<?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>0035-0052</journal-id>
<journal-title><![CDATA[Revista mexicana de pediatría]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. mex. pediatr.]]></abbrev-journal-title>
<issn>0035-0052</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Mexicana de Pediatría A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0035-00522023000600236</article-id>
<article-id pub-id-type="doi">10.35366/117392</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Quilomicronemia familiar en un lactante de dos meses]]></article-title>
<article-title xml:lang="en"><![CDATA[Familial chylomicronemia in a two-month-old infant]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Camacho-Contreras]]></surname>
<given-names><![CDATA[Karina Alexandra]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Zárate-Vergara]]></surname>
<given-names><![CDATA[Andrea Carolina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cuadros-Mendoza]]></surname>
<given-names><![CDATA[Carlos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Becerra-Riaño]]></surname>
<given-names><![CDATA[Karen Linceyth]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Tirado-Pérez]]></surname>
<given-names><![CDATA[Irina Suley]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Internacional de Colombia (HIC) Unidad de Cuidado Intensivo Pediátrico ]]></institution>
<addr-line><![CDATA[Medellín ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Clínica Especializada la Concepción Unidad de Cuidado Intensivo Pediátrico ]]></institution>
<addr-line><![CDATA[Sincelejo ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,HIC Departamento de Gastroenterología Pediátrica ]]></institution>
<addr-line><![CDATA[Medellín ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Universidad de Santander  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Universidad Piloto de Colombia Corporación Universitaria Remington ]]></institution>
<addr-line><![CDATA[Medellín ]]></addr-line>
<country>Colombia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2023</year>
</pub-date>
<volume>90</volume>
<numero>6</numero>
<fpage>236</fpage>
<lpage>239</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0035-00522023000600236&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0035-00522023000600236&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0035-00522023000600236&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Introducción:  La quilomicronemia familiar (QMF) es un trastorno metabólico genético, caracterizado por niveles elevados de lípidos.  Objetivo:  Presentar un paciente con QMF, sin antecedentes familiares de esta condición.  Caso clínico:  Lactante de dos meses de edad atendido por evacuaciones diarreicas, pero que durante la toma sanguínea para estudios de laboratorio, el suero se identificó de aspecto lechoso. El análisis lipídico evidenció hipertrigliceridemia extrema (&gt;14,000 mg/dL). Mientras que el estudio genético confirmó la deficiencia familiar de lipoproteína lipasa secundaria a dos variantes patogénicas heterocigotas (LPL [NM_000237.3]: c.127dup; p. Leu43ProfsTer5 y LPL [NM_000237.3]: c.1136del; p. Thr379IlefsTer14). El paciente se manejó con plasmaféresis y dieta especial, obteniendo buena respuesta terapéutica.  Conclusiones:  La QMF es una condición infrecuente que altera la capacidad de metabolizar los triglicéridos y puede causar complicaciones potencialmente letales. Su reconocimiento y tratamiento oportuno es importante para prevenir complicaciones.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction:  Familial chylomicronemia (FCM) is a genetic metabolic disorder, characterized by elevated lipid levels.  Objective:  We present a patient with FCM, without a family history of this condition.  Clinical case:  2-months-old infant seen for diarrheal stools, but during blood sampling for laboratory studies, the serum was identified as milky in appearance. Lipid analysis showed extreme hypertriglyceridemia (&gt;14,000 mg/dL). Genetic testing confirmed familial lipoprotein lipase deficiency, secondary to two heterozygous pathogenic variants (LPL (NM_000237.3): c.127dup; p. Leu43ProfsTer5 and LPL (NM_000237.3): c.1136del; p. Thr379IlefsTer14). The patient was managed with plasmapheresis and a special diet, obtaining a good therapeutic response.  Conclusions:  FCM is a rare condition that impairs the ability to metabolize triglycerides and can cause potentially life-threatening complications. Its early recognition and treatment is important to prevent complications.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[hiperquilomicronemia familiar]]></kwd>
<kwd lng="es"><![CDATA[triglicéridos]]></kwd>
<kwd lng="es"><![CDATA[hipertrigliceridemia]]></kwd>
<kwd lng="es"><![CDATA[dislipidemias]]></kwd>
<kwd lng="es"><![CDATA[lactante]]></kwd>
<kwd lng="en"><![CDATA[familial hyperchylomicronemia]]></kwd>
<kwd lng="en"><![CDATA[triglycerides]]></kwd>
<kwd lng="en"><![CDATA[hypertriglyceridemia]]></kwd>
<kwd lng="en"><![CDATA[dyslipidemia]]></kwd>
<kwd lng="en"><![CDATA[infant]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Paquette]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Bernard]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Hegele]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
<name>
<surname><![CDATA[Baass]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Chylomicronemia: Differences between familial chylomicronemia syndrome and multifactorial chylomicronemia]]></article-title>
<source><![CDATA[Atherosclerosis]]></source>
<year>2019</year>
<volume>283</volume>
<page-range>137-42</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cohen]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Stefanutti]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Current Approach to the Diagnosis and Treatment of Heterozygote and Homozygous FH Children and Adolescents]]></article-title>
<collab>The Mighty Medic Satellite Research Group for Pediatric Dyslipidemia</collab>
<source><![CDATA[Curr Atheroscler Rep]]></source>
<year>2021</year>
<volume>23</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>30</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Baass]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Paquette]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Bernard]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Hegele]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Familial chylomicronemia syndrome: an under-recognized cause of severe hypertriglyceridaemia]]></article-title>
<source><![CDATA[J Intern Med]]></source>
<year>2020</year>
<volume>287</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>340-8</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Muñiz-Grijalvo]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Diaz-Diaz]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Familial chylomicronemia and multifactorial chylomicronemia]]></article-title>
<source><![CDATA[Clin Investig Arterioscler]]></source>
<year>2021</year>
<volume>33</volume>
<numero>^s2</numero>
<issue>^s2</issue>
<supplement>2</supplement>
<page-range>56-62</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[Blom]]></surname>
<given-names><![CDATA[DJ]]></given-names>
</name>
<name>
<surname><![CDATA[O&#8217;Dea]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Digenio]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Alexander]]></surname>
<given-names><![CDATA[VJ]]></given-names>
</name>
<name>
<surname><![CDATA[Karwatowska-Prokopczuk]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Williams]]></surname>
<given-names><![CDATA[KR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Characterizing familial chylomicronemia syndrome: Baseline data of the APPROACH study]]></article-title>
<source><![CDATA[J Clin Lipidol]]></source>
<year>2018</year>
<volume>12</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>1234-1243.e5</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[Ruiz]]></surname>
<given-names><![CDATA[ÁJ]]></given-names>
</name>
<name>
<surname><![CDATA[Patiño]]></surname>
<given-names><![CDATA[LF]]></given-names>
</name>
<name>
<surname><![CDATA[Amaya]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Gómez]]></surname>
<given-names><![CDATA[JE]]></given-names>
</name>
<name>
<surname><![CDATA[Ordóñez]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Paternina]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hipercolesterolemia familiar: serie de 36 casos con fenotipo de hipercolesterolemia familiar homocigótica]]></article-title>
<source><![CDATA[Rev Colomb Cardiol]]></source>
<year>2020</year>
<volume>27</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>501-10</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[Quiroga-Padilla]]></surname>
<given-names><![CDATA[PJ]]></given-names>
</name>
<name>
<surname><![CDATA[Gaete]]></surname>
<given-names><![CDATA[PV]]></given-names>
</name>
<name>
<surname><![CDATA[Mendivil]]></surname>
<given-names><![CDATA[CO]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Quilomicronemia familiar [Familial chylomicronemia]]]></article-title>
<source><![CDATA[Medicina (B Aires)]]></source>
<year>2020</year>
<volume>80</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>348-58</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[Rahalkar]]></surname>
<given-names><![CDATA[AR]]></given-names>
</name>
<name>
<surname><![CDATA[Giffen]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Har]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Ho]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Morrison]]></surname>
<given-names><![CDATA[KM]]></given-names>
</name>
<name>
<surname><![CDATA[Hill]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Novel LPL mutations associated with lipoprotein lipase deficiency: two case reports and a literature review]]></article-title>
<source><![CDATA[Can J Physiol Pharmacol]]></source>
<year>2009</year>
<volume>87</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>151-60</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Toro]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Román-González]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Builes-Barrera]]></surname>
<given-names><![CDATA[CA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Identifying familial hypercholesterolemia in Colombia]]></article-title>
<source><![CDATA[J Clin Lipidol]]></source>
<year>2017</year>
<volume>11</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>1106-7</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[Bruikman]]></surname>
<given-names><![CDATA[CS]]></given-names>
</name>
<name>
<surname><![CDATA[Hovingh]]></surname>
<given-names><![CDATA[GK]]></given-names>
</name>
<name>
<surname><![CDATA[Kastelein]]></surname>
<given-names><![CDATA[JJP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Molecular basis of familial hypercholesterolemia]]></article-title>
<source><![CDATA[Curr Opin Cardiol]]></source>
<year>2017</year>
<volume>32</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>262-6</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[Abul-Husn]]></surname>
<given-names><![CDATA[NS]]></given-names>
</name>
<name>
<surname><![CDATA[Manickam]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Jones]]></surname>
<given-names><![CDATA[LK]]></given-names>
</name>
<name>
<surname><![CDATA[Wright]]></surname>
<given-names><![CDATA[EA]]></given-names>
</name>
<name>
<surname><![CDATA[Hartzel]]></surname>
<given-names><![CDATA[DN]]></given-names>
</name>
<name>
<surname><![CDATA[Gonzaga-Jauregui]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Genetic identification of familial hypercholesterolemia within a single U.S]]></article-title>
<source><![CDATA[Science]]></source>
<year>2016</year>
<volume>354</volume>
<numero>6319</numero>
<issue>6319</issue>
<page-range>aaf7000</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[Stroes]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Moulin]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Parhofer]]></surname>
<given-names><![CDATA[KG]]></given-names>
</name>
<name>
<surname><![CDATA[Rebours]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Lohr]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Averna]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Diagnostic algorithm for familial chylomicronemia syndrome]]></article-title>
<source><![CDATA[Atheroscler Suppl]]></source>
<year>2017</year>
<volume>23</volume>
<page-range>1-7</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[Raffan]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Semple]]></surname>
<given-names><![CDATA[RK]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Next generation sequencing--implications for clinical practice]]></article-title>
<source><![CDATA[Br Med Bull]]></source>
<year>2011</year>
<volume>99</volume>
<page-range>53-71</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[Matías-Pérez]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Pérez-Campos]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[García-Montalvo]]></surname>
<given-names><![CDATA[IA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Una visión genética de la hipercolesterolemia familiar [A genetic view of familial hypercholesterolemia]]]></article-title>
<source><![CDATA[Nutr Hosp]]></source>
<year>2015</year>
<volume>32</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>2421-6</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[Paragh]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Németh]]></surname>
<given-names><![CDATA[Á]]></given-names>
</name>
<name>
<surname><![CDATA[Harangi]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Banach]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Fülop]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Causes, clinical findings and therapeutic options in chylomicronemia syndrome, a special form of hypertriglyceridemia]]></article-title>
<source><![CDATA[Lipids Health Dis]]></source>
<year>2022</year>
<volume>21</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>21</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[Wilson]]></surname>
<given-names><![CDATA[DP]]></given-names>
</name>
<name>
<surname><![CDATA[McNeal]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Blackett]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pediatric dyslipidemia: recommendations for clinical management]]></article-title>
<source><![CDATA[South Med J]]></source>
<year>2015</year>
<volume>108</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>7-14</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[Reeskamp]]></surname>
<given-names><![CDATA[LF]]></given-names>
</name>
<name>
<surname><![CDATA[Tromp]]></surname>
<given-names><![CDATA[TR]]></given-names>
</name>
<name>
<surname><![CDATA[Defesche]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
<name>
<surname><![CDATA[Grefhorst]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Stroes]]></surname>
<given-names><![CDATA[ESG]]></given-names>
</name>
<name>
<surname><![CDATA[Hovingh]]></surname>
<given-names><![CDATA[GK]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Next-generation sequencing to confirm clinical familial hypercholesterolemia]]></article-title>
<source><![CDATA[Eur J Prev Cardiol]]></source>
<year>2021</year>
<volume>28</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>875-83</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[Valencia-Enciso]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Mendivil]]></surname>
<given-names><![CDATA[CO]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[New biotechnological treatments for lipid disorders]]></article-title>
<source><![CDATA[Rev Invest Clin]]></source>
<year>2018</year>
<volume>70</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>244-54</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
