Statistics

 array:25 [
  "pii" => "S0021755717302206"
  "issn" => "00217557"
  "doi" => "10.1016/j.jped.2016.11.009"
  "estado" => "S300"
  "fechaPublicacion" => "2017-09-01"
  "aid" => "482"
  "copyright" => "Sociedade Brasileira de Pediatria"
  "copyrightAnyo" => "2017"
  "documento" => "article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "fla"
  "cita" => "J Pediatr (Rio J). 2017;93:517-24"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 1594
    "formatos" => array:3 [
      "EPUB" => 99
      "HTML" => 1236
      "PDF" => 259
    ]
  ]
  "Traduccion" => array:1 [
    "pt" => array:20 [
      "pii" => "S2255553617300344"
      "issn" => "22555536"
      "doi" => "10.1016/j.jpedp.2017.03.005"
      "estado" => "S300"
      "fechaPublicacion" => "2017-09-01"
      "aid" => "482"
      "copyright" => "Sociedade Brasileira de Pediatria"
      "documento" => "article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "fla"
      "cita" => "J Pediatr (Rio J). 2017;93:517-24"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 1067
        "formatos" => array:3 [
          "EPUB" => 111
          "HTML" => 720
          "PDF" => 236
        ]
      ]
      "pt" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Artigo Original</span>"
        "titulo" => "IL&#8208;6&#44; TNF&#8208;&#945;&#44; IL&#8208;10&#44; and nutritional status in pediatric patients with biliary atresia"
        "tienePdf" => "pt"
        "tieneTextoCompleto" => "pt"
        "tieneResumen" => array:2 [
          0 => "en"
          1 => "pt"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "517"
            "paginaFinal" => "524"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "pt" => array:1 [
            "titulo" => "IL&#8208;6&#44; TNF&#8208;&#945;&#44; IL&#8208;10 e estado nutricional em pacientes pedi&#225;tricos com atresia biliar"
          ]
        ]
        "contieneResumen" => array:2 [
          "en" => true
          "pt" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "pt" => true
        ]
        "contienePdf" => array:1 [
          "pt" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figura 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1308
                "Ancho" => 3352
                "Tamanyo" => 226369
              ]
            ]
            "descripcion" => array:1 [
              "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Valores das citocinas estratificadas em tercis de estatura para a idade&#58; a&#44; valores de IL&#8208;6 no soro&#59; b&#44; valores de IL&#8208;10 no soro&#59; c&#44; valores de TNF&#8208;&#945; no soro&#46;</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">As crian&#231;as classificadas no primeiro e segundo tercis mostraram maiores n&#237;veis de IL&#8208;6 e IL&#8208;10 do que aquelas classificadas no terceiro tercil&#44; o que demonstra o comprometimento do estado nutricional &#40;conforme representado pela estatura para a idade&#41;&#46; A linha dentro da caixa representa a mediana&#46; Os limites superiores e inferiores da caixa representam os percentis 25 e 75&#44; respectivamente&#46; As barras de erro superiores e inferiores representam os valores m&#237;nimos e m&#225;ximos da amostra&#46; Os asteriscos e c&#237;rculos representam discrepantes&#46;</p> <p id="spar0055" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">¿<span class="elsevierStyleSup">2</span></span>&#44; eta quadrado&#59; M&#44; mediana &#40;percentis 25 e 75&#41;&#59; EDP&#8208;H&#47;A&#44; escore de desvio padr&#227;o da estatura para a idade&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Maria Ines de Albuquerque Wilasco, Carolina Uribe&#8208;Cruz, Daniele Santetti, Gabriel Rodrigo Fries, Cristina Toscani Leal Dornelles, Themis Reverbel da Silveira"
            "autores" => array:6 [
              0 => array:2 [
                "nombre" => "Maria Ines de Albuquerque"
                "apellidos" => "Wilasco"
              ]
              1 => array:2 [
                "nombre" => "Carolina"
                "apellidos" => "Uribe&#8208;Cruz"
              ]
              2 => array:2 [
                "nombre" => "Daniele"
                "apellidos" => "Santetti"
              ]
              3 => array:2 [
                "nombre" => "Gabriel Rodrigo"
                "apellidos" => "Fries"
              ]
              4 => array:2 [
                "nombre" => "Cristina Toscani Leal"
                "apellidos" => "Dornelles"
              ]
              5 => array:2 [
                "nombre" => "Themis Reverbel da"
                "apellidos" => "Silveira"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "pt"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S0021755717302206"
          "doi" => "10.1016/j.jped.2016.11.009"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0021755717302206?idApp=UINPBA000049"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2255553617300344?idApp=UINPBA000049"
      "url" => "/22555536/0000009300000005/v1_201709220128/S2255553617300344/v1_201709220128/pt/main.assets"
    ]
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S0021755717304746"
    "issn" => "00217557"
    "doi" => "10.1016/j.jped.2016.11.014"
    "estado" => "S300"
    "fechaPublicacion" => "2017-09-01"
    "aid" => "505"
    "copyright" => "Sociedade Brasileira de Pediatria"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "J Pediatr &#40;Rio J&#41;. 2017;93:525-31"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 736
      "formatos" => array:3 [
        "EPUB" => 101
        "HTML" => 369
        "PDF" => 266
      ]
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Performance of different diagnostic criteria of overweight and obesity as predictors of metabolic syndrome in adolescents"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "525"
          "paginaFinal" => "531"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Desempenho de diferentes crit&#233;rios diagn&#243;sticos de sobrepeso e obesidade como preditores de s&#237;ndrome metab&#243;lica em adolescentes"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "pt" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Raphael Gon&#231;alves de Oliveira, Dartagnan Pinto Guedes"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "Raphael Gon&#231;alves de"
              "apellidos" => "Oliveira"
            ]
            1 => array:2 [
              "nombre" => "Dartagnan Pinto"
              "apellidos" => "Guedes"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "pt" => array:9 [
        "pii" => "S2255553617300642"
        "doi" => "10.1016/j.jpedp.2017.06.003"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "pt"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2255553617300642?idApp=UINPBA000049"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0021755717304746?idApp=UINPBA000049"
    "url" => "/00217557/0000009300000005/v1_201709220054/S0021755717304746/v1_201709220054/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S0021755717304758"
    "issn" => "00217557"
    "doi" => "10.1016/j.jped.2016.11.015"
    "estado" => "S300"
    "fechaPublicacion" => "2017-09-01"
    "aid" => "506"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "J Pediatr &#40;Rio J&#41;. 2017;93:508-16"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 783
      "formatos" => array:3 [
        "EPUB" => 85
        "HTML" => 443
        "PDF" => 255
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Age at introduction of ultra-processed food among preschool children attending day-care centers"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "508"
          "paginaFinal" => "516"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Idade de introdu&#231;&#227;o de alimentos ultraprocessados entre pr&#233;-escolares frequentadores de centros de educa&#231;&#227;o infantil"
        ]
      ]
      "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" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1868
              "Ancho" => 3400
              "Tamanyo" => 354363
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Survival curves by the Kaplan&#8211;Meier estimator of variables associated with the introduction of ultra processed foods among preschoolers attending day-care centers in Macei&#243;&#44; Alagoas&#44; Brazil&#44; 2014&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Giovana Longo-Silva, Jonas Augusto C&#46; Silveira, R&#237;sia Cristina Egito de Menezes, Maysa Helena de Aguiar Toloni"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Giovana"
              "apellidos" => "Longo-Silva"
            ]
            1 => array:2 [
              "nombre" => "Jonas Augusto C&#46;"
              "apellidos" => "Silveira"
            ]
            2 => array:2 [
              "nombre" => "R&#237;sia Cristina Egito de"
              "apellidos" => "Menezes"
            ]
            3 => array:2 [
              "nombre" => "Maysa Helena de Aguiar"
              "apellidos" => "Toloni"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "pt" => array:9 [
        "pii" => "S2255553617300654"
        "doi" => "10.1016/j.jpedp.2017.06.004"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "pt"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2255553617300654?idApp=UINPBA000049"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0021755717304758?idApp=UINPBA000049"
    "url" => "/00217557/0000009300000005/v1_201709220054/S0021755717304758/v1_201709220054/en/main.assets"
  ]
  "en" => array:20 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
    "titulo" => "IL-6&#44; TNF-&#945;&#44; IL-10&#44; and nutritional status in pediatric patients with biliary atresia"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "517"
        "paginaFinal" => "524"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Maria Ines de Albuquerque Wilasco, Carolina Uribe-Cruz, Daniele Santetti, Gabriel Rodrigo Fries, Cristina Toscani Leal Dornelles, Themis Reverbel da Silveira"
        "autores" => array:6 [
          0 => array:4 [
            "nombre" => "Maria Ines de Albuquerque"
            "apellidos" => "Wilasco"
            "email" => array:1 [
              0 => "ineswilasco&#64;gmail&#46;com"
            ]
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Carolina"
            "apellidos" => "Uribe-Cruz"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Daniele"
            "apellidos" => "Santetti"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Gabriel Rodrigo"
            "apellidos" => "Fries"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">e</span>"
                "identificador" => "aff0025"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Cristina Toscani Leal"
            "apellidos" => "Dornelles"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">f</span>"
                "identificador" => "aff0030"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Themis Reverbel da"
            "apellidos" => "Silveira"
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:6 [
          0 => array:3 [
            "entidad" => "Hospital de Cl&#237;nicas de Porto Alegre&#44; Centro de Pesquisa&#44; Laborat&#243;rio Experimental de Hepatologia e Gastroenterologia&#44; Porto Alegre&#44; RS&#44; Brazil"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Universidade Federal do Rio Grande do Sul &#40;UFRGS&#41;&#44; Faculdade de Medicina&#44; Programa de P&#243;s-gradua&#231;&#227;o em Sa&#250;de da Crian&#231;a e do Adolescente&#44; Porto Alegre&#44; RS&#44; Brazil"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Universidade Federal do Rio Grande do Sul &#40;UFRGS&#41;&#44; Faculdade de Medicina&#44; Programa de P&#243;s-gradua&#231;&#227;o em Gastroenterologia&#44; Porto Alegre&#44; RS&#44; Brazil"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Universidade do Vale do Rio dos Sinos &#40;Unisinos&#41;&#44; Faculdade de Nutri&#231;&#227;o&#44; S&#227;o Leopoldo&#44; RS&#44; Brazil"
            "etiqueta" => "d"
            "identificador" => "aff0020"
          ]
          4 => array:3 [
            "entidad" => "Hospital de Cl&#237;nicas de Porto Alegre&#44; Centro de Pesquisa&#44; Laborat&#243;rio de Psiquiatria Molecular&#44; Porto Alegre&#44; RS&#44; Brazil"
            "etiqueta" => "e"
            "identificador" => "aff0025"
          ]
          5 => array:3 [
            "entidad" => "Hospital de Cl&#237;nicas de Porto Alegre&#44; Departamento de Pediatria&#44; Porto Alegre&#44; RS&#44; Brazil"
            "etiqueta" => "f"
            "identificador" => "aff0030"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1267
            "Ancho" => 3352
            "Tamanyo" => 225892
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Cytokine values stratified into tertiles of height for age&#46; &#40;A&#41; IL-6 serum values&#59; &#40;B&#41; IL-10 serum values&#59; &#40;C&#41; TNF-&#945; serum values&#46; Children classified into the first and the second tertiles presented higher levels of IL-6 and IL-10 than those classified into the third tertile&#44; demonstrating the impairment in nutritional status &#40;as represented by height-for-age&#41;&#46; The line inside the box represents the median&#46; The upper and lower limits of the box represent the 25th and 75th percentiles&#44; respectively&#46; Upper and lower error bars represent the minimum and maximum values of the sample&#46; The asterisks and circles represent outliers&#46; &#951;&#44;2&#44; eta squared&#59; M&#44; median &#40;25th and 75th percentiles&#41;&#59; SDS-H&#47;A&#44; standard deviation score of height-for-age&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Biliary atresia &#40;BA&#41; is an idiopathic cholangiopathy of childhood characterized by complete obstruction of the bile ducts&#46; Progressive inflammation and fibrosis lead to secondary biliary cirrhosis in the majority of patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">1&#44;2</span></a> Cirrhosis&#44; which is the end stage of many liver diseases&#44; is histopathologically identified as a diffuse process of hepatic fibrosis and nodule formation&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">3</span></a> As cirrhosis advances&#44; it leads to an irregular supply of nutrients&#44; oxygen&#44; and metabolites&#46;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">4&#44;5</span></a> These changes affect energy synthesis and metabolism&#44; with an impact on the nutritional status of patients with liver disease&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">6</span></a> The pathogenesis of malnutrition in liver disease is multifactorial&#44; and the possible etiology is a combination of conditions such as reduced caloric intake resulting from anorexia and dietary restrictions&#44; intestinal malabsorption&#44; abnormalities in the metabolism of macronutrients&#44; and increased pro-inflammatory cytokines&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">6</span></a> In fact&#44; malnutrition is recognized as a factor associated with increased morbidity and mortality in the pre- and post-liver transplantation periods&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">7</span></a> Children and adolescents with chronic liver disease have increased energy needs&#44; corresponding to 120&#37; to 150&#37; of their estimated energy requirement &#40;EER&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">8</span></a> Cytokines and growth factors are known to play an important role in cirrhosis&#46; Interleukin-6 &#40;IL-6&#41; has been associated with worsening nutritional status in chronically ill patients&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">9</span></a> In patients with cirrhosis&#44; a significant association of tumor necrosis factor alpha &#40;TNF-&#945;&#41; and its receptors with energy metabolism has been described&#44; suggesting that the activation of the TNF-&#945; system contributes to the anorexia-cachexia syndrome observed in these patients&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">10</span></a> Conversely&#44; interleukin-10 &#40;IL-10&#41; is a cytokine with anti-inflammatory properties&#59; its expression in BA is controversial&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">11</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Nutritional assessment of patients with cirrhosis is hindered by the presence of organomegaly and edema and by the complexity of the interpretation of laboratory parameters commonly used to evaluate nutrition&#44; which are rendered abnormal by liver disease&#46;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">8&#44;12</span></a> The nutritional assessment of children with cirrhosis is complicated by the presence of fluid retention&#44; hepatomegaly&#44; and splenomegaly&#44; all of which can distort anthropometric measurements&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">6</span></a> Considering the associations between cytokines and nutritional status&#44; they may be indirect biomarkers to support nutritional assessment&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The objective of the present study was to evaluate whether IL-6&#44; TNF-&#945;&#44; and IL-10 are associated with nutritional status in patients with cirrhosis secondary to BA&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">From December 2006 to December 2011&#44; 53 children with cirrhosis secondary to BA and 33 healthy&#44; well-nourished&#44; sex- and age-matched controls were recruited at Hospital de Cl&#237;nicas de Porto Alegre&#46; Participants&#8217; age ranged from 4 months to 17 years&#46; All participants underwent a nutritional status assessment and completed a questionnaire designed to collect clinical&#44; dietary&#44; and demographic data&#46; This study was approved by the Research Ethics Committee of the Hospital de Cl&#237;nicas de Porto Alegre&#46; The study followed the principles set forth by Resolution 466&#47;12 on human research&#44; and was approved under CAEE No&#46; 0317&#46;0&#46;001&#46;000-10&#46; Informed and written consent was obtained from the parents&#47;guardians of all participants&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Cirrhosis group</span><p id="par0025" class="elsevierStylePara elsevierViewall">The Kasai surgery was performed in all patients&#46; From 53 patients&#44; four were temporarily drained &#40;two aged 4 months and two aged 5 months&#41;&#59; nonetheless&#44; all of them had the diagnosis of cirrhosis confirmed by biopsy performed in surgery&#46; Regarding the cirrhosis diagnosis&#44; 39 &#40;73&#46;6&#37;&#41; underwent biopsy&#46; The remaining patients could not undergo an invasive procedure&#59; therefore&#44; they were diagnosed by clinical evaluation&#44; biochemical tests&#44; and ultrasound changes consistent with cirrhosis&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The exclusion criteria were presence of any other disease &#40;chronic or acute&#41;&#44; acute infection&#44; fever at the time of blood collection&#44; antibiotic therapy up to 15 days of blood collection&#44; and steroid therapy&#46; All participants received vitamins A&#44; D&#44; E&#44; and K&#44; minerals&#44; antacids&#44; and proton pump inhibitors if necessary as part of the standard of care&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The severity of cirrhosis was evaluated using the Child&#8211;Pugh score and the Pediatric End-stage Liver Disease &#40;PELD&#41; and Model for End-stage Liver Disease &#40;MELD&#41; scores&#46; Patients were categorized as Child&#8211;Pugh class A &#40;mild disease&#41;&#44; B &#40;moderate disease&#41;&#44; or C &#40;severe disease&#41;&#46; In the interest of uniformity&#44; categories B and C were pooled together&#46; Subjects aged 12 years or younger were also assessed using the PELD scores&#44; while older participants were evaluated through MELD scores&#46; In both cases&#44; higher values are indicative of more severe disease&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Control group</span><p id="par0040" class="elsevierStylePara elsevierViewall">All participants allocated to the control group were healthy&#44; well-nourished children and adolescents scheduled to undergo blood collection for regular healthcare checks or minor surgical procedures&#46; The exclusion criteria were&#58; preterm birth&#44; presence of any other conditions &#40;chronic or acute&#41;&#44; a restrictive diet&#44; and medication use &#40;except iron and vitamins at prophylactic doses&#41;&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Assessment of nutritional status</span><p id="par0045" class="elsevierStylePara elsevierViewall">In both groups&#44; nutritional status was assessed through anthropometric measurements&#44; obtained as described in the World Health Organization &#40;WHO&#41; Training Course on Child Growth Assessment&#46; Nutritional status was classified using standard deviation scores &#40;SDS&#41;&#44; in accordance with the WHO Standards and Reference&#46; The parameters used for nutritional status classification were height-for-age &#40;H&#47;A&#41;&#44; triceps skinfold thickness-for-age &#40;TSF&#47;A&#41;&#44; and mid-upper arm circumference-for-age &#40;MUAC&#47;A&#41;&#46; The body mass index-for-age &#40;BMI&#47;A&#41; parameter was used to classify controls as well-nourished &#40;data not shown&#41;&#46; SDS-BMI&#47;A values outside the &#8722;2&#46;0 and &#43;2&#46;0 range for children younger than 5 years and outside of the &#8722;2&#46;0 and &#43;1&#46;0 range for children older than 5 years were used to define well-nourishment in the control group&#46; In the cirrhosis group&#44; undernourishment was defined as SDS-H&#47;A and&#47;or SDS-TSF&#47;A equal to or below &#8722;2&#46;0&#46; The same parameters used for individual nutritional status assessment in the cirrhosis group were used to compare the results of the assessment between groups&#46; The WHO Anthro software&#44; version 3&#46;0&#44;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a> was used to calculate anthropometric data for children under 5 years&#44; whereas the data of children over 5 years and adolescents were calculated using the WHO AnthroPlus<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">14</span></a> and Frisancho Anthropometric Standards<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">15</span></a> software suites&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Participants&#8217; habitual diets were evaluated using a three-day dietary recall &#40;two non-consecutive weekdays and one weekend day&#41;&#46; All dietary records were calculated in the Nutwin &#40;version 2&#46;5&#41; computer program&#46; After calculating the mean dietary intake over the three days recorded&#44; EER was determined&#44; taking into account patient age&#44; height&#44; and weight&#44; pursuant to the dietary reference intake &#40;DRI&#41; and recommended dietary allowance &#40;RDA&#41; recommendations&#46; After analyzing the three-day dietary record&#44; patients who did not reach the minimum target of 120&#37; of the recommended individual needs received supplements&#46; Those who did not meet the energy needs orally received enteral supplementation and those who could not feed themselves received exclusive enteral nutrition&#46; Fifty patients were in oral feeding &#40;33&#46;9&#37; of patients were supplemented by hypercaloric formula&#41;&#44; two patients were in enteral feeding&#44; and one was in both oral and enteral feeding&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Cytokine quantitation</span><p id="par0055" class="elsevierStylePara elsevierViewall">Blood samples were collected with at least a three-hour fast&#46; Serum was centrifuged for 10<span class="elsevierStyleHsp" style=""></span>min at 1000<span class="elsevierStyleHsp" style=""></span>g &#40;4<span class="elsevierStyleHsp" style=""></span>&#176;C&#41; and stored at &#8722;80<span class="elsevierStyleHsp" style=""></span>&#176;C for later analysis&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Quantitation of IL-6&#44; IL-10&#44; and TNF-&#945; in serum was analyzed in duplicate by Cytometric Bead Array flow cytometry&#44; in accordance with the manufacturer&#39;s protocol &#40;BD Biosciences&#44; USA&#41;&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">The biomarkers evaluation was performed along with nutritional assessment and not with the Kasai surgery&#46; Nutritional assessment and blood collection were performed with an interval of no longer than one week&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Statistical analysis</span><p id="par0070" class="elsevierStylePara elsevierViewall">Variables were expressed as mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD or median&#46; The Kolmogorov&#8722;Smirnov test was used to assess the normality of data distribution&#46; Normally distributed variables were compared by analysis of variance &#40;ANOVA&#41; and Student&#39;s <span class="elsevierStyleItalic">t</span>-test&#46; Asymmetrically distributed variables were analyzed by the Kruskal&#8722;Wallis and Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span> tests&#46; Spearman coefficients were used to test for correlation&#46; Analysis of covariance &#40;ANCOVA&#41; was used to control for confounding factors between cytokines and nutritional parameters&#46; To this end&#44; nutritional parameters were stratified into tertiles and cytokine levels were log-transformed to enable use of a parametric test&#46; The square root of eta squared was used to estimate the size effect and interpreted on Pearson&#39;s scale&#46; The significance level was set at 5&#37; for all analyses&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Results</span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">General characteristics</span><p id="par0075" class="elsevierStylePara elsevierViewall">There were no significant differences between groups regarding age or sex&#46; Most patients were classified as Child&#8722;Pugh A and had PELD&#47;MELD scores below 15 &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">Regarding the clinical presentation of the disease&#44; all patients &#40;100&#37;&#41; had splenomegaly&#44; seven &#40;13&#46;2&#37;&#41; had ascites&#44; 19 &#40;35&#46;8&#37;&#41; had variceral bleed&#44; 31 &#40;58&#46;5&#37;&#41; had overt jaundice&#44; and 38 &#40;71&#46;7&#37;&#41; had thrombocytopenia&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Nutritional status and dietary assessment</span><p id="par0085" class="elsevierStylePara elsevierViewall">The nutritional parameters of interest and the results of the nutritional assessment are shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46; For the assessment of dietary intake by EER &#40;&#37;&#41;&#44; participants were divided into four age ranges&#58; 0&#8722;2&#44; 2&#8722;5&#44; 5&#8722;10&#44; and &#62;10 years&#46; The median &#40;interquartile range&#41; EER &#40;&#37;&#41; for each age group was 122 &#40;97&#8722;162&#41;&#44; 106 &#40;85&#8722;128&#41;&#44; 88 &#40;77&#8722;105&#41;&#44; and 81 &#40;63&#8722;95&#41;&#44; respectively&#46; The nutritional assessment indicated that most patients in the cirrhosis group were well-nourished &#40;69&#46;2&#37;&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Correlation of severity of cirrhosis with cytokine levels and nutritional parameters</span><p id="par0090" class="elsevierStylePara elsevierViewall">Levels of the studied cytokines were significantly higher in the cirrhosis group than in the control group &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; The Child&#8722;Pugh score was used to correlate cytokine levels with the severity of cirrhosis&#46; Correlations were classified according to the Spearman coefficient as weak &#40;&#60;0&#46;3&#41;&#44; moderate &#40;0&#46;3&#8722;0&#46;59&#41;&#44; strong &#40;0&#46;6&#8722;0&#46;89&#41;&#44; or very strong &#40;&#62;0&#46;9&#41;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">The Child&#8722;Pugh scores and Spearman coefficients were also used to determine nutritional parameters and disease severity were correlated&#46; All nutritional parameters of interest were moderately correlated with disease severity&#46; IL-6 and IL-10 demonstrated a positive correlation with disease severity &#40;0&#46;45 &#91;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#93; and 0&#46;41&#91;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#93;&#44; respectively&#41;&#46; TNF-&#945; was not significantly correlated &#40;0&#46;10&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;478&#41;&#46; Regarding anthropometric parameters&#44; SDS-H&#47;A&#44; SDS-MUAC&#47;A&#44; and SDS-TSF&#47;A showed an inverse correlation with disease severity&#44; &#40;&#8722;0&#46;47 &#91;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#93;&#44; &#8722;0&#46;45 &#91;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#93;&#44; and &#8722;0&#46;43 &#91;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#93;&#44; respectively&#41;&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Correlation between cytokines and nutritional parameters</span><p id="par0100" class="elsevierStylePara elsevierViewall">Spearman coefficients indicated a moderate&#44; inverse&#44; statistically significant correlation of the nutritional parameters of interest with IL-6 and IL-10 &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">To control for potential confounders&#44; analysis of covariance &#40;ANCOVA&#41; was performed to detect whether these factors remained independently associated with cytokines&#46; Of the three nutritional parameters assessed&#44; only SDS-H&#47;A remained associated with cytokines after adjustment for Child&#8211;Pugh score&#44; age&#44; and EER &#40;&#37;&#41;&#46; To better understand this association&#44; SDS-H&#47;A was stratified into tertiles&#46; The results are shown in <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#46; Children classified into the first and second tertiles presented higher levels of IL-6 and IL-10 than those classified into the third tertile&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">According to eta-squared values&#44; SDS-H&#47;A explained 15&#46;4&#37; and 19&#46;7&#37; of the variability in IL-6 and IL-10 levels&#44; respectively&#44; while TNF-&#945; explained only 3&#46;6&#37; &#40;no statistical significance&#41;&#46;</p></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Discussion</span><p id="par0115" class="elsevierStylePara elsevierViewall">In the present study&#44; the authors correlated nutritional status with cytokines and disease severity&#46; The literature indicates that deteriorated nutritional status increases disease severity&#44; which in turns worsens nutritional status&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">8</span></a> Regarding nutritional status&#44; all anthropometric parameters were evaluated and statistically analyzed as <span class="elsevierStyleItalic">Z</span>-score&#44; recommended by WHO&#46;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">13&#44;14</span></a> Concerning cirrhosis severity&#44; statistical analysis was performed with both the Child&#8211;Pugh score &#40;all patients&#41; and PELD &#40;children under 12 years&#41;&#47;MELD &#40;children over 12 years and adolescents&#41;&#46; The results were similar in both scores&#46; Thus&#44; the Child&#8211;Pugh score was chosen in order to standardize the analysis with only one score&#44; since due to wide age range&#44; both the PELD and MELD scores would have to be used together&#44; reducing the uniformity&#46; To evaluate food consumption&#44; the EER was used&#46; This score is calculated through equations that consider energy expenditure&#44; age&#44; sex&#44; weight&#44; height and level of physical activity&#59; the formulas are different for each stage of life&#46; The EER was calculated individually&#59; after analyzing the three-day dietary recall&#44; it was possible to assess whether patients were ingesting the energy value recommended for cirrhosis&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">The American Society for Parenteral and Enteral Nutrition &#40;ASPEN&#41; recently published a document redefining pediatric malnutrition&#44; suggesting the inclusion of proinflammatory cytokines as adjuvants in nutritional assessment&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a> IL-6 is a cytokine that reflects the inflammatory status of patients with chronic liver disease&#44; and may be a potential marker of disease progression&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a> In the present sample&#44; higher levels of IL-6 were found in patients than in the control group &#40;2&#46;40 vs&#46; 0&#46;24<span class="elsevierStyleHsp" style=""></span>pg&#47;mL&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; and a moderate correlation was observed between IL-6 and disease severity &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleInf">s</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;45&#41;&#46; In a recent publication&#44; the authors have already shown an association between IL-6 and nutritional status in children and adolescents with chronic liver disease&#46; Pediatric patients at nutritional risk were compared with those well-nourished and the IL-6 values were higher in the first group &#40;7&#46;12<span class="elsevierStyleHsp" style=""></span>pg&#47;mL vs&#46; 1&#46;63<span class="elsevierStyleHsp" style=""></span>pg&#47;mL&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;02&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">18</span></a> Although the samples in both studies differ &#40;the present study&#39;s sample comprises only patients with cirrhosis due to BA&#41;&#44; the results are similar&#44; demonstrating a relationship between nutritional status and IL-6&#46; El-Faramawy et al&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">1</span></a> assessed IL-6 in a sample of younger children &#40;aged 17&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;8 months&#41; and found values very similar to those of the present study&#46; Kobayashi et al&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">19</span></a> assessed IL-6 in older children &#40;age 12&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;4 years&#41; and classified liver function by severity and age&#46; They demonstrated that the cytokine levels were higher in patients with more severe disease across all age ranges&#46; Therefore&#44; the present results confirm the role of IL-6 as a possible supporting biomarker of cirrhosis severity in children with cirrhosis secondary to BA&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">TNF-&#945; is considered a proinflammatory cytokine&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">20</span></a> In adults patients with cancer&#44; it has been shown to reduce appetite and food intake&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">21</span></a> Despite the fact that the cirrhosis group presented higher values of TNF-&#945; than the control group &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;004&#41;&#44; the present findings did not reveal a correlation of this cytokine and disease severity &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;478&#41;&#44; nor with any anthropometric parameter&#46; The same results were demonstrated by Santetti et al&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">18</span></a> In an adult sample&#44; Shiraki et al&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">10</span></a> found higher values in cirrhotic patients when compared with the control group &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; as well as in patients with more severe disease &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; The present results may be explained by the fact that the study sample was largely composed of patients with cirrhosis Child&#8211;Pugh A &#40;and PELD&#47;MELD below 15&#41;&#44; with a low prevalence of malnutrition &#40;28&#46;3&#37;&#41;&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">According to Nelson et al&#46;&#44; IL-10 is an anti-inflammatory cytokine with a protective effect against hepatic fibrogenesis&#44; playing a major role in regulating the immune response&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">22</span></a> Variation in levels may be associated with polymorphisms in the gene that encodes IL-10&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">23</span></a> Narayanaswamy et al&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">24</span></a> measured this cytokine in patients with BA who had undergone portoenterostomy and found no significant difference in levels when compared with those of healthy controls &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;8&#41;&#59; however&#44; these levels were higher than those found in cholestatic controls &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; In the present sample&#44; the levels of this cytokine were higher in cirrhotic patients than in the control group &#40;0&#46;65 vs&#46; 0&#46;36<span class="elsevierStyleHsp" style=""></span>pg&#47;mL&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;004&#41;&#44; and showed a moderate correlation with disease severity &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleInf">s</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;41&#41;&#46; Conversely&#44; Jian et al&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">11</span></a> and Wu et al&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">25</span></a> evaluated IL-10 in patients who had undergone portoenterostomy and found no significant difference between patients and controls&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">In this study&#44; anthropometric assessment findings were correlated with disease severity &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; The present findings are similar to those reported by Hurtado-L&#243;pez et al&#46;&#44; Saron et al&#46;&#44; and Elkabbany et al&#46;&#44; who compared TSF&#47;A with disease severity in children with chronic liver disease and found that the degree of deterioration in liver function was closely related to nutritional status&#46;<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">26&#8211;28</span></a> The present data reflect the fact that disease severity leads to deterioration of nutritional status&#59; this&#44; in turn&#44; worsens patient clinical condition&#46; Therefore&#44; it is essential that nutritional interventions should be implemented as soon as nutritional risk is identified in patients with BA&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">The authors agree with Mehta et al&#46;&#44; who suggested that IL-6 may serve as a marker of worsening nutritional status in patients with chronic disease&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">9</span></a> Shiraki et al&#46; suggested that activation of TNF-&#945; leads to abnormal metabolism&#44; which contributes to the malnutrition process in adults with cirrhosis&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">10</span></a> The present findings demonstrated a moderate correlation of height with IL-6 and IL-10 &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; After dividing SDS-H&#47;A measurements into tertiles and comparing IL-6 and IL-10 values in each tertile&#44; significant differences were found in the first and second tertiles when compared with the third tertile&#44; which demonstrates that&#44; the greater the impairment in nutritional status &#40;as represented by H&#47;A&#41;&#44; the higher the levels of IL-6 and IL-10 &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Thus&#44; children classified into the first and the second tertiles presented higher levels of IL-6 and IL-10 than those classified into the third tertile&#44; demonstrating the impairment in nutritional status&#46; Although the present findings have shown correlation between cytokines and severity of the disease&#44; some factors must be considered as changes in liver metabolism&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Monk et al&#46;&#44; in a recent publication&#44; studied body weight progression in weaned mice that were fed different diets<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">29</span></a>&#59; their findings suggest that high IL-10 levels are dependent on the altered metabolism that occurs with nutritional deficits&#46; In practice&#44; the present results demonstrated that greater stunting of growth is associated with higher levels of IL-6 and IL-10&#46; Since height is an indicator of malnutrition in the pediatric population&#44; it is possible to conclude that higher IL-6 and IL-10 concentrations are associated with worse malnutrition&#46; These results confirm the role of IL-6 as an indicator of worsening nutritional status&#44; and suggest that IL-10 level could serve as an alert system of an attempt of the body to overcome the inflammatory process that occurs with deterioration of nutritional status&#46; Although there are several gene polymorphisms of these interleukins&#44;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">30</span></a> further studies should evaluate these alleles in this population&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">The major strength of this study was the prospective analysis of a group of patients with a homogeneous etiology of liver disease&#59; its limitations were a relatively small sample size limited to patients who were attended to at this hospital&#44; and a small number of patients with severe disease&#46; The recommendation for further research is to replicate this study using a larger sample&#44; including more patients with severe disease&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">In conclusion&#44; IL-6 could be used as a possible supporting biomarker of deficient nutritional status&#44; and elevated IL-10 levels may be used as a possible early-stage supporting biomarker of deteriorating nutritional status in patients with cirrhosis secondary to BA&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Funding</span><p id="par0160" class="elsevierStylePara elsevierViewall">Coordena&#231;&#227;o de Aperfei&#231;oamento de Pessoal de N&#237;vel Superior &#40;CAPES&#41;&#44; Fundo de Incentivo a Pesquisa &#40;FIPE&#41;&#44; and Programa de P&#243;s-gradua&#231;&#227;o em Sa&#250;de da Crian&#231;a e do Adolescente &#40;PPG-SCA&#41;&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Conflicts of interest</span><p id="par0165" class="elsevierStylePara elsevierViewall">The authors declare no conflicts of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:12 [
        0 => array:3 [
          "identificador" => "xres904139"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Objectives"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Methods"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Conclusion"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec884751"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres904138"
          "titulo" => "Resumo"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Objetivos"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "M&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Conclus&#227;o"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec884750"
          "titulo" => "Palavras-chave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Methods"
          "secciones" => array:5 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Cirrhosis group"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Control group"
            ]
            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Assessment of nutritional status"
            ]
            3 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Cytokine quantitation"
            ]
            4 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Statistical analysis"
            ]
          ]
        ]
        6 => array:3 [
          "identificador" => "sec0040"
          "titulo" => "Results"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "General characteristics"
            ]
            1 => array:2 [
              "identificador" => "sec0050"
              "titulo" => "Nutritional status and dietary assessment"
            ]
            2 => array:2 [
              "identificador" => "sec0055"
              "titulo" => "Correlation of severity of cirrhosis with cytokine levels and nutritional parameters"
            ]
            3 => array:2 [
              "identificador" => "sec0060"
              "titulo" => "Correlation between cytokines and nutritional parameters"
            ]
          ]
        ]
        7 => array:2 [
          "identificador" => "sec0065"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0070"
          "titulo" => "Funding"
        ]
        9 => array:2 [
          "identificador" => "sec0075"
          "titulo" => "Conflicts of interest"
        ]
        10 => array:2 [
          "identificador" => "xack301063"
          "titulo" => "Acknowledgements"
        ]
        11 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2016-08-19"
    "fechaAceptado" => "2016-11-25"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec884751"
          "palabras" => array:6 [
            0 => "IL-6"
            1 => "TNF-&#945;"
            2 => "IL-10"
            3 => "Nutritional status"
            4 => "Cirrhosis"
            5 => "Biliary atresia"
          ]
        ]
      ]
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palavras-chave"
          "identificador" => "xpalclavsec884750"
          "palabras" => array:6 [
            0 => "IL-6"
            1 => "TNF-&#945;"
            2 => "IL-10"
            3 => "Estado nutricional"
            4 => "Cirrose"
            5 => "Atresia Biliar"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The objective of the present study is to evaluate whether IL-6&#44; TNF-&#945;&#44; IL-10 are associated with nutritional status in patients with cirrhosis secondary to biliary atresia and compare to healthy controls&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The parameters used for nutritional assessment were the standard deviation scores of height-for-age and of triceps skinfold thickness-for-age&#46; The severity of cirrhosis was evaluated using the Child&#8211;Pugh score and PELD&#47;MELD&#46; Serum cytokines were measured using Cytometric Bead Array flow cytometry&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">IL-6&#44; TNF-&#945;&#44; and IL-10 were significantly higher in the cirrhosis group when compared with the control group &#40;2&#46;4 vs&#46; 0&#46;24 &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; 0&#46;21 vs&#46; 0&#46;14 &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;007&#41;&#44; and 0&#46;65 vs&#46; 0&#46;36 &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;004&#41;&#44; respectively&#46; IL-6 and IL-10 were positively correlated with disease severity &#40;0&#46;450 &#91;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#93; and 0&#46;410&#59; &#91;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#93;&#44; respectively&#41;&#46; TNF-&#945; did not show a significant correlation with disease severity &#40;0&#46;100&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;478&#41;&#46; Regarding nutritional evaluation&#44; IL-6 was negatively correlated with the standard deviation score of height-for-age &#40;&#8722;0&#46;493&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and of triceps skinfold thickness-for-age &#40;&#8722;0&#46;503&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; respectively&#46; IL-10 exhibited a negative correlation with the standard deviation score of height-for-age &#40;&#8722;0&#46;476&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and the standard deviation score of triceps skinfold thickness-for-age &#40;&#8722;0&#46;388&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;004&#41;&#46; TNF-&#945; did not show any significance in both anthropometric parameters &#40;&#8722;0&#46;083 &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;555&#41; and &#8722;0&#46;161 &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;253&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The authors suggest that&#44; in patients with cirrhosis secondary to biliary atresia&#44; IL-6 could be used as a possible supporting biomarker of deficient nutritional status and elevated IL-10 levels could be used as a possible early-stage supporting biomarker of deteriorating nutritional status&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objectives"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusion"
          ]
        ]
      ]
      "pt" => array:3 [
        "titulo" => "Resumo"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">O objetivo deste estudo &#233; avaliar se h&#225; associa&#231;&#227;o entre a IL-6&#44; o TNF-&#945; e a IL-10 com o estado nutricional de pacientes com cirrose por Atresia Biliar e comparar com controles saud&#225;veis&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Os par&#226;metros utilizados na avalia&#231;&#227;o nutricional foram o escore-z da estatura para a idade e da dobra cut&#226;nea tricipital para idade&#46; A gravidade da cirrose foi avaliada pelo escore Chil-Pugh e pelos modelos PELD&#47;MELD&#46; As citocinas s&#233;ricas foram quantificadas por citometria de fluxo&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A IL-6&#44; o TNF-&#945; e a IL-10 foram significativamente mais elevados no grupo cirrose quando comparado ao grupo controle &#91;2&#44;4<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>0&#44;24 &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#93;&#44; &#91;0&#44;21<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>0&#44;14 &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;007&#93; e &#91;0&#44;65<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>0&#44;36 &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#41;&#93;&#44; respectivamente&#46; A IL-6 e a IL-10 demonstraram correla&#231;&#227;o direta com a gravidade da doen&#231;a &#40;0&#44;450&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; e &#40;0&#44;410&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41;&#44; respectivamente&#46; O TNF-&#945; n&#227;o apresentou signific&#226;ncia com a gravidade da doen&#231;a &#40;0&#44;100&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;478&#41;&#46; Em rela&#231;&#227;o &#224; avalia&#231;&#227;o nutricional&#44; a IL-6 mostrou correla&#231;&#227;o inversa com o escore-z da estatura para idade &#40;&#8722;0&#44;493&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; e com o escore-z da dobra cut&#226;nea tricipital &#40;&#8722;0&#44;503&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; respectivamente&#46; A IL-10 mostrou correla&#231;&#227;o inversa com o escore-z da estatura para idade &#40;&#8722;0&#44;476&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; e com o escore-z da dobra cut&#226;nea tricipital &#40;&#8722;0&#44;388&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#41;&#44; respectivamente&#46; O TNF-&#945; n&#227;o mostrou signific&#226;ncia em ambos par&#226;metros antropom&#233;tricos &#91;&#40;&#8722;0&#44;083&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;555&#41;&#59; &#40;&#8722;0&#44;161&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;253&#41;&#93;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#227;o</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Os autores sugerem que&#44; em pacientes com cirrose por Atresia Biliar&#44; a IL-6 possa ser usada como um poss&#237;vel biomarcador coadjuvante do estado nutricional deficiente e que n&#237;veis elevados de IL-10 possam ser utilizados como um biomarcador coadjuvante precoce na deterioriza&#231;&#227;o do estado nutricional&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Objetivos"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "M&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclus&#227;o"
          ]
        ]
      ]
    ]
    "NotaPie" => array:2 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0035">Please cite this article as&#58; Wilasco MI&#44; Uribe-Cruz C&#44; Santetti D&#44; Fries GR&#44; Dornelles CT&#44; Silveira TR&#46; IL-6&#44; TNF-&#945;&#44; IL-10&#44; and nutritional status in pediatric patients with biliary atresia&#46; J Pediatr &#40;Rio J&#41;&#46; 2017&#59;93&#58;517&#8211;24&#46;</p>"
      ]
      1 => array:2 [
        "etiqueta" => "&#9734;&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0040">Study conducted at Universidade Federal do Rio Grande do Sul&#44; Faculdade de Medicina&#44; Programa de P&#243;s-gradua&#231;&#227;o em Sa&#250;de da Crian&#231;a e do Adolescente&#44; Porto Alegre&#44; RS&#44; Brazil&#46;</p>"
      ]
    ]
    "multimedia" => array:4 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1267
            "Ancho" => 3352
            "Tamanyo" => 225892
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Cytokine values stratified into tertiles of height for age&#46; &#40;A&#41; IL-6 serum values&#59; &#40;B&#41; IL-10 serum values&#59; &#40;C&#41; TNF-&#945; serum values&#46; Children classified into the first and the second tertiles presented higher levels of IL-6 and IL-10 than those classified into the third tertile&#44; demonstrating the impairment in nutritional status &#40;as represented by height-for-age&#41;&#46; The line inside the box represents the median&#46; The upper and lower limits of the box represent the 25th and 75th percentiles&#44; respectively&#46; Upper and lower error bars represent the minimum and maximum values of the sample&#46; The asterisks and circles represent outliers&#46; &#951;&#44;2&#44; eta squared&#59; M&#44; median &#40;25th and 75th percentiles&#41;&#59; SDS-H&#47;A&#44; standard deviation score of height-for-age&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">PELD&#44; Pediatric End-stage Liver Disease score&#59; MELD&#44; Model for End-stage Liver Disease score&#46;</p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Data expressed as <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41; or median &#40;interquartile range&#41;&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                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">Characteristics&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">Cirrhosis group<br>&#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>53&#41;&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">Control group<br>&#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>33&#41;&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"><span class="elsevierStyleItalic">p</span>&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"><span class="elsevierStyleItalic">Age &#40;months&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="center" valign="top">23&#46;6 &#40;8&#46;4&#8211;87&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="center" valign="top">28&#46;6 &#40;16&#46;0&#8211;89&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;647<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&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="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></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="elsevierStyleItalic">Sex</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;780<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&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>Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="center" valign="top">18 &#40;34&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="center" valign="top">13 &#40;39&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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>Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="center" valign="top">35 &#40;66&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="center" valign="top">20 &#40;60&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></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="elsevierStyleItalic">IL-6 &#40;pg&#47;mL&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="center" valign="top">2&#46;40 &#40;0&#46;98&#8211;6&#46;03&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="center" valign="top">0&#46;24 &#40;0&#46;18&#8211;0&#46;56&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&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="elsevierStyleItalic">TNF-&#945; &#40;pg&#47;mL&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="center" valign="top">0&#46;21 &#40;0&#46;13&#8211;0&#46;44&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="center" valign="top">0&#46;14 &#40;0&#46;12&#8211;0&#46;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;007<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&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="elsevierStyleItalic">IL-10 &#40;pg&#47;mL&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="center" valign="top">0&#46;65 &#40;0&#46;36&#8211;1&#46;79&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="center" valign="top">0&#46;36 &#40;0&#46;56&#8211;0&#46;53&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;004<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&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="4" 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="4" align="left" valign="top"><span class="elsevierStyleItalic">Child&#8211;Pugh score</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>A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="center" valign="top">31 &#40;58&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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>B<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="center" valign="top">22 &#40;41&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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="4" 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="4" align="left" valign="top"><span class="elsevierStyleItalic">PELD &#40;n</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">46&#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>&#60;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="center" valign="top">36 &#40;78&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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>&#8805;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="center" valign="top">10 &#40;21&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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="4" 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="4" align="left" valign="top"><span class="elsevierStyleItalic">MELD &#40;n</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">7&#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>&#60;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="center" valign="top">7 &#40;100&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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>&#8805;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="center" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1520169.png"
              ]
            ]
          ]
          "notaPie" => array:2 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Mann&#8211;Whitney&#39;s <span class="elsevierStyleItalic">U</span>-test&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Chi-squared test&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">General characteristics of the cirrhosis and control groups&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">SDS-H&#47;A&#44; standard deviation score of height-for-age&#59; SDS-MUAC&#47;A&#44; standard deviation score of mid-upper arm circumference-for-age&#59; SDS-TSF&#47;A&#44; standard deviation score of triceps skinfold thickness-for-age&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                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-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Characteristics&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Cirrhosis group</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Control group</th><th class="td" title="table-head  " align="left" valign="top" scope="col"><span class="elsevierStyleItalic">p</span><a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">d</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr><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"><span class="elsevierStyleItalic">n</span>&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"><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&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"><span class="elsevierStyleItalic">n</span>&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"><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><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></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"><span class="elsevierStyleItalic">SDS-H&#47;A</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&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><span class="elsevierStyleUnderline">&#8804;</span>&#8722;2&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;30&#46;2&#41;<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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>&#8722;1&#46;99 to &#8722;1&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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;32&#46;1&#41;<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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;6&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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>&#8722;1&#46;00 to &#43;1&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;34&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23 &#40;69&#46;7&#41;<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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>&#43;1&#46;00 to &#43;1&#46;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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;3&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;18&#46;2&#41;<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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>&#8805;&#43;2&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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;6&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></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="elsevierStyleItalic">SDS-MUAC&#47;A</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&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><span class="elsevierStyleUnderline">&#8804;</span>&#8722;2&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;21&#46;1&#41;<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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>&#8722;1&#46;99 to &#8722;1&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14 &#40;26&#46;9&#41;<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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>&#8722;1&#46;00 to &#43;1&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21 &#40;40&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31 &#40;93&#46;9&#41;<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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>&#43;1&#46;00 to &#43;1&#46;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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;9&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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;6&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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>&#8805;&#43;2&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;1&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></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="elsevierStyleItalic">SDS-TSF&#47;A</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;002&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><span class="elsevierStyleUnderline">&#8804;</span>&#8722;2&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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;17&#46;3&#41;<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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>&#8722;1&#46;99 to &#8722;1&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;21&#46;2&#41;<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;3&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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>&#8722;1&#46;00 to &#43;1&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;53&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30 &#40;90&#46;9&#41;<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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>&#43;1&#46;00 to &#43;1&#46;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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;6&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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>&#8805;&#43;2&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></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="elsevierStyleItalic">Nutritional classification &#40;SDS-H&#47;A and SDS-TSF&#47;A&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;002&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>Undernourished&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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;28&#46;8&#41;<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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>Well-nourished&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36 &#40;69&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33 &#40;100&#41;<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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>Overweight&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;1&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1520168.png"
              ]
            ]
          ]
          "notaPie" => array:4 [
            0 => array:3 [
              "identificador" => "tblfn0015"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">The lowest of the two values was used for nutritional classification&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0020"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0020">One patient had a standard deviation score below &#8722;0&#46;01 SD and was excluded from the sample&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0025"
              "etiqueta" => "c"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0025">Association significant at 5&#37;&#44; according to adjusted residuals test&#46;</p>"
            ]
            3 => array:3 [
              "identificador" => "tblfn0030"
              "etiqueta" => "d"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0030">Chi-squared test &#40;categorical variables&#41; and Student&#39;s <span class="elsevierStyleItalic">t</span>-test &#40;continuous variables&#41;&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Nutritional parameters and assessment&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">SDS-H&#47;A&#44; standard deviation score of height-for-age&#59; SDS-MUAC&#47;A&#44; standard deviation score of mid-upper arm circumference-for-age&#59; SDS-TSF&#47;A&#44; standard deviation score of triceps skinfold thickness-for-age&#59; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleInf">s</span>&#44; Spearman coefficient&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                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">Characteristics&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">IL-6<br><span class="elsevierStyleItalic">r</span><span class="elsevierStyleInf">s</span> &#40;<span class="elsevierStyleItalic">p</span>-value&#41;&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">IL-10<br><span class="elsevierStyleItalic">r</span><span class="elsevierStyleInf">s</span> &#40;<span class="elsevierStyleItalic">p</span>-value&#41;&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">TNF-&#945;<br><span class="elsevierStyleItalic">r</span><span class="elsevierStyleInf">s</span> &#40;<span class="elsevierStyleItalic">p</span>-value&#41;&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">SDS-H&#47;A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;493 &#40;&#60;0&#46;001&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;476 &#40;&#60;0&#46;001&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;083 &#40;0&#46;555&#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">SDS-MUAC&#47;A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;320 &#40;0&#46;022&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;363 &#40;0&#46;008&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;129 &#40;0&#46;362&#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">SDS-TSF&#47;A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;503 &#40;&#60;0&#46;001&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;388 &#40;0&#46;004&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;161 &#40;0&#46;253&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1520170.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Correlation between cytokines and nutritional parameters &#40;Spearman&#39;s coefficient&#41;&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:30 [
            0 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Serum IL-6 and IL-8 in infants with biliary atresia in comparison to intrahepatic cholestasis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46;A&#46; El-Faramawy"
                            1 => "L&#46;B&#46; El-Shazly"
                            2 => "A&#46;A&#46; Abbass"
                            3 => "H&#46;A&#46; Ismail"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Trop Gastroenterol"
                        "fecha" => "2011"
                        "volumen" => "32"
                        "paginaInicial" => "50"
                        "paginaFinal" => "55"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21922857"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Biliary atresia&#58; clinical lessons learned"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46;G&#46; Feldman"
                            1 => "C&#46;L&#46; Mack"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/MPG.0000000000000755"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr Gastroenterol Nutr"
                        "fecha" => "2015"
                        "volumen" => "61"
                        "paginaInicial" => "167"
                        "paginaFinal" => "175"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25658057"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cirrhosis in children and adolescents&#58; an overview"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46;B&#46; Pinto"
                            1 => "A&#46;C&#46; Schneider"
                            2 => "T&#46;R&#46; da Silveira"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4254/wjh.v7.i3.392"
                      "Revista" => array:6 [
                        "tituloSerie" => "World J Hepatol"
                        "fecha" => "2015"
                        "volumen" => "7"
                        "paginaInicial" => "392"
                        "paginaFinal" => "405"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25848466"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estado nutricional e absor&#231;&#227;o intestinal de ferro em crian&#231;as com doen&#231;a hep&#225;tica cr&#244;nica com e sem colestase"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "R&#46;H&#46; Mattar"
                            1 => "R&#46;A&#46; Azevedo"
                            2 => "P&#46;G&#46; Speridi&#227;o"
                            3 => "U&#46; Fagundes Neto"
                            4 => "M&#46;B&#46; Morais"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Pediatr &#40;Rio J&#41;"
                        "fecha" => "2005"
                        "volumen" => "81"
                        "paginaInicial" => "317"
                        "paginaFinal" => "324"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "N&#237;veis plasm&#225;ticos de vitamina D em crian&#231;as e adolescentes com colestase"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46;D&#46; Bastos"
                            1 => "T&#46;R&#46; da Silveira"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Pediatr &#40;Rio J&#41;"
                        "fecha" => "2003"
                        "volumen" => "79"
                        "paginaInicial" => "245"
                        "paginaFinal" => "252"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation and management of end-stage liver disease in children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46;A&#46; Leonis"
                            1 => "W&#46;F&#46; Balistreri"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1053/j.gastro.2008.02.029"
                      "Revista" => array:6 [
                        "tituloSerie" => "Gastroenterology"
                        "fecha" => "2008"
                        "volumen" => "134"
                        "paginaInicial" => "1741"
                        "paginaFinal" => "1751"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18471551"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Role of nutrition in pediatric chronic liver disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;I&#46; Sultan"
                            1 => "C&#46;D&#46; Leon"
                            2 => "V&#46;F&#46; Biank"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/0884533611405535"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nutr Clin Pract"
                        "fecha" => "2011"
                        "volumen" => "26"
                        "paginaInicial" => "401"
                        "paginaFinal" => "408"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21531738"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nutrition assessment and support in children with end-stage liver disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46; Young"
                            1 => "E&#46; Kwarta"
                            2 => "R&#46; Azzam"
                            3 => "T&#46; Sentongo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/0884533612474043"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nutr Clin Pract"
                        "fecha" => "2013"
                        "volumen" => "28"
                        "paginaInicial" => "317"
                        "paginaFinal" => "329"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23466471"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nutritional deficiencies during critical illness"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "N&#46;M&#46; Mehta"
                            1 => "C&#46;P&#46; Duggan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.pcl.2009.06.007"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Clin North Am"
                        "fecha" => "2009"
                        "volumen" => "56"
                        "paginaInicial" => "1143"
                        "paginaFinal" => "1160"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19931068"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Elevated serum tumor necrosis factor-alpha and soluble tumor necrosis factor receptors correlate with aberrant energy metabolism in liver cirrhosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Shiraki"
                            1 => "Y&#46; Terakura"
                            2 => "J&#46; Iwasa"
                            3 => "M&#46; Shimizu"
                            4 => "Y&#46; Miwa"
                            5 => "N&#46; Murakami"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.nut.2009.04.016"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nutrition"
                        "fecha" => "2010"
                        "volumen" => "26"
                        "paginaInicial" => "269"
                        "paginaFinal" => "275"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19695831"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The correlation between plasma cytokine levels in jaundice-free children with biliary atresia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "Z&#46;H&#46; Jian"
                            1 => "L&#46;C&#46; Wang"
                            2 => "C&#46;C&#46; Lin"
                            3 => "J&#46;D&#46; Wang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s12519-015-0023-5"
                      "Revista" => array:6 [
                        "tituloSerie" => "World J Pediatr"
                        "fecha" => "2015"
                        "volumen" => "11"
                        "paginaInicial" => "352"
                        "paginaFinal" => "357"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25846069"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nutritional evaluation of children with chronic cholestatic disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46;V&#46; da Silva"
                            1 => "P&#46;M&#46; Ferri"
                            2 => "T&#46;C&#46; Nascentes Queiroz"
                            3 => "P&#46; de Souza Haueisen Barbosa"
                            4 => "M&#46;C&#46; Cassiano de Oliveira"
                            5 => "L&#46;J&#46; de Melo Pereira"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Pediatr &#40;Rio J&#41;"
                        "fecha" => "2016"
                        "volumen" => "92"
                        "paginaInicial" => "197"
                        "paginaFinal" => "205"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Multicentre Growth Reference Study Group&#46; WHO Child Growth Standards&#58; length&#47;height-for-age&#44; weight-for-age&#44; weight-for-length&#44; weight-for-height and body mass index-for-age&#58; methods and development"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "World Health Organization &#40;WHO&#41;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2006"
                        "editorial" => "WHO"
                        "editorialLocalizacion" => "Geneva"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "WHO Child Growth Standards&#58; head circumference-for-age&#44; arm circumference-for-age&#44; triceps skinfold-for-age and subscapular skinfold-for-age&#58; methods and development"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "Multicentre Growth Reference Study Group"
                          "etal" => false
                          "autores" => array:1 [
                            0 => "World Health Organization &#40;WHO&#41;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2007"
                        "editorial" => "WHO"
                        "editorialLocalizacion" => "Geneva"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Anthropometric standards&#58; an interactive nutritional reference of body composition for children and adults"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46;R&#46; Frisancho"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2008"
                        "editorial" => "The University of Michigan Press"
                        "editorialLocalizacion" => "Ann Arbor"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Defining pediatric malnutrition&#58; a paradigm shift toward etiology-related definitions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46;M&#46; Mehta"
                            1 => "M&#46;R&#46; Corkins"
                            2 => "B&#46; Lyman"
                            3 => "A&#46; Malone"
                            4 => "P&#46;S&#46; Goday"
                            5 => "L&#46;N&#46; Carney"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Parenter Enteral Nutr"
                        "fecha" => "2013"
                        "volumen" => "37"
                        "paginaInicial" => "460"
                        "paginaFinal" => "481"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Interleukin-6 signaling drives fibrosis in unresolved inflammation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46;A&#46; Fielding"
                            1 => "G&#46;W&#46; Jones"
                            2 => "R&#46;M&#46; McLoughlin"
                            3 => "L&#46; McLeod"
                            4 => "V&#46;J&#46; Hammond"
                            5 => "J&#46; Uceda"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.immuni.2013.10.022"
                      "Revista" => array:6 [
                        "tituloSerie" => "Immunity"
                        "fecha" => "2014"
                        "volumen" => "40"
                        "paginaInicial" => "40"
                        "paginaFinal" => "50"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24412616"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Serum proinflammatory cytokines and nutritional status in pediatric chronic liver disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Santetti"
                            1 => "M&#46;I&#46; de Albuquerque Wilasco"
                            2 => "C&#46;T&#46; Dornelles"
                            3 => "I&#46;C&#46; Werlang"
                            4 => "F&#46;U&#46; Fontella"
                            5 => "C&#46;O&#46; Kieling"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3748/wjg.v21.i29.8927"
                      "Revista" => array:6 [
                        "tituloSerie" => "World J Gastroenterol"
                        "fecha" => "2015"
                        "volumen" => "21"
                        "paginaInicial" => "8927"
                        "paginaFinal" => "8934"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26269683"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Levels of circulating antiinflammatory cytokine interleukin-1 receptor antagonist and proinflammatory cytokines at different stages of biliary atresia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H&#46; Kobayashi"
                            1 => "A&#46; Yamataka"
                            2 => "G&#46;J&#46; Lane"
                            3 => "T&#46; Miyano"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr Surg"
                        "fecha" => "2002"
                        "volumen" => "37"
                        "paginaInicial" => "1038"
                        "paginaFinal" => "1041"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12077767"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "How TNF was recognized as a key mechanism of disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "I&#46;A&#46; Clark"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.cytogfr.2007.04.002"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cytokine Growth Factor Rev"
                        "fecha" => "2007"
                        "volumen" => "18"
                        "paginaInicial" => "335"
                        "paginaFinal" => "343"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17493863"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Molecular mechanisms involved in muscle wasting in cancer and ageing&#58; cachexia <span class="elsevierStyleItalic">versus</span> sarcopenia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;M&#46; Argil&#233;s"
                            1 => "S&#46; Busquets"
                            2 => "A&#46; Felipe"
                            3 => "F&#46;J&#46; L&#243;pez-Soriano"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.biocel.2004.10.003"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Biochem Cell Biol"
                        "fecha" => "2005"
                        "volumen" => "37"
                        "paginaInicial" => "1084"
                        "paginaFinal" => "1104"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15743680"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Interleukin 10 treatment reduces fibrosis in patients with chronic hepatitis C&#58; a pilot trial of interferon nonresponders"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "D&#46;R&#46; Nelson"
                            1 => "G&#46;Y&#46; Lauwers"
                            2 => "J&#46;Y&#46; Lau"
                            3 => "G&#46;L&#46; Davis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Gastroenterology"
                        "fecha" => "2000"
                        "volumen" => "118"
                        "paginaInicial" => "655"
                        "paginaFinal" => "660"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10734016"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Is interleukin-10 gene polymorphism a predictive marker in HCV infection&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "B&#46;J&#46; Swi&#261;tek"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.cytogfr.2012.01.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cytokine Growth Factor Rev"
                        "fecha" => "2012"
                        "volumen" => "23"
                        "paginaInicial" => "47"
                        "paginaFinal" => "59"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22390924"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Serial circulating markers of inflammation in biliary atresia &#8211; evolution of the post-operative inflammatory process"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "B&#46; Narayanaswamy"
                            1 => "C&#46; Gonde"
                            2 => "J&#46;M&#46; Tredger"
                            3 => "M&#46; Hussain"
                            4 => "D&#46; Vergani"
                            5 => "M&#46; Davenport"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/hep.21701"
                      "Revista" => array:7 [
                        "tituloSerie" => "Hepatology"
                        "fecha" => "2007"
                        "volumen" => "46"
                        "paginaInicial" => "180"
                        "paginaFinal" => "187"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17596879"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0190962216301293"
                          "estado" => "S300"
                          "issn" => "01909622"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A high serum interleukin-12p40 level prior to Kasai surgery predict a favourable outcome in children with biliary atresia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;F&#46; Wu"
                            1 => "P&#46;C&#46; Kao"
                            2 => "H&#46;L&#46; Chen"
                            3 => "H&#46;S&#46; Lai"
                            4 => "H&#46;Y&#46; Hsu"
                            5 => "M&#46;H&#46; Chang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/liv.12001"
                      "Revista" => array:6 [
                        "tituloSerie" => "Liver Int"
                        "fecha" => "2012"
                        "volumen" => "32"
                        "paginaInicial" => "1557"
                        "paginaFinal" => "1563"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22958268"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Liver function test results predict nutritional status evaluated by arm anthropometric indicators"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "E&#46;F&#46; Hurtado-L&#243;pez"
                            1 => "A&#46; Larrosa-Haro"
                            2 => "E&#46;M&#46; V&#225;squez-Garibay"
                            3 => "R&#46; Mac&#237;as-Rosales"
                            4 => "R&#46; Troyo-Sanrom&#225;n"
                            5 => "M&#46;C&#46; Boj&#243;rquez-Ramos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/MPG.0b013e3180f60b9e"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Pediatr Gastroenterol Nutr"
                        "fecha" => "2007"
                        "volumen" => "45"
                        "paginaInicial" => "451"
                        "paginaFinal" => "457"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18030212"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0140673610621757"
                          "estado" => "S300"
                          "issn" => "01406736"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nutritional status of patients with biliary atresia and autoimmune hepatitis related to serum levels of vitamins A&#44; D and E"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;L&#46; Saron"
                            1 => "H&#46;T&#46; Godoy"
                            2 => "G&#46; Hessel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arq Gastroenterol"
                        "fecha" => "2009"
                        "volumen" => "46"
                        "paginaInicial" => "62"
                        "paginaFinal" => "68"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19466312"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessment of serum acylated ghrelin in children and adolescents with chronic liver diseases&#58; relation to nutritional status"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "Z&#46;A&#46; Elkabbany"
                            1 => "R&#46;T&#46; Hamza"
                            2 => "N&#46;H&#46; Mahmoud"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Scientific World J"
                        "fecha" => "2014"
                        "volumen" => "2014"
                        "paginaInicial" => "560516"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Constitutive&#44; but not challenge-induced&#44; interleukin-10 production is robust in acute pre-pubescent protein and energy deficits&#58; new support for the tolerance hypothesis of malnutrition-associated immune depression based on cytokine production <span class="elsevierStyleItalic">in vivo</span>"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;M&#46; Monk"
                            1 => "T&#46;A&#46; Steevels"
                            2 => "L&#46;M&#46; Hillyer"
                            3 => "B&#46; Woodward"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/ijerph8010117"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Environ Res Public Health"
                        "fecha" => "2011"
                        "volumen" => "8"
                        "paginaInicial" => "117"
                        "paginaFinal" => "135"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21318019"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "IL-6 572 C&#47;G&#44; 190 C&#47;T&#44; and 174 G&#47;C gene polymorphisms in children&#39;s malnutrition"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46;O&#46; Marginean"
                            1 => "C&#46; Banescu"
                            2 => "S&#46; Voidazan"
                            3 => "C&#46; Duicu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/MPG.0000000000000492"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr Gastroenterol Nutr"
                        "fecha" => "2014"
                        "volumen" => "59"
                        "paginaInicial" => "666"
                        "paginaFinal" => "673"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25023587"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:4 [
        "identificador" => "xack301063"
        "titulo" => "Acknowledgements"
        "texto" => "<p id="par0170" class="elsevierStylePara elsevierViewall">The authors would like to acknowledge the support and help provided by the Experimental Laboratory of Gastroenterology and Hepatology and the Laboratory of Molecular Psychiatry&#44; Hospital de Cl&#237;nicas de Porto Alegre&#46;</p>"
        "vista" => "all"
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/00217557/0000009300000005/v1_201709220054/S0021755717302206/v1_201709220054/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "10179"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/00217557/0000009300000005/v1_201709220054/S0021755717302206/v1_201709220054/en/main.pdf?idApp=UINPBA000049&text.app=https://jped.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0021755717302206?idApp=UINPBA000049"
]