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          "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Descriptive of CSU activity by visit stratified by wheals&#44; pruritus&#44; UAS and UAS7 mean scores by visit&#46;</p> <p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Wheals &#40;A&#41;&#44; pruritus &#40;B&#41;&#44; UAS &#40;C&#41; and UAS7 &#40;D&#41; mean scores by visit&#46;</p> <p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Evaluable population &#40;N&#160;&#61;&#160;176&#41;&#46;</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Mild pruritus&#58; pruritus present but not irritating or annoying&#59; moderate pruritus&#58; annoying itching but without interfering with patient&#8217;s daily activities or with patient&#8217;s sleep&#59; intense pruritus&#58; severe itching&#44; annoying enough to interfere with patient&#8217;s daily activities and with patient&#8217;s sleep&#46;</p> <p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; CSU&#44; chronic spontaneous urticaria&#59; h&#44; hours&#59; UAS&#44; Urticaria Activity Score&#59; UAS7&#44; Urticaria Activity Score over 7 days&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">INTRODUCTION</span><p id="par0005" class="elsevierStylePara elsevierViewall">Chronic urticaria &#40;CU&#41; is a cutaneous disease characterized by the presence of wheals with redness&#44; inflammation&#44; pruritus and&#44; in some cases&#44; burning and pain&#44; for at least six weeks&#44; with or without angioedema&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;3</span></a> It is estimated that between 8-20&#37; of the population is susceptible to experience at least one episode of urticaria throughout their life&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> Based on Gaig et al&#46; the prevalence of CU in Spain is 0&#46;6&#37;&#44; being twice more prevalent in women than in men&#46; The average age of onset for CU is around 40 years&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;4</span></a> CU can be classified into chronic spontaneous urticaria &#40;CSU&#59; symptoms persist &#62;6 weeks with no known specific trigger&#41; and chronic inducible urticaria &#40;CINDU&#59; induced by specific triggers&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Several studies indicate that CU negatively affects patients&#8217; quality-of-life &#40;QoL&#41;&#44; as well as work activity&#44;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2&#44;5</span></a> having a considerable impact on direct and indirect health-related costs&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> CU has no cure and therefore&#44; appropriate management of disease symptoms become crucial&#46; Current guidelines recommended non-sedating H1-antihistamines &#40;NS-H1AH&#41; at licensed doses as the first-line of treatment for CU&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> In case of non-respondent patients&#44; NS-H1AH dose could be increased up to four-fold&#46; If a third-line is needed&#44; addition of omalizumab is the recommended option&#44; followed by cyclosporine A as fourth-line of treatment &#40;when omalizumab fails&#41;&#46; The use of systemic corticosteroids can be considered for short periods in case of severe exacerbations&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;3&#44;6&#44;7</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Although guidelines provide a framework for the management of CU patients&#44; specialists&#8217; experience is the cornerstone for treatment individualization to achieve the most effective pharmacotherapy and healthcare results&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> In this regard&#44; UCREX study was designed to understand CU patients&#8217; profile&#44; clinical management&#44; CU impact in patients&#8217; QoL and healthcare resources use &#40;HRU&#41; of daily clinical practice in Spain&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">MATERIALS AND METHODS</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Study design</span><p id="par0020" class="elsevierStylePara elsevierViewall">UCREX is an observational&#44; multicenter&#44; and prospective study &#40;12 months&#41; conducted in Spain between May 31<span class="elsevierStyleSup">st</span>&#44; 2013 and January 31<span class="elsevierStyleSup">st</span>&#44; 2015&#46; 39 hospitals and 42 investigators &#40;21 dermatologists and 21 allergists&#41; participated in the study&#46; Patients were aged &#8805;18 years&#44; with <span class="elsevierStyleItalic">de novo</span> or established CSU or CINDU diagnosis&#44; and attended at allergy or dermatology services&#46; Patients with acute urticaria&#44; urticarial vasculitis or other type of physical urticaria not associated with CU or angioedema without wheals or pruritus related to cutaneous diseases or participating in any other study were excluded&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The study was structured in four visits &#40;baseline visit&#44; and at 3&#44; 6 and 12 months&#41;&#46; Basic study data was recorded by an <span class="elsevierStyleItalic">ad-hoc</span> electronic Case Report Form &#40;eCRF&#41;&#46; Patient reported outcomes &#40;PROs&#41; were recorded through physical questionnaires and transferred to the study database&#46; Data collection referred to daily clinical practice was based on clinical charts and the following completed by study questionnaires&#58; Urticaria Activity Score &#40;UAS&#41; and UAS over 7 days &#40;UAS7&#41; to assess key urticaria signs and symptoms&#59; Chronic Urticaria Quality-of-Life Questionnaire &#40;CU-Q<span class="elsevierStyleInf">2</span>oL&#41; and EuroQol-5 dimensions &#40;EQ-5D&#41; to evaluate impact on QoL&#59; Medical Outcomes Study Sleep &#40;MOS-Sleep&#41; Scale to assess disease impact on sleep quality and Hospital Anxiety and Depression Scale &#40;HADS&#41; to measure levels of hospital anxiety and depression &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">Secondary variables included&#58; sociodemographic and clinical data&#44; associated comorbidities&#44; disease management&#44; treatment patterns&#44; direct healthcare resources and PROs&#46; CU-Q<span class="elsevierStyleInf">2</span>oL and EQ-5D questionnaire was used to evaluate symptoms and impact of CU on QoL&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#8211;12</span></a> To assess disease impact on sleep quality&#44; MOS-Sleep scale was used&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">13&#44;14</span></a> The HADS questionnaire measured levels of hospital anxiety and depression&#46;<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">15&#44;16</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The main study variables were UAS and UAS7&#46; To collect the direct healthcare resources associated with CU&#44; the number of hospital admissions&#44; visits to primary care &#40;PC&#41;&#44; emergency&#44; allergology and dermatology services&#44; diagnostic tests performed before and during the study and prescribed treatments were analyzed&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Statistical methods</span><p id="par0040" class="elsevierStylePara elsevierViewall">Sample size estimation was based on a 0&#46;6&#37; CU prevalence in Spain<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> and an accuracy of 5&#46;5&#37;&#44; estimating a maximum uncertainty proportion and greater variability of 50&#37; and a confidence interval of 95&#37; and considering 5&#37; of losses&#46; An estimated 335 patients were considered as a representative sample size for the study&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Statistical analyses were carried out in evaluable patients and descriptive analyses of all variables were carried out separately&#44; using tables of absolute and relative frequencies for discrete qualitative and quantitative variables&#44; and by means of average statistics&#44; standard deviation &#40;SD&#41;&#44; extreme values &#8203;&#8203;and quartiles for continuous quantitative variables&#46; For all comparisons a statistical significance level of 0&#46;05 was considered&#46; Statistical package Statistical Analysis System &#40;SAS&#41; version 9&#46;2 or later for Windows was used&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Ethical considerations</span><p id="par0050" class="elsevierStylePara elsevierViewall">The study was carried out following the ethical principles of the Declaration of Helsinki and the guidelines specified in Order SAS&#47;3470&#47;2009 of the Spanish Agency of Medicines and Medical Devices &#40;AEMPS&#41;&#46; Protocol&#44; informed consent form and other information for the patients were approved by the reference Clinical Research Ethics Committee &#40;CEIC&#41; of Hospital del Mar &#40;IMIM of Barcelona&#41;&#44; as well as all the CEICs and autonomous communities of the participating hospitals&#44; as needed&#46; All patients signed a written informed consent before being included in the study&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">RESULTS</span><p id="par0055" class="elsevierStylePara elsevierViewall">A total of 364 CU patients were initially recruited&#46; Baseline sample was formed by 361 patients meeting all the selection criteria&#46; For primary endpoint analysis&#44; 176 patients were evaluable&#58; patients who had data on the primary endpoint &#40;UAS&#47;UAS7&#41; and who received CU treatment at 12 months visit &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Patients&#8217; profile</span><p id="par0060" class="elsevierStylePara elsevierViewall">Baseline sociodemographic and clinical characteristics of the study population are collected in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;The patients included in the study had a mean age &#40;SD&#41; of 46&#46;6 &#40;14&#46;2&#41; years&#44; were mainly female &#40;71&#46;8&#37;&#41; and 152 &#40;42&#46;1&#37;&#41; patients showed angioedema in any of the episodes&#47;outbreaks of urticaria&#46; Most patients &#40;n&#160;&#61;&#160;345&#59; 95&#46;6&#37;&#41; were diagnosed with CSU&#44; being associated to CINDU in 38&#46;6&#37; of cases&#46; Only 16 patients &#40;4&#46;4&#37;&#41; were diagnosed with CINDU &#40;not associated with CSU&#41;&#46; Among the 361 patients included in the study&#44; 199 were actively working &#40;55&#46;1&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; Within these active patients&#44; 195 &#40;98&#46;0&#37;&#41; presented absenteeism during the year prior to inclusion and 147 &#40;73&#46;9&#37;&#41; during the 12 months of the study&#44; with a mean &#40;SD&#41; of 2&#46;7 &#40;17&#46;5&#41; and 4&#46;8 &#40;37&#46;4&#41; days&#44; respectively&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Disease activity</span><p id="par0065" class="elsevierStylePara elsevierViewall">In the study&#44; 75&#46;6&#37; of the CU patients were symptomatic &#40;UAS7&#160;&#62;0&#41; at the 12-months visit despite being treated according to daily clinical practice&#46; Among patients who responded to the questionnaires &#40;N&#160;&#61;&#160;176&#41;&#44; the incidence of wheals and&#47;or pruritus was tended to reduce according to the UAS scale between baseline and the 12-months visit &#40;117 &#91;66&#46;5&#37;&#93; and 131 &#91;74&#46;4&#37;&#93; patients with wheals and pruritus&#44; respectively&#44; at baseline vs 58 &#91;33&#46;0&#37;&#93; and 80 &#91;45&#46;5&#37;&#93; patients at the 12-months visit&#44; respectively&#41;&#46; Mean &#40;SD&#41; UAS and UAS7 scores also tended to decrease throughout the study &#40;2&#46;6 &#91;2&#46;0&#93; and 14&#46;3 &#91;11&#46;0&#93; at baseline vs 1&#46;1 &#91;1&#46;5&#93; and 8&#46;6 &#91;9&#46;7&#93; at 12 months&#44; respectively&#41;&#46; Although UAS and UAS7 score reductions were related to symptom improvement&#44; the severity of the disease in these patients at the 12-months visit was categorized as moderate for 22 patients &#40;12&#46;5&#37;&#41; and as intense for seven patients &#40;4&#46;0&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Disease management</span><p id="par0070" class="elsevierStylePara elsevierViewall">Disease management of the CU patients was considered from the year prior to study inclusion until the 12-months visit&#46; During the year prior to inclusion&#44; emergency services had a mean &#40;SD&#41; of 1&#46;6 &#40;2&#46;8&#41; visits due to CU &#40;n&#160;&#61;&#160;355&#41;&#44; tended to reduce by 0&#46;3 &#40;1&#46;3&#41; during the 12 months of the study &#40;n&#160;&#61;&#160;268&#41;&#46; Hospitalization was rarely needed during the year prior to study inclusion &#40;n&#160;&#61;&#160;357&#59; mean &#91;SD&#93; of 0&#46;0 &#91;0&#46;1&#93;&#41; and during the 12 months of the study &#40;n&#160;&#61;&#160;268&#59; mean &#91;SD&#93; of 0&#46;0 &#91;0&#46;2&#93;&#41;&#46; PC was the management reference during the year prior to inclusion &#40;n&#160;&#61;&#160;340&#41;&#44; with a mean &#40;SD&#41; of 3&#46;6 &#40;6&#46;8&#41; visits &#40;vs allergology and dermatology &#91;n&#160;&#61;&#160;358 in both cases&#93;&#44; with 2&#46;4 &#91;4&#46;3&#93; and 2&#46;6 &#91;4&#46;2&#93; visits&#44; respectively&#41;&#46; CU patients were initially identified in PC centers &#40;294 patients&#44; 81&#46;9&#37;&#41; and subsequently tendency of patients being referred to dermatology services &#40;155 patients&#44; 42&#46;9&#37;&#41; was higher than allergy services &#40;139 patients&#44; 38&#46;5&#37;&#41; for diagnosis confirmation and monitoring&#46; After being referred to specialists&#44; CU patients had a mean &#40;SD&#41; average of 1&#46;7 &#40;3&#46;3&#41; follow-up visits to allergy services and 1&#46;4 &#40;2&#46;8&#41; to dermatology services per year&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Diagnostic tests were conducted in 328 &#40;95&#46;1&#37;&#41; of CSU patients&#44; being blood count the most commonly used &#40;323 patients&#44; 93&#46;6&#37;&#41;&#46; Extension tests were also performed in 286 patients &#40;82&#46;9&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; Regarding CINDU patients &#40;n&#160;&#61;&#160;16&#41;&#44; 14 patients &#40;87&#46;5&#37;&#41; had undergone diagnostic tests at inclusion&#44; and provocation tests has the tendency to be the most frequents &#40;11 patients&#44; 68&#46;8&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">Trends of dermatology and allergology specialists &#40;n&#160;&#61;&#160;164 and n&#160;&#61;&#160;189 patients&#44; respectively&#41; were detected in the routine tests of patients with CSU performed in the study&#46; At baseline visit&#44; more number of diagnostic tests were tended to be performed by allergology services &#40;n&#160;&#61;&#160;788&#44; 55&#46;3&#37;&#41; than dermatology &#40;n&#160;&#61;&#160;637&#44; 44&#46;7&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46; Among CINDU patients&#44; routine tests and provocation tests were carried out for 26 &#40;15&#46;9&#37;&#41; and 28 &#40;17&#46;1&#37;&#41; patients in dermatology services&#44; respectively&#44; and 47 &#40;24&#46;9&#37;&#41; and 26 &#40;13&#46;8&#37;&#41; patients in allergy services at baseline visit&#44; respectively&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Treatment patterns</span><p id="par0085" class="elsevierStylePara elsevierViewall">During the 1-year UCREX study in Spain&#44; NS-H1AH &#40;336 patients&#44; 47&#46;6&#37;&#41; was tended to be the most frequently prescribed treatments for CU patients &#40;n&#160;&#61;&#160;706&#41;&#44; followed by sedating H1-antihistamines &#40;S-H1AH&#41; &#40;99 patients&#44; 14&#46;0&#37;&#41;&#44; omalizumab &#40;91 patients&#44; 12&#46;9&#37;&#41; and corticosteroids &#40;80 patients&#44; 11&#46;3&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41;&#46; Omalizumab prescription was present along the 1-year UCREX study&#46; The trend of omalizumab prescriptions were mostly at the beginning of the study &#40;44 prescriptions at baseline&#41;&#44; although they also occurred in subsequent visits &#40;24&#44; 8 and 12 prescriptions at 3-&#44; 6- and 12-months visits&#44; respectively&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41;&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">CU impact on patients&#58; PROs</span><p id="par0090" class="elsevierStylePara elsevierViewall">CU patients reported a CU-Q<span class="elsevierStyleInf">2</span>oL mean score &#40;SD&#41; of 24&#46;1 &#40;17&#46;0&#41; at baseline visit &#40;n&#160;&#61;&#160;336&#41; and 13&#46;9 &#40;15&#46;0&#41; at 12-months visit &#40;n&#160;&#61;&#160;254&#41;&#44; showing pruritus as the main negative impact &#40;46&#46;4 &#40;30&#46;3&#41; and 23&#46;2 &#40;23&#46;2&#41;&#44; respectively&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0025">Fig&#46; 5</a>&#41;&#46; According to EQ-5D questionnaire&#44; at baseline visit &#40;n&#160;&#61;&#160;357&#41; 212 CU patients &#40;58&#46;7&#37;&#41; referred pain&#47;discomfort&#44; 179 patients &#40;49&#46;6&#37;&#41; anxiety&#47;depression&#44; 90 patients &#40;24&#46;9&#37;&#41; impact on daily activities and 61 patients &#40;16&#46;9&#37;&#41; referred mobility problems&#46; These percentages remained stable&#44; except for pain&#47;discomfort and anxiety&#47;depression&#44; which tended to decrease at 12-months visit &#40;n&#160;&#61;&#160;266&#58; 107 &#91;29&#46;6&#37;&#93; and 97 &#91;26&#46;9&#37;&#93; patients&#44; respectively&#41;&#46; Mean VAS score &#40;SD&#41; was 68&#46;4 &#40;20&#46;4&#41; at baseline visit &#40;n&#160;&#61;&#160;355&#41;&#44; which tended to increase by 73&#46;6 &#40;19&#46;6&#41; at 12-months visit &#40;n&#160;&#61;&#160;266&#41;&#46; Index score remained stable during the study &#40;0&#46;8 &#91;0&#46;2&#93;&#41; &#40;n&#160;&#61;&#160;357 at baseline and n&#160;&#61;&#160;266 at 12-months visit&#41; &#40;Appendix A1&#41;&#46;</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">MOS-Sleep questionnaire established that CU had a negative impact in sleep quality&#44; and this trend was barely improved with the treatment&#46; Patients slept a mean &#40;SD&#41; of 6&#46;4 &#40;1&#46;4&#41; hours per night at baseline visit &#40;n&#160;&#61;&#160;331&#41; and 6&#46;6 &#40;1&#46;2&#41; at 12-months visit &#40;n&#160;&#61;&#160;236&#41;&#46; The trend of mean scores for the different dimensions hardly improved throughout the study &#40;<a class="elsevierStyleCrossRef" href="#fig0030">Fig&#46; 6</a>&#41;&#46;</p><elsevierMultimedia ident="fig0030"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">Anxiety and depression levels according to HADS scale remained steady during the 1-year UCREX study&#46; Anxiety mean &#40;SD&#41; value went from 8&#46;7 &#40;4&#46;5&#41; at baseline &#40;n&#160;&#61;&#160;349&#41; to 7&#46;0 &#40;4&#46;3&#41; at 12-months visit &#40;n&#160;&#61;&#160;262&#41;&#44; while mean &#40;SD&#41; depression value went from 5&#46;1 &#40;4&#46;4&#41; &#40;n&#160;&#61;&#160;345&#41; to 4&#46;7 &#40;4&#46;3&#41; &#40;n&#160;&#61;&#160;261&#41;&#44; respectively&#46;</p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">DISCUSSION</span><p id="par0105" class="elsevierStylePara elsevierViewall">UCREX study was designed to identify the percentage of CU patients that remained symptomatic despite standard treatment established according to daily clinical practice in Spain&#46; The study results suggest that although there is a positive trend in symptom control throughout the treatment&#44; there is still a high proportion of uncontrolled patients at the end of the study&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">There are several scales validated for Spanish population focused in the CU symptoms monitoring&#46; In this study we used UAS&#47;UAS7 scale&#44; being the most common tool to evaluate CU activity<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2&#44;5&#44;17</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> and recommended by clinical consensus in the European clinical guide of urticaria&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">Most CU patients were treated according to the standard guidelines at the time of the beginning of the study&#44; decreasing the proportion of patients with wheals and&#47;or pruritus by 33&#46;5&#37; and 28&#46;9&#37;&#44; respectively&#44; at the 12-months visit&#46; However&#44; 75&#46;6&#37; of CU patients were symptomatic at the 12-months visit&#44; showing a moderate activity of the disease&#46; According to previous studies carried out in daily clinical practice&#44; less than 50&#37; of CSU patients respond to treatment with authorized doses of NS-H1AH&#44;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> possibly due to a considerable delay between diagnosis and specialized referral&#44; as well as a low follow-up of the urticaria clinical guide by specialists<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> or to a lack of effectiveness of the H1-antihistamines&#46; Additionally&#44; suboptimal control of CU symptoms could be explained by low therapeutic adherence&#44; as was shown for S-H1AH&#44; and attributed to their anticholinergic and sedative effects&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">A limitation of this study is lack of data regarding adherence&#44; discontinuation and treatment changes in non-responders&#44; which could have provided an explanation for the high rate of uncontrolled patients&#46; Our results show that CU disease is still active according to UAS7 score despite the use of recommended treatments&#44; which might point toward the lack of effectiveness of the available therapies&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">According to the clinical guidelines during the UCREX study&#44; CU-Q<span class="elsevierStyleInf">2</span>oL and EQ-5D were the recommended questionnaires to assess patients&#8217; health-related QoL &#40;HRQoL&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;3&#44;5&#44;20</span></a> Consistent with previous studies&#44; our results show that CU negatively impacts patient&#8217;s QoL&#44; although there is a positive trend of the QoL throughout the study&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;21&#8211;24</span></a> Pain and discomfort were evidenced from disease onset&#44; with VAS values above 60&#44; indicating a moderate-to-severe pain&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> Regarding sleep quality&#44; results of the MOS-Sleep questionnaire revealed that the disease showed a negative impact at baseline&#44; consistent with previous studies&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">In line with the used guidelines at the time of the study&#44; during the 12-months of the UCREX study the most frequently prescribed treatments were NS-H1AH &#40;47&#46;6&#37; of patients&#41;&#46; Omalizumab&#44; was launched for CSU during the period of inclusion of patients and was mostly prescribed at the beginning of the study&#46; The results of a phase III clinical trial analyzing of omalizumab in CSU showed that a three-fold higher number of patients receiving omalizumab achieved a good control of the disease versus placebo&#44; improving patient&#8217;s QoL&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a><span class="elsevierStyleSup">&#44;27</span> In this sense&#44; updated European Urticaria clinical guidelines<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> recommend <span class="elsevierStyleItalic">ad-hoc</span> treatment with biologics in patients who remain symptomatic after receiving up to four-fold dose of NS-H1AH from one to four weeks&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">The lack of control of the CU symptoms despite using the standard treatment based on NS-H1AH<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;5</span></a> leads to daily life disability for the patient&#44; a low QoL and work absenteeism&#46; The inability to control CU activity&#44; negatively impacts on HRU&#44; including PC&#44; specialists and&#47;or emergency visits&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;5</span></a> This points toward the need for a better management of the patients and optimization of the use of resources associated to the disease&#44; as well as improved treatments that would allow a better control of the CU symptoms&#46; The development of new biological therapies such as omalizumab is a promising strategy to tackle CSU symptoms and improve the patients&#8217; QoL&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">CONCLUSIONS</span><p id="par0140" class="elsevierStylePara elsevierViewall">CU is an insidious long-term disease that mostly affects actively working population &#40;women and men&#41;&#44; leading to a negative impact in their QoL&#44; labor&#44; and HRU&#46; Data collected from the UCREX study showed that in Spain&#44; during the studied period&#44; 75&#46;6&#37; of patients still have moderate CU activity despite being treated according to routine clinical practice&#46; An appropriated management from the physicians could be the basis to reduce the burden of disease and improve patients&#8217; symptoms and QoL&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Funding statement</span><p id="par0145" class="elsevierStylePara elsevierViewall">Funding for the UCREX Study was provided by Novartis Pharmaceuticals&#44; Spain&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Declaration of authorship</span><p id="par0150" class="elsevierStylePara elsevierViewall">All the authors participated actively both in the conception and design of the work&#46; All the authors have equally contributed to the development of the current manuscript&#44; have performed an exhaustive review of its content and have approved the final version&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Data availability statement</span><p id="par0155" class="elsevierStylePara elsevierViewall">Upon confidentiality agreement data might be shared</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Conflict of interests</span><p id="par0160" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">J&#46; Bartra&#44; M&#46; Labrador-Horrillo&#44; J&#46; Miquel-Miquel&#44; J&#46; Ortiz and A&#46; Valero</span> have collaborated with Novartis and other pharmaceutical industries&#46; Pau Terradas and Marian Vidal are Novartis employees&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">M&#46; Ferrer&#58;</span> is on the scientific advisory board and is a speaker for Novartis and FAES Farma&#44; has served on the scientific advisory board for Genentech&#44; has received research grants from Novartis&#44; and has received speaker honorarium from Menarini&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">J&#46;F&#46; Silvestre</span>&#58; has performed consultancies and has lectured at educational events for Sanofi-Genzyme&#44; Regeneron&#44; Abbvie and Novartis&#46; He has been principal investigator in clinical trials sponsored by AbbVie&#44; Amgen&#44; Eli-Lilly&#44; Leo Pharma&#44; Novartis and Pfizer&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">A&#46; Gim&#233;nez-Arnau</span>&#58; Medical Advisor for Uriach Pharma&#44; Genentech&#44; Novartis&#44; FAES&#44; GSK&#44; Sanofi&#46; Research Grants supported by Uriach Pharma&#44; Novartis&#44; Grants from Instituto Carlos III FEDER&#46; Educational activities for Uriach Pharma&#44; Novartis&#44; Genentech&#44; Menarini&#44; LEO- PHARMA&#44; GSK&#44; MSD&#44; Almirall&#44; Sanofi&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">J&#46; Sastre</span>&#58; has served as a consultant to Thermofisher&#44; MSD&#44; Novartis&#44; Sanofi&#44; Leti&#44; Roche&#44; ALK&#44; FAES FARMA&#44; Mundipharma&#44; and GSK&#59; having been paid lecture fees by Novartis&#44; GSK&#44; Stallergenes&#44; LETI&#44; and FAES FARMA&#59; as well as having received grant support for research from Thermofisher&#44; ALK and Sanofi&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">I&#46; J&#225;uregui&#58;</span> has acted as a paid member of advisory boards for Novartis Spain&#44; Sanofi-Genzyme and Abbvie&#44; has served as a consultant to FAES Farma&#44; has received educational grants from Leti Pharma and Menarini&#44; and has been paid for lecture fees by Novartis&#44; Sanofi-Genzyme&#44; MSD&#44; Roxall Laboratories&#44; and FAES Farma&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0165" class="elsevierStyleSimplePara elsevierViewall">Chronic Urticaria &#40;CU&#41; is a debilitating disease whose treatment is mainly symptomatic&#46; UCREX study aimed to identify CU patients&#8217; profile&#44; disease management and quality-of-life &#40;QoL&#41; in daily clinical practice in Spain&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0170" class="elsevierStyleSimplePara elsevierViewall">Observational&#44; 12-months prospective&#44; multicenter study&#44; included <span class="elsevierStyleItalic">de novo</span> or established CU patients attending to dermatology&#47;allergy consultations in 39 Spanish hospitals&#46; Main variables&#58; Urticaria Activity Score &#40;UAS&#41;&#44; UAS over 7 days &#40;UAS7&#41;&#46; Secondary variables&#58; CU-QoL Questionnaire &#40;CU-Q<span class="elsevierStyleInf">2</span>oL&#41;&#44; EuroQol-5 dimensions &#40;EQ-5D&#41;&#44; Medical Outcomes Study Sleep &#40;MOS-Sleep&#41; scale&#44; Hospital Anxiety and Depression Scale &#40;HADS&#41;&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0175" class="elsevierStyleSimplePara elsevierViewall">361 patients included&#46; Of them&#44; 176 &#40;48&#46;8&#37;&#41; considered for the main objective analysis&#46; Mean age &#40;SD&#41; of 46&#46;6 &#40;14&#46;2&#41; years and 71&#46;8&#37; women&#46; The year prior to inclusion&#44; most patients &#40;57&#46;1&#37;&#41; were treated with non-sedating H1-antihistamines &#40;NS-H1AH&#41;&#46; At baseline&#44; mean &#40;SD&#41; 3&#46;6 &#40;6&#46;8&#41; visits were registered to primary care&#46; Mean &#40;SD&#41; UAS7 at baseline was 14&#46;3 &#40;11&#46;0&#41; and CU-Q<span class="elsevierStyleInf">2</span>oL 24&#46;1 &#40;17&#46;0&#41; which tended to improve by 8&#46;6 &#40;9&#46;7&#41; and 13&#46;9 &#40;15&#46;0&#41;&#44; respectively&#44; at 12-months&#46; MOS-Sleep and EQ-5D remained steady during the study&#44; except pain&#47;discomfort and anxiety&#47;depression which went from 58&#46;7&#37; and 49&#46;6&#37; to 29&#46;6&#37; and 26&#46;9&#37;&#44; respectively&#46; At baseline&#44; HADS showed a mean &#40;SD&#41; anxiety of 8&#46;7 &#40;4&#46;5&#41; and depression 5&#46;1 &#40;4&#46;4&#41;&#44; decreasing to 7&#46;0 &#40;4&#46;3&#41; and 4&#46;7 &#40;4&#46;3&#41;&#44; respectively&#44; at 12-months&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0180" class="elsevierStyleSimplePara elsevierViewall">Although most CU patients are treated with NS-H1AH&#44; disease activity is still important&#44; negatively affecting patients&#8217; QoL&#44; work activity and healthcare resources use&#46; An appropriate disease management could be the basis for symptoms control&#44; QoL improvement and resources optimization&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Antecedentes</span><p id="spar0185" class="elsevierStyleSimplePara elsevierViewall">La urticaria cr&#243;nica &#40;UC&#41; es una enfermedad debilitante cuyo tratamiento es principalmente sintom&#225;tico&#46; El estudio UCREX tuvo como objetivo identificar el perfil de los pacientes con UC&#44; el manejo de la enfermedad y la calidad de vida &#40;CdV&#41; en la pr&#225;ctica cl&#237;nica diaria en Espa&#241;a&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0190" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional&#44; prospectivo&#44; multic&#233;ntrico de 12 meses&#44; que incluy&#243; pacientes con UC <span class="elsevierStyleItalic">de novo</span> o establecida que acudieron a la consulta de dermatolog&#237;a&#47;alergolog&#237;a de 39 hospitales espa&#241;oles&#46; Las variables principales fueron&#58; el <span class="elsevierStyleItalic">Urticaria Activity Score</span> &#40;UAS&#41; y el UAS por siete d&#237;as &#40;UAS7&#41;&#46; Las variables secundarias fueron&#58; el cuestionario de CdV de urticaria cr&#243;nica &#40;CU-Q<span class="elsevierStyleInf">2</span>oL&#41;&#44; el EuroQol-5 Dimensiones &#40;EQ-5D&#41;&#44; la escala <span class="elsevierStyleItalic">Medical Outcomes Study Sleep</span> &#40;MOS-Sleep&#41; y la escala hospitalaria de ansiedad y depresi&#243;n &#40;HADS&#41;&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0195" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 361 pacientes&#44; de los cuales 176 &#40;48&#44;8&#37;&#41; formaron parte del an&#225;lisis del objetivo principal&#46; La edad media &#40;DE&#41; fue de 46&#44;6 &#40;14&#44;2&#41; a&#241;os y el 71&#44;8&#37; eran del sexo femenino&#46; El a&#241;o anterior al periodo de inclusi&#243;n de los pacientes&#44; la mayor&#237;a de ellos &#40;57&#44;1&#37;&#41; se hab&#237;an tratado con antihistam&#237;nicos H1 no sedantes &#40;AHNS-H1&#41;&#46; En la basal&#44; se registr&#243; una media &#40;DE&#41; de 3&#44;6 &#40;6&#44;8&#41; de visitas a atenci&#243;n primaria&#46; La media &#40;DE&#41; del UAS7 en la basal fue de 14&#44;3 &#40;11&#44;0&#41; y del CU-Q<span class="elsevierStyleInf">2</span>oL 24&#44;1 &#40;17&#44;0&#41;&#44; observ&#225;ndose una tendencia en la mejor&#237;a en 8&#44;6 &#40;9&#44;7&#41; y 13&#44;9 &#40;15&#44;0&#41;&#44; respectivamente&#44; a los 12 meses&#46; El MOS-Sleep y el EQ-5D se mantuvieron estables durante el estudio&#44; excepto por el dolor&#47;malestar y la ansiedad&#47;depresi&#243;n que pasaron de 58&#44;7 y 49&#44;6&#37; a 29&#44;6 y 26&#44;9&#37;&#44; respectivamente&#46; En situaci&#243;n basal&#44; el HADS mostr&#243; una ansiedad media &#40;DE&#41; de 8&#44;7 &#40;4&#44;5&#41; y una depresi&#243;n de 5&#44;1 &#40;4&#44;4&#41;&#44; disminuyendo respectivamente a 7&#44;0 &#40;4&#44;3&#41; y 4&#44;7 &#40;4&#44;3&#41; a los 12 meses&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0200" class="elsevierStyleSimplePara elsevierViewall">Aunque la mayor&#237;a de los pacientes son tratados con AHNS-H1&#44; la actividad de la enfermedad sigue siendo importante&#44; afectando negativamente a su CdV&#44; su actividad laboral y repercutiendo negativamente en el uso de recursos sanitarios&#46; Un manejo adecuado de la enfermedad podr&#237;a ser la base para alcanzar el control de los s&#237;ntomas&#44; la mejora de la CdV y la optimizaci&#243;n de los recursos sanitarios necesarios&#46;</p></span>"
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            "apendice" => "<p id="par0200" class="elsevierStylePara elsevierViewall">The following is Supplementary data to this article&#58;<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
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            "titulo" => "Supplementary data"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Study design from the selection period to the follow-up period&#46;</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">&#42;HADS&#44; HRQoL &#40;CU-Q<span class="elsevierStyleInf">2</span>oL&#44; EQ-5D&#41;&#44; MOS-Sleep&#44; sociodemographic and anthropometric data&#44; clinical characteristics of urticaria&#44; associated comorbidities&#44; direct resources used due to CU&#44; previous referral circuit&#44; days of work absenteeism&#44; time from the onset of symptoms to diagnosis of CU&#46;</p> <p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; CU&#44; chronic urticaria&#59; CU-Q<span class="elsevierStyleInf">2</span>oL&#44; Chronic Urticaria Quality-of-Life Questionnaire&#59; EQ-5D&#44; EuroQol-5 dimensions&#59; HADS&#44; Hospital Anxiety and Depression Scale&#59; HRQoL&#44; Health-Related Quality-of-Life&#59; MOS-Sleep&#44; Medical Outcomes Study Sleep Scale&#59; UAS&#44; Urticaria Activity Score&#59; UAS7&#44; Urticaria Activity Score over 7 days&#59; V&#44; visit&#46;</p>"
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          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Study flow chart of the study population&#46;</p> <p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">&#42;Patients included for secondary variables &#40;evaluable patients&#41;&#58; HADS &#40;n&#160;&#61;&#160;361&#41;&#44; HRQoL &#40;CU-Q<span class="elsevierStyleInf">2</span>oL&#58; n&#160;&#61;&#160;361&#44; EQ-5D&#59; n&#160;&#61;&#160;361&#41;&#44; MOS-Sleep &#40;n&#160;&#61;&#160;361&#41;&#44; sociodemographic and anthropometric data &#40;n&#160;&#61;&#160;361&#41;&#44; clinical characteristics of urticaria &#40;n&#160;&#61;&#160;361&#41;&#44; associated comorbidities &#40;n&#160;&#61;&#160;236&#41;&#44; direct resources used due to CU &#40;n&#160;&#61;&#160;361&#41;&#44; previous referral circuit &#40;n&#160;&#61;&#160;351&#41;&#44; days of work absenteeism &#40;n&#160;&#61;&#160;195 during the year prior to inclusion&#41;&#44; time from the onset of symptoms to diagnosis of CU &#40;n&#160;&#61;&#160;361&#41;&#46;</p> <p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; CU&#44; chronic urticaria&#59; CU-Q<span class="elsevierStyleInf">2</span>oL&#44; Chronic Urticaria Quality-of-Life Questionnaire&#59; EQ-5D&#44; EuroQol-5 dimensions&#59; HADS&#44; Hospital Anxiety and Depression Scale&#59; HRQoL&#44; Health-Related Quality-of-Life&#59; MOS-Sleep&#44; Medical Outcomes Study Sleep Scale&#59; UAS&#44; Urticaria Activity Score&#59; UAS7&#44; Urticaria Activity Score over 7 days&#46;</p>"
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        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0015"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Descriptive of CSU activity by visit stratified by wheals&#44; pruritus&#44; UAS and UAS7 mean scores by visit&#46;</p> <p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Wheals &#40;A&#41;&#44; pruritus &#40;B&#41;&#44; UAS &#40;C&#41; and UAS7 &#40;D&#41; mean scores by visit&#46;</p> <p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Evaluable population &#40;N&#160;&#61;&#160;176&#41;&#46;</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Mild pruritus&#58; pruritus present but not irritating or annoying&#59; moderate pruritus&#58; annoying itching but without interfering with patient&#8217;s daily activities or with patient&#8217;s sleep&#59; intense pruritus&#58; severe itching&#44; annoying enough to interfere with patient&#8217;s daily activities and with patient&#8217;s sleep&#46;</p> <p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; CSU&#44; chronic spontaneous urticaria&#59; h&#44; hours&#59; UAS&#44; Urticaria Activity Score&#59; UAS7&#44; Urticaria Activity Score over 7 days&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "fig0020"
        "etiqueta" => "Figure 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr4.jpeg"
            "Alto" => 3692
            "Ancho" => 3010
            "Tamanyo" => 338014
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0020"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Treatments prescribed to CU patients in Spain throughout UCREX study and Omalizumab prescription during the study&#46;</p> <p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Treatments prescribed to CU patients &#40;A&#41;&#44; Omalizumab prescription &#40;B&#41;&#46;</p> <p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Evaluable population &#40;N&#160;&#61;&#160;361&#41;&#46; A patient may have taken treatments from different treatment families&#46; Treatments could be concomitants and&#47;or sequential&#46;</p> <p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; H2AH&#44; -antihistamines&#59; LTRA&#44; leukotriene receptor antagonists&#59; NSAID&#44; non-steroidal anti-inflammatory drugs&#59; NS-H1AH&#44; non-sedating H1-antihistamines&#59; S-H1AH&#44; sedating H1-antihistamines&#46;</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "fig0025"
        "etiqueta" => "Figure 5"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr5.jpeg"
            "Alto" => 1663
            "Ancho" => 3343
            "Tamanyo" => 235511
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0025"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Questionnaire CU-Q<span class="elsevierStyleInf">2</span>oL results per visit&#46;</p> <p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Evaluable population &#40;N&#160;&#61;&#160;361&#41;&#46;</p> <p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; CU-Q<span class="elsevierStyleInf">2</span>oL&#58; Chronic Urticaria Quality-of-Life questionnaire&#46;</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "fig0030"
        "etiqueta" => "Figure 6"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr6.jpeg"
            "Alto" => 1567
            "Ancho" => 3342
            "Tamanyo" => 251215
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0030"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">MOS-Sleep questionnaire results per visit&#46;</p> <p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Evaluable population &#40;N&#160;&#61;&#160;361&#41;&#46;</p> <p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">MOS-Sleep scores have been transformed so that they present values from 0 to 100 in such a way that 0 would be the worst situation and 100 the best&#46;</p> <p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; MOS-Sleep&#44; Medical Outcomes Study Sleep Scale&#46;</p>"
        ]
      ]
      6 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0035"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0120" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; CINDU&#44; chronic inducible urticaria&#59; CSU&#44; chronic spontaneous urticaria&#59; CU&#44; chronic urticaria&#59; NSAID&#44; non-steroidal anti-inflammatory drugs&#59; SD&#44; standard deviation&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Population&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#40;N&#160;&#61;&#160;361&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Sociodemographic data</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Sex &#40;female&#41;&#44; n &#40;&#37;&#41;</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">259 &#40;71&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Age &#40;years&#41;&#44; mean &#40;SD&#41;</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46&#46;6 &#40;14&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Weight &#40;Kg&#41;&#44; mean &#40;SD&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\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">72&#46;2 &#40;13&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Height &#40;cm&#41;&#44; mean &#40;SD&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#165;</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-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">165&#46;3 &#40;8&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Ethnic group&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Caucasian&nbsp;\t\t\t\t\t\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">345 &#40;95&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>African&nbsp;\t\t\t\t\t\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">1 &#40;0&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>South American&nbsp;\t\t\t\t\t\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">9 &#40;2&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Asian&nbsp;\t\t\t\t\t\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">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Arab&nbsp;\t\t\t\t\t\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">4 &#40;1&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Others&nbsp;\t\t\t\t\t\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">1 &#40;0&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Not available&nbsp;\t\t\t\t\t\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">1 &#40;0&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Employment situation&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Active full time&nbsp;\t\t\t\t\t\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">167 &#40;46&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Active part time&nbsp;\t\t\t\t\t\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">32 &#40;8&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Unemployed&nbsp;\t\t\t\t\t\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">36 &#40;10&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pensioner&nbsp;\t\t\t\t\t\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">47 &#40;13&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Student&nbsp;\t\t\t\t\t\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">15 &#40;4&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Housewife&nbsp;\t\t\t\t\t\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">52 &#40;14&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Not available&nbsp;\t\t\t\t\t\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">12 &#40;3&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Clinical data</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">CSU diagnosis&#44; n &#40;&#37;&#41;</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">345 &#40;95&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">CSU with associated CINDU&#44; n &#40;&#37;&#41;</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">133 &#40;38&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">CINDU&#44; n &#40;&#37;&#41;</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;4&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Time from the onset of symptoms &#40;months&#41;&#44; mean &#40;SD&#41;</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">65&#46;1 &#40;81&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Time from urticaria diagnosis &#40;months&#41;&#44; mean &#40;SD&#41;</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&#46;5 &#40;57&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Flares in year prior to enrolment&#44; mean &#40;SD&#41;</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#46;9 &#40;50&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Patients with angioedema in any of these episodes&#47;outbreaks of urticaria&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Yes&nbsp;\t\t\t\t\t\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">152 &#40;42&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">208 &#40;57&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Not available&nbsp;\t\t\t\t\t\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">1 &#40;0&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Exacerbations in year prior to enrolment&#44; mean &#40;SD&#41;</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;2 &#40;27&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Comorbidities&#44; n &#40;&#37;&#41;</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">236 &#40;65&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>History of atopic illnesses&nbsp;\t\t\t\t\t\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">92 &#40;25&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hypothyroidism&nbsp;\t\t\t\t\t\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">45 &#40;12&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Exacerbation of CU by NSAIDs&nbsp;\t\t\t\t\t\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">37 &#40;10&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Other associated autoimmune pathologies&nbsp;\t\t\t\t\t\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">32 &#40;8&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>NSAID-induced acute urticaria&nbsp;\t\t\t\t\t\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">18 &#40;5&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Previous or concomitant infections&nbsp;\t\t\t\t\t\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">14 &#40;3&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Other types of thyroid disease&nbsp;\t\t\t\t\t\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">13 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Anaphylaxis&nbsp;\t\t\t\t\t\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">7 &#40;1&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hyperthyroidism&nbsp;\t\t\t\t\t\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">7 &#40;1&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Habits&#44; such as use of cannabis&nbsp;\t\t\t\t\t\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">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Other comorbidities&nbsp;\t\t\t\t\t\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">131 &#40;36&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "leyenda" => "<p id="spar0130" class="elsevierStyleSimplePara elsevierViewall">Evaluable population &#40;N&#160;&#61;&#160;345&#41;&#44; &#42; Infectious disease&#58; <span class="elsevierStyleItalic">Helicobacter pylori</span>&#44; Anisakis&#44; and others &#42;&#42; Medical indication&#46;</p><p id="spar0135" class="elsevierStyleSimplePara elsevierViewall">Abbreviation - ANA&#44; antinuclear antibodies&#59; CRP&#44; C-reactive protein&#59; CSU&#44; chronic spontaneous urticaria&#59; ESR&#44; Erythrocytes Sedimentation rate&#59; IgE&#44; immunoglobulin E&#59; NSAID&#44; non-steroidal anti-inflammatory drugs&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Tests</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">CSU patients &#40;N&#160;&#61;&#160;345&#41;</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Baseline visitn &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">3 months visitn &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">6 months visitn &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">12 months visitn &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Routine tests</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">328 &#40;95&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45 &#40;13&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35 &#40;10&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;6&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Blood count&nbsp;\t\t\t\t\t\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">323 &#40;93&#46;6&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42 &#40;12&#46;2&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33 &#40;9&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">ESR&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">CRP&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Determination of total IgE&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">C4 complement&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">D-dimer&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Extension tests</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Infectious diseases&#42;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Type I allergy test&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ANAs&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6 &#40;1&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">Thyroid function&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">16 &#40;4&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">11 &#40;3&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5 &#40;1&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Skin tests including physical provocation tests&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">77 &#40;22&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1 &#40;0&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pseudo allergen free diet for 3 weeks&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">17 &#40;4&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tryptase&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">81 &#40;23&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5 &#40;1&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2 &#40;0&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2 &#40;0&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Autologous serum test&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">27 &#40;7&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;0&#46;3&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\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">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Skin biopsy in an injury&nbsp;\t\t\t\t\t\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">39 &#40;11&#46;3&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;0&#46;6&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;0&#46;9&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;0&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prohibition of suspected NSAIDs treatment&#42;&#42;&nbsp;\t\t\t\t\t\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">101 &#40;29&#46;3&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;2&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;1&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;1&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0125" class="elsevierStyleSimplePara elsevierViewall">Diagnostic tests performed to CSU patients throughout UCREX study</p>"
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      8 => array:8 [
        "identificador" => "tbl0015"
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          "leyenda" => "<p id="spar0145" class="elsevierStyleSimplePara elsevierViewall">Evaluable population &#40;N&#160;&#61;&#160;16 at baseline&#44; N&#160;&#61;&#160;15 at 3 months&#44; N&#160;&#61;&#160;15 at 6 months visit&#44; N&#160;&#61;&#160;14 at 12 months&#41;&#46; Number of tests for CINDU populations is calculated in the evaluable population&#46;</p><p id="spar0150" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; CINDU&#44; chronic inducible urticarial&#46;</p>"
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            0 => array:2 [
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">CINDU patients</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Tests&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Baselinevisitn &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">3 monthsvisitn &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">6 monthsvisitn &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">12 months visitn&#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Routine diagnostic tests</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowgroup " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;87&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowgroup " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;6&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowgroup " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;6&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowgroup " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Provocation tests</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowgroup " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;68&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowgroup " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;6&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowgroup " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;6&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowgroup " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;7&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Other tests performed</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;25&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;6&#46;7&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\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">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cold agglutinins&nbsp;\t\t\t\t\t\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">0&nbsp;\t\t\t\t\t\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">0&nbsp;\t\t\t\t\t\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">0&nbsp;\t\t\t\t\t\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">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cryoglobulins&nbsp;\t\t\t\t\t\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">1 &#40;6&#46;3&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\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">0&nbsp;\t\t\t\t\t\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">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Differential diagnosis of other photo luminal dermatoses&nbsp;\t\t\t\t\t\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">1 &#40;6&#46;3&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\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">0&nbsp;\t\t\t\t\t\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">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sedimentation rate&nbsp;\t\t\t\t\t\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">4 &#40;25&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\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">0&nbsp;\t\t\t\t\t\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">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0140" class="elsevierStyleSimplePara elsevierViewall">Diagnostic tests performed to CINDU patients throughout UCREX study</p>"
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          "leyenda" => "<p id="spar0160" class="elsevierStyleSimplePara elsevierViewall">Abbreviation&#58; ANA&#44; antinuclear antibodies&#59; CRP&#44; C-reactive protein&#59; IgE&#44; immunoglobulin E&#59; NSAID&#44; non-steroidal anti-inflammatory drugs&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Dermatology&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Allergology&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N&#160;&#61;&#160;164&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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Original Article
Daily Clinical Practice in the Management of Chronic Urticaria in Spain: Results of the UCREX Study
Práctica clínica diaria en el manejo de la urticaria crónica en España: resultados del estudio UCREX
M. Ferrer Pugaa,
Corresponding author
mferrerp@unav.es

Corresponding author.
, J.F. Silvestre Salvadorb, J. Bartra Tomasc, A. Giménez-Arnaud, M. Labrador-Horrilloe, J. Miquel-Miquelf, F.J. Ortiz de Frutosg, J. Sastre Dominguezh, A. Valero Santiagoc, P. Terradas-Montanai, M. Vidal-Jorgei, I. Jáuregui Presaj
a Servicio de Alergología, Clínica Universidad de Navarra, Pamplona, Spain
b Servicio de Dermatología, Hospital General Universitario de Alicante, Alicante, Spain
c Sección de Alergología, Servicio de Neumología, Hospital Clínic, IDIBAPS, ARADyAL, Universitat de Barcelona, Barcelona, Spain
d Servicio de Dermatología, Hospital del Mar, Parc de Salut Mar, Universitat Autònoma Barcelona, Barcelona, Spain
e Servicio de Alergología, Hospital Vall d’Hebron, VHIR, Universitat Autònoma Barcelona, ARADyAL (ISCIII), Barcelona, Spain
f Servicio de Dermatología, Hospital Arnau de Vilanova, Valencia, Spain
g Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, Spain
h Servicio de Alergología, Fundación Jiménez Diaz, Departamento de Medicina, Universidad Autónoma de Madrid, Spain
i Novartis Farmacéutica, Barcelona, Spain
j Servicio de Alergología, Hospital Universitario Cruces, Vizcaya, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">INTRODUCTION</span><p id="par0005" class="elsevierStylePara elsevierViewall">Chronic urticaria &#40;CU&#41; is a cutaneous disease characterized by the presence of wheals with redness&#44; inflammation&#44; pruritus and&#44; in some cases&#44; burning and pain&#44; for at least six weeks&#44; with or without angioedema&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;3</span></a> It is estimated that between 8-20&#37; of the population is susceptible to experience at least one episode of urticaria throughout their life&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> Based on Gaig et al&#46; the prevalence of CU in Spain is 0&#46;6&#37;&#44; being twice more prevalent in women than in men&#46; The average age of onset for CU is around 40 years&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;4</span></a> CU can be classified into chronic spontaneous urticaria &#40;CSU&#59; symptoms persist &#62;6 weeks with no known specific trigger&#41; and chronic inducible urticaria &#40;CINDU&#59; induced by specific triggers&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Several studies indicate that CU negatively affects patients&#8217; quality-of-life &#40;QoL&#41;&#44; as well as work activity&#44;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2&#44;5</span></a> having a considerable impact on direct and indirect health-related costs&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> CU has no cure and therefore&#44; appropriate management of disease symptoms become crucial&#46; Current guidelines recommended non-sedating H1-antihistamines &#40;NS-H1AH&#41; at licensed doses as the first-line of treatment for CU&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> In case of non-respondent patients&#44; NS-H1AH dose could be increased up to four-fold&#46; If a third-line is needed&#44; addition of omalizumab is the recommended option&#44; followed by cyclosporine A as fourth-line of treatment &#40;when omalizumab fails&#41;&#46; The use of systemic corticosteroids can be considered for short periods in case of severe exacerbations&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;3&#44;6&#44;7</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Although guidelines provide a framework for the management of CU patients&#44; specialists&#8217; experience is the cornerstone for treatment individualization to achieve the most effective pharmacotherapy and healthcare results&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> In this regard&#44; UCREX study was designed to understand CU patients&#8217; profile&#44; clinical management&#44; CU impact in patients&#8217; QoL and healthcare resources use &#40;HRU&#41; of daily clinical practice in Spain&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">MATERIALS AND METHODS</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Study design</span><p id="par0020" class="elsevierStylePara elsevierViewall">UCREX is an observational&#44; multicenter&#44; and prospective study &#40;12 months&#41; conducted in Spain between May 31<span class="elsevierStyleSup">st</span>&#44; 2013 and January 31<span class="elsevierStyleSup">st</span>&#44; 2015&#46; 39 hospitals and 42 investigators &#40;21 dermatologists and 21 allergists&#41; participated in the study&#46; Patients were aged &#8805;18 years&#44; with <span class="elsevierStyleItalic">de novo</span> or established CSU or CINDU diagnosis&#44; and attended at allergy or dermatology services&#46; Patients with acute urticaria&#44; urticarial vasculitis or other type of physical urticaria not associated with CU or angioedema without wheals or pruritus related to cutaneous diseases or participating in any other study were excluded&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The study was structured in four visits &#40;baseline visit&#44; and at 3&#44; 6 and 12 months&#41;&#46; Basic study data was recorded by an <span class="elsevierStyleItalic">ad-hoc</span> electronic Case Report Form &#40;eCRF&#41;&#46; Patient reported outcomes &#40;PROs&#41; were recorded through physical questionnaires and transferred to the study database&#46; Data collection referred to daily clinical practice was based on clinical charts and the following completed by study questionnaires&#58; Urticaria Activity Score &#40;UAS&#41; and UAS over 7 days &#40;UAS7&#41; to assess key urticaria signs and symptoms&#59; Chronic Urticaria Quality-of-Life Questionnaire &#40;CU-Q<span class="elsevierStyleInf">2</span>oL&#41; and EuroQol-5 dimensions &#40;EQ-5D&#41; to evaluate impact on QoL&#59; Medical Outcomes Study Sleep &#40;MOS-Sleep&#41; Scale to assess disease impact on sleep quality and Hospital Anxiety and Depression Scale &#40;HADS&#41; to measure levels of hospital anxiety and depression &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">Secondary variables included&#58; sociodemographic and clinical data&#44; associated comorbidities&#44; disease management&#44; treatment patterns&#44; direct healthcare resources and PROs&#46; CU-Q<span class="elsevierStyleInf">2</span>oL and EQ-5D questionnaire was used to evaluate symptoms and impact of CU on QoL&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#8211;12</span></a> To assess disease impact on sleep quality&#44; MOS-Sleep scale was used&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">13&#44;14</span></a> The HADS questionnaire measured levels of hospital anxiety and depression&#46;<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">15&#44;16</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The main study variables were UAS and UAS7&#46; To collect the direct healthcare resources associated with CU&#44; the number of hospital admissions&#44; visits to primary care &#40;PC&#41;&#44; emergency&#44; allergology and dermatology services&#44; diagnostic tests performed before and during the study and prescribed treatments were analyzed&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Statistical methods</span><p id="par0040" class="elsevierStylePara elsevierViewall">Sample size estimation was based on a 0&#46;6&#37; CU prevalence in Spain<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> and an accuracy of 5&#46;5&#37;&#44; estimating a maximum uncertainty proportion and greater variability of 50&#37; and a confidence interval of 95&#37; and considering 5&#37; of losses&#46; An estimated 335 patients were considered as a representative sample size for the study&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Statistical analyses were carried out in evaluable patients and descriptive analyses of all variables were carried out separately&#44; using tables of absolute and relative frequencies for discrete qualitative and quantitative variables&#44; and by means of average statistics&#44; standard deviation &#40;SD&#41;&#44; extreme values &#8203;&#8203;and quartiles for continuous quantitative variables&#46; For all comparisons a statistical significance level of 0&#46;05 was considered&#46; Statistical package Statistical Analysis System &#40;SAS&#41; version 9&#46;2 or later for Windows was used&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Ethical considerations</span><p id="par0050" class="elsevierStylePara elsevierViewall">The study was carried out following the ethical principles of the Declaration of Helsinki and the guidelines specified in Order SAS&#47;3470&#47;2009 of the Spanish Agency of Medicines and Medical Devices &#40;AEMPS&#41;&#46; Protocol&#44; informed consent form and other information for the patients were approved by the reference Clinical Research Ethics Committee &#40;CEIC&#41; of Hospital del Mar &#40;IMIM of Barcelona&#41;&#44; as well as all the CEICs and autonomous communities of the participating hospitals&#44; as needed&#46; All patients signed a written informed consent before being included in the study&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">RESULTS</span><p id="par0055" class="elsevierStylePara elsevierViewall">A total of 364 CU patients were initially recruited&#46; Baseline sample was formed by 361 patients meeting all the selection criteria&#46; For primary endpoint analysis&#44; 176 patients were evaluable&#58; patients who had data on the primary endpoint &#40;UAS&#47;UAS7&#41; and who received CU treatment at 12 months visit &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Patients&#8217; profile</span><p id="par0060" class="elsevierStylePara elsevierViewall">Baseline sociodemographic and clinical characteristics of the study population are collected in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;The patients included in the study had a mean age &#40;SD&#41; of 46&#46;6 &#40;14&#46;2&#41; years&#44; were mainly female &#40;71&#46;8&#37;&#41; and 152 &#40;42&#46;1&#37;&#41; patients showed angioedema in any of the episodes&#47;outbreaks of urticaria&#46; Most patients &#40;n&#160;&#61;&#160;345&#59; 95&#46;6&#37;&#41; were diagnosed with CSU&#44; being associated to CINDU in 38&#46;6&#37; of cases&#46; Only 16 patients &#40;4&#46;4&#37;&#41; were diagnosed with CINDU &#40;not associated with CSU&#41;&#46; Among the 361 patients included in the study&#44; 199 were actively working &#40;55&#46;1&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; Within these active patients&#44; 195 &#40;98&#46;0&#37;&#41; presented absenteeism during the year prior to inclusion and 147 &#40;73&#46;9&#37;&#41; during the 12 months of the study&#44; with a mean &#40;SD&#41; of 2&#46;7 &#40;17&#46;5&#41; and 4&#46;8 &#40;37&#46;4&#41; days&#44; respectively&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Disease activity</span><p id="par0065" class="elsevierStylePara elsevierViewall">In the study&#44; 75&#46;6&#37; of the CU patients were symptomatic &#40;UAS7&#160;&#62;0&#41; at the 12-months visit despite being treated according to daily clinical practice&#46; Among patients who responded to the questionnaires &#40;N&#160;&#61;&#160;176&#41;&#44; the incidence of wheals and&#47;or pruritus was tended to reduce according to the UAS scale between baseline and the 12-months visit &#40;117 &#91;66&#46;5&#37;&#93; and 131 &#91;74&#46;4&#37;&#93; patients with wheals and pruritus&#44; respectively&#44; at baseline vs 58 &#91;33&#46;0&#37;&#93; and 80 &#91;45&#46;5&#37;&#93; patients at the 12-months visit&#44; respectively&#41;&#46; Mean &#40;SD&#41; UAS and UAS7 scores also tended to decrease throughout the study &#40;2&#46;6 &#91;2&#46;0&#93; and 14&#46;3 &#91;11&#46;0&#93; at baseline vs 1&#46;1 &#91;1&#46;5&#93; and 8&#46;6 &#91;9&#46;7&#93; at 12 months&#44; respectively&#41;&#46; Although UAS and UAS7 score reductions were related to symptom improvement&#44; the severity of the disease in these patients at the 12-months visit was categorized as moderate for 22 patients &#40;12&#46;5&#37;&#41; and as intense for seven patients &#40;4&#46;0&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Disease management</span><p id="par0070" class="elsevierStylePara elsevierViewall">Disease management of the CU patients was considered from the year prior to study inclusion until the 12-months visit&#46; During the year prior to inclusion&#44; emergency services had a mean &#40;SD&#41; of 1&#46;6 &#40;2&#46;8&#41; visits due to CU &#40;n&#160;&#61;&#160;355&#41;&#44; tended to reduce by 0&#46;3 &#40;1&#46;3&#41; during the 12 months of the study &#40;n&#160;&#61;&#160;268&#41;&#46; Hospitalization was rarely needed during the year prior to study inclusion &#40;n&#160;&#61;&#160;357&#59; mean &#91;SD&#93; of 0&#46;0 &#91;0&#46;1&#93;&#41; and during the 12 months of the study &#40;n&#160;&#61;&#160;268&#59; mean &#91;SD&#93; of 0&#46;0 &#91;0&#46;2&#93;&#41;&#46; PC was the management reference during the year prior to inclusion &#40;n&#160;&#61;&#160;340&#41;&#44; with a mean &#40;SD&#41; of 3&#46;6 &#40;6&#46;8&#41; visits &#40;vs allergology and dermatology &#91;n&#160;&#61;&#160;358 in both cases&#93;&#44; with 2&#46;4 &#91;4&#46;3&#93; and 2&#46;6 &#91;4&#46;2&#93; visits&#44; respectively&#41;&#46; CU patients were initially identified in PC centers &#40;294 patients&#44; 81&#46;9&#37;&#41; and subsequently tendency of patients being referred to dermatology services &#40;155 patients&#44; 42&#46;9&#37;&#41; was higher than allergy services &#40;139 patients&#44; 38&#46;5&#37;&#41; for diagnosis confirmation and monitoring&#46; After being referred to specialists&#44; CU patients had a mean &#40;SD&#41; average of 1&#46;7 &#40;3&#46;3&#41; follow-up visits to allergy services and 1&#46;4 &#40;2&#46;8&#41; to dermatology services per year&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Diagnostic tests were conducted in 328 &#40;95&#46;1&#37;&#41; of CSU patients&#44; being blood count the most commonly used &#40;323 patients&#44; 93&#46;6&#37;&#41;&#46; Extension tests were also performed in 286 patients &#40;82&#46;9&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; Regarding CINDU patients &#40;n&#160;&#61;&#160;16&#41;&#44; 14 patients &#40;87&#46;5&#37;&#41; had undergone diagnostic tests at inclusion&#44; and provocation tests has the tendency to be the most frequents &#40;11 patients&#44; 68&#46;8&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">Trends of dermatology and allergology specialists &#40;n&#160;&#61;&#160;164 and n&#160;&#61;&#160;189 patients&#44; respectively&#41; were detected in the routine tests of patients with CSU performed in the study&#46; At baseline visit&#44; more number of diagnostic tests were tended to be performed by allergology services &#40;n&#160;&#61;&#160;788&#44; 55&#46;3&#37;&#41; than dermatology &#40;n&#160;&#61;&#160;637&#44; 44&#46;7&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46; Among CINDU patients&#44; routine tests and provocation tests were carried out for 26 &#40;15&#46;9&#37;&#41; and 28 &#40;17&#46;1&#37;&#41; patients in dermatology services&#44; respectively&#44; and 47 &#40;24&#46;9&#37;&#41; and 26 &#40;13&#46;8&#37;&#41; patients in allergy services at baseline visit&#44; respectively&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Treatment patterns</span><p id="par0085" class="elsevierStylePara elsevierViewall">During the 1-year UCREX study in Spain&#44; NS-H1AH &#40;336 patients&#44; 47&#46;6&#37;&#41; was tended to be the most frequently prescribed treatments for CU patients &#40;n&#160;&#61;&#160;706&#41;&#44; followed by sedating H1-antihistamines &#40;S-H1AH&#41; &#40;99 patients&#44; 14&#46;0&#37;&#41;&#44; omalizumab &#40;91 patients&#44; 12&#46;9&#37;&#41; and corticosteroids &#40;80 patients&#44; 11&#46;3&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41;&#46; Omalizumab prescription was present along the 1-year UCREX study&#46; The trend of omalizumab prescriptions were mostly at the beginning of the study &#40;44 prescriptions at baseline&#41;&#44; although they also occurred in subsequent visits &#40;24&#44; 8 and 12 prescriptions at 3-&#44; 6- and 12-months visits&#44; respectively&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41;&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">CU impact on patients&#58; PROs</span><p id="par0090" class="elsevierStylePara elsevierViewall">CU patients reported a CU-Q<span class="elsevierStyleInf">2</span>oL mean score &#40;SD&#41; of 24&#46;1 &#40;17&#46;0&#41; at baseline visit &#40;n&#160;&#61;&#160;336&#41; and 13&#46;9 &#40;15&#46;0&#41; at 12-months visit &#40;n&#160;&#61;&#160;254&#41;&#44; showing pruritus as the main negative impact &#40;46&#46;4 &#40;30&#46;3&#41; and 23&#46;2 &#40;23&#46;2&#41;&#44; respectively&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0025">Fig&#46; 5</a>&#41;&#46; According to EQ-5D questionnaire&#44; at baseline visit &#40;n&#160;&#61;&#160;357&#41; 212 CU patients &#40;58&#46;7&#37;&#41; referred pain&#47;discomfort&#44; 179 patients &#40;49&#46;6&#37;&#41; anxiety&#47;depression&#44; 90 patients &#40;24&#46;9&#37;&#41; impact on daily activities and 61 patients &#40;16&#46;9&#37;&#41; referred mobility problems&#46; These percentages remained stable&#44; except for pain&#47;discomfort and anxiety&#47;depression&#44; which tended to decrease at 12-months visit &#40;n&#160;&#61;&#160;266&#58; 107 &#91;29&#46;6&#37;&#93; and 97 &#91;26&#46;9&#37;&#93; patients&#44; respectively&#41;&#46; Mean VAS score &#40;SD&#41; was 68&#46;4 &#40;20&#46;4&#41; at baseline visit &#40;n&#160;&#61;&#160;355&#41;&#44; which tended to increase by 73&#46;6 &#40;19&#46;6&#41; at 12-months visit &#40;n&#160;&#61;&#160;266&#41;&#46; Index score remained stable during the study &#40;0&#46;8 &#91;0&#46;2&#93;&#41; &#40;n&#160;&#61;&#160;357 at baseline and n&#160;&#61;&#160;266 at 12-months visit&#41; &#40;Appendix A1&#41;&#46;</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">MOS-Sleep questionnaire established that CU had a negative impact in sleep quality&#44; and this trend was barely improved with the treatment&#46; Patients slept a mean &#40;SD&#41; of 6&#46;4 &#40;1&#46;4&#41; hours per night at baseline visit &#40;n&#160;&#61;&#160;331&#41; and 6&#46;6 &#40;1&#46;2&#41; at 12-months visit &#40;n&#160;&#61;&#160;236&#41;&#46; The trend of mean scores for the different dimensions hardly improved throughout the study &#40;<a class="elsevierStyleCrossRef" href="#fig0030">Fig&#46; 6</a>&#41;&#46;</p><elsevierMultimedia ident="fig0030"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">Anxiety and depression levels according to HADS scale remained steady during the 1-year UCREX study&#46; Anxiety mean &#40;SD&#41; value went from 8&#46;7 &#40;4&#46;5&#41; at baseline &#40;n&#160;&#61;&#160;349&#41; to 7&#46;0 &#40;4&#46;3&#41; at 12-months visit &#40;n&#160;&#61;&#160;262&#41;&#44; while mean &#40;SD&#41; depression value went from 5&#46;1 &#40;4&#46;4&#41; &#40;n&#160;&#61;&#160;345&#41; to 4&#46;7 &#40;4&#46;3&#41; &#40;n&#160;&#61;&#160;261&#41;&#44; respectively&#46;</p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">DISCUSSION</span><p id="par0105" class="elsevierStylePara elsevierViewall">UCREX study was designed to identify the percentage of CU patients that remained symptomatic despite standard treatment established according to daily clinical practice in Spain&#46; The study results suggest that although there is a positive trend in symptom control throughout the treatment&#44; there is still a high proportion of uncontrolled patients at the end of the study&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">There are several scales validated for Spanish population focused in the CU symptoms monitoring&#46; In this study we used UAS&#47;UAS7 scale&#44; being the most common tool to evaluate CU activity<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2&#44;5&#44;17</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> and recommended by clinical consensus in the European clinical guide of urticaria&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">Most CU patients were treated according to the standard guidelines at the time of the beginning of the study&#44; decreasing the proportion of patients with wheals and&#47;or pruritus by 33&#46;5&#37; and 28&#46;9&#37;&#44; respectively&#44; at the 12-months visit&#46; However&#44; 75&#46;6&#37; of CU patients were symptomatic at the 12-months visit&#44; showing a moderate activity of the disease&#46; According to previous studies carried out in daily clinical practice&#44; less than 50&#37; of CSU patients respond to treatment with authorized doses of NS-H1AH&#44;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> possibly due to a considerable delay between diagnosis and specialized referral&#44; as well as a low follow-up of the urticaria clinical guide by specialists<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> or to a lack of effectiveness of the H1-antihistamines&#46; Additionally&#44; suboptimal control of CU symptoms could be explained by low therapeutic adherence&#44; as was shown for S-H1AH&#44; and attributed to their anticholinergic and sedative effects&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">A limitation of this study is lack of data regarding adherence&#44; discontinuation and treatment changes in non-responders&#44; which could have provided an explanation for the high rate of uncontrolled patients&#46; Our results show that CU disease is still active according to UAS7 score despite the use of recommended treatments&#44; which might point toward the lack of effectiveness of the available therapies&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">According to the clinical guidelines during the UCREX study&#44; CU-Q<span class="elsevierStyleInf">2</span>oL and EQ-5D were the recommended questionnaires to assess patients&#8217; health-related QoL &#40;HRQoL&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;3&#44;5&#44;20</span></a> Consistent with previous studies&#44; our results show that CU negatively impacts patient&#8217;s QoL&#44; although there is a positive trend of the QoL throughout the study&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;21&#8211;24</span></a> Pain and discomfort were evidenced from disease onset&#44; with VAS values above 60&#44; indicating a moderate-to-severe pain&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> Regarding sleep quality&#44; results of the MOS-Sleep questionnaire revealed that the disease showed a negative impact at baseline&#44; consistent with previous studies&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">In line with the used guidelines at the time of the study&#44; during the 12-months of the UCREX study the most frequently prescribed treatments were NS-H1AH &#40;47&#46;6&#37; of patients&#41;&#46; Omalizumab&#44; was launched for CSU during the period of inclusion of patients and was mostly prescribed at the beginning of the study&#46; The results of a phase III clinical trial analyzing of omalizumab in CSU showed that a three-fold higher number of patients receiving omalizumab achieved a good control of the disease versus placebo&#44; improving patient&#8217;s QoL&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a><span class="elsevierStyleSup">&#44;27</span> In this sense&#44; updated European Urticaria clinical guidelines<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> recommend <span class="elsevierStyleItalic">ad-hoc</span> treatment with biologics in patients who remain symptomatic after receiving up to four-fold dose of NS-H1AH from one to four weeks&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">The lack of control of the CU symptoms despite using the standard treatment based on NS-H1AH<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;5</span></a> leads to daily life disability for the patient&#44; a low QoL and work absenteeism&#46; The inability to control CU activity&#44; negatively impacts on HRU&#44; including PC&#44; specialists and&#47;or emergency visits&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;5</span></a> This points toward the need for a better management of the patients and optimization of the use of resources associated to the disease&#44; as well as improved treatments that would allow a better control of the CU symptoms&#46; The development of new biological therapies such as omalizumab is a promising strategy to tackle CSU symptoms and improve the patients&#8217; QoL&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">CONCLUSIONS</span><p id="par0140" class="elsevierStylePara elsevierViewall">CU is an insidious long-term disease that mostly affects actively working population &#40;women and men&#41;&#44; leading to a negative impact in their QoL&#44; labor&#44; and HRU&#46; Data collected from the UCREX study showed that in Spain&#44; during the studied period&#44; 75&#46;6&#37; of patients still have moderate CU activity despite being treated according to routine clinical practice&#46; An appropriated management from the physicians could be the basis to reduce the burden of disease and improve patients&#8217; symptoms and QoL&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Funding statement</span><p id="par0145" class="elsevierStylePara elsevierViewall">Funding for the UCREX Study was provided by Novartis Pharmaceuticals&#44; Spain&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Declaration of authorship</span><p id="par0150" class="elsevierStylePara elsevierViewall">All the authors participated actively both in the conception and design of the work&#46; All the authors have equally contributed to the development of the current manuscript&#44; have performed an exhaustive review of its content and have approved the final version&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Data availability statement</span><p id="par0155" class="elsevierStylePara elsevierViewall">Upon confidentiality agreement data might be shared</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Conflict of interests</span><p id="par0160" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">J&#46; Bartra&#44; M&#46; Labrador-Horrillo&#44; J&#46; Miquel-Miquel&#44; J&#46; Ortiz and A&#46; Valero</span> have collaborated with Novartis and other pharmaceutical industries&#46; Pau Terradas and Marian Vidal are Novartis employees&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">M&#46; Ferrer&#58;</span> is on the scientific advisory board and is a speaker for Novartis and FAES Farma&#44; has served on the scientific advisory board for Genentech&#44; has received research grants from Novartis&#44; and has received speaker honorarium from Menarini&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">J&#46;F&#46; Silvestre</span>&#58; has performed consultancies and has lectured at educational events for Sanofi-Genzyme&#44; Regeneron&#44; Abbvie and Novartis&#46; He has been principal investigator in clinical trials sponsored by AbbVie&#44; Amgen&#44; Eli-Lilly&#44; Leo Pharma&#44; Novartis and Pfizer&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">A&#46; Gim&#233;nez-Arnau</span>&#58; Medical Advisor for Uriach Pharma&#44; Genentech&#44; Novartis&#44; FAES&#44; GSK&#44; Sanofi&#46; Research Grants supported by Uriach Pharma&#44; Novartis&#44; Grants from Instituto Carlos III FEDER&#46; Educational activities for Uriach Pharma&#44; Novartis&#44; Genentech&#44; Menarini&#44; LEO- PHARMA&#44; GSK&#44; MSD&#44; Almirall&#44; Sanofi&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">J&#46; Sastre</span>&#58; has served as a consultant to Thermofisher&#44; MSD&#44; Novartis&#44; Sanofi&#44; Leti&#44; Roche&#44; ALK&#44; FAES FARMA&#44; Mundipharma&#44; and GSK&#59; having been paid lecture fees by Novartis&#44; GSK&#44; Stallergenes&#44; LETI&#44; and FAES FARMA&#59; as well as having received grant support for research from Thermofisher&#44; ALK and Sanofi&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">I&#46; J&#225;uregui&#58;</span> has acted as a paid member of advisory boards for Novartis Spain&#44; Sanofi-Genzyme and Abbvie&#44; has served as a consultant to FAES Farma&#44; has received educational grants from Leti Pharma and Menarini&#44; and has been paid for lecture fees by Novartis&#44; Sanofi-Genzyme&#44; MSD&#44; Roxall Laboratories&#44; and FAES Farma&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0165" class="elsevierStyleSimplePara elsevierViewall">Chronic Urticaria &#40;CU&#41; is a debilitating disease whose treatment is mainly symptomatic&#46; UCREX study aimed to identify CU patients&#8217; profile&#44; disease management and quality-of-life &#40;QoL&#41; in daily clinical practice in Spain&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0170" class="elsevierStyleSimplePara elsevierViewall">Observational&#44; 12-months prospective&#44; multicenter study&#44; included <span class="elsevierStyleItalic">de novo</span> or established CU patients attending to dermatology&#47;allergy consultations in 39 Spanish hospitals&#46; Main variables&#58; Urticaria Activity Score &#40;UAS&#41;&#44; UAS over 7 days &#40;UAS7&#41;&#46; Secondary variables&#58; CU-QoL Questionnaire &#40;CU-Q<span class="elsevierStyleInf">2</span>oL&#41;&#44; EuroQol-5 dimensions &#40;EQ-5D&#41;&#44; Medical Outcomes Study Sleep &#40;MOS-Sleep&#41; scale&#44; Hospital Anxiety and Depression Scale &#40;HADS&#41;&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0175" class="elsevierStyleSimplePara elsevierViewall">361 patients included&#46; Of them&#44; 176 &#40;48&#46;8&#37;&#41; considered for the main objective analysis&#46; Mean age &#40;SD&#41; of 46&#46;6 &#40;14&#46;2&#41; years and 71&#46;8&#37; women&#46; The year prior to inclusion&#44; most patients &#40;57&#46;1&#37;&#41; were treated with non-sedating H1-antihistamines &#40;NS-H1AH&#41;&#46; At baseline&#44; mean &#40;SD&#41; 3&#46;6 &#40;6&#46;8&#41; visits were registered to primary care&#46; Mean &#40;SD&#41; UAS7 at baseline was 14&#46;3 &#40;11&#46;0&#41; and CU-Q<span class="elsevierStyleInf">2</span>oL 24&#46;1 &#40;17&#46;0&#41; which tended to improve by 8&#46;6 &#40;9&#46;7&#41; and 13&#46;9 &#40;15&#46;0&#41;&#44; respectively&#44; at 12-months&#46; MOS-Sleep and EQ-5D remained steady during the study&#44; except pain&#47;discomfort and anxiety&#47;depression which went from 58&#46;7&#37; and 49&#46;6&#37; to 29&#46;6&#37; and 26&#46;9&#37;&#44; respectively&#46; At baseline&#44; HADS showed a mean &#40;SD&#41; anxiety of 8&#46;7 &#40;4&#46;5&#41; and depression 5&#46;1 &#40;4&#46;4&#41;&#44; decreasing to 7&#46;0 &#40;4&#46;3&#41; and 4&#46;7 &#40;4&#46;3&#41;&#44; respectively&#44; at 12-months&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0180" class="elsevierStyleSimplePara elsevierViewall">Although most CU patients are treated with NS-H1AH&#44; disease activity is still important&#44; negatively affecting patients&#8217; QoL&#44; work activity and healthcare resources use&#46; An appropriate disease management could be the basis for symptoms control&#44; QoL improvement and resources optimization&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Antecedentes</span><p id="spar0185" class="elsevierStyleSimplePara elsevierViewall">La urticaria cr&#243;nica &#40;UC&#41; es una enfermedad debilitante cuyo tratamiento es principalmente sintom&#225;tico&#46; El estudio UCREX tuvo como objetivo identificar el perfil de los pacientes con UC&#44; el manejo de la enfermedad y la calidad de vida &#40;CdV&#41; en la pr&#225;ctica cl&#237;nica diaria en Espa&#241;a&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0190" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional&#44; prospectivo&#44; multic&#233;ntrico de 12 meses&#44; que incluy&#243; pacientes con UC <span class="elsevierStyleItalic">de novo</span> o establecida que acudieron a la consulta de dermatolog&#237;a&#47;alergolog&#237;a de 39 hospitales espa&#241;oles&#46; Las variables principales fueron&#58; el <span class="elsevierStyleItalic">Urticaria Activity Score</span> &#40;UAS&#41; y el UAS por siete d&#237;as &#40;UAS7&#41;&#46; Las variables secundarias fueron&#58; el cuestionario de CdV de urticaria cr&#243;nica &#40;CU-Q<span class="elsevierStyleInf">2</span>oL&#41;&#44; el EuroQol-5 Dimensiones &#40;EQ-5D&#41;&#44; la escala <span class="elsevierStyleItalic">Medical Outcomes Study Sleep</span> &#40;MOS-Sleep&#41; y la escala hospitalaria de ansiedad y depresi&#243;n &#40;HADS&#41;&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0195" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 361 pacientes&#44; de los cuales 176 &#40;48&#44;8&#37;&#41; formaron parte del an&#225;lisis del objetivo principal&#46; La edad media &#40;DE&#41; fue de 46&#44;6 &#40;14&#44;2&#41; a&#241;os y el 71&#44;8&#37; eran del sexo femenino&#46; El a&#241;o anterior al periodo de inclusi&#243;n de los pacientes&#44; la mayor&#237;a de ellos &#40;57&#44;1&#37;&#41; se hab&#237;an tratado con antihistam&#237;nicos H1 no sedantes &#40;AHNS-H1&#41;&#46; En la basal&#44; se registr&#243; una media &#40;DE&#41; de 3&#44;6 &#40;6&#44;8&#41; de visitas a atenci&#243;n primaria&#46; La media &#40;DE&#41; del UAS7 en la basal fue de 14&#44;3 &#40;11&#44;0&#41; y del CU-Q<span class="elsevierStyleInf">2</span>oL 24&#44;1 &#40;17&#44;0&#41;&#44; observ&#225;ndose una tendencia en la mejor&#237;a en 8&#44;6 &#40;9&#44;7&#41; y 13&#44;9 &#40;15&#44;0&#41;&#44; respectivamente&#44; a los 12 meses&#46; El MOS-Sleep y el EQ-5D se mantuvieron estables durante el estudio&#44; excepto por el dolor&#47;malestar y la ansiedad&#47;depresi&#243;n que pasaron de 58&#44;7 y 49&#44;6&#37; a 29&#44;6 y 26&#44;9&#37;&#44; respectivamente&#46; En situaci&#243;n basal&#44; el HADS mostr&#243; una ansiedad media &#40;DE&#41; de 8&#44;7 &#40;4&#44;5&#41; y una depresi&#243;n de 5&#44;1 &#40;4&#44;4&#41;&#44; disminuyendo respectivamente a 7&#44;0 &#40;4&#44;3&#41; y 4&#44;7 &#40;4&#44;3&#41; a los 12 meses&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0200" class="elsevierStyleSimplePara elsevierViewall">Aunque la mayor&#237;a de los pacientes son tratados con AHNS-H1&#44; la actividad de la enfermedad sigue siendo importante&#44; afectando negativamente a su CdV&#44; su actividad laboral y repercutiendo negativamente en el uso de recursos sanitarios&#46; Un manejo adecuado de la enfermedad podr&#237;a ser la base para alcanzar el control de los s&#237;ntomas&#44; la mejora de la CdV y la optimizaci&#243;n de los recursos sanitarios necesarios&#46;</p></span>"
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            "apendice" => "<p id="par0200" class="elsevierStylePara elsevierViewall">The following is Supplementary data to this article&#58;<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Study design from the selection period to the follow-up period&#46;</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">&#42;HADS&#44; HRQoL &#40;CU-Q<span class="elsevierStyleInf">2</span>oL&#44; EQ-5D&#41;&#44; MOS-Sleep&#44; sociodemographic and anthropometric data&#44; clinical characteristics of urticaria&#44; associated comorbidities&#44; direct resources used due to CU&#44; previous referral circuit&#44; days of work absenteeism&#44; time from the onset of symptoms to diagnosis of CU&#46;</p> <p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; CU&#44; chronic urticaria&#59; CU-Q<span class="elsevierStyleInf">2</span>oL&#44; Chronic Urticaria Quality-of-Life Questionnaire&#59; EQ-5D&#44; EuroQol-5 dimensions&#59; HADS&#44; Hospital Anxiety and Depression Scale&#59; HRQoL&#44; Health-Related Quality-of-Life&#59; MOS-Sleep&#44; Medical Outcomes Study Sleep Scale&#59; UAS&#44; Urticaria Activity Score&#59; UAS7&#44; Urticaria Activity Score over 7 days&#59; V&#44; visit&#46;</p>"
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          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Study flow chart of the study population&#46;</p> <p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">&#42;Patients included for secondary variables &#40;evaluable patients&#41;&#58; HADS &#40;n&#160;&#61;&#160;361&#41;&#44; HRQoL &#40;CU-Q<span class="elsevierStyleInf">2</span>oL&#58; n&#160;&#61;&#160;361&#44; EQ-5D&#59; n&#160;&#61;&#160;361&#41;&#44; MOS-Sleep &#40;n&#160;&#61;&#160;361&#41;&#44; sociodemographic and anthropometric data &#40;n&#160;&#61;&#160;361&#41;&#44; clinical characteristics of urticaria &#40;n&#160;&#61;&#160;361&#41;&#44; associated comorbidities &#40;n&#160;&#61;&#160;236&#41;&#44; direct resources used due to CU &#40;n&#160;&#61;&#160;361&#41;&#44; previous referral circuit &#40;n&#160;&#61;&#160;351&#41;&#44; days of work absenteeism &#40;n&#160;&#61;&#160;195 during the year prior to inclusion&#41;&#44; time from the onset of symptoms to diagnosis of CU &#40;n&#160;&#61;&#160;361&#41;&#46;</p> <p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; CU&#44; chronic urticaria&#59; CU-Q<span class="elsevierStyleInf">2</span>oL&#44; Chronic Urticaria Quality-of-Life Questionnaire&#59; EQ-5D&#44; EuroQol-5 dimensions&#59; HADS&#44; Hospital Anxiety and Depression Scale&#59; HRQoL&#44; Health-Related Quality-of-Life&#59; MOS-Sleep&#44; Medical Outcomes Study Sleep Scale&#59; UAS&#44; Urticaria Activity Score&#59; UAS7&#44; Urticaria Activity Score over 7 days&#46;</p>"
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          "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Descriptive of CSU activity by visit stratified by wheals&#44; pruritus&#44; UAS and UAS7 mean scores by visit&#46;</p> <p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Wheals &#40;A&#41;&#44; pruritus &#40;B&#41;&#44; UAS &#40;C&#41; and UAS7 &#40;D&#41; mean scores by visit&#46;</p> <p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Evaluable population &#40;N&#160;&#61;&#160;176&#41;&#46;</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Mild pruritus&#58; pruritus present but not irritating or annoying&#59; moderate pruritus&#58; annoying itching but without interfering with patient&#8217;s daily activities or with patient&#8217;s sleep&#59; intense pruritus&#58; severe itching&#44; annoying enough to interfere with patient&#8217;s daily activities and with patient&#8217;s sleep&#46;</p> <p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; CSU&#44; chronic spontaneous urticaria&#59; h&#44; hours&#59; UAS&#44; Urticaria Activity Score&#59; UAS7&#44; Urticaria Activity Score over 7 days&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "fig0020"
        "etiqueta" => "Figure 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr4.jpeg"
            "Alto" => 3692
            "Ancho" => 3010
            "Tamanyo" => 338014
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0020"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Treatments prescribed to CU patients in Spain throughout UCREX study and Omalizumab prescription during the study&#46;</p> <p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Treatments prescribed to CU patients &#40;A&#41;&#44; Omalizumab prescription &#40;B&#41;&#46;</p> <p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Evaluable population &#40;N&#160;&#61;&#160;361&#41;&#46; A patient may have taken treatments from different treatment families&#46; Treatments could be concomitants and&#47;or sequential&#46;</p> <p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; H2AH&#44; -antihistamines&#59; LTRA&#44; leukotriene receptor antagonists&#59; NSAID&#44; non-steroidal anti-inflammatory drugs&#59; NS-H1AH&#44; non-sedating H1-antihistamines&#59; S-H1AH&#44; sedating H1-antihistamines&#46;</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "fig0025"
        "etiqueta" => "Figure 5"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr5.jpeg"
            "Alto" => 1663
            "Ancho" => 3343
            "Tamanyo" => 235511
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0025"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Questionnaire CU-Q<span class="elsevierStyleInf">2</span>oL results per visit&#46;</p> <p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Evaluable population &#40;N&#160;&#61;&#160;361&#41;&#46;</p> <p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; CU-Q<span class="elsevierStyleInf">2</span>oL&#58; Chronic Urticaria Quality-of-Life questionnaire&#46;</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "fig0030"
        "etiqueta" => "Figure 6"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr6.jpeg"
            "Alto" => 1567
            "Ancho" => 3342
            "Tamanyo" => 251215
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0030"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">MOS-Sleep questionnaire results per visit&#46;</p> <p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Evaluable population &#40;N&#160;&#61;&#160;361&#41;&#46;</p> <p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">MOS-Sleep scores have been transformed so that they present values from 0 to 100 in such a way that 0 would be the worst situation and 100 the best&#46;</p> <p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; MOS-Sleep&#44; Medical Outcomes Study Sleep Scale&#46;</p>"
        ]
      ]
      6 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0035"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0120" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; CINDU&#44; chronic inducible urticaria&#59; CSU&#44; chronic spontaneous urticaria&#59; CU&#44; chronic urticaria&#59; NSAID&#44; non-steroidal anti-inflammatory drugs&#59; SD&#44; standard deviation&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Population&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#40;N&#160;&#61;&#160;361&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Sociodemographic data</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Sex &#40;female&#41;&#44; n &#40;&#37;&#41;</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">259 &#40;71&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Age &#40;years&#41;&#44; mean &#40;SD&#41;</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46&#46;6 &#40;14&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Weight &#40;Kg&#41;&#44; mean &#40;SD&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\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">72&#46;2 &#40;13&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Height &#40;cm&#41;&#44; mean &#40;SD&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#165;</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-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">165&#46;3 &#40;8&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Ethnic group&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Caucasian&nbsp;\t\t\t\t\t\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">345 &#40;95&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>African&nbsp;\t\t\t\t\t\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">1 &#40;0&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>South American&nbsp;\t\t\t\t\t\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">9 &#40;2&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Asian&nbsp;\t\t\t\t\t\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">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Arab&nbsp;\t\t\t\t\t\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">4 &#40;1&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Others&nbsp;\t\t\t\t\t\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">1 &#40;0&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Not available&nbsp;\t\t\t\t\t\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">1 &#40;0&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Employment situation&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Active full time&nbsp;\t\t\t\t\t\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">167 &#40;46&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Active part time&nbsp;\t\t\t\t\t\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">32 &#40;8&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Unemployed&nbsp;\t\t\t\t\t\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">36 &#40;10&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pensioner&nbsp;\t\t\t\t\t\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">47 &#40;13&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Student&nbsp;\t\t\t\t\t\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">15 &#40;4&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Housewife&nbsp;\t\t\t\t\t\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">52 &#40;14&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Not available&nbsp;\t\t\t\t\t\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">12 &#40;3&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Clinical data</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">CSU diagnosis&#44; n &#40;&#37;&#41;</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">345 &#40;95&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">CSU with associated CINDU&#44; n &#40;&#37;&#41;</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">133 &#40;38&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">CINDU&#44; n &#40;&#37;&#41;</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;4&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Time from the onset of symptoms &#40;months&#41;&#44; mean &#40;SD&#41;</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">65&#46;1 &#40;81&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Time from urticaria diagnosis &#40;months&#41;&#44; mean &#40;SD&#41;</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&#46;5 &#40;57&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Flares in year prior to enrolment&#44; mean &#40;SD&#41;</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#46;9 &#40;50&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Patients with angioedema in any of these episodes&#47;outbreaks of urticaria&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Yes&nbsp;\t\t\t\t\t\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">152 &#40;42&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">208 &#40;57&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Not available&nbsp;\t\t\t\t\t\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">1 &#40;0&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Exacerbations in year prior to enrolment&#44; mean &#40;SD&#41;</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;2 &#40;27&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Comorbidities&#44; n &#40;&#37;&#41;</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">236 &#40;65&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>History of atopic illnesses&nbsp;\t\t\t\t\t\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">92 &#40;25&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hypothyroidism&nbsp;\t\t\t\t\t\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">45 &#40;12&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Exacerbation of CU by NSAIDs&nbsp;\t\t\t\t\t\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">37 &#40;10&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Other associated autoimmune pathologies&nbsp;\t\t\t\t\t\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">32 &#40;8&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>NSAID-induced acute urticaria&nbsp;\t\t\t\t\t\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">18 &#40;5&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Previous or concomitant infections&nbsp;\t\t\t\t\t\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">14 &#40;3&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Other types of thyroid disease&nbsp;\t\t\t\t\t\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">13 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Anaphylaxis&nbsp;\t\t\t\t\t\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">7 &#40;1&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hyperthyroidism&nbsp;\t\t\t\t\t\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">7 &#40;1&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Habits&#44; such as use of cannabis&nbsp;\t\t\t\t\t\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">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Other comorbidities&nbsp;\t\t\t\t\t\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">131 &#40;36&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "leyenda" => "<p id="spar0130" class="elsevierStyleSimplePara elsevierViewall">Evaluable population &#40;N&#160;&#61;&#160;345&#41;&#44; &#42; Infectious disease&#58; <span class="elsevierStyleItalic">Helicobacter pylori</span>&#44; Anisakis&#44; and others &#42;&#42; Medical indication&#46;</p><p id="spar0135" class="elsevierStyleSimplePara elsevierViewall">Abbreviation - ANA&#44; antinuclear antibodies&#59; CRP&#44; C-reactive protein&#59; CSU&#44; chronic spontaneous urticaria&#59; ESR&#44; Erythrocytes Sedimentation rate&#59; IgE&#44; immunoglobulin E&#59; NSAID&#44; non-steroidal anti-inflammatory drugs&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Tests</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">CSU patients &#40;N&#160;&#61;&#160;345&#41;</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Baseline visitn &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">3 months visitn &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">6 months visitn &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">12 months visitn &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Routine tests</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">328 &#40;95&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45 &#40;13&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35 &#40;10&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;6&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Blood count&nbsp;\t\t\t\t\t\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">323 &#40;93&#46;6&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42 &#40;12&#46;2&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33 &#40;9&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">ESR&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CRP&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Determination of total IgE&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">C4 complement&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">D-dimer&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Extension tests</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">10 &#40;2&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Infectious diseases&#42;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Type I allergy test&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ANAs&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">9 &#40;2&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6 &#40;1&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6 &#40;1&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">Thyroid function&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">16 &#40;4&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">11 &#40;3&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5 &#40;1&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Skin tests including physical provocation tests&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">77 &#40;22&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1 &#40;0&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pseudo allergen free diet for 3 weeks&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">17 &#40;4&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tryptase&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">81 &#40;23&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5 &#40;1&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2 &#40;0&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2 &#40;0&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Autologous serum test&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">27 &#40;7&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1 &#40;0&#46;3&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\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">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Skin biopsy in an injury&nbsp;\t\t\t\t\t\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">39 &#40;11&#46;3&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;0&#46;6&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;0&#46;9&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;0&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prohibition of suspected NSAIDs treatment&#42;&#42;&nbsp;\t\t\t\t\t\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">101 &#40;29&#46;3&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;2&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;1&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;1&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0125" class="elsevierStyleSimplePara elsevierViewall">Diagnostic tests performed to CSU patients throughout UCREX study</p>"
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      8 => array:8 [
        "identificador" => "tbl0015"
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          "leyenda" => "<p id="spar0145" class="elsevierStyleSimplePara elsevierViewall">Evaluable population &#40;N&#160;&#61;&#160;16 at baseline&#44; N&#160;&#61;&#160;15 at 3 months&#44; N&#160;&#61;&#160;15 at 6 months visit&#44; N&#160;&#61;&#160;14 at 12 months&#41;&#46; Number of tests for CINDU populations is calculated in the evaluable population&#46;</p><p id="spar0150" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; CINDU&#44; chronic inducible urticarial&#46;</p>"
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            0 => array:2 [
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">CINDU patients</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Tests&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Baselinevisitn &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">3 monthsvisitn &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">6 monthsvisitn &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">12 months visitn&#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Routine diagnostic tests</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowgroup " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;87&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowgroup " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;6&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowgroup " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;6&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowgroup " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Provocation tests</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowgroup " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;68&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowgroup " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;6&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowgroup " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;6&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowgroup " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;7&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Other tests performed</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;25&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;6&#46;7&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\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">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cold agglutinins&nbsp;\t\t\t\t\t\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">0&nbsp;\t\t\t\t\t\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">0&nbsp;\t\t\t\t\t\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">0&nbsp;\t\t\t\t\t\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">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cryoglobulins&nbsp;\t\t\t\t\t\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">1 &#40;6&#46;3&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\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">0&nbsp;\t\t\t\t\t\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">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Differential diagnosis of other photo luminal dermatoses&nbsp;\t\t\t\t\t\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">1 &#40;6&#46;3&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\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">0&nbsp;\t\t\t\t\t\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">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sedimentation rate&nbsp;\t\t\t\t\t\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">4 &#40;25&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\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">0&nbsp;\t\t\t\t\t\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">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0140" class="elsevierStyleSimplePara elsevierViewall">Diagnostic tests performed to CINDU patients throughout UCREX study</p>"
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          "leyenda" => "<p id="spar0160" class="elsevierStyleSimplePara elsevierViewall">Abbreviation&#58; ANA&#44; antinuclear antibodies&#59; CRP&#44; C-reactive protein&#59; IgE&#44; immunoglobulin E&#59; NSAID&#44; non-steroidal anti-inflammatory drugs&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Dermatology&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Allergology&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N&#160;&#61;&#160;164&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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