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basado en los criterios propuestos por el Colegio Americano de Reumatolog&#237;a &#40;ACR-SCORE&#41;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">4</span></a>&#44; en el a&#241;o 1990&#44; que incluyen signos y s&#237;ntomas cl&#237;nicos propios de la enfermedad&#58; edad &#62;<span class="elsevierStyleHsp" style=""></span>50 a&#241;os&#44; cefalea localizada de reciente aparici&#243;n&#44; dolor a la palpaci&#243;n de la arteria temporal o disminuci&#243;n de su pulso&#44; velocidad de sedimentaci&#243;n &#62;<span class="elsevierStyleHsp" style=""></span>50<span class="elsevierStyleHsp" style=""></span>mm&#47;hora en la primera hora&#44; alteraci&#243;n histol&#243;gica &#40;arteritis necrosante o proceso granulomatoso con c&#233;lulas gigantes multinucleadas&#41;&#46; Con la presencia de 3 o m&#225;s de los 5 par&#225;metros se establece el diagn&#243;stico de AT con una sensibilidad del 93&#44;5&#37; y una especificidad del 91&#44;2&#37;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">4</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">La biopsia de AT es un procedimiento que se realiza habitualmente en r&#233;gimen ambulatorio y cuyo tiempo quir&#250;rgico oscila entre los 20 y los 50<span class="elsevierStyleHsp" style=""></span>min&#46; Presenta un porcentaje de complicaciones de entre el 0&#44;5 y el 1&#37;&#59; la principal complicaci&#243;n es el sangrado &#40;hemorragia o hematoma&#41;&#44; seguida de la infecci&#243;n de la herida quir&#250;rgica&#44; lesi&#243;n nerviosa&#44; lesi&#243;n vascular &#40;arterial o venosa&#41;&#44; necrosis cut&#225;nea o ictus&#44; en este trabajo no se han valorado las complicaciones asociadas a la biopsia&#44; actualmente se realizan t&#233;cnicas m&#237;nimamente invasivas y la biopsia en una t&#233;cnica cruenta<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">5</span></a>&#46; La biopsia sigue siendo el <span class="elsevierStyleItalic">gold standard</span> del diagn&#243;stico de la AT<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">2</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">El tratamiento indicado para estos pacientes son los glucocorticoides a dosis elevadas&#44; que presentan muchos efectos secundarios como son fracturas &#243;seas&#44; necrosis avascular de la cadera&#44; diabetes mellitus&#44; infecciones&#44; hemorragia gastrointestinal&#44; cataratas e hipertensi&#243;n<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">2&#44;6</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Los an&#225;lisis de coste&#47;efectividad no persiguen buscar la t&#233;cnica m&#225;s barata ni la m&#225;s eficaz&#44; sino que buscan la optimizaci&#243;n de recursos de los sistemas sanitarios&#44; para alcanzar el m&#225;ximo beneficio para la salud con los recursos disponibles<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">7&#44;8</span></a>&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">En nuestro hospital el diagn&#243;stico de la AT se realiza por el servicio de medicina interna&#44; que es quien solicita las anal&#237;ticas&#44; ecograf&#237;a y biopsias&#46; En este trabajo pretendemos conocer los gastos que se generan al realizar dicho diagn&#243;stico y secundariamente realizar un estudio de coste&#47;efectividad de distintas estrategias diagn&#243;sticas &#40;cl&#237;nica&#44; realizaci&#243;n de biopsia y&#47;o eco-Doppler&#41; y de tratamiento &#40;si el diagn&#243;stico negativo de AT implica una suspensi&#243;n de los corticoides&#41;&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Material y m&#233;todo</span><p id="par0035" class="elsevierStylePara elsevierViewall">Se realiza un estudio observacional retrospectivo y unic&#233;ntrico&#44; seg&#250;n pr&#225;ctica cl&#237;nica&#44; de los pacientes con sospecha de AT en el periodo 2012-2021&#46; Se solicit&#243; al servicio de codificaci&#243;n del hospital&#44; los pacientes con diagn&#243;stico primario y secundario de arteritis de arteria temporal&#46; Para la realizaci&#243;n de este estudio se obtuvo la aprobaci&#243;n del comit&#233; &#233;tico del hospital &#40;PI 21-2443&#41;&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Poblaci&#243;n incluida en el estudio y an&#225;lisis descriptivo de las variables</span><p id="par0040" class="elsevierStylePara elsevierViewall">Pacientes con diagn&#243;stico de AT realizado en nuestro centro hospitalario despu&#233;s del a&#241;o 2012&#46; En este periodo existen 107 pacientes con diagn&#243;stico de AT&#44; de los que se excluyen 32 pacientes &#40;26 con diagn&#243;stico antes del a&#241;o 2012&#44; 6 diagn&#243;stico realizado en otro hospital&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">Se recogieron los datos demogr&#225;ficos y de comorbilidades&#44; as&#237; como los signos y los s&#237;ntomas sugestivos de AT&#44; datos anal&#237;ticos como VSG<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>20&#46;00<span class="elsevierStyleHsp" style=""></span>mm y PCR<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>5&#46;00<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#44; realizaci&#243;n de eco-Doppler con valoraci&#243;n de la presencia de halo y biopsia con presencia de c&#233;lulas gigantes multinucleadas&#46; Se consider&#243; el diagn&#243;stico de AT con una puntuaci&#243;n mayor o igual a 3 seg&#250;n los criterios del ACR-SCORE&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Estudio econ&#243;mico</span><p id="par0050" class="elsevierStylePara elsevierViewall">Se analizaron los gastos generados por la biopsia de arteria temporal y por el eco-Doppler&#44; seg&#250;n lo publicado en el Boletin Oficial de Castilla y Le&#243;n &#40;BOCYL&#41;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">9</span></a>&#44; donde la biopsia supone 339&#46;75<span class="elsevierStyleHsp" style=""></span>&#8364; y el doppler arterial&#58; 167&#44;26<span class="elsevierStyleHsp" style=""></span>&#8364;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Se utiliz&#243; como gu&#237;a la declaraci&#243;n Consolidated Health Economic Evaluation Reporting Standards &#40;CHEERS&#41;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">10</span></a>&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">An&#225;lisis estad&#237;stico</span><p id="par0060" class="elsevierStylePara elsevierViewall">Se realiza un an&#225;lisis estad&#237;stico de las variables de la muestra con el programa estad&#237;stico SPSS&#174; 18 y G-Stat 2&#46;0&#46; Para la comparaci&#243;n de las variables categ&#243;ricas se utilizaron tablas de contingencia&#44; utilizando siempre que fue posible el test exacto de Fisher o el test de Chi-cuadrado&#59; se utiliz&#243; el test ANOVA para las variables cuantitativas&#46; Se consider&#243; significaci&#243;n estad&#237;stica los valores de p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46; Para analizar la validez del eco-Doppler y de la biopsia se calcul&#243; la sensibilidad y la especificidad compar&#225;ndolo con el diagn&#243;stico seg&#250;n ACR-SCORE<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>3&#44; tambi&#233;n se estableci&#243; la retirada de corticoides o la modificaci&#243;n del tratamiento como criterio de repercusi&#243;n&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Resultados</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Poblaci&#243;n incluida en el estudio y an&#225;lisis descriptivo de las variables&#58; <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Caracteristicas generales</span><p id="par0065" class="elsevierStylePara elsevierViewall">Para el objetivo primario se incluyeron 75 pacientes con una mediana de edad de 77 a&#241;os &#40;46-87&#41;&#59; 41 &#40;54&#44;7&#37;&#41; mujeres&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Dentro de los antecedentes en 46 casos exist&#237;a HTA &#40;61&#44;3&#37;&#41;&#59; 20 casos con dislipemia &#40;26&#44;7&#37;&#41;&#59; 15 casos con diabetes mellitus &#40;20&#37;&#41;&#59; 11 casos exist&#237;a EPOC &#40;14&#44;7&#37;&#41;&#59; un caso aparec&#237;a insuficiencia renal &#40;1&#44;3&#37;&#41;&#59; 21 casos presentaban polimialgia reum&#225;tica &#40;28&#37;&#41; y 22 casos ten&#237;an una cardiopat&#237;a &#40;29&#44;3&#37;&#41;&#46; Ning&#250;n antecedente present&#243; significaci&#243;n estad&#237;stica para diagn&#243;stico de AT&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Caracter&#237;sticas cl&#237;nicas</span><p id="par0075" class="elsevierStylePara elsevierViewall">Los s&#237;ntomas fueron cefalea 43casos &#40;57&#44;3&#37;&#41;&#44; dolores articulares 42 casos &#40;56&#37;&#41;&#44; mal estado general 40 casos &#40;53&#44;3&#37;&#41;&#44; cl&#237;nica visual 40 casos &#40;53&#44;3&#37;&#41;&#44; dolor temporal 31 casos &#40;41&#44;3&#37;&#41;&#44; claudicaci&#243;n mandibular 21 casos &#40;28&#37;&#41;&#44; fiebre 18 casos &#40;24&#37;&#41;&#44; accidente isqu&#233;mico transitorio 10 casos &#40;13&#44;3&#37;&#41;&#46; En este estudio la presencia de cefalea &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41; dolor temporal &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41; y claudicaci&#243;n mandibular &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;018&#41; son estad&#237;sticamente significativos para diagn&#243;stico de AT&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Diagn&#243;stico</span><p id="par0080" class="elsevierStylePara elsevierViewall">En cuanto a los resultados de laboratorio exist&#237;a&#44; elevaci&#243;n VSG en 67 casos &#40;89&#44;3&#37;&#41; &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;160&#41; y de PCR en 66 casos &#40;88&#37;&#41; &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;254&#41;&#44; sin existir significaci&#243;n estad&#237;stica para el diagn&#243;stico de AT&#46; En los pacientes que presentaban diagn&#243;stico de ACR-SCORE<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>3&#44; presentaban una elevaci&#243;n de VSG &#40;65&#44;04<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>31&#44;20<span class="elsevierStyleHsp" style=""></span>mm&#47;h&#41; y de PCR &#40;59&#44;05<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>45&#44;54<span class="elsevierStyleHsp" style=""></span>mg&#47;l&#41; en comparaci&#243;n con los que no tienen el diagn&#243;stico de AT VSG &#40;54<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>34&#44;3<span class="elsevierStyleHsp" style=""></span>mm&#47;h&#41; &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;168&#41; y PCR &#40;50&#44;29<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>50&#44;65<span class="elsevierStyleHsp" style=""></span>mg&#47;l&#41; &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;465&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">Se realiz&#243; eco-Doppler temporal en 60 pacientes &#40;80&#37;&#41;&#44; apreci&#225;ndose en 32 casos &#40;53&#44;33&#37;&#41; el halo caracter&#237;stico&#46; A los pacientes&#44; a los que se observa el halo&#44; presentaban una elevaci&#243;n de la VSG y de PCR de forma significativa en comparaci&#243;n con los pacientes a los que no &#40;VSG halo 71&#44;28<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>27&#44;50<span class="elsevierStyleHsp" style=""></span>mm&#47;h y VSG no halo 45&#44;59<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>34&#44;32<span class="elsevierStyleHsp" style=""></span>mm&#47;h &#91;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;0066&#93; PCR halo 69&#59;96<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>44&#44;26<span class="elsevierStyleHsp" style=""></span>mg&#47;l y PCR no halo 37&#44;81<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>41&#44;84<span class="elsevierStyleHsp" style=""></span>mg&#47;l &#91;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0255&#93;&#41;&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">La biopsia temporal se practic&#243; en 62 pacientes &#40;82&#44;7&#37;&#41;&#44; siendo positiva en 31 casos &#40;50&#37;&#41;&#46; De los 62 pacientes biopsiados fueron muestras insuficientes el 4&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#41;&#46; Los pacientes con biopsia positiva presentaron una PCR y VSG significativamente superiores&#59; &#40;VSG biopsia positiva 70&#44;58<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>27&#44;84<span class="elsevierStyleHsp" style=""></span>mm&#47;l versus 47&#44;43<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>34&#44;69<span class="elsevierStyleHsp" style=""></span>mm&#47;l &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;015&#41; y PCR biopsia positiva 70<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>43&#44;75<span class="elsevierStyleHsp" style=""></span>mg&#47;l versus 35&#44;47<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>40&#44;17<span class="elsevierStyleHsp" style=""></span>mg&#47;l &#91;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;007&#93;&#41;&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Tratamiento</span><p id="par0095" class="elsevierStylePara elsevierViewall">En el 92&#37; &#40;69 casos&#41; de los pacientes tienen tratamiento con corticoides&#46; En 53 pacientes &#40;70&#44;67&#37;&#41; presentan un diagn&#243;stico positivo de AT&#44; pero 22 casos &#40;29&#44;33&#37;&#41; a pesar de un diagn&#243;stico negativo se mantienen los corticoides&#46; Solo se retira el corticoide en 6 casos &#40;8&#37;&#41;&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">De los pacientes que ten&#237;an un diagn&#243;stico de polimialgia reum&#225;tica &#40;21&#41;&#44; todos tomaban corticoides&#44; y solo 14 ten&#237;an diagn&#243;stico de AT&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">En esta muestra se producen 2 <span class="elsevierStyleItalic">exitus</span> &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;505&#41;&#44; sin significaci&#243;n estad&#237;stica para el diagn&#243;stico de AT&#46; Los 2 casos &#40;2&#44;6&#37;&#41; estaban con corticoides &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;845&#41;&#44; y solo uno ten&#237;a un diagn&#243;stico de AT&#46;</p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Estudio econ&#243;mico</span><p id="par0110" class="elsevierStylePara elsevierViewall">Para el objetivo secundario se incluyen 47 pacientes con una mediana de edad 76 a&#241;os &#40;46-87&#41;&#44; 24 &#40;51&#37;&#41; mujeres&#44; que son a los pacientes a los que se ha realizado tanto eco-Doppler de arteria temporal como biopsia&#46;</p><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Total del gasto que se genera en esta muestra</span><p id="par0115" class="elsevierStylePara elsevierViewall">En esta muestra &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>75&#41; se realizaron 60 eco-Doppler temporales &#40;10&#46;035&#44;6<span class="elsevierStyleHsp" style=""></span>&#8364;&#41; y 62 biopsias temporales &#40;21&#46;064&#44;5<span class="elsevierStyleHsp" style=""></span>&#8364;&#41;&#46; El an&#225;lisis del coste que genera el diagn&#243;stico de AT en nuestro centro son 414&#44;7<span class="elsevierStyleHsp" style=""></span>&#8364;&#47;paciente&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Gastos que se generan al emplear la biopsia temporal&#58; <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a></span><p id="par0120" class="elsevierStylePara elsevierViewall">El gasto que genera la biopsia de la temporal son 339&#44;75<span class="elsevierStyleHsp" style=""></span>&#8364;&#47;paciente&#46; En esta muestra la biopsia de la arteria temporal presenta una sensibilidad del 33&#44;33&#37; &#40;IC 95&#37;&#58; 18&#44;56-50&#44;97&#37;&#41; y una especificidad del 0&#37; &#40;IC 95&#37;&#58; 0&#44;00-28&#44;49&#37;&#41;&#44; para el diagn&#243;stico de AT&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0125" class="elsevierStylePara elsevierViewall">El emplear en el diagn&#243;stico de AT los criterios de American College de reumatolog&#237;a con biopsia supone un ahorro del 18&#37; si lo comparamos con la estrategia diagn&#243;stica que se emplea en nuestro hospital&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Gastos que se generan al emplear el eco-Doppler temporal&#58; <a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a></span><p id="par0130" class="elsevierStylePara elsevierViewall">El gasto que genera el eco-Doppler es de 167&#44;26 euros&#47;paciente&#46; Esta exploraci&#243;n en nuestra muestra presenta una sensibilidad de 58&#44;33&#37; &#40;IC 95&#37; 40&#44;76&#37;-74&#44;49&#37;&#41; y una especificidad del 63&#44;64&#37; &#40;IC 95&#37; 30&#44;79-89&#44;07&#37;&#41; para el diagn&#243;stico de AT&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0135" class="elsevierStylePara elsevierViewall">El emplear en el diagn&#243;stico de arteritis temporal los criterios del ACR-SCORE con eco-Doppler supone un ahorro del 59&#37; compar&#225;ndolo con la estrategia diagn&#243;stico que se emplea en nuestro hospital&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Gastos que se generan cuando se modificaba el tratamiento &#40;retirada de corticoide&#41;&#58; <a class="elsevierStyleCrossRef" href="#tbl0025">tabla 5</a></span><p id="par0140" class="elsevierStylePara elsevierViewall">Al valorar el gasto en la estrategia de retirar el tratamiento con corticoides&#44; solo tendr&#237;amos que realizar biopsias o eco-Doppler cuando se ha retirado el tratamiento&#46; En la muestra analizada &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>47&#41; solo se retira el tratamiento en 3 pacientes &#40;6&#37;&#41;&#59; es decir&#44; solo tendr&#237;amos que haber realizado 3 biopsias&#44; que supone un gasto de 21&#44;68<span class="elsevierStyleHsp" style=""></span>&#8364;&#47;paciente&#44; o bien 3 eco-Doppler&#44; lo que supone un gasto de 10&#44;67<span class="elsevierStyleHsp" style=""></span>&#8364;&#47;paciente&#44; y el ahorro var&#237;a del 94 al 97&#37;&#44; respectivamente&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0145" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0030">tabla 6</a> aparece una comparaci&#243;n de los gastos y ahorro que se generan por el empleo de las distintas estrategias de diagn&#243;stico y cambio de tratamiento&#46;</p><elsevierMultimedia ident="tbl0030"></elsevierMultimedia></span></span></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Discusi&#243;n</span><p id="par0150" class="elsevierStylePara elsevierViewall">La AT es una enfermedad que preocupa a los m&#233;dicos y pacientes en cuanto a su diagn&#243;stico o posibles reca&#237;das<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">11</span></a>&#46; La anamnesis y el examen cl&#237;nico exhaustivos siguen siendo de suma importancia en su diagn&#243;stico<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">12</span></a>&#46;Los s&#237;ntomas y los signos con mayor valor predictivo son los s&#237;ntomas visuales &#40;p&#233;rdida de visi&#243;n o diplop&#237;a&#41;&#44; la cefalea de reciente aparici&#243;n&#44; el dolor preauricular&#44; la claudicaci&#243;n mandibular&#44; una VSG mayor de 50 y la edad mayor de 50 a&#241;os<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">2&#44;11&#44;13&#44;14</span></a>&#46; En nuestra serie la cefalea&#44; el dolor temporal y la claudicaci&#243;n mandibular son predictores de arteritis de c&#233;lulas gigantes&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Smith et al&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">15</span></a> en el a&#241;o 1997&#44; fueron los primeros en utilizar el eco-Doppler color&#44; para establecer el diagn&#243;stico de AT&#46; Concluyeron que existen unos signos caracter&#237;sticos&#44; detectables con el eco-Doppler&#44; siendo el m&#225;s espec&#237;fico la presencia de un halo oscuro&#44; secundario al edema de la pared arterial&#46; Desde entonces se han realizado varios estudios valorando esta t&#233;cnica&#44; en los que obtienen una sensibilidad y especificidad del halo en el diagn&#243;stico de la AT del 68-69&#37; y del 81-91&#37;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">16&#8211;18</span></a>&#46; En nuestro estudio&#44; la presencia de halo tiene una sensibilidad y especificidad del 58&#44;3 y 63&#44;6&#37;&#44; respectivamente para el diagn&#243;stico de la AT&#44; que difiere con lo publicado&#44; y esto es debido a que se compara la presencia de halo con anatom&#237;a patol&#243;gica positiva y no con el diagn&#243;stico seg&#250;n los criterios ACR-SCORE mayor de 3&#46; Sin embargo&#44; para Gonz&#225;lez Porto et al&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">19</span></a> que comparan la ecograf&#237;a con la cl&#237;nica&#44; la sensibilidad es del 42&#44;6&#37; y la especificidad es del 65&#44;7&#37;&#44; que son unos resultados m&#225;s similares a los obtenidos en nuestro estudio&#46; Aunque este&#44; no ha sido el objetivo de nuestro trabajo&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Algunos autores sugieren que en caso de una alta probabilidad pretest &#40;cl&#237;nica y anal&#237;tica&#41;&#44; un Doppler patol&#243;gico puede ser suficiente para realizar el diagn&#243;stico de AT&#44; sin necesidad de realizar una biopsia<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">11&#44;12&#44;20&#44;21</span></a>&#46; En este trabajo la elevaci&#243;n de VSG y de PCR son predictores de biopsia positiva o bien la presencia de halo en la ecograf&#237;a&#44; por tanto&#44; el diagn&#243;stico de AT&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">La sensibilidad de la biopsia de arteria temporal puede ser tan baja como el 39&#37; y alrededor del 7&#37; de todas las biopsias de arteria temporal pueden no consistir realmente en tejido arterial<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">22</span></a>&#46; En nuestro trabajo la biopsia prestaba una sensibilidad del 33&#37; y solo el 4&#37; de las muestras fueron insuficientes&#46; La positividad de la biopsia de la arteria temporal depende del tama&#241;o&#44; con biopsias inferiores a 0&#44;5<span class="elsevierStyleHsp" style=""></span>cm el rendimiento es bajo y con aquellas superiores a 2<span class="elsevierStyleHsp" style=""></span>cm de longitud suelen ser altos<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">2</span></a>&#46; No ha sido objetivo de este trabajo determinar la longitud de la arteria temporal analizada&#46; En el estudio de Gonz&#225;lez-Gay et al&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">23</span></a> diagnosticaron 190 pacientes con AT&#59; el mejor modelo predictivo de AT comprobada por biopsia inclu&#237;a antecedentes de s&#237;ndrome constitucional &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6&#44;1&#41;&#44; una arteria temporal anormal en el examen f&#237;sico &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#44;2&#41; y la presencia de complicaciones visuales &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#44;9&#41;&#46; Un subconjunto de pacientes ten&#237;a una alta probabilidad de tener una biopsia de arteria temporal negativa&#44; pero al aplicarlos&#44; cumpl&#237;an los criterios de clasificaci&#243;n ACR del a&#241;o 1990 para AT&#46; Este subconjunto con biopsia de arteria temporal negativa ten&#237;a complicaciones isqu&#233;micas menos graves que las de la ACG comprobada por biopsia&#46; Por ello&#44; en pacientes sin manifestaciones visuales&#44; con una arteria temporal normal en el examen f&#237;sico y sin un s&#237;ndrome constitucional&#44; el riesgo de tener una biopsia de arteria temporal anormal era bajo<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">23</span></a>&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Muchas biopsias de la arteria temporal son negativas&#44; menos del 60&#37; de los pacientes con cl&#237;nica de arteritis temporal tienen biopsia positiva<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">11&#44;13&#44;24&#44;25</span></a>&#44; en nuestro trabajo solo el 50&#37; de las biopsias fueron positivas&#44; consideramos fundamental igual que Gajree et al&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">13</span></a> y Lyons et al&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">11</span></a>&#44; encontrar formas de reducir el n&#250;mero de pacientes que se someten innecesariamente a una biopsia&#44; para reducir la carga de trabajo y optimizar los servicios&#46; Ya no es pr&#225;ctica cl&#237;nica habitual&#44; por el uso de la ecograf&#237;a de la arteria temporal&#44; la realizaci&#243;n de una segunda biopsia contralateral en pacientes con alta sospecha de ACG&#44; pues aumenta el rendimiento de la biopsia en un 10&#37;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">26</span></a>&#46; En este estudio se demuestra que existen factores cl&#237;nicos &#40;cefalea&#44; dolor temporal y claudicaci&#243;n mandibular&#41;&#44; y anal&#237;ticos &#40;elevaci&#243;n VSG y PCR&#41; ya descritos por otros autores&#44; como Gonz&#225;lez-L&#243;pez<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">12</span></a> que presenta una herramienta como la calculadora &#40;an&#225;lisis de regresi&#243;n log&#237;stica&#41; que puede ayudar a predecir el resultado de la biopsia y ayudar a mejorar la toma de decisiones cl&#237;nicas y evitar biopsias innecesarias<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">10</span></a>&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">El an&#225;lisis de rentabilidad de Luqmani et al&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">21</span></a> indica que la ecograf&#237;a sola es m&#225;s rentable que la biopsia sola&#44; en gran parte debido a su costo mucho m&#225;s bajo &#40;58 versus 514<span class="elsevierStyleHsp" style=""></span>&#163;&#41; y mayor sensibilidad &#40;54 versus 39&#37;&#41;&#44; en nuestro trabajo existen tambi&#233;n una diferencia ostensible entre los 167&#44;26<span class="elsevierStyleHsp" style=""></span>&#8364; del eco-Doppler y 339&#46;75<span class="elsevierStyleHsp" style=""></span>&#8364; de la biopsia y tenemos los resultados similares en cuanto a la sensibilidad &#40;58 versus 33&#37;&#41;&#46; Si esto lo comparamos con el gasto que se produce en nuestro hospital &#40;414<span class="elsevierStyleHsp" style=""></span>&#8364;&#47;paciente&#41; &#40;a muchos pacientes se les realiza tanto biopsia como eco-Doppler&#41;&#44; hablamos de un ahorro que oscila del 59 al 18&#37;&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">Si seguimos la estrategia m&#225;s rentable&#44; confiar&#237;amos en la ecograf&#237;a y el juicio cl&#237;nico por s&#237; solos como medio de diagn&#243;stico<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">21</span></a>&#46; El motivo del uso adicional de la biopsia&#44; a pesar de una exploraci&#243;n negativa&#44; ser&#237;a proporcionar m&#225;s pruebas para descartar la enfermedad&#44; as&#237; como para apoyar la retirada de la terapia en el caso de que ambas pruebas sean negativas<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">2&#44;20&#44;21</span></a>&#46; Brabyn et al&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">14</span></a> hablan de un mantenimiento de corticoides en el 70-75&#37; de los pacientes&#44; datos que son comparables a los de nuestro estudio&#44; donde solamente se retira la corticoterapia al 6&#37; de nuestros pacientes&#46; Existe en este estudio un 29&#44;3&#37; de los pacientes que se mantienen la corticoterapia a pesar del diagn&#243;stico negativo&#46; Una de las posibles justificaciones podr&#237;a deberse a&#44; que en un 28&#37; de los pacientes presentan un diagn&#243;stico de polimialgia reum&#225;tica&#46; Tambi&#233;n en nuestro trabajo existen 2 <span class="elsevierStyleItalic">exitus</span>&#44; y ambos tomaban corticoides a dosis elevadas&#44; lo cierto que no han sido objetivo de este estudio la mortalidad y posibles complicaciones&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Ya est&#225; publicado que el emplear una v&#237;a de probabilidad cl&#237;nica prestest y pruebas diagn&#243;sticas no cruentas para iniciar un tratamiento precoz y evitar la p&#233;rdida de visi&#243;n&#44; son estrategias coste&#47;eficaces<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">11&#44;12&#44;21</span></a> cosa con la que estamos totalmente de acuerdo&#46; Tenemos que ser conscientes de los gastos que generan nuestras actuaciones e incluso posibles complicaciones para los pacientes&#46; Con este trabajo&#44; podemos concluir que cuando existen datos cl&#237;nicos y de laboratorio&#44; se puede realizar un diagn&#243;stico de AT&#44; solo dejar la biopsia para aquellos pacientes a los que queramos retirar el corticoide&#44; es decir no realizar biopsia cuando sepamos que no vamos a retirar el corticoide&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">Son necesarios trabajos de validaci&#243;n de la calculadora predictiva&#46;</p><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Limitaciones</span><p id="par0195" class="elsevierStylePara elsevierViewall">Este estudio es retrospectivo&#44; no se ha valorado la calidad de vida de los pacientes&#44; ni se ha tenido en cuenta la longitud de la arteria biopsiada&#44; las complicaciones que se generan por la biopsia&#44; posibles complicaciones del tratamiento a largo plazo con corticoides&#44; mortalidad&#46;</p></span></span><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Conclusiones</span><p id="par0200" class="elsevierStylePara elsevierViewall">En nuestra poblaci&#243;n&#44; la presencia de cefalea&#44; dolor temporal y claudicaci&#243;n mandibular son predictores de arteritis de c&#233;lulas gigantes&#46; La elevaci&#243;n de VSG y PCR son predictores de biopsia positiva y de presencia de halo en la ecograf&#237;a&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">El empleo de ACR-SCORE<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>3 con eco-Doppler o con biopsia&#44; as&#237; como el diagn&#243;stico con suspensi&#243;n del corticoide son coste&#47;efectivos&#46;</p></span><span id="sec0105" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Financiaci&#243;n</span><p id="par0215" class="elsevierStylePara elsevierViewall">La presente investigaci&#243;n no ha recibido ayudas espec&#237;ficas provenientes de agencias del sector p&#250;blico&#44; sector comercial ni entidades sin &#225;nimo de lucro&#46;</p></span><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Conflicto de intereses</span><p id="par0210" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La arteritis de la temporal &#40;AT&#41; es la forma m&#225;s frecuente de vasculitis sist&#233;mica&#44; su diagn&#243;stico est&#225; basado en criterios propuestos por el Colegio Americano de Reumatolog&#237;a &#40;1990&#41;&#44; y su tratamiento son corticoides a dosis elevadas&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Nuestro objetivo es valorar el gasto del diagn&#243;stico de la AT&#44; y secundariamente an&#225;lisis coste&#47;efectivo de distintas estrategias diagn&#243;sticas &#40;cl&#237;nica&#44; biopsia&#44; eco-Doppler&#41; y terap&#233;uticas &#40;suspensi&#243;n del corticoide&#41;&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Material y m&#233;todo</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional&#44; retrospectivo de pacientes con AT &#40;2012-2021&#41;&#46; Se recogieron datos demogr&#225;ficos&#44; comorbilidades&#44; signos y s&#237;ntomas sugestivos de AT&#46; Se diagnostic&#243; AT con una puntuaci&#243;n &#8805;<span class="elsevierStyleHsp" style=""></span>3 seg&#250;n los criterios del American College of Reumatology &#40;ACR-SCORE&#41;&#46; Se analizaron los gastos del diagn&#243;stico y modificaci&#243;n de tratamiento&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Setenta y cinco pacientes&#44; mediana edad 77 &#40;6-87&#41; a&#241;os&#46; Cefalea&#44; dolor temporal y claudicaci&#243;n mandibular fueron significativos para el diagn&#243;stico de AT&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Los pacientes con halo en eco-Doppler y biopsia positiva&#44; presentaron elevaci&#243;n de VSG y PCR de forma significativa en comparaci&#243;n con los pacientes que no&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">El gasto diagn&#243;stico de AT fue de 414&#44;7<span class="elsevierStyleHsp" style=""></span>&#8364;&#47;paciente&#46; Si empleamos ACR-SCORE<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>3-eco-Doppler ser&#237;an 167&#44;2<span class="elsevierStyleHsp" style=""></span>&#8364;&#47;paciente &#40;ahorro del 59&#44;6&#37;&#41; y ACR-SCORE<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>3-biopsia 339&#44;75<span class="elsevierStyleHsp" style=""></span>&#8364;&#47;paciente &#40;ahorro del 18&#37;&#41;&#46; Si se retiraba corticoide y se realizaba biopsia hubiesen sido 21&#44;6<span class="elsevierStyleHsp" style=""></span>&#8364;&#47;paciente &#40;ahorro del 94&#44;7&#37;&#41;&#44; si se retiraba corticoide y se realizaba eco-Doppler hubiesen sido 10&#44;6<span class="elsevierStyleHsp" style=""></span>&#8364;&#47;paciente &#40;ahorro del 97&#44;4&#37;&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Conclusiones</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Cefalea&#44; dolor temporal y claudicaci&#243;n mandibular son predictores de AT&#46; La elevaci&#243;n de VSG y PCR son predictores de biopsia positiva y presencia de halo en la ecograf&#237;a&#46;</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">El empleo de ACR-SCORE<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>3 con eco-Doppler o con biopsia&#44; y con suspensi&#243;n del corticoide son coste&#47;efectivos&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Temporal arteritis &#40;TA&#41; is the most common form of systemic vasculitis&#46; Its diagnosis is based on criteria proposed by the American College of Rheumatology &#40;1990&#41;&#44; and its treatment is high-dose corticosteroids&#46;</p><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Our objective is to assess the cost of diagnosing TA&#44; and secondarily&#44; cost-effective analysis of different diagnostic strategies &#40;clinical&#44; biopsy&#44; Doppler ultrasound&#41; and therapeutic strategies &#40;corticosteroid suspension&#41;&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Material and method</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Observational&#44; retrospective study has been carried out on patients with TA &#40;2012&#8211;2021&#41;&#46; Demographic data&#44; comorbidities&#44; signs and symptoms suggestive of TA were collected&#46; TA was diagnosed with a score &#8805;3 according to American College of Rheumatoloy criteria &#40;ACR-SCORE&#41;&#46; The costs of diagnosis and treatment modification were analysed&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Results</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Seventy-five patients have been included&#44; median age 77 &#40;46-87&#41; years&#46; Headache&#44; temporal pain and jaw claudication were significant for the diagnosis of TA&#46;</p><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Patients with a halo on Doppler ultrasound and a positive biopsy have significantly elevated ESR and CRP compared to patients who do not&#46;</p><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">The cost of the TA diagnosis was 414&#46;7 euros&#47;patient&#46; If we use ACR-SCORE&#8805;3-echodoppler it is 167&#46;2 &#8364;&#47;patient &#40;savings 59&#46;6&#37;&#41; and ACR-SCORE&#8805;3-biopsy 339&#46;75 &#8364;&#47;patient &#40;savings 18&#37;&#41;&#46; If the corticosteroid was removed and a biopsy was performed&#44; 21&#46;6 &#8364;&#47;patient &#40;94&#46;7&#37; savings&#41;&#44; if the corticosteroid was removed and Doppler ultrasound was performed&#44; 10&#46;6 &#8364;&#47;patient &#40;97&#46;4&#37; savings&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conclusions</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Headache&#44; temporary pain and jaw claudication are predictors of TA&#46; Elevated ESR and CRP are predictors of positive biopsy and presence of halo on ultrasound&#46;</p><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">The uses of ACR-SCORE&#8805;3 with Doppler ultrasound or biopsy&#44; and with corticosteroid suspension&#44; are cost-effective&#46;</p></span>"
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          "leyenda" => "<p id="spar0081" class="elsevierStyleSimplePara elsevierViewall">ACR-SCORE&#58; criterios del American College of Rheumatology&#59; EPOC&#58; enfermedad pulmonar obstructiva cr&#243;nica&#59; HTA&#58; hipertensi&#243;n arterial&#59; PCR&#58; prote&#237;na C reactiva&#59; VSG&#58; velocidad de sedimentaci&#243;n globular&#46;</p><p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Valor de p&#58; calculado con el test de Chi-cuadrado o el test exacto de Fisher&#44; considerando estad&#237;sticamente significativo p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#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="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Porcentaje&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Valor de p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mediana edad&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sexo masculino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;315&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sexo femenino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;315&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Antecedentes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">casos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HTA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;437&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cardiopat&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;761&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Polimialgia reum&#225;tica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;635&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dislipemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;219&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diabetes mellitus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;536&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">EPOC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;047&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Insuficiencia renal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;707&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Cl&#237;nica</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dolor de cabeza&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">57&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dolores articulares&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;184&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cl&#237;nica visual&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;156&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mal estado general&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;059&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dolor temporal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Claudicaci&#243;n mandibular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;018&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fiebre&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;508&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Accidente isqu&#233;mico transitorio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;371&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Exitus</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;845&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Laboratorio</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Elevaci&#243;n VSG&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">89&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;160&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Elevaci&#243;n PCR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">66&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;254&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;393&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ecodoppler temporal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Biopsia temporal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">82&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Biopsia positiva&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ACR-SCORE<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">70&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&nbsp;\t\t\t\t\t\t\n
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                  """
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          "leyenda" => "<p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">ACR-SCORE&#58; criterios del American College of Rheumatology&#59; PCR&#58; prote&#237;na C reactiva&#59; VSG&#58; velocidad de sedimentaci&#243;n globular&#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="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ACR-SCORE<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ACR-SCORE<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Valor de p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Halo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No halo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Valor de p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Biopsia<span class="elsevierStyleSup">&#43;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Biopsia<span class="elsevierStyleSup">&#8722;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Valor de p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">VSG mm&#47;h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">65&#44;04<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>31&#44;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>34&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;168&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71&#44;28<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>27&#44;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45&#44;59<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>34&#44;32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;0066&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">70&#44;58<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>27&#44;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47&#44;43<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>34&#44;69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PCR Mg&#47;l&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59&#44;05<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>45&#44;54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&#44;29<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>50&#44;65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;464&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">69&#44;96<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>44&#44;26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37&#44;81<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>41&#44;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;0255&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">70<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>43&#44;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&#44;47<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>40&#44;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab3511939.png"
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        ]
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          "es" => "<p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Comportamiento de los valores de VSG y PCR en el estudio</p>"
        ]
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          "leyenda" => "<p id="spar0120" class="elsevierStyleSimplePara elsevierViewall">ACR-SCORE&#58; criterios del American College of Rheumatology&#46;</p>"
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            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="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Biopsia negativa &#40;ausencia de c&#233;lulas gigantes&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Biopsia positiva &#40;presencia de c&#233;lulas gigantes&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ACR-SCORE<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;23&#44;40&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;23&#44;40&#37;&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ACR-SCORE<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;25&#44;53&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 &#40;51&#44;06&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36 &#40;76&#44;60&#37;&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;48&#44;93&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 &#40;51&#44;06&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47 &#40;100&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "es" => "<p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">Relaci&#243;n existente entre el resultado de la anatom&#237;a patol&#243;gica y el diagn&#243;stico &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>47&#41;</p>"
        ]
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          0 => array:3 [
            "identificador" => "at4"
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0130" class="elsevierStyleSimplePara elsevierViewall">ACR-SCORE&#58; criterios del American College of Rheumatology&#46;</p>"
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            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="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Ecodoppler negativa &#40;ausencia de halo&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Ecodoppler positiva &#40;presencia de halo&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ACR-SCORE<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;14&#44;98&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;8&#44;51&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;23&#44;40&#37;&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ACR-SCORE<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;31&#44;91&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;44&#44;68&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36 &#40;76&#44;60&#37;&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;46&#44;80&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25 &#40;53&#44;19&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47 &#40;100&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                0 => "xTab3511940.png"
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          "es" => "<p id="spar0125" class="elsevierStyleSimplePara elsevierViewall">Relaci&#243;n existente entre el resultado del eco-Doppler de arteria temporal y el diagn&#243;stico &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>47&#41;</p>"
        ]
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        "etiqueta" => "Tabla 5"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
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        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at5"
            "detalle" => "Tabla "
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0140" class="elsevierStyleSimplePara elsevierViewall">ACR-SCORE&#58; criterios del American College of Rheumatology&#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="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Ausencia de tratamiento con corticoides&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Tratamiento con corticoides&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ACR-SCORE<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;4&#44;16&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;19&#44;15&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;23&#44;40&#37;&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ACR-SCORE<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;2&#44;13&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35 &#40;74&#44;47&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36 &#40;76&#44;60&#37;&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;6&#44;38&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44 &#40;93&#44;62&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47 &#40;100&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "es" => "<p id="spar0135" class="elsevierStyleSimplePara elsevierViewall">Relaci&#243;n existente entre el tratamiento y el diagn&#243;stico &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>47&#41;</p>"
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      ]
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          "leyenda" => "<p id="spar0150" class="elsevierStyleSimplePara elsevierViewall">AC&#58; criterios del American College of Rheumatology&#59; ED&#58; eco-Doppler&#59; IC 95&#37;&#58; intervalo de confianza del 95&#37;&#46;</p>"
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            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="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">AC y ED&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">AC y Biopsia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Modificar tratamiento y biopsia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Modificar tratamiento y ED&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sensibilidad&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">58&#44;3&#37;IC 95&#37;&#58; 40&#44;76-74&#44;49&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&#44;33&#37;IC 95&#37;&#58; 18&#44;56-50&#44;97&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">97&#44;22&#37; con IC 95&#37;&#58; 85&#44;47-99&#44;93&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">97&#44;22&#37; con IC 95&#37;&#58; 85&#44;47-99&#44;93&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Especificidad&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">63&#44;6&#37;IC 95&#37;&#58; 30&#44;79-89&#44;07&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#37;IC 95&#37;&#58; 0&#44;00-28&#44;49&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#44;18&#37; con IC 95&#37;&#58; 2&#44;28-51&#44;78&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#44;18&#37; con IC 95&#37;&#58; 2&#44;28-51&#44;78&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Euros&#47;paciente&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">414&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">167&#44;26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">339&#44;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#44;68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#44;67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ahorro&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59&#44;66&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#44;07&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">94&#44;77&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">97&#44;42&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "es" => "<p id="spar0145" class="elsevierStyleSimplePara elsevierViewall">Comparativa de los gastos que generan las distintas estrategias analizadas y su ahorro</p>"
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    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliograf&#237;a"
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        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:26 [
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              "identificador" => "bib0135"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Valor de la ecograf&#237;a doppler en el diagn&#243;stico de la arteritis de la temporal"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;M&#46; Zaragoz&#225; Garc&#237;a"
                            1 => "A&#46; Plaza Mart&#237;nez"
                            2 => "J&#46;L&#46; Briones Est&#233;banez"
                            3 => "C&#46; Mart&#237;nez Parre&#241;o"
                            4 => "F&#46;J&#46; G&#243;mez Palom&#233;s"
                            5 => "E&#46; Ortiz Monz&#243;n"
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1157/13111003"
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "2007"
                        "volumen" => "129"
                        "paginaInicial" => "451"
                        "paginaFinal" => "453"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17953909"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Giant Cell Arteritis&#58; Epidemiology&#44; Diagnosis&#44; and Management"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46;A&#46; Gonzalez Gay"
                            1 => "C&#46; Martinez-Dubois"
                            2 => "M&#46; Agudo"
                            3 => "O&#46; Pompei"
                            4 => "R&#46; Blanco"
                            5 => "J&#46; Lorca"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s11926-010-0135-9"
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Rheumatol Rep"
                        "fecha" => "2010"
                        "volumen" => "12"
                        "paginaInicial" => "436"
                        "paginaFinal" => "442"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20857242"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology of biopsy proven giant cell arteritis in nothwestern Spain&#58; Trend over an 18 year period"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46;A&#46; Gonzalez Gay"
                            1 => "C&#46; Garcia Porrua"
                            2 => "M&#46;J&#46; Rivas"
                            3 => "P&#46; Rodriguez Ledo"
                            4 => "J&#46; Llorca"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/ard.60.4.367"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Rheum Dis"
                        "fecha" => "2001"
                        "volumen" => "60"
                        "paginaInicial" => "367"
                        "paginaFinal" => "371"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11247867"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The American College of Rheumatology 1990 criteria for the classification of giant cell arteritis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46;G&#46; Hunder"
                            1 => "D&#46;A&#46; Bloch"
                            2 => "B&#46;A&#46; Michel"
                            3 => "M&#46;B&#46; Stevens"
                            4 => "W&#46;P&#46; Arend"
                            5 => "L&#46;H&#46; Calabrese"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/art.1780330810"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arthritis Rheum"
                        "fecha" => "1990"
                        "volumen" => "33"
                        "paginaInicial" => "1122"
                        "paginaFinal" => "1128"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2202311"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estudio comparativo de la ecograf&#237;a Doppler frente a la biopsia de arteria temporal en el diagn&#243;stico de la arteritis de c&#233;lulas gigantes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;A&#46; Gonz&#225;lez Porto"
                            1 => "M&#46;T&#46; Silva D&#237;az"
                            2 => "A&#46; Reguera Arias"
                            3 => "J&#46; Pombo Otero"
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