array:23 [
  "pii" => "S2341287914001094"
  "issn" => "23412879"
  "doi" => "10.1016/j.anpede.2014.10.001"
  "estado" => "S300"
  "fechaPublicacion" => "2015-01-01"
  "aid" => "1754"
  "copyright" => "Asociación Española de Pediatría"
  "copyrightAnyo" => "2014"
  "documento" => "article"
  "subdocumento" => "sco"
  "cita" => "An Pediatr (Barc). 2015;82:4-5"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 2300
    "formatos" => array:3 [
      "EPUB" => 117
      "HTML" => 1770
      "PDF" => 413
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:18 [
      "pii" => "S169540331400513X"
      "issn" => "16954033"
      "doi" => "10.1016/j.anpedi.2014.10.020"
      "estado" => "S300"
      "fechaPublicacion" => "2015-01-01"
      "aid" => "1754"
      "copyright" => "Asociación Española de Pediatría"
      "documento" => "article"
      "subdocumento" => "sco"
      "cita" => "An Pediatr (Barc). 2015;82:4-5"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:2 [
        "total" => 7765
        "formatos" => array:3 [
          "EPUB" => 141
          "HTML" => 6981
          "PDF" => 643
        ]
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">EDITORIAL</span>"
        "titulo" => "Introducci&#243;n del gluten y riesgo de enfermedad cel&#237;aca"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "4"
            "paginaFinal" => "5"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Gluten introduction and coeliac disease risk"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "C&#46; Ribes Koninckx"
            "autores" => array:1 [
              0 => array:2 [
                "nombre" => "C&#46;"
                "apellidos" => "Ribes Koninckx"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2341287914001094"
          "doi" => "10.1016/j.anpede.2014.10.001"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287914001094?idApp=UINPBA00005H"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S169540331400513X?idApp=UINPBA00005H"
      "url" => "/16954033/0000008200000001/v1_201501010024/S169540331400513X/v1_201501010024/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S2341287914001227"
    "issn" => "23412879"
    "doi" => "10.1016/j.anpede.2014.02.002"
    "estado" => "S300"
    "fechaPublicacion" => "2015-01-01"
    "aid" => "1553"
    "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
    "documento" => "article"
    "subdocumento" => "fla"
    "cita" => "An Pediatr &#40;Barc&#41;. 2015;82:6-11"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 1737
      "formatos" => array:3 [
        "EPUB" => 136
        "HTML" => 1123
        "PDF" => 478
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Has the presence of parents during invasive procedures in the emergency department increased in the last few years&#63;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "6"
          "paginaFinal" => "11"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "&#191;Ha aumentado la presencia de los padres durante los procedimientos invasivos en urgencias en los &#250;ltimos a&#241;os&#63;"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1247
              "Ancho" => 1667
              "Tamanyo" => 79927
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Acceptance by health care staff according to the invasiveness of the procedures&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "J&#46; Angel Sol&#224;, S&#46; Sagu&#233; Bravo, C&#46; Parra Cotanda, V&#46; Trenchs Sainz de la Maza, C&#46; Luaces Cubells"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Angel Sol&#224;"
            ]
            1 => array:2 [
              "nombre" => "S&#46;"
              "apellidos" => "Sagu&#233; Bravo"
            ]
            2 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Parra Cotanda"
            ]
            3 => array:2 [
              "nombre" => "V&#46;"
              "apellidos" => "Trenchs Sainz de la Maza"
            ]
            4 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Luaces Cubells"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S1695403314000824"
        "doi" => "10.1016/j.anpedi.2014.02.004"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403314000824?idApp=UINPBA00005H"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287914001227?idApp=UINPBA00005H"
    "url" => "/23412879/0000008200000001/v1_201501110050/S2341287914001227/v1_201501110050/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S234128791400132X"
    "issn" => "23412879"
    "doi" => "10.1016/j.anpede.2014.10.005"
    "estado" => "S300"
    "fechaPublicacion" => "2015-01-01"
    "aid" => "1741"
    "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
    "documento" => "article"
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "sco"
    "cita" => "An Pediatr &#40;Barc&#41;. 2015;82:1-3"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1597
      "formatos" => array:3 [
        "EPUB" => 129
        "HTML" => 1077
        "PDF" => 391
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
      "titulo" => "Role of parents in paediatric emergencies&#58; Tradition&#44; conflict or improvement&#63;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "1"
          "paginaFinal" => "3"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Papel de los padres en las urgencias pedi&#225;tricas&#58; &#191;tradici&#243;n&#44; conflicto o mejor&#237;a&#63;"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "J&#46; Gonz&#225;lez del Rey"
          "autores" => array:1 [
            0 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Gonz&#225;lez del Rey"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S169540331400469X"
        "doi" => "10.1016/j.anpedi.2014.10.007"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S169540331400469X?idApp=UINPBA00005H"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S234128791400132X?idApp=UINPBA00005H"
    "url" => "/23412879/0000008200000001/v1_201501110050/S234128791400132X/v1_201501110050/en/main.assets"
  ]
  "en" => array:12 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
    "titulo" => "Gluten introduction and coeliac disease risk"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "4"
        "paginaFinal" => "5"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "C&#46; Ribes Koninckx"
        "autores" => array:1 [
          0 => array:3 [
            "nombre" => "C&#46;"
            "apellidos" => "Ribes Koninckx"
            "email" => array:1 [
              0 => "ribes&#95;car&#64;gva&#46;es"
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Hospital Universitari i Polit&#232;cnic La Fe&#44; Valencia&#44; Spain"
            "identificador" => "aff0005"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Introducci&#243;n del gluten y riesgo de enfermedad cel&#237;aca"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Based on previous epidemiological studies on celiac disease &#40;CD&#41;&#44; especially those by Anneli Ivarsson and collaborators on the so called Swedish CD epidemic in the mid 1980s&#44; in the last decade it has been hypothesized that early introduction of small quantities of gluten&#44; preferably during a period of breastfeeding&#44; may reduce the risk of CD&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Moreover a study by Norris et al reported that in infants at genetic risk&#44; introduction of gluten at &#8804;3 months of age or at &#8805;7 months was associated with a higher risk of CD autoimmunity and of CD development&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Thus a &#8220;window of opportunity&#8221; for gluten introduction between 4 and 6 months of age was almost generally accepted by the scientific community&#46; Accordingly the ESPGHAN Committee on Nutrition recommended avoiding gluten introduction before 4 months or later than 6 months of age&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">To specifically investigate the potential of CD prevention through dietary intervention&#44; a prospective European multicenter project &#8220;Prevent Coeliac Disease&#8221; &#40;PreventCD&#44; <a id="intr0010" class="elsevierStyleInterRef" href="http://www.preventcd.com/">www&#46;preventcd&#46;com</a>&#44; FP6-2005-FOOD-4B-36383 &#8211; PREVENTCD&#41; was carried out in which the collaboration between hospitals&#44; universities&#44; laboratories and industries from 7 European countries and Israel&#44; was achieved&#44; under the coordination of the Leiden University Medical Center&#44; the Netherlands&#46; The results of this investigation have been published in the 2 October issue of the NEJM&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In summary&#44; 994 infants at high risk for CD&#44; because of having one first degree relative already diagnosed with CD &#40;father&#44; mother or sibling&#41; and carrying at least one HLA risk gene &#40;DQ2 and&#47;or DQ8&#41; were recruited shortly after birth&#46; After informed consent from the parents was obtained they were blindly randomized to receive&#44; at 16 weeks of age&#44; either 100<span class="elsevierStyleHsp" style=""></span>mg of gluten daily or placebo &#40;lactose&#41; and breast feeding was strongly encouraged&#46; At 24 weeks of age a fixed progressively increasing gluten intake was advised for both groups and after 11 months of age free gluten consumption was allowed&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Up to the age of 3 years&#44; the participants were screened for the development of celiac disease by determination of celiac antibodies &#40;anti-tissue transglutaminase antibodies&#41; in serum&#46; In addition&#44; health status&#44; growth and feeding habits &#40;breastfeeding&#44; formula feeding and gluten consumption&#41; were monitored&#46; Celiac disease was diagnosed according to the accepted European guidelines and involves small bowel biopsies in the vast majority of the cases&#46; The study endpoint was the frequency of celiac disease at the age of 3 years&#44; which was found to be 5&#46;2&#37; in the whole cohort&#46; No differences in incidence were observed between children that had been introduced to gluten at 16 weeks and those that received placebo and no gluten untill the age of 24 weeks&#46; Moreover CD development was neither influenced by the duration of breastfeeding nor by continuing breastfeeding during gluten introduction&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The authors conclude &#8220;<span class="elsevierStyleItalic">the introduction of small quantities of gluten at 16 to 24 weeks of age did not reduce CD risk</span>&#8221;&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Other environmental factors such as rotavirus vaccination&#44; gastrointestinal or respiratory tract infection&#44; were also not related to the development of CD&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">In the same issue of NEJM an Italian multicenter study addresses the hypothesis that delaying gluten introduction till 12 months of age in at-risk infants may reduce the risk of CD development&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Although at 2 years of age a statistically significant higher percentage of infants which had gluten introduced at 6 months had developed CD&#44; as compared to those with gluten introduced after 12 months &#40;12&#37; vs 5&#37;&#41;&#44; at 5 and 10 years of age the differences between the 2 groups were no longer statistically significant&#46; At 10 years of age 25&#46;8&#37; of children with high-risk phenotype &#40;DQ2&#47;DQ2&#41; had overt CD as compared to 15&#46;8&#37; in those bearing other at-risk phenotypes&#46; Although the authors suggest that delaying CD development to later ages may have some potential benefit on developing organs such as the brain&#44; there is no evidence to support this premise&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The authors conclude &#8220;<span class="elsevierStyleItalic">neither the delayed introduction of gluten nor breastfeeding modified the risk of CD among at-risk infants&#44; although the later introduction of gluten was associated with a delayed onset of the disease&#8221;</span><a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Thus both studies come to the same main conclusions&#44; i&#46;e&#46; in at-high-risk infants neither the timing of gluten introduction nor the duration of breastfeeding and the continuation of breast feeding during gluten introduction have proven to exert a protective effect on CD development&#46; Carrying the DQ2&#47;DQ2 genotype was found by the two investigation groups to be an important predictive factor for CD&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The relevant consequences of these studies are that no clear recommendations on gluten introduction in at-risk infants can be established&#46; In addition other environmental factors have been found not to be related to disease development&#44; thus leaving research in this field open to intriguing and exciting new investigation hypothesis&#46; In the short term&#44; special attention will be paid to the potential impact of gut microbiota particularly in early life&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">An additional issue is if data obtained for at-risk infants&#44; such as the populations included in both studies&#44; can be extrapolated to the general infant population&#44; thus not supporting current European guidelines on complementary feeding which recommend gluten introduction not earlier than 4 and not later than 7 months&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">Faced to the anguish of parents looking for advice to prevent CD development&#44; pediatricians have to deal with a difficult situation as at the moment no evidence supports any specific recommendation neither on the timing nor on the pattern of gluten introduction&#46; However&#44; in agreement with the general recommendations of the ESPGHAN committee on Nutrition not to delay complementary feeding introduction beyond 26 weeks of age&#44; introduction of gluten at around 6 months seems&#44; for the time being&#44; a reasonable and sensible option&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Ribes Koninckx C&#46; Introducci&#243;n del gluten y riesgo de enfermedad cel&#237;aca&#46; An Pediatr &#40;Barc&#41;&#46; 2015&#59;82&#58;4&#8211;5&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:5 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemic of coeliac disease in Swedish children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Ivarsson"
                            1 => "Persson L&#197;"
                            2 => "L&#46; Nystr&#246;m"
                            3 => "H&#46; Ascher"
                            4 => "B&#46; Cavell"
                            5 => "L&#46; Danielsson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Acta Paediatr"
                        "fecha" => "2000"
                        "volumen" => "89"
                        "paginaInicial" => "165"
                        "paginaFinal" => "171"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10709885"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0302283812005015"
                          "estado" => "S300"
                          "issn" => "03022838"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk of celiac disease autoimmunity and timing of gluten introduction in the diet of infants at increased risk of disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;M&#46; Norris"
                            1 => "K&#46; Barriga"
                            2 => "E&#46;J&#46; Hoffenberg"
                            3 => "I&#46; Taki"
                            4 => "D&#46; Miao"
                            5 => "J&#46;E&#46; Haas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Am Med Assoc"
                        "fecha" => "2005"
                        "volumen" => "293"
                        "paginaInicial" => "2343"
                        "paginaFinal" => "2351"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Complementary feeding&#58; a commentary by the ESPGHAN Committee on Nutrition"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Agostoni"
                            1 => "C&#46; Braegger"
                            2 => "T&#46; Decsi"
                            3 => "S&#46; Kolacek"
                            4 => "B&#46; Koletzko"
                            5 => "K&#46;F&#46; Michaelsen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.mpg.0000304464.60788.bd"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr Gastroenterol Nutr"
                        "fecha" => "2008"
                        "volumen" => "46"
                        "paginaInicial" => "99"
                        "paginaFinal" => "110"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18162844"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Randomized feeding intervention in infants at high risk for celiac disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;L&#46; Vriezinga"
                            1 => "R&#46; Auricchio"
                            2 => "E&#46; Bravi"
                            3 => "G&#46; Castillejo"
                            4 => "A&#46; Chmielewska"
                            5 => "P&#46; Crespo Escobar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa1404172"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2014"
                        "volumen" => "371"
                        "paginaInicial" => "1304"
                        "paginaFinal" => "1315"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25271603"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Introduction of gluten&#44; HLA status&#44; and the risk of celiac disease in children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Lionetti"
                            1 => "S&#46; Castellaneta"
                            2 => "R&#46; Francavilla"
                            3 => "A&#46; Pulvirenti"
                            4 => "E&#46; Tonutti"
                            5 => "S&#46; Amarri"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa1400697"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2014"
                        "volumen" => "371"
                        "paginaInicial" => "1295"
                        "paginaFinal" => "1303"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25271602"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/23412879/0000008200000001/v1_201501110050/S2341287914001094/v1_201501110050/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "26006"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Editorials"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/23412879/0000008200000001/v1_201501110050/S2341287914001094/v1_201501110050/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287914001094?idApp=UINPBA00005H"
]
Share
Journal Information

Statistics

Follow this link to access the full text of the article

Editorial
Gluten introduction and coeliac disease risk
Introducción del gluten y riesgo de enfermedad celíaca
C. Ribes Koninckx
Hospital Universitari i Politècnic La Fe, Valencia, Spain
Read
6193
Times
was read the article
2275
Total PDF
3918
Total HTML
Share statistics
 array:23 [
  "pii" => "S2341287914001094"
  "issn" => "23412879"
  "doi" => "10.1016/j.anpede.2014.10.001"
  "estado" => "S300"
  "fechaPublicacion" => "2015-01-01"
  "aid" => "1754"
  "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
  "copyrightAnyo" => "2014"
  "documento" => "article"
  "subdocumento" => "sco"
  "cita" => "An Pediatr &#40;Barc&#41;. 2015;82:4-5"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 2300
    "formatos" => array:3 [
      "EPUB" => 117
      "HTML" => 1770
      "PDF" => 413
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:18 [
      "pii" => "S169540331400513X"
      "issn" => "16954033"
      "doi" => "10.1016/j.anpedi.2014.10.020"
      "estado" => "S300"
      "fechaPublicacion" => "2015-01-01"
      "aid" => "1754"
      "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
      "documento" => "article"
      "subdocumento" => "sco"
      "cita" => "An Pediatr &#40;Barc&#41;. 2015;82:4-5"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:2 [
        "total" => 7765
        "formatos" => array:3 [
          "EPUB" => 141
          "HTML" => 6981
          "PDF" => 643
        ]
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">EDITORIAL</span>"
        "titulo" => "Introducci&#243;n del gluten y riesgo de enfermedad cel&#237;aca"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "4"
            "paginaFinal" => "5"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Gluten introduction and coeliac disease risk"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "C&#46; Ribes Koninckx"
            "autores" => array:1 [
              0 => array:2 [
                "nombre" => "C&#46;"
                "apellidos" => "Ribes Koninckx"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2341287914001094"
          "doi" => "10.1016/j.anpede.2014.10.001"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287914001094?idApp=UINPBA00005H"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S169540331400513X?idApp=UINPBA00005H"
      "url" => "/16954033/0000008200000001/v1_201501010024/S169540331400513X/v1_201501010024/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S2341287914001227"
    "issn" => "23412879"
    "doi" => "10.1016/j.anpede.2014.02.002"
    "estado" => "S300"
    "fechaPublicacion" => "2015-01-01"
    "aid" => "1553"
    "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
    "documento" => "article"
    "subdocumento" => "fla"
    "cita" => "An Pediatr &#40;Barc&#41;. 2015;82:6-11"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 1737
      "formatos" => array:3 [
        "EPUB" => 136
        "HTML" => 1123
        "PDF" => 478
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Has the presence of parents during invasive procedures in the emergency department increased in the last few years&#63;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "6"
          "paginaFinal" => "11"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "&#191;Ha aumentado la presencia de los padres durante los procedimientos invasivos en urgencias en los &#250;ltimos a&#241;os&#63;"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1247
              "Ancho" => 1667
              "Tamanyo" => 79927
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Acceptance by health care staff according to the invasiveness of the procedures&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "J&#46; Angel Sol&#224;, S&#46; Sagu&#233; Bravo, C&#46; Parra Cotanda, V&#46; Trenchs Sainz de la Maza, C&#46; Luaces Cubells"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Angel Sol&#224;"
            ]
            1 => array:2 [
              "nombre" => "S&#46;"
              "apellidos" => "Sagu&#233; Bravo"
            ]
            2 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Parra Cotanda"
            ]
            3 => array:2 [
              "nombre" => "V&#46;"
              "apellidos" => "Trenchs Sainz de la Maza"
            ]
            4 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Luaces Cubells"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S1695403314000824"
        "doi" => "10.1016/j.anpedi.2014.02.004"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403314000824?idApp=UINPBA00005H"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287914001227?idApp=UINPBA00005H"
    "url" => "/23412879/0000008200000001/v1_201501110050/S2341287914001227/v1_201501110050/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S234128791400132X"
    "issn" => "23412879"
    "doi" => "10.1016/j.anpede.2014.10.005"
    "estado" => "S300"
    "fechaPublicacion" => "2015-01-01"
    "aid" => "1741"
    "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
    "documento" => "article"
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "sco"
    "cita" => "An Pediatr &#40;Barc&#41;. 2015;82:1-3"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1597
      "formatos" => array:3 [
        "EPUB" => 129
        "HTML" => 1077
        "PDF" => 391
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
      "titulo" => "Role of parents in paediatric emergencies&#58; Tradition&#44; conflict or improvement&#63;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "1"
          "paginaFinal" => "3"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Papel de los padres en las urgencias pedi&#225;tricas&#58; &#191;tradici&#243;n&#44; conflicto o mejor&#237;a&#63;"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "J&#46; Gonz&#225;lez del Rey"
          "autores" => array:1 [
            0 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Gonz&#225;lez del Rey"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S169540331400469X"
        "doi" => "10.1016/j.anpedi.2014.10.007"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S169540331400469X?idApp=UINPBA00005H"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S234128791400132X?idApp=UINPBA00005H"
    "url" => "/23412879/0000008200000001/v1_201501110050/S234128791400132X/v1_201501110050/en/main.assets"
  ]
  "en" => array:12 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
    "titulo" => "Gluten introduction and coeliac disease risk"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "4"
        "paginaFinal" => "5"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "C&#46; Ribes Koninckx"
        "autores" => array:1 [
          0 => array:3 [
            "nombre" => "C&#46;"
            "apellidos" => "Ribes Koninckx"
            "email" => array:1 [
              0 => "ribes&#95;car&#64;gva&#46;es"
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Hospital Universitari i Polit&#232;cnic La Fe&#44; Valencia&#44; Spain"
            "identificador" => "aff0005"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Introducci&#243;n del gluten y riesgo de enfermedad cel&#237;aca"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Based on previous epidemiological studies on celiac disease &#40;CD&#41;&#44; especially those by Anneli Ivarsson and collaborators on the so called Swedish CD epidemic in the mid 1980s&#44; in the last decade it has been hypothesized that early introduction of small quantities of gluten&#44; preferably during a period of breastfeeding&#44; may reduce the risk of CD&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Moreover a study by Norris et al reported that in infants at genetic risk&#44; introduction of gluten at &#8804;3 months of age or at &#8805;7 months was associated with a higher risk of CD autoimmunity and of CD development&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Thus a &#8220;window of opportunity&#8221; for gluten introduction between 4 and 6 months of age was almost generally accepted by the scientific community&#46; Accordingly the ESPGHAN Committee on Nutrition recommended avoiding gluten introduction before 4 months or later than 6 months of age&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">To specifically investigate the potential of CD prevention through dietary intervention&#44; a prospective European multicenter project &#8220;Prevent Coeliac Disease&#8221; &#40;PreventCD&#44; <a id="intr0010" class="elsevierStyleInterRef" href="http://www.preventcd.com/">www&#46;preventcd&#46;com</a>&#44; FP6-2005-FOOD-4B-36383 &#8211; PREVENTCD&#41; was carried out in which the collaboration between hospitals&#44; universities&#44; laboratories and industries from 7 European countries and Israel&#44; was achieved&#44; under the coordination of the Leiden University Medical Center&#44; the Netherlands&#46; The results of this investigation have been published in the 2 October issue of the NEJM&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In summary&#44; 994 infants at high risk for CD&#44; because of having one first degree relative already diagnosed with CD &#40;father&#44; mother or sibling&#41; and carrying at least one HLA risk gene &#40;DQ2 and&#47;or DQ8&#41; were recruited shortly after birth&#46; After informed consent from the parents was obtained they were blindly randomized to receive&#44; at 16 weeks of age&#44; either 100<span class="elsevierStyleHsp" style=""></span>mg of gluten daily or placebo &#40;lactose&#41; and breast feeding was strongly encouraged&#46; At 24 weeks of age a fixed progressively increasing gluten intake was advised for both groups and after 11 months of age free gluten consumption was allowed&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Up to the age of 3 years&#44; the participants were screened for the development of celiac disease by determination of celiac antibodies &#40;anti-tissue transglutaminase antibodies&#41; in serum&#46; In addition&#44; health status&#44; growth and feeding habits &#40;breastfeeding&#44; formula feeding and gluten consumption&#41; were monitored&#46; Celiac disease was diagnosed according to the accepted European guidelines and involves small bowel biopsies in the vast majority of the cases&#46; The study endpoint was the frequency of celiac disease at the age of 3 years&#44; which was found to be 5&#46;2&#37; in the whole cohort&#46; No differences in incidence were observed between children that had been introduced to gluten at 16 weeks and those that received placebo and no gluten untill the age of 24 weeks&#46; Moreover CD development was neither influenced by the duration of breastfeeding nor by continuing breastfeeding during gluten introduction&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The authors conclude &#8220;<span class="elsevierStyleItalic">the introduction of small quantities of gluten at 16 to 24 weeks of age did not reduce CD risk</span>&#8221;&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Other environmental factors such as rotavirus vaccination&#44; gastrointestinal or respiratory tract infection&#44; were also not related to the development of CD&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">In the same issue of NEJM an Italian multicenter study addresses the hypothesis that delaying gluten introduction till 12 months of age in at-risk infants may reduce the risk of CD development&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Although at 2 years of age a statistically significant higher percentage of infants which had gluten introduced at 6 months had developed CD&#44; as compared to those with gluten introduced after 12 months &#40;12&#37; vs 5&#37;&#41;&#44; at 5 and 10 years of age the differences between the 2 groups were no longer statistically significant&#46; At 10 years of age 25&#46;8&#37; of children with high-risk phenotype &#40;DQ2&#47;DQ2&#41; had overt CD as compared to 15&#46;8&#37; in those bearing other at-risk phenotypes&#46; Although the authors suggest that delaying CD development to later ages may have some potential benefit on developing organs such as the brain&#44; there is no evidence to support this premise&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The authors conclude &#8220;<span class="elsevierStyleItalic">neither the delayed introduction of gluten nor breastfeeding modified the risk of CD among at-risk infants&#44; although the later introduction of gluten was associated with a delayed onset of the disease&#8221;</span><a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Thus both studies come to the same main conclusions&#44; i&#46;e&#46; in at-high-risk infants neither the timing of gluten introduction nor the duration of breastfeeding and the continuation of breast feeding during gluten introduction have proven to exert a protective effect on CD development&#46; Carrying the DQ2&#47;DQ2 genotype was found by the two investigation groups to be an important predictive factor for CD&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The relevant consequences of these studies are that no clear recommendations on gluten introduction in at-risk infants can be established&#46; In addition other environmental factors have been found not to be related to disease development&#44; thus leaving research in this field open to intriguing and exciting new investigation hypothesis&#46; In the short term&#44; special attention will be paid to the potential impact of gut microbiota particularly in early life&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">An additional issue is if data obtained for at-risk infants&#44; such as the populations included in both studies&#44; can be extrapolated to the general infant population&#44; thus not supporting current European guidelines on complementary feeding which recommend gluten introduction not earlier than 4 and not later than 7 months&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">Faced to the anguish of parents looking for advice to prevent CD development&#44; pediatricians have to deal with a difficult situation as at the moment no evidence supports any specific recommendation neither on the timing nor on the pattern of gluten introduction&#46; However&#44; in agreement with the general recommendations of the ESPGHAN committee on Nutrition not to delay complementary feeding introduction beyond 26 weeks of age&#44; introduction of gluten at around 6 months seems&#44; for the time being&#44; a reasonable and sensible option&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Ribes Koninckx C&#46; Introducci&#243;n del gluten y riesgo de enfermedad cel&#237;aca&#46; An Pediatr &#40;Barc&#41;&#46; 2015&#59;82&#58;4&#8211;5&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:5 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemic of coeliac disease in Swedish children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Ivarsson"
                            1 => "Persson L&#197;"
                            2 => "L&#46; Nystr&#246;m"
                            3 => "H&#46; Ascher"
                            4 => "B&#46; Cavell"
                            5 => "L&#46; Danielsson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Acta Paediatr"
                        "fecha" => "2000"
                        "volumen" => "89"
                        "paginaInicial" => "165"
                        "paginaFinal" => "171"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10709885"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0302283812005015"
                          "estado" => "S300"
                          "issn" => "03022838"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk of celiac disease autoimmunity and timing of gluten introduction in the diet of infants at increased risk of disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;M&#46; Norris"
                            1 => "K&#46; Barriga"
                            2 => "E&#46;J&#46; Hoffenberg"
                            3 => "I&#46; Taki"
                            4 => "D&#46; Miao"
                            5 => "J&#46;E&#46; Haas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Am Med Assoc"
                        "fecha" => "2005"
                        "volumen" => "293"
                        "paginaInicial" => "2343"
                        "paginaFinal" => "2351"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Complementary feeding&#58; a commentary by the ESPGHAN Committee on Nutrition"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Agostoni"
                            1 => "C&#46; Braegger"
                            2 => "T&#46; Decsi"
                            3 => "S&#46; Kolacek"
                            4 => "B&#46; Koletzko"
                            5 => "K&#46;F&#46; Michaelsen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.mpg.0000304464.60788.bd"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr Gastroenterol Nutr"
                        "fecha" => "2008"
                        "volumen" => "46"
                        "paginaInicial" => "99"
                        "paginaFinal" => "110"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18162844"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Randomized feeding intervention in infants at high risk for celiac disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;L&#46; Vriezinga"
                            1 => "R&#46; Auricchio"
                            2 => "E&#46; Bravi"
                            3 => "G&#46; Castillejo"
                            4 => "A&#46; Chmielewska"
                            5 => "P&#46; Crespo Escobar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa1404172"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2014"
                        "volumen" => "371"
                        "paginaInicial" => "1304"
                        "paginaFinal" => "1315"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25271603"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Introduction of gluten&#44; HLA status&#44; and the risk of celiac disease in children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Lionetti"
                            1 => "S&#46; Castellaneta"
                            2 => "R&#46; Francavilla"
                            3 => "A&#46; Pulvirenti"
                            4 => "E&#46; Tonutti"
                            5 => "S&#46; Amarri"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa1400697"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2014"
                        "volumen" => "371"
                        "paginaInicial" => "1295"
                        "paginaFinal" => "1303"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25271602"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/23412879/0000008200000001/v1_201501110050/S2341287914001094/v1_201501110050/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "26006"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Editorials"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/23412879/0000008200000001/v1_201501110050/S2341287914001094/v1_201501110050/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287914001094?idApp=UINPBA00005H"
]
Article information
ISSN: 23412879
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 6 8 14
2024 October 47 23 70
2024 September 51 29 80
2024 August 77 68 145
2024 July 48 24 72
2024 June 45 24 69
2024 May 62 33 95
2024 April 47 27 74
2024 March 36 22 58
2024 February 42 39 81
2024 January 28 52 80
2023 December 33 22 55
2023 November 37 24 61
2023 October 35 28 63
2023 September 18 22 40
2023 August 32 22 54
2023 July 47 33 80
2023 June 39 28 67
2023 May 40 27 67
2023 April 39 18 57
2023 March 29 18 47
2023 February 22 17 39
2023 January 25 24 49
2022 December 42 28 70
2022 November 39 38 77
2022 October 46 53 99
2022 September 22 37 59
2022 August 50 48 98
2022 July 24 38 62
2022 June 32 35 67
2022 May 36 52 88
2022 April 43 44 87
2022 March 63 48 111
2022 February 38 29 67
2022 January 61 49 110
2021 December 43 47 90
2021 November 41 53 94
2021 October 38 73 111
2021 September 25 51 76
2021 August 25 53 78
2021 July 24 44 68
2021 June 28 49 77
2021 May 42 31 73
2021 April 61 67 128
2021 March 48 39 87
2021 February 21 15 36
2021 January 31 20 51
2020 December 27 18 45
2020 November 36 22 58
2020 October 30 14 44
2020 September 34 22 56
2020 August 34 20 54
2020 July 31 21 52
2020 June 37 14 51
2020 May 37 15 52
2020 April 35 16 51
2020 March 29 14 43
2020 February 17 18 35
2020 January 33 12 45
2019 December 35 14 49
2019 November 41 9 50
2019 October 34 6 40
2019 September 21 6 27
2019 August 41 15 56
2019 July 68 30 98
2019 June 157 23 180
2019 May 41 23 64
2019 April 54 23 77
2019 March 38 11 49
2019 February 41 15 56
2019 January 39 16 55
2018 December 44 34 78
2018 November 67 25 92
2018 October 83 16 99
2018 September 42 17 59
2018 August 3 0 3
2018 July 2 0 2
2018 June 8 0 8
2018 May 15 0 15
2018 April 39 0 39
2018 March 40 0 40
2018 February 25 0 25
2018 January 36 0 36
2017 December 22 0 22
2017 November 37 0 37
2017 October 23 0 23
2017 September 29 0 29
2017 August 31 0 31
2017 July 30 0 30
2017 June 48 17 65
2017 May 46 8 54
2017 April 55 18 73
2017 March 38 11 49
2017 February 32 6 38
2017 January 26 3 29
2016 December 43 13 56
2016 November 63 12 75
2016 October 67 15 82
2016 September 55 6 61
2016 August 50 4 54
2016 July 21 0 21
Show all

Follow this link to access the full text of the article

Idiomas
Anales de Pediatría (English Edition)
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?