array:25 [
  "pii" => "S2255553617301088"
  "issn" => "22555536"
  "doi" => "10.1016/j.jpedp.2017.08.020"
  "estado" => "S300"
  "fechaPublicacion" => "2018-01-01"
  "aid" => "533"
  "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). 2018;94:69-75"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 721
    "formatos" => array:3 [
      "EPUB" => 81
      "HTML" => 425
      "PDF" => 215
    ]
  ]
  "Traduccion" => array:1 [
    "en" => array:20 [
      "pii" => "S0021755716303758"
      "issn" => "00217557"
      "doi" => "10.1016/j.jped.2017.03.010"
      "estado" => "S300"
      "fechaPublicacion" => "2018-01-01"
      "aid" => "533"
      "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). 2018;94:69-75"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 711
        "formatos" => array:3 [
          "EPUB" => 80
          "HTML" => 360
          "PDF" => 271
        ]
      ]
      "en" => array:12 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
        "titulo" => "Advanced bone age as an indicator facilitates the diagnosis of precocious puberty"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "tieneResumen" => array:2 [
          0 => "en"
          1 => "pt"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "69"
            "paginaFinal" => "75"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "pt" => array:1 [
            "titulo" => "Idade &#243;ssea avan&#231;ada como um indicador de facilita&#231;&#227;o do diagn&#243;stico de puberdade precoce"
          ]
        ]
        "contieneResumen" => array:2 [
          "en" => true
          "pt" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Yue-Qin Xu, Gui-Mei Li, Yan Li"
            "autores" => array:3 [
              0 => array:2 [
                "nombre" => "Yue-Qin"
                "apellidos" => "Xu"
              ]
              1 => array:2 [
                "nombre" => "Gui-Mei"
                "apellidos" => "Li"
              ]
              2 => array:2 [
                "nombre" => "Yan"
                "apellidos" => "Li"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "pt" => array:9 [
          "pii" => "S2255553617301088"
          "doi" => "10.1016/j.jpedp.2017.08.020"
          "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/S2255553617301088?idApp=UINPBA000049"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0021755716303758?idApp=UINPBA000049"
      "url" => "/00217557/0000009400000001/v2_202010230715/S0021755716303758/v2_202010230715/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S2255553617301106"
    "issn" => "22555536"
    "doi" => "10.1016/j.jpedp.2017.08.021"
    "estado" => "S300"
    "fechaPublicacion" => "2018-01-01"
    "aid" => "534"
    "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;. 2018;94:76-81"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 842
      "formatos" => array:3 [
        "EPUB" => 95
        "HTML" => 488
        "PDF" => 259
      ]
    ]
    "pt" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Artigo Original</span>"
      "titulo" => "Differences in perioperative femoral and radial arterial blood pressure in neonates and infants undergoing cardiac surgery requiring cardiopulmonary bypass"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => "pt"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "76"
          "paginaFinal" => "81"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Diferen&#231;as na press&#227;o arterial femoral e radial no perioperat&#243;rio em neonatos e beb&#234;s submetidos a cirurgia card&#237;aca com <span class="elsevierStyleItalic">bypass</span> cardiopulmonar"
        ]
      ]
      "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" => 2643
              "Ancho" => 2328
              "Tamanyo" => 221783
            ]
          ]
          "descripcion" => array:1 [
            "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Altera&#231;&#227;o da press&#227;o arterial m&#233;dia na art&#233;ria radial e femoral de acordo com o tempo&#46; A&#44; Compara&#231;&#227;o da press&#227;o arterial m&#233;dia durante o intraoperat&#243;rio &#40;a&#44; b&#44; c&#44; d&#58; p &#60; 0&#44;05&#41; B&#44; Compara&#231;&#227;o da press&#227;o arterial m&#233;dia nas primeiras 24 horas do p&#243;s&#8208;operat&#243;rio&#46; ACC&#44; pin&#231;amento cruzado da aorta&#59; CPB&#44; <span class="elsevierStyleItalic">bypass</span> cardiopulmonar&#59; UTI&#44; unidade de terapia intensiva&#59; PAM&#44; press&#227;o arterial m&#233;dia&#59; PreOp&#44; pr&#233;&#8208;operat&#243;rio&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Hwa Jin Cho, Sang Hoon Lee, In Seok Jeong, Nam Sik Yoon, Jae Sook Ma, Byoung Hee Ahn"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "Hwa Jin"
              "apellidos" => "Cho"
            ]
            1 => array:2 [
              "nombre" => "Sang Hoon"
              "apellidos" => "Lee"
            ]
            2 => array:2 [
              "nombre" => "In Seok"
              "apellidos" => "Jeong"
            ]
            3 => array:2 [
              "nombre" => "Nam Sik"
              "apellidos" => "Yoon"
            ]
            4 => array:2 [
              "nombre" => "Jae Sook"
              "apellidos" => "Ma"
            ]
            5 => array:2 [
              "nombre" => "Byoung Hee"
              "apellidos" => "Ahn"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0021755716304338"
        "doi" => "10.1016/j.jped.2017.03.011"
        "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/S0021755716304338?idApp=UINPBA000049"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2255553617301106?idApp=UINPBA000049"
    "url" => "/22555536/0000009400000001/v2_202010270619/S2255553617301106/v2_202010270619/pt/main.assets"
  ]
  "itemAnterior" => array:20 [
    "pii" => "S2255553617300915"
    "issn" => "22555536"
    "doi" => "10.1016/j.jpedp.2017.08.009"
    "estado" => "S300"
    "fechaPublicacion" => "2018-01-01"
    "aid" => "523"
    "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;. 2018;94:62-8"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2723
      "formatos" => array:3 [
        "EPUB" => 110
        "HTML" => 2125
        "PDF" => 488
      ]
    ]
    "pt" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Artigo Original</span>"
      "titulo" => "Bromopride&#44; metoclopramide&#44; or ondansetron for the treatment of vomiting in the pediatric emergency department&#58; a randomized controlled trial"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => "pt"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "62"
          "paginaFinal" => "68"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Bromoprida&#44; metoclopramida ou ondansetrona no tratamento de v&#244;mito no departamento de emerg&#234;ncia pedi&#225;trica&#58; ensaio controlado randomizado"
        ]
      ]
      "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" => 2051
              "Ancho" => 2237
              "Tamanyo" => 272919
            ]
          ]
          "descripcion" => array:1 [
            "pt" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Fluxograma de participa&#231;&#227;o&#44; tratamento e acompanhamento Consort&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Matias Epifanio, Janete de L&#46; Portela, Jefferson P&#46; Piva, Cristina H&#46; Targa Ferreira, Edgar E&#46; Sarria, Rita Mattiello"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "Matias"
              "apellidos" => "Epifanio"
            ]
            1 => array:2 [
              "nombre" => "Janete de L&#46;"
              "apellidos" => "Portela"
            ]
            2 => array:2 [
              "nombre" => "Jefferson P&#46;"
              "apellidos" => "Piva"
            ]
            3 => array:2 [
              "nombre" => "Cristina H&#46; Targa"
              "apellidos" => "Ferreira"
            ]
            4 => array:2 [
              "nombre" => "Edgar E&#46;"
              "apellidos" => "Sarria"
            ]
            5 => array:2 [
              "nombre" => "Rita"
              "apellidos" => "Mattiello"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0021755716302431"
        "doi" => "10.1016/j.jped.2017.06.004"
        "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/S0021755716302431?idApp=UINPBA000049"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2255553617300915?idApp=UINPBA000049"
    "url" => "/22555536/0000009400000001/v2_202010270619/S2255553617300915/v2_202010270619/pt/main.assets"
  ]
  "pt" => array:19 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Artigo Original</span>"
    "titulo" => "Advanced bone age as an indicator facilitates the diagnosis of precocious puberty"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "69"
        "paginaFinal" => "75"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Yue&#8208;Qin Xu, Gui&#8208;Mei Li, Yan Li"
        "autores" => array:3 [
          0 => array:3 [
            "nombre" => "Yue&#8208;Qin"
            "apellidos" => "Xu"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff1"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          1 => array:4 [
            "nombre" => "Gui&#8208;Mei"
            "apellidos" => "Li"
            "email" => array:1 [
              0 => "liguimei0531@126.com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff1"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Yan"
            "apellidos" => "Li"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Shandong Provincial Hospital Affiliated to Shandong University&#44; Department of Pediatrics&#44; 9677 Jinshi Road&#44; Jinan 250014&#44; China"
            "etiqueta" => "a"
            "identificador" => "aff1"
          ]
          1 => array:3 [
            "entidad" => "Shandong Qianfoshan Hospital Affiliated to Shandong University&#44; Department of Children Healthcare&#44; 16766 Jinshi Road&#44; Jinan 250014&#44; China"
            "etiqueta" => "b"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Autor para correspond&#234;ncia&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "Idade &#243;ssea avan&#231;ada como um indicador de facilita&#231;&#227;o do diagn&#243;stico de puberdade precoce"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introdu&#231;&#227;o</span><p id="par0005" class="elsevierStylePara elsevierViewall">A puberdade precoce &#40;PP&#41; &#233; o in&#237;cio da puberdade antes dos oito anos em meninas ou nove anos em meninos&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">1</span></a> Na maior parte dos casos&#44; a PP &#233; um resultado da ativa&#231;&#227;o prematura do eixo hipot&#225;lamo&#8208;hip&#243;fise&#8208;gonadal &#40;HPG&#41;&#44; &#233; tamb&#233;m chamada de puberdade precoce central &#40;PPC&#41;&#46; A PPC geralmente &#233; idiop&#225;tica&#44; exceto quando h&#225; causas identific&#225;veis &#40;por exemplo&#44; tumores&#44; hidrocefalia&#44; les&#245;es cerebrais ou trauma craniano&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">2</span></a> A matura&#231;&#227;o &#243;ssea precoce&#44; o crescimento linear acelerado e altera&#231;&#245;es na ultrassonografia p&#233;lvica &#40;USG&#41;&#44; inclusive altera&#231;&#245;es anormais no volume ovariano&#44; uterino e adrenal&#44; geralmente est&#227;o presentes na PP&#44;<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">3&#44;4</span></a> al&#233;m de outras caracter&#237;sticas sexuais secund&#225;rias&#44; como crescimento precoce dos pelos pubianos&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">5</span></a> A PPC pode levar ao fechamento precoce da ep&#237;fise&#44; que consequentemente resulta em redu&#231;&#227;o de estatura&#44; entre outros impactos como estresse psicol&#243;gico&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">6</span></a> As literaturas relataram que as meninas com desenvolvimento puberal precoce apresentaram mais comportamentos problem&#225;ticos&#44; em compara&#231;&#227;o com seus pares&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">7</span></a> Assim&#44; &#233; muito importante haver uma avalia&#231;&#227;o detalhada do desenvolvimento puberal nas meninas com suspeita de PP e&#44; caso seja feito um diagn&#243;stico&#44; deve&#8208;se iniciar um tratamento adequado&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">A telarca prematura &#40;TP&#41; &#233; definida pelo desenvolvimento isolado do tecido mam&#225;rio&#44; com outros sinais de matura&#231;&#227;o sexual&#44; que normalmente acontece nos primeiros quatro anos de vida&#46; Na maior parte dos casos&#44; a TP &#233; vista como uma varia&#231;&#227;o no desenvolvimento f&#237;sico normal e n&#227;o &#233; considerada patol&#243;gica&#46;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">8&#44;9</span></a> As crian&#231;as com TP n&#227;o apresentam sinais de aumento no crescimento nem matura&#231;&#227;o &#243;ssea avan&#231;ada&#44; com n&#237;vel normal de gonadotropina basal e E2&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">10&#44;11</span></a> Com uma preval&#234;ncia de 4&#44;7&#37;&#44; a causa da telarca prematura &#233;&#44; em grande parte&#44; desconhecida&#59; 2&#8208;13&#37; dos casos de TP podem progredir para PPC&#59;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">12&#8211;14</span></a> portanto&#44; deve ser feita uma avalia&#231;&#227;o cuidadosa com rela&#231;&#227;o &#224;s caracter&#237;sticas cl&#237;nicas&#44; &#224; idade &#243;ssea e &#224;s concentra&#231;&#245;es de gonadotropina basal e estimulada dos casos de TP&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">O teste de estimula&#231;&#227;o do LH &#233; um teste assistido que verifica a atividade do eixo HPG e diferencia os casos de PPC dos casos de TP&#46; Para crian&#231;as com progress&#227;o precoce de sinais puberais&#44; crescimento linear acelerado e matura&#231;&#227;o &#243;ssea precoce&#44; &#233; feito um diagn&#243;stico de PPC quando confirmada a ativa&#231;&#227;o prematura do eixo HPG&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">15</span></a> Contudo&#44; o teste de estimula&#231;&#227;o do LHRH exige um procedimento de amostragem complexo que dura um bom tempo e&#44; &#224;s vezes&#44; v&#225;rios testes s&#227;o necess&#225;rios antes que um diagn&#243;stico de PPC possa ser feito&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">9&#44;13</span></a> Foi relatado que a mensura&#231;&#227;o do n&#237;vel de LH de duas amostras ao ponto de 45 minutos &#233; necess&#225;ria para um diagn&#243;stico preciso de PPC&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">9</span></a> Neste estudo&#44; visamos a encontrar um indicador laboratorial ou cl&#237;nico que preveja um resultado positivo no teste de estimula&#231;&#227;o do LHRH&#44; pois conhecer esses indicadores pode facilitar o diagn&#243;stico de PPC&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Aqui&#44; os par&#226;metros cl&#237;nicos e laboratoriais dos indiv&#237;duos com sinais puberais precoces s&#227;o perfilados e comparados&#46; Par&#226;metros relevantes foram correlacionados com os resultados do teste de estimula&#231;&#227;o do LHRH inicial e de acompanhamento para encontrar o indicador mais significativo&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">M&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Indiv&#237;duos</span><p id="par0025" class="elsevierStylePara elsevierViewall">Foram selecionadas para a pesquisa 382 meninas encaminhadas ao Hospital Shandong Provincial afiliado &#224; Shandong University entre abril de 2010 e maio de 2015 para avalia&#231;&#227;o de suspeita de PP&#46; Os pacientes selecionados para o estudo atenderam aos seguintes crit&#233;rios&#58; a&#41; sexo feminino com desenvolvimento prematuro das mamas &#40;est&#225;gio Tanner &#8805; B<span class="elsevierStyleInf">2</span>&#41; antes dos oito anos&#59; b&#41; idade &#243;ssea &#8805; 1 ano acima da idade cronol&#243;gica &#40;IC&#41;&#59; c&#41; teste de estimula&#231;&#227;o do LHRH positivo antes dos nove anos&#59; d&#41; cada caso foi submetido a acompanhamento &#40;&#8805; 6 meses&#41;&#44; cada caso deve ser acompanhado acima dos nove anos&#46; Os pacientes com hist&#243;rico de doen&#231;as end&#243;crinas e les&#245;es intracranianas foram exclu&#237;dos&#46; Esta pesquisa foi aprovada pelo Comit&#234; de Pesquisa Cl&#237;nica do Hospital Shandong Provincial afiliado &#224; Shandong University&#46; O consentimento informado foi obtido de cada respons&#225;vel pela crian&#231;a participante do estudo&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Foi feito diagn&#243;stico de PPC quando&#58; 1&#41; houve apresenta&#231;&#227;o de matura&#231;&#227;o sexual secund&#225;ria abaixo dos oito anos&#59; 2&#41; idade &#243;ssea avan&#231;ada&#59; 3&#41; n&#237;vel m&#225;ximo de LH &#8805; 5 IU&#47;L durante o teste de estimula&#231;&#227;o do LHRH&#46; Os indiv&#237;duos foram agrupados de acordo com os resultados dos testes de estimula&#231;&#227;o do LHRH iniciais e de acompanhamento&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">M&#233;todos</span><p id="par0035" class="elsevierStylePara elsevierViewall">Os par&#226;metros de idade cronol&#243;gica &#40;IC&#41;&#44; idade &#243;ssea &#40;IO&#41;&#44; peso&#44; estatura&#44; IMC e laboratoriais foram coletados no in&#237;cio do teste de estimula&#231;&#227;o do LHRH&#46; O peso corporal e a estatura foram apresentados como escore de desvio&#8208;padr&#227;o &#40;EDP&#41;&#46; A velocidade de crescimento em seis meses foi determinada como aumento da estatura a partir do dia em que o teste de estimula&#231;&#227;o do LHRH &#40;inje&#231;&#227;o de gonadorelina&#41; foi feito&#46; A propor&#231;&#227;o de velocidade de crescimento foi determinada por&#58; aumento da estatura em seis meses dos indiv&#237;duos&#47;incremento na altura das meninas chinesas no per&#237;odo de seis meses&#46; O teste de estimula&#231;&#227;o do LHRH de acompanhamento foi feito a cada tr&#234;s ou seis meses de acordo com a velocidade de crescimento e a progress&#227;o puberal&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">A avalia&#231;&#227;o do desenvolvimento das mamas foi feita com a escala de Tanner&#46; A idade &#243;ssea foi determinada com o m&#233;todo Greulich&#8208;Pyle &#40;com radiografia do pulso e da m&#227;o esquerda&#41;&#46; A altura adulta prevista &#40;AAP&#41; foi medida com o m&#233;todo de Bayley&#8208;Pinneau&#44; ap&#243;s a dedu&#231;&#227;o da estatura m&#233;dia de mulheres chinesas de 20 anos &#40;161&#44;2<span class="elsevierStyleHsp" style=""></span>cm&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">O n&#237;vel sangu&#237;neo do FSH e do LH foi determinado com kits de ensaio imunofluorim&#233;trico &#40;Roche&#174;&#44; FIA&#44; IFMA&#44; IN&#44; EUA&#41;&#46; A imuniza&#231;&#227;o por eletroquimioluminesc&#234;ncia &#40;Roche&#174;&#44; Cobas e601&#44; IN&#44; EUA&#41; foi aplicada para avaliar os marcadores de tumor&#44; inclusive alfa&#8208;fetoprote&#237;na &#40;AFP&#41; e gonadotrofina cori&#244;nica humana &#40;HCG&#41;&#46; O n&#237;vel sangu&#237;neo de E2 foi determinado com os kits de radioimunoensaio &#40;Cisbio Bioassays&#44; Fran&#231;a&#41;&#46; No teste de estimula&#231;&#227;o do LHRH&#44; amostras de sangue foram coletadas aos 30&#44; 60 e 90 minutos ap&#243;s a administra&#231;&#227;o do LHRH &#40;100<span class="elsevierStyleHsp" style=""></span>&#956;g&#41; e submetidas ao teste de LH e FSH&#46; Os resultados das pacientes com n&#237;vel m&#225;ximo de LH &#8805; 5 IU&#47;L foram considerados positivos no teste de estimula&#231;&#227;o do LHRH&#46;</p><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">An&#225;lise estat&#237;stica</span><p id="par0050" class="elsevierStylePara elsevierViewall">As vari&#225;veis cont&#237;nuas foram expressas como m&#233;dia &#177; desvio&#8208;padr&#227;o e as vari&#225;veis categ&#243;ricas foram expressas como frequ&#234;ncia e percentuais&#46; O teste <span class="elsevierStyleItalic">t</span> de Student foi feito nas vari&#225;veis cont&#237;nuas e foram feitos testes qui&#8208;quadrado ou testes exatos de Fisher nas vari&#225;veis categ&#243;ricas&#46; Uma an&#225;lise de regress&#227;o log&#237;stica bin&#225;ria e uma an&#225;lise de regress&#227;o linear foram feitas para avaliar os indicadores significativos que podem prever os resultados do teste de estimula&#231;&#227;o do LHRH&#46; Uma curva ROC tamb&#233;m foi criada para obter o valor de corte da IO&#8208;IC na previs&#227;o diagn&#243;stica de PPC&#46; Todos os testes significativos foram bicaudais&#44; p &#60; 0&#44;05 foi considerado estatisticamente significativo&#46; Todas as an&#225;lises estat&#237;sticas foram feitas com o <span class="elsevierStyleItalic">software</span> SPSS &#40;SPSS&#44; estat&#237;stica para Windows&#44; Vers&#227;o 17&#46;0&#46; Chicago&#44; EUA&#41;&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Resultados</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Caracter&#237;sticas cl&#237;nicas e auxol&#243;gicas dos indiv&#237;duos</span><p id="par0055" class="elsevierStylePara elsevierViewall">Foram investigadas 382 meninas e as caracter&#237;sticas cl&#237;nicas e auxol&#243;gicas dos indiv&#237;duos foram mostradas na <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a><span class="elsevierStyleHsp" style=""></span>da seguinte forma&#58; a idade cronol&#243;gica dos indiv&#237;duos foi 7&#44;8 &#177; 0&#44;6 anos no teste de estimula&#231;&#227;o do LHRH inicial&#59; a idade &#243;ssea dos indiv&#237;duos foi 9&#44;3 &#177; 0&#44;8 anos&#59; o avan&#231;o da idade &#243;ssea &#40;IA&#8208;IC&#41; foi 22&#44;5 &#177; 5&#44;4 meses&#59; o peso foi 1&#44;4 &#177; 0&#44;4&#59; o EDP da altura dos indiv&#237;duos foi 1&#44;6 &#177; 0&#44;6&#59; a velocidade de crescimento em seis meses foi 3&#44;7 &#177; 0&#44;7<span class="elsevierStyleHsp" style=""></span>cm&#59; o IMC foi 18&#44;7 &#177; 2&#44;9<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">An&#225;lise das caracter&#237;sticas cl&#237;nicas e laboratoriais</span><p id="par0060" class="elsevierStylePara elsevierViewall">Foram diagnosticados 237 indiv&#237;duos com PPC de acordo com o teste de estimula&#231;&#227;o do LHRH inicial e agrupados no grupo de PPC&#44; 145 indiv&#237;duos com resultados negativos foram tratado como controle negativo &#40;grupo CN&#41;&#46; Conforme mostrado na <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#44; idade &#243;ssea &#40;10&#44;4 &#177; 0&#44;9 anos para o grupo de PPC e 9&#44;1 &#177; 0&#44;7 anos para o grupo CN&#44; p &#60; 0&#44;001&#41; e idade cronol&#243;gica &#40;7&#44;9 &#177; 0&#44;9 anos para o grupo de PPC e 7&#44;7 &#177; 0&#44;7 anos para o grupo CN&#44; p &#60; 0&#44;02&#41; maiores foram observadas entre os grupos de PPC e CN&#46; Al&#233;m disso&#44; foi encontrado IMC significativamente menor &#40;18&#44;1 &#177; 3&#44;4<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span> para o grupo de PPC e 19&#44;2 &#177; 3&#44;7<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span> para o grupo CN&#44; p &#61; 0&#44;003&#41;&#44; IO&#8208;IC maiores &#40;23&#44;7 &#177; 7&#44;5 meses para o grupo de PPC e 20&#44;1 &#177; 6&#44;9 meses para o grupo CN&#44; p &#60; 0&#44;001&#41;&#44; maior velocidade de crescimento do per&#237;odo de seis meses &#40;4&#44;2 &#177; 0&#44;8<span class="elsevierStyleHsp" style=""></span>cm para o grupo de PPC e 3&#44;3 &#177; 0&#44;6<span class="elsevierStyleHsp" style=""></span>cm para o grupo CN&#44; p &#60; 0&#44;001&#41; e maior propor&#231;&#227;o de velocidade de crescimento &#40;1&#44;4 &#177; 0&#44;3 para o grupo de PPC e 1&#44;1 &#177; 0&#44;2 para o grupo CN&#44; p &#60; 0&#44;001&#41; nos indiv&#237;duos com diagn&#243;stico de PPC&#44; em compara&#231;&#227;o com o grupo CN&#46; Al&#233;m disso&#44; foram detectadas maior concentra&#231;&#227;o basal de LH&#44; concentra&#231;&#245;es sangu&#237;neas basais de FSH&#44; E2 e IGF&#8208;1 no grupo de PPC&#44; em compara&#231;&#227;o com o grupo de CN&#46; Nenhuma diferen&#231;a significativa foi observada entre os dois grupos em termos de estatura e n&#237;veis sangu&#237;neos de AFP e HCG&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Testes de estimula&#231;&#227;o do LHRH de acompanhamento</span><p id="par0065" class="elsevierStylePara elsevierViewall">As 145 meninas com resultados negativos no teste de estimula&#231;&#227;o do LHRH inicial foram submetidas aos testes de estimula&#231;&#227;o do LHRH de acompanhamento&#46; Dentre os 145 indiv&#237;duos&#44; 42 foram diagnosticados com PPC nos testes de estimula&#231;&#227;o do LHRH de acompanhamento &#40;grupo positivo de acompanhamento&#41; e 103 meninas apresentaram resultados negativos &#40;grupo negativo de acompanhamento&#41;&#46; Foram encontradas maior idade &#243;ssea &#40;9&#44;5 &#177; 0&#44;8 anos para o grupo positivo de acompanhamento e 9&#44;1 &#177; 0&#44;7 anos para o grupo negativo de acompanhamento&#44; p &#60; 0&#44;005&#41;&#44; maior IO&#8208;IC &#40;22&#44;8 &#177; 6&#44;8 meses para o grupo positive de acompanhamento e 19&#44;5 &#177; 6&#44;4 meses para o grupo negativo de acompanhamento&#44; p &#61; 0&#44;006&#41;&#44; maior velocidade de crescimento durante seis meses &#40;3&#44;5 &#177; 0&#44;9<span class="elsevierStyleHsp" style=""></span>cm para o grupo positivo de acompanhamento e 3&#44;1 &#177; 0&#44;8<span class="elsevierStyleHsp" style=""></span>cm para o grupo negativo de acompanhamento&#44; p &#61; 0&#44;009&#41; e propor&#231;&#227;o de velocidade de crescimento &#40;1&#44;2 &#177; 0&#44;4 para o grupo positivo de acompanhamento e 1&#44;0 &#177; 0&#44;2 para o grupo negativo de acompanhamento&#44; p &#60; 0&#44;001&#41;&#44; em compara&#231;&#227;o com os indiv&#237;duos com resultado positivo&#46; Nenhuma diferen&#231;a estatisticamente significativa foi encontrada entre os grupos em termos de IMC&#44; EDP do peso corporal&#44; EDP da estatura&#44; concentra&#231;&#245;es sangu&#237;neas basais de E2 e sangu&#237;nea de IGF&#8208;1 e os n&#237;veis sangu&#237;neos de AFP e HCG &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a>&#41;&#46; Usamos os dados de IO&#8208;IC do teste inicial para criar uma curva ROC e criamos uma &#225;rea abaixo da curva ROC de 0&#44;605 &#40;0&#44;605 &#177; 0&#44;03&#41;&#46; O tempo de 19&#44;5 meses como valor de corte de IO&#8208;IC apresentou uma sensibilidade de 0&#44;7 e uma taxa de falso positivo de 0&#44;53 na previs&#227;o de diagn&#243;stico de PPC no acompanhamento&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">An&#225;lise de regress&#227;o log&#237;stica bin&#225;ria</span><p id="par0070" class="elsevierStylePara elsevierViewall">Foi criado um modelo de regress&#227;o log&#237;stica bin&#225;ria para analisar os par&#226;metros relevantes&#44; como IO&#8208;IC&#44; EDP do peso corporal IMC&#44; propor&#231;&#227;o da velocidade de crescimento&#44; concentra&#231;&#245;es sangu&#237;neas basais de E2&#44; LH e FSH e sangu&#237;neas de IGF&#8208;1 para avaliar os indicadores significativos que podem prever os resultados do teste de simula&#231;&#227;o do LHRH&#46; De acordo com a an&#225;lise de regress&#227;o log&#237;stica bin&#225;ria&#44; quatro par&#226;metros foram associados aos resultados do teste de estimula&#231;&#227;o do LHRH no teste de estimula&#231;&#227;o do LHRH inicial&#58; IO&#8208;IC &#40;RC&#44; 5&#44;62&#59; IC de 95&#37;&#44; 3&#44;08&#8208;8&#44;96&#59; p &#60; 0&#44;001&#41;&#44; propor&#231;&#227;o da velocidade de crescimento &#40;RC&#44; 3&#44;63&#59; IC de 95&#37;&#44; 2&#44;17&#8208;5&#44;34&#59; p &#60; 0&#44;001&#41;&#44; n&#237;vel sangu&#237;neo basal de FSH &#40;RC&#44; 2&#44;11&#59; IC de 95&#37;&#44; 1&#44;52&#8208;3&#44;49&#59; p &#60; 0&#44;01&#41;&#44; concentra&#231;&#227;o sangu&#237;nea basal de LH &#40;RC&#44; 1&#44;46&#59; IC de 95&#37;&#44; 1&#44;03&#8208;2&#44;47&#59; p &#61; 0&#44;02&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabela 4</a>&#41;&#46; Al&#233;m disso&#44; fizemos tamb&#233;m uma an&#225;lise de regress&#227;o linear sobre a correla&#231;&#227;o entre IO&#8208;IC e o n&#237;vel m&#225;ximo de LH&#46; No modelo de regress&#227;o linear&#44; os dados de IO&#8208;IC do teste inicial e do teste de acompanhamento foram positivamente correlacionados ao n&#237;vel m&#225;ximo de LH&#44; com um coeficiente de determina&#231;&#227;o &#40;R<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">2</span></a>&#41; de 0&#44;78 e 0&#44;65&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Discuss&#227;o</span><p id="par0075" class="elsevierStylePara elsevierViewall">Neste estudo&#44; 382 meninas foram submetidas aos testes de estimula&#231;&#227;o do LHRH inicial em nosso hospital e 145 delas apresentaram resultados negativos para os testes&#46; Com uma no&#231;&#227;o de que podemos ter errado em algum diagn&#243;stico &#40;negativo no teste de estimula&#231;&#227;o do LHRH inicial&#41;&#44; acompanhamos esses 145 casos regularmente&#46; Usamos os dados iniciais dos 382 casos&#44; conduzimos uma an&#225;lise de regress&#227;o bin&#225;ria e encontramos uma forte correla&#231;&#227;o entre o avan&#231;o na idade &#243;ssea e o resultado do teste de estimula&#231;&#227;o do LHRH &#40;e o diagn&#243;stico de PPC&#41;&#46; Tamb&#233;m foi encontrado o maior n&#237;vel sangu&#237;neo basal de LH&#44; E2 e FSH&#44; em compara&#231;&#227;o com os indiv&#237;duos com resposta negativa durante o teste de estimula&#231;&#227;o do LHRH&#46; Com os dados iniciais do diagn&#243;stico de IO&#8208;IC e de PPC&#44; criamos uma curva ROC e usamos o valor de corte para prever o diagn&#243;stico de PPC &#40;com uma sensibilidade de 0&#44;7 e taxa de falso positivo de 0&#44;53&#41;&#46; Apresentaram diagn&#243;stico de PPC durante o teste de acompanhamento 42 meninas&#46; Comparamos essas 42 meninas com as meninas com resultado negativo &#40;e outras 103 meninas&#41; e encontramos um avan&#231;o na idade &#243;ssea significativamente maior entre as meninas com PPC&#46; O avan&#231;o na idade &#243;ssea sozinho prev&#234; de maneira efetiva um valor de diagn&#243;stico de PPC&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">As an&#225;lises de tend&#234;ncias no in&#237;cio de puberdade mostraram uma tend&#234;ncia de puberdade precoce em meninas em todo o mundo&#46; De acordo com uma pesquisa feita com 17&#46;077 meninas americanas em 1997 pela rede <span class="elsevierStyleItalic">Pediatric Research in Office Settings</span>&#44; a m&#233;dia da idade de in&#237;cio da telarca foi 9&#44;96 anos&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">16</span></a> Com uma tend&#234;ncia de in&#237;cio puberal precoce&#44; foi observado um n&#250;mero crescente de meninas encaminhadas para a cl&#237;nica de endocrinologia pedi&#225;trica para avalia&#231;&#227;o dos sinais puberais precoces&#46; Em alguns casos&#44; o diagn&#243;stico de puberdade precoce pode ser desafiador devido &#224; inconsist&#234;ncia entre as caracter&#237;sticas cl&#237;nicas e os resultados do teste de estimula&#231;&#227;o do LHRH&#46;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">17&#44;18</span></a> Apesar de o teste de estimula&#231;&#227;o do LHRH ser o padr&#227;o&#8208;ouro no diagn&#243;stico de PPC&#44; o teste em si &#233; demorado e exige amostragem frequente&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">19</span></a> Neste estudo&#44; 382 meninas investigadas apresentaram v&#225;rios sinais puberais precoces&#44; como desenvolvimento prematuro das mamas&#44; matura&#231;&#227;o &#243;ssea avan&#231;ada e crescimento linear acelerado&#46; No teste de estimula&#231;&#227;o do LHRH inicial&#44; 237 indiv&#237;duos apresentaram diagn&#243;sticos positivos de PPC&#46; Os indiv&#237;duos com resultados positivos no teste inicial apresentaram menor IMC&#44; maior IO&#8208;IC&#44; velocidade de crescimento mais r&#225;pida&#44; maiores n&#237;veis sangu&#237;neos basais de LH&#44; FSH e E2 e maiores n&#237;veis sangu&#237;neos de IGF&#8208;1&#44; em compara&#231;&#227;o com os indiv&#237;duos com resultados negativos no teste inicial&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">De acordo com Della Manna et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">20</span></a> foram observados crescimento linear acelerado&#44; aumento no tamanho do &#250;tero e ov&#225;rio&#44; idade &#243;ssea avan&#231;ada e alta concentra&#231;&#227;o espont&#226;nea de LH nos indiv&#237;duos com PP&#46; Tamb&#233;m foram encontradas diferen&#231;as nos achados cl&#237;nicos e no par&#226;metro bioqu&#237;mico entre os dois grupos&#44; por&#233;m nenhuma investiga&#231;&#227;o adicional foi conduzida a respeito dessas correla&#231;&#245;es&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">15</span></a> Tamb&#233;m foram encontrados aumento significativo do crescimento em anos&#44; matura&#231;&#227;o precoce do esqueleto&#44; LH sangu&#237;neo basal&#44; n&#237;vel m&#225;ximo de LH e FSH no teste de simula&#231;&#227;o do LHRH nas meninas diagnosticadas com PP&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">21</span></a> Neste estudo&#44; descobrimos que a idade &#243;ssea foi o indicador mais sens&#237;vel do teste de estimula&#231;&#227;o do LHRH entre indiv&#237;duos com sinais puberais precoces&#46; As pesquisas demonstraram uma correla&#231;&#227;o positiva entre a matura&#231;&#227;o puberal precoce e aumento no IMC&#46;<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">22&#44;23</span></a> Neste estudo&#44; foi observada uma diferen&#231;a significativa do IMC entre os indiv&#237;duos nos diferentes resultados dos testes iniciais e todos os valores estavam dentro da faixa et&#225;ria geral das crian&#231;as&#46; &#201; importante mencionar que alguns sinais de desenvolvimento das mamas observados em indiv&#237;duos com resultados de teste negativos no teste inicial foram apenas tecidos adiposos e telarca n&#227;o verdadeira&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Foi feita uma pesquisa sobre a diferencia&#231;&#227;o de diagn&#243;stico entre PP e TP&#46; As pesquisas sugeriram que a concentra&#231;&#227;o sangu&#237;nea basal de LH pode revelar a atividade do eixo HPG na maior parte dos pacientes com PPC&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">24</span></a> Um n&#237;vel maior de IGF&#8208;1 no sangue em indiv&#237;duos com PPC tamb&#233;m foi encontrado quando comparado com o dos indiv&#237;duos com TP&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">25</span></a> O n&#237;vel m&#225;ximo de LH durante o teste de estimula&#231;&#227;o do LHRH mostrou&#8208;se um indicador significativo de PPC nos indiv&#237;duos com desenvolvimento prematuro das mamas&#46; O desenvolvimento prematuro das mamas acontece no est&#225;gio inicial tanto nos casos de TP quanto PP&#59; assim&#44; devida aten&#231;&#227;o deve ser dada aos casos com telarca anormal&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">26</span></a> Um estudo recente demonstrou que o crescimento linear acelerado &#233; um poderoso indicador para resultados positivos de testes do LHRH em meninas com sinais puberais precoces&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">17</span></a> Nesse estudo&#44; 29&#37; dos indiv&#237;duos com resultados negativos do teste inicial apresentaram diagn&#243;stico de PPC durante o teste de acompanhamento&#46; Foi observado um crescimento significativamente maior e mais r&#225;pido da IO&#8208;IC em indiv&#237;duos com resultados positivos para o teste inicial&#44; em compara&#231;&#227;o com os indiv&#237;duos com resultados negativos para o teste de acompanhamento&#46; Nenhuma diferen&#231;a significativa foi encontrada entre os grupos em termos de IMC&#44; n&#237;veis de LH sangu&#237;neo basal&#44; FSH sangu&#237;neo basal&#44; E2 sangu&#237;neo basal e concentra&#231;&#227;o sangu&#237;nea de IGF&#8208;1&#46; O diagn&#243;stico de diferencia&#231;&#227;o de PPC de casos com resultado negativo inicial &#40;TP&#44; por exemplo&#41;&#44; por meio da simples avalia&#231;&#227;o de caracter&#237;sticas cl&#237;nicas e laboratoriais&#44; &#233; dif&#237;cil&#46; Os achados nesta pesquisa sugerem que &#233; necess&#225;ria uma avalia&#231;&#227;o detalhada sobre a idade &#243;ssea para determinar se os pacientes precisam de teste de estimula&#231;&#227;o do LHRH de acompanhamento e tratamento com o agonista LHRH&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">&#201; necess&#225;ria uma pesquisa adicional para abordar as limita&#231;&#245;es deste estudo&#46; Primeiro&#44; um n&#250;mero limitado de casos levou a um tamanho da amostra relativamente pequeno&#59; segundo&#44; este ensaio incluiu apenas participantes chineses&#46; Assim&#44; nossos achados podem n&#227;o ser aplic&#225;veis &#224; popula&#231;&#227;o geral&#59; terceiro&#44; este estudo &#233; um ensaio em um &#250;nico centro&#46; S&#227;o necess&#225;rios um estudo de coorte multic&#234;ntrico com um tamanho da amostra maior e mais etnias&#46; Vale lembrar tamb&#233;m que&#44; apesar de a idade &#243;ssea avan&#231;ada ser um par&#226;metro &#250;til no diagn&#243;stico de PPC ou PP&#44; os m&#233;dicos nunca devem enfatizar demais qualquer par&#226;metro exclusivo na pr&#225;tica cl&#237;nica&#46; Uma boa tomada de decis&#245;es na pr&#225;tica cl&#237;nica deve ser flex&#237;vel e incluir todos os par&#226;metros &#250;teis&#46; Os estudos futuros devem incluir mais par&#226;metros para obter um diagn&#243;stico mais preciso&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Os pacientes com puberdade precoce central com resultados positivos do teste de estimula&#231;&#227;o do LHRH apresentaram idade &#243;ssea mais avan&#231;ada&#44; crescimento linear mais r&#225;pido e altas concentra&#231;&#245;es sangu&#237;neas de gonadotrofina&#46; Idade &#243;ssea avan&#231;ada&#44; em especial&#44; &#233; o indicador mais significativo para o teste de estimula&#231;&#227;o do LHRH&#44; ao diagnosticar casos com suspeita de PPC&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflitos de interesse</span><p id="par0105" class="elsevierStylePara elsevierViewall">Os autores declaram n&#227;o haver conflitos de interesse&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:11 [
        0 => array:3 [
          "identificador" => "xres1404747"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Objective"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Methods"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1285613"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres1404746"
          "titulo" => "Resumo"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Objetivo"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "M&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Conclus&#245;es"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec1285612"
          "titulo" => "Palavras&#8208;chave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introdu&#231;&#227;o"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "M&#233;todos"
          "secciones" => array:1 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Indiv&#237;duos"
            ]
          ]
        ]
        6 => array:3 [
          "identificador" => "sec0020"
          "titulo" => "M&#233;todos"
          "secciones" => array:1 [
            0 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "An&#225;lise estat&#237;stica"
            ]
          ]
        ]
        7 => array:3 [
          "identificador" => "sec0030"
          "titulo" => "Resultados"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Caracter&#237;sticas cl&#237;nicas e auxol&#243;gicas dos indiv&#237;duos"
            ]
            1 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "An&#225;lise das caracter&#237;sticas cl&#237;nicas e laboratoriais"
            ]
            2 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Testes de estimula&#231;&#227;o do LHRH de acompanhamento"
            ]
            3 => array:2 [
              "identificador" => "sec0050"
              "titulo" => "An&#225;lise de regress&#227;o log&#237;stica bin&#225;ria"
            ]
          ]
        ]
        8 => array:2 [
          "identificador" => "sec0055"
          "titulo" => "Discuss&#227;o"
        ]
        9 => array:2 [
          "identificador" => "sec0060"
          "titulo" => "Conflitos de interesse"
        ]
        10 => array:1 [
          "titulo" => "Refer&#234;ncias"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2016-12-09"
    "fechaAceptado" => "2017-02-15"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1285613"
          "palabras" => array:4 [
            0 => "Central precocious puberty"
            1 => "Bone age"
            2 => "Luteinizing hormone&#8208;releasing hormone stimulation test"
            3 => "Growth velocity"
          ]
        ]
      ]
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palavras&#8208;chave"
          "identificador" => "xpalclavsec1285612"
          "palabras" => array:4 [
            0 => "Puberdade precoce central"
            1 => "Idade &#243;ssea"
            2 => "Teste de estimula&#231;&#227;o do horm&#244;nio liberador do horm&#244;nio luteinizante"
            3 => "Velocidade de crescimento"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Diagnosis of central precocious puberty has always been challenging in clinicalpractice&#46; As an important method in the diagnosis of central precocious puberty&#44; luteinizinghormone&#8208;releasing hormone stimulation test is complex and time&#8208;consuming&#46; In many cases&#44; clinical traits are inconsistent with luteinizing hormone&#8208;releasing hormone stimulation testresults&#44; therefore not reliable for diagnosis&#46; In this study&#44; the authors intended to find an indi&#8208;cator that predicts the results of the luteinizing hormone&#8208;releasing hormone stimulation testamong subjects with early pubertal signs&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Cases of 382 girls with early breast development before 8 years old and luteinizinghormone-releasing hormone stimulation test before 9 years old were included and underwentfollow-up tests&#46; Patients with peak luteinizing hormone level &#8805;5 IU&#47;L were considered positivein the luteinizing hormone-releasing hormone stimulation test&#46; Anthropometric data&#44; body massindex&#44; bone age evaluation&#44; blood hormones levels of luteinizing hormone&#44; estradiol&#44; follicle-stimulating hormone&#44; and uterine and ovarian volumes were analyzed&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">Subjects with positive results in the initial test demonstrated early bone maturation&#44; accelerated growth&#44; and elevated basal blood luteinizing hormone&#44; estradiol&#44; and follicle-stimulating hormone levels&#44; when compared with subjects with negative results in the initialtest&#46; Subjects with positive results in the follow-up test presented a more advanced bone ageand more accelerated linear growth&#44; when compared with subjects with negative results in thefollow-up test&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">According to the statistical analysis&#44; advanced bone age is the most effectivepredictor of the result of luteinizing hormone-releasing hormone stimulation test&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objective"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "pt" => array:3 [
        "titulo" => "Resumo"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">O diagn&#243;stico da puberdade precoce central sempre foi complicado na pr&#225;tica cl&#237;nica&#46; Como um importante m&#233;todo no diagn&#243;stico de puberdade precoce central&#44; o teste de estimula&#231;&#227;o do horm&#244;nio liberador do horm&#244;nio luteinizante &#233; complexo e demorado&#46; Em muitos casos&#44; as caracter&#237;sticas cl&#237;nicas s&#227;o incompat&#237;veis com os resultados do teste de estimula&#231;&#227;o do horm&#244;nio liberador do horm&#244;nio luteinizante e&#44; assim&#44; n&#227;o s&#227;o confi&#225;veis para o diagn&#243;stico&#46; Neste estudo&#44; visamos constatar um indicador que previsse os resultados do teste de estimula&#231;&#227;o do horm&#244;nio liberador do horm&#244;nio luteinizante entre indiv&#237;duos com sinais puberais precoces&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0120" class="elsevierStyleSimplePara elsevierViewall">Foram inclu&#237;dos casos de 382 meninas com desenvolvimento precoce das mamas antes dos 8 anos de idade e teste de estimula&#231;&#227;o do horm&#244;nio liberador do horm&#244;nio luteinizanteantes dos 9 anos e elas foram submetidas a testes de acompanhamento&#46; Os resultados das pacientes com n&#237;vel m&#225;ximo de horm&#244;nio luteinizante &#8805; 5 IU&#47;L foram consideradas positivos no teste de estimula&#231;&#227;o do horm&#244;nio liberador do horm&#244;nio luteinizante&#46; Foi feita uma an&#225;lise dos dados antropom&#233;tricos&#44; do &#237;ndice de massa corporal&#44; da avalia&#231;&#227;o da idade &#243;ssea&#44; dos n&#237;veis sangu&#237;neos de horm&#244;nio luteinizante&#44; volumes uterinos e ovarianos de estradiol &#40;E2&#41; e do horm&#244;nio fol&#237;culo-estimulante&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0125" class="elsevierStyleSimplePara elsevierViewall">Os indiv&#237;duos com resultado positive no teste inicial demonstraram matura&#231;&#227;o precoce do osso&#44; crescimento acelerado e n&#237;veis sangu&#237;neos elevados de horm&#244;nio luteinizante&#44; estradiol e horm&#244;nio fol&#237;culo-estimulante&#44; em compara&#231;&#227;o aos indiv&#237;duos com resultados negativos no teste inicial&#46; Os indiv&#237;duos com resultados positivos no teste de acompanhamento apresentaram um maior avan&#231;o na idade &#243;ssea e crescimento linear mais acelerado&#44; em compara&#231;&#227;o aos indiv&#237;duos com resultados negativos no teste de acompanhamento&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#245;es</span><p id="spar0130" class="elsevierStyleSimplePara elsevierViewall">De acordo com a an&#225;lise estat&#237;stica&#44; a idade &#243;ssea avan&#231;ada &#233; o indicador mais efetivo do resultado do teste de estimula&#231;&#227;o do horm&#244;nio liberador do horm&#244;nio luteinizante&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Objetivo"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "M&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclus&#245;es"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Como citar este artigo&#58; Xu Y&#8208;Q&#44; Li G&#8208;M&#44; Li Y&#46; Advanced bone age as an indicator facilitates the diagnosis of precocious puberty&#46; J Pediatr &#40;Rio J&#41;&#46; 2018&#59;94&#58;69&#8211;75&#46;</p>"
      ]
    ]
    "multimedia" => array:4 [
      0 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Tabela 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Tabela "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">EDP&#44; escore de desvio padr&#227;o&#59; IMC&#44; &#237;ndice de massa corporal&#59; IO&#8208;IC&#44; a diferen&#231;a entre a idade &#243;ssea e a idade cronol&#243;gica&#46;</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Dados apresentados como m&#233;dia &#177; DP&#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="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Caracter&#237;sticas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Indiv&#237;duos &#40;n &#61; 382&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Idade &#243;ssea &#40;anos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;3 &#177; 0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Idade cronol&#243;gica &#40;anos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;8 &#177; 0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;IO&#8208;IC&#41; &#40;meses&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#44;5 &#177; 5&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">EDP da altura&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;6 &#177; 0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">EDP do peso corporal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;4 &#177; 0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IMC &#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#44;7 &#177; 2&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Velocidade de crescimento &#40;cm&#47;6 meses&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;7 &#177; 0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#237;vel m&#225;ximo de LH &#40;IU&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;7 &#177; 2&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2408837.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas b&#225;sicas dos indiv&#237;duos</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Tabela 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Tabela "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">AFP&#44; alfa&#8208;fetoprote&#237;na&#59; CN&#44; controle negativo&#59; E2&#44; estradiol&#59; EDP&#44; escore de desvio padr&#227;o&#59; FSH&#44; horm&#244;nio fol&#237;culo&#8208;estimulante&#59; HCG&#44; gonadotrofina cori&#244;nica humana&#59; IGF&#8208;1&#44; fator de crescimento semelhante &#224; insulina tipo 1&#59; IMC&#44; &#237;ndice de massa corporal&#59; IO&#8208;IC&#44; diferen&#231;a entre a idade &#243;ssea e a idade cronol&#243;gica&#59; LH&#44; horm&#244;nio luteinizante&#59; PPC&#44; puberdade precoce central&#46;</p><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Dados apresentados como m&#233;dia &#177; DP&#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="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Caracter&#237;sticas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Grupo CN inicial &#40;n &#61; 145&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Grupo de PPC inicial &#40;n &#61; 237&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Valor de p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Idade &#243;ssea &#40;anos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;1 &#177; 0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#44;4 &#177; 0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Idade cronol&#243;gica &#40;anos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;7 &#177; 0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;9 &#177; 0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IO&#8208;IC &#40;meses&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#44;1 &#177; 6&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#44;7 &#177; 7&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">EDP da altura&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;6 &#177; 0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;7 &#177; 0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">EDP do peso corporal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;5 &#177; 0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;3 &#177; 0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IMC &#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#44;2 &#177; 3&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#44;1 &#177; 3&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Velocidade de crescimento &#40;cm&#47;6 meses&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;3 &#177; 0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;2 &#177; 0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Propor&#231;&#227;o de velocidade de crescimento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;1 &#177; 0&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;4 &#177; 0&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LH &#40;IL&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;8 &#177; 0&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;3 &#177; 0&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">FSH &#40;IU&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;7 &#177; 0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;5 &#177; 0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">E2 &#40;pg&#47;mL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;6 &#177; 3&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;2 &#177; 4&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IGF&#8208;1 &#40;ng&#47;mL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">237&#44;1 &#177; 52&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">327&#44;4 &#177; 62&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HCG &#40;mIU&#47;mL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#62; 0&#44;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AFP &#40;ng&#47;mL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#237;vel m&#225;ximo de LH &#40;IL&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;8 &#177; 0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;5 &#177; 2&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2408836.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas cl&#237;nicas e bioqu&#237;micas dos participantes no teste de estimula&#231;&#227;o do LHRH inicial &#40;n &#61; 382&#41;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Tabela 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Tabela "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">AFP&#44; alfa&#8208;fetoprote&#237;na&#59; CN&#44; controle negativo&#59; E2&#44; estradiol&#59; EDP&#44; escore de desvio padr&#227;o&#59; FSH&#44; horm&#244;nio fol&#237;culo&#8208;estimulante&#59; HCG&#44; gonadotrofina cori&#244;nica humana&#59; IGF&#8208;1&#44; fator de crescimento semelhante &#224; insulina tipo 1&#59; IMC&#44; &#237;ndice de massa corporal&#59; IO&#8208;IC&#44; diferen&#231;a entre a idade &#243;ssea e a idade cronol&#243;gica&#59; LH&#44; horm&#244;nio luteinizante&#59; PPC&#44; puberdade precoce central&#46;</p><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Dados apresentados como m&#233;dia &#177; DP&#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="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Caracter&#237;sticas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Grupo CN de acompanhamento &#40;n &#61; 103&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Grupo PPC de acompanhamento &#40;n &#61;<span class="elsevierStyleHsp" style=""></span>42&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Valor de p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Idade &#243;ssea &#40;anos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;1 &#177; 0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;5 &#177; 0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Idade cronol&#243;gica &#40;anos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#44;0 &#177; 0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;5 &#177; 0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IO&#8208;IC &#40;meses&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#44;5 &#177; 6&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#44;8 &#177; 6&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">EDP da altura&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;6 &#177; 0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;6 &#177; 0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#62; 0&#44;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">EDP do peso corporal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;5 &#177; 0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;6 &#177; 0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IMC &#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#44;3 &#177; 3&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#44;1 &#177; 3&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Velocidade de crescimento &#40;cm&#47;6 meses&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;1 &#177; 0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;5 &#177; 0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Propor&#231;&#227;o de velocidade de crescimento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;0 &#177; 0&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;2 &#177; 0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LH &#40;IL&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;8 &#177; 0&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;9 &#177; 0&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">FSH &#40;IU&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;7 &#177; 0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;0 &#177; 0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">E2 &#40;pg&#47;mL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;7 &#177; 5&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#44;4 &#177; 5&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IGF&#8208;1 &#40;ng&#47;mL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">232&#44;7 &#177; 49&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">248&#44;5 &#177; 58&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HCG &#40;mIU&#47;mL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#62; 0&#44;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AFP &#40;ng&#47;mL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#237;vel m&#225;ximo de LH &#40;IL&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;4 &#177; 0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;2 &#177; 2&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2408838.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas cl&#237;nicas e bioqu&#237;micas dos participantes no teste de estimula&#231;&#227;o do LHRH de acompanhamento &#40;n &#61; 145&#41;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0020"
        "etiqueta" => "Tabela 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at4"
            "detalle" => "Tabela "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">E2&#44; estradiol&#59; EDP&#44; escore de desvio padr&#227;o&#59; FSH&#44; horm&#244;nio fol&#237;culo&#8208;estimulante&#59; IGF&#8208;1&#44; fator de crescimento semelhante &#224; insulina tipo 1&#59; IO&#8208;IC&#44; diferen&#231;a entre a idade &#243;ssea e a idade cronol&#243;gica&#59; LH&#44; horm&#244;nio luteinizante&#46;</p><p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Os fatores do grupo de resultados positivos iniciais &#40;n &#61; 237&#41; foram comparados com os do grupo de resultados negativos iniciais &#40;n &#61; 145&#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="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Fatores&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Raz&#227;o de chance&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Intervalo de confian&#231;a de 95&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Valor de p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IO&#8208;IC &#40;meses&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;08&#8208;8&#44;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">EDP do peso corporal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;92&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;56&#8208;1&#44;77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IMC &#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;94&#8208;1&#44;86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Propor&#231;&#227;o de velocidade de crescimento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;17&#8208;5&#44;34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LH &#40;IL&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;03&#8208;2&#44;47&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">FSH &#40;IU&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;52&#8208;3&#44;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">E2 &#40;pg&#47;mL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;96&#8208;1&#44;56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IGF&#8208;1 &#40;ng&#47;mL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;05&#8208;1&#44;62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2408835.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">An&#225;lise de regress&#227;o log&#237;stica dos fatores associados aos resultados do teste de estimula&#231;&#227;o do LHRH inicial</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Refer&#234;ncias"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:26 [
            0 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation and management of precocious puberty"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46;P&#46; Merke"
                            1 => "G&#46;B&#46; Cutler Jr&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/adc.75.4.269"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dis Child"
                        "fecha" => "1996"
                        "volumen" => "75"
                        "paginaInicial" => "269"
                        "paginaFinal" => "271"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8984908"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Etiology and age incidence of precocious puberty in girls&#58; a multicentric study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Cisternino"
                            1 => "T&#46; Arrigo"
                            2 => "A&#46;M&#46; Pasquino"
                            3 => "C&#46; Tinelli"
                            4 => "F&#46; Antoniazzi"
                            5 => "L&#46; Beduschi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1515/jpem.2000.13.s1.695"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr Endocrinol Metab"
                        "fecha" => "2000"
                        "volumen" => "13"
                        "paginaInicial" => "695"
                        "paginaFinal" => "701"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10969911"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Precocious puberty in adolescent girls&#58; a biomarker of later psychosocial adjustment problems"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "L&#46; Tremblay"
                            1 => "J&#46;Y&#46; Frigon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s10578-004-3489-2"
                      "Revista" => array:6 [
                        "tituloSerie" => "Child Psychiatry Hum Dev"
                        "fecha" => "2005"
                        "volumen" => "36"
                        "paginaInicial" => "73"
                        "paginaFinal" => "94"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16049645"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sonography of abdominal organs in precocious puberty in girls"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46; Mazgaj"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.15557/JoU.2013.0044"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Ultrason"
                        "fecha" => "2013"
                        "volumen" => "13"
                        "paginaInicial" => "418"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26673282"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Final height of girls with central precocious puberty&#44; untreated versus treated with cyproterone acetate or GnRH analogue&#46; A comparative study with re&#8208;evaluation of predictions by the Bayley&#8208;Pinneau method"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "R&#46; Kauli"
                            1 => "A&#46; Galatzer"
                            2 => "L&#46; Kornreich"
                            3 => "L&#46; Lazar"
                            4 => "A&#46; Pertzelan"
                            5 => "Z&#46; Laron"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000185432"
                      "Revista" => array:6 [
                        "tituloSerie" => "Horm Res"
                        "fecha" => "1997"
                        "volumen" => "47"
                        "paginaInicial" => "54"
                        "paginaFinal" => "61"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9030968"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Adult height in girls with idiopathic true precocious puberty"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46; Brauner"
                            1 => "L&#46; Adan"
                            2 => "F&#46; Malandry"
                            3 => "D&#46; Zantleifer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1210/jcem.79.2.8045957"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "1994"
                        "volumen" => "79"
                        "paginaInicial" => "415"
                        "paginaFinal" => "420"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8045957"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical review 60&#58; effects of gonadotropin&#8208;releasing hormone analog therapy on adult stature in precocious puberty"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46;B&#46; Kletter"
                            1 => "R&#46;P&#46; Kelch"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1210/jcem.79.2.8045943"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "1994"
                        "volumen" => "79"
                        "paginaInicial" => "331"
                        "paginaFinal" => "334"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8045943"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A pediatrician&#39;s guide to central precocious puberty"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "G&#46;B&#46; Kletter"
                            1 => "K&#46;O&#46; Klein"
                            2 => "Y&#46;Y&#46; Wong"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Clin Pediatr &#40;Phila&#41;"
                        "fecha" => "2015"
                        "volumen" => "54"
                        "paginaInicial" => "414"
                        "paginaFinal" => "424"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gonadotropin&#8208;releasing hormone stimulation test for precocious puberty"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "H&#46;K&#46; Kim"
                            1 => "S&#46;J&#46; Kee"
                            2 => "J&#46;Y&#46; Seo"
                            3 => "E&#46;M&#46; Yang"
                            4 => "H&#46;J&#46; Chae"
                            5 => "C&#46;J&#46; Kim"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3343/kjlm.2011.31.4.244"
                      "Revista" => array:6 [
                        "tituloSerie" => "Korean J Lab Med"
                        "fecha" => "2011"
                        "volumen" => "31"
                        "paginaInicial" => "244"
                        "paginaFinal" => "249"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22016677"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of central precocious puberty"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46;J&#46; Partsch"
                            1 => "W&#46;G&#46; Sippell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1053/beem.2002.0188"
                      "Revista" => array:6 [
                        "tituloSerie" => "Best Pract Res Clin Endocrinol Metab"
                        "fecha" => "2002"
                        "volumen" => "16"
                        "paginaInicial" => "165"
                        "paginaFinal" => "189"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11987906"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Basal luteinizing hormone and follicular stimulating hormone&#58; is it sufficient for the diagnosis of precocious puberty in girls&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "D&#46;S&#46; Lee"
                            1 => "N&#46;Y&#46; Ryoo"
                            2 => "S&#46;H&#46; Lee"
                            3 => "S&#46; Kim"
                            4 => "J&#46;H&#46; Kim"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.6065/apem.2013.18.4.196"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Pediatr Endocrinol Metab"
                        "fecha" => "2013"
                        "volumen" => "18"
                        "paginaInicial" => "196"
                        "paginaFinal" => "201"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24904877"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Progression of premature thelarche to central precocious puberty"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46;M&#46; Pasquino"
                            1 => "I&#46; Pucarelli"
                            2 => "F&#46; Passeri"
                            3 => "M&#46; Segni"
                            4 => "M&#46;A&#46; Mancini"
                            5 => "G&#46; Municchi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/s0022-3476(95)70492-2"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr"
                        "fecha" => "1995"
                        "volumen" => "126"
                        "paginaInicial" => "11"
                        "paginaFinal" => "14"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7815198"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Utility of basal luteinizing hormone levels for detecting central precocious puberty in girls"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "H&#46;S&#46; Lee"
                            1 => "H&#46;K&#46; Park"
                            2 => "J&#46;H&#46; Ko"
                            3 => "Y&#46;J&#46; Kim"
                            4 => "J&#46;S&#46; Hwang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1055/s-0032-1321905"
                      "Revista" => array:6 [
                        "tituloSerie" => "Horm Metab Res"
                        "fecha" => "2012"
                        "volumen" => "44"
                        "paginaInicial" => "851"
                        "paginaFinal" => "854"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22893259"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The response to gonadotropin releasing hormone &#40;GnRH&#41; stimulation test does not predict the progression to true precocious puberty in girls with onset of premature thelarche in the first three years of life"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Bizzarri"
                            1 => "G&#46;L&#46; Spadoni"
                            2 => "G&#46; Bottaro"
                            3 => "G&#46; Montanari"
                            4 => "G&#46; Giannone"
                            5 => "M&#46; Cappa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1210/jc.2013-3292"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "2013"
                        "volumen" => "99"
                        "paginaInicial" => "433"
                        "paginaFinal" => "439"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24297793"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Factors that predict a positive response on gonadotropin&#8208;releasing hormone stimulation test for diagnosing central precocious puberty in girls"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Suh"
                            1 => "M&#46;H&#46; Choi"
                            2 => "A&#46;R&#46; Kwon"
                            3 => "Y&#46;J&#46; Kim"
                            4 => "J&#46;W&#46; Jeong"
                            5 => "J&#46;M&#46; Ahn"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.6065/apem.2013.18.4.202"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Pediatr Endocrinol Metab"
                        "fecha" => "2013"
                        "volumen" => "18"
                        "paginaInicial" => "202"
                        "paginaFinal" => "207"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24904878"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Secondary sexual characteristics and menses in young girls seen in office practice&#58; a study from the Pediatric Research in Office Settings Network"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;E&#46; Herman-Giddens"
                            1 => "E&#46;J&#46; Slora"
                            2 => "R&#46;C&#46; Wasserman"
                            3 => "C&#46;J&#46; Bourdony"
                            4 => "M&#46;V&#46; Bhapkar"
                            5 => "G&#46;G&#46; Koch"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1542/peds.99.4.505"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatrics"
                        "fecha" => "1997"
                        "volumen" => "99"
                        "paginaInicial" => "505"
                        "paginaFinal" => "512"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9093289"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Factors to predict positive results of gonadotropin releasing hormone stimulation test in girls with suspected precocious puberty"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "H&#46;K&#46; Nam"
                            1 => "Y&#46;J&#46; Rhie"
                            2 => "C&#46;S&#46; Son"
                            3 => "S&#46;H&#46; Park"
                            4 => "K&#46;H&#46; Lee"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3346/jkms.2012.27.2.194"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Korean Med Sci"
                        "fecha" => "2012"
                        "volumen" => "27"
                        "paginaInicial" => "194"
                        "paginaFinal" => "199"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22323868"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Spontaneous serum gonadotropin concentrations in the evaluation of precocious puberty"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "E&#46;K&#46; Neely"
                            1 => "D&#46;M&#46; Wilson"
                            2 => "P&#46;A&#46; Lee"
                            3 => "M&#46; Stene"
                            4 => "R&#46;L&#46; Hintz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/s0022-3476(95)70255-5"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr"
                        "fecha" => "1995"
                        "volumen" => "127"
                        "paginaInicial" => "47"
                        "paginaFinal" => "52"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7608810"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The significance and characteristics of the LHRH test in diagnosing precocious puberty development in girls&#58; the stimulated LH&#47;FSH quotient differentiates between central precocious puberty and premature thelarche"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46;J&#46; Partsch"
                            1 => "R&#46; Hummelink"
                            2 => "F&#46; Lorenzen"
                            3 => "W&#46;G&#46; Sippell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Monatsschr Kinderheilkd"
                        "fecha" => "1989"
                        "volumen" => "137"
                        "paginaInicial" => "284"
                        "paginaFinal" => "288"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2525665"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Premature thelarche&#58; identification of clinical and laboratory data for the diagnosis of precocious puberty"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "T&#46; Della Manna"
                            1 => "N&#46; Setian"
                            2 => "D&#46; Damiani"
                            3 => "H&#46; Kuperman"
                            4 => "V&#46; Dichtchekenian"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1590/s0041-87812002000200001"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Hosp Clin Fac Med S&#227;o Paulo"
                        "fecha" => "2002"
                        "volumen" => "57"
                        "paginaInicial" => "49"
                        "paginaFinal" => "54"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11981584"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The utility of basal serum LH in prediction of central precocious puberty in girls"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "Y&#46; Pasternak"
                            1 => "M&#46; Friger"
                            2 => "N&#46; Loewenthal"
                            3 => "A&#46; Haim"
                            4 => "E&#46; Hershkovitz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1530/EJE-11-0720"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Endocrinol"
                        "fecha" => "2012"
                        "volumen" => "166"
                        "paginaInicial" => "295"
                        "paginaFinal" => "299"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22084156"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pubertal maturation in girls and the relationship to anthropometric changes&#58; pathways through puberty"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46;M&#46; Biro"
                            1 => "A&#46;W&#46; Lucky"
                            2 => "L&#46;A&#46; Simbartl"
                            3 => "B&#46;A&#46; Barton"
                            4 => "S&#46;R&#46; Daniels"
                            5 => "R&#46; Striegel-Moore"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1067/mpd.2003.244"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr"
                        "fecha" => "2003"
                        "volumen" => "142"
                        "paginaInicial" => "643"
                        "paginaFinal" => "646"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12838192"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Girls with premature adrenarche have accelerated early childhood growth"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46; Utriainen"
                            1 => "R&#46; Voutilainen"
                            2 => "J&#46; Jaaskelainen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jpeds.2008.12.038"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr"
                        "fecha" => "2009"
                        "volumen" => "154"
                        "paginaInicial" => "882"
                        "paginaFinal" => "887"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19230905"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Basal luteinizing hormone&#47;follicle stimulating hormone ratio in diagnosis of central precocious puberty"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "V&#46; Supornsilchai"
                            1 => "P&#46; Hiranrat"
                            2 => "S&#46; Wacharasindhu"
                            3 => "S&#46; Srivuthana"
                            4 => "S&#46; Aroonparkmongkol"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Med Assoc Thai"
                        "fecha" => "2003"
                        "volumen" => "86"
                        "paginaInicial" => "S145"
                        "paginaFinal" => "S151"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12929982"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Serum insulin&#8208;like growth factor &#40;IGF&#41;&#8208;I and IGF&#8208;binding protein&#8208;3 in girls with premature thelarche"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46;S&#46; Sales"
                            1 => "A&#46;C&#46; Moreira"
                            2 => "C&#46; Camacho-Hubner"
                            3 => "R&#46;G&#46; Ricco"
                            4 => "J&#46;C&#46; Daneluzzi"
                            5 => "A&#46;D&#46; Campos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1515/jpem.2003.16.6.827"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr Endocrinol Metab"
                        "fecha" => "2003"
                        "volumen" => "16"
                        "paginaInicial" => "827"
                        "paginaFinal" => "833"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12948294"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Premature thelarche&#58; clinical and laboratorial assessment by immunochemiluminescent assay"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;F&#46; Borges"
                            1 => "K&#46;D&#46; Pacheco"
                            2 => "A&#46;A&#46; Oliveira"
                            3 => "C&#46;V&#46; Rita"
                            4 => "K&#46;D&#46; Pacheco"
                            5 => "E&#46;A&#46; Resende"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1590/s0004-27302008000100013"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arq Bras Endocrinol Metabol"
                        "fecha" => "2008"
                        "volumen" => "52"
                        "paginaInicial" => "93"
                        "paginaFinal" => "100"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18345401"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "pt"
  "url" => "/22555536/0000009400000001/v2_202010270619/S2255553617301088/v2_202010270619/pt/main.assets"
  "Apartado" => array:4 [
    "identificador" => "24841"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Artigo original"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/22555536/0000009400000001/v2_202010270619/S2255553617301088/v2_202010270619/pt/main.pdf?idApp=UINPBA000049&text.app=https://jped.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2255553617301088?idApp=UINPBA000049"
]
Compartilhar
Informação da revista

Estatísticas

Siga este link para acessar o texto completo do artigo

Artigo Original
Advanced bone age as an indicator facilitates the diagnosis of precocious puberty
Idade óssea avançada como um indicador de facilitação do diagnóstico de puberdade precoce
Yue‐Qin Xua,b, Gui‐Mei Lia,
Autor para correspondência
liguimei0531@126.com

Autor para correspondência.
, Yan Lib
a Shandong Provincial Hospital Affiliated to Shandong University, Department of Pediatrics, 9677 Jinshi Road, Jinan 250014, China
b Shandong Qianfoshan Hospital Affiliated to Shandong University, Department of Children Healthcare, 16766 Jinshi Road, Jinan 250014, China
Lido
2825
Vezes
que se leu este artigo
1325
Total PDF
1500
Total HTML
Compartilhar estatísticas
 array:25 [
  "pii" => "S2255553617301088"
  "issn" => "22555536"
  "doi" => "10.1016/j.jpedp.2017.08.020"
  "estado" => "S300"
  "fechaPublicacion" => "2018-01-01"
  "aid" => "533"
  "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 &#40;Rio J&#41;. 2018;94:69-75"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 721
    "formatos" => array:3 [
      "EPUB" => 81
      "HTML" => 425
      "PDF" => 215
    ]
  ]
  "Traduccion" => array:1 [
    "en" => array:20 [
      "pii" => "S0021755716303758"
      "issn" => "00217557"
      "doi" => "10.1016/j.jped.2017.03.010"
      "estado" => "S300"
      "fechaPublicacion" => "2018-01-01"
      "aid" => "533"
      "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;. 2018;94:69-75"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 711
        "formatos" => array:3 [
          "EPUB" => 80
          "HTML" => 360
          "PDF" => 271
        ]
      ]
      "en" => array:12 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
        "titulo" => "Advanced bone age as an indicator facilitates the diagnosis of precocious puberty"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "tieneResumen" => array:2 [
          0 => "en"
          1 => "pt"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "69"
            "paginaFinal" => "75"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "pt" => array:1 [
            "titulo" => "Idade &#243;ssea avan&#231;ada como um indicador de facilita&#231;&#227;o do diagn&#243;stico de puberdade precoce"
          ]
        ]
        "contieneResumen" => array:2 [
          "en" => true
          "pt" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Yue-Qin Xu, Gui-Mei Li, Yan Li"
            "autores" => array:3 [
              0 => array:2 [
                "nombre" => "Yue-Qin"
                "apellidos" => "Xu"
              ]
              1 => array:2 [
                "nombre" => "Gui-Mei"
                "apellidos" => "Li"
              ]
              2 => array:2 [
                "nombre" => "Yan"
                "apellidos" => "Li"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "pt" => array:9 [
          "pii" => "S2255553617301088"
          "doi" => "10.1016/j.jpedp.2017.08.020"
          "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/S2255553617301088?idApp=UINPBA000049"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0021755716303758?idApp=UINPBA000049"
      "url" => "/00217557/0000009400000001/v2_202010230715/S0021755716303758/v2_202010230715/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S2255553617301106"
    "issn" => "22555536"
    "doi" => "10.1016/j.jpedp.2017.08.021"
    "estado" => "S300"
    "fechaPublicacion" => "2018-01-01"
    "aid" => "534"
    "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;. 2018;94:76-81"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 842
      "formatos" => array:3 [
        "EPUB" => 95
        "HTML" => 488
        "PDF" => 259
      ]
    ]
    "pt" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Artigo Original</span>"
      "titulo" => "Differences in perioperative femoral and radial arterial blood pressure in neonates and infants undergoing cardiac surgery requiring cardiopulmonary bypass"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => "pt"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "76"
          "paginaFinal" => "81"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Diferen&#231;as na press&#227;o arterial femoral e radial no perioperat&#243;rio em neonatos e beb&#234;s submetidos a cirurgia card&#237;aca com <span class="elsevierStyleItalic">bypass</span> cardiopulmonar"
        ]
      ]
      "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" => 2643
              "Ancho" => 2328
              "Tamanyo" => 221783
            ]
          ]
          "descripcion" => array:1 [
            "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Altera&#231;&#227;o da press&#227;o arterial m&#233;dia na art&#233;ria radial e femoral de acordo com o tempo&#46; A&#44; Compara&#231;&#227;o da press&#227;o arterial m&#233;dia durante o intraoperat&#243;rio &#40;a&#44; b&#44; c&#44; d&#58; p &#60; 0&#44;05&#41; B&#44; Compara&#231;&#227;o da press&#227;o arterial m&#233;dia nas primeiras 24 horas do p&#243;s&#8208;operat&#243;rio&#46; ACC&#44; pin&#231;amento cruzado da aorta&#59; CPB&#44; <span class="elsevierStyleItalic">bypass</span> cardiopulmonar&#59; UTI&#44; unidade de terapia intensiva&#59; PAM&#44; press&#227;o arterial m&#233;dia&#59; PreOp&#44; pr&#233;&#8208;operat&#243;rio&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Hwa Jin Cho, Sang Hoon Lee, In Seok Jeong, Nam Sik Yoon, Jae Sook Ma, Byoung Hee Ahn"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "Hwa Jin"
              "apellidos" => "Cho"
            ]
            1 => array:2 [
              "nombre" => "Sang Hoon"
              "apellidos" => "Lee"
            ]
            2 => array:2 [
              "nombre" => "In Seok"
              "apellidos" => "Jeong"
            ]
            3 => array:2 [
              "nombre" => "Nam Sik"
              "apellidos" => "Yoon"
            ]
            4 => array:2 [
              "nombre" => "Jae Sook"
              "apellidos" => "Ma"
            ]
            5 => array:2 [
              "nombre" => "Byoung Hee"
              "apellidos" => "Ahn"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0021755716304338"
        "doi" => "10.1016/j.jped.2017.03.011"
        "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/S0021755716304338?idApp=UINPBA000049"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2255553617301106?idApp=UINPBA000049"
    "url" => "/22555536/0000009400000001/v2_202010270619/S2255553617301106/v2_202010270619/pt/main.assets"
  ]
  "itemAnterior" => array:20 [
    "pii" => "S2255553617300915"
    "issn" => "22555536"
    "doi" => "10.1016/j.jpedp.2017.08.009"
    "estado" => "S300"
    "fechaPublicacion" => "2018-01-01"
    "aid" => "523"
    "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;. 2018;94:62-8"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2723
      "formatos" => array:3 [
        "EPUB" => 110
        "HTML" => 2125
        "PDF" => 488
      ]
    ]
    "pt" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Artigo Original</span>"
      "titulo" => "Bromopride&#44; metoclopramide&#44; or ondansetron for the treatment of vomiting in the pediatric emergency department&#58; a randomized controlled trial"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => "pt"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "62"
          "paginaFinal" => "68"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Bromoprida&#44; metoclopramida ou ondansetrona no tratamento de v&#244;mito no departamento de emerg&#234;ncia pedi&#225;trica&#58; ensaio controlado randomizado"
        ]
      ]
      "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" => 2051
              "Ancho" => 2237
              "Tamanyo" => 272919
            ]
          ]
          "descripcion" => array:1 [
            "pt" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Fluxograma de participa&#231;&#227;o&#44; tratamento e acompanhamento Consort&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Matias Epifanio, Janete de L&#46; Portela, Jefferson P&#46; Piva, Cristina H&#46; Targa Ferreira, Edgar E&#46; Sarria, Rita Mattiello"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "Matias"
              "apellidos" => "Epifanio"
            ]
            1 => array:2 [
              "nombre" => "Janete de L&#46;"
              "apellidos" => "Portela"
            ]
            2 => array:2 [
              "nombre" => "Jefferson P&#46;"
              "apellidos" => "Piva"
            ]
            3 => array:2 [
              "nombre" => "Cristina H&#46; Targa"
              "apellidos" => "Ferreira"
            ]
            4 => array:2 [
              "nombre" => "Edgar E&#46;"
              "apellidos" => "Sarria"
            ]
            5 => array:2 [
              "nombre" => "Rita"
              "apellidos" => "Mattiello"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0021755716302431"
        "doi" => "10.1016/j.jped.2017.06.004"
        "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/S0021755716302431?idApp=UINPBA000049"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2255553617300915?idApp=UINPBA000049"
    "url" => "/22555536/0000009400000001/v2_202010270619/S2255553617300915/v2_202010270619/pt/main.assets"
  ]
  "pt" => array:19 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Artigo Original</span>"
    "titulo" => "Advanced bone age as an indicator facilitates the diagnosis of precocious puberty"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "69"
        "paginaFinal" => "75"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Yue&#8208;Qin Xu, Gui&#8208;Mei Li, Yan Li"
        "autores" => array:3 [
          0 => array:3 [
            "nombre" => "Yue&#8208;Qin"
            "apellidos" => "Xu"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff1"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          1 => array:4 [
            "nombre" => "Gui&#8208;Mei"
            "apellidos" => "Li"
            "email" => array:1 [
              0 => "liguimei0531@126.com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff1"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Yan"
            "apellidos" => "Li"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Shandong Provincial Hospital Affiliated to Shandong University&#44; Department of Pediatrics&#44; 9677 Jinshi Road&#44; Jinan 250014&#44; China"
            "etiqueta" => "a"
            "identificador" => "aff1"
          ]
          1 => array:3 [
            "entidad" => "Shandong Qianfoshan Hospital Affiliated to Shandong University&#44; Department of Children Healthcare&#44; 16766 Jinshi Road&#44; Jinan 250014&#44; China"
            "etiqueta" => "b"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Autor para correspond&#234;ncia&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "Idade &#243;ssea avan&#231;ada como um indicador de facilita&#231;&#227;o do diagn&#243;stico de puberdade precoce"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introdu&#231;&#227;o</span><p id="par0005" class="elsevierStylePara elsevierViewall">A puberdade precoce &#40;PP&#41; &#233; o in&#237;cio da puberdade antes dos oito anos em meninas ou nove anos em meninos&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">1</span></a> Na maior parte dos casos&#44; a PP &#233; um resultado da ativa&#231;&#227;o prematura do eixo hipot&#225;lamo&#8208;hip&#243;fise&#8208;gonadal &#40;HPG&#41;&#44; &#233; tamb&#233;m chamada de puberdade precoce central &#40;PPC&#41;&#46; A PPC geralmente &#233; idiop&#225;tica&#44; exceto quando h&#225; causas identific&#225;veis &#40;por exemplo&#44; tumores&#44; hidrocefalia&#44; les&#245;es cerebrais ou trauma craniano&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">2</span></a> A matura&#231;&#227;o &#243;ssea precoce&#44; o crescimento linear acelerado e altera&#231;&#245;es na ultrassonografia p&#233;lvica &#40;USG&#41;&#44; inclusive altera&#231;&#245;es anormais no volume ovariano&#44; uterino e adrenal&#44; geralmente est&#227;o presentes na PP&#44;<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">3&#44;4</span></a> al&#233;m de outras caracter&#237;sticas sexuais secund&#225;rias&#44; como crescimento precoce dos pelos pubianos&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">5</span></a> A PPC pode levar ao fechamento precoce da ep&#237;fise&#44; que consequentemente resulta em redu&#231;&#227;o de estatura&#44; entre outros impactos como estresse psicol&#243;gico&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">6</span></a> As literaturas relataram que as meninas com desenvolvimento puberal precoce apresentaram mais comportamentos problem&#225;ticos&#44; em compara&#231;&#227;o com seus pares&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">7</span></a> Assim&#44; &#233; muito importante haver uma avalia&#231;&#227;o detalhada do desenvolvimento puberal nas meninas com suspeita de PP e&#44; caso seja feito um diagn&#243;stico&#44; deve&#8208;se iniciar um tratamento adequado&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">A telarca prematura &#40;TP&#41; &#233; definida pelo desenvolvimento isolado do tecido mam&#225;rio&#44; com outros sinais de matura&#231;&#227;o sexual&#44; que normalmente acontece nos primeiros quatro anos de vida&#46; Na maior parte dos casos&#44; a TP &#233; vista como uma varia&#231;&#227;o no desenvolvimento f&#237;sico normal e n&#227;o &#233; considerada patol&#243;gica&#46;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">8&#44;9</span></a> As crian&#231;as com TP n&#227;o apresentam sinais de aumento no crescimento nem matura&#231;&#227;o &#243;ssea avan&#231;ada&#44; com n&#237;vel normal de gonadotropina basal e E2&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">10&#44;11</span></a> Com uma preval&#234;ncia de 4&#44;7&#37;&#44; a causa da telarca prematura &#233;&#44; em grande parte&#44; desconhecida&#59; 2&#8208;13&#37; dos casos de TP podem progredir para PPC&#59;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">12&#8211;14</span></a> portanto&#44; deve ser feita uma avalia&#231;&#227;o cuidadosa com rela&#231;&#227;o &#224;s caracter&#237;sticas cl&#237;nicas&#44; &#224; idade &#243;ssea e &#224;s concentra&#231;&#245;es de gonadotropina basal e estimulada dos casos de TP&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">O teste de estimula&#231;&#227;o do LH &#233; um teste assistido que verifica a atividade do eixo HPG e diferencia os casos de PPC dos casos de TP&#46; Para crian&#231;as com progress&#227;o precoce de sinais puberais&#44; crescimento linear acelerado e matura&#231;&#227;o &#243;ssea precoce&#44; &#233; feito um diagn&#243;stico de PPC quando confirmada a ativa&#231;&#227;o prematura do eixo HPG&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">15</span></a> Contudo&#44; o teste de estimula&#231;&#227;o do LHRH exige um procedimento de amostragem complexo que dura um bom tempo e&#44; &#224;s vezes&#44; v&#225;rios testes s&#227;o necess&#225;rios antes que um diagn&#243;stico de PPC possa ser feito&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">9&#44;13</span></a> Foi relatado que a mensura&#231;&#227;o do n&#237;vel de LH de duas amostras ao ponto de 45 minutos &#233; necess&#225;ria para um diagn&#243;stico preciso de PPC&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">9</span></a> Neste estudo&#44; visamos a encontrar um indicador laboratorial ou cl&#237;nico que preveja um resultado positivo no teste de estimula&#231;&#227;o do LHRH&#44; pois conhecer esses indicadores pode facilitar o diagn&#243;stico de PPC&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Aqui&#44; os par&#226;metros cl&#237;nicos e laboratoriais dos indiv&#237;duos com sinais puberais precoces s&#227;o perfilados e comparados&#46; Par&#226;metros relevantes foram correlacionados com os resultados do teste de estimula&#231;&#227;o do LHRH inicial e de acompanhamento para encontrar o indicador mais significativo&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">M&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Indiv&#237;duos</span><p id="par0025" class="elsevierStylePara elsevierViewall">Foram selecionadas para a pesquisa 382 meninas encaminhadas ao Hospital Shandong Provincial afiliado &#224; Shandong University entre abril de 2010 e maio de 2015 para avalia&#231;&#227;o de suspeita de PP&#46; Os pacientes selecionados para o estudo atenderam aos seguintes crit&#233;rios&#58; a&#41; sexo feminino com desenvolvimento prematuro das mamas &#40;est&#225;gio Tanner &#8805; B<span class="elsevierStyleInf">2</span>&#41; antes dos oito anos&#59; b&#41; idade &#243;ssea &#8805; 1 ano acima da idade cronol&#243;gica &#40;IC&#41;&#59; c&#41; teste de estimula&#231;&#227;o do LHRH positivo antes dos nove anos&#59; d&#41; cada caso foi submetido a acompanhamento &#40;&#8805; 6 meses&#41;&#44; cada caso deve ser acompanhado acima dos nove anos&#46; Os pacientes com hist&#243;rico de doen&#231;as end&#243;crinas e les&#245;es intracranianas foram exclu&#237;dos&#46; Esta pesquisa foi aprovada pelo Comit&#234; de Pesquisa Cl&#237;nica do Hospital Shandong Provincial afiliado &#224; Shandong University&#46; O consentimento informado foi obtido de cada respons&#225;vel pela crian&#231;a participante do estudo&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Foi feito diagn&#243;stico de PPC quando&#58; 1&#41; houve apresenta&#231;&#227;o de matura&#231;&#227;o sexual secund&#225;ria abaixo dos oito anos&#59; 2&#41; idade &#243;ssea avan&#231;ada&#59; 3&#41; n&#237;vel m&#225;ximo de LH &#8805; 5 IU&#47;L durante o teste de estimula&#231;&#227;o do LHRH&#46; Os indiv&#237;duos foram agrupados de acordo com os resultados dos testes de estimula&#231;&#227;o do LHRH iniciais e de acompanhamento&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">M&#233;todos</span><p id="par0035" class="elsevierStylePara elsevierViewall">Os par&#226;metros de idade cronol&#243;gica &#40;IC&#41;&#44; idade &#243;ssea &#40;IO&#41;&#44; peso&#44; estatura&#44; IMC e laboratoriais foram coletados no in&#237;cio do teste de estimula&#231;&#227;o do LHRH&#46; O peso corporal e a estatura foram apresentados como escore de desvio&#8208;padr&#227;o &#40;EDP&#41;&#46; A velocidade de crescimento em seis meses foi determinada como aumento da estatura a partir do dia em que o teste de estimula&#231;&#227;o do LHRH &#40;inje&#231;&#227;o de gonadorelina&#41; foi feito&#46; A propor&#231;&#227;o de velocidade de crescimento foi determinada por&#58; aumento da estatura em seis meses dos indiv&#237;duos&#47;incremento na altura das meninas chinesas no per&#237;odo de seis meses&#46; O teste de estimula&#231;&#227;o do LHRH de acompanhamento foi feito a cada tr&#234;s ou seis meses de acordo com a velocidade de crescimento e a progress&#227;o puberal&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">A avalia&#231;&#227;o do desenvolvimento das mamas foi feita com a escala de Tanner&#46; A idade &#243;ssea foi determinada com o m&#233;todo Greulich&#8208;Pyle &#40;com radiografia do pulso e da m&#227;o esquerda&#41;&#46; A altura adulta prevista &#40;AAP&#41; foi medida com o m&#233;todo de Bayley&#8208;Pinneau&#44; ap&#243;s a dedu&#231;&#227;o da estatura m&#233;dia de mulheres chinesas de 20 anos &#40;161&#44;2<span class="elsevierStyleHsp" style=""></span>cm&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">O n&#237;vel sangu&#237;neo do FSH e do LH foi determinado com kits de ensaio imunofluorim&#233;trico &#40;Roche&#174;&#44; FIA&#44; IFMA&#44; IN&#44; EUA&#41;&#46; A imuniza&#231;&#227;o por eletroquimioluminesc&#234;ncia &#40;Roche&#174;&#44; Cobas e601&#44; IN&#44; EUA&#41; foi aplicada para avaliar os marcadores de tumor&#44; inclusive alfa&#8208;fetoprote&#237;na &#40;AFP&#41; e gonadotrofina cori&#244;nica humana &#40;HCG&#41;&#46; O n&#237;vel sangu&#237;neo de E2 foi determinado com os kits de radioimunoensaio &#40;Cisbio Bioassays&#44; Fran&#231;a&#41;&#46; No teste de estimula&#231;&#227;o do LHRH&#44; amostras de sangue foram coletadas aos 30&#44; 60 e 90 minutos ap&#243;s a administra&#231;&#227;o do LHRH &#40;100<span class="elsevierStyleHsp" style=""></span>&#956;g&#41; e submetidas ao teste de LH e FSH&#46; Os resultados das pacientes com n&#237;vel m&#225;ximo de LH &#8805; 5 IU&#47;L foram considerados positivos no teste de estimula&#231;&#227;o do LHRH&#46;</p><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">An&#225;lise estat&#237;stica</span><p id="par0050" class="elsevierStylePara elsevierViewall">As vari&#225;veis cont&#237;nuas foram expressas como m&#233;dia &#177; desvio&#8208;padr&#227;o e as vari&#225;veis categ&#243;ricas foram expressas como frequ&#234;ncia e percentuais&#46; O teste <span class="elsevierStyleItalic">t</span> de Student foi feito nas vari&#225;veis cont&#237;nuas e foram feitos testes qui&#8208;quadrado ou testes exatos de Fisher nas vari&#225;veis categ&#243;ricas&#46; Uma an&#225;lise de regress&#227;o log&#237;stica bin&#225;ria e uma an&#225;lise de regress&#227;o linear foram feitas para avaliar os indicadores significativos que podem prever os resultados do teste de estimula&#231;&#227;o do LHRH&#46; Uma curva ROC tamb&#233;m foi criada para obter o valor de corte da IO&#8208;IC na previs&#227;o diagn&#243;stica de PPC&#46; Todos os testes significativos foram bicaudais&#44; p &#60; 0&#44;05 foi considerado estatisticamente significativo&#46; Todas as an&#225;lises estat&#237;sticas foram feitas com o <span class="elsevierStyleItalic">software</span> SPSS &#40;SPSS&#44; estat&#237;stica para Windows&#44; Vers&#227;o 17&#46;0&#46; Chicago&#44; EUA&#41;&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Resultados</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Caracter&#237;sticas cl&#237;nicas e auxol&#243;gicas dos indiv&#237;duos</span><p id="par0055" class="elsevierStylePara elsevierViewall">Foram investigadas 382 meninas e as caracter&#237;sticas cl&#237;nicas e auxol&#243;gicas dos indiv&#237;duos foram mostradas na <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a><span class="elsevierStyleHsp" style=""></span>da seguinte forma&#58; a idade cronol&#243;gica dos indiv&#237;duos foi 7&#44;8 &#177; 0&#44;6 anos no teste de estimula&#231;&#227;o do LHRH inicial&#59; a idade &#243;ssea dos indiv&#237;duos foi 9&#44;3 &#177; 0&#44;8 anos&#59; o avan&#231;o da idade &#243;ssea &#40;IA&#8208;IC&#41; foi 22&#44;5 &#177; 5&#44;4 meses&#59; o peso foi 1&#44;4 &#177; 0&#44;4&#59; o EDP da altura dos indiv&#237;duos foi 1&#44;6 &#177; 0&#44;6&#59; a velocidade de crescimento em seis meses foi 3&#44;7 &#177; 0&#44;7<span class="elsevierStyleHsp" style=""></span>cm&#59; o IMC foi 18&#44;7 &#177; 2&#44;9<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">An&#225;lise das caracter&#237;sticas cl&#237;nicas e laboratoriais</span><p id="par0060" class="elsevierStylePara elsevierViewall">Foram diagnosticados 237 indiv&#237;duos com PPC de acordo com o teste de estimula&#231;&#227;o do LHRH inicial e agrupados no grupo de PPC&#44; 145 indiv&#237;duos com resultados negativos foram tratado como controle negativo &#40;grupo CN&#41;&#46; Conforme mostrado na <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#44; idade &#243;ssea &#40;10&#44;4 &#177; 0&#44;9 anos para o grupo de PPC e 9&#44;1 &#177; 0&#44;7 anos para o grupo CN&#44; p &#60; 0&#44;001&#41; e idade cronol&#243;gica &#40;7&#44;9 &#177; 0&#44;9 anos para o grupo de PPC e 7&#44;7 &#177; 0&#44;7 anos para o grupo CN&#44; p &#60; 0&#44;02&#41; maiores foram observadas entre os grupos de PPC e CN&#46; Al&#233;m disso&#44; foi encontrado IMC significativamente menor &#40;18&#44;1 &#177; 3&#44;4<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span> para o grupo de PPC e 19&#44;2 &#177; 3&#44;7<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span> para o grupo CN&#44; p &#61; 0&#44;003&#41;&#44; IO&#8208;IC maiores &#40;23&#44;7 &#177; 7&#44;5 meses para o grupo de PPC e 20&#44;1 &#177; 6&#44;9 meses para o grupo CN&#44; p &#60; 0&#44;001&#41;&#44; maior velocidade de crescimento do per&#237;odo de seis meses &#40;4&#44;2 &#177; 0&#44;8<span class="elsevierStyleHsp" style=""></span>cm para o grupo de PPC e 3&#44;3 &#177; 0&#44;6<span class="elsevierStyleHsp" style=""></span>cm para o grupo CN&#44; p &#60; 0&#44;001&#41; e maior propor&#231;&#227;o de velocidade de crescimento &#40;1&#44;4 &#177; 0&#44;3 para o grupo de PPC e 1&#44;1 &#177; 0&#44;2 para o grupo CN&#44; p &#60; 0&#44;001&#41; nos indiv&#237;duos com diagn&#243;stico de PPC&#44; em compara&#231;&#227;o com o grupo CN&#46; Al&#233;m disso&#44; foram detectadas maior concentra&#231;&#227;o basal de LH&#44; concentra&#231;&#245;es sangu&#237;neas basais de FSH&#44; E2 e IGF&#8208;1 no grupo de PPC&#44; em compara&#231;&#227;o com o grupo de CN&#46; Nenhuma diferen&#231;a significativa foi observada entre os dois grupos em termos de estatura e n&#237;veis sangu&#237;neos de AFP e HCG&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Testes de estimula&#231;&#227;o do LHRH de acompanhamento</span><p id="par0065" class="elsevierStylePara elsevierViewall">As 145 meninas com resultados negativos no teste de estimula&#231;&#227;o do LHRH inicial foram submetidas aos testes de estimula&#231;&#227;o do LHRH de acompanhamento&#46; Dentre os 145 indiv&#237;duos&#44; 42 foram diagnosticados com PPC nos testes de estimula&#231;&#227;o do LHRH de acompanhamento &#40;grupo positivo de acompanhamento&#41; e 103 meninas apresentaram resultados negativos &#40;grupo negativo de acompanhamento&#41;&#46; Foram encontradas maior idade &#243;ssea &#40;9&#44;5 &#177; 0&#44;8 anos para o grupo positivo de acompanhamento e 9&#44;1 &#177; 0&#44;7 anos para o grupo negativo de acompanhamento&#44; p &#60; 0&#44;005&#41;&#44; maior IO&#8208;IC &#40;22&#44;8 &#177; 6&#44;8 meses para o grupo positive de acompanhamento e 19&#44;5 &#177; 6&#44;4 meses para o grupo negativo de acompanhamento&#44; p &#61; 0&#44;006&#41;&#44; maior velocidade de crescimento durante seis meses &#40;3&#44;5 &#177; 0&#44;9<span class="elsevierStyleHsp" style=""></span>cm para o grupo positivo de acompanhamento e 3&#44;1 &#177; 0&#44;8<span class="elsevierStyleHsp" style=""></span>cm para o grupo negativo de acompanhamento&#44; p &#61; 0&#44;009&#41; e propor&#231;&#227;o de velocidade de crescimento &#40;1&#44;2 &#177; 0&#44;4 para o grupo positivo de acompanhamento e 1&#44;0 &#177; 0&#44;2 para o grupo negativo de acompanhamento&#44; p &#60; 0&#44;001&#41;&#44; em compara&#231;&#227;o com os indiv&#237;duos com resultado positivo&#46; Nenhuma diferen&#231;a estatisticamente significativa foi encontrada entre os grupos em termos de IMC&#44; EDP do peso corporal&#44; EDP da estatura&#44; concentra&#231;&#245;es sangu&#237;neas basais de E2 e sangu&#237;nea de IGF&#8208;1 e os n&#237;veis sangu&#237;neos de AFP e HCG &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a>&#41;&#46; Usamos os dados de IO&#8208;IC do teste inicial para criar uma curva ROC e criamos uma &#225;rea abaixo da curva ROC de 0&#44;605 &#40;0&#44;605 &#177; 0&#44;03&#41;&#46; O tempo de 19&#44;5 meses como valor de corte de IO&#8208;IC apresentou uma sensibilidade de 0&#44;7 e uma taxa de falso positivo de 0&#44;53 na previs&#227;o de diagn&#243;stico de PPC no acompanhamento&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">An&#225;lise de regress&#227;o log&#237;stica bin&#225;ria</span><p id="par0070" class="elsevierStylePara elsevierViewall">Foi criado um modelo de regress&#227;o log&#237;stica bin&#225;ria para analisar os par&#226;metros relevantes&#44; como IO&#8208;IC&#44; EDP do peso corporal IMC&#44; propor&#231;&#227;o da velocidade de crescimento&#44; concentra&#231;&#245;es sangu&#237;neas basais de E2&#44; LH e FSH e sangu&#237;neas de IGF&#8208;1 para avaliar os indicadores significativos que podem prever os resultados do teste de simula&#231;&#227;o do LHRH&#46; De acordo com a an&#225;lise de regress&#227;o log&#237;stica bin&#225;ria&#44; quatro par&#226;metros foram associados aos resultados do teste de estimula&#231;&#227;o do LHRH no teste de estimula&#231;&#227;o do LHRH inicial&#58; IO&#8208;IC &#40;RC&#44; 5&#44;62&#59; IC de 95&#37;&#44; 3&#44;08&#8208;8&#44;96&#59; p &#60; 0&#44;001&#41;&#44; propor&#231;&#227;o da velocidade de crescimento &#40;RC&#44; 3&#44;63&#59; IC de 95&#37;&#44; 2&#44;17&#8208;5&#44;34&#59; p &#60; 0&#44;001&#41;&#44; n&#237;vel sangu&#237;neo basal de FSH &#40;RC&#44; 2&#44;11&#59; IC de 95&#37;&#44; 1&#44;52&#8208;3&#44;49&#59; p &#60; 0&#44;01&#41;&#44; concentra&#231;&#227;o sangu&#237;nea basal de LH &#40;RC&#44; 1&#44;46&#59; IC de 95&#37;&#44; 1&#44;03&#8208;2&#44;47&#59; p &#61; 0&#44;02&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabela 4</a>&#41;&#46; Al&#233;m disso&#44; fizemos tamb&#233;m uma an&#225;lise de regress&#227;o linear sobre a correla&#231;&#227;o entre IO&#8208;IC e o n&#237;vel m&#225;ximo de LH&#46; No modelo de regress&#227;o linear&#44; os dados de IO&#8208;IC do teste inicial e do teste de acompanhamento foram positivamente correlacionados ao n&#237;vel m&#225;ximo de LH&#44; com um coeficiente de determina&#231;&#227;o &#40;R<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">2</span></a>&#41; de 0&#44;78 e 0&#44;65&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Discuss&#227;o</span><p id="par0075" class="elsevierStylePara elsevierViewall">Neste estudo&#44; 382 meninas foram submetidas aos testes de estimula&#231;&#227;o do LHRH inicial em nosso hospital e 145 delas apresentaram resultados negativos para os testes&#46; Com uma no&#231;&#227;o de que podemos ter errado em algum diagn&#243;stico &#40;negativo no teste de estimula&#231;&#227;o do LHRH inicial&#41;&#44; acompanhamos esses 145 casos regularmente&#46; Usamos os dados iniciais dos 382 casos&#44; conduzimos uma an&#225;lise de regress&#227;o bin&#225;ria e encontramos uma forte correla&#231;&#227;o entre o avan&#231;o na idade &#243;ssea e o resultado do teste de estimula&#231;&#227;o do LHRH &#40;e o diagn&#243;stico de PPC&#41;&#46; Tamb&#233;m foi encontrado o maior n&#237;vel sangu&#237;neo basal de LH&#44; E2 e FSH&#44; em compara&#231;&#227;o com os indiv&#237;duos com resposta negativa durante o teste de estimula&#231;&#227;o do LHRH&#46; Com os dados iniciais do diagn&#243;stico de IO&#8208;IC e de PPC&#44; criamos uma curva ROC e usamos o valor de corte para prever o diagn&#243;stico de PPC &#40;com uma sensibilidade de 0&#44;7 e taxa de falso positivo de 0&#44;53&#41;&#46; Apresentaram diagn&#243;stico de PPC durante o teste de acompanhamento 42 meninas&#46; Comparamos essas 42 meninas com as meninas com resultado negativo &#40;e outras 103 meninas&#41; e encontramos um avan&#231;o na idade &#243;ssea significativamente maior entre as meninas com PPC&#46; O avan&#231;o na idade &#243;ssea sozinho prev&#234; de maneira efetiva um valor de diagn&#243;stico de PPC&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">As an&#225;lises de tend&#234;ncias no in&#237;cio de puberdade mostraram uma tend&#234;ncia de puberdade precoce em meninas em todo o mundo&#46; De acordo com uma pesquisa feita com 17&#46;077 meninas americanas em 1997 pela rede <span class="elsevierStyleItalic">Pediatric Research in Office Settings</span>&#44; a m&#233;dia da idade de in&#237;cio da telarca foi 9&#44;96 anos&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">16</span></a> Com uma tend&#234;ncia de in&#237;cio puberal precoce&#44; foi observado um n&#250;mero crescente de meninas encaminhadas para a cl&#237;nica de endocrinologia pedi&#225;trica para avalia&#231;&#227;o dos sinais puberais precoces&#46; Em alguns casos&#44; o diagn&#243;stico de puberdade precoce pode ser desafiador devido &#224; inconsist&#234;ncia entre as caracter&#237;sticas cl&#237;nicas e os resultados do teste de estimula&#231;&#227;o do LHRH&#46;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">17&#44;18</span></a> Apesar de o teste de estimula&#231;&#227;o do LHRH ser o padr&#227;o&#8208;ouro no diagn&#243;stico de PPC&#44; o teste em si &#233; demorado e exige amostragem frequente&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">19</span></a> Neste estudo&#44; 382 meninas investigadas apresentaram v&#225;rios sinais puberais precoces&#44; como desenvolvimento prematuro das mamas&#44; matura&#231;&#227;o &#243;ssea avan&#231;ada e crescimento linear acelerado&#46; No teste de estimula&#231;&#227;o do LHRH inicial&#44; 237 indiv&#237;duos apresentaram diagn&#243;sticos positivos de PPC&#46; Os indiv&#237;duos com resultados positivos no teste inicial apresentaram menor IMC&#44; maior IO&#8208;IC&#44; velocidade de crescimento mais r&#225;pida&#44; maiores n&#237;veis sangu&#237;neos basais de LH&#44; FSH e E2 e maiores n&#237;veis sangu&#237;neos de IGF&#8208;1&#44; em compara&#231;&#227;o com os indiv&#237;duos com resultados negativos no teste inicial&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">De acordo com Della Manna et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">20</span></a> foram observados crescimento linear acelerado&#44; aumento no tamanho do &#250;tero e ov&#225;rio&#44; idade &#243;ssea avan&#231;ada e alta concentra&#231;&#227;o espont&#226;nea de LH nos indiv&#237;duos com PP&#46; Tamb&#233;m foram encontradas diferen&#231;as nos achados cl&#237;nicos e no par&#226;metro bioqu&#237;mico entre os dois grupos&#44; por&#233;m nenhuma investiga&#231;&#227;o adicional foi conduzida a respeito dessas correla&#231;&#245;es&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">15</span></a> Tamb&#233;m foram encontrados aumento significativo do crescimento em anos&#44; matura&#231;&#227;o precoce do esqueleto&#44; LH sangu&#237;neo basal&#44; n&#237;vel m&#225;ximo de LH e FSH no teste de simula&#231;&#227;o do LHRH nas meninas diagnosticadas com PP&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">21</span></a> Neste estudo&#44; descobrimos que a idade &#243;ssea foi o indicador mais sens&#237;vel do teste de estimula&#231;&#227;o do LHRH entre indiv&#237;duos com sinais puberais precoces&#46; As pesquisas demonstraram uma correla&#231;&#227;o positiva entre a matura&#231;&#227;o puberal precoce e aumento no IMC&#46;<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">22&#44;23</span></a> Neste estudo&#44; foi observada uma diferen&#231;a significativa do IMC entre os indiv&#237;duos nos diferentes resultados dos testes iniciais e todos os valores estavam dentro da faixa et&#225;ria geral das crian&#231;as&#46; &#201; importante mencionar que alguns sinais de desenvolvimento das mamas observados em indiv&#237;duos com resultados de teste negativos no teste inicial foram apenas tecidos adiposos e telarca n&#227;o verdadeira&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Foi feita uma pesquisa sobre a diferencia&#231;&#227;o de diagn&#243;stico entre PP e TP&#46; As pesquisas sugeriram que a concentra&#231;&#227;o sangu&#237;nea basal de LH pode revelar a atividade do eixo HPG na maior parte dos pacientes com PPC&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">24</span></a> Um n&#237;vel maior de IGF&#8208;1 no sangue em indiv&#237;duos com PPC tamb&#233;m foi encontrado quando comparado com o dos indiv&#237;duos com TP&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">25</span></a> O n&#237;vel m&#225;ximo de LH durante o teste de estimula&#231;&#227;o do LHRH mostrou&#8208;se um indicador significativo de PPC nos indiv&#237;duos com desenvolvimento prematuro das mamas&#46; O desenvolvimento prematuro das mamas acontece no est&#225;gio inicial tanto nos casos de TP quanto PP&#59; assim&#44; devida aten&#231;&#227;o deve ser dada aos casos com telarca anormal&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">26</span></a> Um estudo recente demonstrou que o crescimento linear acelerado &#233; um poderoso indicador para resultados positivos de testes do LHRH em meninas com sinais puberais precoces&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">17</span></a> Nesse estudo&#44; 29&#37; dos indiv&#237;duos com resultados negativos do teste inicial apresentaram diagn&#243;stico de PPC durante o teste de acompanhamento&#46; Foi observado um crescimento significativamente maior e mais r&#225;pido da IO&#8208;IC em indiv&#237;duos com resultados positivos para o teste inicial&#44; em compara&#231;&#227;o com os indiv&#237;duos com resultados negativos para o teste de acompanhamento&#46; Nenhuma diferen&#231;a significativa foi encontrada entre os grupos em termos de IMC&#44; n&#237;veis de LH sangu&#237;neo basal&#44; FSH sangu&#237;neo basal&#44; E2 sangu&#237;neo basal e concentra&#231;&#227;o sangu&#237;nea de IGF&#8208;1&#46; O diagn&#243;stico de diferencia&#231;&#227;o de PPC de casos com resultado negativo inicial &#40;TP&#44; por exemplo&#41;&#44; por meio da simples avalia&#231;&#227;o de caracter&#237;sticas cl&#237;nicas e laboratoriais&#44; &#233; dif&#237;cil&#46; Os achados nesta pesquisa sugerem que &#233; necess&#225;ria uma avalia&#231;&#227;o detalhada sobre a idade &#243;ssea para determinar se os pacientes precisam de teste de estimula&#231;&#227;o do LHRH de acompanhamento e tratamento com o agonista LHRH&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">&#201; necess&#225;ria uma pesquisa adicional para abordar as limita&#231;&#245;es deste estudo&#46; Primeiro&#44; um n&#250;mero limitado de casos levou a um tamanho da amostra relativamente pequeno&#59; segundo&#44; este ensaio incluiu apenas participantes chineses&#46; Assim&#44; nossos achados podem n&#227;o ser aplic&#225;veis &#224; popula&#231;&#227;o geral&#59; terceiro&#44; este estudo &#233; um ensaio em um &#250;nico centro&#46; S&#227;o necess&#225;rios um estudo de coorte multic&#234;ntrico com um tamanho da amostra maior e mais etnias&#46; Vale lembrar tamb&#233;m que&#44; apesar de a idade &#243;ssea avan&#231;ada ser um par&#226;metro &#250;til no diagn&#243;stico de PPC ou PP&#44; os m&#233;dicos nunca devem enfatizar demais qualquer par&#226;metro exclusivo na pr&#225;tica cl&#237;nica&#46; Uma boa tomada de decis&#245;es na pr&#225;tica cl&#237;nica deve ser flex&#237;vel e incluir todos os par&#226;metros &#250;teis&#46; Os estudos futuros devem incluir mais par&#226;metros para obter um diagn&#243;stico mais preciso&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Os pacientes com puberdade precoce central com resultados positivos do teste de estimula&#231;&#227;o do LHRH apresentaram idade &#243;ssea mais avan&#231;ada&#44; crescimento linear mais r&#225;pido e altas concentra&#231;&#245;es sangu&#237;neas de gonadotrofina&#46; Idade &#243;ssea avan&#231;ada&#44; em especial&#44; &#233; o indicador mais significativo para o teste de estimula&#231;&#227;o do LHRH&#44; ao diagnosticar casos com suspeita de PPC&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflitos de interesse</span><p id="par0105" class="elsevierStylePara elsevierViewall">Os autores declaram n&#227;o haver conflitos de interesse&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:11 [
        0 => array:3 [
          "identificador" => "xres1404747"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Objective"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Methods"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1285613"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres1404746"
          "titulo" => "Resumo"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Objetivo"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "M&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Conclus&#245;es"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec1285612"
          "titulo" => "Palavras&#8208;chave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introdu&#231;&#227;o"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "M&#233;todos"
          "secciones" => array:1 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Indiv&#237;duos"
            ]
          ]
        ]
        6 => array:3 [
          "identificador" => "sec0020"
          "titulo" => "M&#233;todos"
          "secciones" => array:1 [
            0 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "An&#225;lise estat&#237;stica"
            ]
          ]
        ]
        7 => array:3 [
          "identificador" => "sec0030"
          "titulo" => "Resultados"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Caracter&#237;sticas cl&#237;nicas e auxol&#243;gicas dos indiv&#237;duos"
            ]
            1 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "An&#225;lise das caracter&#237;sticas cl&#237;nicas e laboratoriais"
            ]
            2 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Testes de estimula&#231;&#227;o do LHRH de acompanhamento"
            ]
            3 => array:2 [
              "identificador" => "sec0050"
              "titulo" => "An&#225;lise de regress&#227;o log&#237;stica bin&#225;ria"
            ]
          ]
        ]
        8 => array:2 [
          "identificador" => "sec0055"
          "titulo" => "Discuss&#227;o"
        ]
        9 => array:2 [
          "identificador" => "sec0060"
          "titulo" => "Conflitos de interesse"
        ]
        10 => array:1 [
          "titulo" => "Refer&#234;ncias"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2016-12-09"
    "fechaAceptado" => "2017-02-15"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1285613"
          "palabras" => array:4 [
            0 => "Central precocious puberty"
            1 => "Bone age"
            2 => "Luteinizing hormone&#8208;releasing hormone stimulation test"
            3 => "Growth velocity"
          ]
        ]
      ]
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palavras&#8208;chave"
          "identificador" => "xpalclavsec1285612"
          "palabras" => array:4 [
            0 => "Puberdade precoce central"
            1 => "Idade &#243;ssea"
            2 => "Teste de estimula&#231;&#227;o do horm&#244;nio liberador do horm&#244;nio luteinizante"
            3 => "Velocidade de crescimento"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Diagnosis of central precocious puberty has always been challenging in clinicalpractice&#46; As an important method in the diagnosis of central precocious puberty&#44; luteinizinghormone&#8208;releasing hormone stimulation test is complex and time&#8208;consuming&#46; In many cases&#44; clinical traits are inconsistent with luteinizing hormone&#8208;releasing hormone stimulation testresults&#44; therefore not reliable for diagnosis&#46; In this study&#44; the authors intended to find an indi&#8208;cator that predicts the results of the luteinizing hormone&#8208;releasing hormone stimulation testamong subjects with early pubertal signs&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Cases of 382 girls with early breast development before 8 years old and luteinizinghormone-releasing hormone stimulation test before 9 years old were included and underwentfollow-up tests&#46; Patients with peak luteinizing hormone level &#8805;5 IU&#47;L were considered positivein the luteinizing hormone-releasing hormone stimulation test&#46; Anthropometric data&#44; body massindex&#44; bone age evaluation&#44; blood hormones levels of luteinizing hormone&#44; estradiol&#44; follicle-stimulating hormone&#44; and uterine and ovarian volumes were analyzed&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">Subjects with positive results in the initial test demonstrated early bone maturation&#44; accelerated growth&#44; and elevated basal blood luteinizing hormone&#44; estradiol&#44; and follicle-stimulating hormone levels&#44; when compared with subjects with negative results in the initialtest&#46; Subjects with positive results in the follow-up test presented a more advanced bone ageand more accelerated linear growth&#44; when compared with subjects with negative results in thefollow-up test&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">According to the statistical analysis&#44; advanced bone age is the most effectivepredictor of the result of luteinizing hormone-releasing hormone stimulation test&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objective"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "pt" => array:3 [
        "titulo" => "Resumo"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">O diagn&#243;stico da puberdade precoce central sempre foi complicado na pr&#225;tica cl&#237;nica&#46; Como um importante m&#233;todo no diagn&#243;stico de puberdade precoce central&#44; o teste de estimula&#231;&#227;o do horm&#244;nio liberador do horm&#244;nio luteinizante &#233; complexo e demorado&#46; Em muitos casos&#44; as caracter&#237;sticas cl&#237;nicas s&#227;o incompat&#237;veis com os resultados do teste de estimula&#231;&#227;o do horm&#244;nio liberador do horm&#244;nio luteinizante e&#44; assim&#44; n&#227;o s&#227;o confi&#225;veis para o diagn&#243;stico&#46; Neste estudo&#44; visamos constatar um indicador que previsse os resultados do teste de estimula&#231;&#227;o do horm&#244;nio liberador do horm&#244;nio luteinizante entre indiv&#237;duos com sinais puberais precoces&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0120" class="elsevierStyleSimplePara elsevierViewall">Foram inclu&#237;dos casos de 382 meninas com desenvolvimento precoce das mamas antes dos 8 anos de idade e teste de estimula&#231;&#227;o do horm&#244;nio liberador do horm&#244;nio luteinizanteantes dos 9 anos e elas foram submetidas a testes de acompanhamento&#46; Os resultados das pacientes com n&#237;vel m&#225;ximo de horm&#244;nio luteinizante &#8805; 5 IU&#47;L foram consideradas positivos no teste de estimula&#231;&#227;o do horm&#244;nio liberador do horm&#244;nio luteinizante&#46; Foi feita uma an&#225;lise dos dados antropom&#233;tricos&#44; do &#237;ndice de massa corporal&#44; da avalia&#231;&#227;o da idade &#243;ssea&#44; dos n&#237;veis sangu&#237;neos de horm&#244;nio luteinizante&#44; volumes uterinos e ovarianos de estradiol &#40;E2&#41; e do horm&#244;nio fol&#237;culo-estimulante&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0125" class="elsevierStyleSimplePara elsevierViewall">Os indiv&#237;duos com resultado positive no teste inicial demonstraram matura&#231;&#227;o precoce do osso&#44; crescimento acelerado e n&#237;veis sangu&#237;neos elevados de horm&#244;nio luteinizante&#44; estradiol e horm&#244;nio fol&#237;culo-estimulante&#44; em compara&#231;&#227;o aos indiv&#237;duos com resultados negativos no teste inicial&#46; Os indiv&#237;duos com resultados positivos no teste de acompanhamento apresentaram um maior avan&#231;o na idade &#243;ssea e crescimento linear mais acelerado&#44; em compara&#231;&#227;o aos indiv&#237;duos com resultados negativos no teste de acompanhamento&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#245;es</span><p id="spar0130" class="elsevierStyleSimplePara elsevierViewall">De acordo com a an&#225;lise estat&#237;stica&#44; a idade &#243;ssea avan&#231;ada &#233; o indicador mais efetivo do resultado do teste de estimula&#231;&#227;o do horm&#244;nio liberador do horm&#244;nio luteinizante&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Objetivo"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "M&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclus&#245;es"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Como citar este artigo&#58; Xu Y&#8208;Q&#44; Li G&#8208;M&#44; Li Y&#46; Advanced bone age as an indicator facilitates the diagnosis of precocious puberty&#46; J Pediatr &#40;Rio J&#41;&#46; 2018&#59;94&#58;69&#8211;75&#46;</p>"
      ]
    ]
    "multimedia" => array:4 [
      0 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Tabela 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Tabela "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">EDP&#44; escore de desvio padr&#227;o&#59; IMC&#44; &#237;ndice de massa corporal&#59; IO&#8208;IC&#44; a diferen&#231;a entre a idade &#243;ssea e a idade cronol&#243;gica&#46;</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Dados apresentados como m&#233;dia &#177; DP&#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="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Caracter&#237;sticas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Indiv&#237;duos &#40;n &#61; 382&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Idade &#243;ssea &#40;anos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;3 &#177; 0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Idade cronol&#243;gica &#40;anos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;8 &#177; 0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;IO&#8208;IC&#41; &#40;meses&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#44;5 &#177; 5&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">EDP da altura&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;6 &#177; 0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">EDP do peso corporal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;4 &#177; 0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IMC &#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#44;7 &#177; 2&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Velocidade de crescimento &#40;cm&#47;6 meses&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;7 &#177; 0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#237;vel m&#225;ximo de LH &#40;IU&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;7 &#177; 2&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2408837.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas b&#225;sicas dos indiv&#237;duos</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Tabela 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Tabela "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">AFP&#44; alfa&#8208;fetoprote&#237;na&#59; CN&#44; controle negativo&#59; E2&#44; estradiol&#59; EDP&#44; escore de desvio padr&#227;o&#59; FSH&#44; horm&#244;nio fol&#237;culo&#8208;estimulante&#59; HCG&#44; gonadotrofina cori&#244;nica humana&#59; IGF&#8208;1&#44; fator de crescimento semelhante &#224; insulina tipo 1&#59; IMC&#44; &#237;ndice de massa corporal&#59; IO&#8208;IC&#44; diferen&#231;a entre a idade &#243;ssea e a idade cronol&#243;gica&#59; LH&#44; horm&#244;nio luteinizante&#59; PPC&#44; puberdade precoce central&#46;</p><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Dados apresentados como m&#233;dia &#177; DP&#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="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Caracter&#237;sticas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Grupo CN inicial &#40;n &#61; 145&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Grupo de PPC inicial &#40;n &#61; 237&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Valor de p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Idade &#243;ssea &#40;anos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;1 &#177; 0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#44;4 &#177; 0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Idade cronol&#243;gica &#40;anos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;7 &#177; 0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;9 &#177; 0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IO&#8208;IC &#40;meses&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#44;1 &#177; 6&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#44;7 &#177; 7&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">EDP da altura&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;6 &#177; 0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;7 &#177; 0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">EDP do peso corporal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;5 &#177; 0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;3 &#177; 0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IMC &#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#44;2 &#177; 3&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#44;1 &#177; 3&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Velocidade de crescimento &#40;cm&#47;6 meses&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;3 &#177; 0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;2 &#177; 0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Propor&#231;&#227;o de velocidade de crescimento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;1 &#177; 0&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;4 &#177; 0&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LH &#40;IL&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;8 &#177; 0&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;3 &#177; 0&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">FSH &#40;IU&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;7 &#177; 0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;5 &#177; 0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">E2 &#40;pg&#47;mL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;6 &#177; 3&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;2 &#177; 4&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IGF&#8208;1 &#40;ng&#47;mL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">237&#44;1 &#177; 52&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">327&#44;4 &#177; 62&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HCG &#40;mIU&#47;mL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#62; 0&#44;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AFP &#40;ng&#47;mL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#237;vel m&#225;ximo de LH &#40;IL&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;8 &#177; 0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;5 &#177; 2&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2408836.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas cl&#237;nicas e bioqu&#237;micas dos participantes no teste de estimula&#231;&#227;o do LHRH inicial &#40;n &#61; 382&#41;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Tabela 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Tabela "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">AFP&#44; alfa&#8208;fetoprote&#237;na&#59; CN&#44; controle negativo&#59; E2&#44; estradiol&#59; EDP&#44; escore de desvio padr&#227;o&#59; FSH&#44; horm&#244;nio fol&#237;culo&#8208;estimulante&#59; HCG&#44; gonadotrofina cori&#244;nica humana&#59; IGF&#8208;1&#44; fator de crescimento semelhante &#224; insulina tipo 1&#59; IMC&#44; &#237;ndice de massa corporal&#59; IO&#8208;IC&#44; diferen&#231;a entre a idade &#243;ssea e a idade cronol&#243;gica&#59; LH&#44; horm&#244;nio luteinizante&#59; PPC&#44; puberdade precoce central&#46;</p><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Dados apresentados como m&#233;dia &#177; DP&#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="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Caracter&#237;sticas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Grupo CN de acompanhamento &#40;n &#61; 103&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Grupo PPC de acompanhamento &#40;n &#61;<span class="elsevierStyleHsp" style=""></span>42&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Valor de p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Idade &#243;ssea &#40;anos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;1 &#177; 0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;5 &#177; 0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Idade cronol&#243;gica &#40;anos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#44;0 &#177; 0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;5 &#177; 0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IO&#8208;IC &#40;meses&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#44;5 &#177; 6&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#44;8 &#177; 6&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">EDP da altura&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;6 &#177; 0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;6 &#177; 0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#62; 0&#44;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">EDP do peso corporal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;5 &#177; 0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;6 &#177; 0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IMC &#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#44;3 &#177; 3&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#44;1 &#177; 3&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Velocidade de crescimento &#40;cm&#47;6 meses&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;1 &#177; 0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;5 &#177; 0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Propor&#231;&#227;o de velocidade de crescimento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;0 &#177; 0&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;2 &#177; 0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LH &#40;IL&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;8 &#177; 0&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;9 &#177; 0&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">FSH &#40;IU&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;7 &#177; 0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;0 &#177; 0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">E2 &#40;pg&#47;mL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;7 &#177; 5&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#44;4 &#177; 5&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IGF&#8208;1 &#40;ng&#47;mL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">232&#44;7 &#177; 49&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">248&#44;5 &#177; 58&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HCG &#40;mIU&#47;mL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#62; 0&#44;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AFP &#40;ng&#47;mL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#237;vel m&#225;ximo de LH &#40;IL&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;4 &#177; 0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;2 &#177; 2&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2408838.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas cl&#237;nicas e bioqu&#237;micas dos participantes no teste de estimula&#231;&#227;o do LHRH de acompanhamento &#40;n &#61; 145&#41;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0020"
        "etiqueta" => "Tabela 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at4"
            "detalle" => "Tabela "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">E2&#44; estradiol&#59; EDP&#44; escore de desvio padr&#227;o&#59; FSH&#44; horm&#244;nio fol&#237;culo&#8208;estimulante&#59; IGF&#8208;1&#44; fator de crescimento semelhante &#224; insulina tipo 1&#59; IO&#8208;IC&#44; diferen&#231;a entre a idade &#243;ssea e a idade cronol&#243;gica&#59; LH&#44; horm&#244;nio luteinizante&#46;</p><p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Os fatores do grupo de resultados positivos iniciais &#40;n &#61; 237&#41; foram comparados com os do grupo de resultados negativos iniciais &#40;n &#61; 145&#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="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Fatores&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Raz&#227;o de chance&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Intervalo de confian&#231;a de 95&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Valor de p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IO&#8208;IC &#40;meses&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;08&#8208;8&#44;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">EDP do peso corporal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;92&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;56&#8208;1&#44;77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IMC &#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;94&#8208;1&#44;86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Propor&#231;&#227;o de velocidade de crescimento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;17&#8208;5&#44;34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LH &#40;IL&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;03&#8208;2&#44;47&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">FSH &#40;IU&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;52&#8208;3&#44;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">E2 &#40;pg&#47;mL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;96&#8208;1&#44;56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IGF&#8208;1 &#40;ng&#47;mL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;05&#8208;1&#44;62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2408835.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">An&#225;lise de regress&#227;o log&#237;stica dos fatores associados aos resultados do teste de estimula&#231;&#227;o do LHRH inicial</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Refer&#234;ncias"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:26 [
            0 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation and management of precocious puberty"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46;P&#46; Merke"
                            1 => "G&#46;B&#46; Cutler Jr&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/adc.75.4.269"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dis Child"
                        "fecha" => "1996"
                        "volumen" => "75"
                        "paginaInicial" => "269"
                        "paginaFinal" => "271"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8984908"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Etiology and age incidence of precocious puberty in girls&#58; a multicentric study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Cisternino"
                            1 => "T&#46; Arrigo"
                            2 => "A&#46;M&#46; Pasquino"
                            3 => "C&#46; Tinelli"
                            4 => "F&#46; Antoniazzi"
                            5 => "L&#46; Beduschi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1515/jpem.2000.13.s1.695"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr Endocrinol Metab"
                        "fecha" => "2000"
                        "volumen" => "13"
                        "paginaInicial" => "695"
                        "paginaFinal" => "701"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10969911"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Precocious puberty in adolescent girls&#58; a biomarker of later psychosocial adjustment problems"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "L&#46; Tremblay"
                            1 => "J&#46;Y&#46; Frigon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s10578-004-3489-2"
                      "Revista" => array:6 [
                        "tituloSerie" => "Child Psychiatry Hum Dev"
                        "fecha" => "2005"
                        "volumen" => "36"
                        "paginaInicial" => "73"
                        "paginaFinal" => "94"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16049645"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sonography of abdominal organs in precocious puberty in girls"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46; Mazgaj"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.15557/JoU.2013.0044"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Ultrason"
                        "fecha" => "2013"
                        "volumen" => "13"
                        "paginaInicial" => "418"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26673282"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Final height of girls with central precocious puberty&#44; untreated versus treated with cyproterone acetate or GnRH analogue&#46; A comparative study with re&#8208;evaluation of predictions by the Bayley&#8208;Pinneau method"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "R&#46; Kauli"
                            1 => "A&#46; Galatzer"
                            2 => "L&#46; Kornreich"
                            3 => "L&#46; Lazar"
                            4 => "A&#46; Pertzelan"
                            5 => "Z&#46; Laron"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000185432"
                      "Revista" => array:6 [
                        "tituloSerie" => "Horm Res"
                        "fecha" => "1997"
                        "volumen" => "47"
                        "paginaInicial" => "54"
                        "paginaFinal" => "61"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9030968"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Adult height in girls with idiopathic true precocious puberty"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46; Brauner"
                            1 => "L&#46; Adan"
                            2 => "F&#46; Malandry"
                            3 => "D&#46; Zantleifer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1210/jcem.79.2.8045957"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "1994"
                        "volumen" => "79"
                        "paginaInicial" => "415"
                        "paginaFinal" => "420"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8045957"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical review 60&#58; effects of gonadotropin&#8208;releasing hormone analog therapy on adult stature in precocious puberty"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46;B&#46; Kletter"
                            1 => "R&#46;P&#46; Kelch"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1210/jcem.79.2.8045943"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "1994"
                        "volumen" => "79"
                        "paginaInicial" => "331"
                        "paginaFinal" => "334"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8045943"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A pediatrician&#39;s guide to central precocious puberty"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "G&#46;B&#46; Kletter"
                            1 => "K&#46;O&#46; Klein"
                            2 => "Y&#46;Y&#46; Wong"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Clin Pediatr &#40;Phila&#41;"
                        "fecha" => "2015"
                        "volumen" => "54"
                        "paginaInicial" => "414"
                        "paginaFinal" => "424"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gonadotropin&#8208;releasing hormone stimulation test for precocious puberty"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "H&#46;K&#46; Kim"
                            1 => "S&#46;J&#46; Kee"
                            2 => "J&#46;Y&#46; Seo"
                            3 => "E&#46;M&#46; Yang"
                            4 => "H&#46;J&#46; Chae"
                            5 => "C&#46;J&#46; Kim"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3343/kjlm.2011.31.4.244"
                      "Revista" => array:6 [
                        "tituloSerie" => "Korean J Lab Med"
                        "fecha" => "2011"
                        "volumen" => "31"
                        "paginaInicial" => "244"
                        "paginaFinal" => "249"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22016677"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of central precocious puberty"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46;J&#46; Partsch"
                            1 => "W&#46;G&#46; Sippell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1053/beem.2002.0188"
                      "Revista" => array:6 [
                        "tituloSerie" => "Best Pract Res Clin Endocrinol Metab"
                        "fecha" => "2002"
                        "volumen" => "16"
                        "paginaInicial" => "165"
                        "paginaFinal" => "189"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11987906"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Basal luteinizing hormone and follicular stimulating hormone&#58; is it sufficient for the diagnosis of precocious puberty in girls&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "D&#46;S&#46; Lee"
                            1 => "N&#46;Y&#46; Ryoo"
                            2 => "S&#46;H&#46; Lee"
                            3 => "S&#46; Kim"
                            4 => "J&#46;H&#46; Kim"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.6065/apem.2013.18.4.196"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Pediatr Endocrinol Metab"
                        "fecha" => "2013"
                        "volumen" => "18"
                        "paginaInicial" => "196"
                        "paginaFinal" => "201"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24904877"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Progression of premature thelarche to central precocious puberty"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46;M&#46; Pasquino"
                            1 => "I&#46; Pucarelli"
                            2 => "F&#46; Passeri"
                            3 => "M&#46; Segni"
                            4 => "M&#46;A&#46; Mancini"
                            5 => "G&#46; Municchi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/s0022-3476(95)70492-2"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr"
                        "fecha" => "1995"
                        "volumen" => "126"
                        "paginaInicial" => "11"
                        "paginaFinal" => "14"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7815198"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Utility of basal luteinizing hormone levels for detecting central precocious puberty in girls"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "H&#46;S&#46; Lee"
                            1 => "H&#46;K&#46; Park"
                            2 => "J&#46;H&#46; Ko"
                            3 => "Y&#46;J&#46; Kim"
                            4 => "J&#46;S&#46; Hwang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1055/s-0032-1321905"
                      "Revista" => array:6 [
                        "tituloSerie" => "Horm Metab Res"
                        "fecha" => "2012"
                        "volumen" => "44"
                        "paginaInicial" => "851"
                        "paginaFinal" => "854"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22893259"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The response to gonadotropin releasing hormone &#40;GnRH&#41; stimulation test does not predict the progression to true precocious puberty in girls with onset of premature thelarche in the first three years of life"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Bizzarri"
                            1 => "G&#46;L&#46; Spadoni"
                            2 => "G&#46; Bottaro"
                            3 => "G&#46; Montanari"
                            4 => "G&#46; Giannone"
                            5 => "M&#46; Cappa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1210/jc.2013-3292"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "2013"
                        "volumen" => "99"
                        "paginaInicial" => "433"
                        "paginaFinal" => "439"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24297793"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Factors that predict a positive response on gonadotropin&#8208;releasing hormone stimulation test for diagnosing central precocious puberty in girls"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Suh"
                            1 => "M&#46;H&#46; Choi"
                            2 => "A&#46;R&#46; Kwon"
                            3 => "Y&#46;J&#46; Kim"
                            4 => "J&#46;W&#46; Jeong"
                            5 => "J&#46;M&#46; Ahn"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.6065/apem.2013.18.4.202"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Pediatr Endocrinol Metab"
                        "fecha" => "2013"
                        "volumen" => "18"
                        "paginaInicial" => "202"
                        "paginaFinal" => "207"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24904878"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Secondary sexual characteristics and menses in young girls seen in office practice&#58; a study from the Pediatric Research in Office Settings Network"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;E&#46; Herman-Giddens"
                            1 => "E&#46;J&#46; Slora"
                            2 => "R&#46;C&#46; Wasserman"
                            3 => "C&#46;J&#46; Bourdony"
                            4 => "M&#46;V&#46; Bhapkar"
                            5 => "G&#46;G&#46; Koch"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1542/peds.99.4.505"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatrics"
                        "fecha" => "1997"
                        "volumen" => "99"
                        "paginaInicial" => "505"
                        "paginaFinal" => "512"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9093289"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Factors to predict positive results of gonadotropin releasing hormone stimulation test in girls with suspected precocious puberty"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "H&#46;K&#46; Nam"
                            1 => "Y&#46;J&#46; Rhie"
                            2 => "C&#46;S&#46; Son"
                            3 => "S&#46;H&#46; Park"
                            4 => "K&#46;H&#46; Lee"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3346/jkms.2012.27.2.194"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Korean Med Sci"
                        "fecha" => "2012"
                        "volumen" => "27"
                        "paginaInicial" => "194"
                        "paginaFinal" => "199"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22323868"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Spontaneous serum gonadotropin concentrations in the evaluation of precocious puberty"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "E&#46;K&#46; Neely"
                            1 => "D&#46;M&#46; Wilson"
                            2 => "P&#46;A&#46; Lee"
                            3 => "M&#46; Stene"
                            4 => "R&#46;L&#46; Hintz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/s0022-3476(95)70255-5"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr"
                        "fecha" => "1995"
                        "volumen" => "127"
                        "paginaInicial" => "47"
                        "paginaFinal" => "52"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7608810"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The significance and characteristics of the LHRH test in diagnosing precocious puberty development in girls&#58; the stimulated LH&#47;FSH quotient differentiates between central precocious puberty and premature thelarche"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46;J&#46; Partsch"
                            1 => "R&#46; Hummelink"
                            2 => "F&#46; Lorenzen"
                            3 => "W&#46;G&#46; Sippell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Monatsschr Kinderheilkd"
                        "fecha" => "1989"
                        "volumen" => "137"
                        "paginaInicial" => "284"
                        "paginaFinal" => "288"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2525665"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Premature thelarche&#58; identification of clinical and laboratory data for the diagnosis of precocious puberty"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "T&#46; Della Manna"
                            1 => "N&#46; Setian"
                            2 => "D&#46; Damiani"
                            3 => "H&#46; Kuperman"
                            4 => "V&#46; Dichtchekenian"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1590/s0041-87812002000200001"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Hosp Clin Fac Med S&#227;o Paulo"
                        "fecha" => "2002"
                        "volumen" => "57"
                        "paginaInicial" => "49"
                        "paginaFinal" => "54"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11981584"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The utility of basal serum LH in prediction of central precocious puberty in girls"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "Y&#46; Pasternak"
                            1 => "M&#46; Friger"
                            2 => "N&#46; Loewenthal"
                            3 => "A&#46; Haim"
                            4 => "E&#46; Hershkovitz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1530/EJE-11-0720"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Endocrinol"
                        "fecha" => "2012"
                        "volumen" => "166"
                        "paginaInicial" => "295"
                        "paginaFinal" => "299"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22084156"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pubertal maturation in girls and the relationship to anthropometric changes&#58; pathways through puberty"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46;M&#46; Biro"
                            1 => "A&#46;W&#46; Lucky"
                            2 => "L&#46;A&#46; Simbartl"
                            3 => "B&#46;A&#46; Barton"
                            4 => "S&#46;R&#46; Daniels"
                            5 => "R&#46; Striegel-Moore"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1067/mpd.2003.244"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr"
                        "fecha" => "2003"
                        "volumen" => "142"
                        "paginaInicial" => "643"
                        "paginaFinal" => "646"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12838192"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Girls with premature adrenarche have accelerated early childhood growth"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46; Utriainen"
                            1 => "R&#46; Voutilainen"
                            2 => "J&#46; Jaaskelainen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jpeds.2008.12.038"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr"
                        "fecha" => "2009"
                        "volumen" => "154"
                        "paginaInicial" => "882"
                        "paginaFinal" => "887"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19230905"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Basal luteinizing hormone&#47;follicle stimulating hormone ratio in diagnosis of central precocious puberty"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "V&#46; Supornsilchai"
                            1 => "P&#46; Hiranrat"
                            2 => "S&#46; Wacharasindhu"
                            3 => "S&#46; Srivuthana"
                            4 => "S&#46; Aroonparkmongkol"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Med Assoc Thai"
                        "fecha" => "2003"
                        "volumen" => "86"
                        "paginaInicial" => "S145"
                        "paginaFinal" => "S151"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12929982"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Serum insulin&#8208;like growth factor &#40;IGF&#41;&#8208;I and IGF&#8208;binding protein&#8208;3 in girls with premature thelarche"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46;S&#46; Sales"
                            1 => "A&#46;C&#46; Moreira"
                            2 => "C&#46; Camacho-Hubner"
                            3 => "R&#46;G&#46; Ricco"
                            4 => "J&#46;C&#46; Daneluzzi"
                            5 => "A&#46;D&#46; Campos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1515/jpem.2003.16.6.827"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr Endocrinol Metab"
                        "fecha" => "2003"
                        "volumen" => "16"
                        "paginaInicial" => "827"
                        "paginaFinal" => "833"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12948294"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Premature thelarche&#58; clinical and laboratorial assessment by immunochemiluminescent assay"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;F&#46; Borges"
                            1 => "K&#46;D&#46; Pacheco"
                            2 => "A&#46;A&#46; Oliveira"
                            3 => "C&#46;V&#46; Rita"
                            4 => "K&#46;D&#46; Pacheco"
                            5 => "E&#46;A&#46; Resende"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1590/s0004-27302008000100013"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arq Bras Endocrinol Metabol"
                        "fecha" => "2008"
                        "volumen" => "52"
                        "paginaInicial" => "93"
                        "paginaFinal" => "100"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18345401"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "pt"
  "url" => "/22555536/0000009400000001/v2_202010270619/S2255553617301088/v2_202010270619/pt/main.assets"
  "Apartado" => array:4 [
    "identificador" => "24841"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Artigo original"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/22555536/0000009400000001/v2_202010270619/S2255553617301088/v2_202010270619/pt/main.pdf?idApp=UINPBA000049&text.app=https://jped.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2255553617301088?idApp=UINPBA000049"
]
Informação do artigo
ISSN: 22555536
Idioma original: Português
Dados atualizados diariamente
Ano/Mês Html Pdf Total
2024 Novembro 6 1 7
2024 Outubro 33 22 55
2024 Setembro 32 20 52
2024 Agosto 41 32 73
2024 Julho 35 39 74
2024 Junho 20 17 37
2024 Maio 19 11 30
2024 Abril 28 26 54
2024 Março 22 19 41
2024 Fevereiro 41 32 73
2024 Janeiro 43 23 66
2023 Dezembro 23 30 53
2023 Novembro 21 27 48
2023 Outubro 21 31 52
2023 Setembro 23 32 55
2023 Agosto 15 12 27
2023 Julho 19 10 29
2023 Junho 16 6 22
2023 Maio 16 17 33
2023 Abril 16 10 26
2023 Março 38 35 73
2023 Fevereiro 21 15 36
2023 Janeiro 19 20 39
2022 Dezembro 42 36 78
2022 Novembro 28 38 66
2022 Outubro 50 40 90
2022 Setembro 19 31 50
2022 Agosto 15 37 52
2022 Julho 20 36 56
2022 Junho 19 35 54
2022 Maio 19 34 53
2022 Abril 45 42 87
2022 Março 25 39 64
2022 Fevereiro 20 26 46
2022 Janeiro 11 12 23
2021 Dezembro 10 12 22
2021 Novembro 13 21 34
2021 Outubro 8 15 23
2021 Setembro 8 8 16
2021 Agosto 7 8 15
2021 Julho 4 4 8
2021 Junho 8 6 14
2021 Maio 12 12 24
2021 Abril 17 14 31
2021 Março 4 9 13
2021 Fevereiro 12 12 24
2021 Janeiro 8 6 14
2020 Dezembro 10 9 19
2020 Novembro 11 11 22
2020 Outubro 16 11 27
2020 Setembro 12 20 32
2020 Agosto 5 11 16
2020 Julho 3 7 10
2020 Junho 6 3 9
2020 Maio 3 2 5
2020 Abril 8 12 20
2020 Março 7 4 11
2020 Fevereiro 10 6 16
2020 Janeiro 10 15 25
2019 Dezembro 12 7 19
2019 Novembro 17 7 24
2019 Outubro 8 12 20
2019 Setembro 18 6 24
2019 Agosto 12 10 22
2019 Julho 15 8 23
2019 Junho 17 13 30
2019 Maio 18 5 23
2019 Abril 9 12 21
2019 Março 11 11 22
2019 Fevereiro 8 8 16
2019 Janeiro 6 10 16
2018 Dezembro 10 7 17
2018 Novembro 22 2 24
2018 Outubro 24 12 36
2018 Setembro 10 8 18
2018 Maio 5 2 7
2018 Abril 25 4 29
2018 Março 91 25 116
2018 Fevereiro 59 17 76
2018 Janeiro 7 3 10
2017 Novembro 1 3 4
2017 Outubro 2 2 4
Mostrar tudo

Siga este link para acessar o texto completo do artigo

Idiomas
Jornal de Pediatria
en pt
Taxa de publicaçao Publication fee
Os artigos submetidos a partir de 1º de setembro de 2018, que forem aceitos para publicação no Jornal de Pediatria, estarão sujeitos a uma taxa para que tenham sua publicação garantida. O artigo aceito somente será publicado após a comprovação do pagamento da taxa de publicação. Ao submeterem o manuscrito a este jornal, os autores concordam com esses termos. A submissão dos manuscritos continua gratuita. Para mais informações, contate assessoria@jped.com.br. Articles submitted as of September 1, 2018, which are accepted for publication in the Jornal de Pediatria, will be subject to a fee to have their publication guaranteed. The accepted article will only be published after proof of the publication fee payment. By submitting the manuscript to this journal, the authors agree to these terms. Manuscript submission remains free of charge. For more information, contact assessoria@jped.com.br.
Cookies policy Política de cookies
To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here. Utilizamos cookies próprios e de terceiros para melhorar nossos serviços e mostrar publicidade relacionada às suas preferências, analisando seus hábitos de navegação. Se continuar a navegar, consideramos que aceita o seu uso. Você pode alterar a configuração ou obter mais informações aqui.