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array:23 [ "pii" => "S1130147305704334" "issn" => "11301473" "doi" => "10.1016/S1130-1473(05)70433-4" "estado" => "S300" "fechaPublicacion" => "2005-01-01" "aid" => "70433" "copyright" => "Sociedad Española de Neurocirugía" "copyrightAnyo" => "2005" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Neurocirugia. 2005;16:39-49" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1823 "formatos" => array:3 [ "EPUB" => 16 "HTML" => 1113 "PDF" => 694 ] ] "itemSiguiente" => array:18 [ "pii" => "S1130147305704346" "issn" => "11301473" "doi" => "10.1016/S1130-1473(05)70434-6" "estado" => "S300" "fechaPublicacion" => "2005-01-01" "aid" => "70434" "copyright" => "Sociedad Española de Neurocirugía" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Neurocirugia. 2005;16:50-3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1902 "formatos" => array:3 [ "EPUB" => 13 "HTML" => 1236 "PDF" => 653 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Consumo de cocaína como desencadenante de hemorragia en un oligoastrocitoma" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "50" "paginaFinal" => "53" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Cocaine abuse as precipitating factor of tumoral bleeding in an oligoastrocitoma" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. 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"apellidos" => "Caldera-Duarte" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147305704322?idApp=UINPBA00004B" "url" => "/11301473/0000001600000001/v1_201305151233/S1130147305704322/v1_201305151233/es/main.assets" ] "es" => array:15 [ "idiomaDefecto" => true "titulo" => "Revisión de los ensayos clínicos sobre prevención del daño neurológico en el traumatismo craneoencefálico grave y análisis de su fracaso terapéutico" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "39" "paginaFinal" => "49" ] ] "autores" => array:2 [ 0 => array:4 [ "autoresLista" => "G.R. Boto, P.A. Gómez, R.D. Lobato" "autores" => array:3 [ 0 => array:3 [ "nombre" => "G.R." "apellidos" => "Boto" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "P.A." "apellidos" => "Gómez" ] 2 => array:2 [ "nombre" => "R.D." "apellidos" => "Lobato" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Neurocirugía. Hospital 12 de Octubre. Madrid" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Correspondencia postal: Avda. Dr. García Tapia, 159. Escalera D. 4°-B. 28030 Madrid." ] ] ] 1 => array:3 [ "autoresLista" => "J. De la Cruz" "autores" => array:1 [ 0 => array:3 [ "nombre" => "J." "apellidos" => "De la Cruz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Unidad de Epidemiología Clínica. Hospital 12 de Octubre. Madrid" "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Overview of the recent clinical triáis in severe head injury and analysis of their therapeutic failure" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2004-01-08" "fechaAceptado" => "2004-11-12" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec158731" "palabras" => array:3 [ 0 => "Ensayos clínicos" 1 => "Traumatismo craneoencefálico grave" 2 => "Neuroprotección" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec158730" "palabras" => array:3 [ 0 => "Clinical triáis" 1 => "Severe head injury" 2 => "Neuroprotection" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">En la pasada “Década del Cerebro” se han sometido a ensayo clínico distintos fármacos neuroprotectores frente al traumatismo craneoencefálico grave (TCEG) sin que ninguno de ellos haya mejorado de manera significativa el pronóstico final de estos pacientes. La eficacia neuroprotectora de estas sustancias, confirmada en los modelos animales, no ha podido trasladarse al ámbito clínico, creando gran decepción en la comunidad científica.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Este trabajo se ha estructurado en tres partes: en la primera, se resumen los mecanismos fisiopatológicos involucrados en el TCEG, diana de los fármacos neuroprotectores. En la segunda parte se revisan cuáles han sido los ensayos clínicos más importantes sobre TCEG llevados a cabo en estos últimos años y en la tercera, se analizan los motivos que pueden explicar el “fracaso” terapéutico de estos fármacos.</p>" ] "en" => array:2 [ "titulo" => "Summary" "resumen" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">During the past “Decade of the Brain” several neuroprotective agents have been tested in phase III clinical triáis for severe head injury (SHI) but unfortu-nately none of them significantly improved the outcome of these patients. In contrast to the success achieved by these drugs in animal laboratory studies, the results in terms of neuroprotection in the clinical setting have been disappointing.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">This paper has been divided in three parts: in the first one, we summarize the pathophysiological mecha-nisms related to SHI, targeted by the neuroprotective agents. In the second part we review the main clinical triáis carried out for SHI to date, and in the third one, we analyze the possible reasons that explain why these agents have failed to show efficacy.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Boto, G.R.; Gómez, P.A.; De la Cruz, J.; Lobato, R.D.: Revisión de los ensayos clínicos sobre prevención del daño neurológico en el traumatismo craneoencefálico grave y análisis de su fracaso terapéutico. Neurocirugía 2005; 16: 39–49.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:55 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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