que se leu este artigo
array:24 [ "pii" => "S0870255121002262" "issn" => "08702551" "doi" => "10.1016/j.repc.2021.05.005" "estado" => "S300" "fechaPublicacion" => "2021-09-01" "aid" => "1756" "copyright" => "Sociedade Portuguesa de Cardiologia" "copyrightAnyo" => "2021" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "dis" "cita" => "Rev Port Cardiol. 2021;40:685-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:19 [ "pii" => "S0870255121001499" "issn" => "08702551" "doi" => "10.1016/j.repc.2021.02.010" "estado" => "S300" "fechaPublicacion" => "2021-09-01" "aid" => "1726" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "rev" "cita" => "Rev Port Cardiol. 2021;40:687-93" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Review Article</span>" "titulo" => "SGLT-2 inhibitors: A step forward in the treatment of heart failure with reduced ejection fraction" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "687" "paginaFinal" => "693" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Inibidores do SGLT-2: um passo em frente no tratamento da ICFEr" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "José Silva-Cardoso, Aurora Andrade, Dulce Brito, Jorge Ferreira, Cândida Fonseca, Marisa Peres, Fátima Franco, Brenda Moura" "autores" => array:8 [ 0 => array:2 [ "nombre" => "José" "apellidos" => "Silva-Cardoso" ] 1 => array:2 [ "nombre" => "Aurora" "apellidos" => "Andrade" ] 2 => array:2 [ "nombre" => "Dulce" "apellidos" => "Brito" ] 3 => array:2 [ "nombre" => "Jorge" "apellidos" => "Ferreira" ] 4 => array:2 [ "nombre" => "Cândida" "apellidos" => "Fonseca" ] 5 => array:2 [ "nombre" => "Marisa" "apellidos" => "Peres" ] 6 => array:2 [ "nombre" => "Fátima" "apellidos" => "Franco" ] 7 => array:2 [ "nombre" => "Brenda" "apellidos" => "Moura" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255121001499?idApp=UINPBA00004E" "url" => "/08702551/0000004000000009/v1_202109020549/S0870255121001499/v1_202109020549/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0870255121002249" "issn" => "08702551" "doi" => "10.1016/j.repc.2020.10.019" "estado" => "S300" "fechaPublicacion" => "2021-09-01" "aid" => "1754" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Rev Port Cardiol. 2021;40:679-84" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>" "titulo" => "Clinical value of the combined use of P-wave dispersion and troponin values to predict atrial fibrillation recurrence in patients with paroxysmal atrial fibrillation" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "679" "paginaFinal" => "684" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Valor clínico da utilização combinada da dispersão da onda P e dos valores de troponina para prever a recorrência de fibrilhação auricular em doentes com fibrilhação auricular paroxística" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1325 "Ancho" => 2091 "Tamanyo" => 119620 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Comparison of atrial fibrillation recurrence rates in the three groups.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Metin Ocak, Mustafa Begenc Tascanov" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Metin" "apellidos" => "Ocak" ] 1 => array:2 [ "nombre" => "Mustafa Begenc" "apellidos" => "Tascanov" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255121002249?idApp=UINPBA00004E" "url" => "/08702551/0000004000000009/v1_202109020549/S0870255121002249/v1_202109020549/en/main.assets" ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial comment</span>" "titulo" => "Serum biomarkers and the electrocardiogram: Best friends forever?" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "685" "paginaFinal" => "686" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Pedro Silva Cunha" "autores" => array:1 [ 0 => array:3 [ "nombre" => "Pedro Silva" "apellidos" => "Cunha" "email" => array:1 [ 0 => "psilvacunha@sapo.pt" ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Service, Central Lisbon Hospital and University Center, Lisbon, Portugal" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Biomarcadores séricos e ECG: melhores amigos para sempre?" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleDisplayedQuote" id="dsq0005"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">“When I pronounce the word Future, the first syllable already belongs to the past.”</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">– Wisława Szymborska, Poems New and Collected</p></span></p><p id="par0010" class="elsevierStylePara elsevierViewall">In recent decades, cardiovascular medicine has been actively looking for biomarkers that could be used as additional tools to predict therapeutic failure or morbidity and mortality in patients with heart disease.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The measurement of biomarkers such as troponin and natriuretic peptides has consistently been shown to improve risk prediction in addition to clinical risk stratification models.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Recently, a study investigated the relationship between troponin level, coronary angiography, and all-cause mortality in patients presenting with atrial fibrillation (AF).<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">1</span></a> In this study the presence of elevated troponin levels in patients presenting to the hospital with AF was associated with a high risk of mortality, with higher levels associated with worse prognosis. Importantly, the risk of mortality associated with troponin increase was lower in patients who underwent coronary angiography than in those who did not.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The exact pathophysiology of circulating troponin in AF is still the subject of research, and there are no clear answers. One hypothesis is that myocardial necrosis is caused by rapidly conducted AF in the context of pre-existing coronary artery disease (causing oxygen supply-demand mismatch). But several other pathophysiological mechanisms may be involved, including volume and pressure overload, changes in microvascular blood flow, atrial calcium overload, oxidative stress, and changes in tissue structure.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">2,3</span></a> Oxygen supply-demand mismatch is probably a credible explanation, as it has been observed that rate control can reduce troponin leak.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">4</span></a> Nonetheless, there are also circumstances in which troponin release also occurs at normal ventricular rates, and furthermore in several patients with stroke and AF there is evidence of troponin increase in the acute phase.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">5</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">The role of coronary revascularization is not obvious, as the identified coronary artery disease is not always severe or functionally significant, which makes clear treatment decisions difficult, but this debate is beyond the scope of the present discussion.</p><p id="par0035" class="elsevierStylePara elsevierViewall">In the area of electrical activity analysis, research has shown that the presence of P-wave disturbance is a predictive factor not only of arrhythmia morbidity, but also of overall mortality, stroke and dementia.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">6</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Prolonged P-wave duration is a marker of left atrial abnormality, and in a sub-analysis of the Atherosclerosis Risk in Communities study, an association was also found between the presence of P-wave prolongation and the increased risk of sudden cardiac death in the general population.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">7</span></a> This association was independent of cardiovascular risk factors and conditions including AF.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Recently, a deep convolutional neural network using digital electrocardiogram (ECG) traces, trained on >1 million 12-lead resting ECGs, predicted new-onset AF within one year.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">8</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Electrocardiographic analysis during sinus rhythm could thus be an additional tool to predict the development of cardiovascular disease.</p><p id="par0055" class="elsevierStylePara elsevierViewall">In the context set out above, it seems extremely attractive to include the combined assessment of different biomarkers and electrical parameters, so that together they add predictive value to clinical data.</p><p id="par0060" class="elsevierStylePara elsevierViewall">Ocak et al., <a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">9</span></a> in their study published in this issue of the <span class="elsevierStyleItalic">Journal</span>, analyzed the clinical usefulness of combining P-wave dispersion and cardiac troponin I to predict AF recurrence in patients presenting to the emergency department with paroxysmal AF. P-wave dispersion (PWD) is defined as the difference between maximum and minimum P-wave duration recorded by 12-lead surface ECG.</p><p id="par0065" class="elsevierStylePara elsevierViewall">In this analysis, 65 patients with paroxysmal AF were included, divided into three groups according to baseline troponin I and PWD values. The novelty of this approach is the combination of a serum biomarker with an electrocardiographic parameter.</p><p id="par0070" class="elsevierStylePara elsevierViewall">The multivariate logistic regression analysis, in which age, C-reactive protein, white blood cell count, erythrocyte sedimentation rate, glucose, platelets and gender were analyzed, revealed that higher values of troponin and PWD were independent predictors of AF recurrence.</p><p id="par0075" class="elsevierStylePara elsevierViewall">Troponin I values ≥0.11 ng/ml predicted AF recurrence with a specificity of 61.9% and sensitivity of 72.7%, and PWD≥44.5 ms predicted AF recurrence with a specificity of 79.5% and sensitivity of 71.4%.</p><p id="par0080" class="elsevierStylePara elsevierViewall">The combined use of PWD and baseline troponin I values had higher predictive value than PWD or troponin alone.</p><p id="par0085" class="elsevierStylePara elsevierViewall">As the authors report, the study is limited by its small sample size and the inclusion only of patients with the paroxysmal phenotype of AF, and this should be taken into consideration when analyzing the results.</p><p id="par0090" class="elsevierStylePara elsevierViewall">Even with the above limitations, this study is a further step in the inclusion of relatively accessible markers in the risk stratification of patients with AF. Its findings suggest that it will soon be possible to integrate these data routinely into clinical decision-making.</p><p id="par0095" class="elsevierStylePara elsevierViewall">The combination of these two parameters could add significant information on the likelihood of AF recurrence, ultimately resulting in the therapeutic approach being decided based on this prediction, particularly with regard to the maintenance of oral anticoagulation. However, in order for its use as a prediction tool to become routine, it will be necessary to demonstrate its validity in larger numbers of patients.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0100" class="elsevierStylePara elsevierViewall">The author has no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:9 [ 0 => array:3 [ "identificador" => "bib0050" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prognostic significance of troponin level in 3121 patients presenting with atrial fibrillation (The NIHR Health Informatics Collaborative TROP-AF study)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "A. Kaura" 1 => "A.D. Arnold" 2 => "V. Panoulas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/JAHA.119.013684" "Revista" => array:5 [ "tituloSerie" => "J Am Heart Assoc" "fecha" => "2020" "volumen" => "9" "paginaInicial" => "e013684" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32212911" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0055" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Narrative review: alternative causes for elevated cardiac troponin levels when acute coronary syndromes are excluded" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A. Jeremias" 1 => "C.M. Gibson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.7326/0003-4819-142-9-200505030-00015" "Revista" => array:6 [ "tituloSerie" => "Ann Intern Med" "fecha" => "2005" "volumen" => "142" "paginaInicial" => "786" "paginaFinal" => "791" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15867411" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0060" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Biomarkers in atrial fibrillation: a clinical review" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "Z. Hijazi" 1 => "J. Oldgren" 2 => "A. Siegbahn" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/eurheartj/eht024" "Revista" => array:7 [ "tituloSerie" => "Eur Heart J" "fecha" => "2013" "volumen" => "34" "numero" => "May" "paginaInicial" => "1475" "paginaFinal" => "1480" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23386711" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0065" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Improved rate control reduces cardiac troponin T levels in permanent atrial fibrillation" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "S.R. Ulimoen" 1 => "S. Enger" 2 => "J. Norseth" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/clc.22281" "Revista" => array:6 [ "tituloSerie" => "Clin Cardiol" "fecha" => "2014" "volumen" => "37" "paginaInicial" => "422" "paginaFinal" => "427" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24700386" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0070" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "New-onset atrial fibrillation in patients with elevated troponin I levels in the acute phase of stroke" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "A. Lasek-Bal" 1 => "Z. Gąsior" 2 => "T. Kowalewska-Twardela" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ijcard.2015.05.117" "Revista" => array:6 [ "tituloSerie" => "Int J Cardiol" "fecha" => "2015" "volumen" => "195" "paginaInicial" => "210" "paginaFinal" => "211" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26048377" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0075" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "P wave duration is associated with cardiovascular and all-cause mortality outcomes: the National Health and Nutrition Examination Survey" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "J.W. Magnani" 1 => "E.Z. Gorodeski" 2 => "V.M. Johnson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.hrthm.2010.09.020" "Revista" => array:7 [ "tituloSerie" => "Heart Rhythm" "fecha" => "2011" "volumen" => "8" "numero" => "January" "paginaInicial" => "93" "paginaFinal" => "100" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20868770" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0080" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Relation of prolonged p-wave duration to risk of sudden cardiac death in the general population (from the Atherosclerosis Risk in Communities Study)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "A. Maheshwari" 1 => "F.L. Norby" 2 => "E.Z. Soliman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.amjcard.2017.01.012" "Revista" => array:8 [ "tituloSerie" => "Am J Cardiol" "fecha" => "2017" "volumen" => "119" "numero" => "May" "paginaInicial" => "1302" "paginaFinal" => "1306" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28267962" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0091674912017022" "estado" => "S300" "issn" => "00916749" ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0085" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Deep neural networks can predict new-onset atrial fibrillation from the 12-lead ECG and help identify those at risk of atrial fibrillation-related stroke" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "S. Raghunath" 1 => "J.M. Pfeifer" 2 => "A. Ulloa-Cerna" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/CIRCULATIONAHA.120.047829" "Revista" => array:7 [ "tituloSerie" => "Circulation" "fecha" => "2021" "volumen" => "143" "paginaInicial" => "1287" "paginaFinal" => "1298" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33588584" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0091674911001357" "estado" => "S300" "issn" => "00916749" ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0090" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical value of the combined use of P-wave dispersion and troponin values to predict atrial fibrillation recurrence in patients with paroxysmal atrial fibrillation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Metin Ocak" 1 => "M.B. Tascanov" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Rev Port Cardiol" "fecha" => "2021" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2631811" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/08702551/0000004000000009/v1_202109020549/S0870255121002262/v1_202109020549/en/main.assets" "Apartado" => array:4 [ "identificador" => "29261" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Artigos Originais" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/08702551/0000004000000009/v1_202109020549/S0870255121002262/v1_202109020549/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255121002262?idApp=UINPBA00004E" ]
Ano/Mês | Html | Total | |
---|---|---|---|
2024 Novembro | 4 | 5 | 9 |
2024 Outubro | 47 | 34 | 81 |
2024 Setembro | 44 | 24 | 68 |
2024 Agosto | 51 | 29 | 80 |
2024 Julho | 38 | 30 | 68 |
2024 Junho | 46 | 29 | 75 |
2024 Maio | 41 | 14 | 55 |
2024 Abril | 35 | 31 | 66 |
2024 Maro | 33 | 23 | 56 |
2024 Fevereiro | 26 | 17 | 43 |
2024 Janeiro | 28 | 24 | 52 |
2023 Dezembro | 24 | 28 | 52 |
2023 Novembro | 33 | 35 | 68 |
2023 Outubro | 24 | 14 | 38 |
2023 Setembro | 26 | 21 | 47 |
2023 Agosto | 18 | 19 | 37 |
2023 Julho | 32 | 10 | 42 |
2023 Junho | 32 | 14 | 46 |
2023 Maio | 32 | 24 | 56 |
2023 Abril | 13 | 12 | 25 |
2023 Maro | 34 | 21 | 55 |
2023 Fevereiro | 24 | 26 | 50 |
2023 Janeiro | 17 | 22 | 39 |
2022 Dezembro | 36 | 35 | 71 |
2022 Novembro | 35 | 30 | 65 |
2022 Outubro | 36 | 29 | 65 |
2022 Setembro | 22 | 30 | 52 |
2022 Agosto | 28 | 35 | 63 |
2022 Julho | 28 | 47 | 75 |
2022 Junho | 30 | 29 | 59 |
2022 Maio | 28 | 35 | 63 |
2022 Abril | 28 | 36 | 64 |
2022 Maro | 39 | 45 | 84 |
2022 Fevereiro | 39 | 45 | 84 |
2022 Janeiro | 54 | 39 | 93 |
2021 Dezembro | 37 | 38 | 75 |
2021 Novembro | 43 | 44 | 87 |
2021 Outubro | 78 | 85 | 163 |
2021 Setembro | 127 | 87 | 214 |
2021 Agosto | 44 | 36 | 80 |
2021 Julho | 22 | 17 | 39 |
2021 Junho | 58 | 48 | 106 |