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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">La bronquiolitis aguda &#40;BA&#41; del lactante tiene una evoluci&#243;n grave precisando cuidados especiales en una unidad de cuidados intensivos pedi&#225;tricos &#40;UCIP&#41; entre el 6 y el 16&#37; de los casos ingresados en hospital<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">1-3</span></a>&#46; Diversos estudios han tratado de aproximarse a los factores implicados en una evoluci&#243;n grave de la enfermedad<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">2&#44;4-8</span></a>&#44; aunque cuando se trata de ni&#241;os sanos sin factores predisponentes&#44; las conclusiones no acaban de delimitar con cierta verosimilitud qu&#233; lactantes tienen mayor riesgo<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">9</span></a>&#46; Existe acuerdo en considerar a los prematuros y a los de menor edad como los de mayor propensi&#243;n para precisar un nivel superior de cuidados<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">2</span></a>&#44; y al virus respiratorio sincitial &#40;VRS&#41; como el de mayor incidencia y virulencia entre los lactantes<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">5&#44;10&#44;11</span></a>&#46; El mes de nacimiento tambi&#233;n se ha relacionado con la gravedad de la BA<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">12&#44;13</span></a>&#46; No est&#225; claro si la presencia de coinfecciones virales aumenta la gravedad del cuadro&#44; aunque cada vez est&#225; m&#225;s admitido que en un porcentaje importante de casos&#44; la sobreinfecci&#243;n bacteriana aumenta la estancia y la necesidad de cuidados especiales<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">2&#44;14&#44;15</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Los lactantes son muy susceptibles a complicaciones graves de las infecciones virales respiratorias&#46; Es conocido que la patogenia de la BA est&#225; relacionada con la respuesta de los linfocitos Th &#40;linfocitos T-<span class="elsevierStyleItalic">helper</span>&#41;&#44; reclutados a nivel del epitelio respiratorio por las diversas citoquinas y quimiocinas que se desencadenan tras la infecci&#243;n&#44; y concretamente con la relaci&#243;n aumentada CD8&#47;CD4 tanto mayor cuanto m&#225;s grave el cuadro cl&#237;nico<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">16</span></a>&#46; En este sentido&#44; se ha indicado la posibilidad de que el nivel cuantitativo de la respuesta linfocitaria sist&#233;mica&#44; muy en relaci&#243;n con la elevaci&#243;n de interfer&#243;n-gamma &#40;INF-&#947;&#41; al inicio de la infecci&#243;n&#44; est&#233; asociada con una peor evoluci&#243;n de la BA como expresi&#243;n de un disbalance inmunol&#243;gico hacia una mayor respuesta Th2 al&#233;rgica-inflamatoria<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">17&#44;18</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">El objeto del presente estudio es comprobar si la respuesta linfocitaria sist&#233;mica en la infecci&#243;n por el VRS est&#225; relacionada con una peor evoluci&#243;n en nuestra serie de lactantes ingresados por BA sin otras complicaciones&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Pacientes y m&#233;todo</span><p id="par0020" class="elsevierStylePara elsevierViewall">Estudio observacional anal&#237;tico retrospectivo de casos y controles anidados en una cohorte de ingresados con diagn&#243;stico de BA en el periodo del 1 de octubre del 2010 al 31 de marzo del 2015&#46; El estudio fue posible al tratarse de una patolog&#237;a frecuente y estandarizada donde la historia cl&#237;nica informatizada utilizada en nuestro hospital recoge de forma activa las principales variables del estudio&#44; tanto en las anotaciones de enfermer&#237;a como en los evolutivos cl&#237;nicos&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Durante estas 5 epidemias&#44; consideramos a aquellos pacientes menores de 12 meses con criterios cl&#225;sicos de BA<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">19</span></a> y presencia del ant&#237;geno VRS en el aspirado nasofar&#237;ngeo al ingreso&#44; seg&#250;n t&#233;cnicas previamente descritas<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">20</span></a>&#46; Se revisaron&#44; desde el ingreso hasta el alta&#44; los registros diarios de todos los lactantes previamente sanos con BA por VRS para incluir aquellos que en las primeras 48 h de distr&#233;s respiratorio hubieran precisado un hemograma por cualquier criterio cl&#237;nico&#46; Se excluy&#243; del estudio a aquellos pacientes con patolog&#237;a de base&#44; los tratados previamente con corticoides o palivizumab y los nacidos prematuros por debajo de la semana 32 de gestaci&#243;n&#44; por presentar estos casos&#44; por s&#237; mismos&#44; una demostrada propensi&#243;n hacia una evoluci&#243;n m&#225;s grave y podr&#237;an estar tratados con palivizumab<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">21</span></a>&#46; Se excluy&#243; tambi&#233;n a aquellos cuya anal&#237;tica hiciera comprobar o sospechar una sobreinfecci&#243;n bacteriana considerando tal situaci&#243;n en caso de hemocultivo o urocultivo positivo&#44; leucocituria y&#47;o nitrituria&#44; as&#237; como elevaci&#243;n de la cifra de reactantes de fase aguda&#44; como prote&#237;na C reactiva superior a 70 mg&#47;l y&#47;o procalcitonina superior a 0&#44;5 ng&#47;ml y tambi&#233;n en aquellos casos donde el cl&#237;nico sospechara una sobreinfecci&#243;n bacteriana con independencia de las pruebas complementarias&#44; seg&#250;n criterios previamente publicados<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">14&#44;15</span></a>&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">La variable principal fue la necesidad de &#171;ingreso en UCIP&#187; durante la estancia hospitalaria para el empleo de ventilaci&#243;n mec&#225;nica&#44; considerando esta cualquier modalidad de tipo invasivo &#40;ventilaci&#243;n mec&#225;nica convencional o de alta frecuencia&#41; o no invasivo &#40;presi&#243;n positiva no invasiva ya fuera CPAP o BiPAP&#41;&#44; sin incluir la modalidad de c&#225;nulas de alto flujo&#46; Esta variable fue categorizada de forma binaria&#58; s&#237;&#47;no&#46; Los criterios habituales seguidos para el ingreso en UCIP se muestran en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">Adem&#225;s&#44; de cada paciente se recogieron las variables al ingreso que pudieran actuar como variables de confusi&#243;n&#58; sexo&#44; edad&#44; edad posmenstrual&#44; exposici&#243;n gestacional y posnatal al tabaco&#44; mes de ingreso&#44; tipo de lactancia&#44; presencia de apneas y d&#237;as de evoluci&#243;n del distr&#233;s respiratorio&#46; Asimismo&#44; las cifras de hemoglobina&#44; neutr&#243;filos&#44; linfocitos&#44; eosin&#243;filos&#44; bas&#243;filos y monocitos&#44; que fueron categorizadas por cuartiles para su an&#225;lisis&#46; La variable edad posmenstrual se categoriz&#243; seg&#250;n hubiera alcanzado el lactante la cifra de 44 semanas&#44; considerada esta como el l&#237;mite del periodo neonatal en condiciones de igualdad con independencia de la edad gestacional&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Tras el seguimiento retrospectivo de la cohorte&#44; se consider&#243; <span class="elsevierStyleItalic">casos</span> a aquellos lactantes que durante el ingreso hubieran precisado los cuidados incluidos en la variable principal&#46; Los restantes fueron considerados <span class="elsevierStyleItalic">controles&#46;</span> El an&#225;lisis estad&#237;stico se realiz&#243; mediante el programa PSPP GNU de software libre&#46; Los resultados se expresaron como porcentajes para las variables cualitativas&#44; con intervalo de confianza &#40;IC&#41; para la variable principal y media con desviaci&#243;n est&#225;ndar para las variables cuantitativas&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Para examinar los posibles factores de relaci&#243;n se realiz&#243; una prueba t de Student para las variables cuantitativas respecto del ingreso en UCIP y un an&#225;lisis bivariante mediante la prueba <span class="elsevierStyleItalic">chi al cuadrado</span> o <span class="elsevierStyleItalic">exacta de Fisher</span>&#44; seg&#250;n conveniencia&#44; entre la variable principal &#40;ingreso en UCIP&#41; y la cifra de linfocitos&#44; as&#237; como con las distintas variables independientes del estudio&#46; Para evitar sesgos de confusi&#243;n&#44; se realiz&#243; an&#225;lisis multivariante de la variable principal mediante regresi&#243;n log&#237;stica binomial con la cifra de linfocitos&#44; junto al resto de los factores asociados&#44; incluyendo en el modelo las variables con una p &#60; 0&#44;20 en el an&#225;lisis bivariante y aquellos cl&#237;nicamente posibles seg&#250;n estudios previos&#46; Se consider&#243; estad&#237;sticamente significativa cualquier p &#60; 0&#44;05 y todos los IC se calcularon al 95&#37;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">El estudio fue aprobado por el comit&#233; de &#233;tica de nuestro hospital y no se consider&#243; necesario el consentimiento informado al tratarse de un estudio observacional retrospectivo cuya obtenci&#243;n de datos fue disociada an&#243;nimamente&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Resultados</span><p id="par0055" class="elsevierStylePara elsevierViewall">De un total de 1&#46;197 casos ingresados por bronquiolitis durante el periodo de estudio&#44; en 901 se constat&#243; la presencia de VRS en el aspirado nasofar&#237;ngeo&#46; De ellos&#44; en 434 se comprob&#243; la obtenci&#243;n de una anal&#237;tica en las primeras 48<span class="elsevierStyleHsp" style=""></span>h del distr&#233;s respiratorio realizada por criterios cl&#237;nicos&#46; En 127 se descart&#243; su inclusi&#243;n pues recibieron el diagn&#243;stico de infecci&#243;n bacteriana grave asociada seg&#250;n los criterios previamente expuestos&#46; Adem&#225;s&#44; fueron descartados los lactantes con enfermedades de base&#44; los mayores de 12 meses y los pret&#233;rminos de menos de 32 semanas de gestaci&#243;n&#46; Al final fueron incluidos en el estudio 252 lactantes con BA por VRS&#44; previamente sanos y sin evidencia de complicaci&#243;n infecciosa bacteriana&#46; Las caracter&#237;sticas demogr&#225;ficas de la muestra se presentan en la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">La incidencia de ingresos en UCIP durante la estancia hospitalaria de la muestra fue de 17 pacientes&#44; el 6&#44;6&#37; &#40;IC del 95&#37;&#58; 4-10&#37;&#41;&#46; El an&#225;lisis de las variables num&#233;ricas se presenta en la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#44; donde se muestra la significaci&#243;n estad&#237;stica en la diferencia de la cifra de linfocitos y la edad posmenstrual respecto al ingreso en la UCIP&#46; La cifra global de frecuencias y la distribuci&#243;n seg&#250;n la necesidad de ingreso en la UCIP de las variables cualitativas&#44; junto al nivel de significaci&#243;n alcanzado en el an&#225;lisis bivariante&#44; se muestran en la <a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#46; En ella destaca la asociaci&#243;n de la variable principal con la cifra de linfocitos categorizada&#44; con la edad posmenstrual &#60; 44 semanas&#44; con la presencia de apneas y con la fiebre&#46; No hubo relaci&#243;n entre los principales tramos etarios y la distribuci&#243;n por cuartiles de linfocitos &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">tabla 5</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">El an&#225;lisis multivariante por regresi&#243;n log&#237;stica binomial de la variable principal necesidad de cuidados en la UCIP con las variables independientes incluidas en el modelo se presenta en la <a class="elsevierStyleCrossRef" href="#tbl0030">tabla 6</a>&#46; Alcanzaron significaci&#243;n estad&#237;stica la edad posmenstrual menor de 44 semanas y los casos con linfocitosis en el cuartil 1 de la cohorte&#44; en concreto aquellos con una cifra de linfocitos menor de 3&#46;700&#47;ml&#46;</p><elsevierMultimedia ident="tbl0030"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discusi&#243;n</span><p id="par0070" class="elsevierStylePara elsevierViewall">Los hallazgos encontrados en nuestro trabajo indican la asociaci&#243;n entre una menor respuesta linfocitaria sist&#233;mica y la evoluci&#243;n m&#225;s grave de la enfermedad&#46; Puede interpretarse&#44; por tanto&#44; como un factor de riesgo de peor evoluci&#243;n&#44; con independencia del mes de nacimiento&#44; la fiebre&#44; la edad&#44; los menores de 44 semanas de edad posmenstrual o la presencia de apneas &#40;<a class="elsevierStyleCrossRef" href="#tbl0030">tabla 6</a>&#41;&#46; En el an&#225;lisis bivariante se ha establecido&#44; asimismo&#44; la independencia de factores como el tabaquismo&#44; el tiempo de evoluci&#243;n del distr&#233;s respiratorio y la modalidad de lactancia &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">La BA por el VRS supone la primoinfecci&#243;n en un hu&#233;sped que no tiene mecanismos de inmunidad contra este agente y su desarrollo tiene implicaciones en la patogenia que es distinta de las sucesivas reinfecciones que acontecer&#225;n a lo largo de la vida<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">9</span></a>&#46; La probabilidad de que una BA provoque una mayor afectaci&#243;n est&#225; condicionada por la virulencia del agente causante y la susceptibilidad individual del paciente&#44; lo que involucra la madurez y el comportamiento de su sistema inmunitario&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">En cuanto a la virulencia&#44; parece que el VRS es el de mayor incidencia y gravedad entre los lactantes<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">5&#44;10&#44;11</span></a> en cuanto a estancia total&#44; necesidad de cuidados respiratorios y generales se refiere<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">22</span></a>&#46; La incidencia de ingresos en UCIP del 6&#44;6&#37; se refiere a lactantes sanos sin complicaciones bacterianas asociadas ni otros factores de riesgo previos&#46; Es&#44; por tanto&#44; una cifra atribuible a la bronquiolitis per se y por ello es algo menor que las cifras globales publicadas en los estudios previos<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">1&#44;2&#44;23&#44;24</span></a>&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">La inmadurez inmunol&#243;gica del lactante implica una preponderancia de linfocitos T inespec&#237;ficos circulantes producidos en el timo frente al adulto&#46; La regulaci&#243;n y la producci&#243;n de c&#233;lulas T de memoria acontecen en epitelio intestinal y bronquial<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">25</span></a>&#46; La patogenia de la BA se caracteriza por una respuesta balanceada de citoquinas Th1&#47;Th2 adem&#225;s del efecto citop&#225;tico&#46; El mejor representante Th1 es el IFN-&#947; que&#44; como exponente de la respuesta innata inicial&#44; limita la replicaci&#243;n viral y contrarresta la acci&#243;n de citocinas Th2 relacionada muy directamente con el nivel de interleucina 4 &#40;IL-4&#41;&#46; El desequilibrio hacia una respuesta Th2 se ha asociado a los casos m&#225;s graves de BA<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">26</span></a> y a un menor n&#250;mero de linfocitos&#44; como en nuestro estudio&#46; Para el an&#225;lisis de dicha polarizaci&#243;n&#44; lo m&#225;s correcto ser&#237;a usar &#237;ndices entre representantes de ambas v&#237;as&#44; como puede ser el &#237;ndice IL-4&#47;IFN-&#947;&#46; Se ha descrito que un d&#233;ficit de IFN-&#945;&#946; y de INF- &#947; tras la infecci&#243;n viral refleja el desarrollo insuficiente de la respuesta celular T&#44; la mayor&#237;a de los circulantes&#44; y con menor capacidad de eliminaci&#243;n de c&#233;lulas infectadas&#44; y explicar&#237;a la gravedad de la BA<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">27</span></a>&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Asimismo&#44; se han hallado niveles plasm&#225;ticos bajos de IFN-&#947; y de linfocitos T en ni&#241;os con BA moderada-grave&#44; explicado por un posible efecto inhibitorio del virus sobre la respuesta innata&#44; ya de por s&#237; inmadura<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">17</span></a>&#46; Este efecto ser&#237;a adem&#225;s caracter&#237;stico de la infecci&#243;n por VRS respecto de otros pat&#243;genos para el mismo periodo de la vida<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">28</span></a>&#46; Tras la primoinfecci&#243;n por el VRS acontecen los mecanismos tanto de proliferaci&#243;n como de apoptosis que modular&#225;n la respuesta inmunitaria y que tendr&#225;n reflejo en el hemograma una vez establecida la enfermedad<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">29</span></a>&#46; Adem&#225;s&#44; recientemente se ha demostrado que el VRS reduce parcialmente la respuesta Th1 al inhibir gen&#233;ticamente al IFN en la fase aguda y meses despu&#233;s de la infecci&#243;n que se ha denominado como &#171;inmunodisregulaci&#243;n&#187; por VRS<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">30&#44;31</span></a>&#46; La maduraci&#243;n del lactante con la edad confiere demostrada eficacia contra la infecci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">32&#44;33</span></a>&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">La mayor fortaleza del estudio es haber podido delimitar en perspectiva la cohorte de casos de BA sin complicaciones asociadas que pudieran influir en la evoluci&#243;n grave&#44; con una selecci&#243;n cuidadosa de lactantes previamente sanos y de un tiempo de evoluci&#243;n homog&#233;neo&#44; que generalmente coincide con la llegada del lactante al hospital en el inicio del distr&#233;s respiratorio con la enfermedad claramente establecida y en su periodo de estado&#44; como se muestra en la <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a>&#46; La cifra escogida como l&#237;mite de 3&#46;700 linfocitos&#47;ml puede parecer arbitraria&#44; pero es orientativa y resulta del an&#225;lisis de la distribuci&#243;n de la muestra&#46; Representa el primer cuartil de los ingresados por BA con los mencionados criterios de inclusi&#243;n&#46; Aunque la escasa respuesta linfocitaria ha sido referida con anterioridad en casos graves de BA<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">17&#44;18</span></a>&#44; nuestro an&#225;lisis ofrece esta cifra orientativa como valor pr&#225;ctico de uso cl&#237;nico&#46; La conveniencia de proponer un an&#225;lisis de sangre en determinados casos de BA para anticipar el mayor riesgo de evoluci&#243;n grave est&#225; dentro de las consecuencias de nuestros hallazgos&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">Como limitaciones del trabajo&#44; cabe se&#241;alar que no se ha estudiado la muy probable asociaci&#243;n de coinfecciones virales&#44; que en las series pr&#243;ximas a nuestro medio alcanzan el 30&#37; de las BA<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">34</span></a>&#46; Tampoco se ha tipificado el VRS en A o B&#46; Adem&#225;s&#44; el tama&#241;o de la muestra es peque&#241;o&#44; con IC amplios&#44; por lo que har&#237;an falta estudios prospectivos multic&#233;ntricos para afianzar la certeza de nuestros resultados&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">En conclusi&#243;n&#44; nuestros datos ofrecen una relaci&#243;n entre la cifra de linfocitos circulantes inferior a 3&#46;700 &#47;ml en las primeras 48 h del distr&#233;s respiratorio y una peor evoluci&#243;n en lactantes menores de 12 meses previamente sanos y edad gestacional &#62; 32 semanas con BA por el VRS&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conflicto de intereses</span><p id="par0110" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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            0 => "Bronquiolitis"
            1 => "Virus respiratorio sincitial"
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            0 => "Bronchiolitis"
            1 => "Respiratory Syncytial Virus"
            2 => "Lymphocytosis"
            3 => "Severity"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La bronquiolitis aguda &#40;BA&#41; del lactante tiene una evoluci&#243;n grave entre el 6 y el 16&#37; de los casos ingresados&#46; Su patogenia y evoluci&#243;n est&#225; relacionada con la respuesta de los linfocitos T&#46; El objetivo del presente estudio es comprobar si la menor respuesta linfocitaria sist&#233;mica est&#225; relacionada con una peor evoluci&#243;n de la BA en lactantes ingresados&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Pacientes y m&#233;todo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional-anal&#237;tico retrospectivo de casos-controles anidados en una cohorte de ingresados por BA-VRS en el periodo de octubre del 2010 a marzo del 2015&#46; Se incluy&#243; a aquellos con hemograma en las primeras 48 h de dificultad respiratoria&#46; Se excluy&#243; a los lactantes con patolog&#237;a de base&#44; sobreinfecci&#243;n bacteriana y prematuros &#8804; 32 semanas de gestaci&#243;n&#46; La variable principal dicot&#243;mica fue ingreso UCIP&#46; Otras variables fueron&#58; sexo&#44; edad&#44; edad posmenstrual&#44; exposici&#243;n gestacional y posnatal al tabaco&#44; mes de ingreso&#44; tipo de lactancia y d&#237;as de evoluci&#243;n del distr&#233;s respiratorio&#46; Las cifras de linfocitos fueron categorizadas por cuartiles&#46; Se realiz&#243; un an&#225;lisis bivariante con la variable principal y posteriormente regresi&#243;n log&#237;stica para analizar factores de confusi&#243;n&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">El estudio incluy&#243; a 252 lactantes&#46; El 6&#44;6&#37; &#40;17&#41; precis&#243; UCIP&#46; La diferencia de media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DE de linfocitos para pacientes ingresados y no ingresados en UCIP fue de 4&#46;044<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;755 y 5&#46;035<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;786&#44; respectivamente &#40;t de Student&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; Se encontr&#243; asociaci&#243;n entre ingreso UCIP y la cifra de linfocitos &#60; 3&#46;700&#47;ml &#40;Chicuadrado p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;019&#59; OR&#58; 3&#44;2&#41;&#44; que se mantuvo en la regresi&#243;n log&#237;stica con independencia de la edad y del resto de factores estudiados &#40;Wald 4&#44;191 p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;041&#59; OR&#58; 3&#44;8&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Existe relaci&#243;n entre la linfocitosis<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>3&#46;700&#47;ml en los primeros d&#237;as de la dificultad respiratoria y una peor evoluci&#243;n en lactantes &#60; 12 meses previamente sanos y edad gestacional mayor de 32 semanas con BA-VRS&#46;</p></span>"
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            "titulo" => "Introducci&#243;n"
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          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Pacientes y m&#233;todo"
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          2 => array:2 [
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            "titulo" => "Resultados"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Acute bronchiolitis &#40;AB&#41; of the infant has a serious outcome in 6-16&#37; of the hospital admitted cases&#46; Its pathogenesis and evolution is related to the response of the T lymphocytes&#46; The objective of the present study is to determine if the lower systemic lymphocytic response is related to a worse outcome of AB in hospitalised infants&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Patients and method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Retrospective observational-analytical study of cases-controls nested in a cohort of patients admitted due to RSV-AB between the period from October 2010 to March 2015&#46; Those with a full blood count in the first 48<span class="elsevierStyleHsp" style=""></span>hours of respiratory distress were included&#46; Infants with underlying disease&#44; bacterial superinfection&#44; and premature infants &#60;32 weeks of gestation were excluded&#46; The main dichotomous variable was PICU admission&#46; Other variables were&#58; gender&#44; age&#44; post-menstrual age&#44; gestational and post-natal tobacco exposure&#44; admission month&#44; type of lactation&#44; and days of onset of respiratory distress&#46; Lymphocyte counts were categorised by quartiles&#46; Bivariate analysis was performed with the main variable and then by logistic regression to analyse confounding factors&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The study included 252 infants&#44; of whom 6&#46;6&#37; &#40;17&#41; required PICU admission&#46; The difference in mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD of lymphocytes for patients admitted to and not admitted to PICU was 4&#44;044<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1755 and 5&#44;035<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1786&#44; respectively &#40;Student-t test&#44; <span class="elsevierStyleItalic">P</span>&#60;&#46;05&#41;&#46; An association was found between PICU admission and lymphocyte count &#60;3700&#47;ml &#40;Chi-squared&#44; <span class="elsevierStyleItalic">P</span>&#61;&#46;019&#59; OR&#58; 3&#46;2&#41; and it was found to be maintained in the logistic regression&#44; regardless of age and all other studied factors &#40;Wald 4&#46;191 <span class="elsevierStyleItalic">P</span>&#61;&#46;041&#44; OR&#58; 3&#46;8&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">A relationship was found between lymphocytosis &#60;3700&#47;ml in the first days of respiratory distress and a worse outcome in previously healthy infants &#60;12 months and gestational age greater than 32 weeks with RSV-AB&#46;</p></span>"
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          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Secuencia de eventos de la inmunidad en la primoinfecci&#243;n por VRS en lactantes con bronquiolitis aguda&#46; Tras la incubaci&#243;n prodr&#243;mica&#44; el pico de carga viral acontece en torno al 4&#46;&#176; d&#237;a asociado a la activaci&#243;n de c&#233;lulas <span class="elsevierStyleItalic">natural killer</span> &#40;NK&#41; que liberan interfer&#243;n-&#947;&#44; seguida del reclutamiento de linfocitos T CD4 y CD8&#46; Los s&#237;ntomas catarrales aparecen entre el 3 y 5 desde la infecci&#243;n y el distr&#233;s respiratorio sobreviene sobre las 48 h de los s&#237;ntomas catarrales&#46; La formaci&#243;n de anticuerpos neutralizantes contra las prote&#237;nas de superficie &#40;Ac anti-VRS&#41; es tard&#237;a&#44; a la vez que se elimina el virus y decrece la sintomatolog&#237;a&#46;</p>"
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                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hipoxemia &#60; 90&#37; con FiO<span class="elsevierStyleInf">2</span> &#62; 40&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">pH &#60;7&#44;1 y&#47;o PCO<span class="elsevierStyleInf">2</span> &#62; 70<span class="elsevierStyleHsp" style=""></span>mm Hg&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Apneas de repetici&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Agotamiento respiratorio&nbsp;\t\t\t\t\t\t\n
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">N&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">M&#237;nimo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">M&#225;ximo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Media&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">DE&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Peso al nacimiento &#40;g&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">243&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;440&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;162&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">565&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Edad gestacional &#40;semanas&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">252&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">38&#44;41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Edad &#40;meses&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">252&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#44;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Edad posmenstrual &#40;semanas&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36&#44;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">85&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">48&#44;87&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Edad madre &#40;a&#241;os&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">187&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29&#44;32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Estancia hospitalaria &#40;d&#237;as&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">252&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hemoglobina &#40;g&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">252&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Neutr&#243;filos&#47;ml&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">252&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">900&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&#46;989&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;497&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;141&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">252&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">280&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19&#46;430&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#46;969&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;749&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "es" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Estad&#237;sticos num&#233;ricos descriptivos de lactantes con bronquiolitis por VRS previamente sanos menores de 12 meses</p>"
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      ]
      3 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Tabla 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">UCIP s&#237;&#47;no &#61; 1&#47;0</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">N&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Media&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Desviaci&#243;n est&#225;ndar&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Prueba t &#40;p&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hemoglobina &#40;g&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">235&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;92&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;637&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Leucocitos &#40;n&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">235&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#46;576&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;314&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;083&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;0691&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;182&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Neutr&#243;filos &#40;n&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">234&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;652&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;141&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;357&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;932&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;570&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Linfocitos &#40;n&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">232&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;035&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;786&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;028&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;044&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;765&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Eosin&#243;filos &#40;n&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">229&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">116&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">148&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;319&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Monocitos &#40;n&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">229&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;142&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">484&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;896&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;158&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">488&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Bas&#243;filos &#40;n&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">228&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">134&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">117&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;206&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">98&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">61&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Plaquetas &#40;n&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">231&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">475&#46;601&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">159&#46;151&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;320&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">435&#46;764&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">160&#46;240&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Peso al nacimiento &#40;g&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">228&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;167&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">574&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;647&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;098&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">397&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Semana de gestaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">241&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">38&#44;42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;85&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;770&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">38&#44;28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Edad posmenstrual &#40;semanas&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">232&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49&#44;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">43&#44;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1760223.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Prueba t de Student de variables cuantitativas en lactantes con bronquiolitis aguda</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0020"
        "etiqueta" => "Tabla 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at4"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">EF&#58; exacta de Fisher&#59; UCIP&#58; unidad de cuidados intensivos pedi&#225;tricos&#59; VRS&#58; virus respiratorio sincitial&#46;</p>"
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            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total&#37; &#40;n &#61; 252&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">UCIP &#37; &#40;n&#61; 17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No UCIP &#37; &#40;n&#61; 235&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p &#40;chi al cuadrado&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Sexo var&#243;n</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;828&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Peso en p &#60; 3&#37;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;646&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Edad gestacional</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;859&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#62; 37 semanas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">86&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">88&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">86&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">32-36 semanas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Nacimiento riesgo estacional</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;019&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Evoluci&#243;n distr&#233;s &#60; 48 h</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">77&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">81&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">76&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;911&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Linfocitos &#40;primer cuartil&#41;</span>&#44; n&#47;ml&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;034 &#40;EF&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#60; 3&#46;700&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">47&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#8805; 3&#46;700&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Lactancia materna</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;585&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Edad posmenstrual &#60; 44 semanas</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Tabaquismo gestacional</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;292&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Tabaquismo ambiental</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;713&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Fiebre &#62; 38&#176; C</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">55&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Apneas</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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              "imagenFichero" => array:1 [
                0 => "xTab1760222.png"
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        "descripcion" => array:1 [
          "es" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Frecuencia de las variables cualitativas en pacientes menores de 12 meses sin patolog&#237;a de base con edad gestacional &#62; 32 semanas&#44; ingresados por bronquiolitis aguda por el VRS</p>"
        ]
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        "etiqueta" => "Tabla 5"
        "tipo" => "MULTIMEDIATABLA"
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            "rol" => "short"
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Chi al cuadrado&#44; n &#61; 258&#59; p &#61; 0&#44;736&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="4" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Linfocitos &#40;cuartiles de la distribuci&#243;n de linfocitos&#41;</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#8804; 3700&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">3&#46;701&#44;00-4&#46;900&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">4&#46;901&#44;00&#8211;6&#46;180&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">6&#46;181&#44;00&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " rowspan="6" align="left" valign="top">Edad tramos</td><td class="td" title="table-entry  " rowspan="2" align="char" valign="top">&#60; 1 mes</td><td class="td" title="table-entry  " align="char" valign="top">Recuento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">31&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="2" align="char" valign="top">1-3 meses</td><td class="td" title="table-entry  " align="char" valign="top">Recuento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">130&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="2" align="char" valign="top">&#62; 3 meses</td><td class="td" title="table-entry  " align="char" valign="top">Recuento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">75&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22&#44;7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">249&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#44;677&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;946&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#44;516&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#44;528&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#44;660&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#44;398&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#44;036&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;991&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;095&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#44;973&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;393&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#44;065&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;892&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&#44;395&nbsp;\t\t\t\t\t\t\n
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          "es" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">An&#225;lisis de regresi&#243;n log&#237;stica binomial de la muestra de lactantes con bronquiolitis por VRS respecto a la necesidad de cuidados en UCIP</p>"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Prospective multicenter bronchiolitis study&#58; Predicting intensive care unit admissions"
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                          "etal" => false
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                            0 => "D&#46; Damore"
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                            2 => "S&#46; Clark"
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                            4 => "C&#46;A&#46; Camargo"
                          ]
                        ]
                      ]
                    ]
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                    0 => array:2 [
                      "doi" => "10.1111/j.1553-2712.2008.00245.x"
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                        "tituloSerie" => "Acad Emerg Med"
                        "fecha" => "2008"
                        "volumen" => "15"
                        "paginaInicial" => "887"
                        "paginaFinal" => "894"
                        "link" => array:1 [
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                            "web" => "Medline"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Prospective multicenter study of children with bronchiolitis requiring mechanical ventilation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;M&#46; Mansbach"
                            1 => "P&#46;A&#46; Piedra"
                            2 => "M&#46;D&#46; Stevenson"
                            3 => "A&#46;F&#46; Sullivan"
                            4 => "T&#46;F&#46; Forgey"
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                          ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1542/peds.2012-0444"
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                        "tituloSerie" => "Pediatrics"
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              "identificador" => "bib0015"
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                    0 => array:2 [
                      "titulo" => "Bronquiolitis grave&#46; Epidemiolog&#237;a y evoluci&#243;n de 284 pacientes"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; L&#243;pez Guinea"
                            1 => "J&#46; Casado Flores"
                            2 => "M&#46;A&#46; Mart&#237;n Sobrino"
                            3 => "B&#46; Esp&#237;nola Docio"
                            4 => "T&#46; de la Calle Cabrera"
                            5 => "A&#46; Serrano"
                          ]
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                    0 => array:2 [
                      "doi" => "10.1016/S1695-4033(07)70571-4"
                      "Revista" => array:5 [
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                      ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prospective validation of a prognostic model for respiratory syncytial virus bronchiolitis in late preterm infants&#58; A multicenter birth cohort study"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
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                            4 => "L&#46; Bont"
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pone.0059161"
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                        "tituloSerie" => "PLoS One"
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                        "paginaInicial" => "e59161"
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23554987"
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                0 => array:2 [
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                          "etal" => true
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                            0 => "S&#46; Ricart"
                            1 => "M&#46;A&#46; Marcos"
                            2 => "M&#46; Sarda"
                            3 => "A&#46; Anton"
                            4 => "C&#46; Mu&#241;oz-Almagro"
                            5 => "T&#46; Pumarola"
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                        "tituloSerie" => "J Infect Dis"
                        "fecha" => "1996"
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                        "paginaFinal" => "820"
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ORIGINAL
Menor respuesta linfocitaria en casos graves de bronquiolitis aguda por virus respiratorio sincitial
Lower lymphocyte response in severe cases of acute bronchiolitis due to respiratory syncytial virus
José Miguel Ramos-Fernándeza,
Autor para correspondencia
dr.jmramos@gmail.com

Autor para correspondencia.
, David Moreno-Pérezb, Cristina Antúnez-Fernándeza, Guillermo Milano-Mansoc, Ana María Cordón-Martíneza, Antonio Urda-Cardonaa
a Unidad de Gestión Clínica de Pediatría, Grupo de Investigación IBIMA, Hospital Materno-Infantil Regional Universitario de Málaga, Málaga, España
b Infectología Pediátrica e Inmunodeficiencias, Unidad de Gestión Clínica de Pediatría, Hospital Materno-Infantil Regional Universitario de Málaga, Grupo de Investigación IBIMA, Departamento de Pediatría y Farmacología, Facultad de Medicina de la Universidad de Málaga, Málaga, España
c Unidad de Gestión Clínica de Cuidados Críticos y Urgencias, Hospital Materno-Infantil Regional Universitario de Málaga, Grupo de Investigación IBIMA, Departamento de Pediatría y Farmacología, Facultad de Medicina de la Universidad de Málaga, Málaga, España
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">La bronquiolitis aguda &#40;BA&#41; del lactante tiene una evoluci&#243;n grave precisando cuidados especiales en una unidad de cuidados intensivos pedi&#225;tricos &#40;UCIP&#41; entre el 6 y el 16&#37; de los casos ingresados en hospital<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">1-3</span></a>&#46; Diversos estudios han tratado de aproximarse a los factores implicados en una evoluci&#243;n grave de la enfermedad<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">2&#44;4-8</span></a>&#44; aunque cuando se trata de ni&#241;os sanos sin factores predisponentes&#44; las conclusiones no acaban de delimitar con cierta verosimilitud qu&#233; lactantes tienen mayor riesgo<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">9</span></a>&#46; Existe acuerdo en considerar a los prematuros y a los de menor edad como los de mayor propensi&#243;n para precisar un nivel superior de cuidados<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">2</span></a>&#44; y al virus respiratorio sincitial &#40;VRS&#41; como el de mayor incidencia y virulencia entre los lactantes<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">5&#44;10&#44;11</span></a>&#46; El mes de nacimiento tambi&#233;n se ha relacionado con la gravedad de la BA<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">12&#44;13</span></a>&#46; No est&#225; claro si la presencia de coinfecciones virales aumenta la gravedad del cuadro&#44; aunque cada vez est&#225; m&#225;s admitido que en un porcentaje importante de casos&#44; la sobreinfecci&#243;n bacteriana aumenta la estancia y la necesidad de cuidados especiales<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">2&#44;14&#44;15</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Los lactantes son muy susceptibles a complicaciones graves de las infecciones virales respiratorias&#46; Es conocido que la patogenia de la BA est&#225; relacionada con la respuesta de los linfocitos Th &#40;linfocitos T-<span class="elsevierStyleItalic">helper</span>&#41;&#44; reclutados a nivel del epitelio respiratorio por las diversas citoquinas y quimiocinas que se desencadenan tras la infecci&#243;n&#44; y concretamente con la relaci&#243;n aumentada CD8&#47;CD4 tanto mayor cuanto m&#225;s grave el cuadro cl&#237;nico<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">16</span></a>&#46; En este sentido&#44; se ha indicado la posibilidad de que el nivel cuantitativo de la respuesta linfocitaria sist&#233;mica&#44; muy en relaci&#243;n con la elevaci&#243;n de interfer&#243;n-gamma &#40;INF-&#947;&#41; al inicio de la infecci&#243;n&#44; est&#233; asociada con una peor evoluci&#243;n de la BA como expresi&#243;n de un disbalance inmunol&#243;gico hacia una mayor respuesta Th2 al&#233;rgica-inflamatoria<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">17&#44;18</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">El objeto del presente estudio es comprobar si la respuesta linfocitaria sist&#233;mica en la infecci&#243;n por el VRS est&#225; 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seg&#250;n t&#233;cnicas previamente descritas<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">20</span></a>&#46; Se revisaron&#44; desde el ingreso hasta el alta&#44; los registros diarios de todos los lactantes previamente sanos con BA por VRS para incluir aquellos que en las primeras 48 h de distr&#233;s respiratorio hubieran precisado un hemograma por cualquier criterio cl&#237;nico&#46; Se excluy&#243; del estudio a aquellos pacientes con patolog&#237;a de base&#44; los tratados previamente con corticoides o palivizumab y los nacidos prematuros por debajo de la semana 32 de gestaci&#243;n&#44; por presentar estos casos&#44; por s&#237; mismos&#44; una demostrada propensi&#243;n hacia una evoluci&#243;n m&#225;s grave y podr&#237;an estar tratados con palivizumab<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">21</span></a>&#46; Se excluy&#243; tambi&#233;n a aquellos cuya anal&#237;tica hiciera comprobar o sospechar una sobreinfecci&#243;n bacteriana considerando tal situaci&#243;n en caso de hemocultivo o urocultivo positivo&#44; leucocituria y&#47;o nitrituria&#44; as&#237; como elevaci&#243;n de la cifra de reactantes de fase aguda&#44; como prote&#237;na C reactiva superior a 70 mg&#47;l y&#47;o procalcitonina superior a 0&#44;5 ng&#47;ml y tambi&#233;n en aquellos casos donde el cl&#237;nico sospechara una sobreinfecci&#243;n bacteriana con independencia de las pruebas complementarias&#44; seg&#250;n criterios previamente publicados<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">14&#44;15</span></a>&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">La variable principal fue la necesidad de &#171;ingreso en UCIP&#187; durante la estancia hospitalaria para el empleo de ventilaci&#243;n mec&#225;nica&#44; considerando esta cualquier modalidad de tipo invasivo &#40;ventilaci&#243;n mec&#225;nica convencional o de alta frecuencia&#41; o no invasivo &#40;presi&#243;n positiva no invasiva ya fuera CPAP o BiPAP&#41;&#44; sin incluir la modalidad de c&#225;nulas de alto flujo&#46; Esta variable fue categorizada de forma binaria&#58; s&#237;&#47;no&#46; Los criterios habituales seguidos para el ingreso en UCIP se muestran en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">Adem&#225;s&#44; de cada paciente se recogieron las variables al ingreso que pudieran actuar como variables de confusi&#243;n&#58; sexo&#44; edad&#44; edad posmenstrual&#44; exposici&#243;n gestacional y posnatal al tabaco&#44; mes de ingreso&#44; tipo de lactancia&#44; presencia de apneas y d&#237;as de evoluci&#243;n del distr&#233;s respiratorio&#46; Asimismo&#44; las cifras de hemoglobina&#44; neutr&#243;filos&#44; linfocitos&#44; eosin&#243;filos&#44; bas&#243;filos y monocitos&#44; que fueron categorizadas por cuartiles para su an&#225;lisis&#46; La variable edad posmenstrual se categoriz&#243; seg&#250;n hubiera alcanzado el lactante la cifra de 44 semanas&#44; considerada esta como el l&#237;mite del periodo neonatal en condiciones de igualdad con independencia de la edad gestacional&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Tras el seguimiento retrospectivo de la cohorte&#44; se consider&#243; <span class="elsevierStyleItalic">casos</span> a aquellos lactantes que durante el ingreso hubieran precisado los cuidados incluidos en la variable principal&#46; Los restantes fueron considerados <span class="elsevierStyleItalic">controles&#46;</span> El an&#225;lisis estad&#237;stico se realiz&#243; mediante el programa PSPP GNU de software libre&#46; Los resultados se expresaron como porcentajes para las variables cualitativas&#44; con intervalo de confianza &#40;IC&#41; para la variable principal y media con desviaci&#243;n est&#225;ndar para las variables cuantitativas&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Para examinar los posibles factores de relaci&#243;n se realiz&#243; una prueba t de Student para las variables cuantitativas respecto del ingreso en UCIP y un an&#225;lisis bivariante mediante la prueba <span class="elsevierStyleItalic">chi al cuadrado</span> o <span class="elsevierStyleItalic">exacta de Fisher</span>&#44; seg&#250;n conveniencia&#44; entre la variable principal &#40;ingreso en UCIP&#41; y la cifra de linfocitos&#44; as&#237; como con las distintas variables independientes del estudio&#46; Para evitar sesgos de confusi&#243;n&#44; se realiz&#243; an&#225;lisis multivariante de la variable principal mediante regresi&#243;n log&#237;stica binomial con la cifra de linfocitos&#44; junto al resto de los factores asociados&#44; incluyendo en el modelo las variables con una p &#60; 0&#44;20 en el an&#225;lisis bivariante y aquellos cl&#237;nicamente posibles seg&#250;n estudios previos&#46; Se consider&#243; estad&#237;sticamente significativa cualquier p &#60; 0&#44;05 y todos los IC se calcularon al 95&#37;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">El estudio fue aprobado por el comit&#233; de &#233;tica de nuestro hospital y no se consider&#243; necesario el consentimiento informado al tratarse de un estudio observacional retrospectivo cuya obtenci&#243;n de datos fue disociada an&#243;nimamente&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Resultados</span><p id="par0055" class="elsevierStylePara elsevierViewall">De un total de 1&#46;197 casos ingresados por bronquiolitis durante el periodo de estudio&#44; en 901 se constat&#243; la presencia de VRS en el aspirado nasofar&#237;ngeo&#46; De ellos&#44; en 434 se comprob&#243; la obtenci&#243;n de una anal&#237;tica en las primeras 48<span class="elsevierStyleHsp" style=""></span>h del distr&#233;s respiratorio realizada por criterios cl&#237;nicos&#46; En 127 se descart&#243; su inclusi&#243;n pues recibieron el diagn&#243;stico de infecci&#243;n bacteriana grave asociada seg&#250;n los criterios previamente expuestos&#46; Adem&#225;s&#44; fueron descartados los lactantes con enfermedades de base&#44; los mayores de 12 meses y los pret&#233;rminos de menos de 32 semanas de gestaci&#243;n&#46; Al final fueron incluidos en el estudio 252 lactantes con BA por VRS&#44; previamente sanos y sin evidencia de complicaci&#243;n infecciosa bacteriana&#46; Las caracter&#237;sticas demogr&#225;ficas de la muestra se presentan en la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">La incidencia de ingresos en UCIP durante la estancia hospitalaria de la muestra fue de 17 pacientes&#44; el 6&#44;6&#37; &#40;IC del 95&#37;&#58; 4-10&#37;&#41;&#46; El an&#225;lisis de las variables num&#233;ricas se presenta en la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#44; donde se muestra la significaci&#243;n estad&#237;stica en la diferencia de la cifra de linfocitos y la edad posmenstrual respecto al ingreso en la UCIP&#46; La cifra global de frecuencias y la distribuci&#243;n seg&#250;n la necesidad de ingreso en la UCIP de las variables cualitativas&#44; junto al nivel de significaci&#243;n alcanzado en el an&#225;lisis bivariante&#44; se muestran en la <a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#46; En ella destaca la asociaci&#243;n de la variable principal con la cifra de linfocitos categorizada&#44; con la edad posmenstrual &#60; 44 semanas&#44; con la presencia de apneas y con la fiebre&#46; No hubo relaci&#243;n entre los principales tramos etarios y la distribuci&#243;n por cuartiles de linfocitos &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">tabla 5</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">El an&#225;lisis multivariante por regresi&#243;n log&#237;stica binomial de la variable principal necesidad de cuidados en la UCIP con las variables independientes incluidas en el modelo se presenta en la <a class="elsevierStyleCrossRef" href="#tbl0030">tabla 6</a>&#46; Alcanzaron significaci&#243;n estad&#237;stica la edad posmenstrual menor de 44 semanas y los casos con linfocitosis en el cuartil 1 de la cohorte&#44; en concreto aquellos con una cifra de linfocitos menor de 3&#46;700&#47;ml&#46;</p><elsevierMultimedia ident="tbl0030"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discusi&#243;n</span><p id="par0070" class="elsevierStylePara elsevierViewall">Los hallazgos encontrados en nuestro trabajo indican la asociaci&#243;n entre una menor respuesta linfocitaria sist&#233;mica y la evoluci&#243;n m&#225;s grave de la enfermedad&#46; Puede interpretarse&#44; por tanto&#44; como un factor de riesgo de peor evoluci&#243;n&#44; con independencia del mes de nacimiento&#44; la fiebre&#44; la edad&#44; los menores de 44 semanas de edad posmenstrual o la presencia de apneas &#40;<a class="elsevierStyleCrossRef" href="#tbl0030">tabla 6</a>&#41;&#46; En el an&#225;lisis bivariante se ha establecido&#44; asimismo&#44; la independencia de factores como el tabaquismo&#44; el tiempo de evoluci&#243;n del distr&#233;s respiratorio y la modalidad de lactancia &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">La BA por el VRS supone la primoinfecci&#243;n en un hu&#233;sped que no tiene mecanismos de inmunidad contra este agente y su desarrollo tiene implicaciones en la patogenia que es distinta de las sucesivas reinfecciones que acontecer&#225;n a lo largo de la vida<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">9</span></a>&#46; La probabilidad de que una BA provoque una mayor afectaci&#243;n est&#225; condicionada por la virulencia del agente causante y la susceptibilidad individual del paciente&#44; lo que involucra la madurez y el comportamiento de su sistema inmunitario&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">En cuanto a la virulencia&#44; parece que el VRS es el de mayor incidencia y gravedad entre los lactantes<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">5&#44;10&#44;11</span></a> en cuanto a estancia total&#44; necesidad de cuidados respiratorios y generales se refiere<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">22</span></a>&#46; La incidencia de ingresos en UCIP del 6&#44;6&#37; se refiere a lactantes sanos sin complicaciones bacterianas asociadas ni otros factores de riesgo previos&#46; Es&#44; por tanto&#44; una cifra atribuible a la bronquiolitis per se y por ello es algo menor que las cifras globales publicadas en los estudios previos<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">1&#44;2&#44;23&#44;24</span></a>&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">La inmadurez inmunol&#243;gica del lactante implica una preponderancia de linfocitos T inespec&#237;ficos circulantes producidos en el timo frente al adulto&#46; La regulaci&#243;n y la producci&#243;n de c&#233;lulas T de memoria acontecen en epitelio intestinal y bronquial<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">25</span></a>&#46; La patogenia de la BA se caracteriza por una respuesta balanceada de citoquinas Th1&#47;Th2 adem&#225;s del efecto citop&#225;tico&#46; El mejor representante Th1 es el IFN-&#947; que&#44; como exponente de la respuesta innata inicial&#44; limita la replicaci&#243;n viral y contrarresta la acci&#243;n de citocinas Th2 relacionada muy directamente con el nivel de interleucina 4 &#40;IL-4&#41;&#46; El desequilibrio hacia una respuesta Th2 se ha asociado a los casos m&#225;s graves de BA<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">26</span></a> y a un menor n&#250;mero de linfocitos&#44; como en nuestro estudio&#46; Para el an&#225;lisis de dicha polarizaci&#243;n&#44; lo m&#225;s correcto ser&#237;a usar &#237;ndices entre representantes de ambas v&#237;as&#44; como puede ser el &#237;ndice IL-4&#47;IFN-&#947;&#46; Se ha descrito que un d&#233;ficit de IFN-&#945;&#946; y de INF- &#947; tras la infecci&#243;n viral refleja el desarrollo insuficiente de la respuesta celular T&#44; la mayor&#237;a de los circulantes&#44; y con menor capacidad de eliminaci&#243;n de c&#233;lulas infectadas&#44; y explicar&#237;a la gravedad de la BA<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">27</span></a>&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Asimismo&#44; se han hallado niveles plasm&#225;ticos bajos de IFN-&#947; y de linfocitos T en ni&#241;os con BA moderada-grave&#44; explicado por un posible efecto inhibitorio del virus sobre la respuesta innata&#44; ya de por s&#237; inmadura<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">17</span></a>&#46; Este efecto ser&#237;a adem&#225;s caracter&#237;stico de la infecci&#243;n por VRS respecto de otros pat&#243;genos para el mismo periodo de la vida<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">28</span></a>&#46; Tras la primoinfecci&#243;n por el VRS acontecen los mecanismos tanto de proliferaci&#243;n como de apoptosis que modular&#225;n la respuesta inmunitaria y que tendr&#225;n reflejo en el hemograma una vez establecida la enfermedad<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">29</span></a>&#46; Adem&#225;s&#44; recientemente se ha demostrado que el VRS reduce parcialmente la respuesta Th1 al inhibir gen&#233;ticamente al IFN en la fase aguda y meses despu&#233;s de la infecci&#243;n que se ha denominado como &#171;inmunodisregulaci&#243;n&#187; por VRS<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">30&#44;31</span></a>&#46; La maduraci&#243;n del lactante con la edad confiere demostrada eficacia contra la infecci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">32&#44;33</span></a>&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">La mayor fortaleza del estudio es haber podido delimitar en perspectiva la cohorte de casos de BA sin complicaciones asociadas que pudieran influir en la evoluci&#243;n grave&#44; con una selecci&#243;n cuidadosa de lactantes previamente sanos y de un tiempo de evoluci&#243;n homog&#233;neo&#44; que generalmente coincide con la llegada del lactante al hospital en el inicio del distr&#233;s respiratorio con la enfermedad claramente establecida y en su periodo de estado&#44; como se muestra en la <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a>&#46; La cifra escogida como l&#237;mite de 3&#46;700 linfocitos&#47;ml puede parecer arbitraria&#44; pero es orientativa y resulta del an&#225;lisis de la distribuci&#243;n de la muestra&#46; Representa el primer cuartil de los ingresados por BA con los mencionados criterios de inclusi&#243;n&#46; Aunque la escasa respuesta linfocitaria ha sido referida con anterioridad en casos graves de BA<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">17&#44;18</span></a>&#44; nuestro an&#225;lisis ofrece esta cifra orientativa como valor pr&#225;ctico de uso cl&#237;nico&#46; La conveniencia de proponer un an&#225;lisis de sangre en determinados casos de BA para anticipar el mayor riesgo de evoluci&#243;n grave est&#225; dentro de las consecuencias de nuestros hallazgos&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">Como limitaciones del trabajo&#44; cabe se&#241;alar que no se ha estudiado la muy probable asociaci&#243;n de coinfecciones virales&#44; que en las series pr&#243;ximas a nuestro medio alcanzan el 30&#37; de las BA<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">34</span></a>&#46; Tampoco se ha tipificado el VRS en A o B&#46; Adem&#225;s&#44; el tama&#241;o de la muestra es peque&#241;o&#44; con IC amplios&#44; por lo que har&#237;an falta estudios prospectivos multic&#233;ntricos para afianzar la certeza de nuestros resultados&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">En conclusi&#243;n&#44; nuestros datos ofrecen una relaci&#243;n entre la cifra de linfocitos circulantes inferior a 3&#46;700 &#47;ml en las primeras 48 h del distr&#233;s respiratorio y una peor evoluci&#243;n en lactantes menores de 12 meses previamente sanos y edad gestacional &#62; 32 semanas con BA por el VRS&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conflicto de intereses</span><p id="par0110" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La bronquiolitis aguda &#40;BA&#41; del lactante tiene una evoluci&#243;n grave entre el 6 y el 16&#37; de los casos ingresados&#46; Su patogenia y evoluci&#243;n est&#225; relacionada con la respuesta de los linfocitos T&#46; El objetivo del presente estudio es comprobar si la menor respuesta linfocitaria sist&#233;mica est&#225; relacionada con una peor evoluci&#243;n de la BA en lactantes ingresados&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Pacientes y m&#233;todo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional-anal&#237;tico retrospectivo de casos-controles anidados en una cohorte de ingresados por BA-VRS en el periodo de octubre del 2010 a marzo del 2015&#46; Se incluy&#243; a aquellos con hemograma en las primeras 48 h de dificultad respiratoria&#46; Se excluy&#243; a los lactantes con patolog&#237;a de base&#44; sobreinfecci&#243;n bacteriana y prematuros &#8804; 32 semanas de gestaci&#243;n&#46; La variable principal dicot&#243;mica fue ingreso UCIP&#46; Otras variables fueron&#58; sexo&#44; edad&#44; edad posmenstrual&#44; exposici&#243;n gestacional y posnatal al tabaco&#44; mes de ingreso&#44; tipo de lactancia y d&#237;as de evoluci&#243;n del distr&#233;s respiratorio&#46; Las cifras de linfocitos fueron categorizadas por cuartiles&#46; Se realiz&#243; un an&#225;lisis bivariante con la variable principal y posteriormente regresi&#243;n log&#237;stica para analizar factores de confusi&#243;n&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">El estudio incluy&#243; a 252 lactantes&#46; El 6&#44;6&#37; &#40;17&#41; precis&#243; UCIP&#46; La diferencia de media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DE de linfocitos para pacientes ingresados y no ingresados en UCIP fue de 4&#46;044<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;755 y 5&#46;035<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;786&#44; respectivamente &#40;t de Student&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; Se encontr&#243; asociaci&#243;n entre ingreso UCIP y la cifra de linfocitos &#60; 3&#46;700&#47;ml &#40;Chicuadrado p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;019&#59; OR&#58; 3&#44;2&#41;&#44; que se mantuvo en la regresi&#243;n log&#237;stica con independencia de la edad y del resto de factores estudiados &#40;Wald 4&#44;191 p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;041&#59; OR&#58; 3&#44;8&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Existe relaci&#243;n entre la linfocitosis<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>3&#46;700&#47;ml en los primeros d&#237;as de la dificultad respiratoria y una peor evoluci&#243;n en lactantes &#60; 12 meses previamente sanos y edad gestacional mayor de 32 semanas con BA-VRS&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Acute bronchiolitis &#40;AB&#41; of the infant has a serious outcome in 6-16&#37; of the hospital admitted cases&#46; Its pathogenesis and evolution is related to the response of the T lymphocytes&#46; The objective of the present study is to determine if the lower systemic lymphocytic response is related to a worse outcome of AB in hospitalised infants&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Patients and method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Retrospective observational-analytical study of cases-controls nested in a cohort of patients admitted due to RSV-AB between the period from October 2010 to March 2015&#46; Those with a full blood count in the first 48<span class="elsevierStyleHsp" style=""></span>hours of respiratory distress were included&#46; Infants with underlying disease&#44; bacterial superinfection&#44; and premature infants &#60;32 weeks of gestation were excluded&#46; The main dichotomous variable was PICU admission&#46; Other variables were&#58; gender&#44; age&#44; post-menstrual age&#44; gestational and post-natal tobacco exposure&#44; admission month&#44; type of lactation&#44; and days of onset of respiratory distress&#46; Lymphocyte counts were categorised by quartiles&#46; Bivariate analysis was performed with the main variable and then by logistic regression to analyse confounding factors&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The study included 252 infants&#44; of whom 6&#46;6&#37; &#40;17&#41; required PICU admission&#46; The difference in mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD of lymphocytes for patients admitted to and not admitted to PICU was 4&#44;044<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1755 and 5&#44;035<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1786&#44; respectively &#40;Student-t test&#44; <span class="elsevierStyleItalic">P</span>&#60;&#46;05&#41;&#46; An association was found between PICU admission and lymphocyte count &#60;3700&#47;ml &#40;Chi-squared&#44; <span class="elsevierStyleItalic">P</span>&#61;&#46;019&#59; OR&#58; 3&#46;2&#41; and it was found to be maintained in the logistic regression&#44; regardless of age and all other studied factors &#40;Wald 4&#46;191 <span class="elsevierStyleItalic">P</span>&#61;&#46;041&#44; OR&#58; 3&#46;8&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">A relationship was found between lymphocytosis &#60;3700&#47;ml in the first days of respiratory distress and a worse outcome in previously healthy infants &#60;12 months and gestational age greater than 32 weeks with RSV-AB&#46;</p></span>"
        "secciones" => array:4 [
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            "titulo" => "Introduction"
          ]
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            "titulo" => "Patients and method"
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            "identificador" => "abst0035"
            "titulo" => "Results"
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            "identificador" => "abst0040"
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          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Secuencia de eventos de la inmunidad en la primoinfecci&#243;n por VRS en lactantes con bronquiolitis aguda&#46; Tras la incubaci&#243;n prodr&#243;mica&#44; el pico de carga viral acontece en torno al 4&#46;&#176; d&#237;a asociado a la activaci&#243;n de c&#233;lulas <span class="elsevierStyleItalic">natural killer</span> &#40;NK&#41; que liberan interfer&#243;n-&#947;&#44; seguida del reclutamiento de linfocitos T CD4 y CD8&#46; Los s&#237;ntomas catarrales aparecen entre el 3 y 5 desde la infecci&#243;n y el distr&#233;s respiratorio sobreviene sobre las 48 h de los s&#237;ntomas catarrales&#46; La formaci&#243;n de anticuerpos neutralizantes contra las prote&#237;nas de superficie &#40;Ac anti-VRS&#41; es tard&#237;a&#44; a la vez que se elimina el virus y decrece la sintomatolog&#237;a&#46;</p>"
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                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hipoxemia &#60; 90&#37; con FiO<span class="elsevierStyleInf">2</span> &#62; 40&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">pH &#60;7&#44;1 y&#47;o PCO<span class="elsevierStyleInf">2</span> &#62; 70<span class="elsevierStyleHsp" style=""></span>mm Hg&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Apneas de repetici&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Agotamiento respiratorio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "es" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Criterios de ingreso en UCIP para lactantes con bronquiolitis aguda</p>"
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          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">DE&#58; desviaci&#243;n est&#225;ndar&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">N&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">M&#237;nimo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">M&#225;ximo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Media&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">DE&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Peso al nacimiento &#40;g&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">243&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;440&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;162&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">565&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Edad gestacional &#40;semanas&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">252&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">38&#44;41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Edad &#40;meses&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">252&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#44;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Edad posmenstrual &#40;semanas&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">247&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36&#44;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">85&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">48&#44;87&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Edad madre &#40;a&#241;os&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">187&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29&#44;32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Estancia hospitalaria &#40;d&#237;as&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">252&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hemoglobina &#40;g&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">252&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Neutr&#243;filos&#47;ml&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">252&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">900&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&#46;989&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;497&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;141&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Linfomonocitos&#47;ml&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">280&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19&#46;430&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#46;969&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;749&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "es" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Estad&#237;sticos num&#233;ricos descriptivos de lactantes con bronquiolitis por VRS previamente sanos menores de 12 meses</p>"
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">UCIP s&#237;&#47;no &#61; 1&#47;0</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">N&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;92&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;637&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Leucocitos &#40;n&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">235&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#46;576&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;314&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;083&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;0691&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;182&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Neutr&#243;filos &#40;n&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">234&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;652&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;141&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;357&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;932&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;570&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Linfocitos &#40;n&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">232&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;035&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;786&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;028&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;044&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;765&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Eosin&#243;filos &#40;n&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">229&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">116&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">148&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;319&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Monocitos &#40;n&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">229&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;142&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">484&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;896&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;158&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">488&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Bas&#243;filos &#40;n&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">228&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">134&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">117&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;206&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">98&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">61&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Plaquetas &#40;n&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">231&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">475&#46;601&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">159&#46;151&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;320&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">435&#46;764&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">160&#46;240&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Peso al nacimiento &#40;g&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">228&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;167&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">574&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;647&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;098&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">397&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Semana de gestaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">241&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">38&#44;42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;85&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;770&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">38&#44;28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Edad posmenstrual &#40;semanas&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">232&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49&#44;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">43&#44;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">EF&#58; exacta de Fisher&#59; UCIP&#58; unidad de cuidados intensivos pedi&#225;tricos&#59; VRS&#58; virus respiratorio sincitial&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total&#37; &#40;n &#61; 252&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">UCIP &#37; &#40;n&#61; 17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No UCIP &#37; &#40;n&#61; 235&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p &#40;chi al cuadrado&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Sexo var&#243;n</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;828&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Peso en p &#60; 3&#37;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;646&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Edad gestacional</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;859&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#62; 37 semanas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">86&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">88&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">86&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">32-36 semanas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Nacimiento riesgo estacional</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;019&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Evoluci&#243;n distr&#233;s &#60; 48 h</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">77&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">81&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">76&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;911&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Linfocitos &#40;primer cuartil&#41;</span>&#44; n&#47;ml&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;034 &#40;EF&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#60; 3&#46;700&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">47&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#8805; 3&#46;700&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Lactancia materna</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;585&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Edad posmenstrual &#60; 44 semanas</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Tabaquismo gestacional</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;292&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Tabaquismo ambiental</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;713&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Fiebre &#62; 38&#176; C</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">55&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Apneas</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "es" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Frecuencia de las variables cualitativas en pacientes menores de 12 meses sin patolog&#237;a de base con edad gestacional &#62; 32 semanas&#44; ingresados por bronquiolitis aguda por el VRS</p>"
        ]
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          "leyenda" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Chi al cuadrado&#44; n &#61; 258&#59; p &#61; 0&#44;736&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="4" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Linfocitos &#40;cuartiles de la distribuci&#243;n de linfocitos&#41;</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#8804; 3700&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">3&#46;701&#44;00-4&#46;900&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">4&#46;901&#44;00&#8211;6&#46;180&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">6&#46;181&#44;00&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " rowspan="6" align="left" valign="top">Edad tramos</td><td class="td" title="table-entry  " rowspan="2" align="char" valign="top">&#60; 1 mes</td><td class="td" title="table-entry  " align="char" valign="top">Recuento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">31&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="2" align="char" valign="top">1-3 meses</td><td class="td" title="table-entry  " align="char" valign="top">Recuento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">130&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="2" align="char" valign="top">&#62; 3 meses</td><td class="td" title="table-entry  " align="char" valign="top">Recuento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">Total</td><td class="td" title="table-entry  " align="char" valign="top">Recuento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">249&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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Información del artículo
ISSN: 16954033
Idioma original: Español
DOI:10.1016/j.anpedi.2017.07.003
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