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    "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 disfun&#231;&#227;o mioc&#225;rdica e a insufici&#234;ncia card&#237;aca foram consideradas causas comuns de morbidez e mortalidade em crian&#231;as com talassemia beta maior&#44; que foram relacionadas principalmente a hem&#243;lise cr&#244;nica e sobrecarga de ferro&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">1</span></a> Contudo&#44; a hipertens&#227;o arterial pulmonar &#40;HAP&#41; surgiu como um importante fator de risco de fun&#231;&#227;o ventricular direita prejudicada desses pacientes&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">1</span></a> A HAP &#233; uma doen&#231;a vascular multifatorial e complexa&#46; O principal mecanismo subjacente da HAP em pacientes talassemia beta ainda n&#227;o &#233; entendido&#46; Foram sugeridos v&#225;rios fatores que interagem&#44; inclusive ativa&#231;&#227;o plaquet&#225;ria&#44; hem&#243;lise cr&#244;nica&#44; angiog&#234;nese disfuncional&#44; estresse oxidativo e sobrecarga de ferro&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">2</span></a> O processo de hem&#243;lise cr&#244;nica na talassemia causa mais produ&#231;&#227;o de hemoglobina livre&#44; que elimina o &#243;xido n&#237;trico que protege contra o dano endotelial vascular e libera enzima arginase na circula&#231;&#227;o&#44; converte L&#8208;arginina para ornitina&#44; passa&#44; assim&#44; a produzir &#243;xido n&#237;trico&#44; que tamb&#233;m serve de mediador para relaxamento vascular&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">3</span></a> A HAP &#233; uma das doen&#231;as proangiog&#234;nicas&#59; contudo&#44; o papel dos fatores angiog&#234;nicos&#44; como o fator de crescimento endotelial vascular &#40;VEGF&#41; na patog&#234;nese de HAP&#44; n&#227;o &#233; bem demonstrado&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">A ecocardiografia convencional &#233; uma ferramenta confi&#225;vel&#44; n&#227;o invasiva&#44; para detec&#231;&#227;o e acompanhamento da press&#227;o arterial pulmonar&#59; contudo&#44; a cateteriza&#231;&#227;o card&#237;aca &#233; o m&#233;todo padr&#227;o de base de diagn&#243;stico de HAP&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">4</span></a> Al&#233;m desses m&#233;todos de diagn&#243;stico tradicionais&#44; os biomarcadores s&#233;ricos relacionados &#224; cepa mioc&#225;rdica ou &#224; patologia subjacente t&#234;m emergido amplamente&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">5</span></a> Como a HAP &#233; uma doen&#231;a progressiva&#44; irrevers&#237;vel com risco de vida&#44; h&#225; urg&#234;ncia de uma ferramenta f&#225;cil&#44; dispon&#237;vel e subjetiva para avaliar o risco e a progress&#227;o individualizados da HAP em crian&#231;as com talassemia beta maior&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">As c&#233;lulas endoteliais vasculares pulmonares s&#227;o um importante regulador de t&#244;nus vascular&#46; O VEGF &#233; um pept&#237;deo angiog&#234;nico potente que regula a prolifera&#231;&#227;o do endot&#233;lico vascular e a permeabilidade vascular e promove neovasculariza&#231;&#227;o&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">6</span></a> Suspeitou&#8208;se que o n&#237;vel elevado no plasma do VEGF &#233; um dos mecanismos envolvidos na remodela&#231;&#227;o vascular e no desenvolvimento de HAP&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">7</span></a> A <span class="elsevierStyleItalic">upregulation</span> &#40;suprarregula&#231;&#227;o&#41; do VEGF foi induzida ao expor pacientes com anemia hemol&#237;tica cr&#244;nica a hip&#243;xia&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">8</span></a> Estudos anteriores relataram eleva&#231;&#227;o das citocinas angiog&#234;nicas na talassemia&#44; como VEGF&#44; fator de crescimento de fibroblasto b&#225;sico&#44; angiogenina&#44; angiopoetina ou VEGF e fator de necrose tumoral&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">9</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Na tentativa de melhorar nosso entendimento do mecanismo patofisiol&#243;gico e dos fatores de risco de HAP em crian&#231;as com talassemia beta maior&#44; fizemos este estudo para exemplificar a associa&#231;&#227;o com o n&#237;vel s&#233;rico do VEGF e a HAP nessas crian&#231;as&#46; Al&#233;m disso&#44; para explorar a rela&#231;&#227;o entre os n&#237;veis s&#233;ricos do VEGF com os dados cl&#237;nicos&#44; as caracter&#237;sticas de quela&#231;&#227;o e a ferritina s&#233;rica nas crian&#231;as com talassemia beta maior&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">M&#233;todos</span><p id="par0025" class="elsevierStylePara elsevierViewall">Este estudo caso&#8208;controle comparativo foi feito em 116 crian&#231;as com diagn&#243;stico confirmado de talassemia beta maior que receberam transfus&#227;o sangu&#237;nea regular de setembro de 2015 a janeiro de 2017&#59; 58 delas apresentaram hipertens&#227;o pulmonar &#40;m&#233;dia da press&#227;o arterial pulmonar<span class="elsevierStyleHsp" style=""></span>&#62; 25<span class="elsevierStyleHsp" style=""></span>mmHg&#41; confirmada por ecocardiografia&#44; ao passo que o restante das 58 crian&#231;as apresentou press&#227;o arterial pulmonar normal&#46; As crian&#231;as que atenderam a nossos crit&#233;rios de inclus&#227;o foram selecionadas consecutivamente do Departamento de Pediatria do Hospital Universit&#225;rio Al&#8208;Zahraa&#44; Al&#8208;Azhar University&#44; Cairo&#44; Egito&#46; Al&#233;m disso&#44; 58 crian&#231;as saud&#225;veis &#40;grupo de controle&#41; que n&#227;o apresentaram doen&#231;a hematol&#243;gica confirmada por hemograma completo&#44; eletroforese de hemoglobina e n&#227;o apresentaram anomalias card&#237;acas confirmadas por ecocardiografia e que atenderam aos mesmos crit&#233;rios de exclus&#227;o do grupo de pacientes&#46; Elas foram selecionadas a partir da idade e sexo pareados das crian&#231;as com talassemia&#46; O consentimento informado por escrito foi obtido dos respons&#225;veis pelas crian&#231;as e a aprova&#231;&#227;o foi fornecida pelo Comit&#234; de &#201;tica da Faculdade de Medicina&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Os crit&#233;rios de inclus&#227;o foram crian&#231;as com talassemia beta maior confirmada por eletroforese de hemoglobina e suas idades variaram de 10 a 13 anos&#46; Elas receberam uma transfus&#227;o sangu&#237;nea regular a cada 1&#8208;2 meses na quantidade m&#233;dia de 150&#8208;250 cc de c&#233;lulas vermelhas do sangue &#40;CVSs&#41; em cada transfus&#227;o&#46; As crian&#231;as com doen&#231;a card&#237;aca cong&#234;nita reum&#225;tica&#44; insufici&#234;ncia card&#237;aca&#44; doen&#231;as cr&#244;nicas sist&#234;micas&#44; exceto talassemia&#44; ou qualquer doen&#231;a aguda concomitante foram exclu&#237;das do estudo&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Hist&#243;rico e exame cl&#237;nico</span><p id="par0035" class="elsevierStylePara elsevierViewall">Foi coletado o hist&#243;rico detalhado e feito exame cl&#237;nico abrangente em todas as crian&#231;as&#46; Os dados em detalhes foram registrados com rela&#231;&#227;o aos dados demogr&#225;ficos&#44; a idade no in&#237;cio da doen&#231;a&#44; a frequ&#234;ncia de transfus&#227;o sangu&#237;nea&#44; a idade no in&#237;cio e o tipo de terapia de quela&#231;&#227;o de ferro&#44; o hist&#243;rico de esplenectomia e quaisquer sintomas de congest&#227;o pulmonar&#44; d&#233;bito card&#237;aco baixo ou insufici&#234;ncia card&#237;aca&#46; Os achados dos exames sist&#234;mico&#44; abdominal e card&#237;aco foram registrados em detalhes&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Os n&#237;veis s&#233;ricos do VEGF e a avalia&#231;&#227;o ecocardiogr&#225;fica foram feitos em todas as crian&#231;as inclu&#237;das&#46; Avaliamos a associa&#231;&#227;o entre o n&#237;vel s&#233;rico do VEGF e da HAP em crian&#231;as com talassemia beta maior e sua rela&#231;&#227;o com outros dados cl&#237;nicos e laboratoriais&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Ecocardiografia</span><p id="par0045" class="elsevierStylePara elsevierViewall">Todos os pacientes e crian&#231;as do grupo de controle foram encaminhados para ecocardiografia &#40;Sistema Philips&#44; modelo HD7&#46;XE&#44; Amsterd&#227;&#41;&#46; A avalia&#231;&#227;o foi feita com v&#225;rios transdutores que variam de 3&#44;5 a 7 MHZ com registro eletrocardiogr&#225;fico simult&#226;neo para possibilitar tempo de fluxo&#46; Foi usada a ecocardiografia modo M e 2D na posi&#231;&#227;o lateral supina e esquerda para estimar a press&#227;o pulmonar e determinar o di&#226;metro das c&#226;maras card&#237;acas&#46;</p><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Medidas do modo M</span><p id="par0050" class="elsevierStylePara elsevierViewall">O modo M foi feito do eixo curto paraesternal do ventr&#237;culo esquerdo ao aplicar a linha do cursor perpendicular no n&#237;vel m&#233;dio papilar para estimar o que segue&#58; dimens&#245;es internas do ventr&#237;culo esquerdo no fim da s&#237;stole e di&#225;stole &#40;LVESD&#44; LVEDD&#41; respectivamente&#44; fra&#231;&#227;o de encurtamento &#40;&#37; FS&#41;&#44; fra&#231;&#227;o de eje&#231;&#227;o &#40;&#37; EF&#41;&#44; di&#226;metro do ventr&#237;culo direito &#40;VD&#41;&#44; espessamento da parede posterior &#40;PP&#41;&#44; espessamento da parede septal&#44; di&#226;metro da aorta &#40;DA&#41; e di&#226;metro do &#225;trio direito &#40;AD&#41;&#46; O valor normal do &#37; EF varia de faixas et&#225;rias de 55&#8208;65&#37; nas crian&#231;as&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Eco bidimensional &#40;eco 2D&#41;&#58; as imagens de eco 2D foram obtidas das vistas paraesternal &#40;eixo longo e curto&#41;&#44; subcostal e apical &#40;quatro apical e cinco c&#226;maras&#41; para avaliar a anatomia e a integridade das v&#225;lvulas atrioventriculares&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Ecocardiografia Doppler</span><p id="par0060" class="elsevierStylePara elsevierViewall">O Doppler de onda pulsada do fluxo das v&#225;lvulas mitral e tric&#250;spide foi obtido das vistas apicais de quatro e cinco c&#226;maras com amostra de volume posicionada na ponta das valvas mitral e tric&#250;spide&#44; a velocidade de influxo transmital e tric&#250;spide foi tra&#231;ada e foram medidas as velocidades disast&#243;lica precoce &#40;E&#41;&#44; diast&#243;lica tardia &#40;A&#41; e a raz&#227;o E&#47;A&#46; O estudo do Doppler cont&#237;nuo das v&#225;lvulas pulmonares e a&#243;rticas foi feito para avaliar o gradiente press&#243;rico sist&#243;lico em todas as v&#225;lvulas pulmonares e a&#243;rticas&#46; A press&#227;o arterial pulmonar sist&#243;lica foi calculada ao obter o gradiente sist&#243;lico m&#225;ximo da regurgita&#231;&#227;o tric&#250;spide e acrescentando o valor da press&#227;o atrial direita&#46; A HAP &#233; definida como a m&#233;dia da press&#227;o arterial pulmonar<span class="elsevierStyleHsp" style=""></span>&#62; 25<span class="elsevierStyleHsp" style=""></span>mm Hg em todas as faixas et&#225;rias&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">10</span></a></p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Investiga&#231;&#245;es laboratoriais</span><p id="par0065" class="elsevierStylePara elsevierViewall">Foram coletados 5<span class="elsevierStyleHsp" style=""></span>mL de amostras de sangue venoso de cada indiv&#237;duo&#44; em uma condi&#231;&#227;o ass&#233;ptica completa&#44; em tubos Vacutainers com gel separador&#46; As amostras de soro foram obtidas ap&#243;s coagula&#231;&#227;o ao coloc&#225;&#8208;las em &#225;gua a 37<span class="elsevierStyleHsp" style=""></span>&#176;C por 20 minutos e serem ent&#227;o centrifugadas a 3&#46;000 rpm por cinco minutos&#46; O soro obtido foi dividido em dois tubos&#44; um foi armazenado a &#8208;70<span class="elsevierStyleHsp" style=""></span>&#176;C para an&#225;lises do VEGF e o segundo foi analisado para ferritina no soro&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">A avalia&#231;&#227;o de VEGF no soro foi feita com os Kits Elisa VEGF para Humanos &#40;Elabscience Biotechnology Co&#44; Ltd&#44; EUA&#41;&#46; O limite de detec&#231;&#227;o do ensaio VEGF foi 9 pg&#47;mL&#44; a precis&#227;o intraensaio foi &#8804; 6 e a precis&#227;o interensaio foi &#8804; 10&#37;&#46; A ferritina s&#233;rica foi medida com o m&#233;todo de ensaio imunossorvente ligado &#224; enzima &#40;Elisa&#41; &#40;Padian Elm Co&#44; Ltd&#44; EUA&#41;&#46; Foram avaliadas as investiga&#231;&#245;es laboratoriais de rotina&#44; como hemograma completo&#44; testes da fun&#231;&#227;o hep&#225;tica e renal&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">An&#225;lise estat&#237;stica</span><p id="par0075" class="elsevierStylePara elsevierViewall">A an&#225;lise estat&#237;stica foi feita com a vers&#227;o 19&#46;0 do Pacote Estat&#237;stico para as Ci&#234;ncias Sociais &#40;SPSS Inc&#46;&#44; Chicago&#44; IL&#44; EUA&#41;&#46; Os dados quantitativos foram expressos como m&#233;dia<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DP&#46; As diferen&#231;as entre os dois grupos foram analisadas com o teste <span class="elsevierStyleItalic">t</span> de Student e o teste U de Mann Whitney independentes&#46; A diferen&#231;a entre mais de dois grupos foi avaliada com a an&#225;lise de vari&#226;ncia unidirecional &#40;Anova&#41; e as diferen&#231;as entre os subgrupos foram analisadas pelo teste de diferen&#231;a m&#237;nima significativa <span class="elsevierStyleItalic">post hoc</span> &#40;DMS&#41;&#46; Os dados n&#227;o program&#225;ticos foram comparados com o teste qui&#8208;quadrado&#46; As correla&#231;&#245;es entre os grupos foram feitas com os coeficientes de correla&#231;&#227;o de Spearman&#46; As curvas da caracter&#237;stica de opera&#231;&#227;o do receptor &#40;ROC&#41; foram usadas para identificar os pontos de corte ideais dos n&#237;veis s&#233;ricos do VEGF na presen&#231;a de HAP&#46; Foi feita a an&#225;lise de regress&#227;o log&#237;stica para determinar os fatores de risco para HAP em crian&#231;as com talassemia beta maior&#46; O valor de p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05 foi significativo e no teste de DMS foi significativo se &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#46;</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Resultados</span><p id="par0080" class="elsevierStylePara elsevierViewall">Este estudo incluiu 116 crian&#231;as com talassemia beta maior &#40;70 meninos e 46 meninas&#41; em transfus&#227;o sangu&#237;nea regular&#46; A idade de in&#237;cio da talassemia beta variou entre 6&#8208;14 meses e a dura&#231;&#227;o da transfus&#227;o variou entre 9&#44;5&#8208;12&#44;5 anos&#59; 46 delas foram submetidas a esplenectomia&#46; Todas elas receberam terapia de quela&#231;&#227;o de ferro &#40;78 receberam deferasirox e 38 receberam deferiprona&#41;&#46; Al&#233;m disso&#44; 58 crian&#231;as saud&#225;veis atuaram como grupo de controle &#40;34 meninos&#44; 24 meninas&#41;&#46; Sua idade variou entre 10&#8208;13 anos&#46; Classificamos as crian&#231;as com talassemia beta em 58 crian&#231;as com HAP e 58 crian&#231;as com valor normal de press&#227;o arterial pulmonar&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">A <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a> mostra os achados demogr&#225;ficos&#44; laboratoriais e ecocardiogr&#225;ficos dos grupos do estudo&#46; A dura&#231;&#227;o da terapia de quela&#231;&#227;o foi significativamente menor em pacientes com talassemia com HAP em compara&#231;&#227;o com os sem HAP &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41;&#46; A hemoglobina e o valor de hemat&#243;critos foram estat&#237;stica e significativamente menores nos casos comparados com os grupos de controle &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; A contagem de plaquetas e a ferritina s&#233;rica foram estat&#237;stica e significativamente maiores nos casos comparados com os grupos de controle &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; A press&#227;o arterial pulmonar&#44; LVEDD&#44; LVESD&#44; espessura da PP&#44; doen&#231;a do septo e di&#226;metro do VD foram estat&#237;stica e significativamente maiores em pacientes com talassemia com HAP em compara&#231;&#227;o com os sem HAP e aos grupos de controle &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; N&#227;o foi encontrada diferen&#231;a significativa entre todas as faixas et&#225;rias&#44; sexo&#44; contagem de leuc&#243;citos&#44; &#37; EF&#44; &#37; FS&#44; di&#226;metro do AD e di&#226;metro da aorta &#40;p<span class="elsevierStyleHsp" style=""></span>&#62; 0&#44;05&#41;&#46; O n&#237;vel s&#233;rico do VEGF foi significativamente maior em pacientes com talassemia com HAP em compara&#231;&#227;o com os sem HAP e os grupos de controle &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Uma an&#225;lise adicional com a DMS <span class="elsevierStyleItalic">post hoc</span> n&#227;o mostrou diferen&#231;a significativa nos n&#237;veis s&#233;ricos do VEGF entre os pacientes com talassemia sem HAP e o grupo de controle &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;110&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">O n&#237;vel s&#233;rico do VEGF no ponto de corte<span class="elsevierStyleHsp" style=""></span>&#62; 169 &#40;pg&#47;mL&#41; apresentou sensibilidade de 93&#44;1&#37; e especificidade de 93&#44;1&#37; na presen&#231;a de HAP em crian&#231;as com talassemia beta maior&#44; conforme demonstrado no estudo da curva ROC&#44; <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a>&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">A an&#225;lise da correla&#231;&#227;o de Spearman mostrou que o n&#237;vel s&#233;rico do VEGF apresentou correla&#231;&#227;o positiva significativa com a ferritina s&#233;rica e a press&#227;o arterial pulmonar &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;399&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#44; r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;706&#44; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#59; respectivamente&#41;&#46; Al&#233;m disso&#44; houve uma correla&#231;&#227;o negativa significativa entre o n&#237;vel s&#233;rico do VEGF e a dura&#231;&#227;o da terapia de quela&#231;&#227;o de ferro nas crian&#231;as com talassemia beta maior&#44; conforme demonstrado &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;392&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41; na <a class="elsevierStyleCrossRef" href="#tbl0020">tabela 2</a>&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">A an&#225;lise de regress&#227;o log&#237;stica demonstrou que houve uma associa&#231;&#227;o estat&#237;stica altamente significativa com a idade de in&#237;cio <span class="elsevierStyleUnderline">&#60;</span><span class="elsevierStyleHsp" style=""></span>6 meses &#40;RC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;5&#59; IC de 95&#37;&#58; 0&#44;428&#8208;0&#44;797&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; ferritina s&#233;rica<span class="elsevierStyleHsp" style=""></span>&#62; 1&#46;000 ng&#47;mL &#40;RC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;002&#59; IC de 95&#37;&#58; 1&#44;001&#8208;2&#44;004&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; VEGF elevado &#8805; 169 pg&#47;mL &#40;RC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;5&#59; IC de 95&#37;&#58; 1&#44;137&#8208;2&#44;065&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;005&#41; e esplenectomia &#40;RC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;58&#59; IC de 95&#37;&#58; 0&#44;084&#8208;0&#44;793&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;018&#41; com o desenvolvimento de HAP nas crian&#231;as com talassemia beta maior&#44; conforme demonstrado na <a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a>&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">Neste estudo&#44; descobrimos que 46 casos foram submetidos a esplenectomia e 70 casos n&#227;o&#46; Com rela&#231;&#227;o ao efeito da esplenectomia&#44; a HAP e o VEGF foram estat&#237;stica e significativamente maiores nos pacientes submetidos a esplenectomia &#91;&#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;007&#41;&#44; &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;11&#41;&#59; respectivamente&#93;&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Discuss&#227;o</span><p id="par0110" class="elsevierStylePara elsevierViewall">O manejo adequado das crian&#231;as com talassemia beta melhora sua qualidade de vida e reduz as comorbidades&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">11</span></a> A ativa&#231;&#227;o endotelial desempenha um papel importante na patog&#234;nese da HAP por meio da remodela&#231;&#227;o vascular e angiog&#234;nese&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">3</span></a> A HAP representa uma complica&#231;&#227;o comum da talassemia beta e a incid&#234;ncia variou de 10&#37; a 75&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">12</span></a> Trabalhamos com a hip&#243;tese de que o n&#237;vel s&#233;rico elevado do VEGF pode refletir a gravidade da remodela&#231;&#227;o vascular pulmonar envolvida no desenvolvimento de HAP&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">A hipertens&#227;o pulmonar &#233; uma doen&#231;a multifatorial progressiva&#46; Nosso estudo demonstrou associa&#231;&#227;o significativa entre a idade de in&#237;cio mais cedo&#44; VEGF elevado&#44; n&#237;veis de ferritina s&#233;rica&#44; esplenectomia e desenvolvimento de HAP em casos de talassemia&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">O VEGF &#233; um importante regulador de prolifera&#231;&#245;es endoteliais&#44; remodela&#231;&#227;o vascular e angiog&#234;nese envolvidas no desenvolvimento e progress&#227;o da HAP&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">13&#44;14</span></a> O papel da superexpress&#227;o do VEGF no desenvolvimento de HAP foi amplamente estudado em modelos com animais e em doen&#231;as n&#227;o hematol&#243;gicas&#46;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">15&#44;16</span></a> A anemia cr&#244;nica reduz a tens&#227;o do oxig&#234;nio e a capacidade de transporte do oxig&#234;nio&#44; leva a um estado est&#225;vel de hip&#243;xia tecidual&#44; um potente estimulador da express&#227;o do mRNA do VEGF&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">17</span></a> Al&#233;m disso&#44; o aumento do VEGF reflete a ativa&#231;&#227;o vascular que pode ser mediada pelo efeito t&#243;xico da terapia de quela&#231;&#227;o ou sobrecarga de ferro&#46; V&#225;rios estudos demonstraram que o n&#237;vel s&#233;rico do VEGF foi elevado em pacientes com anemia hemol&#237;tica cr&#244;nica&#44; inclusive talassemia sozinha ou com outras citocinas angiog&#234;nicas e fator de necrose tumoral&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">9&#44;18&#44;19</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">Nosso achado destaca a associa&#231;&#227;o significativa entre VEGF elevado e HAP nesses pacientes com alta sensibilidade &#40;93&#44;1&#37;&#41; e especificidade &#40;93&#44;1&#37;&#41; no ponto de corte de<span class="elsevierStyleHsp" style=""></span>&#62; 169 &#40;pg&#47;mL&#41;&#46; O n&#237;vel s&#233;rico do VEGF tem correla&#231;&#227;o positiva significativa com a press&#227;o pulmonar&#46; Adicionalmente&#44; VEGF elevado<span class="elsevierStyleHsp" style=""></span>&#62; 169 pg&#47;mL foi associado a 1&#44;5 vez risco mais elevado de desenvolver HAP&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">A sobrecarga de ferro contribui para o desenvolvimento de HAP por meio de v&#225;rios mecanismos&#44; inclusive deposi&#231;&#227;o de ferro no par&#234;nquima do pulm&#227;o&#44; que induz fibrose intersticial&#44; aumento de radicais livres e estresse oxidativo&#44; que geram muitas cascatas inflamat&#243;rias e causam dano vascular&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">20</span></a> A sobrecarga de ferro foi avaliada ao se medir a ferritina s&#233;rica&#44; que mostrou correla&#231;&#227;o positiva significativa com a press&#227;o pulmonar&#44; o que est&#225; de acordo com outros relatos sobre talassemia beta dependente de transfus&#227;o e independente de transfus&#227;o&#46;<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">21&#44;22</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">Estudos anteriores relataram que o uso precoce e regular de quela&#231;&#227;o de ferro reduziu a incid&#234;ncia de hipertens&#227;o pulmonar na talassemia beta ao reduzir a sobrecarga de ferro&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">11&#44;23</span></a> Os modelos em animais revelaram que a quela&#231;&#227;o de ferro reduz a deposi&#231;&#227;o de ferro nos pulm&#245;es e previne complica&#231;&#245;es pulmonares em indiv&#237;duos com talassemia&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">24</span></a> Por&#233;m&#44; isso n&#227;o est&#225; em linha com nossos resultados&#44; que n&#227;o mostraram correla&#231;&#227;o significativa entre a dura&#231;&#227;o da terapia de quela&#231;&#227;o e o desenvolvimento de HAP&#46; Isso pode ser explicado pela dura&#231;&#227;o mais curta do recebimento da terapia de quela&#231;&#227;o de ferro e pela baixa conformidade em nosso estudo em compara&#231;&#227;o a outros estudos&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">No estudo atual&#44; a HAP foi estat&#237;stica e significativamente maior nos pacientes submetidos a esplenectomia&#46; Semelhante a nossos achados&#44; Chueamuangphan et al&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">25</span></a> exemplificaram a forte associa&#231;&#227;o entre a esplenectomia e o aumento do risco de HAP em pacientes com talassemia beta&#46; V&#225;rios mecanismos foram sugeridos para explicar essa associa&#231;&#227;o&#44; inclusive trombocitose&#44; ativa&#231;&#227;o plaquet&#225;ria&#44; aumento de micropart&#237;culas&#44; gl&#243;bulos vermelhos nucleados&#44; <span class="elsevierStyleItalic">upregulation</span> das mol&#233;culas de ades&#227;o vascular e estado de hipercoagulabilidade em pacientes submetidos a esplenectomia&#44; que induz oblitera&#231;&#227;o tromb&#243;tica da vasculatura pulmonar&#46;<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">24&#44;26</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">Al&#233;m disso&#44; este estudo mostrou que o n&#237;vel s&#233;rico do VEGF apresentou correla&#231;&#227;o positiva com a ferritina s&#233;rica em crian&#231;as com talassemia beta &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41;&#46; Em contraste com nossos resultados&#44; outros estudos n&#227;o relataram correla&#231;&#227;o significativa entre os n&#237;veis s&#233;ricos do VEGF e da ferritina&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">18&#44;19&#44;27</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">No estudo atual&#44; o VEGF no soro apresentou uma correla&#231;&#227;o negativa com a dura&#231;&#227;o do recebimento da terapia de quela&#231;&#227;o de ferro &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8208;0&#44;392&#44; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41;&#46; Estudos que exploraram o impacto da quela&#231;&#227;o de ferro sobre a express&#227;o do VEGF mostraram resultados vari&#225;veis que corroboram nossos achados<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">18&#44;28</span></a> ou n&#227;o encontraram correla&#231;&#227;o significativa&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">11&#44;19</span></a> Isso pode ser explicado pela diferente dura&#231;&#227;o do recebimento da terapia de quela&#231;&#227;o de ferro&#44; que afeta a sobrecarga de ferro&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Nosso estudo demonstrou um aumento mais significativo no n&#237;vel s&#233;rico do VEGF nos casos de talassemia p&#243;s&#8208;esplenectomia do que nos casos de talassemia n&#227;o submetidos a esplenectomia&#44; o que coincide com o relatado por Abdel&#8208;Aziz et al&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">9</span></a> e Olgar et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">27</span></a> que a esplenectomia e mais dura&#231;&#227;o da terapia de quela&#231;&#227;o t&#234;m correla&#231;&#227;o negativa com o n&#237;vel s&#233;rico do VEGF&#44; ao passo que o in&#237;cio precoce da transfus&#227;o e a transfus&#227;o sangu&#237;nea frequente apresentaram correla&#231;&#227;o positiva com o n&#237;vel s&#233;rico do VEGF em pacientes com talassemia&#46; Contudo&#44; o estudo anterior n&#227;o revelou correla&#231;&#227;o significativa entre os n&#237;veis de hemoglobina e os n&#237;veis s&#233;ricos do VEGF&#44; o que &#233; compat&#237;vel com nossos achados&#46; A ativa&#231;&#227;o plaquet&#225;ria p&#243;s&#8208;esplenectomia pode contribuir para o aumento dos n&#237;veis do VEGF no sangue perif&#233;rico&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">28</span></a></p><p id="par0160" class="elsevierStylePara elsevierViewall">O n&#237;vel s&#233;rico do VEGF foi maior em pacientes com talassemia beta maior com HAP que nos pacientes sem HAP e nos grupos de controle&#46; O VEGF apresentou correla&#231;&#227;o positiva com a ferritina s&#233;rica e a press&#227;o arterial pulmonar&#46; O n&#237;vel s&#233;rico do VEGF no ponto de corte<span class="elsevierStyleHsp" style=""></span>&#62; 169 &#40;pg&#47;mL&#41; apresentou sensibilidade de 93&#44;1&#37; e especificidade de 93&#44;1&#37; na presen&#231;a de HAP em crian&#231;as com talassemia beta maior&#46; Recomendamos que haja estudos adicionais sobre o mesmo assunto em grande escala de pacientes&#44; avalia&#231;&#227;o da hipertens&#227;o pulmonar por cateteriza&#231;&#227;o&#44; que &#233; mais precisa que a ecocardiografia&#44; e incentivar bom tratamento&#44; manejo adequado e acompanhamento de nossos pacientes com talassemia beta sem HAP para prevenir que eles desenvolvam essa complica&#231;&#227;o possivelmente fatal&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conflitos de interesse</span><p id="par0165" class="elsevierStylePara elsevierViewall">Os autores declaram n&#227;o haver conflitos de interesse&#46;</p></span></span>"
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            1 => "Vascular endothelial growth factor"
            2 => "&#946;&#8208;Thalassemia"
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            2 => "Talassemia beta"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The purpose of this study was to illustrate the association between vascular endothelial growth factor level and pulmonary artery hypertension in children with &#946;&#8208;thalassemia major&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Method</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">This case&#8211;control study was conducted on 116 children with &#946;&#8208;thalassemia major&#59; 58 of them had pulmonary artery hypertension&#46; They were compared to 58 healthy children who were age and sex&#8208;matched &#40;control group&#41;&#46; Serum levels of vascular endothelial growth factor and echocardiographic assessment were done for all children&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Vascular endothelial growth factor serum level was significantly higher in children with &#946;&#8208;thalassemia major with pulmonary artery hypertension than in those without pulmonary artery hypertension&#44; as well as in control groups &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; Vascular endothelial growth factor serum level had a significant positive correlation with pulmonary artery pressure and serum ferritin&#44; as well as a significant negative correlation with the duration of chelation therapy&#46; Logistic regression analysis revealed that elevated vascular endothelial growth factor &#40;Odd Ratio<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;5&#59; 95&#37; Confidence Interval&#44; 1&#46;137&#8211;2&#46;065&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;005&#41; was an independent risk factor of pulmonary artery hypertension in such children&#46; Vascular endothelial growth factor serum level at a cutoff point of &#62;169<span class="elsevierStyleHsp" style=""></span>pg&#47;mL had 93&#46;1&#37; sensitivity and 93&#46;1&#37; specificity for the presence of pulmonary artery hypertension in children with &#946;&#8208;thalassemia major&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Elevated vascular endothelial growth factor serum level is associated with pulmonary artery hypertension in children with &#946;&#8208;thalassemia&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A finalidade deste estudo foi exemplificar a associa&#231;&#227;o entre o n&#237;vel de fator de crescimento endotelial vascular e a hipertens&#227;o arterial pulmonar em crian&#231;as com talassemia beta maior&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todo</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Este estudo caso&#8208;controle foi realizado em 116 crian&#231;as com talassemia beta maior&#59; 58 das quais apresentaram hipertens&#227;o arterial pulmonar em compara&#231;&#227;o com 58 crian&#231;as saud&#225;veis pareadas por idade e sexo &#40;grupo de controle&#41;&#46; Os n&#237;veis s&#233;ricos do fator de crescimento endotelial vascular e a avalia&#231;&#227;o ecocardiogr&#225;fica foram realizados em todas as crian&#231;as&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">O n&#237;vel s&#233;rico do fator de crescimento endotelial vascular foi significativamente maior em crian&#231;as com talassemia beta maior com hipertens&#227;o arterial pulmonar que as crian&#231;as sem hipertens&#227;o arterial pulmonar e os grupos de controle &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; O n&#237;vel s&#233;rico do fator de crescimento endotelial vascular apresentou uma correla&#231;&#227;o positiva significativa com a press&#227;o arterial pulmonar e a ferritina s&#233;rica e correla&#231;&#227;o negativa significativa com a dura&#231;&#227;o da terapia de quela&#231;&#227;o&#46; A an&#225;lise de regress&#227;o log&#237;stica revelou que o fator de crescimento endotelial vascular elevado &#40;RC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;5&#59; IC de 95&#37;&#58; 1&#44;137&#8208;2&#44;065&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;005&#41; foi um fator de risco independente de hipertens&#227;o arterial pulmonar nessas crian&#231;as&#46; O n&#237;vel s&#233;rico do fator de crescimento endotelial vascular no ponto de corte<span class="elsevierStyleHsp" style=""></span>&#62; 169 &#40;pg&#47;mL&#41; apresentou 93&#44;1&#37; de sensibilidade e 93&#44;1&#37; de especificidade na presen&#231;a de hipertens&#227;o arterial pulmonar em crian&#231;as com talassemia beta maior&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#227;o</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">O n&#237;vel s&#233;rico do fator de crescimento endotelial vascular elevado est&#225; associado &#224; hipertens&#227;o arterial pulmonar em crian&#231;as com talassemia beta&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Objetivo"
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          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "M&#233;todo"
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          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
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          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclus&#227;o"
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    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Como citar este artigo&#58; Alkholy UM&#44; Mohamed SA&#44; Elhady M&#44; Attar SE&#44; Abdalmonem N&#44; Zaki A&#46; Vascular endothelial growth factor and pulmonary hypertension in children with beta thalassemia major&#46; J Pediatr &#40;Rio J&#41;&#46; 2019&#59;95&#58;593&#8211;9&#46;</p>"
      ]
    ]
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        "descripcion" => array:1 [
          "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Estudo da curva ROC no qual o n&#237;vel s&#233;rico do VEGF no ponto de corte<span class="elsevierStyleHsp" style=""></span>&#62; 169 &#40;pg&#47;mL&#41; com &#225;rea abaixo da curva de 0&#44;956 apresentou sensibilidade de 93&#44;1&#37; e especificidade de 93&#44;1&#37; na presen&#231;a de HAP em crian&#231;as com talassemia beta maior&#46;</p>"
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        "etiqueta" => "Tabela 1"
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        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
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        "tabla" => array:3 [
          "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">&#37; EF&#44; fra&#231;&#227;o de eje&#231;&#227;o&#59; &#37; FS&#44; fra&#231;&#227;o de encurtamento&#59; AD&#44; &#225;trio direito&#59; AS&#44; altamente significativo&#59; DMS&#44; diferen&#231;a menos significativa&#59; GBs&#44; gl&#243;bulos brancos&#59; HAP&#44; hipertens&#227;o arterial pulmonar&#59; Hb&#44; hemoglobina&#59; LVEED&#44; dimens&#227;o diast&#243;lica final do ventr&#237;culo esquerdo&#59; LVESD&#44; dimens&#227;o sist&#243;lica final do ventr&#237;culo esquerdo&#59; PCV&#44; volume de c&#233;lulas compactadas&#59; PP&#44; parede posterior&#59; Sig&#44; significativo&#59; VD&#44; ventr&#237;culo direito&#59; VEGF&#44; fator de crescimento endotelial vascular&#46;</p>"
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                  \t\t\t\t" scope="col">Talassemia com HAP&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>58&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">20 &#40;43&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">11&#44;66<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;70&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">186&#44;94&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;<span class="elsevierStyleHsp" style=""></span>0&#44;0001AS&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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"><span class="elsevierStyleHsp" style=""></span>PCV &#37;&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">24&#44;89<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#44;93&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;32<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>19&#44;40&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">37&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;99&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;32&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;<span class="elsevierStyleHsp" style=""></span>0&#44;0001AS&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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"><span class="elsevierStyleHsp" style=""></span>GBs &#40;10<span class="elsevierStyleSup">3</span>&#47;mm<span class="elsevierStyleSup">3</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">10&#44;09<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;59&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;61<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#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">8&#44;24<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;01&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;82&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;065&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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"><span class="elsevierStyleHsp" style=""></span>Plaquetas &#40;10<span class="elsevierStyleSup">3</span>&#47;mm<span class="elsevierStyleSup">3</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">437&#44;44<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>286&#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">455&#44;93<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>220&#44;88&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">297&#44;60<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>62&#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">10&#44;95&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;<span class="elsevierStyleHsp" style=""></span>0&#44;0001AS&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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"><span class="elsevierStyleHsp" style=""></span>Ferritina &#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">2977&#44;60<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>986&#44;95&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">1843&#44;74<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>519&#44;01&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">73&#44;75<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>24&#44;67&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">145&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001 AS&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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"><span class="elsevierStyleHsp" style=""></span>VEGF &#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">208&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>57&#44;982&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">156&#44;275<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#44;661&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">141&#44;118<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#44;403&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">28&#44;55&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;<span class="elsevierStyleHsp" style=""></span>0&#44;0001 AS&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;<span class="elsevierStyleHsp" style=""></span>0&#44;0001<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>0&#44;110<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Dados ecocardiogr&#225;ficos</span></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"><span class="elsevierStyleHsp" style=""></span>Press&#227;o pulmonar &#40;mmHg&#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">40&#44;55<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#44;59&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;48<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;52&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;14<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;33&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">190&#44;54&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;<span class="elsevierStyleHsp" style=""></span>0&#44;0001 AS&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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"><span class="elsevierStyleHsp" style=""></span>Escore Z da LVEDD &#40;mm&#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;37<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;82&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<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;66&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;23<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;84&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;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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001 AS&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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"><span class="elsevierStyleHsp" style=""></span>Escore Z da LVESD &#40;mm&#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;42<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;79&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;86<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;55&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;52<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;80&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">15&#44;17&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;<span class="elsevierStyleHsp" style=""></span>0&#44;0001 AS&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="" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;005 Sig&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;703&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Escore Z da aorta &#40;mm&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;32<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;18&nbsp;\t\t\t\t\t\t\n
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                  \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">Dura&#231;&#227;o da doen&#231;a&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
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                  \t\t\t\t">0&#44;093&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#44;482&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
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hemoglobina &#40;gm&#47;dl&#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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8208;0&#44;047&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#44;752&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">Ferritina s&#233;rica &#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="char" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \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
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                  \t\t\t\t">Press&#227;o pulmonar &#40;mmHg&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Dura&#231;&#227;o da terapia de quela&#231;&#227;o &#40;anos&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8208;0&#44;392&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;002 Sig&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2139647.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Correla&#231;&#227;o entre o n&#237;vel s&#233;rico do VEGF e outros par&#226;metros</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0015"
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        "tipo" => "MULTIMEDIATABLA"
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        "detalles" => array:1 [
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">B&#44; coeficiente&#59; ER&#44; erro&#8208;padr&#227;o&#59; HAP&#44; hipertens&#227;o arterial pulmonar&#59; IC&#44; intervalo de confian&#231;a&#59; VEGF&#44; fator de crescimento endotelial vascular&#59; Wald&#44; teste qui&#8208;quadrado de Wald&#46;</p>"
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Inferior&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">VEGF&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#44;152&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">2&#44;065&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
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                  \t\t\t\t">Idade no in&#237;cio&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#8208;0&#44;537&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#44;797&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">Dura&#231;&#227;o da doen&#231;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#44;281&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">2&#44;631&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;577&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;910&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;733&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">Hemoglobina&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;086&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#44;203&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#44;672&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;090&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#44;732&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;622&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">Ferritina s&#233;rica&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="char" 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><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#44;001&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;209&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="char" valign="\n
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                  \t\t\t\t">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#44;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#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">Dura&#231;&#227;o da terapia de quela&#231;&#227;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardiac complications in thalassemia major"
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                        0 => array:2 [
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                          "autores" => array:1 [
                            0 => "J&#46;C&#46; Wood"
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                      "doi" => "10.3109/03630260903347526"
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                        "tituloSerie" => "Hemoglobin"
                        "fecha" => "2009"
                        "volumen" => "33"
                        "paginaInicial" => "S81"
                        "paginaFinal" => "S86"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20001637"
                            "web" => "Medline"
                          ]
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pulmonary hypertension associated with thalassemia syndromes"
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                        0 => array:2 [
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                          "autores" => array:2 [
                            0 => "D&#46;R&#46; Fraidenburg"
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                    0 => array:2 [
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                        "tituloSerie" => "Ann N Y Acad Sci"
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                        "paginaInicial" => "127"
                        "paginaFinal" => "139"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27008311"
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                          ]
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              "identificador" => "bib0155"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hematological disorders and pulmonary hypertension"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "R&#46; Mathew"
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                            2 => "J&#46;M&#46; Wu"
                            3 => "J&#46;T&#46; Fallon"
                            4 => "M&#46;H&#46; Gewitz"
                          ]
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                    ]
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                    0 => array:2 [
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                        "tituloSerie" => "World J Cardiol"
                        "fecha" => "2016"
                        "volumen" => "8"
                        "paginaInicial" => "703"
                        "paginaFinal" => "718"
                        "link" => array:1 [
                          0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "The value of tools to assess pulmonary arterial hypertension"
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                          "etal" => false
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                        "tituloSerie" => "Eur Respir Rev"
                        "fecha" => "2011"
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                        "paginaInicial" => "222"
                        "paginaFinal" => "235"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22130815"
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                        "tituloSerie" => "Front Pediatr"
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                    0 => array:2 [
                      "titulo" => "Current insights on the biology and clinical aspects of VEGF regulation"
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                            3 => "R&#46;A&#46; Chaer"
                          ]
                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Vasc Endovasc Surg"
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                        "paginaInicial" => "517"
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                      "titulo" => "The critical role of vascular endothelial growth factor in pulmonary vascular remodeling after lung injury"
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                        "tituloSerie" => "Shock"
                        "fecha" => "2007"
                        "volumen" => "28"
                        "paginaInicial" => "4"
                        "paginaFinal" => "14"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17510598"
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                            4 => "H&#46; Becker"
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                  "host" => array:1 [
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                        "tituloSerie" => "Strahlenther Onkol"
                        "fecha" => "2002"
                        "volumen" => "178"
                        "paginaInicial" => "436"
                        "paginaFinal" => "441"
                        "link" => array:1 [
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                    0 => array:2 [
                      "titulo" => "Serum vascular endothelial growth factor in children with beta thalassemia major"
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                            3 => "E&#46;M&#46; Sedek"
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                        "tituloSerie" => "JMSCR"
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                        "paginaInicial" => "14955"
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                    0 => array:2 [
                      "titulo" => "Introduction to echocardiography"
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                        0 => array:2 [
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                      "titulo" => "Vascular endothelial growth factor in children with thalassemia major"
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                    0 => array:2 [
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                        "tituloSerie" => "Mediterr J Hematol Infect Dis"
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                        "volumen" => "5"
                        "paginaInicial" => "e2013044"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23795282"
                            "web" => "Medline"
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                    0 => array:2 [
                      "titulo" => "Pulmonary hypertension in patients with thalassemia major"
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                            2 => "E&#46; Milgram"
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                            4 => "A&#46; Koren"
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                    0 => array:2 [
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                        "tituloSerie" => "Am Heart J"
                        "fecha" => "1997"
                        "volumen" => "134"
                        "paginaInicial" => "532"
                        "paginaFinal" => "537"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9327712"
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                      "titulo" => "The role of vascular endothelial growth factor in pulmonary arterial hypertension&#46; The angiogenesis paradox"
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                          "autores" => array:2 [
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                    0 => array:2 [
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                        "tituloSerie" => "Am J Respir Cell Mol Biol"
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                        "volumen" => "51"
                        "paginaInicial" => "474"
                        "paginaFinal" => "484"
                        "link" => array:1 [
                          0 => array:2 [
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                    0 => array:2 [
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              "identificador" => "bib0220"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Plasma vascular endothelial growth factor A and placental growth factor&#58; novel biomarkers of pulmonary hypertension in congenital diaphragmatic hernia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "N&#46; Patel"
                            1 => "F&#46; Moenkemeyer"
                            2 => "S&#46; Germano"
                            3 => "M&#46; Cheung"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1152/ajplung.00261.2014"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Physiol Lung Cell Mol Physiol"
                        "fecha" => "2015"
                        "volumen" => "308"
                        "paginaInicial" => "L378"
                        "paginaFinal" => "L383"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25480334"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Expression of VEGF and its receptors Flt&#8208;1 and Flk&#8208;1&#47;KDR is altered in lambs with increased pulmonary blood flow and pulmonary hypertension"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "E&#46; Mata-Greenwood"
                            1 => "B&#46; Meyrick"
                            2 => "S&#46;J&#46; Soifer"
                            3 => "J&#46;R&#46; Fineman"
                            4 => "S&#46;M&#46; Black"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1152/ajplung.00388.2002"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Physiol Lung Cell Mol Physiol"
                        "fecha" => "2003"
                        "volumen" => "285"
                        "paginaInicial" => "L222"
                        "paginaFinal" => "L231"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12665467"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Correlation of vascular endothelial growth factor with the severity of thalassemia intermedia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Shitrit"
                            1 => "H&#46; Tamary"
                            2 => "A&#46; Koren"
                            3 => "C&#46; Levin"
                            4 => "B&#46; Shitrit"
                            5 => "J&#46; Sulkes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Blood Coagul Fibrinol"
                        "fecha" => "2008"
                        "volumen" => "19"
                        "paginaInicial" => "611"
                        "paginaFinal" => "614"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The relationship between serum vascular endothelial growth factor &#40;SVEGF&#41; and beta thalassemia major"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46; Farokhi"
                            1 => "J&#46; Razaviyan"
                            2 => "M&#46; Kosaryan"
                            3 => "M&#46; Roudbari"
                            4 => "S&#46; Reykande"
                            5 => "A&#46; Aliasghariyan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Int J Med Invest"
                        "fecha" => "2015"
                        "volumen" => "4"
                        "paginaInicial" => "289"
                        "paginaFinal" => "292"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pulmonary hypertension in non&#8208;transfusion&#8208;dependent thalassemia&#58; correlation with clinical parameters&#44; liver iron concentration&#44; and non&#8208;transferrin&#8208;bound iron"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46; Inthawong"
                            1 => "P&#46; Charoenkwan"
                            2 => "S&#46; Silvilairat"
                            3 => "A&#46; Tantiworawit"
                            4 => "A&#46; Phrommintikul"
                            5 => "W&#46; Choeyprasert"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1179/1607845415Y.0000000014"
                      "Revista" => array:6 [
                        "tituloSerie" => "Hematology"
                        "fecha" => "2015"
                        "volumen" => "20"
                        "paginaInicial" => "610"
                        "paginaFinal" => "617"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25964094"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pulmonary hypertension in children with &#946; thalassemia major&#44; are splenectomy and high&#8208;ferritin levels related or not&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46; Dedeoglu"
                            1 => "H&#46; Bornaun"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/MPH.0000000000000803"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr Hematol Oncol"
                        "fecha" => "2017"
                        "volumen" => "39"
                        "paginaInicial" => "259"
                        "paginaFinal" => "265"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28234742"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Elevated liver iron concentration is a marker of increased morbidity in patients with beta thalassemia intermedia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46;M&#46; Musallam"
                            1 => "M&#46;D&#46; Cappellini"
                            2 => "J&#46;C&#46; Wood"
                            3 => "I&#46; Motta"
                            4 => "G&#46; Graziadei"
                            5 => "H&#46; Tamim"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3324/haematol.2011.047852"
                      "Revista" => array:6 [
                        "tituloSerie" => "Haematologica"
                        "fecha" => "2011"
                        "volumen" => "96"
                        "paginaInicial" => "1605"
                        "paginaFinal" => "1612"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21791471"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "23"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pulmonary hypertension in well&#8208;transfused thalassemia major patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46; Meloni"
                            1 => "J&#46; Detterich"
                            2 => "A&#46; Pepe"
                            3 => "P&#46; Harmatz"
                            4 => "T&#46;D&#46; Coates"
                            5 => "J&#46;C&#46; Wood"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.bcmd.2014.11.003"
                      "Revista" => array:6 [
                        "tituloSerie" => "Blood Cells Mol Dis"
                        "fecha" => "2015"
                        "volumen" => "54"
                        "paginaInicial" => "189"
                        "paginaFinal" => "194"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25488617"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0260"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effects of iron chelators on pulmonary iron overload and oxidative stress in &#946;&#8208;thalassemic mice"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
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                            1 => "N&#46;P&#46; Morales"
                            2 => "U&#46; Chaisri"
                            3 => "S&#46; Wichaiyo"
                            4 => "W&#46; Hemstapat"
                            5 => "S&#46; Srichairatanakool"
                          ]
                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000438994"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pharmacology"
                        "fecha" => "2015"
                        "volumen" => "96"
                        "paginaInicial" => "192"
                        "paginaFinal" => "199"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26316149"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical indicators for pulmonary arterial hypertension in thalassemia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46; Chueamuangphan"
                            1 => "W&#46; Wongtheptien"
                            2 => "W&#46; Nawarawong"
                            3 => "A&#46; Sukornthasarn"
                            4 => "S&#46; Chuncharunee"
                            5 => "C&#46; Tawichasri"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Med Assoc Thai"
                        "fecha" => "2012"
                        "volumen" => "95"
                        "paginaInicial" => "16"
                        "paginaFinal" => "21"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22379736"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0270"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Post splenectomy related pulmonary hypertension"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46;V&#46; Palkar"
                            1 => "A&#46; Agrawal"
                            2 => "S&#46; Verma"
                            3 => "A&#46; Iftikhar"
                            4 => "E&#46;J&#46; Miller"
                            5 => "A&#46; Talwar"
                          ]
                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.5320/wjr.v5.i2.69"
                      "Revista" => array:6 [
                        "tituloSerie" => "World J Respirol"
                        "fecha" => "2015"
                        "volumen" => "5"
                        "paginaInicial" => "69"
                        "paginaFinal" => "77"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26949600"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of angiogenesis with vascular endothelial growth factor in patients with thalassemia major"
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                          "etal" => false
                          "autores" => array:5 [
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                            1 => "A&#46; Kara"
                            2 => "H&#46; Hicyilmaz"
                            3 => "N&#46; Balta"
                            4 => "D&#46; Canatan"
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                        ]
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                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1442-200X.2009.02956.x"
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                        "tituloSerie" => "Pediatr Int"
                        "fecha" => "2010"
                        "volumen" => "52"
                        "paginaInicial" => "247"
                        "paginaFinal" => "251"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19744226"
                            "web" => "Medline"
                          ]
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                    0 => array:2 [
                      "titulo" => "Study of platelet activation&#44; hypercoagulable state&#44; and the association with pulmonary hypertension in children with &#946;&#8208;thalassemia"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
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                            1 => "H&#46;E&#46; Abdel-Hady"
                            2 => "M&#46;M&#46; Hafez"
                            3 => "O&#46;S&#46; Salama"
                            4 => "Y&#46;A&#46; Al-Tonbary"
                          ]
                        ]
                      ]
                    ]
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                    0 => array:2 [
                      "doi" => "10.1016/j.hemonc.2017.05.028"
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                        "tituloSerie" => "Hematol Oncol Stem Cell Ther"
                        "fecha" => "2018"
                        "volumen" => "11"
                        "paginaInicial" => "65"
                        "paginaFinal" => "74"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28633041"
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