array:24 [
  "pii" => "S1699258X12002677"
  "issn" => "1699258X"
  "doi" => "10.1016/j.reuma.2012.09.006"
  "estado" => "S300"
  "fechaPublicacion" => "2013-07-01"
  "aid" => "513"
  "copyright" => "Elsevier España, S.L.. All rights reserved"
  "copyrightAnyo" => "2012"
  "documento" => "article"
  "crossmark" => 0
  "subdocumento" => "sco"
  "cita" => "Reumatol Clin. 2013;9:226-8"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 4887
    "formatos" => array:3 [
      "EPUB" => 152
      "HTML" => 3529
      "PDF" => 1206
    ]
  ]
  "Traduccion" => array:1 [
    "en" => array:19 [
      "pii" => "S2173574313000282"
      "issn" => "21735743"
      "doi" => "10.1016/j.reumae.2013.03.002"
      "estado" => "S300"
      "fechaPublicacion" => "2013-07-01"
      "aid" => "513"
      "copyright" => "Elsevier España, S.L."
      "documento" => "article"
      "crossmark" => 0
      "subdocumento" => "sco"
      "cita" => "Reumatol Clin. 2013;9:226-8"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:2 [
        "total" => 2924
        "formatos" => array:3 [
          "EPUB" => 51
          "HTML" => 2080
          "PDF" => 793
        ]
      ]
      "en" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original breve</span>"
        "titulo" => "Weather conditions may worsen symptoms in rheumatoid arthritis patients&#58; The possible effect of temperature"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "tieneResumen" => array:2 [
          0 => "en"
          1 => "es"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "226"
            "paginaFinal" => "228"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "es" => array:1 [
            "titulo" => "Influencia de las condiciones clim&#225;ticas en el empeoramiento de los s&#237;ntomas de artritis reumatoide&#58; El posible efecto de la temperatura"
          ]
        ]
        "contieneResumen" => array:2 [
          "en" => true
          "es" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Fig&#46; 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1750
                "Ancho" => 2389
                "Tamanyo" => 194542
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Graphical representation of the non-parametric adjustment of the relationship between daily RA worsening and daily mean temperature&#44; by age group&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Lydia Abasolo, Aurelio Tob&#237;as, Leticia Leon, Loreto Carmona, Jose Luis Fernandez-Rueda, Ana Belen Rodriguez, Benjamin Fernandez-Gutierrez, Juan Angel Jover"
            "autores" => array:8 [
              0 => array:2 [
                "nombre" => "Lydia"
                "apellidos" => "Abasolo"
              ]
              1 => array:2 [
                "nombre" => "Aurelio"
                "apellidos" => "Tob&#237;as"
              ]
              2 => array:2 [
                "nombre" => "Leticia"
                "apellidos" => "Leon"
              ]
              3 => array:2 [
                "nombre" => "Loreto"
                "apellidos" => "Carmona"
              ]
              4 => array:2 [
                "nombre" => "Jose Luis"
                "apellidos" => "Fernandez-Rueda"
              ]
              5 => array:2 [
                "nombre" => "Ana Belen"
                "apellidos" => "Rodriguez"
              ]
              6 => array:2 [
                "nombre" => "Benjamin"
                "apellidos" => "Fernandez-Gutierrez"
              ]
              7 => array:2 [
                "nombre" => "Juan Angel"
                "apellidos" => "Jover"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S1699258X12002677"
          "doi" => "10.1016/j.reuma.2012.09.006"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X12002677?idApp=UINPBA00004M"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574313000282?idApp=UINPBA00004M"
      "url" => "/21735743/0000000900000004/v1_201307160008/S2173574313000282/v1_201307160008/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S1699258X12001799"
    "issn" => "1699258X"
    "doi" => "10.1016/j.reuma.2012.06.008"
    "estado" => "S300"
    "fechaPublicacion" => "2013-07-01"
    "aid" => "482"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "ssu"
    "cita" => "Reumatol Clin. 2013;9:229-38"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 65219
      "formatos" => array:3 [
        "EPUB" => 179
        "HTML" => 61720
        "PDF" => 3320
      ]
    ]
    "es" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Revisi&#243;n</span>"
      "titulo" => "Microbios y articulaciones&#58; la relaci&#243;n entre infecci&#243;n y articulaciones"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "229"
          "paginaFinal" => "238"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Of bugs and joints&#58; The relationship between infection and joints"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figura 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1448
              "Ancho" => 1256
              "Tamanyo" => 158526
            ]
          ]
          "descripcion" => array:1 [
            "es" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Manifestaciones cl&#237;nicas de la artritis reactiva&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Luis R&#46; Espinoza, Ignacio Garc&#237;a-Valladares"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "Luis R&#46;"
              "apellidos" => "Espinoza"
            ]
            1 => array:2 [
              "nombre" => "Ignacio"
              "apellidos" => "Garc&#237;a-Valladares"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2173574312001608"
        "doi" => "10.1016/j.reumae.2012.10.004"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574312001608?idApp=UINPBA00004M"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X12001799?idApp=UINPBA00004M"
    "url" => "/1699258X/0000000900000004/v2_201309261323/S1699258X12001799/v2_201309261323/es/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1699258X13000065"
    "issn" => "1699258X"
    "doi" => "10.1016/j.reuma.2012.09.008"
    "estado" => "S300"
    "fechaPublicacion" => "2013-07-01"
    "aid" => "520"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Reumatol Clin. 2013;9:221-5"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 8368
      "formatos" => array:3 [
        "EPUB" => 139
        "HTML" => 6296
        "PDF" => 1933
      ]
    ]
    "es" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
      "titulo" => "Diferente expresi&#243;n cl&#237;nica de los pacientes con espondilitis anquilosante seg&#250;n el sexo en funci&#243;n del tiempo de evoluci&#243;n&#46; Datos de REGISPONSER"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "221"
          "paginaFinal" => "225"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Different clinical expression of patients with ankylosing spondylitis according to gender in relation to time since onset of disease&#46; Data from REGISPONSER"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Rafaela Ortega Castro, Pilar Font Ugalde, M&#46; Carmen Castro Villegas, Jerusal&#233;n Calvo Guti&#233;rrez, Elisa Mu&#241;oz Gomariz, Pedro Zarco Montejo, Raquel Almod&#243;var, Juan Mulero Mendoza, Juan Carlos Torre-Alonso, Jordi Gratac&#243;s Masmitj&#225;, Xavier Juanola Roura, Rafael Ariza Ariza, Pilar Fern&#225;ndez Dapica, Luis Francisco Linares Ferrando, M&#46; Elia Brito Brito, Eduardo Cuende Quintana, Carlos V&#225;zquez Galeano, Manuel Jos&#233; Moreno Ramos, Eugenio Gim&#233;nez &#218;beda, Jos&#233; Carlos Rodr&#237;guez Lozano, Manuel Fern&#225;ndez Prada, Rub&#233;n Queiro Silva, Estefan&#237;a Moreno Ruzafa, Enrique J&#250;dez Navarro, Antonio Juan M&#225;s, Cristina Medrano Le Quement, Enrique Ornilla, Carlos Montilla Morales, Manuel Pujol Busquets, Teresa Clavaguera Poch, M&#46; Cruz Fern&#225;ndez-Espartero, Loreto Carmona Ortell, Eduardo Collantes Est&#233;vez"
          "autores" => array:33 [
            0 => array:2 [
              "nombre" => "Rafaela"
              "apellidos" => "Ortega Castro"
            ]
            1 => array:2 [
              "nombre" => "Pilar"
              "apellidos" => "Font Ugalde"
            ]
            2 => array:2 [
              "nombre" => "M&#46; Carmen"
              "apellidos" => "Castro Villegas"
            ]
            3 => array:2 [
              "nombre" => "Jerusal&#233;n"
              "apellidos" => "Calvo Guti&#233;rrez"
            ]
            4 => array:2 [
              "nombre" => "Elisa"
              "apellidos" => "Mu&#241;oz Gomariz"
            ]
            5 => array:2 [
              "nombre" => "Pedro"
              "apellidos" => "Zarco Montejo"
            ]
            6 => array:2 [
              "nombre" => "Raquel"
              "apellidos" => "Almod&#243;var"
            ]
            7 => array:2 [
              "nombre" => "Juan"
              "apellidos" => "Mulero Mendoza"
            ]
            8 => array:2 [
              "nombre" => "Juan Carlos"
              "apellidos" => "Torre-Alonso"
            ]
            9 => array:2 [
              "nombre" => "Jordi"
              "apellidos" => "Gratac&#243;s Masmitj&#225;"
            ]
            10 => array:2 [
              "nombre" => "Xavier"
              "apellidos" => "Juanola Roura"
            ]
            11 => array:2 [
              "nombre" => "Rafael"
              "apellidos" => "Ariza Ariza"
            ]
            12 => array:2 [
              "nombre" => "Pilar"
              "apellidos" => "Fern&#225;ndez Dapica"
            ]
            13 => array:2 [
              "nombre" => "Luis Francisco"
              "apellidos" => "Linares Ferrando"
            ]
            14 => array:2 [
              "nombre" => "M&#46; Elia"
              "apellidos" => "Brito Brito"
            ]
            15 => array:2 [
              "nombre" => "Eduardo"
              "apellidos" => "Cuende Quintana"
            ]
            16 => array:2 [
              "nombre" => "Carlos"
              "apellidos" => "V&#225;zquez Galeano"
            ]
            17 => array:2 [
              "nombre" => "Manuel Jos&#233;"
              "apellidos" => "Moreno Ramos"
            ]
            18 => array:2 [
              "nombre" => "Eugenio"
              "apellidos" => "Gim&#233;nez &#218;beda"
            ]
            19 => array:2 [
              "nombre" => "Jos&#233; Carlos"
              "apellidos" => "Rodr&#237;guez Lozano"
            ]
            20 => array:2 [
              "nombre" => "Manuel"
              "apellidos" => "Fern&#225;ndez Prada"
            ]
            21 => array:2 [
              "nombre" => "Rub&#233;n"
              "apellidos" => "Queiro Silva"
            ]
            22 => array:2 [
              "nombre" => "Estefan&#237;a"
              "apellidos" => "Moreno Ruzafa"
            ]
            23 => array:2 [
              "nombre" => "Enrique"
              "apellidos" => "J&#250;dez Navarro"
            ]
            24 => array:2 [
              "nombre" => "Antonio Juan"
              "apellidos" => "M&#225;s"
            ]
            25 => array:2 [
              "nombre" => "Cristina"
              "apellidos" => "Medrano Le Quement"
            ]
            26 => array:2 [
              "nombre" => "Enrique"
              "apellidos" => "Ornilla"
            ]
            27 => array:2 [
              "nombre" => "Carlos"
              "apellidos" => "Montilla Morales"
            ]
            28 => array:2 [
              "nombre" => "Manuel"
              "apellidos" => "Pujol Busquets"
            ]
            29 => array:2 [
              "nombre" => "Teresa"
              "apellidos" => "Clavaguera Poch"
            ]
            30 => array:2 [
              "nombre" => "M&#46; Cruz"
              "apellidos" => "Fern&#225;ndez-Espartero"
            ]
            31 => array:2 [
              "nombre" => "Loreto"
              "apellidos" => "Carmona Ortell"
            ]
            32 => array:2 [
              "nombre" => "Eduardo"
              "apellidos" => "Collantes Est&#233;vez"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2173574313000476"
        "doi" => "10.1016/j.reumae.2012.09.004"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574313000476?idApp=UINPBA00004M"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X13000065?idApp=UINPBA00004M"
    "url" => "/1699258X/0000000900000004/v2_201309261323/S1699258X13000065/v2_201309261323/es/main.assets"
  ]
  "en" => array:19 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original breve</span>"
    "titulo" => "Weather conditions may worsen symptoms in rheumatoid arthritis patients&#58; The possible effect of temperature"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "226"
        "paginaFinal" => "228"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Lydia Abasolo, Aurelio Tob&#237;as, Leticia Leon, Loreto Carmona, Jose Luis Fernandez-Rueda, Ana Belen Rodriguez, Benjamin Fernandez-Gutierrez, Juan Angel Jover"
        "autores" => array:8 [
          0 => array:3 [
            "nombre" => "Lydia"
            "apellidos" => "Abasolo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Aurelio"
            "apellidos" => "Tob&#237;as"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:4 [
            "nombre" => "Leticia"
            "apellidos" => "Leon"
            "email" => array:1 [
              0 => "lleon&#46;hcsc&#64;salud&#46;madrid&#46;org"
            ]
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">¿</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Loreto"
            "apellidos" => "Carmona"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Jose Luis"
            "apellidos" => "Fernandez-Rueda"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Ana Belen"
            "apellidos" => "Rodriguez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "Benjamin"
            "apellidos" => "Fernandez-Gutierrez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
          7 => array:3 [
            "nombre" => "Juan Angel"
            "apellidos" => "Jover"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:4 [
          0 => array:3 [
            "entidad" => "Rheumatology Unit&#44; Fundaci&#243;n para la Investigaci&#243;n Biom&#233;dica&#44; Instituto de Investigaci&#243;n Sanitaria&#44; Hospital Cl&#237;nico San Carlos&#44; Madrid&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Institute of Environmental Assessment and Water Research &#40;IDAEA&#41;&#44; Spanish Council for Scientific Research &#40;CSIC&#41;&#44; Barcelona&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Camilo Jos&#233; Cela University&#44; Madrid&#44; Spain"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Rheumatology Unit&#44; Hospital Cl&#237;nico San Carlos&#44; Madrid&#44; Spain"
            "etiqueta" => "d"
            "identificador" => "aff0020"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Influencia de las condiciones clim&#225;ticas en el empeoramiento de los s&#237;ntomas de artritis reumatoide&#58; El posible efecto de la temperatura"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1750
            "Ancho" => 2382
            "Tamanyo" => 180367
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Graphical representation of the non-parametric adjustment of the relationship between daily RA worsening and daily mean temperature&#44; by age group&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Patients with rheumatic conditions often complain that certain meteorological conditions aggravate their disease symptoms&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;3</span></a> However&#44; studies on influence of weather conditions<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;3&#8211;8</span></a> have reported conflicting results&#44; most related to rheumatoid arthritis patients &#40;RA&#41;&#46; Some studies indicated that weather conditions do not influence the symptoms of arthritis&#44;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;3</span></a> whereas others found an influence related to low temperature&#44; high atmospheric pressure&#44; and high humidity&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;4&#44;9</span></a> Moreover&#44; some authors found a seasonal effect<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;7</span></a> but others did not&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;8</span></a> Thus&#44; scientific evidence on the effects of atmospheric factors on rheumatic diseases is sparse and non-conclusive&#46; Discrepancies could be related to the diverse climatic conditions from each geographic area studied and also due to the different methodologies used&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">To our knowledge no study has previously been conducted in our setting for these rheumatic disorders&#46; Our objective is to investigate the short-term effects of weather conditions on the acute worsening in rheumatic patients due to RA related conditions and also to determine possible seasonal fluctuations&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Methods</span><p id="par0015" class="elsevierStylePara elsevierViewall">This study was conducted in the city of Madrid&#44; Spain&#44; with a Mediterranean continental climate very influenced by urban conditions&#46; Winters are cold&#44; with mean temperatures below 10<span class="elsevierStyleHsp" style=""></span>&#176;C with frequent frosts at night and occasional snowfalls&#46; Summers are warm with mean temperatures over 20<span class="elsevierStyleHsp" style=""></span>&#176;C&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Daily cases of RA worsening&#44; were defined as those patients who come to the emergency room&#44; were attended by a rheumatologist of Hospital Cl&#237;nico San Carlos&#44; and were diagnosed with RA as the main cause reflected in the ICD code &#40;10th revision&#41;&#44; from 1st January 2004 until 31st December 2007&#46; The Hospital Cl&#237;nico San Carlos is a tertiary hospital&#44; covering a population over 500&#44;000 inhabitants&#46; For all cases we also collected age&#44; gender&#44; and disability index&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The study was approved by the HCSC Ethics Committee&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">As weather conditions we measured&#58; Daily mean&#44; maximum and minimum temperatures &#40;in &#176;C&#41;&#44; relative humidity &#40;&#37;&#41;&#44; pressure &#40;hPA&#41;&#44; rain &#40;mm&#41;&#44; hours of sun&#44; and cloud cover &#40;octas&#41; were obtained from the European Climate Assessment &#38; Dataset &#40;ECA&#38;D&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The association of weather conditions with daily RA worsening was investigated using a case-crossover design&#44;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> which uses the day on which the RA aggravation occurs as a case day&#46; Exposure on case days is compared with exposure on days on which the RA worsening does not occur &#40;control days&#41;&#46; A time-stratified approach was selecting control days from the same day of the week&#44; month&#44; and year as case days&#46; This minimise bias from time-trends and other time-varying confounders&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> Short-term effects of weather variables on daily cases&#44; from the same day up to one-week lag&#44; were estimated using conditional logistic regression&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Results</span><p id="par0040" class="elsevierStylePara elsevierViewall">A total of 245 patients with 306 RA visits to the emergency room due to RA as the main diagnostic reason during the study period were included&#46; Most were women &#40;71&#37;&#41;&#44; with a mean age of 63&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16&#46;4 years&#46; Two thirds were attended at least twice in the emergency room due to RA worsening&#44; with some level of disability &#40;90&#37; with a Rosser index less than 0&#46;990&#41;&#46; During the study period weather conditions were on average&#58; 14&#46;6<span class="elsevierStyleHsp" style=""></span>&#176;C of temperature &#40;ranging from &#8722;5 to 39&#41;&#44; 54&#37; of relative humidity &#40;15&#8211;96&#41;&#44; 1&#46;018<span class="elsevierStyleHsp" style=""></span>hPA of pressure &#40;904&#8211;1408&#41;&#44; 111<span class="elsevierStyleHsp" style=""></span>mm of rain &#40;0&#8211;420&#41;&#44; 8&#46;3<span class="elsevierStyleHsp" style=""></span>h of sun &#40;1&#8211;14&#41;&#44; and 3&#46;2 octas of cloud cover &#40;0&#8211;8&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Statistical significant &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41; association with RA worsening was only found for daily mean temperature&#44; with a lagged effect of 1 day&#44; in middle age patients from 50 to 65 years old &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; These were 16&#37; more likely to present symptomatic deterioration of RA&#44; with lower mean temperature &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;86&#44; 95&#37; CI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#91;0&#46;78&#8211;0&#46;96&#93; for an increase of 1<span class="elsevierStyleHsp" style=""></span>&#176;C&#41;&#46; Both&#44; men and women&#44; showed similar risk estimates with mean temperature&#46; No other weather conditions were statistically associated with the need of RA patients to bee attended in the emergency room due to RA related conditions&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">To evaluate seasonal variations mean temperature was fitted in the conditional logistic regression model using a cubic spline&#44; with 3 degrees of freedom &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Significant effects were only found in the most extreme ranges of mean temperature for middle age people&#44; being 15&#37; and 20&#37; more likely of RA worsening with mean temperatures below 10<span class="elsevierStyleHsp" style=""></span>&#176;C &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;83&#44; 95&#37; CI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#91;0&#46;69&#8211;0&#46;99&#93;&#41; and above 20<span class="elsevierStyleHsp" style=""></span>&#176;C &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;82&#44; 95&#37; CI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#91;0&#46;66&#8211;0&#46;99&#93;&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discussion</span><p id="par0055" class="elsevierStylePara elsevierViewall">There is a popular belief that rheumatic conditions are particularly sensitive to fluctuations of weather&#46; We have found associations with meteorological conditions &#40;specifically with temperature&#41;&#44; and RA related problems in the subgroup of middle age patients&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The failure to find associations with other age groups could be explained because age itself is a risk factor for disability&#44; thus elderly could have in general more difficulty to go to the emergency room by themselves&#46; Moreover&#44; rheumatic pain is frequently considered to be a natural part of the aging process&#46; Otherwise&#44; the younger may have problems to miss work using other ways rather than emergency room to control their RA symptoms&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Previous studies in similar settings have also found that mean temperature is related with rheumatic disorders&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;4&#44;9</span></a> Nevertheless&#44; we did not find associations with other weather variables&#44; as atmospheric pressure or relative humidity&#44; probably due to Madrid has a Mediterranean continental climate much dryer and less humid than other cities studied&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;4&#44;9</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">We found that the strongest effects of daily mean temperature on RA worsening were found below 10<span class="elsevierStyleHsp" style=""></span>&#176;C and above 20<span class="elsevierStyleHsp" style=""></span>&#176;C&#44; meanwhile no statistical association was observed between 10 and 20<span class="elsevierStyleHsp" style=""></span>&#176;C&#46; This could reflect the possible seasonal distribution of RA symptomatic deterioration with higher incidence in winter and summer&#46; Additionally&#44; between 10 and 20<span class="elsevierStyleHsp" style=""></span>&#176;C the thermal sensation and small changes probably are better tolerated than in the others&#44; where we subjectively feel cooler or warmer&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">It is important to note that in our setting&#44; RA patients receive long-term monitoring&#44; with self-education in the management of pain and small flares&#46; They are encourage to contact us when they have some kind of medical problem&#44; either by telephone or by medical appointments in 24&#8211;48<span class="elsevierStyleHsp" style=""></span>h&#46; When they have the need to go to the emergency room is often a due to a disabling pain or significant inflammatory activity&#46; With the data available we cannot specify the main cause of RA symptomatic deterioration&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">The main contribution of our study is the methodological approach using a case-crossover design&#44; a common study design to assess for short-term effects of environmental factors on health&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">13&#44;14</span></a> Moreover&#44; our RA patients were well represented&#44; 70&#37; women in their sixties&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">The explanation of the influence of temperature on rheumatic diseases is not clear enough&#46; It is known that cold unleash some diseases such as Raynaud phenomenon or crioglobulinemia&#44; both closely related to rheumatic diseases&#46; Maybe muscles also play a role in relation to flares or pain in RA patients and cold weather&#44; due to coldness stiffens muscles around the joints&#44; and this might worsen the arthritis symptoms&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">In conclusion&#44; our results support that weather conditions&#44; essentially daily mean temperature&#44; may be influencing in RA patients&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Ethical considerations</span><p id="par0095" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Protection of human and animal subjects</span>&#46; The authors declare that the procedures followed were in accordance with the regulations of the responsible Clinical Research Ethics Committee and in accordance with those of the World Medical Association and the Helsinki Declaration&#46;<span class="elsevierStyleVsp" style="height:0.5px"></span><span class="elsevierStyleBold">Confidentiality of data</span>&#46; The authors declare that they have followed the protocols of their work centre on the publication of patient data and that all the patients included in the study have received sufficient information and have given their informed consent in writing to participate in that study&#46;<span class="elsevierStyleVsp" style="height:0.5px"></span><span class="elsevierStyleBold">Right to privacy and informed consent</span>&#46; The authors declare that no patient data appears in this article&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflict of interest</span><p id="par0100" class="elsevierStylePara elsevierViewall">Authors declare that they have no conflict of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:11 [
        0 => array:2 [
          "identificador" => "xres276965"
          "titulo" => array:5 [
            0 => "Abstract"
            1 => "Objective"
            2 => "Methods"
            3 => "Results"
            4 => "Conclusions"
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec258848"
          "titulo" => "Keywords"
        ]
        2 => array:2 [
          "identificador" => "xres276966"
          "titulo" => array:5 [
            0 => "Resumen"
            1 => "Objetivo"
            2 => "M&#233;todos"
            3 => "Resultados"
            4 => "Conclusiones"
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec258847"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Methods"
        ]
        6 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Results"
        ]
        7 => array:2 [
          "identificador" => "sec0020"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0025"
          "titulo" => "Ethical considerations"
        ]
        9 => array:2 [
          "identificador" => "sec0030"
          "titulo" => "Conflict of interest"
        ]
        10 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2012-05-29"
    "fechaAceptado" => "2012-09-12"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec258848"
          "palabras" => array:3 [
            0 => "Weather conditions"
            1 => "Rheumatoid arthritis"
            2 => "Temperature"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec258847"
          "palabras" => array:3 [
            0 => "Condiciones meteorol&#243;gicas"
            1 => "Artritis reumatoide"
            2 => "Temperatura"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Patients with rheumatoid arthritis &#40;RA&#41; complain that weather conditions aggravate their symptoms&#46; We investigated the short-term effects of weather conditions on worsening of RA and determined possible seasonal fluctuations&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">We conducted a case-crossover study in Madrid&#44; Spain&#46; Daily cases of RA flares were collected from the emergency room of a tertiary level hospital between 2004 and 2007&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">245 RA patients who visited the emergency room 306 times due to RA related complaints as the main diagnostic reason were included in the study&#46; Patients from 50 to 65 years old were 16&#37; more likely to present a flare with lower mean temperatures&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Our results support the belief that weather influences rheumatic pain in middle aged patients&#46;</p>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Los pacientes con artritis reumatoide &#40;AR&#41; se quejan de que las condiciones meteorol&#243;gicas empeoran sus s&#237;ntomas&#46; Este estudio trata de ver los efectos a corto plazo de las condiciones clim&#225;ticas en empeoramiento sintom&#225;tico en pacientes con AR y determinar posibles fluctuaciones estacionales&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Se realiz&#243; un estudio de casos cruzados en Madrid&#44; Espa&#241;a&#46; Los casos diarios de empeoramiento de la AR se obtuvieron de la sala de urgencias de un hospital terciario entre 2004 y 2007&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">245 pacientes con AR con 306 visitas a urgencias con AR como diagnostico principal se incluyeron en el estudio&#46; Los pacientes de 50 a 65 a&#241;os tuvieron un 16&#37; m&#225;s de probabilidades de presentar empeoramiento sintom&#225;tico de la AR con una menor temperatura media&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Nuestros resultados apoyan la creencia de que el clima influye en el dolor reum&#225;tico de los pacientes con mediana edad&#46;</p>"
      ]
    ]
    "multimedia" => array:2 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1750
            "Ancho" => 2382
            "Tamanyo" => 180367
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Graphical representation of the non-parametric adjustment of the relationship between daily RA worsening and daily mean temperature&#44; by age group&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">n</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">OR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">95&#37; CI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Age group</span></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#60;50 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;20&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;999&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;0&#46;909&#8211;1&#46;098&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;986&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>50&#8211;65 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;23&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;868&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;0&#46;783&#8211;0&#46;962&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#62;65 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">173&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;56&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;035&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;0&#46;979&#8211;1&#46;095&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;223&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Total</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">306&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;993&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;0&#46;952&#8211;1&#46;037&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;776&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab398802.png"
              ]
            ]
          ]
          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "&#42;"
              "nota" => "<p class="elsevierStyleNotepara">Number of AR cases&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Odds ratio &#40;OR&#41;&#44; and 95&#37; confidence interval &#40;95&#37; CI&#41;&#44; of daily RA worsening for an increase of 1<span class="elsevierStyleHsp" style=""></span>&#176;C of daily mean temperature &#40;for a 1-day lag&#41;&#44; by age group&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:15 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Weather effects in rheumatoid arthritis&#58; from controversy to consensus&#46; A review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "W&#46;R&#46; Patberg"
                            1 => "J&#46;J&#46; Rasker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Rheumatol"
                        "fecha" => "2004"
                        "volumen" => "31"
                        "paginaInicial" => "1327"
                        "paginaFinal" => "1334"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15229951"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Does the weather really matter&#63; A cohort study of influences of weather and solar conditions on daily variations of joint pain in patients with rheumatoid arthritis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "G&#46; Smedslund"
                            1 => "P&#46; Mowinckel"
                            2 => "T&#46; Heiberg"
                            3 => "T&#46;K&#46; Kvien"
                            4 => "K&#46;B&#46; Hagen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/art.24729"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arthritis Rheum"
                        "fecha" => "2009"
                        "volumen" => "61"
                        "paginaInicial" => "1243"
                        "paginaFinal" => "1247"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19714599"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rheumatoid arthritis patients show weather sensitivity in daily life&#44; but the relationship is not clinically significant"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;A&#46; Gorin"
                            1 => "J&#46;M&#46; Smyth"
                            2 => "J&#46;N&#46; Weisberg"
                            3 => "G&#46; Affleck"
                            4 => "H&#46; Tennen"
                            5 => "S&#46; Urrows"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pain"
                        "fecha" => "1999"
                        "volumen" => "81"
                        "paginaInicial" => "173"
                        "paginaFinal" => "177"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10353505"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Weather conditions can influence rheumatic diseases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Verges"
                            1 => "E&#46; Montell"
                            2 => "E&#46; Tomas"
                            3 => "G&#46; Cumelles"
                            4 => "G&#46; Castaneda"
                            5 => "N&#46; Marti"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Proc West Pharmacol Soc"
                        "fecha" => "2004"
                        "volumen" => "47"
                        "paginaInicial" => "134"
                        "paginaFinal" => "136"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15633634"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Seasonal symptom severity in patients with rheumatic diseases&#58; a study of 1&#44;424 patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "D&#46;J&#46; Hawley"
                            1 => "F&#46; Wolfe"
                            2 => "F&#46;A&#46; Lue"
                            3 => "H&#46; Moldofsky"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Rheumatol"
                        "fecha" => "2001"
                        "volumen" => "28"
                        "paginaInicial" => "1900"
                        "paginaFinal" => "1909"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11508598"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Seasonal distribution of relapse onset in rheumatoid arthritis and spondyloarthropathy&#58; the possible effect of the solar factor"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Rozin"
                            1 => "A&#46; Balbir-Gurman"
                            2 => "D&#46; Schapira"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Exp Rheumatol"
                        "fecha" => "2003"
                        "volumen" => "21"
                        "paginaInicial" => "161"
                        "paginaFinal" => "169"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12747269"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "What&#39;s in season for rheumatoid arthritis patients&#63; Seasonal fluctuations in disease activity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46; Iikuni"
                            1 => "A&#46; Nakajima"
                            2 => "E&#46; Inoue"
                            3 => "E&#46; Tanaka"
                            4 => "H&#46; Okamoto"
                            5 => "M&#46; Hara"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rheumatology &#40;Oxford&#41;"
                        "fecha" => "2007"
                        "volumen" => "46"
                        "paginaInicial" => "846"
                        "paginaFinal" => "848"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Annual fluctuations in rheumatoid arthritis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "N&#46;S&#46; Latman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Rheumatol"
                        "fecha" => "1981"
                        "volumen" => "8"
                        "paginaInicial" => "725"
                        "paginaFinal" => "729"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7310773"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Influence of weather conditions on rheumatic pain"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "I&#46; Strusberg"
                            1 => "R&#46;C&#46; Mendelberg"
                            2 => "H&#46;A&#46; Serra"
                            3 => "A&#46;M&#46; Strusberg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Rheumatol"
                        "fecha" => "2002"
                        "volumen" => "29"
                        "paginaInicial" => "335"
                        "paginaFinal" => "338"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11838853"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The measurement of hospital output"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46;M&#46; Rosser"
                            1 => "V&#46;C&#46; Watts"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Epidemiol"
                        "fecha" => "1972"
                        "volumen" => "1"
                        "paginaInicial" => "361"
                        "paginaFinal" => "368"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4669084"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Updated and extended European dataset of dialy climate observations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "E&#46;J&#46; Klok"
                            1 => "A&#46;M&#46;G&#46; Klein Tank"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Int J Climatol"
                        "fecha" => "2009"
                        "volumen" => "29"
                        "paginaInicial" => "1182"
                        "paginaFinal" => "1191"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The case-crossover design&#58; a method for studying transient effects on the risk of acute events"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46; Maclure"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Epidemiol"
                        "fecha" => "1991"
                        "volumen" => "133"
                        "paginaInicial" => "144"
                        "paginaFinal" => "153"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1985444"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Case-crossover analyses of air pollution exposure data&#58; referent selection strategies and their implications for bias"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "H&#46; Janes"
                            1 => "L&#46; Sheppard"
                            2 => "T&#46; Lumley"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Epidemiology"
                        "fecha" => "2005"
                        "volumen" => "16"
                        "paginaInicial" => "717"
                        "paginaFinal" => "726"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16222160"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An introduction to epidemiologic and statistical methods useful in environmental epidemiology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H&#46; Nitta"
                            1 => "S&#46; Yamazaki"
                            2 => "T&#46; Omori"
                            3 => "T&#46; Sato"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Epidemiol"
                        "fecha" => "2010"
                        "volumen" => "20"
                        "paginaInicial" => "177"
                        "paginaFinal" => "184"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20431236"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rheumatoid arthritis in Spain&#58; occurrence of extra-articular manifestations and estimates of disease severity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "L&#46; Carmona"
                            1 => "I&#46; Gonzalez-Alvaro"
                            2 => "A&#46; Balsa"
                            3 => "M&#46; Angel Belmonte"
                            4 => "X&#46; Tena"
                            5 => "R&#46; Sanmart&#237;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Rheum Dis"
                        "fecha" => "2003"
                        "volumen" => "62"
                        "paginaInicial" => "897"
                        "paginaFinal" => "900"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12922967"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/1699258X/0000000900000004/v2_201309261323/S1699258X12002677/v2_201309261323/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "17499"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Originales"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/1699258X/0000000900000004/v2_201309261323/S1699258X12002677/v2_201309261323/en/main.pdf?idApp=UINPBA00004M&text.app=https://www.reumatologiaclinica.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X12002677?idApp=UINPBA00004M"
]
Compartir
Información de la revista
Vol. 9. Núm. 4.
Páginas 226-228 (julio - agosto 2013)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 9. Núm. 4.
Páginas 226-228 (julio - agosto 2013)
Original breve
Weather conditions may worsen symptoms in rheumatoid arthritis patients: The possible effect of temperature
Influencia de las condiciones climáticas en el empeoramiento de los síntomas de artritis reumatoide: El posible efecto de la temperatura
Lydia Abasoloa, Aurelio Tobíasb, Leticia Leona,c,
Autor para correspondencia
lleon.hcsc@salud.madrid.org

Corresponding author.
, Loreto Carmonac, Jose Luis Fernandez-Ruedaa, Ana Belen Rodriguezd, Benjamin Fernandez-Gutierrezd, Juan Angel Joverd
a Rheumatology Unit, Fundación para la Investigación Biomédica, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos, Madrid, Spain
b Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain
c Camilo José Cela University, Madrid, Spain
d Rheumatology Unit, Hospital Clínico San Carlos, Madrid, Spain

Estadísticas

Siga este enlace para acceder al texto completo del artículo

Original breve
Weather conditions may worsen symptoms in rheumatoid arthritis patients: The possible effect of temperature
Influencia de las condiciones climáticas en el empeoramiento de los síntomas de artritis reumatoide: El posible efecto de la temperatura
Lydia Abasoloa, Aurelio Tobíasb, Leticia Leona,c,
Autor para correspondencia
lleon.hcsc@salud.madrid.org

Corresponding author.
, Loreto Carmonac, Jose Luis Fernandez-Ruedaa, Ana Belen Rodriguezd, Benjamin Fernandez-Gutierrezd, Juan Angel Joverd
a Rheumatology Unit, Fundación para la Investigación Biomédica, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos, Madrid, Spain
b Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain
c Camilo José Cela University, Madrid, Spain
d Rheumatology Unit, Hospital Clínico San Carlos, Madrid, Spain
Leído
12041
Veces
se ha leído el artículo
3366
Total PDF
8675
Total HTML
Compartir estadísticas
 array:24 [
  "pii" => "S1699258X12002677"
  "issn" => "1699258X"
  "doi" => "10.1016/j.reuma.2012.09.006"
  "estado" => "S300"
  "fechaPublicacion" => "2013-07-01"
  "aid" => "513"
  "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;. All rights reserved"
  "copyrightAnyo" => "2012"
  "documento" => "article"
  "crossmark" => 0
  "subdocumento" => "sco"
  "cita" => "Reumatol Clin. 2013;9:226-8"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 4887
    "formatos" => array:3 [
      "EPUB" => 152
      "HTML" => 3529
      "PDF" => 1206
    ]
  ]
  "Traduccion" => array:1 [
    "en" => array:19 [
      "pii" => "S2173574313000282"
      "issn" => "21735743"
      "doi" => "10.1016/j.reumae.2013.03.002"
      "estado" => "S300"
      "fechaPublicacion" => "2013-07-01"
      "aid" => "513"
      "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;"
      "documento" => "article"
      "crossmark" => 0
      "subdocumento" => "sco"
      "cita" => "Reumatol Clin. 2013;9:226-8"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:2 [
        "total" => 2924
        "formatos" => array:3 [
          "EPUB" => 51
          "HTML" => 2080
          "PDF" => 793
        ]
      ]
      "en" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original breve</span>"
        "titulo" => "Weather conditions may worsen symptoms in rheumatoid arthritis patients&#58; The possible effect of temperature"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "tieneResumen" => array:2 [
          0 => "en"
          1 => "es"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "226"
            "paginaFinal" => "228"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "es" => array:1 [
            "titulo" => "Influencia de las condiciones clim&#225;ticas en el empeoramiento de los s&#237;ntomas de artritis reumatoide&#58; El posible efecto de la temperatura"
          ]
        ]
        "contieneResumen" => array:2 [
          "en" => true
          "es" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Fig&#46; 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1750
                "Ancho" => 2389
                "Tamanyo" => 194542
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Graphical representation of the non-parametric adjustment of the relationship between daily RA worsening and daily mean temperature&#44; by age group&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Lydia Abasolo, Aurelio Tob&#237;as, Leticia Leon, Loreto Carmona, Jose Luis Fernandez-Rueda, Ana Belen Rodriguez, Benjamin Fernandez-Gutierrez, Juan Angel Jover"
            "autores" => array:8 [
              0 => array:2 [
                "nombre" => "Lydia"
                "apellidos" => "Abasolo"
              ]
              1 => array:2 [
                "nombre" => "Aurelio"
                "apellidos" => "Tob&#237;as"
              ]
              2 => array:2 [
                "nombre" => "Leticia"
                "apellidos" => "Leon"
              ]
              3 => array:2 [
                "nombre" => "Loreto"
                "apellidos" => "Carmona"
              ]
              4 => array:2 [
                "nombre" => "Jose Luis"
                "apellidos" => "Fernandez-Rueda"
              ]
              5 => array:2 [
                "nombre" => "Ana Belen"
                "apellidos" => "Rodriguez"
              ]
              6 => array:2 [
                "nombre" => "Benjamin"
                "apellidos" => "Fernandez-Gutierrez"
              ]
              7 => array:2 [
                "nombre" => "Juan Angel"
                "apellidos" => "Jover"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S1699258X12002677"
          "doi" => "10.1016/j.reuma.2012.09.006"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X12002677?idApp=UINPBA00004M"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574313000282?idApp=UINPBA00004M"
      "url" => "/21735743/0000000900000004/v1_201307160008/S2173574313000282/v1_201307160008/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S1699258X12001799"
    "issn" => "1699258X"
    "doi" => "10.1016/j.reuma.2012.06.008"
    "estado" => "S300"
    "fechaPublicacion" => "2013-07-01"
    "aid" => "482"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "ssu"
    "cita" => "Reumatol Clin. 2013;9:229-38"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 65219
      "formatos" => array:3 [
        "EPUB" => 179
        "HTML" => 61720
        "PDF" => 3320
      ]
    ]
    "es" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Revisi&#243;n</span>"
      "titulo" => "Microbios y articulaciones&#58; la relaci&#243;n entre infecci&#243;n y articulaciones"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "229"
          "paginaFinal" => "238"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Of bugs and joints&#58; The relationship between infection and joints"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figura 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1448
              "Ancho" => 1256
              "Tamanyo" => 158526
            ]
          ]
          "descripcion" => array:1 [
            "es" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Manifestaciones cl&#237;nicas de la artritis reactiva&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Luis R&#46; Espinoza, Ignacio Garc&#237;a-Valladares"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "Luis R&#46;"
              "apellidos" => "Espinoza"
            ]
            1 => array:2 [
              "nombre" => "Ignacio"
              "apellidos" => "Garc&#237;a-Valladares"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2173574312001608"
        "doi" => "10.1016/j.reumae.2012.10.004"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574312001608?idApp=UINPBA00004M"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X12001799?idApp=UINPBA00004M"
    "url" => "/1699258X/0000000900000004/v2_201309261323/S1699258X12001799/v2_201309261323/es/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1699258X13000065"
    "issn" => "1699258X"
    "doi" => "10.1016/j.reuma.2012.09.008"
    "estado" => "S300"
    "fechaPublicacion" => "2013-07-01"
    "aid" => "520"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Reumatol Clin. 2013;9:221-5"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 8368
      "formatos" => array:3 [
        "EPUB" => 139
        "HTML" => 6296
        "PDF" => 1933
      ]
    ]
    "es" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
      "titulo" => "Diferente expresi&#243;n cl&#237;nica de los pacientes con espondilitis anquilosante seg&#250;n el sexo en funci&#243;n del tiempo de evoluci&#243;n&#46; Datos de REGISPONSER"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "221"
          "paginaFinal" => "225"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Different clinical expression of patients with ankylosing spondylitis according to gender in relation to time since onset of disease&#46; Data from REGISPONSER"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Rafaela Ortega Castro, Pilar Font Ugalde, M&#46; Carmen Castro Villegas, Jerusal&#233;n Calvo Guti&#233;rrez, Elisa Mu&#241;oz Gomariz, Pedro Zarco Montejo, Raquel Almod&#243;var, Juan Mulero Mendoza, Juan Carlos Torre-Alonso, Jordi Gratac&#243;s Masmitj&#225;, Xavier Juanola Roura, Rafael Ariza Ariza, Pilar Fern&#225;ndez Dapica, Luis Francisco Linares Ferrando, M&#46; Elia Brito Brito, Eduardo Cuende Quintana, Carlos V&#225;zquez Galeano, Manuel Jos&#233; Moreno Ramos, Eugenio Gim&#233;nez &#218;beda, Jos&#233; Carlos Rodr&#237;guez Lozano, Manuel Fern&#225;ndez Prada, Rub&#233;n Queiro Silva, Estefan&#237;a Moreno Ruzafa, Enrique J&#250;dez Navarro, Antonio Juan M&#225;s, Cristina Medrano Le Quement, Enrique Ornilla, Carlos Montilla Morales, Manuel Pujol Busquets, Teresa Clavaguera Poch, M&#46; Cruz Fern&#225;ndez-Espartero, Loreto Carmona Ortell, Eduardo Collantes Est&#233;vez"
          "autores" => array:33 [
            0 => array:2 [
              "nombre" => "Rafaela"
              "apellidos" => "Ortega Castro"
            ]
            1 => array:2 [
              "nombre" => "Pilar"
              "apellidos" => "Font Ugalde"
            ]
            2 => array:2 [
              "nombre" => "M&#46; Carmen"
              "apellidos" => "Castro Villegas"
            ]
            3 => array:2 [
              "nombre" => "Jerusal&#233;n"
              "apellidos" => "Calvo Guti&#233;rrez"
            ]
            4 => array:2 [
              "nombre" => "Elisa"
              "apellidos" => "Mu&#241;oz Gomariz"
            ]
            5 => array:2 [
              "nombre" => "Pedro"
              "apellidos" => "Zarco Montejo"
            ]
            6 => array:2 [
              "nombre" => "Raquel"
              "apellidos" => "Almod&#243;var"
            ]
            7 => array:2 [
              "nombre" => "Juan"
              "apellidos" => "Mulero Mendoza"
            ]
            8 => array:2 [
              "nombre" => "Juan Carlos"
              "apellidos" => "Torre-Alonso"
            ]
            9 => array:2 [
              "nombre" => "Jordi"
              "apellidos" => "Gratac&#243;s Masmitj&#225;"
            ]
            10 => array:2 [
              "nombre" => "Xavier"
              "apellidos" => "Juanola Roura"
            ]
            11 => array:2 [
              "nombre" => "Rafael"
              "apellidos" => "Ariza Ariza"
            ]
            12 => array:2 [
              "nombre" => "Pilar"
              "apellidos" => "Fern&#225;ndez Dapica"
            ]
            13 => array:2 [
              "nombre" => "Luis Francisco"
              "apellidos" => "Linares Ferrando"
            ]
            14 => array:2 [
              "nombre" => "M&#46; Elia"
              "apellidos" => "Brito Brito"
            ]
            15 => array:2 [
              "nombre" => "Eduardo"
              "apellidos" => "Cuende Quintana"
            ]
            16 => array:2 [
              "nombre" => "Carlos"
              "apellidos" => "V&#225;zquez Galeano"
            ]
            17 => array:2 [
              "nombre" => "Manuel Jos&#233;"
              "apellidos" => "Moreno Ramos"
            ]
            18 => array:2 [
              "nombre" => "Eugenio"
              "apellidos" => "Gim&#233;nez &#218;beda"
            ]
            19 => array:2 [
              "nombre" => "Jos&#233; Carlos"
              "apellidos" => "Rodr&#237;guez Lozano"
            ]
            20 => array:2 [
              "nombre" => "Manuel"
              "apellidos" => "Fern&#225;ndez Prada"
            ]
            21 => array:2 [
              "nombre" => "Rub&#233;n"
              "apellidos" => "Queiro Silva"
            ]
            22 => array:2 [
              "nombre" => "Estefan&#237;a"
              "apellidos" => "Moreno Ruzafa"
            ]
            23 => array:2 [
              "nombre" => "Enrique"
              "apellidos" => "J&#250;dez Navarro"
            ]
            24 => array:2 [
              "nombre" => "Antonio Juan"
              "apellidos" => "M&#225;s"
            ]
            25 => array:2 [
              "nombre" => "Cristina"
              "apellidos" => "Medrano Le Quement"
            ]
            26 => array:2 [
              "nombre" => "Enrique"
              "apellidos" => "Ornilla"
            ]
            27 => array:2 [
              "nombre" => "Carlos"
              "apellidos" => "Montilla Morales"
            ]
            28 => array:2 [
              "nombre" => "Manuel"
              "apellidos" => "Pujol Busquets"
            ]
            29 => array:2 [
              "nombre" => "Teresa"
              "apellidos" => "Clavaguera Poch"
            ]
            30 => array:2 [
              "nombre" => "M&#46; Cruz"
              "apellidos" => "Fern&#225;ndez-Espartero"
            ]
            31 => array:2 [
              "nombre" => "Loreto"
              "apellidos" => "Carmona Ortell"
            ]
            32 => array:2 [
              "nombre" => "Eduardo"
              "apellidos" => "Collantes Est&#233;vez"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2173574313000476"
        "doi" => "10.1016/j.reumae.2012.09.004"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574313000476?idApp=UINPBA00004M"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X13000065?idApp=UINPBA00004M"
    "url" => "/1699258X/0000000900000004/v2_201309261323/S1699258X13000065/v2_201309261323/es/main.assets"
  ]
  "en" => array:19 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original breve</span>"
    "titulo" => "Weather conditions may worsen symptoms in rheumatoid arthritis patients&#58; The possible effect of temperature"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "226"
        "paginaFinal" => "228"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Lydia Abasolo, Aurelio Tob&#237;as, Leticia Leon, Loreto Carmona, Jose Luis Fernandez-Rueda, Ana Belen Rodriguez, Benjamin Fernandez-Gutierrez, Juan Angel Jover"
        "autores" => array:8 [
          0 => array:3 [
            "nombre" => "Lydia"
            "apellidos" => "Abasolo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Aurelio"
            "apellidos" => "Tob&#237;as"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:4 [
            "nombre" => "Leticia"
            "apellidos" => "Leon"
            "email" => array:1 [
              0 => "lleon&#46;hcsc&#64;salud&#46;madrid&#46;org"
            ]
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">¿</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Loreto"
            "apellidos" => "Carmona"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Jose Luis"
            "apellidos" => "Fernandez-Rueda"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Ana Belen"
            "apellidos" => "Rodriguez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "Benjamin"
            "apellidos" => "Fernandez-Gutierrez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
          7 => array:3 [
            "nombre" => "Juan Angel"
            "apellidos" => "Jover"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:4 [
          0 => array:3 [
            "entidad" => "Rheumatology Unit&#44; Fundaci&#243;n para la Investigaci&#243;n Biom&#233;dica&#44; Instituto de Investigaci&#243;n Sanitaria&#44; Hospital Cl&#237;nico San Carlos&#44; Madrid&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Institute of Environmental Assessment and Water Research &#40;IDAEA&#41;&#44; Spanish Council for Scientific Research &#40;CSIC&#41;&#44; Barcelona&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Camilo Jos&#233; Cela University&#44; Madrid&#44; Spain"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Rheumatology Unit&#44; Hospital Cl&#237;nico San Carlos&#44; Madrid&#44; Spain"
            "etiqueta" => "d"
            "identificador" => "aff0020"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Influencia de las condiciones clim&#225;ticas en el empeoramiento de los s&#237;ntomas de artritis reumatoide&#58; El posible efecto de la temperatura"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1750
            "Ancho" => 2382
            "Tamanyo" => 180367
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Graphical representation of the non-parametric adjustment of the relationship between daily RA worsening and daily mean temperature&#44; by age group&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Patients with rheumatic conditions often complain that certain meteorological conditions aggravate their disease symptoms&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;3</span></a> However&#44; studies on influence of weather conditions<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;3&#8211;8</span></a> have reported conflicting results&#44; most related to rheumatoid arthritis patients &#40;RA&#41;&#46; Some studies indicated that weather conditions do not influence the symptoms of arthritis&#44;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;3</span></a> whereas others found an influence related to low temperature&#44; high atmospheric pressure&#44; and high humidity&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;4&#44;9</span></a> Moreover&#44; some authors found a seasonal effect<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;7</span></a> but others did not&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;8</span></a> Thus&#44; scientific evidence on the effects of atmospheric factors on rheumatic diseases is sparse and non-conclusive&#46; Discrepancies could be related to the diverse climatic conditions from each geographic area studied and also due to the different methodologies used&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">To our knowledge no study has previously been conducted in our setting for these rheumatic disorders&#46; Our objective is to investigate the short-term effects of weather conditions on the acute worsening in rheumatic patients due to RA related conditions and also to determine possible seasonal fluctuations&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Methods</span><p id="par0015" class="elsevierStylePara elsevierViewall">This study was conducted in the city of Madrid&#44; Spain&#44; with a Mediterranean continental climate very influenced by urban conditions&#46; Winters are cold&#44; with mean temperatures below 10<span class="elsevierStyleHsp" style=""></span>&#176;C with frequent frosts at night and occasional snowfalls&#46; Summers are warm with mean temperatures over 20<span class="elsevierStyleHsp" style=""></span>&#176;C&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Daily cases of RA worsening&#44; were defined as those patients who come to the emergency room&#44; were attended by a rheumatologist of Hospital Cl&#237;nico San Carlos&#44; and were diagnosed with RA as the main cause reflected in the ICD code &#40;10th revision&#41;&#44; from 1st January 2004 until 31st December 2007&#46; The Hospital Cl&#237;nico San Carlos is a tertiary hospital&#44; covering a population over 500&#44;000 inhabitants&#46; For all cases we also collected age&#44; gender&#44; and disability index&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The study was approved by the HCSC Ethics Committee&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">As weather conditions we measured&#58; Daily mean&#44; maximum and minimum temperatures &#40;in &#176;C&#41;&#44; relative humidity &#40;&#37;&#41;&#44; pressure &#40;hPA&#41;&#44; rain &#40;mm&#41;&#44; hours of sun&#44; and cloud cover &#40;octas&#41; were obtained from the European Climate Assessment &#38; Dataset &#40;ECA&#38;D&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The association of weather conditions with daily RA worsening was investigated using a case-crossover design&#44;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> which uses the day on which the RA aggravation occurs as a case day&#46; Exposure on case days is compared with exposure on days on which the RA worsening does not occur &#40;control days&#41;&#46; A time-stratified approach was selecting control days from the same day of the week&#44; month&#44; and year as case days&#46; This minimise bias from time-trends and other time-varying confounders&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> Short-term effects of weather variables on daily cases&#44; from the same day up to one-week lag&#44; were estimated using conditional logistic regression&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Results</span><p id="par0040" class="elsevierStylePara elsevierViewall">A total of 245 patients with 306 RA visits to the emergency room due to RA as the main diagnostic reason during the study period were included&#46; Most were women &#40;71&#37;&#41;&#44; with a mean age of 63&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16&#46;4 years&#46; Two thirds were attended at least twice in the emergency room due to RA worsening&#44; with some level of disability &#40;90&#37; with a Rosser index less than 0&#46;990&#41;&#46; During the study period weather conditions were on average&#58; 14&#46;6<span class="elsevierStyleHsp" style=""></span>&#176;C of temperature &#40;ranging from &#8722;5 to 39&#41;&#44; 54&#37; of relative humidity &#40;15&#8211;96&#41;&#44; 1&#46;018<span class="elsevierStyleHsp" style=""></span>hPA of pressure &#40;904&#8211;1408&#41;&#44; 111<span class="elsevierStyleHsp" style=""></span>mm of rain &#40;0&#8211;420&#41;&#44; 8&#46;3<span class="elsevierStyleHsp" style=""></span>h of sun &#40;1&#8211;14&#41;&#44; and 3&#46;2 octas of cloud cover &#40;0&#8211;8&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Statistical significant &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41; association with RA worsening was only found for daily mean temperature&#44; with a lagged effect of 1 day&#44; in middle age patients from 50 to 65 years old &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; These were 16&#37; more likely to present symptomatic deterioration of RA&#44; with lower mean temperature &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;86&#44; 95&#37; CI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#91;0&#46;78&#8211;0&#46;96&#93; for an increase of 1<span class="elsevierStyleHsp" style=""></span>&#176;C&#41;&#46; Both&#44; men and women&#44; showed similar risk estimates with mean temperature&#46; No other weather conditions were statistically associated with the need of RA patients to bee attended in the emergency room due to RA related conditions&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">To evaluate seasonal variations mean temperature was fitted in the conditional logistic regression model using a cubic spline&#44; with 3 degrees of freedom &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Significant effects were only found in the most extreme ranges of mean temperature for middle age people&#44; being 15&#37; and 20&#37; more likely of RA worsening with mean temperatures below 10<span class="elsevierStyleHsp" style=""></span>&#176;C &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;83&#44; 95&#37; CI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#91;0&#46;69&#8211;0&#46;99&#93;&#41; and above 20<span class="elsevierStyleHsp" style=""></span>&#176;C &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;82&#44; 95&#37; CI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#91;0&#46;66&#8211;0&#46;99&#93;&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discussion</span><p id="par0055" class="elsevierStylePara elsevierViewall">There is a popular belief that rheumatic conditions are particularly sensitive to fluctuations of weather&#46; We have found associations with meteorological conditions &#40;specifically with temperature&#41;&#44; and RA related problems in the subgroup of middle age patients&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The failure to find associations with other age groups could be explained because age itself is a risk factor for disability&#44; thus elderly could have in general more difficulty to go to the emergency room by themselves&#46; Moreover&#44; rheumatic pain is frequently considered to be a natural part of the aging process&#46; Otherwise&#44; the younger may have problems to miss work using other ways rather than emergency room to control their RA symptoms&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Previous studies in similar settings have also found that mean temperature is related with rheumatic disorders&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;4&#44;9</span></a> Nevertheless&#44; we did not find associations with other weather variables&#44; as atmospheric pressure or relative humidity&#44; probably due to Madrid has a Mediterranean continental climate much dryer and less humid than other cities studied&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;4&#44;9</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">We found that the strongest effects of daily mean temperature on RA worsening were found below 10<span class="elsevierStyleHsp" style=""></span>&#176;C and above 20<span class="elsevierStyleHsp" style=""></span>&#176;C&#44; meanwhile no statistical association was observed between 10 and 20<span class="elsevierStyleHsp" style=""></span>&#176;C&#46; This could reflect the possible seasonal distribution of RA symptomatic deterioration with higher incidence in winter and summer&#46; Additionally&#44; between 10 and 20<span class="elsevierStyleHsp" style=""></span>&#176;C the thermal sensation and small changes probably are better tolerated than in the others&#44; where we subjectively feel cooler or warmer&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">It is important to note that in our setting&#44; RA patients receive long-term monitoring&#44; with self-education in the management of pain and small flares&#46; They are encourage to contact us when they have some kind of medical problem&#44; either by telephone or by medical appointments in 24&#8211;48<span class="elsevierStyleHsp" style=""></span>h&#46; When they have the need to go to the emergency room is often a due to a disabling pain or significant inflammatory activity&#46; With the data available we cannot specify the main cause of RA symptomatic deterioration&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">The main contribution of our study is the methodological approach using a case-crossover design&#44; a common study design to assess for short-term effects of environmental factors on health&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">13&#44;14</span></a> Moreover&#44; our RA patients were well represented&#44; 70&#37; women in their sixties&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">The explanation of the influence of temperature on rheumatic diseases is not clear enough&#46; It is known that cold unleash some diseases such as Raynaud phenomenon or crioglobulinemia&#44; both closely related to rheumatic diseases&#46; Maybe muscles also play a role in relation to flares or pain in RA patients and cold weather&#44; due to coldness stiffens muscles around the joints&#44; and this might worsen the arthritis symptoms&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">In conclusion&#44; our results support that weather conditions&#44; essentially daily mean temperature&#44; may be influencing in RA patients&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Ethical considerations</span><p id="par0095" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Protection of human and animal subjects</span>&#46; The authors declare that the procedures followed were in accordance with the regulations of the responsible Clinical Research Ethics Committee and in accordance with those of the World Medical Association and the Helsinki Declaration&#46;<span class="elsevierStyleVsp" style="height:0.5px"></span><span class="elsevierStyleBold">Confidentiality of data</span>&#46; The authors declare that they have followed the protocols of their work centre on the publication of patient data and that all the patients included in the study have received sufficient information and have given their informed consent in writing to participate in that study&#46;<span class="elsevierStyleVsp" style="height:0.5px"></span><span class="elsevierStyleBold">Right to privacy and informed consent</span>&#46; The authors declare that no patient data appears in this article&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflict of interest</span><p id="par0100" class="elsevierStylePara elsevierViewall">Authors declare that they have no conflict of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:11 [
        0 => array:2 [
          "identificador" => "xres276965"
          "titulo" => array:5 [
            0 => "Abstract"
            1 => "Objective"
            2 => "Methods"
            3 => "Results"
            4 => "Conclusions"
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec258848"
          "titulo" => "Keywords"
        ]
        2 => array:2 [
          "identificador" => "xres276966"
          "titulo" => array:5 [
            0 => "Resumen"
            1 => "Objetivo"
            2 => "M&#233;todos"
            3 => "Resultados"
            4 => "Conclusiones"
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec258847"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Methods"
        ]
        6 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Results"
        ]
        7 => array:2 [
          "identificador" => "sec0020"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0025"
          "titulo" => "Ethical considerations"
        ]
        9 => array:2 [
          "identificador" => "sec0030"
          "titulo" => "Conflict of interest"
        ]
        10 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2012-05-29"
    "fechaAceptado" => "2012-09-12"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec258848"
          "palabras" => array:3 [
            0 => "Weather conditions"
            1 => "Rheumatoid arthritis"
            2 => "Temperature"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec258847"
          "palabras" => array:3 [
            0 => "Condiciones meteorol&#243;gicas"
            1 => "Artritis reumatoide"
            2 => "Temperatura"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Patients with rheumatoid arthritis &#40;RA&#41; complain that weather conditions aggravate their symptoms&#46; We investigated the short-term effects of weather conditions on worsening of RA and determined possible seasonal fluctuations&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">We conducted a case-crossover study in Madrid&#44; Spain&#46; Daily cases of RA flares were collected from the emergency room of a tertiary level hospital between 2004 and 2007&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">245 RA patients who visited the emergency room 306 times due to RA related complaints as the main diagnostic reason were included in the study&#46; Patients from 50 to 65 years old were 16&#37; more likely to present a flare with lower mean temperatures&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Our results support the belief that weather influences rheumatic pain in middle aged patients&#46;</p>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Los pacientes con artritis reumatoide &#40;AR&#41; se quejan de que las condiciones meteorol&#243;gicas empeoran sus s&#237;ntomas&#46; Este estudio trata de ver los efectos a corto plazo de las condiciones clim&#225;ticas en empeoramiento sintom&#225;tico en pacientes con AR y determinar posibles fluctuaciones estacionales&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Se realiz&#243; un estudio de casos cruzados en Madrid&#44; Espa&#241;a&#46; Los casos diarios de empeoramiento de la AR se obtuvieron de la sala de urgencias de un hospital terciario entre 2004 y 2007&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">245 pacientes con AR con 306 visitas a urgencias con AR como diagnostico principal se incluyeron en el estudio&#46; Los pacientes de 50 a 65 a&#241;os tuvieron un 16&#37; m&#225;s de probabilidades de presentar empeoramiento sintom&#225;tico de la AR con una menor temperatura media&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Nuestros resultados apoyan la creencia de que el clima influye en el dolor reum&#225;tico de los pacientes con mediana edad&#46;</p>"
      ]
    ]
    "multimedia" => array:2 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1750
            "Ancho" => 2382
            "Tamanyo" => 180367
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Graphical representation of the non-parametric adjustment of the relationship between daily RA worsening and daily mean temperature&#44; by age group&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">n</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">OR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">95&#37; CI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Age group</span></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#60;50 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;20&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;999&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;0&#46;909&#8211;1&#46;098&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;986&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>50&#8211;65 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;23&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;868&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;0&#46;783&#8211;0&#46;962&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#62;65 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">173&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;56&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;035&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;0&#46;979&#8211;1&#46;095&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;223&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Total</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">306&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;993&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;0&#46;952&#8211;1&#46;037&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;776&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab398802.png"
              ]
            ]
          ]
          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "&#42;"
              "nota" => "<p class="elsevierStyleNotepara">Number of AR cases&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Odds ratio &#40;OR&#41;&#44; and 95&#37; confidence interval &#40;95&#37; CI&#41;&#44; of daily RA worsening for an increase of 1<span class="elsevierStyleHsp" style=""></span>&#176;C of daily mean temperature &#40;for a 1-day lag&#41;&#44; by age group&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:15 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Weather effects in rheumatoid arthritis&#58; from controversy to consensus&#46; A review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "W&#46;R&#46; Patberg"
                            1 => "J&#46;J&#46; Rasker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Rheumatol"
                        "fecha" => "2004"
                        "volumen" => "31"
                        "paginaInicial" => "1327"
                        "paginaFinal" => "1334"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15229951"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Does the weather really matter&#63; A cohort study of influences of weather and solar conditions on daily variations of joint pain in patients with rheumatoid arthritis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "G&#46; Smedslund"
                            1 => "P&#46; Mowinckel"
                            2 => "T&#46; Heiberg"
                            3 => "T&#46;K&#46; Kvien"
                            4 => "K&#46;B&#46; Hagen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/art.24729"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arthritis Rheum"
                        "fecha" => "2009"
                        "volumen" => "61"
                        "paginaInicial" => "1243"
                        "paginaFinal" => "1247"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19714599"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rheumatoid arthritis patients show weather sensitivity in daily life&#44; but the relationship is not clinically significant"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;A&#46; Gorin"
                            1 => "J&#46;M&#46; Smyth"
                            2 => "J&#46;N&#46; Weisberg"
                            3 => "G&#46; Affleck"
                            4 => "H&#46; Tennen"
                            5 => "S&#46; Urrows"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pain"
                        "fecha" => "1999"
                        "volumen" => "81"
                        "paginaInicial" => "173"
                        "paginaFinal" => "177"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10353505"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Weather conditions can influence rheumatic diseases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Verges"
                            1 => "E&#46; Montell"
                            2 => "E&#46; Tomas"
                            3 => "G&#46; Cumelles"
                            4 => "G&#46; Castaneda"
                            5 => "N&#46; Marti"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Proc West Pharmacol Soc"
                        "fecha" => "2004"
                        "volumen" => "47"
                        "paginaInicial" => "134"
                        "paginaFinal" => "136"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15633634"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Seasonal symptom severity in patients with rheumatic diseases&#58; a study of 1&#44;424 patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "D&#46;J&#46; Hawley"
                            1 => "F&#46; Wolfe"
                            2 => "F&#46;A&#46; Lue"
                            3 => "H&#46; Moldofsky"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Rheumatol"
                        "fecha" => "2001"
                        "volumen" => "28"
                        "paginaInicial" => "1900"
                        "paginaFinal" => "1909"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11508598"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Seasonal distribution of relapse onset in rheumatoid arthritis and spondyloarthropathy&#58; the possible effect of the solar factor"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Rozin"
                            1 => "A&#46; Balbir-Gurman"
                            2 => "D&#46; Schapira"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Exp Rheumatol"
                        "fecha" => "2003"
                        "volumen" => "21"
                        "paginaInicial" => "161"
                        "paginaFinal" => "169"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12747269"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "What&#39;s in season for rheumatoid arthritis patients&#63; Seasonal fluctuations in disease activity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46; Iikuni"
                            1 => "A&#46; Nakajima"
                            2 => "E&#46; Inoue"
                            3 => "E&#46; Tanaka"
                            4 => "H&#46; Okamoto"
                            5 => "M&#46; Hara"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rheumatology &#40;Oxford&#41;"
                        "fecha" => "2007"
                        "volumen" => "46"
                        "paginaInicial" => "846"
                        "paginaFinal" => "848"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Annual fluctuations in rheumatoid arthritis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "N&#46;S&#46; Latman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Rheumatol"
                        "fecha" => "1981"
                        "volumen" => "8"
                        "paginaInicial" => "725"
                        "paginaFinal" => "729"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7310773"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Influence of weather conditions on rheumatic pain"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "I&#46; Strusberg"
                            1 => "R&#46;C&#46; Mendelberg"
                            2 => "H&#46;A&#46; Serra"
                            3 => "A&#46;M&#46; Strusberg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Rheumatol"
                        "fecha" => "2002"
                        "volumen" => "29"
                        "paginaInicial" => "335"
                        "paginaFinal" => "338"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11838853"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The measurement of hospital output"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46;M&#46; Rosser"
                            1 => "V&#46;C&#46; Watts"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Epidemiol"
                        "fecha" => "1972"
                        "volumen" => "1"
                        "paginaInicial" => "361"
                        "paginaFinal" => "368"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4669084"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Updated and extended European dataset of dialy climate observations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "E&#46;J&#46; Klok"
                            1 => "A&#46;M&#46;G&#46; Klein Tank"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Int J Climatol"
                        "fecha" => "2009"
                        "volumen" => "29"
                        "paginaInicial" => "1182"
                        "paginaFinal" => "1191"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The case-crossover design&#58; a method for studying transient effects on the risk of acute events"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46; Maclure"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Epidemiol"
                        "fecha" => "1991"
                        "volumen" => "133"
                        "paginaInicial" => "144"
                        "paginaFinal" => "153"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1985444"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Case-crossover analyses of air pollution exposure data&#58; referent selection strategies and their implications for bias"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "H&#46; Janes"
                            1 => "L&#46; Sheppard"
                            2 => "T&#46; Lumley"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Epidemiology"
                        "fecha" => "2005"
                        "volumen" => "16"
                        "paginaInicial" => "717"
                        "paginaFinal" => "726"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16222160"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An introduction to epidemiologic and statistical methods useful in environmental epidemiology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H&#46; Nitta"
                            1 => "S&#46; Yamazaki"
                            2 => "T&#46; Omori"
                            3 => "T&#46; Sato"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Epidemiol"
                        "fecha" => "2010"
                        "volumen" => "20"
                        "paginaInicial" => "177"
                        "paginaFinal" => "184"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20431236"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rheumatoid arthritis in Spain&#58; occurrence of extra-articular manifestations and estimates of disease severity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "L&#46; Carmona"
                            1 => "I&#46; Gonzalez-Alvaro"
                            2 => "A&#46; Balsa"
                            3 => "M&#46; Angel Belmonte"
                            4 => "X&#46; Tena"
                            5 => "R&#46; Sanmart&#237;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Rheum Dis"
                        "fecha" => "2003"
                        "volumen" => "62"
                        "paginaInicial" => "897"
                        "paginaFinal" => "900"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12922967"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/1699258X/0000000900000004/v2_201309261323/S1699258X12002677/v2_201309261323/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "17499"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Originales"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/1699258X/0000000900000004/v2_201309261323/S1699258X12002677/v2_201309261323/en/main.pdf?idApp=UINPBA00004M&text.app=https://www.reumatologiaclinica.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X12002677?idApp=UINPBA00004M"
]
Información del artículo
ISSN: 1699258X
Idioma original: Inglés
Datos actualizados diariamente
año/Mes Html Pdf Total
2024 Octubre 43 16 59
2024 Septiembre 121 26 147
2024 Agosto 117 43 160
2024 Julio 82 35 117
2024 Junio 111 76 187
2024 Mayo 104 52 156
2024 Abril 76 28 104
2024 Marzo 100 37 137
2024 Febrero 98 30 128
2024 Enero 84 25 109
2023 Diciembre 98 36 134
2023 Noviembre 100 64 164
2023 Octubre 97 38 135
2023 Septiembre 129 41 170
2023 Agosto 84 18 102
2023 Julio 77 31 108
2023 Junio 66 21 87
2023 Mayo 80 28 108
2023 Abril 57 23 80
2023 Marzo 115 32 147
2023 Febrero 64 34 98
2023 Enero 77 24 101
2022 Diciembre 114 22 136
2022 Noviembre 86 42 128
2022 Octubre 83 45 128
2022 Septiembre 76 35 111
2022 Agosto 76 85 161
2022 Julio 83 83 166
2022 Junio 74 39 113
2022 Mayo 113 59 172
2022 Abril 111 58 169
2022 Marzo 105 59 164
2022 Febrero 68 49 117
2022 Enero 61 42 103
2021 Diciembre 91 60 151
2021 Noviembre 102 47 149
2021 Octubre 90 58 148
2021 Septiembre 51 49 100
2021 Agosto 58 52 110
2021 Julio 43 46 89
2021 Junio 80 48 128
2021 Mayo 64 42 106
2021 Abril 238 74 312
2021 Marzo 82 35 117
2021 Febrero 50 24 74
2021 Enero 58 22 80
2020 Diciembre 45 14 59
2020 Noviembre 278 20 298
2020 Octubre 277 20 297
2020 Septiembre 82 39 121
2020 Agosto 88 20 108
2020 Julio 53 18 71
2020 Junio 45 27 72
2020 Mayo 52 22 74
2020 Abril 74 12 86
2020 Marzo 85 28 113
2020 Febrero 76 24 100
2020 Enero 53 25 78
2019 Diciembre 54 32 86
2019 Noviembre 27 17 44
2019 Octubre 65 20 85
2019 Septiembre 51 33 84
2019 Agosto 67 44 111
2019 Julio 60 14 74
2019 Junio 45 20 65
2019 Mayo 67 50 117
2019 Abril 59 16 75
2019 Marzo 48 22 70
2019 Febrero 39 14 53
2019 Enero 58 26 84
2018 Diciembre 99 50 149
2018 Noviembre 115 13 128
2018 Octubre 106 9 115
2018 Septiembre 37 9 46
2018 Agosto 33 9 42
2018 Julio 16 6 22
2018 Mayo 4 0 4
2018 Abril 34 9 43
2018 Marzo 99 5 104
2018 Febrero 24 6 30
2018 Enero 25 9 34
2017 Diciembre 36 9 45
2017 Noviembre 27 7 34
2017 Octubre 23 11 34
2017 Septiembre 22 8 30
2017 Agosto 28 20 48
2017 Julio 27 23 50
2017 Junio 50 23 73
2017 Mayo 51 17 68
2017 Abril 27 11 38
2017 Marzo 34 53 87
2017 Febrero 30 10 40
2017 Enero 34 21 55
2016 Diciembre 59 23 82
2016 Noviembre 57 20 77
2016 Octubre 60 20 80
2016 Septiembre 58 19 77
2016 Agosto 35 15 50
2016 Julio 17 8 25
2016 Mayo 0 22 22
2016 Febrero 1 28 29
2016 Enero 2 0 2
2015 Diciembre 2 0 2
2015 Octubre 1 25 26
2015 Septiembre 3 0 3
2015 Agosto 3 0 3
2015 Julio 30 5 35
2015 Junio 51 9 60
2015 Mayo 63 22 85
2015 Abril 56 13 69
2015 Marzo 56 19 75
2015 Febrero 55 0 55
2015 Enero 55 0 55
2014 Diciembre 31 0 31
2014 Noviembre 45 0 45
2014 Octubre 63 0 63
2014 Septiembre 52 0 52
2014 Agosto 55 0 55
2014 Julio 52 0 52
2014 Junio 70 0 70
2014 Mayo 57 0 57
2014 Abril 56 0 56
2014 Marzo 65 13 78
2014 Febrero 47 19 66
2014 Enero 44 9 53
2013 Diciembre 46 7 53
2013 Noviembre 48 8 56
2013 Octubre 64 13 77
2013 Septiembre 65 16 81
2013 Agosto 83 48 131
2013 Julio 202 137 339
Mostrar todo

Siga este enlace para acceder al texto completo del artículo

Idiomas
Reumatología Clínica
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?