<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0034-7493</journal-id>
<journal-title><![CDATA[Revista Cubana de Cirugía]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Cubana Cir]]></abbrev-journal-title>
<issn>0034-7493</issn>
<publisher>
<publisher-name><![CDATA[Editorial Ciencias Médicas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0034-74932020000400006</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Morbimortalidad por cáncer gástrico en un servicio de cirugía general]]></article-title>
<article-title xml:lang="en"><![CDATA[Morbidity and mortality from gastric cancer in a general surgery service]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Morales de la Torre]]></surname>
<given-names><![CDATA[Roger]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Brismat Remedios]]></surname>
<given-names><![CDATA[Ihosvany]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gutiérrez Rojas]]></surname>
<given-names><![CDATA[Ángel Reinaldo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Ciencias Médicas de La Habana Hospital Universitario &#8220;General Calixto García&#8221; ]]></institution>
<addr-line><![CDATA[La Habana ]]></addr-line>
<country>Cuba</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad de Ciencias Médicas de La Habana Hospital Clínico Docente &#8220;Dr. Miguel Enríquez&#8221; ]]></institution>
<addr-line><![CDATA[La Habana ]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2020</year>
</pub-date>
<volume>59</volume>
<numero>4</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S0034-74932020000400006&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S0034-74932020000400006&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S0034-74932020000400006&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  El cáncer de estómago representa la segunda causa más frecuente de muerte relacionada con neoplasias en el mundo, es responsable del 8 al 10 % de todas las muertes por cáncer.  Objetivo:  Determinar la morbilidad y la mortalidad por cáncer gástrico en el servicio de cirugía del Hospital Universitario &#8220;General Calixto García&#8221;.  Métodos: Se realizó un estudio observacional descriptivo, transversal. El universo estuvo conformado por 145 pacientes que cumplieron con los criterios de inclusión. Se utilizaron métodos estadísticos descriptivos y cálculos con valores porcentuales.  Resultados:  El 67,6 % de los pacientes pertenecían al sexo masculino, mientras que 87 se ubicaron en los grupos de edades entre 60 y 79 años. El 37,2 % de los pacientes presentaron lesión ulcerada infiltrante de acuerdo a la clasificación endoscópica de Borrmann. El adenocarcinoma gástrico fue el tipo histológico más encontrado. La técnica quirúrgica más empleada fue la gastrectomía subtotal, y la gastroyeyunostomía. La complicación postoperatoria más frecuente la constituyó la bronconeumonía con 35 pacientes. La mayoría de los pacientes egresaron vivos.  Conclusiones:  La investigación sugiere que el diagnóstico precoz y la cirugía en la actualidad es la única modalidad con potencial curativo y puede elevar la calidad de vida y mejorar los índices de morbimortalidad en la población.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction: Stomach cancer is the second leading cause of death related to neoplasms worldwide. It is responsible for 8-10% of all cancer-related deaths.  Objective: To determine the morbidity and mortality for gastric cancer in the surgery service of General Calixto García University Hospital.  Methods: A descriptive, cross-sectional and observational study was carried out. The universe consisted of 145 patients who met the inclusion criteria. Descriptive statistical methods and calculations with percentage values were used.  Results: 67.6% of the patients belonged to the male sex, while 87 were located in the age groups between 60 and 79 years. 37.2% of the patients presented an infiltrating ulcerated lesion according to Borrmann endoscopic classification. Gastric adenocarcinoma was the most common histological type. The most used surgical technique was subtotal gastrectomy, followed by gastrojejunostomy. The most frequent postoperative complication was bronchopneumonia, accounting for 35 patients. Most of the patients were discharged alive.  Conclusions:  Research suggests that early diagnosis and surgery are currently the only modality with curative potential and can raise the quality of life as well as improve morbidity and mortality rates among the population.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[cáncer gástrico]]></kwd>
<kwd lng="es"><![CDATA[adenocarcinoma gástrico]]></kwd>
<kwd lng="es"><![CDATA[tratamiento quirúrgico]]></kwd>
<kwd lng="en"><![CDATA[gastric cancer]]></kwd>
<kwd lng="en"><![CDATA[gastric adenocarcinoma]]></kwd>
<kwd lng="en"><![CDATA[surgical treatment]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kitagawa]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Dempsey]]></surname>
<given-names><![CDATA[TD]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Malignant neoplasm of the stomach]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Charles Brunicardi]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Anderson Dana]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<source><![CDATA[Schawartz Principios de Cirugía]]></source>
<year>2015</year>
<edition>10</edition>
<page-range>1074</page-range><publisher-loc><![CDATA[Mc Graw-Hill Interamericana editores ]]></publisher-loc>
<publisher-name><![CDATA[SA de CV]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Teitelbaum]]></surname>
<given-names><![CDATA[NE]]></given-names>
</name>
<name>
<surname><![CDATA[Hungness]]></surname>
<given-names><![CDATA[SE]]></given-names>
</name>
<name>
<surname><![CDATA[Mahvi]]></surname>
<given-names><![CDATA[MD]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Gastric Cancer]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Courtney]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Towsand]]></surname>
<given-names><![CDATA[Jr]]></given-names>
</name>
<name>
<surname><![CDATA[Beauchamp]]></surname>
<given-names><![CDATA[R Daniel]]></given-names>
</name>
</person-group>
<source><![CDATA[Sabinston Textbook of Surgery: The biological basis of moden surgical practice]]></source>
<year>2017</year>
<edition>20ª</edition>
<page-range>1213- 31</page-range><publisher-loc><![CDATA[Canada by ]]></publisher-loc>
<publisher-name><![CDATA[Elsevier]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ruíz de las Labranderas Delgado]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Comportamiento clínico-epidemiológico del cáncer gástrico en el Hospital Manuel Ascunce durante 5 años]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Cruz Abreu]]></surname>
<given-names><![CDATA[AE]]></given-names>
</name>
<name>
<surname><![CDATA[González Rodríguez]]></surname>
<given-names><![CDATA[LD]]></given-names>
</name>
<name>
<surname><![CDATA[Jiménez Viltres]]></surname>
<given-names><![CDATA[YR]]></given-names>
</name>
</person-group>
<source><![CDATA[Rev Progaleno]]></source>
<year>2019</year>
<volume>2</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>6-16</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sonia Bess]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Alonso Aloma]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Sánchez Sordo]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[López Nistal]]></surname>
<given-names><![CDATA[LM]]></given-names>
</name>
</person-group>
<collab>Dirección de Registros Médicos y estadísticas de Salud</collab>
<source><![CDATA[Anuario Estadístico de Cuba]]></source>
<year>2018</year>
<volume>35</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>915-9</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cuan Corrales]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[López Montaña]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Comportamiento del cáncer de estómago "Archivo médico de]]></article-title>
<source><![CDATA[Camagüey"]]></source>
<year>2018</year>
<volume>5</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>1-6</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Manterola]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Claros Nataniel]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Results of Surgical Treatment of Advanced Gastric Cancer Case Series with Follow-Up. Int]]></article-title>
<source><![CDATA[J. Morphol]]></source>
<year>2020</year>
<volume>38</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>1479-84</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chen]]></surname>
<given-names><![CDATA[QY]]></given-names>
</name>
<name>
<surname><![CDATA[Zhong]]></surname>
<given-names><![CDATA[Q]]></given-names>
</name>
<name>
<surname><![CDATA[Liu]]></surname>
<given-names><![CDATA[YZ]]></given-names>
</name>
<name>
<surname><![CDATA[Xie]]></surname>
<given-names><![CDATA[WJ]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[BJ]]></given-names>
</name>
<name>
<surname><![CDATA[Lin]]></surname>
<given-names><![CDATA[XJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Does Noncompliance in Lymph Node Dissection Affect Oncological Efficacy in Gastric Cancer Patients Undergoing Radical Gastrectomy]]></article-title>
<source><![CDATA[Ann Surg Oncol]]></source>
<year>2019</year>
<volume>26</volume>
<page-range>1759-71</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Delgadillo]]></surname>
<given-names><![CDATA[GH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cáncer gástrico]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Velázquez]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Fernández]]></surname>
<given-names><![CDATA[SP]]></given-names>
</name>
<name>
<surname><![CDATA[Malagón]]></surname>
<given-names><![CDATA[VJ]]></given-names>
</name>
<name>
<surname><![CDATA[Mayagoitia]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Pulido]]></surname>
<given-names><![CDATA[CA]]></given-names>
</name>
</person-group>
<source><![CDATA[Tratado de cirugía general]]></source>
<year>2017</year>
<volume>1</volume>
<edition>3a</edition>
<page-range>1113-111 9</page-range><publisher-loc><![CDATA[México ]]></publisher-loc>
<publisher-name><![CDATA[Manual Moderno, S.A. de C.V]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Crespo Ramírez]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cáncer gástrico en pacientes atendidos en servicio de endoscopia digestiva]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[González Pérez]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[López Vásquez]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Pagarizabal Nuñez]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<source><![CDATA[Rev Ciencias Médicas]]></source>
<year>2017</year>
<volume>21</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>46-53</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Valenzuela]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Katerina]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Na]]></surname>
<given-names><![CDATA[Criollo]]></given-names>
</name>
<name>
<surname><![CDATA[Rodis]]></surname>
<given-names><![CDATA[AR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Factores relacionados a cáncer gástrico en un hospital público de Huánuco]]></article-title>
<source><![CDATA[Rev Peru Investig Salud]]></source>
<year>2018</year>
<volume>2</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>42-9</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Parillo Durand]]></surname>
<given-names><![CDATA[LB]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Endoscopic and pathological characteristics of gastric cancer in a Peruvian public hospital]]></article-title>
<source><![CDATA[Rev Gastroenterol Peru]]></source>
<year>2017</year>
<volume>37</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>209-16</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rojas]]></surname>
<given-names><![CDATA[SM]]></given-names>
</name>
<name>
<surname><![CDATA[Pino]]></surname>
<given-names><![CDATA[RH]]></given-names>
</name>
<name>
<surname><![CDATA[Vargas]]></surname>
<given-names><![CDATA[LG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Ten year surgical experience with gastric cancer at a third level of care hospital, 2007-2016]]></article-title>
<source><![CDATA[Rev Colomb Cir]]></source>
<year>2019</year>
<volume>34</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>55-9</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Atila]]></surname>
<given-names><![CDATA[Csendes]]></given-names>
</name>
<name>
<surname><![CDATA[Marcelo]]></surname>
<given-names><![CDATA[Zamorano]]></given-names>
</name>
<name>
<surname><![CDATA[Manuel]]></surname>
<given-names><![CDATA[Figueroa]]></given-names>
</name>
<name>
<surname><![CDATA[Solange]]></surname>
<given-names><![CDATA[Cortes]]></given-names>
</name>
<name>
<surname><![CDATA[Fernando]]></surname>
<given-names><![CDATA[Maluenda]]></given-names>
</name>
<name>
<surname><![CDATA[Musleh]]></surname>
<given-names><![CDATA[Maher]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Comparative study between total and subtotal gastrectomy for distal gastric cancer: Meta-analysis of prospective and retrospective studies]]></article-title>
<source><![CDATA[Cir Esp]]></source>
<year>2020</year>
<volume>20</volume>
<numero>30</numero>
<issue>30</issue>
<page-range>6-16</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Durán Giménez]]></surname>
<given-names><![CDATA[RH]]></given-names>
</name>
<name>
<surname><![CDATA[Diéguez Aguirre]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Ríos Pérez]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Comparative study between total and subtotal gastrectomy for distal gastric cancer Meta-analysis of prospective and retrospective studies]]></article-title>
<source><![CDATA[Cir Esp]]></source>
<year>2020</year>
<volume>20</volume>
<numero>30</numero>
<issue>30</issue>
<page-range>6-16</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Avalos García]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Comportamiento del cáncer gástrico avanzado diagnosticado por videoendoscopia en el Hospital "Faustino Pérez Hernandez", Matanzas]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Morales Díaz]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Romero Bareira]]></surname>
<given-names><![CDATA[SR]]></given-names>
</name>
<name>
<surname><![CDATA[Laud Martínez]]></surname>
<given-names><![CDATA[PM]]></given-names>
</name>
</person-group>
<source><![CDATA[Rev Méd Electrón]]></source>
<year>2017</year>
<volume>39</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>507-18</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Canseco Ávila]]></surname>
<given-names><![CDATA[LM]]></given-names>
</name>
<name>
<surname><![CDATA[Zamudio Castellanosa]]></surname>
<given-names><![CDATA[FY]]></given-names>
</name>
<name>
<surname><![CDATA[Sánchez González]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
<name>
<surname><![CDATA[Trujillo Vizueta]]></surname>
<given-names><![CDATA[M G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Epidemiología de cáncer gástrico en el tercer nivel de atención en salud en Chiapas]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Domínguez Arrevillaga]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[López López]]></surname>
<given-names><![CDATA[CA]]></given-names>
</name>
</person-group>
<source><![CDATA[Revista de Gastroenterología de México]]></source>
<year>2019</year>
<volume>84</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>310-6</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Salazar Abad]]></surname>
<given-names><![CDATA[SE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Impacto de las complicaciones infecciosas postoperatorias en la sobrevida a largo plazo de pacientes gastrectomizados por carcinoma gástrico avanzado con intención curativa]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Díaz Plasencia]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Yan Quiroz]]></surname>
<given-names><![CDATA[EF]]></given-names>
</name>
<name>
<surname><![CDATA[Calvanapon Prado]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Marín Córdova]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<source><![CDATA[Rev Gastroenterol Perú]]></source>
<year>2017</year>
<volume>37</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>26-32</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Figueroa Giralt]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Factores pronósticos de sobrevida alejada en cáncer gástrico. Introducción del nuevo índice N+/T]]></article-title>
<source><![CDATA[Rev Chil Cir]]></source>
<year>2018</year>
<volume>70</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>147-59</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
