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Se consideran factores de riesgo para su desarrollo&#58; la edad&#44; el sexo femenino&#44; la presencia de insuficiencia pancre&#225;tica exocrina y de la mutaci&#243;n &#916;F508<a class="elsevierStyleCrossRefs" href="#bib5"><span class="elsevierStyleSup">5&#44;6</span></a>&#46; Es importante su diagn&#243;stico y el tratamiento precoz&#44; ya que su presencia se asocia con un empeoramiento del estado nutricional y&#47;o de la funci&#243;n pulmonar &#40;FP&#41;<a class="elsevierStyleCrossRef" href="#bib6"><span class="elsevierStyleSup">6</span></a>&#44; as&#237; como una elevada morbimortalidad&#59; todo ello es mejorable con un buen control metab&#243;lico<a class="elsevierStyleCrossRefs" href="#bib7"><span class="elsevierStyleSup">7&#44;8</span></a>&#46; No obstante&#44; a pesar de las evidencias acerca de la influencia del control de las AHC en la evoluci&#243;n de la FQ&#44; en el momento actual no hay consenso en cuanto a la actitud terap&#233;utica a tomar en las fases precoces de estas AHC<a class="elsevierStyleCrossRefs" href="#bib9"><span class="elsevierStyleSup">9&#44;10</span></a>&#46;</p><p class="elsevierStylePara elsevierViewall">Debido a que la AHC&#44; 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sexo&#44; alteraci&#243;n gen&#233;tica relacionada con FQ y funci&#243;n pancre&#225;tica exocrina&#46; En el momento del estudio y en el a&#241;o anterior se analiz&#243;&#58; el estado nutricional mediante el &#237;ndice de masa corporal &#40;IMC&#41; en desviaciones est&#225;ndar &#40;IMC en DE&#41;<a class="elsevierStyleCrossRef" href="#bib23"><span class="elsevierStyleSup">23</span></a> y la FP mediante la capacidad vital forzada &#40;CVF&#44; &#37;&#41; y el volumen espiratorio forzado en el primer segundo &#40;FEV<span class="elsevierStyleInf">1</span>&#44; &#37;&#41;&#59; se utiliz&#243; el valor en porcentaje sobre el te&#243;rico&#46; Entendemos por empeoramiento del estado nutricional y&#47;o de la funci&#243;n pulmonar la ca&#237;da de los valores de DE del IMC&#44; de la CVF y&#47;o del FEV<span class="elsevierStyleInf">1</span> &#40;&#37;&#41;&#44; en cualquier cuant&#237;a&#44; al comparar las cifras del momento del diagn&#243;stico de la AHC con las del a&#241;o previo&#46; Para analizar estas variables cuantitativas&#44; realizamos un an&#225;lisis estad&#237;stico con el programa SPSS&#44; versi&#243;n 15&#46;0&#46; Asumiendo que nuestra muestra no era normal&#44; utilizamos la prueba de la U de Mann-Whitney y la prueba de Wilcoxon para pruebas no param&#233;tricas con nivel de significaci&#243;n estad&#237;stica p&#60;0&#44;05&#46; Para definir las variables usamos la mediana&#44; con el rango intercuart&#237;lico &#40;percentil 25-75&#41; como medida de dispersi&#243;n&#46;</p><p class="elsevierStylePara elsevierViewall">En cada paciente se hizo un test de SOG &#40;1&#44;75<span class="elsevierStyleHsp" style=""></span>g&#47;kg glucosa &#91;m&#225;ximo de 75<span class="elsevierStyleHsp" style=""></span>g&#93;&#41; y una monitorizaci&#243;n continua de glucosa intersticial &#40;CGMS-Medtronic Minimed&#41;&#46; &#201;sta se realiz&#243; de forma ambulatoria despu&#233;s de instruir correctamente en su manejo a los enfermos y sus familiares&#46; La monitorizaci&#243;n se realiz&#243; mediante un sensor que quedaba insertado en la zona gl&#250;tea&#44; durante un periodo m&#237;nimo de 4 d&#237;as&#46; Para el calibrado del sensor&#44; se introdujeron cuatro determinaciones de glucemia capilar al d&#237;a&#46; Durante los d&#237;as de monitorizaci&#243;n&#44; el paciente rellen&#243; un diario especificando la ingesta de hidratos de carbono y el ejercicio realizado&#46; Finalizada la monitorizaci&#243;n&#44; los datos se descargaron por medio del programa inform&#225;tico del sistema&#46; De estos datos&#44; analizamos la media y los intervalos de los valores de glucosa&#58; global&#44; en ayunas y posprandial &#40;2<span class="elsevierStyleHsp" style=""></span>h tras desayuno&#44; comida y cena&#41;&#59; adem&#225;s&#44; las excursiones de glucosa &#62;140<span class="elsevierStyleHsp" style=""></span>mg&#47;dl en cualquier momento del d&#237;a &#40;en n&#250;mero absoluto y en porcentaje respecto al tiempo total de la monitorizaci&#243;n&#41;&#46; Dichos valores los comparamos con las glucemias basales y a las 2<span class="elsevierStyleHsp" style=""></span>h de la SOG&#46; Adem&#225;s&#44; los relacionamos con las concentraciones de HbA<span class="elsevierStyleInf">1c</span> de cada paciente &#40;valor normal&#44; 5&#44;3&#177;0&#44;3&#44; HPLC Menarini&#41;&#46;</p></span><span class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStylePara elsevierViewall">La mediana de edad al diagn&#243;stico de FQ es 9 &#40;intervalo&#44; 3-15&#41; meses y al diagn&#243;stico de la AHC es de 15&#44;2 &#40;14&#8211;19&#44;2&#41; a&#241;os&#59; 7 &#40;53&#44;8&#37;&#41; de los 13 pacientes son varones&#46; El 84&#44;6&#37; presentan la mutaci&#243;n &#916;F508 &#40;el 46&#44;1&#37; en homocigosis&#41;&#46; Todos tienen insuficiencia pancre&#225;tica exocrina&#46; Ning&#250;n paciente refer&#237;a cl&#237;nica cardinal de diabetes&#46; Las caracter&#237;sticas cl&#237;nicas de los pacientes se muestran en la <a class="elsevierStyleCrossRef" href="#tbl1">tabla 1</a>&#46;</p><elsevierMultimedia ident="tbl1"></elsevierMultimedia><p class="elsevierStylePara elsevierViewall">En el an&#225;lisis retrospectivo&#44; objetivamos un empeoramiento en el &#250;ltimo a&#241;o&#44; aunque no estad&#237;sticamente significativo&#44; del estado nutricional &#40;IMC en DE&#41; en el 66&#44;6&#37; de los pacientes&#44; de la FP &#40;CVF y&#47;o FEV<span class="elsevierStyleInf">1</span>&#41; en el 58&#44;3&#37; y de ambos en el 20&#44;7&#37; &#40;<a class="elsevierStyleCrossRef" href="#tbl1">tabla 1</a>&#41;&#46; Cuando dividimos a la muestra en 2 subgrupos&#44; seg&#250;n los resultados de la monitorizaci&#243;n con CGMS&#44; y comparamos la evoluci&#243;n de estas variables entre los subgrupos&#44; apreciamos en aquellos pacientes en los que se detect&#243; diabetes un mayor deterioro de los tres par&#225;metros&#44; pero sin significaci&#243;n estad&#237;stica &#40;<a class="elsevierStyleCrossRef" href="#tbl2">tabla 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl2"></elsevierMultimedia><p class="elsevierStylePara elsevierViewall">En la SOG &#40;<a class="elsevierStyleCrossRef" href="#tbl3">tabla 3</a>&#41; encontramos&#58; alteraci&#243;n de la tolerancia a la glucosa &#40;ATG&#41; en el 76&#44;9&#37; de los pacientes&#44; alteraci&#243;n de la glucemia en ayunas &#40;AGA&#41; en el 38&#44;4&#37; y diabetes en un &#250;nico paciente &#40;7&#44;6&#37;&#41;&#46; Hay que se&#241;alar que en 8 de los 13 pacientes se evidencian glucemias &#10878;200<span class="elsevierStyleHsp" style=""></span>mg&#47;dl en momentos intermedios de la curva de glucemia&#46; Detectamos concentraciones de HbA<span class="elsevierStyleInf">1c</span> patol&#243;gicas en 4 &#40;30&#44;7&#37;&#41; pacientes&#46;</p><elsevierMultimedia ident="tbl3"></elsevierMultimedia><p class="elsevierStylePara elsevierViewall">No hubo complicaciones durante la monitorizaci&#243;n continua de glucosa&#46; &#201;sta se mantuvo una media de 6&#44;8 &#40;4&#8211;10&#41; d&#237;as&#46; Los resultados de CGMS quedan expuestos en la <a class="elsevierStyleCrossRef" href="#tbl4">tabla 4</a>&#46; Encontramos una glucosa media global alterada en el 91&#44;6&#37; de los pacientes&#44; en 2 de ellos en rango de diabetes&#46;</p><elsevierMultimedia ident="tbl4"></elsevierMultimedia><p class="elsevierStylePara elsevierViewall">Seg&#250;n el an&#225;lisis de la glucosa posprandial en el CGMS&#58; el 16&#44;6&#37; de los pacientes presentan cifras patol&#243;gicas del valor de glucosa media&#59; 12 de los 13 pacientes tienen valores patol&#243;gicos teniendo en cuenta el valor m&#225;ximo del rango &#40;el 50&#37; ATG&#44; y el 41&#44;6&#37; diabetes&#41;&#46;</p><p class="elsevierStylePara elsevierViewall">En el an&#225;lisis de la glucosa en ayunas durante el CGMS&#44; al valorar el valor medio&#44; el 65&#37; de los sujetos cumplen criterios de AGA y ninguno presenta concentraciones de glucosa en el rango de diabetes&#46; Sin embargo&#44; teniendo en cuenta el valor m&#225;ximo del rango&#44; todos los pacientes&#44; en alg&#250;n momento de la monitorizaci&#243;n&#44; tienen cifras por encima de la normalidad&#59; en el 30&#44;7&#37; de ellos est&#225; en el rango de diabetes&#46;</p><p class="elsevierStylePara elsevierViewall">La <a class="elsevierStyleCrossRef" href="#fig1">figura 1</a> muestra los resultados del CGMS de 2 pacientes diagnosticados de ATG con la SOG&#44; en los que se evidencia una diferencia clara en las fluctuaciones de glucosa durante la monitorizaci&#243;n&#46;</p><elsevierMultimedia ident="fig1"></elsevierMultimedia></span><span class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discusi&#243;n</span><p class="elsevierStylePara elsevierViewall">En los consensos internacionales el diagn&#243;stico de la AHC en los pacientes con FQ se basa en la glucemia en ayunas o en la SOG<a class="elsevierStyleCrossRefs" href="#bib9"><span class="elsevierStyleSup">9&#44;10&#44;24</span></a>&#46; En la actualidad&#44; los sistemas de monitorizaci&#243;n continua de glucosa pueden permitir la b&#250;squeda de un diagn&#243;stico m&#225;s precoz&#44; con la ventaja de que la valoraci&#243;n se realiza en condiciones de la vida habitual de los pacientes<a class="elsevierStyleCrossRefs" href="#bib17"><span class="elsevierStyleSup">17&#8211;19</span></a>&#46;</p><p class="elsevierStylePara elsevierViewall">Con el estudio con CGMS hemos detectado un mayor n&#250;mero de valores patol&#243;gicos de glucosa en comparaci&#243;n con los resultados del test de SOG y&#44; sobre todo&#44; nos ha permitido el diagn&#243;stico m&#225;s precoz de diabetes&#59; hallazgos similares han sido obtenidos por otros autores<a class="elsevierStyleCrossRefs" href="#bib17"><span class="elsevierStyleSup">17&#8211;20</span></a>&#46; A&#250;n no hay consenso sobre su significaci&#243;n cl&#237;nica y la actitud terap&#233;utica a seguir<a class="elsevierStyleCrossRefs" href="#bib9"><span class="elsevierStyleSup">9&#44;10&#44;12&#44;25</span></a>&#46;</p><p class="elsevierStylePara elsevierViewall">Ser&#237;a importante conocer las fluctuaciones de glucosa durante las 24<span class="elsevierStyleHsp" style=""></span>h en pacientes con FQ&#44; tanto en el caso de normalidad como de alteraci&#243;n hidrocarbonada tras SOG&#46; Hay pocos estudios mediante CGMS en pacientes con FQ y normalidad hidrocarbonada<a class="elsevierStyleCrossRefs" href="#bib17"><span class="elsevierStyleSup">17&#44;19</span></a>&#46; Los datos obtenidos mediante CGMS demuestran que las determinaciones convencionales del test de SOG subestiman las AHC en los pacientes con FQ<a class="elsevierStyleCrossRefs" href="#bib17"><span class="elsevierStyleSup">17&#44;19&#44;20&#44;25</span></a>&#46;</p><p class="elsevierStylePara elsevierViewall">En nuestro estudio tambi&#233;n hemos constatado que la HbA<span class="elsevierStyleInf">1c</span> no es buen par&#225;metro para el diagn&#243;stico precoz de la AHC en la FQ<a class="elsevierStyleCrossRefs" href="#bib20"><span class="elsevierStyleSup">20&#44;26</span></a>&#46;</p><p class="elsevierStylePara elsevierViewall">Adem&#225;s&#44; en nuestros pacientes hemos evidenciado la existencia de insuficiencia pancre&#225;tica exocrina y la presencia frecuente de la mutaci&#243;n &#916;F508&#44; conocidos ya como factores de riesgo de AHC en los pacientes con FQ<a class="elsevierStyleCrossRefs" href="#bib5"><span class="elsevierStyleSup">5&#44;6</span></a>&#46; Sin embargo&#44; no hemos encontrado el predominio del sexo femenino descrito en dichos estudios&#46;</p><p class="elsevierStylePara elsevierViewall">El hecho de que la mayor&#237;a de nuestros pacientes con AHC tengan menos de 18 a&#241;os apoya la necesidad de realizar el cribado de la AHC desde el inicio de la segunda d&#233;cada de la vida&#44; como establecen los consensos existentes<a class="elsevierStyleCrossRefs" href="#bib9"><span class="elsevierStyleSup">9&#44;10</span></a>&#46;</p><p class="elsevierStylePara elsevierViewall">En m&#225;s de la mitad de los pacientes hemos evidenciado un deterioro del estado nutricional y&#47;o de la FP&#44; sin causa aparente&#44; en el momento del diagn&#243;stico de la AHC respecto al a&#241;o previo&#46; Este deterioro debe ser considerado como un signo de alerta para descartar activamente la AHC en la FQ<a class="elsevierStyleCrossRefs" href="#bib7"><span class="elsevierStyleSup">7&#44;11&#44;27&#44;28</span></a>&#46;</p><p class="elsevierStylePara elsevierViewall">Como ya se ha descrito en pacientes con FQ antes del diagn&#243;stico de la diabetes<a class="elsevierStyleCrossRef" href="#bib29"><span class="elsevierStyleSup">29</span></a>&#44; hemos detectado hipoglucemias bioqu&#237;micas&#44; asintom&#225;ticas&#44; durante la monitorizaci&#243;n continua de glucosa&#46; &#201;stas&#44; posiblemente&#44; son debidas a una secreci&#243;n inadecuada de insulina&#44; pero su etiolog&#237;a no est&#225; totalmente esclarecida&#46;</p><p class="elsevierStylePara elsevierViewall">En conclusi&#243;n&#44; en los pacientes con FQ la monitorizaci&#243;n continua de glucosa es un m&#233;todo m&#225;s sensible que la SOG para detectar precozmente las AHC&#44; y especialmente la diabetes&#59; pero todav&#237;a no est&#225; admitida su utilizaci&#243;n como prueba de cribado&#46; La determinaci&#243;n de la HbA<span class="elsevierStyleInf">1c</span> no permite un diagn&#243;stico precoz de las AHC en estos pacientes&#46; Finalmente&#44; ante un empeoramiento del estado nutricional y&#47;o la funci&#243;n pulmonar sin causa aparente&#44; se debe descartar la presencia de AHC&#46;</p><p class="elsevierStylePara elsevierViewall">Se precisan estudios con un mayor n&#250;mero de sujetos&#44; y realizar la monitorizaci&#243;n continua de glucosa a pacientes con FQ y normalidad de la SOG&#44; para determinar si en la FQ se debe modificar el m&#233;todo de cribado y&#47;o los criterios diagn&#243;sticos de alteraci&#243;n hidrocarbonada&#46; Es importante&#44; asimismo&#44; evaluar la repercusi&#243;n cl&#237;nica de la detecci&#243;n y el tratamiento precoz de dichas alteraciones&#46;</p></span></span>"
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          "titulo" => array:6 [
            0 => "Resumen"
            1 => "Introducci&#243;n"
            2 => "Objetivos"
            3 => "Pacientes y m&#233;todos"
            4 => "Resultados"
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          "titulo" => array:6 [
            0 => "Abstract"
            1 => "Background"
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            3 => "Patients and methods"
            4 => "Results"
            5 => "Conclusions"
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          "identificador" => "xpalclavsec92270"
          "titulo" => "Keywords"
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        4 => array:1 [
          "titulo" => "Introducci&#243;n"
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        5 => array:1 [
          "titulo" => "Pacientes y m&#233;todos"
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          "titulo" => "Resultados"
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    "fechaRecibido" => "2008-09-08"
    "fechaAceptado" => "2008-10-17"
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          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec92271"
          "palabras" => array:4 [
            0 => "Monitorizaci&#243;n continua de glucosa"
            1 => "Alteraci&#243;n hidrocarbonada"
            2 => "Cribado"
            3 => "Fibrosis qu&#237;stica"
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        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec92270"
          "palabras" => array:4 [
            0 => "Continuous glucose monitoring"
            1 => "Glucose disorders"
            2 => "Screening"
            3 => "Cystic fibrosis"
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    "resumen" => array:2 [
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p class="elsevierStyleSimplePara elsevierViewall">las alteraciones hidrocarbonadas &#40;AHC&#41; en fibrosis qu&#237;stica &#40;FQ&#41; suelen ser asintom&#225;ticas pero conllevan gran morbilidad&#46; Su diagn&#243;stico precoz puede prevenir el deterioro del estado nutricional y de la funci&#243;n pulmonar &#40;FP&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Objetivos</span><p class="elsevierStyleSimplePara elsevierViewall">comparar los resultados de la monitorizaci&#243;n continua de glucosa &#40;CGMS&#41; con los de la sobrecarga oral de glucosa &#40;SOG&#41; en pacientes con FQ&#46; Evaluar la utilidad de la hemoglobina glicosilada &#40;HbA<span class="elsevierStyleInf">1c</span>&#41; para el diagn&#243;stico precoz de AHC&#46; Analizar los cambios del estado nutritivo y funci&#243;n pulmonar al diagn&#243;stico de AHC&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">en 13 pacientes p&#250;beres &#40;7 varones&#41; con FQ y AHC&#44; diagnosticada por SOG&#44; implantamos CGMS&#46; Analizamos&#58; edad&#44; sexo&#44; mutaci&#243;n relacionada con FQ&#44; insuficiencia pancre&#225;tica exocrina&#44; HbA<span class="elsevierStyleInf">1c</span> &#40;&#37;&#41;&#44; glucemia en ayunas y 2<span class="elsevierStyleHsp" style=""></span>h tras SOG&#46; En el CGMS valoramos&#58; glucosa global&#44; en ayunas y posprandial&#44; y excursiones de glucosa &#62;140<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#46; Adem&#225;s&#44; comparamos el estado nutricional &#40;&#237;ndice de masa corporal&#41; y la FP &#40;capacidad vital forzada y volumen espiratorio forzado en el primer segundo&#41; en ese momento y en el a&#241;o previo&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">media de edad al diagn&#243;stico de AHC de 16&#44;4 a&#241;os &#40;11-22&#41;&#59; 11 pacientes ten&#237;an mutaci&#243;n &#916;F508&#46; Todos ten&#237;an insuficiencia pancre&#225;tica exocrina&#46; Cumpl&#237;an criterios de diabetes 1&#47;13 con SOG y 7&#47;13 &#40;53&#44;8&#37;&#41; con CGMS&#46; Se evidenci&#243; una declinaci&#243;n del estado nutricional y&#47;o de la FP en el 77&#37;&#46; S&#243;lo 4 pacientes ten&#237;an HbA<span class="elsevierStyleInf">1c</span> patol&#243;gica&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">el CGMS detecta mejor la diabetes relacionada con FQ que la SOG&#46; La presencia de AHC tiende a relacionarse con un empeoramiento nutricional y&#47;o de FP&#46; La HbA<span class="elsevierStyleInf">1c</span> no permite el diagn&#243;stico precoz de AHC en FQ&#46;</p>"
      ]
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p class="elsevierStyleSimplePara elsevierViewall">Diabetes mellitus &#40;DM&#41; is an increasing complication of cystic fibrosis &#40;CF&#41;&#46; It is associated with enhance morbidity&#46; Continuous glucose monitoring system &#40;CGMS&#41; could detect glucose disorders earlier than other screening tests usually used&#46;</p> <span class="elsevierStyleSectionTitle">Aims</span><p class="elsevierStyleSimplePara elsevierViewall">To compare oral glucose tolerance test &#40;OGTT&#41;&#44; HbA<span class="elsevierStyleInf">1c</span> and CGMS in patients with CF and recent disorders of glucose homeostasis and to analyse changes in nutritional status and&#47;or pulmonary function&#46;</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">Thirteen patients with CF &#40;11&#8211;22 years&#44; 7 males&#41; were studied using OGTT&#44; HbA<span class="elsevierStyleInf">1c</span> and CGMS&#46; All of them had newly diagnosed glucose disturbances&#46; They were not receiving steroid therapy or had an underlying illness&#46; In all subjects we compared&#58; HbA<span class="elsevierStyleInf">1c</span> levels &#40;&#37;&#41;&#44; fasting and 2-hours glucose OGTT &#40;mg&#47;dl&#41; and glucose CGMS values &#40;overall&#44; fasting&#44; 2-hours post mean-meals and excursions &#62;140<span class="elsevierStyleHsp" style=""></span>mg&#47;dl at any time&#41;&#46; Furthermore&#44; body mass index&#44; forced expiratory volume in the first second &#40;&#37;&#41; and forced vital capacity &#40;&#37;&#41; were evaluated in the previous year and at the time of the study&#46; We also analysed exocrine pancreatic function and CF-mutation&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Mean age at diagnosis of glucose disturbance was 16&#46;4 years&#46; All patients had insufficient exocrine pancreatic function and 11&#47;13 presented &#916;F508 CF-mutation&#46; Only one patient was diagnosed with DM using OGGT and 7&#47;13 &#40;53&#46;8&#37;&#41; with CGMS&#46; A total 77&#37; of patients had poor nutritional status and&#47;or pulmonary function at time of diagnosing the glucose disorder&#46; Only 4 patients had abnormal HbA<span class="elsevierStyleInf">1c</span> levels&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">CGMS allows a better detection of glucose disorders than OGTT&#46; Glucose homeostasis abnormalities are associated with a decrease in nutritional status and&#47;or pulmonary function&#46; HbA<span class="elsevierStyleInf">1c</span> does not aid in the early diagnose of glucose disorders&#46;</p>"
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          "es" => "<p class="elsevierStyleSimplePara elsevierViewall">Comparaci&#243;n de la sobrecarga oral de glucosa &#40;SOG&#41; y el sistema de monitorizaci&#243;n continua de glucosa &#40;CGMS&#41; en dos pacientes con alteraci&#243;n de la tolerancia a la glucosa&#46;</p>"
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                  \t\t\t\t">Edad diagn&#243;stico FQ &#40;meses&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">IMC en DE</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">CVF&#47;FEV<span class="elsevierStyleInf">1</span> &#40;&#37;&#41;</td></tr><tr title="table-row"><td 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" style="border-bottom: 2px solid black">&#8722;1 a&#241;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td 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" style="border-bottom: 2px solid black">actual&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td 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" style="border-bottom: 2px solid black">&#8722;1 a&#241;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td 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" style="border-bottom: 2px solid black">actual&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></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="" valign="\n
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                  \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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&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">&#916;F508&#47;&#916;F508&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
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                  \t\t\t\t">S&#237;&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  " align="" valign="\n
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                  \t\t\t\t">3&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  " align="" valign="\n
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                  \t\t\t\t">&#43;0&#44;6&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#43;0&#44;9&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
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                  \t\t\t\t">97&#47;90&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
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                  \t\t\t\t">85&#47;81&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  " align="" 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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">V&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">G546&#47;Q890X&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">S&#237;&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
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                  \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="" valign="\n
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                  \t\t\t\t">&#43;2&#44;9&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  " align="" valign="\n
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                  \t\t\t\t">&#43;1&#44;7&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  " align="" valign="\n
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                  \t\t\t\t">117&#47;107&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
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                  \t\t\t\t">119&#47;111&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&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">&#916;F508&#47;2183AA-G&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
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                  \t\t\t\t">S&#237;&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
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                  \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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;1&#44;9&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">&#8722;2&#44;3&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  " align="" valign="\n
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                  \t\t\t\t">63&#47;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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">58&#47;53&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&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">V&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">&#916;F508&#47;&#63;&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">S&#237;&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">9&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">&#8722;0&#44;8&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">&#8722;0&#44;8&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">132&#47;125&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
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                  \t\t\t\t">126&#47;120&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&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">M&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">&#916;F508&#47;&#916;F508&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
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                  \t\t\t\t">S&#237;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">14&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&#8722;1&#44;1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&#8722;1&#44;8&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">63&#47;45&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  " align="" valign="\n
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                  \t\t\t\t">63&#47;49&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">V&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">&#916;F508&#47;&#916;F508&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
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                  \t\t\t\t">S&#237;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">12&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;1&#44;3&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;1&#44;6&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">71&#47;48&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  " align="" valign="\n
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                  \t\t\t\t">58&#47;30&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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">V&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">&#916;F508&#47;Q890X&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
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                  \t\t\t\t">S&#237;&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;1&#44;3&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;1&#44;2&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  " align="" valign="\n
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                  \t\t\t\t">79&#47;55&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">104&#47;73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&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
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                  \t\t\t\t">N1303&#47;N1303&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
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                  \t\t\t\t">S&#237;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#44;4&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</td><td class="td" title="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&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
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">V&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">&#916;F508&#47;&#916;F508&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">V&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  " align="" valign="\n
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                  \t\t\t\t">&#916;F508&#47;&#916;F508&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">4&#44;5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">75&#47;66&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">77&#47;77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&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
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                  \t\t\t\t">&#916;F508&#47;2183AA-G&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
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                  \t\t\t\t">S&#237;&nbsp;\t\t\t\t\t\t\n
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                  \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</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">99&#47;101&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
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                  \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">V&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">&#916;F508&#47;&#916;F508&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">S&#237;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">15&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">&#8722;0&#44;8&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  " align="" valign="\n
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                  \t\t\t\t">86&#47;81&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">69&#47;60&nbsp;\t\t\t\t\t\t\n
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                  """
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          "leyenda" => "<p class="elsevierStyleSimplePara elsevierViewall">DRFQ&#58; diabetes relacionada con la fibrosis qu&#237;stica&#59; CVF&#58; capacidad vital forzada&#59; FEV<span class="elsevierStyleInf">1</span>&#58; volumen espiratorio forzado en el primer segundo&#59; IMC en DE&#58; &#237;ndice de masa corporal en desviaciones est&#225;ndar&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">Variables definidas con la mediana y el rango intercuart&#237;lico &#40;percentiles 25 y 75&#41;&#46;</p>"
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                0 => """
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                  \t\t\t\t  " colspan="3" align="" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">IMC &#40;DE&#41;</td><td class="td" title="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">FEV<span class="elsevierStyleInf">1</span> &#40;&#37;&#41;</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Actual&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">&#8722;1 a&#241;o&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Actual&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">&#8722;1 a&#241;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td 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" style="border-bottom: 2px solid black">Actual&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td 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" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Global&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">&#8722;0&#44;7 &#40;&#8722;1&#44;3&#59; 0&#44;09&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#8722;0&#44;8 &#40;&#8722;1&#44;6&#59; &#8722;0&#44;1&#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="char" valign="\n
                  \t\t\t\t\ttop\n
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                  \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">79 &#40;67&#59; 109&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77 &#40;66&#59; 109&#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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">66 &#40;51&#59; 99&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Sin DRFQ&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">78 &#40;45&#59; 117&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">79 &#40;52&#59; 113&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">60 &#40;55&#59; 91&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">65 &#40;53&#59; 101&#41;&nbsp;\t\t\t\t\t\t\n
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                  """
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          "leyenda" => "<p class="elsevierStyleSimplePara elsevierViewall">AGA&#58; alteraci&#243;n de glucemia en ayunas&#59; AHC&#58; alteraci&#243;n hidrocarbonada&#59; ATG&#58; alteraci&#243;n de la tolerancia a la glucosa&#59; DRFQ&#58; diabetes relacionada con fibrosis qu&#237;stica&#46;</p>"
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            0 => array:2 [
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                0 => """
                  <a target="_blank" href="main.stripin/si1.gif"><span class="e-comp" style="background:PowderBlue;" title="Click here to view Table Image">Click&nbsp;Here&nbsp;To&nbsp;View&nbsp;Stripin</span></a><p style="margin-bottom:0em"></p><table border="0" frame="\n
                  \t\t\t\t\tvoid\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">n&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Edad diagn&#243;stico de AHC &#40;a&#241;os&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">HbA<span class="elsevierStyleInf">1c</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Glucemias SOG&#44; basal&#47;2<span class="elsevierStyleHsp" style=""></span>h &#40;mg&#47;dl&#41;&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Valores glucemia tras SOG&#10878;200<span class="elsevierStyleHsp" style=""></span>mg&#47;dl &#40;minuto&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Diagn&#243;stico SOG&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">S&#237; &#40;60&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">104&#47;172&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
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                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">AGA&#43;ATG&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">17&#44;7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">85&#47;177&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">S&#237; &#40;60&#44; 90&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">ATG&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">20&#44;9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5&#44;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">89&#47;180&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&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">ATG&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#44;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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">115&#47;240&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">S&#237; &#40;60&#44; 90&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DRFQ&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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">17&#44;4&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">6&#44;6&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  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">85&#47;182&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">S&#237; &#40;60&#44; 90&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ATG&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&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">13&#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">5&#44;9&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">92&#47;144&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">No&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">ATG&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&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">14&#44;4&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">5&#44;5&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86&#47;153&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">S&#237; &#40;60&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ATG&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  " align="" valign="\n
                  \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
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" 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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;8&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">92&#47;196&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">No&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">ATG&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  " align="" 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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#44;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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">105&#47;178&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">S&#237; &#40;60&#44; 90&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AGA&#43;ATG&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&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">15&#44;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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;4&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">94&#47;157&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">S&#237; &#40;60&#44; 90&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ATG&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&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">11&#44;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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">97&#47;196&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">No&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">ATG&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "es" => "<p class="elsevierStyleSimplePara elsevierViewall">Resultados de la hemoglobina glicosilada &#40;HbA<span class="elsevierStyleInf">1c</span>&#41; y de la sobrecarga oral de glucosa &#40;SOG&#41;</p>"
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      4 => array:7 [
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          "leyenda" => "<p class="elsevierStyleSimplePara elsevierViewall">AGA&#58; alteraci&#243;n de la glucemia en ayunas&#59; ATG&#58; alteraci&#243;n de la tolerancia a la glucosa&#59; DRFQ&#58; diabetes relacionada con fibrosis qu&#237;stica&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">Valores de glucosa expresados en mg&#47;dl&#46;</p>"
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            0 => array:2 [
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " rowspan="2" align="" valign="\n
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                  \t\t\t\t">n</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " rowspan="2" align="" valign="\n
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                  \t\t\t\t">D&#237;as n<span class="elsevierStyleSup">o</span></td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " rowspan="2" align="" valign="\n
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                  \t\t\t\t">Total registros n<span class="elsevierStyleSup">o</span></td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " rowspan="2" align="" valign="\n
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                  \t\t\t\t">Glucosa global media &#40;mg&#47;dl&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Glucosa ayunas</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Glucosa posprandrial</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Excursiones &#62;140<span class="elsevierStyleHsp" style=""></span>mg&#47;dl</td><td 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">Diagn&#243;stico&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-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">media&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td 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" style="border-bottom: 2px solid black">&#40;rango&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td 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" style="border-bottom: 2px solid black">media&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td 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" style="border-bottom: 2px solid black">&#40;rango&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td 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" style="border-bottom: 2px solid black">n<span class="elsevierStyleSup">o</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td 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" style="border-bottom: 2px solid black">duraci&#243;n &#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-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">CGMS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></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="" 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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&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">1&#46;107&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">101&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">102&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">96&#8211;108&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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Monitorización continua de glucosa para cribado de alteraciones hidrocarbonadas en fibrosis quística
Continuous glucose monitoring system in the screening of glucose disorders in cystic fibrosis
M. Martín-Fríasa,
Autor para correspondencia
maria.martin.sg@hotmail.com

Autor para correspondencia.
, A. Lamas Ferreirob, E. Colino Alcola, M.A. Álvarez Gómeza, R. Yelmo Valverdea, R. Barrio Castellanosa
a Unidad de Diabetes Pediátrica, Servicio de Pediatría, Hospital Universitario Ramón y Cajal, Universidad Alcalá de Henares, Madrid, España
b Unidad de Fibrosis Quística, Hospital Universitario Ramón y Cajal, Universidad Alcalá de Henares, Madrid, España
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          "es" => "<p class="elsevierStyleSimplePara elsevierViewall">Comparaci&#243;n de la sobrecarga oral de glucosa &#40;SOG&#41; y el sistema de monitorizaci&#243;n continua de glucosa &#40;CGMS&#41; en dos pacientes con alteraci&#243;n de la tolerancia a la glucosa&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p class="elsevierStylePara elsevierViewall">La alteraci&#243;n del metabolismo hidrocarbonado &#40;AHC&#41; es una complicaci&#243;n evolutiva en los pacientes con fibrosis qu&#237;stica &#40;FQ&#41;&#44; y su m&#225;xima expresi&#243;n es la diabetes &#40;DRFQ&#41;&#46; Estas alteraciones conllevan una gran morbimortalidad y tienen una repercusi&#243;n negativa en la calidad de vida de los pacientes<a class="elsevierStyleCrossRefs" href="#bib1"><span class="elsevierStyleSup">1&#44;2</span></a>&#46; En la actualidad&#44; el mejor conocimiento de la FQ y el tratamiento multifactorial en unidades especializadas han aumentado su esperanza de vida y con ello la prevalencia de las AHC<a class="elsevierStyleCrossRefs" href="#bib3"><span class="elsevierStyleSup">3&#44;4</span></a>&#44; que suelen aparecer al final de la segunda d&#233;cada de la vida<a class="elsevierStyleCrossRef" href="#bib2"><span class="elsevierStyleSup">2</span></a>&#46; Se consideran factores de riesgo para su desarrollo&#58; la edad&#44; el sexo femenino&#44; la presencia de insuficiencia pancre&#225;tica exocrina y de la mutaci&#243;n &#916;F508<a class="elsevierStyleCrossRefs" href="#bib5"><span class="elsevierStyleSup">5&#44;6</span></a>&#46; Es importante su diagn&#243;stico y el tratamiento precoz&#44; ya que su presencia se asocia con un empeoramiento del estado nutricional y&#47;o de la funci&#243;n pulmonar &#40;FP&#41;<a class="elsevierStyleCrossRef" href="#bib6"><span class="elsevierStyleSup">6</span></a>&#44; as&#237; como una elevada morbimortalidad&#59; todo ello es mejorable con un buen control metab&#243;lico<a class="elsevierStyleCrossRefs" href="#bib7"><span class="elsevierStyleSup">7&#44;8</span></a>&#46; No obstante&#44; a pesar de las evidencias acerca de la influencia del control de las AHC en la evoluci&#243;n de la FQ&#44; en el momento actual no hay consenso en cuanto a la actitud terap&#233;utica a tomar en las fases precoces de estas AHC<a class="elsevierStyleCrossRefs" href="#bib9"><span class="elsevierStyleSup">9&#44;10</span></a>&#46;</p><p class="elsevierStylePara elsevierViewall">Debido a que la AHC&#44; inicialmente&#44; suele ser asintom&#225;tica<a class="elsevierStyleCrossRefs" href="#bib9"><span class="elsevierStyleSup">9&#44;11</span></a>&#44; es necesario realizar un cribado anual mediante el test de sobrecarga oral de glucosa &#40;SOG&#41; a partir de los 10 a&#241;os de edad y&#47;o cuando haya comenzado la pubertad<a class="elsevierStyleCrossRefs" href="#bib9"><span class="elsevierStyleSup">9&#44;10</span></a>&#46; Tanto la alteraci&#243;n de la glucemia en ayunas como de la hemoglobina glicosilada &#40;HbA<span class="elsevierStyleInf">1c</span>&#41; son eventos tard&#237;os<a class="elsevierStyleCrossRef" href="#bib9"><span class="elsevierStyleSup">9</span></a>&#46;</p><p class="elsevierStylePara elsevierViewall">Hasta ahora&#44; la realizaci&#243;n de una SOG era el m&#233;todo m&#225;s sensible para detectar la AHC<a class="elsevierStyleCrossRef" href="#bib12"><span class="elsevierStyleSup">12</span></a>&#46; Sin embargo&#44; en la actualidad contamos con sistemas de monitorizaci&#243;n continua de glucosa intersticial &#40;CGMS&#44; Medtronic Minimed&#44; Northridge&#44; CA&#41; que son capaces de detectar un mayor n&#250;mero de fluctuaciones de glucosa en la vida diaria&#46; Distintos estudios<a class="elsevierStyleCrossRefs" href="#bib13"><span class="elsevierStyleSup">13&#8211;15</span></a> han demostrado una buena correlaci&#243;n entre las cifras de glucosa intersticial y la glucemia capilar y venosa&#44; tanto en sujetos sanos como en personas con diabetes&#59; esta correlaci&#243;n tambi&#233;n se ha confirmado en pacientes con FQ<a class="elsevierStyleCrossRef" href="#bib16"><span class="elsevierStyleSup">16</span></a>&#46; Esta t&#233;cnica de monitorizaci&#243;n de glucosa puede permitir detectar m&#225;s tempranamente las AHC con el objetivo de iniciar un tratamiento precoz&#46; Aunque en la actualidad no hay mucha experiencia en la utilizaci&#243;n del CGMS en FQ&#44; algunos autores defienden su uso<a class="elsevierStyleCrossRefs" href="#bib17"><span class="elsevierStyleSup">17&#8211;20</span></a>&#46;</p><p class="elsevierStylePara elsevierViewall">El objetivo principal del estudio es evaluar la utilidad del CGMS para la detecci&#243;n precoz de las AHC&#44; en especial la diabetes&#44; en pacientes con FQ&#46; Como objetivos secundarios nos planteamos analizar las modificaciones del estado nutricional y de la FP en el momento del diagn&#243;stico de la AHC respecto al a&#241;o previo y determinar si la HbA<span class="elsevierStyleInf">1c</span> es un buen predictor de DRFQ&#46;</p></span><span class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p class="elsevierStylePara elsevierViewall">Durante los a&#241;os 2004&#8211;2007 se realizaron&#44; en la unidad de fibrosis qu&#237;stica&#44; 50 SOG en 41 pacientes de edades comprendidas entre los 10 y los 22 a&#241;os&#46; Ninguno presentaba enfermedad intercurrente ni recib&#237;a tratamiento esteroideo sist&#233;mico&#46; En 16 pacientes se evidenci&#243; una AHC no detectada previamente&#46; De &#233;stos&#44; 13 aceptaron la CGMS&#46; Los pacientes y&#47;o sus padres dieron el consentimiento informado para participar en el estudio&#46;</p><p class="elsevierStylePara elsevierViewall">Definimos AHC seg&#250;n los criterios de la Asociaci&#243;n Americana de Diabetes<a class="elsevierStyleCrossRef" href="#bib21"><span class="elsevierStyleSup">21</span></a>&#44; tambi&#233;n aplicables a los enfermos con FQ<a class="elsevierStyleCrossRef" href="#bib22"><span class="elsevierStyleSup">22</span></a>&#46; Seg&#250;n estos criterios&#44; se considera alteraci&#243;n de la glucemia en ayunas cuando &#233;sta est&#225; en 100&#8211;125<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#59; alteraci&#243;n de la tolerancia a la glucosa cuando la glucemia a las 2<span class="elsevierStyleHsp" style=""></span>h de la SOG es de 140&#8211;199<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#44; y diabetes cuando la glucemia en ayunas es &#10878;126<span class="elsevierStyleHsp" style=""></span>mg&#47;dl y&#47;o la glucemia a las 2<span class="elsevierStyleHsp" style=""></span>h de la SOG es &#10878;200<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#46;</p><p class="elsevierStylePara elsevierViewall">En cada paciente se valor&#243;&#58; edad al diagn&#243;stico de la FQ &#40;en meses&#41;&#44; edad al diagn&#243;stico de la AHC &#40;en a&#241;os&#41;&#44; sexo&#44; alteraci&#243;n gen&#233;tica relacionada con FQ y funci&#243;n pancre&#225;tica exocrina&#46; En el momento del estudio y en el a&#241;o anterior se analiz&#243;&#58; el estado nutricional mediante el &#237;ndice de masa corporal &#40;IMC&#41; en desviaciones est&#225;ndar &#40;IMC en DE&#41;<a class="elsevierStyleCrossRef" href="#bib23"><span class="elsevierStyleSup">23</span></a> y la FP mediante la capacidad vital forzada &#40;CVF&#44; &#37;&#41; y el volumen espiratorio forzado en el primer segundo &#40;FEV<span class="elsevierStyleInf">1</span>&#44; &#37;&#41;&#59; se utiliz&#243; el valor en porcentaje sobre el te&#243;rico&#46; Entendemos por empeoramiento del estado nutricional y&#47;o de la funci&#243;n pulmonar la ca&#237;da de los valores de DE del IMC&#44; de la CVF y&#47;o del FEV<span class="elsevierStyleInf">1</span> &#40;&#37;&#41;&#44; en cualquier cuant&#237;a&#44; al comparar las cifras del momento del diagn&#243;stico de la AHC con las del a&#241;o previo&#46; Para analizar estas variables cuantitativas&#44; realizamos un an&#225;lisis estad&#237;stico con el programa SPSS&#44; versi&#243;n 15&#46;0&#46; Asumiendo que nuestra muestra no era normal&#44; utilizamos la prueba de la U de Mann-Whitney y la prueba de Wilcoxon para pruebas no param&#233;tricas con nivel de significaci&#243;n estad&#237;stica p&#60;0&#44;05&#46; Para definir las variables usamos la mediana&#44; con el rango intercuart&#237;lico &#40;percentil 25-75&#41; como medida de dispersi&#243;n&#46;</p><p class="elsevierStylePara elsevierViewall">En cada paciente se hizo un test de SOG &#40;1&#44;75<span class="elsevierStyleHsp" style=""></span>g&#47;kg glucosa &#91;m&#225;ximo de 75<span class="elsevierStyleHsp" style=""></span>g&#93;&#41; y una monitorizaci&#243;n continua de glucosa intersticial &#40;CGMS-Medtronic Minimed&#41;&#46; &#201;sta se realiz&#243; de forma ambulatoria despu&#233;s de instruir correctamente en su manejo a los enfermos y sus familiares&#46; La monitorizaci&#243;n se realiz&#243; mediante un sensor que quedaba insertado en la zona gl&#250;tea&#44; durante un periodo m&#237;nimo de 4 d&#237;as&#46; Para el calibrado del sensor&#44; se introdujeron cuatro determinaciones de glucemia capilar al d&#237;a&#46; Durante los d&#237;as de monitorizaci&#243;n&#44; el paciente rellen&#243; un diario especificando la ingesta de hidratos de carbono y el ejercicio realizado&#46; Finalizada la monitorizaci&#243;n&#44; los datos se descargaron por medio del programa inform&#225;tico del sistema&#46; De estos datos&#44; analizamos la media y los intervalos de los valores de glucosa&#58; global&#44; en ayunas y posprandial &#40;2<span class="elsevierStyleHsp" style=""></span>h tras desayuno&#44; comida y cena&#41;&#59; adem&#225;s&#44; las excursiones de glucosa &#62;140<span class="elsevierStyleHsp" style=""></span>mg&#47;dl en cualquier momento del d&#237;a &#40;en n&#250;mero absoluto y en porcentaje respecto al tiempo total de la monitorizaci&#243;n&#41;&#46; Dichos valores los comparamos con las glucemias basales y a las 2<span class="elsevierStyleHsp" style=""></span>h de la SOG&#46; Adem&#225;s&#44; los relacionamos con las concentraciones de HbA<span class="elsevierStyleInf">1c</span> de cada paciente &#40;valor normal&#44; 5&#44;3&#177;0&#44;3&#44; HPLC Menarini&#41;&#46;</p></span><span class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStylePara elsevierViewall">La mediana de edad al diagn&#243;stico de FQ es 9 &#40;intervalo&#44; 3-15&#41; meses y al diagn&#243;stico de la AHC es de 15&#44;2 &#40;14&#8211;19&#44;2&#41; a&#241;os&#59; 7 &#40;53&#44;8&#37;&#41; de los 13 pacientes son varones&#46; El 84&#44;6&#37; presentan la mutaci&#243;n &#916;F508 &#40;el 46&#44;1&#37; en homocigosis&#41;&#46; Todos tienen insuficiencia pancre&#225;tica exocrina&#46; Ning&#250;n paciente refer&#237;a cl&#237;nica cardinal de diabetes&#46; Las caracter&#237;sticas cl&#237;nicas de los pacientes se muestran en la <a class="elsevierStyleCrossRef" href="#tbl1">tabla 1</a>&#46;</p><elsevierMultimedia ident="tbl1"></elsevierMultimedia><p class="elsevierStylePara elsevierViewall">En el an&#225;lisis retrospectivo&#44; objetivamos un empeoramiento en el &#250;ltimo a&#241;o&#44; aunque no estad&#237;sticamente significativo&#44; del estado nutricional &#40;IMC en DE&#41; en el 66&#44;6&#37; de los pacientes&#44; de la FP &#40;CVF y&#47;o FEV<span class="elsevierStyleInf">1</span>&#41; en el 58&#44;3&#37; y de ambos en el 20&#44;7&#37; &#40;<a class="elsevierStyleCrossRef" href="#tbl1">tabla 1</a>&#41;&#46; Cuando dividimos a la muestra en 2 subgrupos&#44; seg&#250;n los resultados de la monitorizaci&#243;n con CGMS&#44; y comparamos la evoluci&#243;n de estas variables entre los subgrupos&#44; apreciamos en aquellos pacientes en los que se detect&#243; diabetes un mayor deterioro de los tres par&#225;metros&#44; pero sin significaci&#243;n estad&#237;stica &#40;<a class="elsevierStyleCrossRef" href="#tbl2">tabla 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl2"></elsevierMultimedia><p class="elsevierStylePara elsevierViewall">En la SOG &#40;<a class="elsevierStyleCrossRef" href="#tbl3">tabla 3</a>&#41; encontramos&#58; alteraci&#243;n de la tolerancia a la glucosa &#40;ATG&#41; en el 76&#44;9&#37; de los pacientes&#44; alteraci&#243;n de la glucemia en ayunas &#40;AGA&#41; en el 38&#44;4&#37; y diabetes en un &#250;nico paciente &#40;7&#44;6&#37;&#41;&#46; Hay que se&#241;alar que en 8 de los 13 pacientes se evidencian glucemias &#10878;200<span class="elsevierStyleHsp" style=""></span>mg&#47;dl en momentos intermedios de la curva de glucemia&#46; Detectamos concentraciones de HbA<span class="elsevierStyleInf">1c</span> patol&#243;gicas en 4 &#40;30&#44;7&#37;&#41; pacientes&#46;</p><elsevierMultimedia ident="tbl3"></elsevierMultimedia><p class="elsevierStylePara elsevierViewall">No hubo complicaciones durante la monitorizaci&#243;n continua de glucosa&#46; &#201;sta se mantuvo una media de 6&#44;8 &#40;4&#8211;10&#41; d&#237;as&#46; Los resultados de CGMS quedan expuestos en la <a class="elsevierStyleCrossRef" href="#tbl4">tabla 4</a>&#46; Encontramos una glucosa media global alterada en el 91&#44;6&#37; de los pacientes&#44; en 2 de ellos en rango de diabetes&#46;</p><elsevierMultimedia ident="tbl4"></elsevierMultimedia><p class="elsevierStylePara elsevierViewall">Seg&#250;n el an&#225;lisis de la glucosa posprandial en el CGMS&#58; el 16&#44;6&#37; de los pacientes presentan cifras patol&#243;gicas del valor de glucosa media&#59; 12 de los 13 pacientes tienen valores patol&#243;gicos teniendo en cuenta el valor m&#225;ximo del rango &#40;el 50&#37; ATG&#44; y el 41&#44;6&#37; diabetes&#41;&#46;</p><p class="elsevierStylePara elsevierViewall">En el an&#225;lisis de la glucosa en ayunas durante el CGMS&#44; al valorar el valor medio&#44; el 65&#37; de los sujetos cumplen criterios de AGA y ninguno presenta concentraciones de glucosa en el rango de diabetes&#46; Sin embargo&#44; teniendo en cuenta el valor m&#225;ximo del rango&#44; todos los pacientes&#44; en alg&#250;n momento de la monitorizaci&#243;n&#44; tienen cifras por encima de la normalidad&#59; en el 30&#44;7&#37; de ellos est&#225; en el rango de diabetes&#46;</p><p class="elsevierStylePara elsevierViewall">La <a class="elsevierStyleCrossRef" href="#fig1">figura 1</a> muestra los resultados del CGMS de 2 pacientes diagnosticados de ATG con la SOG&#44; en los que se evidencia una diferencia clara en las fluctuaciones de glucosa durante la monitorizaci&#243;n&#46;</p><elsevierMultimedia ident="fig1"></elsevierMultimedia></span><span class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discusi&#243;n</span><p class="elsevierStylePara elsevierViewall">En los consensos internacionales el diagn&#243;stico de la AHC en los pacientes con FQ se basa en la glucemia en ayunas o en la SOG<a class="elsevierStyleCrossRefs" href="#bib9"><span class="elsevierStyleSup">9&#44;10&#44;24</span></a>&#46; En la actualidad&#44; los sistemas de monitorizaci&#243;n continua de glucosa pueden permitir la b&#250;squeda de un diagn&#243;stico m&#225;s precoz&#44; con la ventaja de que la valoraci&#243;n se realiza en condiciones de la vida habitual de los pacientes<a class="elsevierStyleCrossRefs" href="#bib17"><span class="elsevierStyleSup">17&#8211;19</span></a>&#46;</p><p class="elsevierStylePara elsevierViewall">Con el estudio con CGMS hemos detectado un mayor n&#250;mero de valores patol&#243;gicos de glucosa en comparaci&#243;n con los resultados del test de SOG y&#44; sobre todo&#44; nos ha permitido el diagn&#243;stico m&#225;s precoz de diabetes&#59; hallazgos similares han sido obtenidos por otros autores<a class="elsevierStyleCrossRefs" href="#bib17"><span class="elsevierStyleSup">17&#8211;20</span></a>&#46; A&#250;n no hay consenso sobre su significaci&#243;n cl&#237;nica y la actitud terap&#233;utica a seguir<a class="elsevierStyleCrossRefs" href="#bib9"><span class="elsevierStyleSup">9&#44;10&#44;12&#44;25</span></a>&#46;</p><p class="elsevierStylePara elsevierViewall">Ser&#237;a importante conocer las fluctuaciones de glucosa durante las 24<span class="elsevierStyleHsp" style=""></span>h en pacientes con FQ&#44; tanto en el caso de normalidad como de alteraci&#243;n hidrocarbonada tras SOG&#46; Hay pocos estudios mediante CGMS en pacientes con FQ y normalidad hidrocarbonada<a class="elsevierStyleCrossRefs" href="#bib17"><span class="elsevierStyleSup">17&#44;19</span></a>&#46; Los datos obtenidos mediante CGMS demuestran que las determinaciones convencionales del test de SOG subestiman las AHC en los pacientes con FQ<a class="elsevierStyleCrossRefs" href="#bib17"><span class="elsevierStyleSup">17&#44;19&#44;20&#44;25</span></a>&#46;</p><p class="elsevierStylePara elsevierViewall">En nuestro estudio tambi&#233;n hemos constatado que la HbA<span class="elsevierStyleInf">1c</span> no es buen par&#225;metro para el diagn&#243;stico precoz de la AHC en la FQ<a class="elsevierStyleCrossRefs" href="#bib20"><span class="elsevierStyleSup">20&#44;26</span></a>&#46;</p><p class="elsevierStylePara elsevierViewall">Adem&#225;s&#44; en nuestros pacientes hemos evidenciado la existencia de insuficiencia pancre&#225;tica exocrina y la presencia frecuente de la mutaci&#243;n &#916;F508&#44; conocidos ya como factores de riesgo de AHC en los pacientes con FQ<a class="elsevierStyleCrossRefs" href="#bib5"><span class="elsevierStyleSup">5&#44;6</span></a>&#46; Sin embargo&#44; no hemos encontrado el predominio del sexo femenino descrito en dichos estudios&#46;</p><p class="elsevierStylePara elsevierViewall">El hecho de que la mayor&#237;a de nuestros pacientes con AHC tengan menos de 18 a&#241;os apoya la necesidad de realizar el cribado de la AHC desde el inicio de la segunda d&#233;cada de la vida&#44; como establecen los consensos existentes<a class="elsevierStyleCrossRefs" href="#bib9"><span class="elsevierStyleSup">9&#44;10</span></a>&#46;</p><p class="elsevierStylePara elsevierViewall">En m&#225;s de la mitad de los pacientes hemos evidenciado un deterioro del estado nutricional y&#47;o de la FP&#44; sin causa aparente&#44; en el momento del diagn&#243;stico de la AHC respecto al a&#241;o previo&#46; Este deterioro debe ser considerado como un signo de alerta para descartar activamente la AHC en la FQ<a class="elsevierStyleCrossRefs" href="#bib7"><span class="elsevierStyleSup">7&#44;11&#44;27&#44;28</span></a>&#46;</p><p class="elsevierStylePara elsevierViewall">Como ya se ha descrito en pacientes con FQ antes del diagn&#243;stico de la diabetes<a class="elsevierStyleCrossRef" href="#bib29"><span class="elsevierStyleSup">29</span></a>&#44; hemos detectado hipoglucemias bioqu&#237;micas&#44; asintom&#225;ticas&#44; durante la monitorizaci&#243;n continua de glucosa&#46; &#201;stas&#44; posiblemente&#44; son debidas a una secreci&#243;n inadecuada de insulina&#44; pero su etiolog&#237;a no est&#225; totalmente esclarecida&#46;</p><p class="elsevierStylePara elsevierViewall">En conclusi&#243;n&#44; en los pacientes con FQ la monitorizaci&#243;n continua de glucosa es un m&#233;todo m&#225;s sensible que la SOG para detectar precozmente las AHC&#44; y especialmente la diabetes&#59; pero todav&#237;a no est&#225; admitida su utilizaci&#243;n como prueba de cribado&#46; La determinaci&#243;n de la HbA<span class="elsevierStyleInf">1c</span> no permite un diagn&#243;stico precoz de las AHC en estos pacientes&#46; Finalmente&#44; ante un empeoramiento del estado nutricional y&#47;o la funci&#243;n pulmonar sin causa aparente&#44; se debe descartar la presencia de AHC&#46;</p><p class="elsevierStylePara elsevierViewall">Se precisan estudios con un mayor n&#250;mero de sujetos&#44; y realizar la monitorizaci&#243;n continua de glucosa a pacientes con FQ y normalidad de la SOG&#44; para determinar si en la FQ se debe modificar el m&#233;todo de cribado y&#47;o los criterios diagn&#243;sticos de alteraci&#243;n hidrocarbonada&#46; Es importante&#44; asimismo&#44; evaluar la repercusi&#243;n cl&#237;nica de la detecci&#243;n y el tratamiento precoz de dichas alteraciones&#46;</p></span></span>"
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      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p class="elsevierStyleSimplePara elsevierViewall">las alteraciones hidrocarbonadas &#40;AHC&#41; en fibrosis qu&#237;stica &#40;FQ&#41; suelen ser asintom&#225;ticas pero conllevan gran morbilidad&#46; Su diagn&#243;stico precoz puede prevenir el deterioro del estado nutricional y de la funci&#243;n pulmonar &#40;FP&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Objetivos</span><p class="elsevierStyleSimplePara elsevierViewall">comparar los resultados de la monitorizaci&#243;n continua de glucosa &#40;CGMS&#41; con los de la sobrecarga oral de glucosa &#40;SOG&#41; en pacientes con FQ&#46; Evaluar la utilidad de la hemoglobina glicosilada &#40;HbA<span class="elsevierStyleInf">1c</span>&#41; para el diagn&#243;stico precoz de AHC&#46; Analizar los cambios del estado nutritivo y funci&#243;n pulmonar al diagn&#243;stico de AHC&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">en 13 pacientes p&#250;beres &#40;7 varones&#41; con FQ y AHC&#44; diagnosticada por SOG&#44; implantamos CGMS&#46; Analizamos&#58; edad&#44; sexo&#44; mutaci&#243;n relacionada con FQ&#44; insuficiencia pancre&#225;tica exocrina&#44; HbA<span class="elsevierStyleInf">1c</span> &#40;&#37;&#41;&#44; glucemia en ayunas y 2<span class="elsevierStyleHsp" style=""></span>h tras SOG&#46; En el CGMS valoramos&#58; glucosa global&#44; en ayunas y posprandial&#44; y excursiones de glucosa &#62;140<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#46; Adem&#225;s&#44; comparamos el estado nutricional &#40;&#237;ndice de masa corporal&#41; y la FP &#40;capacidad vital forzada y volumen espiratorio forzado en el primer segundo&#41; en ese momento y en el a&#241;o previo&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">media de edad al diagn&#243;stico de AHC de 16&#44;4 a&#241;os &#40;11-22&#41;&#59; 11 pacientes ten&#237;an mutaci&#243;n &#916;F508&#46; Todos ten&#237;an insuficiencia pancre&#225;tica exocrina&#46; Cumpl&#237;an criterios de diabetes 1&#47;13 con SOG y 7&#47;13 &#40;53&#44;8&#37;&#41; con CGMS&#46; Se evidenci&#243; una declinaci&#243;n del estado nutricional y&#47;o de la FP en el 77&#37;&#46; S&#243;lo 4 pacientes ten&#237;an HbA<span class="elsevierStyleInf">1c</span> patol&#243;gica&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">el CGMS detecta mejor la diabetes relacionada con FQ que la SOG&#46; La presencia de AHC tiende a relacionarse con un empeoramiento nutricional y&#47;o de FP&#46; La HbA<span class="elsevierStyleInf">1c</span> no permite el diagn&#243;stico precoz de AHC en FQ&#46;</p>"
      ]
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p class="elsevierStyleSimplePara elsevierViewall">Diabetes mellitus &#40;DM&#41; is an increasing complication of cystic fibrosis &#40;CF&#41;&#46; It is associated with enhance morbidity&#46; Continuous glucose monitoring system &#40;CGMS&#41; could detect glucose disorders earlier than other screening tests usually used&#46;</p> <span class="elsevierStyleSectionTitle">Aims</span><p class="elsevierStyleSimplePara elsevierViewall">To compare oral glucose tolerance test &#40;OGTT&#41;&#44; HbA<span class="elsevierStyleInf">1c</span> and CGMS in patients with CF and recent disorders of glucose homeostasis and to analyse changes in nutritional status and&#47;or pulmonary function&#46;</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">Thirteen patients with CF &#40;11&#8211;22 years&#44; 7 males&#41; were studied using OGTT&#44; HbA<span class="elsevierStyleInf">1c</span> and CGMS&#46; All of them had newly diagnosed glucose disturbances&#46; They were not receiving steroid therapy or had an underlying illness&#46; In all subjects we compared&#58; HbA<span class="elsevierStyleInf">1c</span> levels &#40;&#37;&#41;&#44; fasting and 2-hours glucose OGTT &#40;mg&#47;dl&#41; and glucose CGMS values &#40;overall&#44; fasting&#44; 2-hours post mean-meals and excursions &#62;140<span class="elsevierStyleHsp" style=""></span>mg&#47;dl at any time&#41;&#46; Furthermore&#44; body mass index&#44; forced expiratory volume in the first second &#40;&#37;&#41; and forced vital capacity &#40;&#37;&#41; were evaluated in the previous year and at the time of the study&#46; We also analysed exocrine pancreatic function and CF-mutation&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Mean age at diagnosis of glucose disturbance was 16&#46;4 years&#46; All patients had insufficient exocrine pancreatic function and 11&#47;13 presented &#916;F508 CF-mutation&#46; Only one patient was diagnosed with DM using OGGT and 7&#47;13 &#40;53&#46;8&#37;&#41; with CGMS&#46; A total 77&#37; of patients had poor nutritional status and&#47;or pulmonary function at time of diagnosing the glucose disorder&#46; Only 4 patients had abnormal HbA<span class="elsevierStyleInf">1c</span> levels&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">CGMS allows a better detection of glucose disorders than OGTT&#46; Glucose homeostasis abnormalities are associated with a decrease in nutritional status and&#47;or pulmonary function&#46; HbA<span class="elsevierStyleInf">1c</span> does not aid in the early diagnose of glucose disorders&#46;</p>"
      ]
    ]
    "multimedia" => array:5 [
      0 => array:7 [
        "identificador" => "fig1"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
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        "descripcion" => array:1 [
          "es" => "<p class="elsevierStyleSimplePara elsevierViewall">Comparaci&#243;n de la sobrecarga oral de glucosa &#40;SOG&#41; y el sistema de monitorizaci&#243;n continua de glucosa &#40;CGMS&#41; en dos pacientes con alteraci&#243;n de la tolerancia a la glucosa&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "tbl1"
        "etiqueta" => "Tabla 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p class="elsevierStyleSimplePara elsevierViewall">CVF&#58; capacidad vital forzada&#59; FEV<span class="elsevierStyleInf">1</span>&#58; volumen espiratorio forzado en el primer segundo&#59; FQ&#58; fibrosis qu&#237;stica&#59; IMC en DE&#58; &#237;ndice de masa corporal en desviaciones est&#225;ndar&#59; IPE&#58; insuficiencia pancre&#225;tica exocrina&#59; M&#58; mujer&#59; V&#58; var&#243;n&#59; &#63;&#58; mutaci&#243;n desconocida&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
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                0 => """
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                  \t\t\t\t  " rowspan="2" align="" valign="\n
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                  \t\t\t\t">n</td><td class="td" title="\n
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                  \t\t\t\t">Sexo</td><td class="td" title="\n
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                  \t\t\t\t">Mutaci&#243;n</td><td class="td" title="\n
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                  \t\t\t\t">Edad diagn&#243;stico FQ &#40;meses&#41;</td><td class="td" title="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">CVF&#47;FEV<span class="elsevierStyleInf">1</span> &#40;&#37;&#41;</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">actual&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">M&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  " align="" valign="\n
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                  \t\t\t\t">&#916;F508&#47;&#916;F508&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#43;0&#44;9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">97&#47;90&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">V&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">G546&#47;Q890X&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#43;2&#44;9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">117&#47;107&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">119&#47;111&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">3&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</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&#916;F508&#47;2183AA-G&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">58&#47;53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \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">V&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
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                  \t\t\t\t">&#916;F508&#47;&#63;&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">&#8722;0&#44;8&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  " align="" valign="\n
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                  \t\t\t\t">&#8722;0&#44;8&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">132&#47;125&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  " align="" valign="\n
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                  \t\t\t\t">126&#47;120&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&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
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                  \t\t\t\t">&#916;F508&#47;&#916;F508&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#8722;1&#44;1&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  " align="" valign="\n
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                  \t\t\t\t">&#8722;1&#44;8&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">63&#47;45&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">63&#47;49&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">V&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">&#916;F508&#47;&#916;F508&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">S&#237;&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
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                  \t\t\t\t">12&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">&#8722;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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;1&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71&#47;48&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">58&#47;30&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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">V&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">&#916;F508&#47;Q890X&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">S&#237;&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">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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;1&#44;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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">79&#47;55&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">104&#47;73&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&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">M&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">N1303&#47;N1303&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">S&#237;&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">5&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">&#8722;0&#44;4&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">&#8722;0&#44;5&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">73&#47;57&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">75&#47;65&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&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">M&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
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                  \t\t\t\t">&#916;F508&#47;&#63;&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">S&#237;&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">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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#43;0&#44;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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#44;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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62&#47;45&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">70&#47;53&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  " align="" valign="\n
                  \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
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">V&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">&#916;F508&#47;&#916;F508&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">S&#237;&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">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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#43;0&#44;09&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">&#8722;0&#44;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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">116&#47;115&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">114&#47;111&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  " align="" 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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">V&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">&#916;F508&#47;&#916;F508&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">S&#237;&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">4&#44;5&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">&#8722;1&#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">&#8722;1&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">75&#47;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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77&#47;77&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&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">M&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">&#916;F508&#47;2183AA-G&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">S&#237;&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">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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#44;5&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">102&#47;91&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">99&#47;101&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&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">V&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">&#916;F508&#47;&#916;F508&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">S&#237;&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">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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#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">&#8722;0&#44;8&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">86&#47;81&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">69&#47;60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab189781.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas generales de los pacientes</p>"
        ]
      ]
      2 => array:7 [
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          "leyenda" => "<p class="elsevierStyleSimplePara elsevierViewall">DRFQ&#58; diabetes relacionada con la fibrosis qu&#237;stica&#59; CVF&#58; capacidad vital forzada&#59; FEV<span class="elsevierStyleInf">1</span>&#58; volumen espiratorio forzado en el primer segundo&#59; IMC en DE&#58; &#237;ndice de masa corporal en desviaciones est&#225;ndar&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">Variables definidas con la mediana y el rango intercuart&#237;lico &#40;percentiles 25 y 75&#41;&#46;</p>"
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                  \t\t\t\t" style="border-bottom: 2px solid black">Actual&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Actual&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">66 &#40;51&#59; 99&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">73 &#40;53&#59; 106&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">Sin DRFQ&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#44;5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">86 &#40;62&#59; 120&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">81 &#40;68&#59; 117&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;5&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
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                  \t\t\t\t">78 &#40;45&#59; 117&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">79 &#40;52&#59; 113&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">DRFQ&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#8722;0&#44;7 &#40;&#8722;1&#44;3&#59; &#8722;0&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">79 &#40;71&#59; 102&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">75 &#40;58&#59; 104&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">60 &#40;55&#59; 91&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">65 &#40;53&#59; 101&#41;&nbsp;\t\t\t\t\t\t\n
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      3 => array:7 [
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          "leyenda" => "<p class="elsevierStyleSimplePara elsevierViewall">AGA&#58; alteraci&#243;n de glucemia en ayunas&#59; AHC&#58; alteraci&#243;n hidrocarbonada&#59; ATG&#58; alteraci&#243;n de la tolerancia a la glucosa&#59; DRFQ&#58; diabetes relacionada con fibrosis qu&#237;stica&#46;</p>"
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                  <a target="_blank" href="main.stripin/si1.gif"><span class="e-comp" style="background:PowderBlue;" title="Click here to view Table Image">Click&nbsp;Here&nbsp;To&nbsp;View&nbsp;Stripin</span></a><p style="margin-bottom:0em"></p><table border="0" frame="\n
                  \t\t\t\t\tvoid\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">n&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Edad diagn&#243;stico de AHC &#40;a&#241;os&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">HbA<span class="elsevierStyleInf">1c</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Glucemias SOG&#44; basal&#47;2<span class="elsevierStyleHsp" style=""></span>h &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Valores glucemia tras SOG&#10878;200<span class="elsevierStyleHsp" style=""></span>mg&#47;dl &#40;minuto&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Diagn&#243;stico SOG&nbsp;\t\t\t\t\t\t\n
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                  \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">106&#47;128&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">S&#237; &#40;60&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AGA&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  " align="" 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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#47;133&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">S&#237; &#40;30&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AGA&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#44;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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;9&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">104&#47;172&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">No&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">AGA&#43;ATG&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&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">17&#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">5&#44;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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">85&#47;177&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">S&#237; &#40;60&#44; 90&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ATG&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&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">20&#44;9&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">5&#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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">89&#47;180&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">No&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">ATG&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#44;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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">115&#47;240&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">S&#237; &#40;60&#44; 90&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DRFQ&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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">17&#44;4&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">6&#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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">85&#47;182&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">S&#237; &#40;60&#44; 90&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ATG&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&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">13&#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">5&#44;9&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">92&#47;144&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">No&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">ATG&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&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">14&#44;4&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">5&#44;5&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86&#47;153&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">S&#237; &#40;60&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ATG&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  " align="" valign="\n
                  \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
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" 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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;8&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">92&#47;196&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">No&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">ATG&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  " align="" 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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#44;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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">105&#47;178&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">S&#237; &#40;60&#44; 90&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AGA&#43;ATG&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&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">15&#44;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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;4&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">94&#47;157&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">S&#237; &#40;60&#44; 90&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ATG&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&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">11&#44;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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">97&#47;196&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">No&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">ATG&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "si1.jpeg"
              ]
            ]
          ]
        ]
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ISSN: 16954033
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