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        "titulo" => "Prevalence of obesity according to Edmonton staging in the Internal Medicine consultations&#46; Results of the OBEMI study"
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          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Diagrama de flujo del estudio&#46;</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">EOSS&#58; sistema de estadificaci&#243;n de la obesidad de Edmonton&#59; IMC&#58; &#237;ndice de masa corporal&#46;</p>"
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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">En las &#250;ltimas d&#233;cadas la obesidad ha alcanzado dimensiones de epidemia mundial&#46; Un 20&#37; de la poblaci&#243;n tiene sobrepeso y un 10&#37; obesidad&#44; estim&#225;ndose para 2030 cifras de 2&#44;16 millones de personas con sobrepeso y 1&#44;12 millones con obesidad<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">1</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">En Espa&#241;a la prevalencia de obesidad en la poblaci&#243;n adulta ronda el 23&#37;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">2</span></a>&#46; La mayor&#237;a de estudios epidemiol&#243;gicos utiliza el &#237;ndice de masa corporal &#40;IMC&#44; peso en kg&#47;talla en metros<span class="elsevierStyleSup">2</span>&#41; para clasificarla<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">3</span></a>&#46; Se considera obesa una persona mayor de 18 a&#241;os con IMC<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>30<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#46; Sin embargo&#44; la obesidad tambi&#233;n puede definirse por otros criterios&#59; por ejemplo&#44; como el exceso de tejido adiposo &#40;25&#37; en varones y 30&#37; en mujeres&#41; de suficiente magnitud para producir un aumento en la morbimortalidad del individuo &#40;p&#233;rdida de 3 a 10 a&#241;os de vida en los casos m&#225;s graves<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">4</span></a>&#41;&#44; debido a su papel en el desarrollo de otras comorbilidades como hipertensi&#243;n arterial &#40;HTA&#41;&#44; diabetes mellitus tipo 2 &#40;DM2&#41; o dislipidemia<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">5&#44;6</span></a>&#44; adem&#225;s de las graves limitaciones funcionales de la calidad de vida&#46; Por tanto&#44; clasificar la obesidad bas&#225;ndose exclusivamente en medidas antropom&#233;tricas tiene muchas limitaciones y una marcada variabilidad<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">7</span></a>&#44; pues individuos con el mismo peso corporal pueden tener diferentes problemas de salud que condicionen su pron&#243;stico vital&#46; Adem&#225;s&#44; el IMC es un pobre predictor de mortalidad&#44; sobre todo en la poblaci&#243;n atendida en los servicios de Medicina Interna &#40;MI&#41;&#44; con m&#225;s edad y comorbilidad&#46; El Sistema de Estadificaci&#243;n de la Obesidad de Edmonton &#40;EOSS&#41; aborda una clasificaci&#243;n de la obesidad de forma independiente al IMC<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">8</span></a>&#44; incorporando la presencia y gravedad de las comorbilidades&#44; la gradaci&#243;n de la limitaci&#243;n funcional y el impacto de las mismas en la calidad de vida del paciente obeso&#44; por lo que es m&#225;s &#250;til en t&#233;rminos cl&#237;nicos para tomar decisiones terap&#233;uticas<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">9</span></a>&#46; Adem&#225;s&#44; es un potencial predictor de mortalidad<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">10</span></a>&#44; incluso tras ajustar por otros m&#233;todos de valoraci&#243;n de adiposidad como el per&#237;metro abdominal&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">El objetivo de este estudio fue conocer la prevalencia de obesidad y clasificarla seg&#250;n los estadios de Edmonton en los pacientes atendidos en MI&#46; Como objetivo secundario analizamos las caracter&#237;sticas cl&#237;nico-epidemiol&#243;gicas de los sujetos obesos estratificados seg&#250;n el EOSS&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material y m&#233;todos</span><p id="par0020" class="elsevierStylePara elsevierViewall">Estudio observacional&#44; descriptivo y transversal para valorar la prevalencia de obesidad y su clasificaci&#243;n seg&#250;n el EOSS en pacientes atendidos en consultas externas de MI&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">La clasificaci&#243;n EOSS define los siguientes estadios&#58; a&#41; estadio 0&#58; sin factores de riesgo &#40;presi&#243;n arterial&#44; l&#237;pidos y glucosa basal en rangos de normalidad&#41;&#44; sin psicopatolog&#237;a&#44; s&#237;ntomas f&#237;sicos&#44; limitaci&#243;n funcional o alteraci&#243;n del bienestar relacionado con la obesidad&#59; b&#41; estadio 1&#58; presencia de factores de riesgo subcl&#237;nicos relacionados con la obesidad &#40;pre-HTA&#44; glucosa basal alterada&#44; enzimas hep&#225;ticas elevadas&#41;&#44; s&#237;ntomas f&#237;sicos leves &#40;disnea de moderados esfuerzos&#44; fatiga y dolor articular ocasional&#41;&#44; psicopatolog&#237;a leve&#44; limitaci&#243;n funcional o alteraci&#243;n del bienestar leve&#59; c&#41; estadio 2&#58; presencia de enfermedades cr&#243;nicas establecidas relacionadas con la obesidad &#40;HTA&#44; DM2&#44; s&#237;ndrome de apnea obstructiva del sue&#241;o&#44; osteoartritis&#41;&#44; limitaci&#243;n moderada en las actividades de la vida diaria y alteraci&#243;n moderada del bienestar&#59; d&#41; estadio 3&#58; da&#241;o org&#225;nico establecido &#40;infarto agudo de miocardio&#44; insuficiencia cardiaca&#44; ictus&#44; complicaciones diab&#233;ticas&#41;&#44; psicopatolog&#237;a significativa &#40;depresi&#243;n grave&#44; ideaci&#243;n suicida&#41;&#44; limitaci&#243;n funcional o alteraci&#243;n del bienestar significativos&#59; y e&#41; estadio 4&#58; enfermedades cr&#243;nicas relacionadas con la obesidad con disfunci&#243;n grave &#40;potencialmente da&#241;o terminal&#41;&#44; psicopatolog&#237;a&#44; limitaci&#243;n funcional o alteraci&#243;n del bienestar grave&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Realizamos un estudio en 38 centros de &#225;mbito nacional&#46; Los centros participantes realizaron un corte transversal de un d&#237;a entre el 1 y el 14 de febrero de 2016 para la selecci&#243;n consecutiva de pacientes&#46; Los datos se recogieron en un registro informatizado y anonimizado&#46; Se siguieron los principios &#233;ticos de la investigaci&#243;n en seres humanos recogidos en la Declaraci&#243;n de Helsinki&#44; actualizada en la Asamblea General de Brasil &#40;2013&#41;&#46; Se respetaron la confidencialidad y el secreto de la informaci&#243;n de car&#225;cter personal siguiendo la Ley de Protecci&#243;n de Datos 15&#47;1999 &#40;BOE 1999&#44; no 289&#41;&#46; El estudio fue aprobado por el Comit&#233; &#201;tico de Investigaci&#243;n Cl&#237;nica del Hospital Universitario de Badajoz&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Pacientes</span><p id="par0035" class="elsevierStylePara elsevierViewall">Se incluyeron pacientes que cumplieron los siguientes criterios de inclusi&#243;n&#58; IMC<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>30<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span> y edad<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>18 a&#241;os&#46; Se excluyeron aquellos que rechazaron firmar el consentimiento informado&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Variables</span><p id="par0040" class="elsevierStylePara elsevierViewall">La variable resultado principal fueron las categor&#237;as establecidas por EOSS<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">8</span></a>&#46; La clasificaci&#243;n de la obesidad por IMC se realiz&#243; seg&#250;n el consenso de la Sociedad Espa&#241;ola para el Estudio de la Obesidad<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">3</span></a>&#46; Se obtuvieron datos demogr&#225;ficos&#44; cl&#237;nicos&#44; antropom&#233;tricos y de laboratorio de los pacientes incluidos&#46; En cuanto a las variables demogr&#225;ficas&#44; se determinaron&#58; nivel cultural &#40;sin estudios&#44; estudios b&#225;sicos&#44; secundarios&#47;formaci&#243;n profesional y universitarios&#41;&#44; situaci&#243;n laboral activa o no&#44; procedencia rural &#40;menos de 10&#46;000 habitantes&#41; o urbana &#40;m&#225;s de 10&#46;000 habitantes&#41;&#44; estado civil &#40;soltero o vida en pareja&#41; y&#44; por &#250;ltimo&#44; se consider&#243; que los pacientes practicaban ejercicio f&#237;sico si realizaban m&#225;s de 30<span class="elsevierStyleHsp" style=""></span>min de ejercicio aer&#243;bico m&#225;s de 5 d&#237;as&#47;semana&#46; Como variables cl&#237;nicas se incluyeron el tabaquismo activo y el consumo excesivo de alcohol &#40;ingesta<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>60<span class="elsevierStyleHsp" style=""></span>g&#47;d en varones y<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>40<span class="elsevierStyleHsp" style=""></span>g&#47;d en mujeres&#41;&#46; Tambi&#233;n se registr&#243; la existencia previa de enfermedad pulmonar obstructiva cr&#243;nica&#44; asma y c&#225;ncer activo &#40;excluyendo el c&#225;ncer cut&#225;neo&#44; salvo el melanoma&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Para la estimaci&#243;n de la comorbilidad se emple&#243; el &#237;ndice de Charlson<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">11</span></a> &#40;ausencia de comorbilidad 0-1&#44; comorbilidad baja 2&#44; comorbilidad alta<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>3&#41;&#59; para medir la capacidad funcional&#44; el &#237;ndice de Barthel<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">12</span></a> &#40;dependencia total 0-20 puntos&#44; dependencia grave 21-60 puntos&#44; dependencia moderada 61-90 puntos&#44; dependencia escasa 91-99 puntos&#44; independencia 100 puntos&#41;&#59; y para la depresi&#243;n&#44; la escala de Beck<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a> &#40;0-9 puntos no deprimido&#44; 10-15 ligeramente deprimido&#44; 16-24 puntos moderadamente deprimido&#44; 25-62 puntos gravemente deprimido&#41;&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">An&#225;lisis estad&#237;stico</span><p id="par0050" class="elsevierStylePara elsevierViewall">Asumiendo una prevalencia esperada de obesidad del 23&#37;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">2</span></a>&#44; un error del 2&#37; y un intervalo de confianza del 95&#37;&#44; el tama&#241;o muestral m&#237;nimo calculado fue de 250 pacientes&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Para el c&#225;lculo de la prevalencia se utiliz&#243; el total de los pacientes que cumplieron criterios de inclusi&#243;n&#44; analiz&#225;ndose las variables agrupadas seg&#250;n el EOSS&#46; Las variables cualitativas se han expresado como n&#250;mero total y porcentaje referido a EOSS&#44; y para compararlas se utiliz&#243; el test de Chi cuadrado&#46; Las variables cuantitativas se expresan como mediana y rango intercuart&#237;lico&#44; y para compararlas se utiliz&#243; el test de Kruskal-Wallis&#46; Se realiz&#243; un an&#225;lisis de correspondencias bidimensional para objetivar agrupamientos significativos entre variables cualitativas&#44; determinando coordenadas que permitiesen representar las clases de las variables a estudiar&#46; En el primer modelo se tomaron como variables los grupos de EOSS&#44; la situaci&#243;n laboral&#44; el nivel de estudios&#44; el &#237;ndice de Charlson y el &#237;ndice de Barthel&#46; En el segundo modelo se sustituyeron los grupos de EOSS por el IMC&#44; seg&#250;n los criterios de la Sociedad Espa&#241;ola para el Estudio de la Obesidad<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">3</span></a>&#46; Para la determinaci&#243;n de las coordenadas se utiliz&#243; la distancia Chi cuadrado&#46; Finalmente&#44; se realiz&#243; un an&#225;lisis multivariante de regresi&#243;n log&#237;stica para objetivar la dependencia entre variables&#46; La variable dependiente fue pertenecer o no a un EOSS<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>2&#46; Para el modelo se escogieron las covariables consideradas &#171;a priori&#187; significativas&#44; bas&#225;ndose en estudios previos en pacientes obesos&#44; y aquellas que dictaba la experiencia cl&#237;nica&#44; as&#237; como las que resultaron significativas en el an&#225;lisis univariante&#46; En el modelo final se analizaron la edad&#44; el IMC&#44; el &#237;ndice de Charlson&#44; el aclaramiento de creatinina <span class="elsevierStyleItalic">&#40;Chronic Kidney Disease Epidemiology Collaboration&#41;</span>&#44; la glucosa&#44; el &#225;cido &#250;rico&#44; el colesterol total&#44; los leucocitos y la ratio alb&#250;mina&#47;creatinina&#46; Se utiliz&#243; el programa R &#40;versi&#243;n 3&#46;2&#46;4&#44; Free Software Foundation&#39;s&#44; GNU General Public License&#41;&#46; Se consideraron significativas las diferencias con un valor de p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Resultados</span><p id="par0060" class="elsevierStylePara elsevierViewall">De un total de 1&#46;262 pacientes atendidos en consultas se incluyeron inicialmente 298 pacientes obesos&#44; de los que se excluyeron posteriormente 33 por falta de datos o de consentimiento para utilizarlos&#46; Se analizaron finalmente 265 pacientes obesos &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#44; de los que 135 eran varones&#46; La edad media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DE fue de 62&#44;47<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15&#44;27 a&#241;os y el IMC<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DE 36&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#44;3<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#46; La prevalencia de obesidad por IMC fue del 23&#44;62&#37; y por estadios 0&#44; 1&#44; 2&#44; 3 y 4 de EOSS fue del 4&#44;9&#44; 14&#44;7&#44; 62&#44;3&#44; 15&#44;5 y 2&#44;64&#37;&#44; respectivamente&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> se muestran las caracter&#237;sticas cl&#237;nicas y demogr&#225;ficas de los pacientes&#44; seg&#250;n EOSS&#46; En los pacientes con EOSS 2&#44; 3 y 4 se observ&#243; un incremento significativo de edad &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0000&#41;&#44; DM2 &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41;&#44; dislipidemia &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0003&#41;&#44; s&#237;ndrome de apnea obstructiva del sue&#241;o &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0027&#41; e insuficiencia card&#237;aca &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41;&#44; que condicionaron un incremento significativo del &#237;ndice de Charlson por grupo &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0000&#41;&#46; En las variables de laboratorio &#40;<a class="elsevierStyleCrossRef" href="#sec0045">tabla 1&#44; disponible en el material suplementario de la versi&#243;n electr&#243;nica de este art&#237;culo</a>&#41; se observ&#243; un incremento de la glucemia &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0003&#41;&#44; los leucocitos &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0000&#41;&#44; el &#225;cido &#250;rico &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41; y la urea &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#41;&#44; y una disminuci&#243;n del filtrado glomerular &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41; en las categor&#237;as superiores de EOSS&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">Se observaron diferencias significativas en todos los grupos farmacol&#243;gicos empleados&#44; salvo en las sulfonilureas&#44; los antiinflamatorios no esteroideos&#44; los antidepresivos y los ansiol&#237;ticos&#44; que se utilizaron por igual en todos los grupos de EOSS &#40;<a class="elsevierStyleCrossRef" href="#sec0045">tabla 2&#44; disponible en el material suplementario de la versi&#243;n electr&#243;nica de este art&#237;culo</a>&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">En cuanto al an&#225;lisis de correspondencias &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41;&#44; en el primer modelo&#44; con un porcentaje explicativo acumulado del 78&#44;2&#37;&#44; observamos un primer grupo de pacientes agrupados en torno a EOSS 0 y 1&#44; con estudios secundarios o universitarios&#44; que trabajaban y no ten&#237;an dependencia ni comorbilidad&#59; otro grupo&#44; en torno a EOSS 2&#44; con estudios b&#225;sicos o sin ellos&#44; que no trabajaban&#44; con dependencia escasa y baja comorbilidad&#59; un tercer grupo&#44; en torno a EOSS 3&#44; con dependencia moderada o severa y comorbilidad alta sin relaci&#243;n con el nivel de estudios o situaci&#243;n laboral&#59; y finalmente&#44; un EOSS 4 sin asociaci&#243;n con nada de lo anterior&#46; En el segundo modelo &#40;sustituyendo EOSS por IMC&#41;&#44; con un porcentaje explicativo acumulado menor &#40;70&#44;6&#37;&#41;&#44; no existieron agrupaciones tan definidas como en el primer modelo&#46; La obesidad tipo 2 y 4 no mostr&#243; agrupaci&#243;n&#44; la tipo 1 pudo agruparse con pacientes independientes sin comorbilidad&#44; y la tipo 3 con pacientes con estudios b&#225;sicos y sin trabajo&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">En el modelo de regresi&#243;n log&#237;stica &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#44; las variables que finalmente se relacionaron con un EOSS<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>2 fueron el IMC &#40;odss ratio &#91;OR&#93; 1&#44;07&#44; intervalo de confianza &#91;IC&#93; 95&#37;&#44; 0&#44;99-1&#44;16&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;06&#41;&#44; la edad &#40;OR 1&#44;06&#44; IC 95&#37; 1&#44;03-1&#44;08&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0003&#41;&#44; la glucemia &#40;OR 1&#44;04&#44; IC 95&#37; 1&#44;01-1&#44;07&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0006&#41;&#44; el colesterol total &#40;OR 0&#44;98&#44; IC 95&#37; 0&#44;97-0&#44;99&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;2&#41; y el &#225;cido &#250;rico &#40;OR 1&#44;32&#44; IC 95&#37; 1&#44;03-1&#44;68&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Discusi&#243;n</span><p id="par0085" class="elsevierStylePara elsevierViewall">En este estudio&#44; la prevalencia de obesidad en las consultas de MI fue similar a la hallada en otros estudios epidemiol&#243;gicos en poblaci&#243;n general&#44; como el ENRICA &#40;23&#37;&#41;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">14</span></a> o el ERICE<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">15</span></a> &#40;22&#44;7&#37;&#41;&#44; ambos con un IMC medio de 26&#44;9<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span><a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a>&#46; Esta prevalencia aumenta con la edad&#44; alcanzando un 35&#37; entre los 65 y 70 a&#241;os<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">17&#44;18</span></a>&#46; En nuestro estudio&#44; la mayor&#237;a de los pacientes estaban incluidos en el intervalo de edad comprendido entre los 60 y los 80 a&#241;os&#44; y se demostr&#243; una relaci&#243;n entre un mayor EOSS &#40;fundamentalmente 2 y 3&#41;&#44; un progresivo descenso de la talla&#44; del peso y&#44; menos significativo&#44; del IMC &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;28&#41; con el aumento de la edad &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#46; El IMC para definir la obesidad en ancianos es controvertido debido a la disminuci&#243;n de la estatura mientras se mantiene un peso estable &#40;descenso estimado entre 0-0&#44;65<span class="elsevierStyleHsp" style=""></span>kg&#47;a&#241;o&#41;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">19</span></a>&#44; a la disminuci&#243;n de la masa muscular y a la redistribuci&#243;n del dep&#243;sito adiposo en abdomen y perivisceral &#40;&#171;obesidad sarcop&#233;nica&#187;&#41;&#46; Este aumento de adiposidad es responsable de la discapacidad relacionada con la movilidad&#44; el mayor deterioro funcional&#44; el aumento del riesgo cardiovascular&#44; de la artritis y una mayor mortalidad atribuible a la obesidad&#44; estimada en 28&#46;000 muertes anuales incluso tras ajustar por adiposidad abdominal<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">20</span></a>&#46; Engelmann et al&#46;&#44; al igual que otros autores&#44; describieron una curva en &#171;J&#187; entre IMC y mortalidad<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">21</span></a>&#46; En sentido opuesto&#44; la llamada &#171;paradoja de la obesidad&#187; describe una menor mortalidad&#44; tanto por enfermedades cardiovasculares<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">22</span></a> como no cardiovasculares<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">23</span></a>&#44; en los ancianos obesos&#46; No obstante&#44; existen numerosos factores de confusi&#243;n&#44; como el grado de inflamaci&#243;n o de disfunci&#243;n renal&#44; que podr&#237;an influir en esta paradoja<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">24</span></a>&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">El 80&#37; de los pacientes de este estudio ten&#237;an un EOSS<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>2&#44; lo que se asoci&#243; con mayor edad&#44; m&#225;s deterioro funcional y comorbilidad &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46; La mayor&#237;a de los estudios de prevalencia de obesidad se han basado en el IMC y la edad&#44; mientras que son escasas las referencias a la comorbilidad<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">25&#44;26</span></a> y la capacidad funcional&#46; Es&#44; por tanto&#44; dif&#237;cil reconocer&#44; en este contexto&#44; a la obesidad como una entidad cr&#243;nica compleja y&#44; en consecuencia&#44; abordarla desde una perspectiva integral basada no solo en medidas antropom&#233;tricas&#44; sino en el tratamiento de las complicaciones relacionadas con el peso y la adiposidad&#44; con el objetivo &#250;ltimo de mejorar la salud y la calidad de vida global<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">27&#44;28</span></a>&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Como demuestra el an&#225;lisis de correspondencias &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41;&#44; el EOSS es capaz de discriminar a aquellos pacientes con mayor comorbilidad y menor capacidad funcional&#44; facilitando una aproximaci&#243;n integral al problema&#44; y lo hace mejor que el IMC&#46; Los escasos estudios publicados basados en EOSS inciden en su papel predictor de mortalidad<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">10</span></a> y su utilidad para priorizar tratamientos como la cirug&#237;a bari&#225;trica<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">29</span></a>&#46; Este es el primer estudio nacional de prevalencia de obesidad en pacientes en pr&#225;ctica cl&#237;nica habitual clasificados seg&#250;n las comorbilidades asociadas&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Por otra parte&#44; en el an&#225;lisis multivariante ajustado se observ&#243; una asociaci&#243;n directa entre un EOSS mayor de 2 y algunos rasgos metab&#243;licos como la glucemia &#40;OR 1&#44;04&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0006&#41; y el &#225;cido &#250;rico &#40;OR 1&#44;32&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41;&#44; e inversa con el colesterol s&#233;rico &#40;OR 0&#44;98&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41;&#44; posiblemente debido al mayor uso de estatinas en los grupos con mayor EOSS &#40;ver material suplementario&#44; disponible en la versi&#243;n electr&#243;nica&#41;&#46; La obesidad es el principal factor de riesgo modificable para la aparici&#243;n de hiperuricemia y gota&#46; La relaci&#243;n entre la hiperuricemia y la enfermedad cardiovascular es controvertida y no uniforme entre ambos sexos&#46; Marotta et al&#46;&#44; en uno de los pocos estudios en pacientes a&#241;osos&#44; encontraron una relaci&#243;n lineal entre los niveles de &#225;cido &#250;rico superiores a 5&#44;5<span class="elsevierStyleHsp" style=""></span>mg&#47;dl y la aparici&#243;n de obesidad&#44; HTA y DM2 en mujeres mayores de 60 a&#241;os<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">30</span></a>&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Este estudio tiene algunas limitaciones&#46; La poblaci&#243;n atendida y el tipo de consultas de MI es muy heterog&#233;nea&#44; lo que puede conllevar un sesgo de selecci&#243;n de los pacientes&#46; Sin embargo&#44; s&#237; podemos considerarla representativa de la poblaci&#243;n general adulta y&#44; aunque la muestra pueda parecer escasa&#44; est&#225; acorde con la estimada inicialmente&#44; teniendo en cuenta que el dise&#241;o fue de corte transversal &#40;solo un d&#237;a dentro del per&#237;odo de inclusi&#243;n&#41;&#46; Por otra parte&#44; este dise&#241;o no permite establecer relaciones de causalidad entre las variables&#44; por lo que las asociaciones descritas deber&#225;n ser evaluadas posteriormente&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">En conclusi&#243;n&#44; la prevalencia de obesidad entre los pacientes atendidos en las consultas de MI es similar a la descrita para la poblaci&#243;n general&#46; Sin embargo&#44; los pacientes atendidos en MI son m&#225;s ancianos&#44; tienen un IMC m&#225;s alto y mayor comorbilidad&#44; tanto metab&#243;lica como funcional&#46; El EOSS es &#250;til para hacer una aproximaci&#243;n integral de los pacientes&#44; que independientemente del IMC&#44; nos permita obtener mejores resultados en salud y calidad de vida&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflicto de intereses</span><p id="par0115" class="elsevierStylePara elsevierViewall">Los autores afirman no tener conflictos de intereses con respecto a este art&#237;culo&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Estimar la prevalencia de obesidad y clasificarla seg&#250;n la estadificaci&#243;n de Edmonton &#40;EOSS&#41; en pacientes atendidos por Medicina Interna&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional&#44; descriptivo y transversal&#46; Incluy&#243; pacientes ambulatorios mayores de 18 a&#241;os con un &#237;ndice de masa corporal &#40;IMC&#41;<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>30&#44; procedentes de 38 hospitales&#44; entre el 1 y el 14 de febrero de 2016&#46; Se clasificaron seg&#250;n EOSS y se analizaron variables cl&#237;nicas&#44; anal&#237;ticas y sociodemogr&#225;ficas&#46; Se consider&#243; significaci&#243;n estad&#237;stica con p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">De 1&#46;262 pacientes vistos en las consultas se seleccionaron 298 y se analizaron 265&#46; La prevalencia de obesidad fue del 23&#44;6&#37;&#44; la edad&#44; de 62&#44;47<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15&#44;27 a&#241;os y el IMC&#44; de 36&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#44;3<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#46; Por EOSS &#40;0&#44; 1&#44; 2&#44; 3 y 4&#41; la prevalencia fue de 4&#44;9&#44; 14&#44;7&#44; 62&#44;3&#44; 15&#44;5 y 2&#44;64&#37;&#44; respectivamente&#46;&#160;Aquellos pacientes con EOSS<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>2 ten&#237;an significativamente m&#225;s edad y comorbilidades&#46; El an&#225;lisis multivariante relacion&#243; la edad &#40;OR 1&#44;06&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0003&#41;&#44; la glucemia &#40;OR 1&#44;04&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0006&#41;&#44; el colesterol total &#40;OR 0&#44;98&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41; y el &#225;cido &#250;rico &#40;OR 1&#44;32&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41; con un EOSS<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>2&#46; Un an&#225;lisis de correspondencias agrup&#243;&#44; con un porcentaje explicativo del 78&#44;2&#37;&#44; a los pacientes seg&#250;n su EOSS&#44; comorbilidad&#44; nivel de estudios&#44; situaci&#243;n laboral y capacidad funcional&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La prevalencia de obesidad en pacientes atendidos por Medicina Interna es similar a la de la poblaci&#243;n general&#44; aunque los pacientes son de mayor edad e IMC&#46; El EOSS es &#250;til para hacer una aproximaci&#243;n integral de los pacientes obesos&#44; independientemente del IMC&#44; lo que puede posibilitar la obtenci&#243;n de mejores resultados en salud y en calidad de vida&#46;</p></span>"
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      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objectives</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To estimate the prevalence of obesity in patients treated by departments of Internal Medicine and to classify the patients according to the Edmonton Obesity Staging System &#40;EOSS&#41;&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">An observational&#44; descriptive cross-sectional study included outpatients older than 18 years&#44; with a body mass index &#40;BMI&#41;<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>30&#44; from 38 hospitals between the 1<span class="elsevierStyleHsp" style=""></span>st and 14th of February&#44; 2016&#46; We classified the patients according to the EOSS and analysed their clinical&#44; laboratory and demographic variables&#46; A value of <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05 was considered statistically significant&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Of the 1&#44;262 patients treated in consultations&#44; we recruited 298 and analysed 265&#46; The prevalence of obesity was 23&#46;6&#37;&#44; the mean age was 62&#46;47<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15&#46;27 years&#44; and the mean BMI was 36&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;3<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#46; According to EOSS stage &#40;0&#44; 1&#44; 2&#44; 3 and 4&#41;&#44; the prevalence was 4&#46;9&#44; 14&#46;7&#44; 62&#46;3&#44; 15&#46;5 and 2&#46;64&#37;&#44; respectively&#46;&#160;Those patients with EOSS<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>2 were significantly older and had significantly more comorbidities&#46; The multivariate analysis related age &#40;OR 1&#46;06&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0003&#41;&#44; blood glucose &#40;OR 1&#46;04&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0006&#41;&#44; total cholesterol &#40;OR 0&#46;98&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;02&#41; and uric acid &#40;OR 1&#46;32&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;02&#41; levels with an EOSS<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>2&#46; An analysis of correspondence grouped&#44; with an explanatory percentage of 78&#46;2&#37;&#44; the patients according to their EOSS&#44; comorbidity&#44; education level&#44; employment status and functional capacity&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The prevalence of obesity in the patients treated by Internal Medicine departments is similar to that of the general population&#44; although the patients are older and have a higher BMI&#46; EOSS is useful for implementing a comprehensive approach for patients with obesity&#44; regardless of the BMI&#44; which can help achieve better health and quality-of-life results&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Objectives"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Material and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusions"
          ]
        ]
      ]
    ]
    "apendice" => array:1 [
      0 => array:1 [
        "seccion" => array:2 [
          0 => array:4 [
            "apendice" => "<p id="par0130" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
            "etiqueta" => "Anexo A"
            "titulo" => "Material suplementario"
            "identificador" => "sec0050"
          ]
          1 => array:4 [
            "apendice" => "<p id="par0135" class="elsevierStylePara elsevierViewall">Participantes del Registro OBEMI</p> <p id="par0140" class="elsevierStylePara elsevierViewall">Alonso Pe&#241;a&#44; Javier&#46; Hospital Virgen del Puerto&#44; Plasencia&#46; Ar&#233;valo Lorido&#44; Jos&#233; Carlos&#46; Hospital Comarcal de Zafra&#44; Badajoz&#46; Arg&#252;ello Mart&#237;n&#44; Carlota&#46; Hospital Central de Asturias&#44; Oviedo&#46; Bonilla Hern&#225;ndez&#44; Mar&#237;a&#46; Hospital Reina Sof&#237;a&#44; Tudela&#46; Campo L&#243;pez&#44; Cristina&#46; Hospital La Fe&#44; Valencia&#46; Carabantes Rueda&#44; Juan Jes&#250;s&#46; Hospital de Antequera&#44; Antequera&#46; Carretero G&#243;mez&#44; Juana&#46; Hospital Comarcal de Zafra&#44; Badajoz&#46; Castiella Herrero&#44; Jes&#250;s&#46; Fundaci&#243;n Hospital de Calahorra&#44; Calahorra&#44; La Rioja&#46; Chimeno Vi&#241;as&#44; Mar&#237;a Montserrat&#46; Complejo Asistencial de Zamora&#46; De Escalante Yang&#252;ela&#44; Bego&#241;a&#46; Hospital Cl&#237;nico de Zaragoza&#46; Due&#241;as Gutierrez&#44; Carlos&#46; Hospital de Burgos&#46; Ena Mu&#241;oz&#44; Javier&#46; Hospital Marina Baixa&#44; Alicante&#46; Fern&#225;ndez Rodr&#237;guez&#44; Jos&#233; Mar&#237;a&#46; Hospital Carmen y Severo Ochoa&#44; Cangas del Narcea&#44; Asturias&#46; Fern&#225;ndez P&#233;rez&#44; Ester&#46; Hospital de Le&#243;n&#46; Freixas Descarregas&#44; Pere&#46; Hospital Comarcal Mor&#225; d&#8217;Ebre&#44; Tarragona&#46; Garc&#237;a Contreras&#44; Rosa&#46; Hospital Virgen del Roc&#237;o&#44; Sevilla&#46; Garc&#237;a Ledesma&#44; Luis&#46; Hospital Virgen del Puerto&#44; Plasencia&#46; Garc&#237;a Ordo&#241;ez&#44; Miguel &#193;ngel&#46; Hospital de Antequera&#44; Antequera&#46; Gonz&#225;lez Aguirre&#44; Jos&#233; Manuel&#46; Hospital La Mancha Centro&#44; Alc&#225;zar de San Juan&#44; Ciudad Real&#46; Gonz&#225;lez Hern&#225;ndez&#44; Carmen&#46; Hospital G&#243;mez Ulla&#44; Madrid&#46; Gonz&#225;lez Sarmiento&#44; Enrique&#46; Hospital C&#237;nico&#44; Valladolid&#46; Gracia Tello&#44; Borja&#46; Hospital Cl&#237;nico de Zaragoza&#46; Hurtado&#44; Roberto&#46; Hospital Vega Baja&#44; Alicante&#46; Inglada Galiana&#44; Luis&#46; Hospital R&#237;o Hortega&#44; Valladolid&#46; Ja&#233;n &#193;guila&#44; Fernando&#46; Complejo Hospitalario Universitario de Granada&#46; Jim&#233;nez Hidalgo&#44; Alicia&#46; Hospital Juan Ram&#243;n Jim&#233;nez&#44; Huelva&#46; Lacal Mart&#237;nez&#44; Ana&#46; Hospital del Vendrell&#44; Tarragona&#46; L&#243;pez Carmona&#44; Mar&#237;a Dolores&#46; Hospital Carlos Haya&#44; M&#225;laga&#46; Lucena Calvet&#44; Paloma&#46; Hospital G&#243;mez Ulla&#44; Madrid&#46; Maci&#225; Botejara&#44; Enrique&#46; Hospital Perpetuo Socorro&#44; Badajoz&#46; Mateos Polo&#44; Lourdes&#46; Hospital Universitario de Salamanca&#46; Mediavilla Garc&#237;a&#44; Juan Diego&#46; Complejo Hospitalario Universitario de Granada&#46; Mej&#237;as&#44; Inma&#46; Hospital de Cabra&#46; M&#233;ndez Bail&#243;n&#44; Manuel&#46; Hospital Cl&#237;nico San Carlos&#44; Madrid&#46; Mich&#225;n Do&#241;a&#44; Alfredo&#46; Hospital de Jerez&#44; Jerez de la Frontera&#44; C&#225;diz&#46; Moya Mateo&#44; Eva&#46; Hospital Infanta Leonor&#44; Madrid&#46; Munielo Voces&#44; Isabel&#46; Hospital de Le&#243;n&#46; Mu&#241;oz L&#243;pez&#44; Juan Jos&#233;&#46; Hospital de Alta Resoluci&#243;n de Utrera&#46; Mu&#241;oz Rivas&#44; Nuria&#46; Hospital Infanta Leonor&#44; Madrid&#46; Naranjo Velasco&#44; Virginia&#46; Hospital de Jerez&#44; Jerez de la Frontera&#44; C&#225;diz&#46; Nobilia Gigena&#44; Laura&#46; Hospital del Vendrell&#44; Tarragona&#46; P&#233;rez Bernalte&#44; Rosa&#46; Hospital del Vendrell&#44; Tarragona&#46; P&#233;rez Soto&#44; Mar&#237;a Isabel&#46; Hospital de Vinalopo&#44; Elche&#46; Puchades&#44; Francesc&#46; Hospital Pare Jofr&#233; y Hospital Casa Salud&#44; Valencia&#46; S&#225;nchez Lora&#44; Javier&#46; Hospital Virgen de la Victoria&#44; M&#225;laga&#46; S&#225;nchez Vidal&#44; Mar&#237;a Teresa&#46; Fundaci&#243;n Hospital de Jov&#233;&#44; Gij&#243;n&#46; Su&#225;rez Tembra&#44; Manuel&#46; Hospital San Rafael&#44; A Coru&#241;a&#46; Toro Parodo&#44; Aythami&#46; Hospital de Ceuta&#44; Ceuta&#46; Varela Aguilar&#44; Jos&#233; Manuel&#46; CIBER de Epidemiologia y Salud P&#250;blica&#44; Hospital Virgen del Roc&#237;o&#44; Sevilla&#46; Vigueras P&#233;rez&#44; Juan Francisco&#46; Hospital Santa Catalina&#44; Las Palmas&#46; Zamb&#243;n Rad&#243;s&#44; Daniel&#46; Hospital Cl&#237;nic&#44; Barcelona&#46;</p>"
            "etiqueta" => "Appendix C"
            "titulo" => "Ap&#233;ndice"
            "identificador" => "sec0055"
          ]
        ]
      ]
    ]
    "multimedia" => array:6 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 2293
            "Ancho" => 1583
            "Tamanyo" => 146868
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        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Diagrama de flujo del estudio&#46;</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">EOSS&#58; sistema de estadificaci&#243;n de la obesidad de Edmonton&#59; IMC&#58; &#237;ndice de masa corporal&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figura 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 3482
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            "Tamanyo" => 293110
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        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">An&#225;lisis de correspondencias&#46; Parte superior&#58; an&#225;lisis con los grupos de Edmonton&#59; parte inferior&#58; an&#225;lisis con la clasificaci&#243;n de obesidad seg&#250;n el &#237;ndice de masa corporal&#46; La calificaci&#243;n del &#237;ndice de Barthel hace referencia al grado de dependencia&#46;</p> <p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">EOSS&#58; sistema de estadificaci&#243;n de la obesidad de Edmonton&#59; Est&#58; estudios&#59; IB&#58; &#237;ndice de Barthel&#59; IC&#58; &#237;ndice de Charlson&#59; IMC&#58; &#237;ndice de masa corporal&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Tabla 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">DM&#58; diabetes mellitus&#59; EOSS&#58; Sistema de Estadificaci&#243;n de la Obesidad de Edmonton&#59; EPOC&#58; enfermedad pulmonar obstructiva cr&#243;nica&#59; ERGE&#58; enfermedad por reflujo gastroesof&#225;gico&#59; H&#58; hombre&#59; HTA&#58; hipertensi&#243;n arterial sist&#233;mica&#59; IMC&#58; &#237;ndice de masa corporal&#59; SAHS&#58; s&#237;ndrome de apnea-hipopnea&#46;</p><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Las variables cuantitativas se expresan como mediana &#40;rango intercuart&#237;lico&#41;&#59; las variables cualitativas se expresan como n&#250;mero absoluto &#40;porcentaje&#41;&#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="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable&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">EOSS 0&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">EOSS 1&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">EOSS 2&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">EOSS 3&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">EOSS 4&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&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">N</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">165&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">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">Edad &#40;a&#241;os&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50&#44;12 &#40;13&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50&#44;33 &#40;16&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">64&#44;95 &#40;14&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65&#44;27 &#40;10&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78 &#40;6&#44;8&#41;&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;0000&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">Sexo &#40;H&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;46&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22 &#40;56&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">84 &#40;50&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20 &#40;48&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;42&#44;9&#41;&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;93&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Peso &#40;kg&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">88&#44;9 &#40;73&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">92&#44;9 &#40;69&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">92 &#40;94&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">96&#44;9 &#40;86&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">87 &#40;43&#41;&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;58&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">IMC &#40;kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#41;</span>&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;59 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">34&#44;25 &#40;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">34&#44;76 &#40;25&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35&#44;56 &#40;28&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32&#44;23 &#40;14&#44;8&#41;&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;25&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">Per&#237;metro abdominal &#40;cm&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">114&#44;46 &#40;14&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">110&#44;97 &#40;11&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">115&#44;64 &#40;13&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">117&#44;23 &#40;12&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">114&#44;57 &#40;16&#44;8&#41;&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;27&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">&#205;ndice de Charlson</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;2&#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 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;8&#41;&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;0000&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">Test de Depresi&#243;n de Beck &#40;n</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">259&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#40;11&#41;&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;53&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">No trabaja</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;38&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17 &#40;43&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">122 &#40;73&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">31 &#40;75&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;85&#44;7&#41;&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;0003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">&#205;ndice de Barthel &#40;grado de dependencia&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Independiente &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35 &#40;89&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">114 &#40;69&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25 &#40;60&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#44;0&#41;&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;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="elsevierStyleHsp" style=""></span>Leve &#40;91-99&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;5&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35 &#40;21&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;17&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;42&#44;9&#41;&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;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="elsevierStyleHsp" style=""></span>Moderada &#40;61-90&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#44;0&#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 &#40;2&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12 &#40;7&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;17&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;42&#44;9&#41;&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;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="elsevierStyleHsp" style=""></span>Grave &#40;21-60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#44;0&#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 &#40;2&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;1&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;4&#44;9&#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 &#40;14&#44;3&#41;&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;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="elsevierStyleHsp" style=""></span>Total &#40;0-20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#44;0&#41;&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;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">Sedentarismo</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;53&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20 &#40;51&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">112 &#40;67&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29 &#40;70&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;100&#41;&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;06&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">Residente en medio rural</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;23&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;33&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">58 &#40;35&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;36&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;28&#44;6&#41;&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;9&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</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#40;23&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;15&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22 &#40;13&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;12&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#44;0&#41;&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;6&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">Alcohol</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#44;0&#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 &#40;2&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;7&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;12&#44;2&#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 &#40;14&#44;9&#41;&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;77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">HTA</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">145 &#40;87&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">34 &#40;82&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;57&#44;1&#41;&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;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">DM tipo 2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">86 &#40;52&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24 &#40;58&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;71&#44;4&#41;&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;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Dislipidemia</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19 &#40;48&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">111 &#40;67&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30 &#40;73&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;57&#44;1&#41;&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;0003&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">SHAS</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;12&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42 &#40;25&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;36&#44;6&#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 &#40;14&#44;3&#41;&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;027&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">ERGE</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;38&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;20&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27 &#40;16&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;24&#44;4&#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 &#40;14&#44;3&#41;&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;3&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">EPOC</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;23&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;10&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22 &#40;13&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;14&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;42&#44;9&#41;&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;19&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">Insuficiencia cardiaca</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#44;0&#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 &#40;2&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35 &#40;21&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17 &#40;41&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;57&#44;1&#41;&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;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">H&#237;gado graso</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17 &#40;43&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">52 &#40;31&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;36&#44;6&#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 &#40;14&#44;3&#41;&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;04&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">Cardiopat&#237;a isqu&#233;mica</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;7&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18 &#40;43&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#44;0&#41;&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;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1352957.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Variables cl&#237;nicas y demogr&#225;ficas seg&#250;n el Sistema de Estadificaci&#243;n de la Obesidad de Edmonton</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Tabla 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">IC&#58; intervalo de confianza&#59; IMC&#58; &#237;ndice de masa corporal&#59; OR&#58; odds ratio&#46;</p><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Regresi&#243;n log&#237;stica&#46; El modelo refleja las variables que influyen de forma independiente en tener un Sistema de Estadificaci&#243;n de la Obesidad de Edmonton<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>2&#46; Para el an&#225;lisis se incluyeron la edad&#44; el sexo&#44; el &#237;ndice de masa corporal&#44; el &#237;ndice de Charlson&#44; el aclaramiento de creatinina&#44; la glucemia&#44; el colesterol total&#44; el &#225;cido &#250;rico&#44; el n&#250;mero de leucocitos y la ratio alb&#250;mina&#47;creatinina&#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="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR&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">IC 95&#37;&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&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">Edad&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;06&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;03-1&#44;08&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;0003&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">IMC&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;07&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;99-1&#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">0&#44;06&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">Glucemia&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;04&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;01-1&#44;07&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;0006&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">Colesterol total&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;98&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;97-0&#44;99&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;02&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">&#193;cido &#250;rico&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;32&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;03-1&#44;68&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;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1352956.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">An&#225;lisis multivariante de regresi&#243;n log&#237;stica para la probabilidad de un estadio del Sistema de Estadificaci&#243;n de la Obesidad de Edmonton superior a 2</p>"
        ]
      ]
      4 => 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:2 [
          "leyenda" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">EOSS&#58; Sistema de Estadificaci&#243;n de la Obesidad de Edmonton&#59; IMC&#58; &#237;ndice de masa corporal&#46;</p><p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Las variables cuantitativas se expresan como mediana &#40;rango intercuart&#237;lico&#41;&#59; las variables cualitativas se expresan como n&#250;mero absoluto &#40;porcentaje&#41;&#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="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable&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">&#60;<span class="elsevierStyleHsp" style=""></span>30 a&#241;os&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">31-40 a&#241;os&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">41-50 a&#241;os&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">51-60 a&#241;os&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">61-70 a&#241;os&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">71-80 a&#241;os&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">&#62;<span class="elsevierStyleHsp" style=""></span>80 a&#241;os&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&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">N&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">10&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">65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&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">Talla &#40;cm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">168 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">168 &#40;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">168 &#40;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">165 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">160 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">158 &#40;14&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">155&#44;5 &#40;13&#41;&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;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Peso &#40;kg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">109&#44;4 &#40;43&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">105&#44;15 &#40;35&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">101 &#40;22&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">96&#44;65 &#40;25&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">90&#44;15 &#40;17&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">88&#44;75 &#40;16&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">84&#44;5 &#40;23&#41;&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;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">IMC &#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&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;99 &#40;9&#44;3&#41;&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;05 &#40;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35&#44;36 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">34&#44;25 &#40;6&#41;&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;42 &#40;7&#44;4&#41;&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;34 &#40;4&#44;9&#41;&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;9 &#40;3&#44;9&#41;&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;28&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">EOSS 0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;20&#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 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;6&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;7&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;5&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#41;&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;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">EOSS 1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;27&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12 &#40;18&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;11&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;5&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#41;&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">EOSS 2&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">5 &#40;50&#41;&nbsp;\t\t\t\t\t\t\n
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