Scientific Letter
Does the incidence of congenital pulmonary malformations vary? 11 years of experience
¿Varía la incidencia de las malformaciones pulmonares congénitas?: 11 años de experiencia
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11 years of experience" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">Dear Editor:</span>" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "53" "paginaFinal" => "54" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Rocío Sancho Gutiérrez, Elena Pérez Belmonte, Ernesto de Diego García, Antonia Jesús López López, María Jesús Cabero Pérez" "autores" => array:5 [ 0 => array:3 [ "nombre" => "Rocío" "apellidos" => "Sancho Gutiérrez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "Elena" "apellidos" => "Pérez Belmonte" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Ernesto" "apellidos" => "de Diego García" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Antonia Jesús" "apellidos" => "López López" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:4 [ "nombre" => "María Jesús" "apellidos" => "Cabero Pérez" "email" => array:1 [ 0 => "mariajesuscabero@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Pediatría, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Cirugía Pediátrica, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "¿Varía la incidencia de las malformaciones pulmonares congénitas?: 11 años de experiencia" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Congenital lung malformations (CLMs) constitute a heterogeneous group of lung anomalies involving the airways, parenchyma and blood vessels. Historically, they have been considered infrequent, as their annual incidence has been documented to be of 1 case per 10,000–35,000 pregnancies<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> or about 30–42 cases per 100,000 inhabitants in the general population. There are also authors that assert that their diagnosis has improved considerably with the introduction of routine prenatal ultrasound examinations,<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> but few studies have analysed how their incidence has actually been changing in recent times.</p><p id="par0010" class="elsevierStylePara elsevierViewall">In order to establish the incidence of CLMs in the autonomous community of Cantabria (Spain), we conducted a retrospective descriptive study of all cases of CLM managed in the Department of Paediatrics of the Hospital Universitario Marqués de Valdecilla in Santander, (Cantabria, Spain), specifically in the Units of Paediatric Pulmonology and Paediatric Surgery, in the period between January 2007 and December 2017. Our hospital is the tertiary care hospital that manages all complicated pregnancies in Cantabria, and we identified the patients using information obtained from the Department of Admissions and Clinical Records. In addition, we obtained data on the number of births during this period from the Instituto Cántabro de Estadística (Statistical Institute of Cantabria) and the Instituto Nacional de Estadística (National Institute of Statistics).</p><p id="par0015" class="elsevierStylePara elsevierViewall">A total of 16 cases of CLM were diagnosed during the period under study, corresponding to 9 female patients and 7 male patients. The diagnosis was prenatal in 15 cases (93.7%), with the defect identified in the ultrasound examination performed at 22 weeks’ gestation. All of these patients were evaluated with a chest radiograph and a chest ultrasound examination within 24<span class="elsevierStyleHsp" style=""></span>h from birth, and these imaging tests confirmed the presence of a CLM in the patients whose second trimester ultrasound examination had been positive. In the remaining patient, treated in 2007, the CLM was diagnosed at age 4 months by means of a chest radiograph and a computed tomography angiogram.</p><p id="par0020" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> presents the data on the annual incidence of CLM. The mean annual incidence was of 2.05 cases per 10,000 births (standard deviation, 3.26) and the median was 1.98 cases (interquartile range, 6.79), calculated with data through December 2016. We could not calculate the incidence for 2017 because at the time of this writing there is no published data on the number of births in Cantabria during this year. We ought to highlight the considerable variability between years, as 2 cases were diagnosed in a total of 31,137 children born between 2007 and 2012, compared to 12 cases diagnosed in a total of 17,710 children born between 2013 and 2016.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">These data are consistent with the findings of a study by Stocker et al.,<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> who also found a significant interannual variability and reported an incidence of 1.27 cases per 10,000 births between 1994 and 1998 and an incidence that was nearly triple of 4.15 cases per 10,000 births between 2008 and 2012. Given the increase in the number of CLMs in recent years, we need to consider whether this results from an actual increase in incidence or improvements in diagnostic techniques. Stocker et al.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> favour the hypothesis of an increased incidence, which is also supported by data in the EUROCAT registry, which shows an increase of 6.5% in some CLMs (95% CI, 3.5%–9.4%), a phenomenon for which there is currently no plausible explanation.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">A salient finding in our study was the predominance of the female sex, contrary to previous studies,<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a> which have historically reported a predominance of the male sex. This fact, along with the significant interannual variability, suggests that further studies with a longer follow-up are required to establish the current actual incidence of CLMs, which will also require the participation of a larger number of hospitals to increase the number of cases included in the analyses. Establishing the incidence of CLMs more accurately is relevant for the purpose of improving the management of these patients, as the increase in the number of cases diagnosed prenatally has raised controversy regarding the correct approach to the management of asymptomatic patients.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a></p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as: Sancho Gutiérrez R, Pérez Belmonte E, de Diego García E, López López AJ, Cabero Pérez MJ. ¿Varía la incidencia de las malformaciones pulmonares congénitas?: 11 años de experiencia. An Pediatr (Barc). 2019;91:53–54.</p>" ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Year \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">Births \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">Congenital lung malformations \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">Incidence per 10,000 births \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" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2007 \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4873 \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.05 \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 " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2008 \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5060 \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.00 \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 " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2009 \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5518 \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.00 \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 " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2010 \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5480 \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.00 \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 " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2011 \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5240 \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.90 \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 " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2012 \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4966 \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.00 \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 " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2013 \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4725 \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.34 \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 " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2014 \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4470 \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.71 \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 " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2015 \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4280 \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.00 \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 " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2016 \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4235 \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.08 \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 " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2017 \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2074243.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">We have not included data for 2017 because at the time of this writing the Instituto Nacional de Estadística has not yet published the total number of births in Cantabria.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Annual incidence of congenital lung malformations in Cantabria, 2007–2016.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0035" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Enfoque actual de las malformaciones pulmonares" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Saavedra" 1 => "M. Guelfand" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Med Clin Condes" "fecha" => "2017" "volumen" => "28" "paginaInicial" => "29" "paginaFinal" => "36" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0040" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prenatal imaging and postnatal presentation, diagnosis and management of congenital lung malformations" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J. Wall" 1 => "A. Coates" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/MOP.0000000000000091" "Revista" => array:6 [ "tituloSerie" => "Curr Opin Pediatr" "fecha" => "2014" "volumen" => "26" "paginaInicial" => "315" "paginaFinal" => "319" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24739492" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0045" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The increasing incidence of foetal echogenic congenital lung malformations: an observational study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "L.J. Stocker" 1 => "D.G. Wellesley" 2 => "M.P. Stanton" 3 => "R. Parasuraman" 4 => "D.T. Howe" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/pd.4507" "Revista" => array:6 [ "tituloSerie" => "Prenat Diagn" "fecha" => "2015" "volumen" => "35" "paginaInicial" => "148" "paginaFinal" => "153" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25256093" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0050" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Trends in congenital anomalies in Europe from 1980 to 2012" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.K. Morris" 1 => "A.L. Springett" 2 => "R. Greenlees" 3 => "M. Loane" 4 => "M.C. Addor" 5 => "L. Arriola" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1371/journal.pone.0194986" "Revista" => array:5 [ "tituloSerie" => "PLOS ONE" "fecha" => "2018" "volumen" => "13" "paginaInicial" => "e0194986" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29621304" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0055" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Neonatal outcomes of prenatally diagnosed congenital pulmonary malformations" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "I. Ruchonnet-Metrailler" 1 => "E. Leroy-Terquem" 2 => "J. Stirnemann" 3 => "P. Cros" 4 => "H. Ducoin" 5 => "A. Hadchouel" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Pediatrics" "fecha" => "2014" "volumen" => "133" "paginaInicial" => "e1285" "paginaFinal" => "e1291" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0060" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Asymptomatic congenital lung malformations: is nonoperative management a viable alternative?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C.N. Criss" 1 => "N. Musili" 2 => "N. Matusko" 3 => "S. Baker" 4 => "J.D. Geiger" 5 => "S.M. Kunisaki" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jpedsurg.2018.02.065" "Revista" => array:6 [ "tituloSerie" => "J Pediatr Surg" "fecha" => "2018" "volumen" => "53" "paginaInicial" => "1092" "paginaFinal" => "1097" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29576400" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23412879/0000009100000001/v1_201907020948/S2341287919300869/v1_201907020948/en/main.assets" "Apartado" => array:4 [ "identificador" => "38181" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Scientific letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23412879/0000009100000001/v1_201907020948/S2341287919300869/v1_201907020948/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287919300869?idApp=UINPBA00005H" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 3 | 8 | 11 |
| 2024 October | 28 | 25 | 53 |
| 2024 September | 35 | 20 | 55 |
| 2024 August | 42 | 47 | 89 |
| 2024 July | 28 | 24 | 52 |
| 2024 June | 30 | 23 | 53 |
| 2024 May | 29 | 30 | 59 |
| 2024 April | 38 | 26 | 64 |
| 2024 March | 32 | 24 | 56 |
| 2024 February | 24 | 27 | 51 |
| 2024 January | 21 | 14 | 35 |
| 2023 December | 20 | 21 | 41 |
| 2023 November | 20 | 26 | 46 |
| 2023 October | 28 | 18 | 46 |
| 2023 September | 21 | 21 | 42 |
| 2023 August | 19 | 17 | 36 |
| 2023 July | 25 | 32 | 57 |
| 2023 June | 21 | 28 | 49 |
| 2023 May | 27 | 17 | 44 |
| 2023 April | 17 | 14 | 31 |
| 2023 March | 34 | 17 | 51 |
| 2023 February | 28 | 14 | 42 |
| 2023 January | 13 | 16 | 29 |
| 2022 December | 49 | 18 | 67 |
| 2022 November | 36 | 32 | 68 |
| 2022 October | 51 | 41 | 92 |
| 2022 September | 24 | 23 | 47 |
| 2022 August | 25 | 45 | 70 |
| 2022 July | 25 | 34 | 59 |
| 2022 June | 20 | 29 | 49 |
| 2022 May | 26 | 35 | 61 |
| 2022 April | 23 | 27 | 50 |
| 2022 March | 38 | 40 | 78 |
| 2022 February | 22 | 19 | 41 |
| 2022 January | 23 | 23 | 46 |
| 2021 December | 28 | 37 | 65 |
| 2021 November | 33 | 38 | 71 |
| 2021 October | 41 | 53 | 94 |
| 2021 September | 28 | 28 | 56 |
| 2021 August | 20 | 25 | 45 |
| 2021 July | 16 | 23 | 39 |
| 2021 June | 29 | 42 | 71 |
| 2021 May | 32 | 25 | 57 |
| 2021 April | 36 | 32 | 68 |
| 2021 March | 31 | 30 | 61 |
| 2021 February | 15 | 11 | 26 |
| 2021 January | 31 | 25 | 56 |
| 2020 December | 30 | 15 | 45 |
| 2020 November | 21 | 19 | 40 |
| 2020 October | 17 | 16 | 33 |
| 2020 September | 18 | 14 | 32 |
| 2020 August | 13 | 5 | 18 |
| 2020 July | 15 | 12 | 27 |
| 2020 June | 10 | 7 | 17 |
| 2020 May | 12 | 11 | 23 |
| 2020 April | 13 | 11 | 24 |
| 2020 March | 12 | 7 | 19 |
| 2020 February | 10 | 5 | 15 |
| 2020 January | 7 | 7 | 14 |
| 2019 December | 27 | 20 | 47 |
| 2019 November | 7 | 5 | 12 |
| 2019 October | 18 | 10 | 28 |
| 2019 September | 25 | 5 | 30 |
| 2019 August | 32 | 12 | 44 |
| 2019 July | 56 | 28 | 84 |
| 2019 June | 12 | 7 | 19 |
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