRCT findings inconsistent with UIP &#40;64&#46;44&#37; vs 85&#37; &#91;14&#46;29&#93;&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#44; respectively &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">The most common clinical manifestations were xerostomia &#40;40&#46;9&#37;&#41;&#44; weight loss &#40;38&#37;&#41; and symptoms of gastroesophageal reflux &#40;30&#46;3&#37;&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The most widespread serological finding was the presence of ANA &#40;87&#46;69&#37;&#41; at a titer higher than 1&#58;320 in 44&#37; of the cases&#46; The fine speckled pattern was that most frequently observed in IIF &#40;48&#46;12&#37;&#41;&#46; Anti-Ro&#47;SS-A antibody was tested in 43 patients&#44; and was positive in 11 &#40;25&#46;2&#37;&#41;&#44; whereas anti-Jo-1 antibody was positive in 7 &#40;23&#46;3&#37;&#41; of the 30 participants in whom it was requested&#46; All of the individuals tested for anti-Scl-70 and anti-U1-RNP antibodies were negative&#46; Surgical biopsy was performed in 15 patients &#40;22&#46;7&#37;&#41;&#46; The definitive diagnosis was UIP in 7 of them&#44; but diffuse lymphoid follicles were found in 3&#46; In 7 cases&#44; the diagnosis was NSIP &#40;in 3 combined with features of UIP and in 2 with OP&#41;&#46; Three biopsies were defined as &#8220;unclassifiable&#8221;&#46; The histological findings were involvement of arterioles in 5 biopsies&#44; follicular bronchiolitis in 2 and diffuse lymphoid follicles in 9&#46; In no case was there pleural involvement&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">With regard for therapy&#44; only 47 patients received a specific drug &#40;an immunosuppressive or antifibrotic agent&#41;&#46; The treatments most widely utilized were azathioprine in 23 &#40;48&#46;94&#37;&#41;&#44; mycophenolate mofetil in 14 &#40;29&#46;79&#37;&#41;&#44; methotrexate in 3 &#40;6&#46;38&#37;&#41;&#44; steroids alone in 3 &#40;6&#46;38&#37;&#41;&#44; cyclophosphamide in 2 &#40;4&#46;26&#37;&#41; and pirfenidone in 2 &#40;4&#46;26&#37;&#41;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Defining Patterns&#46; Univariate and Multivariate Analysis</span><p id="par0065" class="elsevierStylePara elsevierViewall">In the univariate analysis&#44; the patients with manifestations that were &#8220;highly specific for CTD&#8221; were younger &#40;mean 52 years &#91;SD 14&#46;58&#93; vs 62 years &#91;9&#46;46&#93;&#59; &#91;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;01&#93;&#41; and the proportion of men was lower &#40;10&#46;34&#37; vs 48&#46;65&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;01&#41;&#46; Although we observed no differences in the baseline FVC&#37; and DLCO&#37;&#44; the individuals with manifestations that were &#8220;highly specific for CTD&#8221; had a more favorable course in terms of the respiratory function test&#46; The change in the median &#40;IQR&#41; of FVC&#37; over time was 1 &#40;&#8722;1 to 10&#41; in the patients with manifestations that were &#8220;highly specific for CTD&#8221; vs &#8722;6 points &#40;&#8722;16 to &#8722;4&#41; in those in whom these manifestations were not encountered &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;01&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; It is important to clarify the fact that both groups &#40;with and without manifestations that were &#8220;highly specific for CTD&#8221;&#41; had similar median &#40;IQR&#41; follow-up periods &#40;34 weeks &#91;27&#8211;56&#93; vs 36 weeks &#91;27&#8211;50&#93;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;758&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">The presence or absence of high ANA titers or with a specific pattern was not associated with differences in terms of sex&#44; age&#44; frequency of manifestations that were &#8220;highly specific for CTD&#8221;&#44; functional data or that provided by HRCT&#46; In the multiple logistic regression analysis using HRCT pattern inconsistent with UIP as a dependent variable&#44; age under 60<span class="elsevierStyleHsp" style=""></span>years was the only variable that showed a statistically significant association&#44; with an OR &#40;95&#37;<span class="elsevierStyleHsp" style=""></span>CI&#41; of 11&#46;53 &#40;2&#46;7&#8211;47&#46;69&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46; In the multivariate analysis employing multiple linear regression&#44; the presence of manifestations that were &#8220;highly specific for CTD&#8221; was associated with an improvement in FVC&#37; values&#44; with a <span class="elsevierStyleItalic">&#946;</span> coefficient of 13&#46;25 &#40;95&#37;<span class="elsevierStyleHsp" style=""></span>CI&#44; 2&#46;41&#8211;24&#46;09&#41;&#44; this being the only independent variable to show a statistically significant association &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><elsevierMultimedia ident="tbl0025"></elsevierMultimedia></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Discussion</span><p id="par0075" class="elsevierStylePara elsevierViewall">In this report&#44; we found that the presence of at least 1 manifestation that was &#8220;highly specific for CTD&#8221; &#40;Raynaud&#39;s phenomenon&#44; xerophthalmia or arthritis&#41; was associated with a higher prevalence of women&#44; lower age at onset and a more favorable course in terms of changes in FVC&#37; over time&#44; which was confirmed after adjusting for potential confounders&#46; This profile differs from that classically observed in patients with IPF&#44; a disease in which there is a predominance of men&#44; advanced age and rapid functional deterioration&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">12</span></a> One datum to point out with respect to our results is the fact that there were significant clinical and radiological differences between the cohorts&#46; Although we do not have a definitive explanation for this finding&#44; it could be that the differences are related to the moment at which the patients are evaluated &#40;during a hospital stay in the INER and in the outpatient clinic in HMF&#41;&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">During the baseline evaluation of a patient with ILD&#44; the presence of clinical manifestations related to a CTD or a positive test for autoantibodies represents a dilemma for a physician&#44; who should decide whether to consider the patient a carrier of idiopathic ILD &#40;IPF&#41; and utilize antifibrotic agents&#44; or consider the case of a ILD associated with a CTD and administer immunosuppressive therapy&#46;<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">19&#44;20</span></a> The detection of clinical manifestations that can contribute to the differentiation of these phenotypes appears to be a relevant finding&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Our results support the proposals of other authors in terms of the impact of clinical manifestations on the course of this group of patients&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">5</span></a> The intersociety consensus recently published includes proposals for new classification criteria &#40;not yet validated&#41; in which the clinical manifestations occupy a specific domain &#40;together with a serological and a morphological domain&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">11</span></a> This consensus eliminates certain clinical manifestations included in previous criteria &#40;for example&#44; symptoms of gastroesophageal reflux&#44; weight loss&#41; and includes others with greater specificity&#44; such as Raynaud&#39;s phenomenon and arthritis&#46; The patients who meet the proposed criteria and do not satisfy those of a defined CTD have an &#8220;interstitial lung disease with autoimmune features&#8221;&#46; We believe that the objective of the results of our study are along the lines of that proposed in this consensus&#44; in the attempt to exclude highly sensitive manifestations that can mean the erroneous inclusion of individuals with IPF in the group of patients with ILD associated with CTD&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">With respect to the serological data&#44; neither the presence of high ANA titers nor the specific patterns according to IIF were helpful in differentiating between the groups presented in the hypothesis of this study&#46; This contrasts with findings reported by other groups&#44; which stress the role of the detection of autoantibodies in the evaluation of these patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">4&#44;21</span></a> We consider that the information provided by the immunology laboratory may be useful&#44; although we know that it can lead to false positives and negatives &#40;even more so in the use of techniques like IIF that depend on the observer&#41; and should be interpreted in accordance with the clinical setting in which it is obtained&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">In a recent article that involved patients with a diagnosis of &#8220;interstitial lung disease with autoimmune features&#8221; according to the abovementioned consensus&#44;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">11</span></a> it was observed that survival was better in those with a pattern not specific for UIP&#46; The authors stressed the importance of the tomographic and histological pattern&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">22</span></a> In our study&#44; the HRCT pattern did not differ among the subgroups evaluated&#46; We found no association with a better functional outcome when a &#8220;pattern inconsistent with UIP&#8221; was included as a covariate in the multivariate analysis of the change in FVC over time&#46; We point out the low prevalence in our cohort of the typical pattern of UIP according to HRCT findings in comparison with other reports&#46;<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">4&#44;22&#44;23</span></a> It could be that there has been a decrease in the strength of the study for detecting differences in the HRCT pattern when compared to the clinical manifestations&#44; immunology laboratory and functional outcome&#46; Our cohort came from 2 centers specialized in respiratory diseases&#44; with physicians who have extensive experience in the evaluation of patients with ILD and numbers of patients similar to those of other cohorts previously reported&#46; Thus&#44; we consider that our findings are representative and comparable to those of other articles&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Our study has certain limitations&#46; The patients were included on the basis of the medical records documented during hospital stays in one center &#40;INER&#41; and from an outpatient clinic in the other &#40;HMF&#41;&#46; This may constitute an important difference regarding the severity of the cases in the 2 centers&#44; which implies possible selection bias&#46; On the other hand&#44; as this is a retrospective study with data taken directly from the medical records&#44; the examination concerning the symptoms linked to CTD was not standardized&#44; leading to possible information bias&#46; The study also has limitations with respect to the evaluation of the features of autoimmune disease&#46; The clinical and serological variables taken into account were those proposed in the Kinder criteria&#46; Thus&#44; they exclude manifestations and serological findings specific for CTD&#44; such as mechanic&#39;s hands&#44; palmar telangiectasias&#44; Gottron&#39;s papules&#44; antisynthetase antibodies other than Jo-1 or anti-cyclic citrullinated peptide antibodies&#46; Many of these variables are now incorporated into the latest intersociety consensus and are valuable in the identification of patients with UCTD&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">11</span></a> Again&#44; we did not analyze the role of capillaroscopy or minor salivary gland biopsy in the evaluation of patients with ILD associated with UCTD&#44; as they are not included in the diagnostic criteria utilized&#46;<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">24&#44;25</span></a> Finally&#44; to evaluate the functional outcome&#44; we chose to study the change in FVC&#37; over time&#44; in the knowledge that it is not the best method in patients who have different follow-up periods&#46; The analysis of the time to event would have been a more accurate approach&#44; but we did not have access to the data necessary to carry it out&#46; While we consider that our study provides useful information&#44; and that it is in keeping with the latest intersociety consensus&#44; we believe that there is a need for prospective studies that evaluate survival and involve a larger number of patients to respond more conclusively to the question being proposed&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Ethical Disclosures</span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Protection of human and animal subjects</span><p id="par0105" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Confidentiality of data</span><p id="par0110" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Right to privacy and informed consent</span><p id="par0115" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Financing</span><p id="par0120" class="elsevierStylePara elsevierViewall">The present report has not received any type of funding&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Conflicts of Interest</span><p id="par0125" class="elsevierStylePara elsevierViewall">The authors declare they have no conflicts of interest&#46;</p></span></span>"
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          "titulo" => "Abstract"
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          "titulo" => "Resumen"
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          "titulo" => "Introduction"
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          "titulo" => "Materials and Methods"
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              "titulo" => "Statistical Analysis"
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          "titulo" => "Results"
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              "identificador" => "sec0030"
              "titulo" => "Characteristics of the Cohorts"
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              "identificador" => "sec0035"
              "titulo" => "Defining Patterns&#46; Univariate and Multivariate Analysis"
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          "titulo" => "Discussion"
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              "titulo" => "Right to privacy and informed consent"
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          "titulo" => "Financing"
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    "pdfFichero" => "main.pdf"
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    "fechaRecibido" => "2016-06-28"
    "fechaAceptado" => "2016-10-30"
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          "palabras" => array:5 [
            0 => "Interstitial lung diseases"
            1 => "Connective tissue diseases"
            2 => "Autoimmune diseases"
            3 => "Antinuclear antibodies"
            4 => "Raynaud phenomenon"
          ]
        ]
      ]
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          "clase" => "keyword"
          "titulo" => "Palabras clave"
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          "palabras" => array:5 [
            0 => "Enfermedad pulmonar intersticial"
            1 => "Enfermedad del tejido conectivo"
            2 => "Enfermedades autoinmunes"
            3 => "Anticuerpos antinucleares"
            4 => "Fen&#243;meno de Raynaud"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To identify clinical or immunological features in patients with undifferentiated connective tissue disease &#40;UCTD&#41; associated interstitial lung disease &#40;ILD&#41;&#44; in order to group them and recognize different functional and high resolution computed tomography &#40;HRCT&#41; behavior&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Retrospective cohort study&#46; Patients meeting Kinder criteria for UCTD were included&#46; We defined the following predictive variables&#58; &#8216;highly specific&#8217; connective tissue disease &#40;CTD&#41; manifestations &#40;Raynaud&#39;s phenomenon&#44; dry eyes or arthritis&#41;&#44; high antinuclear antibody &#40;ANA&#41; titer &#40;above 1&#58;320&#41;&#44; and &#8216;specific&#8217; ANA staining patterns &#40;centromere&#44; cytoplasmic and nucleolar patterns&#41;&#46; We evaluated the following outcomes&#58; change in the percentage of the predicted forced vital capacity &#40;FVC&#37;&#41; during the follow-up period&#44; and HRCT pattern&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Sixty-six patients were included&#46; Twenty-nine &#40;43&#46;94&#37;&#41; showed at least one &#8216;highly specific&#8217; CTD manifestation&#44; 16 &#40;28&#46;57&#37;&#41; had a &#8216;specific&#8217; ANA staining pattern and 29 &#40;43&#46;94&#37;&#41; high ANA titer&#46; Patients with &#8216;highly specific&#8217; CTD manifestations were younger &#40;mean &#91;SD&#93; 52 years &#91;14&#46;58&#93; vs 62&#46;08 years &#91;9&#46;46&#93;&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#44; were more likely men &#40;10&#46;34&#37; vs 48&#46;65&#37;&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41; and showed a smaller decline of the FVC&#37; &#40;median &#91;interquartile range&#93; 1&#37; &#91;&#8722;1 to 10&#93; vs &#8722;6&#37; &#91;&#8722;16 to &#8722;4&#93;&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;006&#41;&#46; In the multivariate analysis&#44; the presence of highly specific manifestations was associated with improvement in the FVC&#37; &#40;<span class="elsevierStyleItalic">B coefficient</span> of 13&#46;25 &#91;95&#37; confidence interval&#44; 2&#46;41 to 24&#46;09&#93;&#41;&#46; No association was observed in relation to the HRCT pattern&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The presence of &#8216;highly specific&#8217; CTD manifestations was associated with female sex&#44; younger age and better functional behavior&#46; These findings highlight the impact of the clinical features in the outcome of patients with UCTD ILD&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objectives"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Methods"
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          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
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            "titulo" => "Conclusion"
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Agrupar a los pacientes con enfermedad pulmonar intersticial &#40;EPI&#41; asociada a enfermedad indiferenciada del tejido conectivo &#40;EITC&#41; seg&#250;n la presencia o no de ciertas manifestaciones cl&#237;nicas o inmunol&#243;gicas&#44; esperando encontrar diferentes expresiones tomogr&#225;ficas o funcionales&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio de cohortes retrospectivas&#46; Se incluyeron pacientes que cumpl&#237;an criterios de Kinder para EITC&#46; Se consideraron variables predictoras&#58; manifestaciones &#171;altamente espec&#237;ficas de enfermedad del tejido conectivo &#40;ETC&#41;&#187; &#40;Raynaud&#44; xeroftalmia o artritis&#41;&#44; t&#237;tulos altos de anticuerpos antinucleares &#40;ANA&#41; &#40;mayores a 1&#58;320&#41; y patrones espec&#237;ficos de ANA &#40;centrom&#233;rico&#44; citopl&#225;smico y nucleolar&#41;&#46; El cambio en la capacidad vital forzada &#37; &#40;CVF&#37;&#41; en el tiempo y el patr&#243;n en TCAR fueron las variables de resultado estudiadas&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 66 pacientes&#46; Veintinueve presentaron al menos una manifestaci&#243;n &#171;altamente espec&#237;fica de ETC&#187; &#40;43&#44;94&#37;&#41;&#44; 16 ANA espec&#237;fico &#40;28&#44;57&#37;&#41; y 29 ANA alto t&#237;tulo &#40;43&#44;94&#37;&#41;&#46; Aquellos con manifestaciones &#171;altamente espec&#237;ficas de ETC&#187; presentaron menor frecuencia de sexo masculino &#40;10&#44;34&#37; vs 48&#44;65&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; menor edad en a&#241;os &#40;media 52 &#91;DE<span class="elsevierStyleHsp" style=""></span>14&#44;58&#93; vs 62&#44;08 &#91;9&#44;46&#93;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y menor mediana de declinaci&#243;n de CVF<span class="elsevierStyleHsp" style=""></span>&#37; &#40;1<span class="elsevierStyleHsp" style=""></span>&#91;RIC &#8722;1 a 10&#93; vs &#8722;6 &#91;RIC &#8722;16 a &#8722;4&#93;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;006&#41;&#46; En el an&#225;lisis de regresi&#243;n lineal m&#250;ltiple la presencia de manifestaciones &#171;altamente espec&#237;ficas de ETC&#187; se asoci&#243; con mejor&#237;a en CVF&#37; &#40;coeficiente B de 13&#44;25 &#91;IC 95&#37; 2&#44;41 a 24&#44;09&#93;&#41;&#46; No encontramos asociaciones en cuanto al patr&#243;n en TACAR&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La presencia de manifestaciones &#171;altamente espec&#237;ficas de ETC&#187; se asoci&#243; con sexo femenino&#44; menor edad al inicio y una evoluci&#243;n m&#225;s favorable en cuanto a la CVF&#37;&#44; lo cual evidencia el impacto de las manifestaciones cl&#237;nicas en la evoluci&#243;n de estos pacientes&#46;</p></span>"
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            "titulo" => "Resultados"
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        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as&#58; Alberti ML&#44; Paulin F&#44; Toledo HM&#44; Fern&#225;ndez ME&#44; Caro FM&#44; Rojas-Serrano J&#44; et al&#46; Enfermedad indiferenciada del tejido conectivo y enfermedad pulmonar intersticial&#58; intentando definir patrones&#46; Reumatol Clin&#46; 2018&#59;14&#58;75&#8211;80&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Diagnostic criteria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Presence of&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Symptoms associated with connective tissue disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">At least one of the following symptoms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46; Raynaud&#39;s phenomenon&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46; Arthralgia&#47;multiple joint swelling&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46; Photosensitivity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46; Unintentional weight loss&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46; Morning stiffness&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#46; Xerostom&#237;a or xerophthalmia &#40;sicca symptoms&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#46; Dysphagia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#46; Recurrent unexplained fever&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#46; Gastroesophageal reflux&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#46; Skin changes &#40;rash&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#46; Oral ulceration&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#46; Nonandrogenic alopecia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#46; Proximal muscle weakness&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Evidence of systemic inflammation in the absence of infection&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Positive findings for at least one of the following&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46; Antinuclear antibodies &#40;ANA&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46; Rheumatoid factor &#40;RF&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46; Anti-Scl-70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46; Anti Ro&#47;SS-A or La&#47;SS-B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46; Anti-Jo-1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#46; Erythrocyte sedimentation rate &#40;more than twice the normal value&#41;&#44; C reactive protein&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Kinder Criteria for Patients With Interstitial Lung Disease Associated With Undifferentiated Connective Tissue Disease&#46;</p>"
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        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
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          "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">ANA&#44; antinuclear antibodies&#59; CTD&#44; connective tissue disease&#59; DLCO&#44; diffusing capacity of the lung for carbon monoxide&#59; FVC&#44; forced vital capacity&#59; GER&#44; gastroesophageal reflux&#59; HMF&#44; Hospital Mar&#237;a Ferrer&#59; HRCT&#44; high-resolution computed tomography&#59; INER&#44; National Institute of Respiratory Diseases Ismael Cosio Villegas&#59; RF&#44; rheumatoid factor&#59; SD&#44; standard deviation&#59; UIP&#44; usual interstitial pneumonia&#46;</p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Data expressed as n &#40;&#37;&#41; or mean &#40;SD&#41;&#46;</p>"
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              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">INER &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">HMF &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>66&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Demographic characteristics</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Men&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17 &#40;37&#46;78&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;19&#46;05&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21 &#40;31&#46;82&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Age at diagnosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57&#46;37 &#40;12&#46;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">58&#46;23 &#40;14&#46;61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57&#46;65 &#40;12&#46;91&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Smoking behavior<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;33&#46;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14 &#40;66&#46;67&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29 &#40;43&#46;94&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Immunology laboratory</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>ANA positive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">37 &#40;84&#46;09&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20 &#40;95&#46;24&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57 &#40;87&#46;69&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>RF positive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20 &#40;48&#46;78&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;42&#46;86&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29 &#40;46&#46;77&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>High ANA titer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17 &#40;37&#46;78&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;57&#46;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29 &#40;43&#46;94&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Specific ANA pattern&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;28&#46;57&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Clinical characteristics</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Raynaud&#39;s phenomenon<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;6&#46;67&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;33&#46;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;15&#46;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Xerophthalmia<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;15&#46;56&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;42&#46;86&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;24&#46;24&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Xerostom&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;33&#46;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;57&#46;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27 &#40;40&#46;91&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Arthritis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;13&#46;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;28&#46;57&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;18&#46;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Arthralgia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;26&#46;67&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;28&#46;57&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;27&#46;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Morning stiffness&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;8&#46; 89&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;6&#46;06&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>GER symptoms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;28&#46;89&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;33&#46;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20 &#40;30&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Weight loss&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19 &#40;42&#46;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;28&#46;57&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25 &#40;37&#46;88&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Photosensitivity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;2&#46;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;4&#46;76&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;3&#46;03&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dysphagia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;4&#46;44&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;3&#46;03&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Recurrent unexplained fever&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;11&#46;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;4&#46;76&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;9&#46;09&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Proximal muscle weakness&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;9&#46;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;3&#46;03&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Alopecia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Manifestations highly specific for CTD<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14 &#40;31&#46;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;71&#46;94&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29 &#40;43&#46;94&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Baseline respiratory function test</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>FVC &#40;predicted &#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60&#46;61 &#40;19&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64&#46;4 &#40;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61&#46;86 &#40;19&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>DLCO &#40;predicted &#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44&#46;36 &#40;23&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45&#46;85 &#40;18&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44&#46;94 &#40;21&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">HRCT pattern</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Typical UIP pattern&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;13&#46;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;14&#46;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;13&#46;64&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Pattern inconsistent with UIP<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29 &#40;64&#46;44&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;14&#46;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32 &#40;48&#46;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab1703958.png"
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            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005"><span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05 in the comparison between INER and HMF&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Cohort of Patients With Interstitial Lung Disease Associated With Undifferentiated Connective Tissue Disease&#44; HMF and INER&#46; Description of the Demographic&#44; Clinical&#44; Immunology Laboratory and Imaging Characteristics&#46; Comparison Between the Two Cohorts&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
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        "detalles" => array:1 [
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            "identificador" => "at3"
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          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">CTD&#44; connective tissue disease&#59; DLCO&#44; diffusing capacity of the lung for carbon monoxide&#59; FVC&#44; forced vital capacity&#59; HMF&#44; Hospital Mar&#237;a Ferrer&#59; HRCT&#44; high-resolution computed tomography&#59; INER&#44; National Institute of Respiratory Diseases Ismael Cosio Villegas&#59; IQR&#44; interquartile range&#59; SD&#44; standard deviation&#59; UCTD&#44; undifferentiated connective tissue disease UIP&#44; usual interstitial pneumonia&#46;</p><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Data expressed as n &#40;&#37;&#41;&#44; mean &#40;SD&#41; or median &#40;IQR&#41;&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">UCTD with manifestations highly specific for CTD &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">UCTD without manifestations highly specific for CTD &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>37&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Men&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;10&#46;34&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;48&#46;65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52 &#40;14&#46;58&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62&#46;08 &#40;9&#46;46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Typical UIP pattern on HRCT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;10&#46;34&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;16&#46;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pattern on HRCT inconsistent with UIP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14 &#40;48&#46;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;48&#46;65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Baseline FVC &#40;predicted &#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">58 &#40;19&#46;78&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64&#46;97 &#40;18&#46;66&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Baseline DLCO &#40;predicted &#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43 &#40;19&#46;02&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">46&#46;38 &#40;23&#46;60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Difference between final and baseline FVC &#40;predicted &#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;&#8722; 1 to 10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722; 6 &#40;&#8722; 16 to &#8722; 4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Follow-up period in weeks&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34 &#40;27 to 56&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36 &#40;27 to 50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab1703959.png"
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        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Cohort of Patients With Interstitial Lung Disease Associated With Undifferentiated Connective Tissue Disease&#44; HMF and INER&#46; Comparison Between Patients With and Without Manifestations &#8220;Highly Specific for Connective Tissue Disease&#8221;&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0020"
        "etiqueta" => "Table 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at4"
            "detalle" => "Table "
            "rol" => "short"
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        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">ANA&#44; antinuclear antibodies&#59; CI&#44; confidence interval&#59; CTD&#44; connective tissue disease&#59; HMF&#44; Hospital Mar&#237;a Ferrer&#59; INER&#44; National Institute of Respiratory Diseases Ismael Cosio Villegas&#59; OR&#44; odds ratio&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR &#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Manifestations &#8220;highly specific for CTD&#8221;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;35 &#40;0&#46;08&#8211;1&#46;46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">High ANA titer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;93 &#40;0&#46;24&#8211;3&#46;59&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;93&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Specific ANA pattern&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;82 &#40;0&#46;18&#8211;3&#46;64&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Men&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;90 &#40;0&#46;18&#8211;4&#46;43&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;90&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age under 60 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#46;53 &#40;2&#46;79&#8211;47&#46;69&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1703960.png"
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        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Cohort of Patients With Interstitial Lung Disease Associated With Undifferentiated Connective Tissue Disease&#44; HMF and INER&#46; Multiple Logistic Regression Analysis With High-Resolution Computed Tomography Pattern Inconsistent With Usual Interstitial Pneumonia as Dependent Variable&#46;</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0025"
        "etiqueta" => "Table 5"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
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            "identificador" => "at5"
            "detalle" => "Table "
            "rol" => "short"
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        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">ANA&#44; antinuclear antibodies&#59; CI&#44; confidence interval&#59; CTD&#44; connective tissue disease&#59; HMF&#44; Hospital Mar&#237;a Ferrer&#59; HRCT&#44; high-resolution computed tomography&#59; INER&#44; National Institute of Respiratory Diseases Ismael Cosio Villegas&#59; UIP&#44; usual interstitial pneumonia&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">&#946;</span> Coefficient&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95&#37; CI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Manifestations &#8220;highly specific for CTD&#8221;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#46;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;41 to 24&#46;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">High ANA titer&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Specific ANA pattern&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;17&#46;06 to 12&#46;86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;77&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;10&#46;34 to 17&#46;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;79&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;10&#46;12 to 17&#46;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;59&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;9&#46;10 to 12&#46;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Received treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;65&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;49&nbsp;\t\t\t\t\t\t\n
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          "en" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Cohort of Patients With Interstitial Lung Disease Associated With Undifferentiated Connective Tissue Disease&#44; HMF and INER&#46; Multiple Linear Regression Analysis With Change in the Forced Vital Capacity &#40;&#37;&#41; as Dependent Variable&#46;</p>"
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