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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">Las terapias biol&#243;gicas est&#225;n aprobadas para su uso en pacientes con psoriasis de moderada a grave&#46; Estos tratamientos se han considerado seguros y bien tolerados hasta la fecha&#44; excepto efalizumab&#44; que fue retirado del mercado<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">1</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Las opciones de tratamiento para la psoriasis van aumentando con nuevos agentes biol&#243;gicos y nuevos datos sobre eficacia y seguridad a largo plazo de las terapias aprobadas&#46; Por eso&#44; cada vez son m&#225;s importantes nuevos estudios basados en la evidencia para poder guiar las decisiones m&#233;dicas&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">En la actualidad existe una amplia experiencia en el tratamiento de los pacientes con psoriasis con f&#225;rmacos biol&#243;gicos&#44; excepto en ciertas circunstancias entre las que se encuentra su uso perioperatorio&#46; En esta situaci&#243;n la literatura es limitada y no hay pruebas que nos permitan extraer conclusiones claras a la hora de tomar decisiones ante dichas situaciones&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">En este estudio analizamos el manejo pr&#225;ctico de esta situaci&#243;n en los pacientes de la base de datos Biobadaderm&#44; registro espa&#241;ol de eventos adversos de tratamientos biol&#243;gicos en pacientes con psoriasis&#46; Se incluyen 2<span class="elsevierStyleHsp" style=""></span>clases de f&#225;rmacos biol&#243;gicos&#58; inhibidores del factor de necrosis tumoral &#40;anti-TNF&#41; &#40;infliximab&#44; adalimumab y etanercept&#41; y un inhibidor de la IL12&#47;23 &#40;ustekinumab&#41;&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">El objetivo fundamental del estudio fue describir el manejo pr&#225;ctico del tratamiento biol&#243;gico en el periodo perioperatorio en los pacientes del registro Biobadaderm y analizar las complicaciones quir&#250;rgicas seg&#250;n diferentes variables como tipo de f&#225;rmaco&#44; suspensi&#243;n del f&#225;rmaco&#44; tipo de intervenci&#243;n&#44; y otras variables cl&#237;nicas y demogr&#225;ficas&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">M&#233;todos</span><p id="par0030" class="elsevierStylePara elsevierViewall">Biobadaderm es el registro espa&#241;ol de acontecimientos adversos de tratamientos sist&#233;micos en psoriasis&#46; En &#233;l se recoge informaci&#243;n prospectiva procedente de 12 hospitales&#44; repartidos en varias comunidades aut&#243;nomas&#44; sobre tratamientos y acontecimientos adversos en pacientes psori&#225;sicos&#44; como estrategia de farmacovigilancia&#46; Los datos se introducen directamente en una plataforma web por los centros participantes&#44; a medida que los pacientes presentan modificaciones en su tratamiento o tienen alg&#250;n acontecimiento adverso&#46; Los datos son revisados <span class="elsevierStyleItalic">on line</span> constantemente por un monitor del estudio y anualmente se realiza una visita de monitorizaci&#243;n a cada centro&#44; en la que se cotejan los datos de la aplicaci&#243;n con los de las historias cl&#237;nicas&#46; La descripci&#243;n de Biobadaderm ya ha sido publicada previamente<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">2</span></a>&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Desde el inicio de Biobadaderm en octubre de 2008 y hasta noviembre de 2014 se ha incluido a 2&#46;113 pacientes&#46; Actualmente est&#225;n registrados 4&#46;450 ciclos de tratamiento y 4&#46;593 acontecimientos adversos&#46; En este estudio se revis&#243; y seleccion&#243; a aquellos pacientes que hab&#237;an recibido tratamiento biol&#243;gico &#40;adalimumab&#44; etanercept&#44; ustekinumab&#44; infliximab&#44; efalizumab&#41; y que&#44; adem&#225;s&#44; fueron intervidos quir&#250;rgicamente durante el curso de dicho tratamiento&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Se revisaron los datos incluidos en Biobadaderm sobre las caracter&#237;sticas demogr&#225;ficas&#44; cl&#237;nicas&#44; de tratamientos &#40;con sus tiempos de suspensi&#243;n y de reinicio&#41; para aquellos pacientes con alguna cirug&#237;a&#46; Tambi&#233;n se recogieron de forma retrospectiva&#44; a trav&#233;s de la revisi&#243;n de las historias cl&#237;nicas&#44; datos sobre las intervenciones quir&#250;rgicas como el tipo de cirug&#237;a&#44; procedimiento quir&#250;rgico&#44; gravedad&#44; urgencia y tipo de anestesia&#46; Del mismo modo se recolect&#243; informaci&#243;n sobre el postoperatorio&#44; principalmente en lo que hace referencia a infecciones de la herida quir&#250;rgica&#44; retraso de la cicatrizaci&#243;n y otras posibles complicaciones&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Se realiz&#243; un an&#225;lisis descriptivo utilizando medias y desviaciones est&#225;ndar &#40;DE&#41; para variables continuas sim&#233;tricas&#59; medianas y cuartiles para variables continuas asim&#233;tricas y frecuencias absolutas y porcentajes para variables cualitativas&#46; Con car&#225;cter exploratorio se analizaron los factores que influyeron en la decisi&#243;n de suspender el tratamiento o no mediante el test Chi-cuadrado &#40;&#967;<span class="elsevierStyleSup">2</span>&#41;&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Resultados</span><p id="par0050" class="elsevierStylePara elsevierViewall">De entre los 2&#46;113 pacientes con psoriasis incluidos en Biobadaderm&#44; 48 fueron tratados mediante una intervenci&#243;n quir&#250;rgica&#46; De estos 48 pacientes&#44; 29 fueron hombres &#40;60&#37;&#41; y 19 mujeres &#40;40&#37;&#41;&#44; con una edad media de 55 a&#241;os &#40;DE<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>13&#41; y con una duraci&#243;n de la enfermedad al inicio del tratamiento biol&#243;gico de 20 a&#241;os &#40;DE<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>11&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46; Un 94&#37; presentaba psoriasis en placas y un 21&#37; ten&#237;a adem&#225;s artritis psori&#225;sica&#44; con un PASI medio al inicio del tratamiento biol&#243;gico de 17 &#40;DE<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>12&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">Los f&#225;rmacos m&#225;s comunes que estaban recibiendo los pacientes&#44; antes del procedimiento quir&#250;rgico&#44; fueron&#58; adalimumab &#40;24 pacientes&#41;&#44; etanercept &#40;14&#41;&#44; ustekinumab &#40;4&#41; e infliximab &#40;3&#41;&#46; En 20 &#40;42&#37;&#41; pacientes el f&#225;rmaco se suspendi&#243; antes de la intervenci&#243;n quir&#250;rgica&#44; con una mediana de tiempo de suspensi&#243;n de 3 semanas &#40;P<span class="elsevierStyleInf">25</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2 semanas&#59; P<span class="elsevierStyleInf">75</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&#44;3 semanas&#41;&#46; El f&#225;rmaco no se reintrodujo en un caso&#44; debido a que fue cirug&#237;a oncol&#243;gica&#46; Para los restantes pacientes&#44; la mediana del tiempo de reintroducci&#243;n fue de 2 semanas &#40;P<span class="elsevierStyleInf">25</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1 semana&#59; P<span class="elsevierStyleInf">75</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#44;9 semanas&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Se registraron un total de 55 intervenciones quir&#250;rgicas en los 48 pacientes&#44; 29 &#40;53&#37;&#41; de las cuales fueron cirug&#237;as mayores&#46; Por &#243;rganos y sistemas 17 &#40;31&#37;&#41; fueron cirug&#237;as cut&#225;neas y 15 &#40;27&#37;&#41;&#44; cirug&#237;as gastrointestinales&#44; urol&#243;gicas y ginecol&#243;gicas &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46; Se suspendi&#243; el tratamiento con mayor frecuencia en las intervenciones gastrointestinales&#44; urol&#243;gicas y ginecol&#243;gicas en un 33&#37; &#40;8&#47;24&#41;&#46; No se describi&#243; ning&#250;n caso de infecci&#243;n de la herida quir&#250;rgica ni de retraso en la cicatrizaci&#243;n entre los pacientes en los que no se suspendi&#243; el tratamiento&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">No se detect&#243; asociaci&#243;n estad&#237;stica entre la aparici&#243;n de complicaciones y la interrupci&#243;n del tratamiento &#40;&#967;<span class="elsevierStyleSup">2</span>&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;59&#41;&#46; Tampoco se detect&#243; asociaci&#243;n entre el sexo &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;58&#41;&#44; la edad &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;53&#41;&#44; la duraci&#243;n de la enfermedad &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;06&#41; y el PASI &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;16&#41; con la interrupci&#243;n del tratamiento &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discusi&#243;n</span><p id="par0070" class="elsevierStylePara elsevierViewall">En la pr&#225;ctica cl&#237;nica diaria es frecuente encontrarnos a pacientes con psoriasis en tratamiento biol&#243;gico que van a ser intervenidos quir&#250;rgicamente&#46; La posibilidad de una intervenci&#243;n quir&#250;rgica&#44; urgente o programada&#44; es una eventualidad que debe tenerse en cuenta en pacientes que reciben un tratamiento cr&#243;nico&#44; como es el caso de pacientes con psoriasis en tratamiento biol&#243;gico&#46; Ante esta situaci&#243;n pueden surgir dudas sobre la necesidad de interrupci&#243;n del f&#225;rmaco&#44; el tiempo que debe mantenerse sin tratamiento y el momento adecuado para su reintroducci&#243;n&#44; en caso de que se interrumpa&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Existe una importante controversia acerca de si los f&#225;rmacos biol&#243;gicos pueden alterar la funci&#243;n inmunol&#243;gica normal necesaria para una correcta recuperaci&#243;n tras una intervenci&#243;n quir&#250;rgica<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">3&#44;4</span></a>&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Existen pocos estudios respecto a los pacientes en tratamiento biol&#243;gico que van a ser intervenidos y sobre las complicaciones posquir&#250;rgicas&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Se realiz&#243; una revisi&#243;n de la literatura y los principales estudios al respecto quedan reflejados en la <a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#46; La mayor&#237;a de estos corresponden a pacientes con enfermedades reumatol&#243;gicas en tratamiento con f&#225;rmacos biol&#243;gicos que fueron tratados con diversos procedimientos quir&#250;rgicos&#46; En estos estudios no se observaron diferencias significativas respecto a las complicaciones en el grupo de pacientes en los que se interrumpi&#243; el tratamiento frente a los que continuaron el tratamiento biol&#243;gico&#44; si bien se trata de estudios con escasa potencia estad&#237;stica<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">5&#8211;11</span></a>&#46; De la literatura consultada solo existe un estudio que relaciona el tratamiento con un anti-TNF como un factor de riesgo de infecci&#243;n quir&#250;rgica en cirug&#237;a ortop&#233;dica<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">12</span></a>&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">En pacientes con enfermedad inflamatoria intestinal en tratamiento biol&#243;gico tratados con cirug&#237;a abdominal no se observaron diferencias estad&#237;sticamente significativas en cuanto a las complicaciones posquir&#250;rgicas entre aquellos que continuaron el tratamiento y los que lo suspendieron<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">13&#8211;15</span></a>&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">En el primer estudio de las complicaciones posquir&#250;rgicas en pacientes con psoriasis o artritis psori&#225;sica en tratamiento biol&#243;gico se incluy&#243; a 42 pacientes tratados mediante 77 procedimientos en los que se observ&#243; que continuar con el f&#225;rmaco biol&#243;gico durante el per&#237;odo perioperatorio no elevaba el riesgo de complicaciones posquir&#250;rgicas y&#44; en cambio&#44; su interrupci&#243;n aumentaba el riesgo de empeoramiento de su enfermedad de base<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">16</span></a>&#46; La mayor&#237;a de las sociedades reumatol&#243;gicas recomiendan interrumpir el tratamiento con f&#225;rmacos biol&#243;gicos durante al menos 4 semividas antes de un procedimiento quir&#250;rgico mayor&#44; en caso de cirug&#237;a programada&#59; en el caso de infliximab ser&#237;an 4-6 semanas&#44; adalimumab 6-8 semanas&#44; etanercept 2-3 semanas y ustekinumab 12-15 semanas antes de la intervenci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">17-19</span></a>&#46; Sin embargo&#44; la evidencia de esta recomendaci&#243;n es d&#233;bil y se sustenta en opiniones de expertos&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">El documento de consenso del grupo espa&#241;ol de psoriasis de la Academia Espa&#241;ola de Dermatolog&#237;a y Venereolog&#237;a publicado en 2013 plantea el tratamiento de la psoriasis como un tratamiento continuo&#44; aunque destaca situaciones en algunos pacientes&#44; tales como las intervenciones quir&#250;rgicas&#44; en las que puede plantearse la interrupci&#243;n del tratamiento<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">20</span></a>&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Debido a que actualmente no existen gu&#237;as ni directrices absolutas acerca del manejo de los f&#225;rmacos biol&#243;gicos en pacientes con psoriasis que van a ser intervenidos&#44; la decisi&#243;n de interrumpir o no el tratamiento debe ser individualizada y es importante tener en cuenta los siguientes factores&#58; el tipo de intervenci&#243;n &#40;cirug&#237;a limpia&#44; de bajo riesgo de infecci&#243;n frente a cirug&#237;a de riesgo s&#233;ptico&#41;&#59; el tipo de paciente con posibles antecedentes infecciosos&#44; la existencia de pr&#243;tesis articulares&#44; el tratamiento con esteroides orales y&#44; por &#250;ltimo&#44; la gravedad de la psoriasis del paciente y su respuesta al tratamiento&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Es importante diferenciar el tipo de intervenci&#243;n&#44; ya que en la cirug&#237;a mayor existe mayor complejidad y mayor riesgo de complicaciones perioperatorias que en la menor&#46; El tiempo de interrupci&#243;n es variable&#44; aunque&#44; en general&#44; se recomienda reintroducir el tratamiento cuando la cicatrizaci&#243;n sea completa y no se observen signos de infecci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">21&#8211;23</span></a>&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Como conclusi&#243;n&#44; nuestro estudio no muestra un incremento de la frecuencia de complicaciones en los pacientes con tratamiento biol&#243;gico que lo contin&#250;an cuando son tratados mediante una intervenci&#243;n quir&#250;rgica&#44; aunque su potencia estad&#237;stica es reducida&#46; Por ello&#44; y a falta de estudios que aporten recomendaciones&#44; la decisi&#243;n final deber&#225; basarse en una adecuada valoraci&#243;n entre los riesgos y los beneficios de mantener el tratamiento biol&#243;gico&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Responsabilidades &#233;ticas</span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Protecci&#243;n de personas y animales</span><p id="par0120" class="elsevierStylePara elsevierViewall">Los autores declaran que para esta investigaci&#243;n no se han realizado experimentos en seres humanos ni en animales&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Confidencialidad de los datos</span><p id="par0125" class="elsevierStylePara elsevierViewall">Los autores declaran que han seguido los protocolos de su centro de trabajo sobre la publicaci&#243;n de datos de pacientes&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Derecho a la privacidad y consentimiento informado</span><p id="par0130" class="elsevierStylePara elsevierViewall">Los autores declaran que en este art&#237;culo no aparecen datos de pacientes&#46;</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Financiaci&#243;n</span><p id="par0135" class="elsevierStylePara elsevierViewall">El proyecto Biobadaderm est&#225; promovido por la Fundaci&#243;n Academia Espa&#241;ola de Dermatolog&#237;a y Venereolog&#237;a&#44; que recibe el apoyo econ&#243;mico de la Agencia Espa&#241;ola de Medicamentos y Productos Sanitarios y de las compa&#241;&#237;as farmac&#233;uticas &#40;Abbott&#47;Abbvie&#44; Pfizer&#44; MSD y Janssen&#41;&#46; Los laboratorios colaboradores aportan cantidades similares y no participan en el an&#225;lisis ni en la interpretaci&#243;n de los resultados&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Autor&#237;a&#47;colaboradores</span><p id="par0140" class="elsevierStylePara elsevierViewall">Este trabajo se llev&#243; a cabo dentro del Grupo Biobadaderm&#46; Los siguientes miembros participaron en la adquisici&#243;n de datos y la revisi&#243;n del manuscrito&#58; Cristina Carazo&#44; Jos&#233; Ba&#241;uls&#44; Juan Francisco Silvestre&#44; Pilar Alvares&#44; Isabel Betlloch&#44; Montserrat Hern&#225;ndez&#44; Patricia Guillem&#44; Esther Margarit&#44; Carlos Mu&#241;oz Santos&#44; Sara Pedregosa&#44; Lara Ferrandiz&#44; Ignacio Garc&#237;a Doval&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflictos de inter&#233;s</span><p id="par0145" class="elsevierStylePara elsevierViewall">G&#46; Carretero ha participado como consultor e investigador para Abbott&#44; Janssen-Cilag&#44; MSD y Pfizer&#44; ha recibido honorarios de Abbott&#44; Janssen y Pfizer y equipamiento de MSD y Pfizer&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">C&#46; Ferrandiz ha participado como consultor para Abbott&#44; Janssen-Cilag y Almirall&#44; ha recibido honorarios de Abbott&#44; Almirall&#44; Janssen-Cilag y Pfizer&#44; y ha participado como ponente para Abbott&#44; Almirall&#44; y Janssen-Cilag&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">F&#46; Vanaclocha ha participado en ponencias para Abbott&#44; Pfizer&#44; MSD y Janssen&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">E&#46; Daud&#233;n es miembro de <span class="elsevierStyleItalic">advisory board</span> y consultor&#44; ha recibido becas y apoyo a la investigaci&#243;n&#44; ha participado en ensayos cl&#237;nicos y ha recibido honorarios por impartir ponencias con las siguientes compa&#241;&#237;as farmac&#233;uticas&#58; Abbvie&#47;Abbott&#44; Amgen&#44; Janssen-Cilag&#44; Leo Pharma&#44; Novartis&#44; Pfizer&#44; MSD-Schering-Plough&#44; Celgene&#44; Lilly&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">E&#46; Herrera Ceballos ha participado como consultor y ponente para Abbvie&#44; Janssen-Cilag y Pfizer-Wyett&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">I&#46; Belinch&#243;n Romero ha participado como consultora para Pfizer-Wyeth&#44; Janssen-Cilag&#44; Almirall y Leo Pharma y ha participado como ponente para Abbvie&#44; Pfizer-Wyeth&#44; Janssen-Cilag y MSD&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">J&#46; L&#46; S&#225;nchez Carazo ha participado como consultor para Abbott&#44; Janssen-Cilag&#44; MSD y Pfizer-Wyeth&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">J&#46; L&#46; L&#243;pez Estebaranz ha participado como consultor para Abbott&#44; Janssen-Cilag&#44; MSD y Pfizer&#44; y ha participado como ponente para Abbott&#44; Janssen-Cilag&#44; MSD y Pfizer-Wyeth&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">M&#46; Alsina ha participado como consultora para Abbvie y Merck&#47;Schering-Plough&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">M&#46; Ferr&#225;n ha participado en <span class="elsevierStyleItalic">advisory boards</span> para MSD&#44; Pfizer&#44; Abbvie y Janssen-Cilag&#59; como ponente para MSD&#44; Abbvie y Janssen-Cilag y como investigador para MSD&#44; Abbvie&#44; Pfizer y Janssen-Cilag&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">J&#46; M&#46; Carrascosa ha participado como consultor y como ponente para Abbvie&#44; Janssen-Cilag&#44; MSD&#44; Pfizer-Wyeth&#44; Lilly&#44; Novartis y Celgene&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">R&#46; Rivera ha participado en <span class="elsevierStyleItalic">advisory boards</span> para Abbvie&#44; Janssen-Cilag&#44; MSD y Pfizer&#47;Wyeth&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">D&#46; Ruiz Genao ha participado como ponente para Abbott&#44; Pfizer&#44; MSD y Janssen&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">P&#46; de la Cueva ha participado como consultor para Janssen-Cilag&#44; Abbvie&#44; MSD&#44; Pfizer&#44; Novartis&#44; Lilly y Leo-Pharma&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">El resto de los autores declara no tener conflicto de intereses&#46;</p></span></span>"
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            0 => "Psoriasis"
            1 => "Biol&#243;gicos"
            2 => "Terapia sist&#233;mica"
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            1 => "Biologic agents"
            2 => "Systemic therapy"
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Introducci&#243;n y objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Disponemos de una gran experiencia en el uso de los f&#225;rmacos biol&#243;gicos para el tratamiento de los pacientes con psoriasis&#44; sin embargo&#44; existen situaciones concretas&#44; como la cirug&#237;a&#44; en las que pueden surgir dudas sobre su manejo&#46; Aunque las gu&#237;as de tratamiento aconsejan su suspensi&#243;n programada previamente a los procedimientos de cirug&#237;a mayor&#44; no existe evidencia de cu&#225;l es la actitud habitual en la pr&#225;ctica cl&#237;nica y su asociaci&#243;n a complicaciones&#46; Nuestro objetivo fue analizar el manejo actual de esta situaci&#243;n en la pr&#225;ctica cl&#237;nica habitual&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todos</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A trav&#233;s de un estudio retrospectivo de la base de datos Biobadaderm se analiz&#243; el manejo pr&#225;ctico de pacientes con psoriasis en tratamiento biol&#243;gico que fueron intervenidos mediante alg&#250;n procedimiento quir&#250;rgico&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">De los 2&#46;113 pacientes incluidos en Biobadaderm&#44; 48 fueron tratados con una intervenci&#243;n quir&#250;rgica&#44; de las que fueron mayoritarias las de tipo cut&#225;neo &#40;31&#37;&#41;&#46; El tratamiento biol&#243;gico se suspendi&#243; en el 42&#37; de los casos&#46; No se observaron asociaciones estad&#237;sticamente significativas entre la aparici&#243;n de complicaciones posquir&#250;rgicas y la interrupci&#243;n del f&#225;rmaco&#46; Tampoco se detect&#243; asociaci&#243;n entre la interrupci&#243;n del tratamiento con otras variables como el sexo&#44; la edad&#44; la duraci&#243;n de la enfermedad y la gravedad de la psoriasis&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusi&#243;n</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">No se ha encontrado asociaci&#243;n entre la continuidad del tratamiento biol&#243;gico y el riesgo de complicaciones posquir&#250;rgicas&#44; aunque el estudio presenta la limitaci&#243;n de tener un tama&#241;o muestral escaso&#46;</p></span>"
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            "identificador" => "abst0015"
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        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Background and objective</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">We now have considerable experience in the use of biologic agents to treat psoriasis&#44; but doubts about management arise in certain clinical settings&#46; Surgery is one of them&#46; Although treatment guidelines advise that biologics be suspended before major surgery&#44; data about actual clinical practices and associated complications are lacking&#46; We aimed to analyze current practice in the clinical management of these cases&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Retrospective study of cases in the Biobadaderm database&#46; We analyzed the management of biologic therapy in patients with psoriasis who underwent surgical procedures&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Forty-eight of the 2113 patients registered in Biobadaderm underwent surgery&#46; The largest percentage of procedures &#40;31&#37;&#41; involved skin lesions&#46; Biologic treatment was interrupted in 42&#37; of the cases&#46; No postsurgical complications were significantly related to treatment interruption&#46; Likewise we detected no associations between treatment interruption and other variables&#44; such as sex&#44; age&#44; or duration or severity of psoriasis&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Conclusion</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Continuity of biologic treatment and the risk of postsurgical complications were not associated in this study&#44; although conclusions are limited by the small sample size&#46;</p></span>"
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          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">DE&#58; desviaci&#243;n est&#225;ndar&#59; PASI&#58; psoriasis area severity index&#59; PUVA&#58; terapia con psolareno y radiaci&#243;n ultravioleta de longitud de onda A&#59; UVB&#58; terapia con radiaci&#243;n ultravioleta de longitud de onda B&#46;</p>"
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                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Caracter&#237;sticas demogr&#225;ficas</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>N&#250;mero de pacientes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mujer&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19 &#40;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Edad actual&#44; media &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">55&#44;1 &#40;12&#44;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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Edad al inicio del tratamiento&#44; media &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Duraci&#243;n de la enfermedad al inicio del tratamiento&#44; media &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&#44;1 &#40;11&#44;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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>PASI&#44; media &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17 &#40;12&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Diagn&#243;sticos al inicio&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Psoriasis en placas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">45 &#40;94&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Psoriasis en gotas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Artritis psori&#225;sica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Comorbilidad&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Cardiopat&#237;a isqu&#233;mica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Insuficiencia cardiaca&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hipertensi&#243;n arterial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diabetes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hipercolesterolemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16 &#40;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>C&#225;ncer previo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">N&#250;mero de tratamientos cl&#225;sicos previos&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20 &#40;42&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>3 o m&#225;s&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Tratamientos cl&#225;sicos previos m&#225;s comunes&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>PUVA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16 &#40;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>UVB-311&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>UVB banda ancha&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Metotrexato&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17 &#40;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ciclosporina&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22 &#40;46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Acitretino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "es" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas demogr&#225;ficas y cl&#237;nicas de los pacientes tratados con una intervenci&#243;n quir&#250;rgica</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Principales caracter&#237;sticas de las cirug&#237;as&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Frecuencia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Gravedad&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Cirug&#237;a mayor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29 &#40;53&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Cirug&#237;a menor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26 &#40;47&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Localizaci&#243;n&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Cirug&#237;a cut&#225;nea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17 &#40;31&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Cirug&#237;a gastrointestinal y urol&#243;gica&#47;ginecol&#243;gica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Cirug&#237;a ortop&#233;dica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Cirug&#237;a ocular&#44; dental y otorrinolaringol&#243;gica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Cirug&#237;a cardiovascular y tor&#225;cica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No especificada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Urgente&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">46 &#40;90&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Tipo de anestesia&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Local&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25 &#40;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>General&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17 &#40;36&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Raquimedular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sedaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Complicaciones&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">51 &#40;93&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Profilaxis antibi&#243;tica&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40 &#40;85&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Caso 2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Caso 3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Caso 4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sexo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Var&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Var&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Var&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mujer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Edad&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Tratamiento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Etanercept&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Adalimumab&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Adalimumab&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Adalimumab&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Suspensi&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Tipo de cirug&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Vascular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Desbridamiento herida&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cardiaca&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Extirpaci&#243;n de quiste de Bartolino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Urgente &#40;s&#237;&#47;no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Complicaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">S&#237;ndrome febril&#44; leucocitosis y neutrofilia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Descompensaci&#243;n asc&#237;tico-edematosa&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neuritis &#243;ptica isqu&#233;mica&#44; seroma&#44; dehiscencia de sutura de esternotom&#237;a y seroma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Infecci&#243;n del tracto urinario&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Enfermedad del paciente&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Tipo de cirug&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Grupos de estudio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">N&#46;&#176; de pacientes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Resultados&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Bibbo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">5</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Artritis reumatoide&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Ortop&#233;dica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">FARME<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>anti-TNF &#40;16&#41;<br>FARME &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Sin diferencias en infecci&#243;n ni curaci&#243;n de las heridas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Wendling et al&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">6</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Artritis reumatoide&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Ortop&#233;dica&#44; abdominal&#44; cabeza y cuello&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Suspensi&#243;n de anti-TNF &#40;18 cirug&#237;as&#41;<br>No se suspende anti-TNF &#40;32 cirug&#237;as&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50 cirug&#237;as en 30 pacientes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Sin infecci&#243;n<br>Sin aumento de efectos adversos relacionados con la continuidad del f&#225;rmaco&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Talwalkar et al&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">7</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Artritis reumatoide&#44; artritis psori&#225;sica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Ortop&#233;dica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No se suspende anti-TNF &#40;4&#41;<br>Suspensi&#243;n de anti-TNF &#40;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16 cirug&#237;as en 11 pacientes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Sin infecci&#243;n<br>Sin aumento del riesgo de infecci&#243;n ni complicaciones relacionadas con la continuidad del f&#225;rmaco&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Giles et al&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">12</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Artritis reumatoide&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Ortop&#233;dica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Tuvieron infecci&#243;n posquir&#250;rgica &#40;10&#44; 7 con anti-TNF&#41;<br>Sin infecci&#243;n posquir&#250;rgica &#40;81&#44; 28 con anti-TNF&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Tratamiento con anti-TNF es factor de riesgo de infecci&#243;n posquir&#250;rgica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ruyssen et al&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">8</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Artritis reumatoide&#44; espondiloartropat&#237;as&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Ortop&#233;dica&#44; abdominal&#44; ginecol&#243;gica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Interrumpir<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>5 semividas &#40;36&#41;<br>Interrumpir 2-4 semividas &#40;55&#41;<br>Interrumpir &#60;2 semividas &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">101&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Complicaciones en 7&#47;36 &#40;19&#44;4&#37;&#41;<br>Complicaciones en 9&#47;55 &#40;16&#44;3&#37;&#41;<br>Complicaciones en 3&#47;10 &#40;30&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Den Broeder et al&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">9</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Artritis reumatoide y sin AR &#40;grupo control&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Ortop&#233;dica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No anti-TNF ni AR &#40;1023&#41;<br>Interrupci&#243;n anti-TNF &#40;104&#41;<br>Continuaci&#243;n anti-TNF &#40;92&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;219&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Infecci&#243;n en 4&#37;<br>Infecci&#243;n en 5&#44;8&#37;<br>Infecci&#243;n en 3&#44;8&#37; &#40;p<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#44;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Kubota et al&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">11</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Artritis reumatoide&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Ortop&#233;dica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Tratamiento biol&#243;gico &#40;276&#41;<br>Tratamiento no biol&#243;gico &#40;278&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">554&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No aumento de infecci&#243;n<br>Sin diferencias significativas en retraso de la cicatrizaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Marchal et al&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">13</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Enfermedad de Crohn&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Abdominal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Tuvieron infusi&#243;n previa a la cirug&#237;a &#40;40&#41;<br>Control &#40;39&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Sin aumento en la tasa de complicaciones&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Kunitake et al&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">14</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Enfermedad de Crohn&#44; colitis ulcerosa&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Abdominal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Infliximab prequir&#250;rgico &#40;101&#41;<br>Sin exposici&#243;n previa a infliximab &#40;312&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">413&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Infliximab prequir&#250;rgico no se relacion&#243; con aumento de complicaciones posquir&#250;rgicas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gainsbury et al&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">15</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Colitis ulcerosa&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Abdominal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Infliximab preoperatorio &#40;29&#41;<br>Sin infliximab &#40;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">81&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Infliximab prequir&#250;rgico no se asoci&#243; con aumento de complicaciones posquir&#250;rgicas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Bakkour et al&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">16</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Psoriasis&#44; artritis psori&#225;sica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cut&#225;nea&#44; cardiotor&#225;cica&#44; ortop&#233;dica&#44; gastrointestinal&#44; urol&#243;gica&#44; dental&#44; maxilofacial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Continuar con tratamiento biol&#243;gico &#40;57&#41;<br>Suspender tratamiento biol&#243;gico &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">77 cirug&#237;as en 42 pacientes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Sin diferencias significativas en el riesgo de infecci&#243;n posquir&#250;rgica ni en retraso en la cicatrizaci&#243;n de la herida posquir&#250;rgica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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