Growth hormone treatment in small for gestational age children in Spain

array:24 ["pii" => "S2341287917300716" "issn" => "23412879" "doi" => "10.1016/j.anpede.2016.04.008" "estado" => "S300" "fechaPublicacion" => "2017-05-01" "aid" => "2092" "copyright" => "Asociación Española de Pediatría" "copyrightAnyo" => "2016" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2017;86:249-54" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1924 "formatos" => array:3 [ "EPUB" => 273 "HTML" => 1137 "PDF" => 514 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S1695403316301680" "issn" => "16954033" "doi" => "10.1016/j.anpedi.2016.04.001" "estado" => "S300" "fechaPublicacion" => "2017-05-01" "aid" => "2092" "copyright" => "Asociación Española de Pediatría" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2017;86:249-54" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 5115 "formatos" => array:3 [ "EPUB" => 172 "HTML" => 4020 "PDF" => 923 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "ORIGINAL" "titulo" => "Tratamiento con hormona de crecimiento en pequeños para la edad gestacional en España" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "249" "paginaFinal" => "254" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Growth hormone treatment in small for gestational age children in Spain" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 807 "Ancho" => 1588 "Tamanyo" => 51485 ] ] "descripcion" => array:1 [ "es" => "Evolución de la talla (DE)." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "José Manuel Rial Rodríguez, Antonio de Arriba Muñoz, Jordi Bosch Muñoz, Paloma Cabanas Rodríguez, Ramón Cañete Estrada, Ignacio Díez López, María Magdalena Hawkins Solís, María José Martínez-Aedo Ollero, Ana Cristina Rodríguez Dehli, Lourdes Ibáñez Toda" "autores" => array:11 [ 0 => array:2 [ "nombre" => "José Manuel" "apellidos" => "Rial Rodríguez" ] 1 => array:2 [ "nombre" => "Antonio" "apellidos" => "de Arriba Muñoz" ] 2 => array:2 [ "nombre" => "Jordi" "apellidos" => "Bosch Muñoz" ] 3 => array:2 [ "nombre" => "Paloma" "apellidos" => "Cabanas Rodríguez" ] 4 => array:2 [ "nombre" => "Ramón" "apellidos" => "Cañete Estrada" ] 5 => array:2 [ "nombre" => "Ignacio" "apellidos" => "Díez López" ] 6 => array:2 [ "nombre" => "María Magdalena" "apellidos" => "Hawkins Solís" ] 7 => array:2 [ "nombre" => "María José" "apellidos" => "Martínez-Aedo Ollero" ] 8 => array:2 [ "nombre" => "Ana Cristina" "apellidos" => "Rodríguez Dehli" ] 9 => array:2 [ "nombre" => "Lourdes" "apellidos" => "Ibáñez Toda" ] 10 => array:1 [ "colaborador" => "en representación del Grupo de trabajo para el estudio del paciente pequeño para la edad gestacional (PEG) de la Sociedad Española de Endocrinología Pediátrica (SEEP)" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2341287917300716" "doi" => "10.1016/j.anpede.2016.04.008" "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/S2341287917300716?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403316301680?idApp=UINPBA00005H" "url" => "/16954033/0000008600000005/v1_201704260013/S1695403316301680/v1_201704260013/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S234128791730073X" "issn" => "23412879" "doi" => "10.1016/j.anpede.2016.05.006" "estado" => "S300" "fechaPublicacion" => "2017-05-01" "aid" => "2119" "copyright" => "Asociación Española de Pediatría" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2017;86:255-63" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1888 "formatos" => array:3 [ "EPUB" => 273 "HTML" => 1091 "PDF" => 524 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original Article" "titulo" => "Spanish patients with central hypoventilation syndrome included in the European Registry. The 2015 data" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "255" "paginaFinal" => "263" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Pacientes españoles con síndrome de hipoventilación central incluidos en el Registro europeo. Datos del 2015" ] ] "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" => 1039 "Ancho" => 1648 "Tamanyo" => 46048 ] ] "descripcion" => array:1 [ "en" => "Ventilatory support modalities used (bars) and number of patients supported by each modality at home discharge and as of December 2015. NIV, noninvasive ventilation with mask; PNP, phrenic nerve pacing; TRACH, tracheostomy." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "María Angeles García Teresa, Raquel Porto Abal, Silvia Rodríguez Torres, Diego García Urabayen, Silvia García Martínez, Ha Trang, Angel Campos Barros" "autores" => array:8 [ 0 => array:2 [ "nombre" => "María Angeles" "apellidos" => "García Teresa" ] 1 => array:2 [ "nombre" => "Raquel" "apellidos" => "Porto Abal" ] 2 => array:2 [ "nombre" => "Silvia" "apellidos" => "Rodríguez Torres" ] 3 => array:2 [ "nombre" => "Diego" "apellidos" => "García Urabayen" ] 4 => array:2 [ "nombre" => "Silvia" "apellidos" => "García Martínez" ] 5 => array:2 [ "nombre" => "Ha" "apellidos" => "Trang" ] 6 => array:2 [ "nombre" => "Angel" "apellidos" => "Campos Barros" ] 7 => array:1 [ "colaborador" => "Grupo Español de Trabajo del SHCC" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1695403316302016" "doi" => "10.1016/j.anpedi.2016.05.008" "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/S1695403316302016?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S234128791730073X?idApp=UINPBA00005H" "url" => "/23412879/0000008600000005/v1_201704260029/S234128791730073X/v1_201704260029/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2341287917300686" "issn" => "23412879" "doi" => "10.1016/j.anpede.2016.05.005" "estado" => "S300" "fechaPublicacion" => "2017-05-01" "aid" => "2111" "copyright" => "Asociación Española de Pediatría" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2017;86:240-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2083 "formatos" => array:3 [ "EPUB" => 280 "HTML" => 1295 "PDF" => 508 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original Article" "titulo" => "Effects of growth hormone treatment on anthropometrics, metabolic risk, and body composition variables in small for gestational age patients" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "240" "paginaFinal" => "248" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Modificaciones en variables antropométricas, analíticas de riesgo metabólico y composición corporal en pequeños para la edad gestacional en tratamiento con hormona de crecimiento" ] ] "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" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1847 "Ancho" => 1614 "Tamanyo" => 95194 ] ] "descripcion" => array:1 [ "en" => "Changes in height (SD) relative to genetic potential (SD) during followup." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Esther Aurensanz Clemente, Pilar Samper Villagrasa, Ariadna Ayerza Casas, Pablo Ruiz Frontera, Olga Bueno Lozano, Luis Alberto Moreno Aznar, Gloria Bueno Lozano" "autores" => array:7 [ 0 => array:2 [ "nombre" => "Esther" "apellidos" => "Aurensanz Clemente" ] 1 => array:2 [ "nombre" => "Pilar" "apellidos" => "Samper Villagrasa" ] 2 => array:2 [ "nombre" => "Ariadna" "apellidos" => "Ayerza Casas" ] 3 => array:2 [ "nombre" => "Pablo" "apellidos" => "Ruiz Frontera" ] 4 => array:2 [ "nombre" => "Olga" "apellidos" => "Bueno Lozano" ] 5 => array:2 [ "nombre" => "Luis Alberto" "apellidos" => "Moreno Aznar" ] 6 => array:2 [ "nombre" => "Gloria" "apellidos" => "Bueno Lozano" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1695403316301898" "doi" => "10.1016/j.anpedi.2016.05.001" "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/S1695403316301898?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287917300686?idApp=UINPBA00005H" "url" => "/23412879/0000008600000005/v1_201704260029/S2341287917300686/v1_201704260029/en/main.assets" ] "en" => array:21 [ "idiomaDefecto" => true "cabecera" => "Original Article" "titulo" => "Growth hormone treatment in small for gestational age children in Spain" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "249" "paginaFinal" => "254" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "José Manuel Rial Rodríguez, Antonio de Arriba Muñoz, Jordi Bosch Muñoz, Paloma Cabanas Rodríguez, Ramón Cañete Estrada, Ignacio Díez López, María Magdalena Hawkins Solís, María José Martínez-Aedo Ollero, Ana Cristina Rodríguez Dehli, Lourdes Ibáñez Toda" "autores" => array:11 [ 0 => array:4 [ "nombre" => "José Manuel" "apellidos" => "Rial Rodríguez" "email" => array:1 [ 0 => "jmrial53@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Antonio" "apellidos" => "de Arriba Muñoz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Jordi" "apellidos" => "Bosch Muñoz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "Paloma" "apellidos" => "Cabanas Rodríguez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "d" "identificador" => "aff0020" ] ] ] 4 => array:3 [ "nombre" => "Ramón" "apellidos" => "Cañete Estrada" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "e" "identificador" => "aff0025" ] ] ] 5 => array:3 [ "nombre" => "Ignacio" "apellidos" => "Díez López" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "f" "identificador" => "aff0030" ] ] ] 6 => array:3 [ "nombre" => "María Magdalena" "apellidos" => "Hawkins Solís" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "g" "identificador" => "aff0035" ] ] ] 7 => array:3 [ "nombre" => "María José" "apellidos" => "Martínez-Aedo Ollero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "h" "identificador" => "aff0040" ] ] ] 8 => array:3 [ "nombre" => "Ana Cristina" "apellidos" => "Rodríguez Dehli" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "i" "identificador" => "aff0045" ] ] ] 9 => array:3 [ "nombre" => "Lourdes" "apellidos" => "Ibáñez Toda" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "j" "identificador" => "aff0050" ] ] ] 10 => array:1 [ "colaborador" => "On behalf of Grupo de trabajo para el estudio del paciente pequeño para la edad gestacional (PEG) de la Sociedad Española de Endocrinología Pediátrica (SEEP)" ] ] "afiliaciones" => array:10 [ 0 => array:3 [ "entidad" => "Unidad de Endocrinología, Servicio de Pediatría, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Endocrinología Pediátrica, Hospital Universitario Miguel Servet, Zaragoza, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Unidad de Endocrinología Pediátrica, Hospital Universitari Arnau de Vilanova, Universidad de Lleida, Lleida, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Unidad de Endocrinología Pediátrica, Crecimiento y Adolescencia, Departamento de Pediatría, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Unidad de Endocrinología Pediátrica, Hospital Universitario Reina Sofía, Córdoba, Spain" "etiqueta" => "e" "identificador" => "aff0025" ] 5 => array:3 [ "entidad" => "Unidad de Endocrinología Pediátrica, OSI-Araba, Hospital Universitario Araba, Departamento de Pediatría, Universidad del País Vasco, Vitoria, Álava, Spain" "etiqueta" => "f" "identificador" => "aff0030" ] 6 => array:3 [ "entidad" => "Servicio de Pediatría, Hospital Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain" "etiqueta" => "g" "identificador" => "aff0035" ] 7 => array:3 [ "entidad" => "Unidad de Endocrinología Pediátrica, Hospital Materno-Infantil Carlos Haya, Málaga, Spain" "etiqueta" => "h" "identificador" => "aff0040" ] 8 => array:3 [ "entidad" => "Unidad de Endocrinología Pediátrica, Hospital San Agustín, Avilés, Asturias, Spain" "etiqueta" => "i" "identificador" => "aff0045" ] 9 => array:3 [ "entidad" => "Unidad de Endocrinología, Hospital Sant Joan de Déu, Universidad de Barcelona, Barcelona, Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain" "etiqueta" => "j" "identificador" => "aff0050" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tratamiento con hormona de crecimiento en pequeños para la edad gestacional en España" ] ] "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" => 807 "Ancho" => 1588 "Tamanyo" => 55004 ] ] "descripcion" => array:1 [ "en" => "Changes in stature (SD)." ] ] ] "textoCompleto" => "IntroductionThe term small for gestational age comprehends all newborns whose birth weight or birth crown-heel length is 2 sd below the mean for their sex and gestational age based on a reference population.<a class="elsevierStyleCrossRef" href="#bib0180">1</a> Since 2003, when the European Medicines Agency approved the use of recombinant human growth hormone (rhGH) for the treatment of children small for gestational age (SGA) or with intrauterine growth restriction (IUGR) without postnatal catchup growth, a large number of patients have received this treatment in Spain. However, we do not know the exact number of patients, their geographical distribution, the age at treatment initiation, the clinical response and the potential adverse effects that have been observed. Much of this information can be found in the registers of the advisory committees that authorise rhGH treatment in the different autonomous communities (regions) of Spain. In order to obtain an objective understanding of the characteristics of the use of rhGH in children born SGA in Spain, we collected the data from these registers in several autonomous communities as a preliminary phase for a nationwide study.After analysing the data and correcting potential errors in the calculated values, we compared the results with those of domestic and international studies on the use of rhGH for the treatment of SGA children.MethodsWe collected all the data contained in the registers of the advisory committees that regulate the distribution of rhGH by the Department of Public Health of the different autonomous communities on the patients in whom treatment was authorised, with the exception of confidential personal information. The collected data included parental heights, gestational age, birth weight and birth length. We also recorded the age, weight, height, pubertal stage of development and growth velocity of patients at the time of treatment initiation and in subsequent checkups, as well as the prescribed doses of rhGH and the final height achieved by those that completed treatment during the period under study. We also recorded the age at menarche in female patients.We assessed auxologic measurements using the charts of the Estudio Colaborativo Español 2008<a class="elsevierStyleCrossRef" href="#bib0185">2</a> and pubertal development by means of Tanner scale.<a class="elsevierStyleCrossRef" href="#bib0190">3</a> We summarised the data as means and standard deviations (SDs). We used the IBM SPSS 19.0 software for Windows for the statistical analysis. We conducted two-tailed Student's t tests and paired-sample t tests. We defined statistical significance for all the analysed variables as a p-value of less than 0.05 for a 95% confidence interval.ResultsWe analysed the treatments (number) registered from 2004 to 2014 in the autonomous communities of Aragón (76), Basque Country (87), Navarra (56), Catalonia (525), Cantabria (69) and Galicia (161). We obtained valid data for a total of 974 patients (48% male). These patients amounted to approximately 21% of the total rhGH treatments authorised in those autonomous communities. Five percent of the patients were born from multiple gestations and 23% born preterm, and the gestational age for the overall sample was 38±3 weeks.The mean birth weight was −2±1 SD and the mean birth length was −2.6±0.9 SD.At birth, the length of 81% of the patients was at least 2 SDs below the mean and the weight of 54% at least 2 SDs below the mean, and both were at least 2 SDs below the mean in 42% of the patients.In 27% of the patients, the target heights ([father's height+mother's height±13]/2) were at least 2 SDs below the mean. The mean target height was −1.5±1 SD.Patients started receiving treatment with rhGH at an age of 7.2±2.8 years. During the period under study, the age at treatment initiation did not change significantly in the more recent patients.The height at treatment initiation was −3.1±0.8 SD, and the baseline growth velocity was −1.4±1.5 SD. The stage of pubertal development at initiation of treatment was Tanner I in 89%, Tanner II in 7% and Tanner III in 2%.The initial dose of rhGH was 35±6μg/kg/day, and we found no significant changes at follow up or depending of the year in which treatment was initiated; the initial dose was also independent of age and stage of pubertal development at initiation. All patients received uninterrupted treatment.The height gains associated with treatment corresponded to 0.7±0.2 SDs in the first year, and 1.2±0.8 SDs in the first two years. Approximately 30% of patients achieved height z-scores greater than −2 SD in the first year of treatment, and another 60% of patients achieved them in the second year (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). In the fifth year of treatment, heights had increased by 2±1.9 SDs compared to baseline. Growth velocity increased by 3.9±2.3 SDs compared to the year before treatment initiation. We did not find statistically significant differences in treatment response based on gestational age.<elsevierMultimedia ident="fig0005"></elsevierMultimedia>Fourteen percent of patients exhibited a response in the first year of treatment that was more than 2 SDs below the mean for the sample, corresponding to height gains of less than 0.3 SD, which can serve as the threshold for defining nonresponders. Up to 24% had height gains of less than 0.5 SD and 55% had growth velocity increases of less than 3cm/year.The response in the first year of treatment was negatively correlated with initial height (r=−0.40) and the age at initiation of treatment (r=−0.36), and positively correlated with the rhGH dose (r=0.24), associations that were statistically significant (P<.05).Eight percent of the patients reached their final heights during the follow-up, corresponding to a mean of −1.4±0.7 SD, very similar to the target height, with a difference of −0.1±1 SD.The age at menarche, available for 13% of female patients, was 13.3±2 years.DiscussionSeveral studies conducted abroad on the use of rhGH in SGA children with no postnatal catchup growth support its efficacy and safety.<a class="elsevierStyleCrossRefs" href="#bib0195">4,5</a> Following its approval by EMA, the Spanish Ministry of Health introduced its indication under the category of intrauterine growth restriction. In the past few years, several publications have reported the outcomes of treatment in different case series that included patients from different hospitals.<a class="elsevierStyleCrossRefs" href="#bib0205">6–10</a>However, until now we had no data on the number of SGA patients treated with rhGH and their proportion compared to other indications for the use of rhGH, their geographical distribution, and the details concerning their followup. Our study analysed data for all SGA children treated with rhGH in a specific geographical area that comprised six autonomous communities in the north of Spain, a preliminary phase in a nationwide study, and included 974 patients that received this treatment in the 2004–2014 period. Our study has the limitations imposed by the source of the data, as the registers do not collect exhaustive information on obstetric factors, comorbidities, side effects or adherence to treatment. However, given the considerable number of patients included and the absence of selection bias (they were treated in different hospitals and received rhGH made by different manufacturers), our study is representative of the use of rhGH for the treatment of SGA children (IUGR) in Spain.Our results reveal a characteristic profile in the patients in whom treatment with rhGH is authorised: target height below the mean, smaller birth lengths compared to birth weights, and in nearly 25%, preterm. This profile could be used to identify SGA children whose growth should be monitored more closely in the early years of life. Other series have also described target heights of approximately 1 SD below the mean,<a class="elsevierStyleCrossRefs" href="#bib0230">11,12</a> but in our series 27% of the target heights were at least 2 SDs below the mean, suggesting a marked genetic component in the short stature of this group of patients.Children born preterm, who amount to 5% to 9% of births in Europe,<a class="elsevierStyleCrossRef" href="#bib0240">13</a> were disproportionally represented in our sample, amounting to 23% of the patients, although this proportion was similar to the one found by another study conducted in Spain, the DATAC study, in which 27% of patients had been born preterm.<a class="elsevierStyleCrossRef" href="#bib0225">10</a> The response to treatment of children born preterm was comparable to that of children born at term.<a class="elsevierStyleCrossRef" href="#bib0245">14</a>Although treatment is approved by the EMA starting at age 4 years, the mean age at initiation in our patients was 7.2 years, a delay that did not improve during the period under study. Other studies conducted in Spain reported similar ages.<a class="elsevierStyleCrossRefs" href="#bib0205">6,7,9,10</a> We hypothesise that the reason for this is that the practise of referring all SGA children that do not experience catchup growth in the early years to paediatric endocrinology services is not yet widespread.The response to rhGH, expressed as an increase in height SDs, is greater the younger the age at initiation, a finding that was confirmed in our study with a strong negative correlation between age and height gain in the first year of treatment. The findings of other series are similar.<a class="elsevierStyleCrossRefs" href="#bib0215">8,11,12</a> An adequate follow-up of SGA children from birth would allow initiation of treatment and the normalisation of stature at earlier ages.<a class="elsevierStyleCrossRef" href="#bib0250">15</a>We found that patients had uniformly received a mean dose of 35μg/kg/day, which did not change during the follow-up nor based on age or the time to initiation of treatment. Although the dose adjustment during puberty remains controversial,<a class="elsevierStyleCrossRefs" href="#bib0255">16,17</a> we also found no evidence of dose adjustment based on the stage of pubertal development. On the other hand, different doses of rhGH do not lead to significantly different outcomes in the long term.<a class="elsevierStyleCrossRefs" href="#bib0265">18,19</a>Our study corroborated that treatment with rhGH in children SGA is generally efficacious, both in the early stages and in patients reaching their final heights, with the latter achieving values within the range of the target height, a goal that has not always been achieved in previous studies.<a class="elsevierStyleCrossRefs" href="#bib0265">18,20–22</a>However, there was variability in the response to treatment, with 14% of nonrespondents, which in our study was defined as a height increase of less than 0.3 SD in the first year, and up to 24% if we were to apply the criteria of height gain less than 0.5 SD.<a class="elsevierStyleCrossRef" href="#bib0290">23</a> Some studies have defined inadequate response as an increase of less than 3cm in the growth velocity.<a class="elsevierStyleCrossRef" href="#bib0295">24</a> Based on this criterion, 55% of the patients in our sample would be categorised as nonrespondents. In any case, the mean response values in our patients are consistent with those reported in other studies,<a class="elsevierStyleCrossRef" href="#bib0300">25</a> both in Spain (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>) and internationally (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>). Higher doses were used in the series of Carrascosa et al.,<a class="elsevierStyleCrossRef" href="#bib0210">7</a> Argente et al.<a class="elsevierStyleCrossRef" href="#bib0215">8</a> and Boguszewski et al.,<a class="elsevierStyleCrossRef" href="#bib0305">26</a> and the last two included younger patients. The meta-analysis conducted by Maiorana and Cianfarani,<a class="elsevierStyleCrossRef" href="#bib0310">27</a> which included several European studies, found that patients failed to achieve their target heights, despite the use of higher doses compared to our study, possibly due to initiation of treatment at older ages. The largest series published to date, in the context of the KIGS study and funded by Pfizer®, with 900 patients and a mean dose of 40μg/kg/day, found a height gain of 0.7 SD in the first year, as did our study, but had final heights around −2 SD.<a class="elsevierStyleCrossRef" href="#bib0230">11</a> In the series of Ridder et al.,<a class="elsevierStyleCrossRef" href="#bib0315">28</a> the final height was far below the target height, despite the use of doses of up to 67μg/kg/day. The height catchup observed in our sample was similar to that observed in patients treated for growth hormone deficiency.<a class="elsevierStyleCrossRefs" href="#bib0300">25,29</a><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia>The response observed in the first year of treatment is a predictor of final height.<a class="elsevierStyleCrossRefs" href="#bib0325">30,31</a> In our sample, the determinants of the initial response were the age at initiation of treatment, the initial height and the dose of rhGH, which was consistent with other studies.<a class="elsevierStyleCrossRefs" href="#bib0315">28,31</a>Although we did not have detailed information on the onset of puberty, the age at menarche in 13% of the female patients was 13 years. While treatment with rhGH does not seem to affect the onset and development of puberty in general,<a class="elsevierStyleCrossRef" href="#bib0335">32</a> a longer followup period is required for confirmation. The SGA population enters puberty at an age close to the mean for the general population, although girls with low birth weights that experience rapid weight and height catchup tend to reach puberty at earlier ages<a class="elsevierStyleCrossRef" href="#bib0340">33</a> and may present with pronounced adrenarche and hyperandrogenism associated with hyperinsulinism.<a class="elsevierStyleCrossRef" href="#bib0345">34</a>The analysis of the data obtained from the official registers of the autonomous communities did not allow us to draw conclusions regarding the safety of treatment with rhGH in SGA patients. However, the evidence in the existing literature consistently suggests that there are no significant risks—at least in the intermediate term—with frequent elevation of blood insulin levels that resolves spontaneously.<a class="elsevierStyleCrossRefs" href="#bib0180">1,4,5,35</a>Conclusions<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005">(1)We present a study based on a population of SGA children managed with rhGH in Spain, with no bias from the use of a specific brand of recombinant hormone, treated in several different hospitals following the criteria of the EMA with the approval the advisory committees of the specific autonomous communities. It includes cases from the initial authorisation for its use in IUGR/SGA to the recent past.</li><li class="elsevierStyleListItem" id="lsti0010">(2)The sample of 974 patients was the largest studied to date, and comparable to those of international studies that included patients from different countries. We believe that this study is representative of the use of rhGH for the treatment of IUGR/SGA in Spain.</li><li class="elsevierStyleListItem" id="lsti0015">(3)We found that most patients responded well to treatment from the first year, achieving final heights that were close to the genetic potential or target height. Twenty-four percent of the patients responded poorly, with height gains of less than 0.5 SD in the first year.</li><li class="elsevierStyleListItem" id="lsti0020">(4)The information pertaining to adverse effects and pubertal development was not recorded in the database with adequate accuracy, and should be investigated with different methods.</li><li class="elsevierStyleListItem" id="lsti0025">(5)The data underscore the importance of starting treatment with rhGH early with the purpose of achieving normal heights in children born SGA. Small for gestational age children whose length was more affected than weight at birth, whose parents have short statures or born preterm should be monitored closely in the first three years of life to initiate treatment promptly if they do not exhibit spontaneous catch-up growth.</li></ul>Conflicts of interestsThe authors have no conflicts of interest to declare" "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres833063" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec828986" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres833064" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec828987" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conclusions" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Conflicts of interests" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-02-15" "fechaAceptado" => "2016-04-12" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec828986" "palabras" => array:4 [ 0 => "Small for gestational age" 1 => "Growth hormone" 2 => "Treatment outcome" 3 => "Public hospitals" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec828987" "palabras" => array:4 [ 0 => "Pequeño para la edad gestacional" 1 => "Hormona de crecimiento" 2 => "Respuesta terapéutica" 3 => "Hospitales públicos" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "IntroductionSince its approval by the European Medicines Agency, a great number of patients born small for gestational date have received recombinant growth hormone treatment in Spain. The aim of this study is to analyse its outcome in the setting of ordinary clinical practice. MethodsInformation was gathered from the registers of the assessment boards that authorise all growth hormone treatments prescribed in public hospitals in six autonomic communities (regions). ResultsValid data from 974 patients was obtained. All of them complied with criteria established by the European Medicines Agency. Patients in the sample were smaller in length than weight at birth, with their median target height being below 1 standard deviation (SD), and 23% of them had been delivered prematurely. Treatment was started at 7.2±2.8 years (mean±SD). The mean patient height at start was −3.1±0.8 SD. They gained 0.7±0.2 SD in the first year, and 1.2±0.8 SD after two years. Final height was attained by 8% of the sample, reaching −1.4±0.7 SD. ConclusionsThese results are similar to other Spanish and international published studies, and are representative of the current practice in Spain.Despite treatment being started at a late age, adequate growth is observed in the short term and in the final height. Up to a 24% of patients show a poor response in the first year." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "IntroducciónDesde su aprobación por la Agencia Europea del Medicamento, el tratamiento con hormona de crecimiento recombinante ha sido empleado en un gran número de pacientes nacidos pequeños para la edad gestacional en España. El propósito de este estudio es conocer objetivamente los resultados del mismo en la práctica habitual. MétodosSe ha recogido información procedente de los registros existentes en los comités asesores que autorizan dichos tratamientos en los hospitales públicos de 6 comunidades autónomas. ResultadosSe han obtenido datos válidos de 974 pacientes. Todos ellos cumplían los criterios exigidos por la Agencia Europea del Medicamento. Los pacientes que recibieron el tratamiento se caracterizaron por tener la longitud al nacer más afectada que el peso, talla diana inferior a –1 desviación estándar (DE) y un 23% con antecedentes de prematuridad. La talla al iniciar el tratamiento fue de −3,1±0,8 DE (media±DE) y la edad de comienzo 7,2±2,8 años. La ganancia de talla en el primer año fue de 0,7±0,2 DE, y de 1,2±0,8 DE hasta los 2 años. La talla final, alcanzada por un 8% de pacientes, fue de –1,4±0,7 DE. ConclusionesLos resultados concuerdan con las series nacionales e internacionales publicadas y son representativos de la práctica habitual en nuestro país.Se constata un inicio tardío del tratamiento, observándose, sin embargo, un adecuado crecimiento, tanto a corto plazo como en la talla final. En el primer año se identifica un 24% de pacientes con respuesta deficiente." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Rial Rodríguez JM, de Arriba Muñoz A, Bosch Muñoz J, Cabanas Rodríguez P, Cañete Estrada R, Díez López I, et al. Tratamiento con hormona de crecimiento en pequeños para la edad gestacional en España. An Pediatr (Barc). 2017;86:249–254." ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 807 "Ancho" => 1588 "Tamanyo" => 55004 ] ] "descripcion" => array:1 [ "en" => "Changes in stature (SD)." ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">STUDY \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Luzuriaga Tomás et al.,<a class="elsevierStyleCrossRef" href="#bib0205">6</a> 2003 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Carrascosa et al.,<a class="elsevierStyleCrossRef" href="#bib0210">7</a> 2006 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Argente et al.,<a class="elsevierStyleCrossRef" href="#bib0215">8</a> 2007 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">López Siguero et al.,<a class="elsevierStyleCrossRef" href="#bib0220">9</a> 2013 \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Number of patients \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">42 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">68 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">76 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">147 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Target height<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> (z-score) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−2±0.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−1.2±0.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−1.0±0.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.9±0.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age at initiation (years)<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8.1±2.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.1±2.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.4±2.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Baseline height<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> (z-score) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−2.5±0.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−3.3±0.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−3.1±0.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−3.0±0.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Height at 1 year<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> (z-score) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−1.7±0.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−2.1±0.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−1.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−2.3±0.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Δ Height in 1st year (z-score) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dose (μg/kg/day) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">65 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">66 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">35 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1403214.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "Values expressed as mean±SD." ] ] ] "descripcion" => array:1 [ "en" => "Studies conducted in Spain." ] ] 2 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "Values are expressed as means." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Study \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">KIGS,<a class="elsevierStyleCrossRef" href="#bib0230">11</a> 2007 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">De Ridder et al.,<a class="elsevierStyleCrossRef" href="#bib0315">28</a> 2008 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Kriström et al.,<a class="elsevierStyleCrossRef" href="#bib0325">30</a> 2009 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Boguszewski et al.,<a class="elsevierStyleCrossRef" href="#bib0305">26</a> 2014 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Maiorana and Cianfarani<a class="elsevierStyleCrossRef" href="#bib0310">27</a> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Current series \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Number of patients \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">900 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">150 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">367 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">156 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">391 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">974 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Target height (z-score) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−1.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−0.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−0.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−0.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−1.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−1.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age at initiation (years) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7.2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Baseline height (z-score) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−3.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−3.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−2.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−3.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−2.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−3.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Height at 1 year (z-score) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−2.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−2.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−2.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Δ Height in 1st year (z-score) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dose (μg/kg/day) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">33/67 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">33 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">33–67 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">35 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Final height (z-score) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−2.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−1.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−1.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−1.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1403213.png" ] ] ] ] "descripcion" => array:1 [ "en" => "International studies." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:35 [ 0 => array:3 [ "identificador" => "bib0180" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "International Small for Gestational Age Advisory Board International Small for Gestational Age Advisory Board consensus development conference statement: management of short children born small for gestational age, April 24-October 1, 2001" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "P.A. Lee" 1 => "S.D. Chernausek" 2 => "A.C. Hokken-Koelega" 3 => "P. Czernichow" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Pediatrics" "fecha" => "2003" "volumen" => "111" "paginaInicial" => "1253" "paginaFinal" => "1261" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12777538" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0185" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Estudio transversal español de crecimiento 2008. Parte II: valores de talla, peso e índice de masa corporal desde el nacimiento a la talla adulta" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Carrascosa Lezcano" 1 => "J.M. Fernández García" 2 => "C. Fernández Ramos" 3 => "A. Ferrández Longás" 4 => "J.P. López-Siguero" 5 => "E. Sánchez González" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "An Pediatr (Barc)" "fecha" => "2008" "volumen" => "68" "paginaInicial" => "544" "paginaFinal" => "551" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0190" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Variations in pattern of pubertal changes in girls" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "W.A. Marshall" 1 => "J.M. Tanner" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Dis Child" "fecha" => "1969" "volumen" => "44" "paginaInicial" => "291" "paginaFinal" => "303" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/5785179" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0195" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Efficacy and safety of long-term continuous growth hormone treatment of children born small for gestational age" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Hokken-Koelega" 1 => "Y. van Pareren" 2 => "N. Arends" 3 => "V. Boonstra" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000080518" "Revista" => array:7 [ "tituloSerie" => "Horm Res" "fecha" => "2004" "volumen" => "62" "numero" => "Suppl. 3" "paginaInicial" => "149" "paginaFinal" => "154" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15539818" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0200" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Safety and efficacy of growth hormone treatment in small for gestational age children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A. Poduval" 1 => "P. Saenger" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/MED.0b013e3283081911" "Revista" => array:6 [ "tituloSerie" => "Curr Opin Endocrinol Diabetes Obes" "fecha" => "2008" "volumen" => "15" "paginaInicial" => "376" "paginaFinal" => "382" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18594280" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0205" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "La hormona de crecimiento (GH) es eficaz y segura en el tratamiento de los niños con talla baja y antecedentes de retraso de crecimiento intrauterino con independencia de la secreción de GH" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Luzuriaga Tomás" 1 => "M. Oyarzabal Irigoyen" 2 => "J. Bel i Comos" 3 => "M.L. Granada Ybern" 4 => "A. Tejerina Puente" 5 => "M. Chueca Guindulain" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Inv Clin Farm" "fecha" => "2003" "paginaInicial" => "13" "paginaFinal" => "23" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0210" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The d3/fl-Growth Hormone (GH) receptor polymorphism does not influence the effect of GH treatment (66mcg/kg per Day) or the spontaneous growth in short non-GH deficient small-for-gestational-age children: results from a two-year controlled prospective study in 170 spanish patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Carrascosa" 1 => "C. Esteban" 2 => "R. Espadero" 3 => "R. Fernández-Cancio" 4 => "P. Andaluz" 5 => "M. Clemente" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1210/jc.2006-0685" "Revista" => array:6 [ "tituloSerie" => "J Clin Endocrinol Metab" "fecha" => "2006" "volumen" => "91" "paginaInicial" => "3281" "paginaFinal" => "3286" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16804042" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0215" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Improvement in growth after two years of growth hormone therapy in very young children born small for gestational age and without spontaneous catch-up growth: results of a multi-center, controlled, randomized, open clinical trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Argente" 1 => "R. Gracia" 2 => "L. Ibáñez" 3 => "A. Oliver" 4 => "E. Borrajo" 5 => "A. Vela" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1210/jc.2007-0078" "Revista" => array:6 [ "tituloSerie" => "J Clin Endocrinol Metab" "fecha" => "2007" "volumen" => "92" "paginaInicial" => "3095" "paginaFinal" => "3101" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17536000" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0220" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Eficacia y seguridad del tratamiento con hormona de crecimiento en niños pequeños para su edad gestacional: Análisis intermedio a 3 años. Estudio multicéntrico" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.P. López Siguero" 1 => "M.J. Martínez Aedo" 2 => "J.A. Bermúdez" 3 => "N. Cabrinety" 4 => "J.L. Lechuga" 5 => "A. Gutiérrez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Rev Esp Endocrinol Pediatr" "fecha" => "2013" "volumen" => "4" "paginaInicial" => "175" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0225" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The DATAC study: a new growth database description of the epidemiology diagnosis and therapeutic attitude in a group of Spanish children with short stature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.D. Rodríguez Arnao" 1 => "A. Rodríguez Sánchez" 2 => "C. García-Rey" 3 => "F. Arroyo Díez" 4 => "R. Cañete Estrada" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1515/jpem-2013-0394" "Revista" => array:6 [ "tituloSerie" => "J Pediatr Endocrinol Metab" "fecha" => "2014" "volumen" => "27" "paginaInicial" => "1201" "paginaFinal" => "1208" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25210749" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0230" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "KIGS 20 years: children born small for gestational age" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "D. Dunger" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Growth hormone therapy in pediatrics. 20 years of KIGS" "paginaInicial" => "400" "paginaFinal" => "406" "serieFecha" => "2007" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0235" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Final height in short children born small for gestational age treated with growth hormone" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J. Dahlgren" 1 => "K. Albertsson Wikland" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1203/01.PDR.0000148716.71231.81" "Revista" => array:6 [ "tituloSerie" => "Pediatr Res" "fecha" => "2005" "volumen" => "57" "paginaInicial" => "216" "paginaFinal" => "222" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15585685" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0240" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidemiology and causes of preterm birth" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R.L. Goldenberg" 1 => "J.F. Culhane" 2 => "J.D. Iams" 3 => "R. Romero" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0140-6736(08)60074-4" "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "2008" "volumen" => "371" "paginaInicial" => "75" "paginaFinal" => "84" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18177778" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0245" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Growth hormone treatment in short children born prematurely — data from KIGS" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.C.S. Boguszewski" 1 => "H. Karlsson" 2 => "H.A. Wollmann" 3 => "P. Wilton" 4 => "J. Dahlgren" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1210/jc.2010-1829" "Revista" => array:6 [ "tituloSerie" => "J Clin Endocrinol Metab" "fecha" => "2011" "volumen" => "96" "paginaInicial" => "1687" "paginaFinal" => "1694" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21430029" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0250" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Early diagnosis and treatment referral of children born small for gestational age without catch-up growth are critical for optimal growth outcomes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C.P. Houk" 1 => "P.A. Lee" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1687-9856-2012-11" "Revista" => array:5 [ "tituloSerie" => "Int J Pediatr Endocrinol" "fecha" => "2012" "volumen" => "2012" "paginaInicial" => "11" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22559301" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0255" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spontaneous growth hormone secretion increases during puberty in normal girls and boys" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.R. Rose" 1 => "G. Municchi" 2 => "K.M. Barnes" 3 => "G.A. Kamp" 4 => "M.M. Uriarte" 5 => "J.L. Ross" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1210/jcem-73-2-428" "Revista" => array:6 [ "tituloSerie" => "J Clin Endocrinol Metab" "fecha" => "1991" "volumen" => "73" "paginaInicial" => "428" "paginaFinal" => "435" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1856268" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0260" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "An analysis of the clinical and cost effectiveness of growth hormone replacement therapy before and during puberty: should we increase the dose?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S.R. Howard" 1 => "G.E. Butler" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000346687" "Revista" => array:6 [ "tituloSerie" => "Horm Res Paediatr" "fecha" => "2013" "volumen" => "79" "paginaInicial" => "75" "paginaFinal" => "82" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23406656" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0265" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Growth hormone therapy for children born small for gestational age: height gain is less dose dependent over the long term than over the short term" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "F. De Zegher" 1 => "A. Hokken-Koelega" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1542/peds.2004-1934" "Revista" => array:6 [ "tituloSerie" => "Pediatrics" "fecha" => "2005" "volumen" => "115" "paginaInicial" => "e458" "paginaFinal" => "e462" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15805349" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0270" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Height after long-term, continuous growth hormone (GH) treatment in short children born small for gestational age: results of a randomized, double-blind, dose-response GH trial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "Y. Van Pareren" 1 => "P. Mulder" 2 => "M. Houdijk" 3 => "M. Jansen" 4 => "M. Reeser" 5 => "A. Hokken-Koelega" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1210/jc.2002-021172" "Revista" => array:6 [ "tituloSerie" => "J Clin Endocrinol Metab" "fecha" => "2003" "volumen" => "88" "paginaInicial" => "3584" "paginaFinal" => "3590" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12915640" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0275" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Adult height of prepubertal short children born small for gestational age treated with GH" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "on behalf of the 0908 Lilly Study Group" "etal" => false "autores" => array:4 [ 0 => "M. Rosilio" 1 => "J.C. Carel" 2 => "E. Ecosse" 3 => "J.L. Chaussain" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1530/eje.1.01916" "Revista" => array:6 [ "tituloSerie" => "Eur J Endocrinol" "fecha" => "2005" "volumen" => "152" "paginaInicial" => "835" "paginaFinal" => "843" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15941922" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0280" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Final height of short subjects of low birth weight with and without growth hormone treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Zucchini" 1 => "E. Cacciari" 2 => "A. Balsamo" 3 => "A. Cicognani" 4 => "D. Tassinari" 5 => "E. Barbieri" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Dis Child" "fecha" => "2001" "volumen" => "84" "paginaInicial" => "340" "paginaFinal" => "343" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11259236" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0285" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Short stature associated with intrauterine growth retardation: final height of untreated and growth hormone-treated children" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Coutant" 1 => "J.C. Carel" 2 => "M. Letrait" 3 => "C. Bouvattier" 4 => "P. Chatelain" 5 => "J. Coste" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1210/jcem.83.4.4750" "Revista" => array:6 [ "tituloSerie" => "J Clin Endocrinol Metab" "fecha" => "1998" "volumen" => "83" "paginaInicial" => "1070" "paginaFinal" => "1074" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9543119" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0290" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Height velocity targets from the National Cooperative Growth Study for first year growth hormone responses in short children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "B. Bakker" 1 => "J. Frane" 2 => "H. Anhalt" 3 => "B. Lippe" 4 => "R.G. Rosenfeld" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1210/jc.2007-1581" "Revista" => array:6 [ "tituloSerie" => "J Clin Endocrinol Metab" "fecha" => "2008" "volumen" => "93" "paginaInicial" => "352" "paginaFinal" => "357" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18000092" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0295" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A comparison of different definitions of growth response in short prepubertal children treated with growth hormone" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Bang" 1 => "R. Bjerknes" 2 => "J. Dahlgren" 3 => "L. Dunkel" 4 => "J. Gustafsson" 5 => "A. Juul" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000322878" "Revista" => array:6 [ "tituloSerie" => "Horm Res Paediatr" "fecha" => "2011" "volumen" => "75" "paginaInicial" => "335" "paginaFinal" => "345" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21228552" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0300" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison of response to 2-years’ growth hormone treatment in children with isolated growth hormone deficiency, born small for gestational age, idiopathic short stature, or multiple pituitary hormone deficiency: combined results from two large observational studies" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P.A. Lee" 1 => "L. Sävendahl" 2 => "I. Oliver" 3 => "M. Tauber" 4 => "O. Blankenstein" 5 => "J. Ross" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1687-9856-2012-22" "Revista" => array:5 [ "tituloSerie" => "Int J Pediatr Endocrinol" "fecha" => "2012" "volumen" => "2012" "paginaInicial" => "22" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22788856" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0305" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Three-year growth response to growth hormone treatment in very young children born small for gestational age — data from KIGS" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.C.S. Boguszewski" 1 => "A. Lindberg" 2 => "H.A. Wollmann" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1210/jc.2013-4117" "Revista" => array:6 [ "tituloSerie" => "J Clin Endocrinol Metab" "fecha" => "2014" "volumen" => "99" "paginaInicial" => "2683" "paginaFinal" => "2688" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24758180" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0310" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Impact of growth hormone therapy on adult height of children born small for gestational age" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A. Maiorana" 1 => "S. Cianfarani" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1542/peds.2009-0293" "Revista" => array:6 [ "tituloSerie" => "Pediatrics" "fecha" => "2009" "volumen" => "124" "paginaInicial" => "e519" "paginaFinal" => "e531" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19706577" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0315" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prediction model for adult height of SGA children at start of growth hormone treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.A.J. De Ridder" 1 => "T.H. Stijnen" 2 => "A.C.S. Hokken-Koelega" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1210/jc.2007-1381" "Revista" => array:6 [ "tituloSerie" => "J Clin Endocrinol Metab" "fecha" => "2008" "volumen" => "93" "paginaInicial" => "477" "paginaFinal" => "483" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18000093" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0320" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Adult height in children with growth hormone deficiency who are treated with biosynthetic growth hormone: the National Cooperative Growth Study experience" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G.P. August" 1 => "J.R. Julius" 2 => "S.L. Blethen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Pediatrics" "fecha" => "1998" "volumen" => "102" "paginaInicial" => "512" "paginaFinal" => "516" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9685455" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0325" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The first-year growth response to growth hormone treatment predicts the long-term prepubertal growth response in children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "B. Kriström" 1 => "J. Dahlgren" 2 => "A. Niklasson" 3 => "A.F.M. Nierop" 4 => "K. Albertsson-Wikland" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1472-6947-9-1" "Revista" => array:5 [ "tituloSerie" => "BMC Med Inform Decis Mak" "fecha" => "2009" "volumen" => "9" "paginaInicial" => "1" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19138407" "web" => "Medline" ] ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0330" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prediction of response to growth hormone treatment in short children born small for gestational age: analysis of data from KIGS (Pharmacia International Growth Database)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.B. Ranke" 1 => "A. Lindberg" 2 => "C.T. Cowell" 3 => "K. Albertsson-Wikland" 4 => "E.O. Reiter" 5 => "P. Wilton" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1210/jc.2002-020867" "Revista" => array:6 [ "tituloSerie" => "J Clin Endocrinol Metab" "fecha" => "2003" "volumen" => "88" "paginaInicial" => "125" "paginaFinal" => "131" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12519840" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0335" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Puberty in growth hormone-treated children born small for gestational age (SGA)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "V. Boonstra" 1 => "Y. van Pareren" 2 => "P. Mulder" 3 => "A. Hokken-Koelega" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1210/jc.2003-030512" "Revista" => array:6 [ "tituloSerie" => "J Clin Endocrinol Metab" "fecha" => "2003" "volumen" => "88" "paginaInicial" => "5753" "paginaFinal" => "5758" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14671164" "web" => "Medline" ] ] ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib0340" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Influence of perinatal factors on the onset of puberty in boys and girls: implications for interpretation of link with risk of long term diseases" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "I. Persson" 1 => "F. Ahlsson" 2 => "U. Ewald" 3 => "T. Tuvemo" 4 => "M. Qingyuan" 5 => "D. von Rosen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Epidemiol" "fecha" => "1999" "volumen" => "150" "paginaInicial" => "747" "paginaFinal" => "755" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10512428" "web" => "Medline" ] ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib0345" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Precocious pubarche, hyperinsulinism, and ovarian hyperandrogenism in girls: relation to reduced fetal growth" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "L. Ibañez" 1 => "N. Potau" 2 => "I. Francois" 3 => "F. de Zegher" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1210/jcem.83.10.5205" "Revista" => array:6 [ "tituloSerie" => "J Clin Endocrinol Metab" "fecha" => "1998" "volumen" => "83" "paginaInicial" => "3558" "paginaFinal" => "3562" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9768664" "web" => "Medline" ] ] ] ] ] ] ] ] 34 => array:3 [ "identificador" => "bib0350" "etiqueta" => "35" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Management of the child born small for gestational age through infancy to adulthood: a consensus statement of the international societies of pediatric endocrinology and the Growth Hormone Research Society" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "P.E. Clayton" 1 => "S. Cianfarani" 2 => "P. Czernichow" 3 => "G. Johannsson" 4 => "R. Rapaport" 5 => "A. Rogol" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1210/jc.2006-2017" "Revista" => array:6 [ "tituloSerie" => "J Clin Endocrinol Metab" "fecha" => "2007" "volumen" => "92" "paginaInicial" => "804" "paginaFinal" => "810" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17200164" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:3 [ "titulo" => "Acknowledgments" "texto" => "We thank the prescribing paediatricians in Aragón, Cantabria, Catalonia, Basque Country, Galicia and Navarra, as well as the advisory boards and committees on growth hormone of those autonomous communities, for providing the data analysed in the study." "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/23412879/0000008600000005/v1_201704260029/S2341287917300716/v1_201704260029/en/main.assets" "Apartado" => array:4 [ "identificador" => "26005" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original Articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23412879/0000008600000005/v1_201704260029/S2341287917300716/v1_201704260029/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287917300716?idApp=UINPBA00005H"]

Statistics

Original Article

Growth hormone treatment in small for gestational age children in Spain

Tratamiento con hormona de crecimiento en pequeños para la edad gestacional en España

José Manuel Rial Rodrígueza,

Corresponding author

jmrial53@gmail.com

Corresponding author.

, Antonio de Arriba Muñozb, Jordi Bosch Muñozc, Paloma Cabanas Rodríguezd, Ramón Cañete Estradae, Ignacio Díez Lópezf, María Magdalena Hawkins Solísg, María José Martínez-Aedo Olleroh, Ana Cristina Rodríguez Dehlii, Lourdes Ibáñez Todaj, On behalf of Grupo de trabajo para el estudio del paciente pequeño para la edad gestacional (PEG) de la Sociedad Española de Endocrinología Pediátrica (SEEP)

a Unidad de Endocrinología, Servicio de Pediatría, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain

b Unidad de Endocrinología Pediátrica, Hospital Universitario Miguel Servet, Zaragoza, Spain

c Unidad de Endocrinología Pediátrica, Hospital Universitari Arnau de Vilanova, Universidad de Lleida, Lleida, Spain

d Unidad de Endocrinología Pediátrica, Crecimiento y Adolescencia, Departamento de Pediatría, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain

e Unidad de Endocrinología Pediátrica, Hospital Universitario Reina Sofía, Córdoba, Spain

f Unidad de Endocrinología Pediátrica, OSI-Araba, Hospital Universitario Araba, Departamento de Pediatría, Universidad del País Vasco, Vitoria, Álava, Spain

g Servicio de Pediatría, Hospital Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain

h Unidad de Endocrinología Pediátrica, Hospital Materno-Infantil Carlos Haya, Málaga, Spain

i Unidad de Endocrinología Pediátrica, Hospital San Agustín, Avilés, Asturias, Spain

j Unidad de Endocrinología, Hospital Sant Joan de Déu, Universidad de Barcelona, Barcelona, Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain

Read

7110

Times
was read the article

2443

Total PDF

4667

Total HTML

Share statistics

 array:24 [
  "pii" => "S2341287917300716"
  "issn" => "23412879"
  "doi" => "10.1016/j.anpede.2016.04.008"
  "estado" => "S300"
  "fechaPublicacion" => "2017-05-01"
  "aid" => "2092"
  "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
  "copyrightAnyo" => "2016"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "cita" => "An Pediatr &#40;Barc&#41;. 2017;86:249-54"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 1924
    "formatos" => array:3 [
      "EPUB" => 273
      "HTML" => 1137
      "PDF" => 514
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S1695403316301680"
      "issn" => "16954033"
      "doi" => "10.1016/j.anpedi.2016.04.001"
      "estado" => "S300"
      "fechaPublicacion" => "2017-05-01"
      "aid" => "2092"
      "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "fla"
      "cita" => "An Pediatr &#40;Barc&#41;. 2017;86:249-54"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:2 [
        "total" => 5115
        "formatos" => array:3 [
          "EPUB" => 172
          "HTML" => 4020
          "PDF" => 923
        ]
      ]
      "es" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">ORIGINAL</span>"
        "titulo" => "Tratamiento con hormona de crecimiento en peque&#241;os para la edad gestacional en Espa&#241;a"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:2 [
          0 => "es"
          1 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "249"
            "paginaFinal" => "254"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Growth hormone treatment in small for gestational age children in Spain"
          ]
        ]
        "contieneResumen" => array:2 [
          "es" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figura 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 807
                "Ancho" => 1588
                "Tamanyo" => 51485
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Evoluci&#243;n de la talla &#40;DE&#41;&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Jos&#233; Manuel Rial Rodr&#237;guez, Antonio de Arriba Mu&#241;oz, Jordi Bosch Mu&#241;oz, Paloma Cabanas Rodr&#237;guez, Ram&#243;n Ca&#241;ete Estrada, Ignacio D&#237;ez L&#243;pez, Mar&#237;a Magdalena Hawkins Sol&#237;s, Mar&#237;a Jos&#233; Mart&#237;nez-Aedo Ollero, Ana Cristina Rodr&#237;guez Dehli, Lourdes Ib&#225;&#241;ez Toda"
            "autores" => array:11 [
              0 => array:2 [
                "nombre" => "Jos&#233; Manuel"
                "apellidos" => "Rial Rodr&#237;guez"
              ]
              1 => array:2 [
                "nombre" => "Antonio"
                "apellidos" => "de Arriba Mu&#241;oz"
              ]
              2 => array:2 [
                "nombre" => "Jordi"
                "apellidos" => "Bosch Mu&#241;oz"
              ]
              3 => array:2 [
                "nombre" => "Paloma"
                "apellidos" => "Cabanas Rodr&#237;guez"
              ]
              4 => array:2 [
                "nombre" => "Ram&#243;n"
                "apellidos" => "Ca&#241;ete Estrada"
              ]
              5 => array:2 [
                "nombre" => "Ignacio"
                "apellidos" => "D&#237;ez L&#243;pez"
              ]
              6 => array:2 [
                "nombre" => "Mar&#237;a Magdalena"
                "apellidos" => "Hawkins Sol&#237;s"
              ]
              7 => array:2 [
                "nombre" => "Mar&#237;a Jos&#233;"
                "apellidos" => "Mart&#237;nez-Aedo Ollero"
              ]
              8 => array:2 [
                "nombre" => "Ana Cristina"
                "apellidos" => "Rodr&#237;guez Dehli"
              ]
              9 => array:2 [
                "nombre" => "Lourdes"
                "apellidos" => "Ib&#225;&#241;ez Toda"
              ]
              10 => array:1 [
                "colaborador" => "en representaci&#243;n del Grupo de trabajo para el estudio del paciente peque&#241;o para la edad gestacional &#40;PEG&#41; de la Sociedad Espa&#241;ola de Endocrinolog&#237;a Pedi&#225;trica &#40;SEEP&#41;"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2341287917300716"
          "doi" => "10.1016/j.anpede.2016.04.008"
          "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/S2341287917300716?idApp=UINPBA00005H"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403316301680?idApp=UINPBA00005H"
      "url" => "/16954033/0000008600000005/v1_201704260013/S1695403316301680/v1_201704260013/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S234128791730073X"
    "issn" => "23412879"
    "doi" => "10.1016/j.anpede.2016.05.006"
    "estado" => "S300"
    "fechaPublicacion" => "2017-05-01"
    "aid" => "2119"
    "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "An Pediatr &#40;Barc&#41;. 2017;86:255-63"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 1888
      "formatos" => array:3 [
        "EPUB" => 273
        "HTML" => 1091
        "PDF" => 524
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Spanish patients with central hypoventilation syndrome included in the European Registry&#46; The 2015 data"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "255"
          "paginaFinal" => "263"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Pacientes espa&#241;oles con s&#237;ndrome de hipoventilaci&#243;n central incluidos en el Registro europeo&#46; Datos del 2015"
        ]
      ]
      "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" => 1039
              "Ancho" => 1648
              "Tamanyo" => 46048
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Ventilatory support modalities used &#40;bars&#41; and number of patients supported by each modality at home discharge and as of December 2015&#46;</p> <p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">NIV&#44; noninvasive ventilation with mask&#59; PNP&#44; phrenic nerve pacing&#59; TRACH&#44; tracheostomy&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Mar&#237;a Angeles Garc&#237;a Teresa, Raquel Porto Abal, Silvia Rodr&#237;guez Torres, Diego Garc&#237;a Urabayen, Silvia Garc&#237;a Mart&#237;nez, Ha Trang, Angel Campos Barros"
          "autores" => array:8 [
            0 => array:2 [
              "nombre" => "Mar&#237;a Angeles"
              "apellidos" => "Garc&#237;a Teresa"
            ]
            1 => array:2 [
              "nombre" => "Raquel"
              "apellidos" => "Porto Abal"
            ]
            2 => array:2 [
              "nombre" => "Silvia"
              "apellidos" => "Rodr&#237;guez Torres"
            ]
            3 => array:2 [
              "nombre" => "Diego"
              "apellidos" => "Garc&#237;a Urabayen"
            ]
            4 => array:2 [
              "nombre" => "Silvia"
              "apellidos" => "Garc&#237;a Mart&#237;nez"
            ]
            5 => array:2 [
              "nombre" => "Ha"
              "apellidos" => "Trang"
            ]
            6 => array:2 [
              "nombre" => "Angel"
              "apellidos" => "Campos Barros"
            ]
            7 => array:1 [
              "colaborador" => "Grupo Espa&#241;ol de Trabajo del SHCC"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S1695403316302016"
        "doi" => "10.1016/j.anpedi.2016.05.008"
        "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/S1695403316302016?idApp=UINPBA00005H"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S234128791730073X?idApp=UINPBA00005H"
    "url" => "/23412879/0000008600000005/v1_201704260029/S234128791730073X/v1_201704260029/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S2341287917300686"
    "issn" => "23412879"
    "doi" => "10.1016/j.anpede.2016.05.005"
    "estado" => "S300"
    "fechaPublicacion" => "2017-05-01"
    "aid" => "2111"
    "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "An Pediatr &#40;Barc&#41;. 2017;86:240-8"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 2083
      "formatos" => array:3 [
        "EPUB" => 280
        "HTML" => 1295
        "PDF" => 508
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Effects of growth hormone treatment on anthropometrics&#44; metabolic risk&#44; and body composition variables in small for gestational age patients"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "240"
          "paginaFinal" => "248"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Modificaciones en variables antropom&#233;tricas&#44; anal&#237;ticas de riesgo metab&#243;lico y composici&#243;n corporal en peque&#241;os para la edad gestacional en tratamiento con hormona de crecimiento"
        ]
      ]
      "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" => "fig0010"
          "etiqueta" => "Figure 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 1847
              "Ancho" => 1614
              "Tamanyo" => 95194
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Changes in height &#40;SD&#41; relative to genetic potential &#40;SD&#41; during followup&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Esther Aurensanz Clemente, Pilar Samper Villagrasa, Ariadna Ayerza Casas, Pablo Ruiz Frontera, Olga Bueno Lozano, Luis Alberto Moreno Aznar, Gloria Bueno Lozano"
          "autores" => array:7 [
            0 => array:2 [
              "nombre" => "Esther"
              "apellidos" => "Aurensanz Clemente"
            ]
            1 => array:2 [
              "nombre" => "Pilar"
              "apellidos" => "Samper Villagrasa"
            ]
            2 => array:2 [
              "nombre" => "Ariadna"
              "apellidos" => "Ayerza Casas"
            ]
            3 => array:2 [
              "nombre" => "Pablo"
              "apellidos" => "Ruiz Frontera"
            ]
            4 => array:2 [
              "nombre" => "Olga"
              "apellidos" => "Bueno Lozano"
            ]
            5 => array:2 [
              "nombre" => "Luis Alberto"
              "apellidos" => "Moreno Aznar"
            ]
            6 => array:2 [
              "nombre" => "Gloria"
              "apellidos" => "Bueno Lozano"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S1695403316301898"
        "doi" => "10.1016/j.anpedi.2016.05.001"
        "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/S1695403316301898?idApp=UINPBA00005H"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287917300686?idApp=UINPBA00005H"
    "url" => "/23412879/0000008600000005/v1_201704260029/S2341287917300686/v1_201704260029/en/main.assets"
  ]
  "en" => array:21 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
    "titulo" => "Growth hormone treatment in small for gestational age children in Spain"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "249"
        "paginaFinal" => "254"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Jos&#233; Manuel Rial Rodr&#237;guez, Antonio de Arriba Mu&#241;oz, Jordi Bosch Mu&#241;oz, Paloma Cabanas Rodr&#237;guez, Ram&#243;n Ca&#241;ete Estrada, Ignacio D&#237;ez L&#243;pez, Mar&#237;a Magdalena Hawkins Sol&#237;s, Mar&#237;a Jos&#233; Mart&#237;nez-Aedo Ollero, Ana Cristina Rodr&#237;guez Dehli, Lourdes Ib&#225;&#241;ez Toda"
        "autores" => array:11 [
          0 => array:4 [
            "nombre" => "Jos&#233; Manuel"
            "apellidos" => "Rial Rodr&#237;guez"
            "email" => array:1 [
              0 => "jmrial53&#64;gmail&#46;com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Antonio"
            "apellidos" => "de Arriba Mu&#241;oz"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Jordi"
            "apellidos" => "Bosch Mu&#241;oz"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Paloma"
            "apellidos" => "Cabanas Rodr&#237;guez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Ram&#243;n"
            "apellidos" => "Ca&#241;ete Estrada"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">e</span>"
                "identificador" => "aff0025"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Ignacio"
            "apellidos" => "D&#237;ez L&#243;pez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">f</span>"
                "identificador" => "aff0030"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "Mar&#237;a Magdalena"
            "apellidos" => "Hawkins Sol&#237;s"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">g</span>"
                "identificador" => "aff0035"
              ]
            ]
          ]
          7 => array:3 [
            "nombre" => "Mar&#237;a Jos&#233;"
            "apellidos" => "Mart&#237;nez-Aedo Ollero"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">h</span>"
                "identificador" => "aff0040"
              ]
            ]
          ]
          8 => array:3 [
            "nombre" => "Ana Cristina"
            "apellidos" => "Rodr&#237;guez Dehli"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">i</span>"
                "identificador" => "aff0045"
              ]
            ]
          ]
          9 => array:3 [
            "nombre" => "Lourdes"
            "apellidos" => "Ib&#225;&#241;ez Toda"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">j</span>"
                "identificador" => "aff0050"
              ]
            ]
          ]
          10 => array:1 [
            "colaborador" => "On behalf of Grupo de trabajo para el estudio del paciente peque&#241;o para la edad gestacional &#40;PEG&#41; de la Sociedad Espa&#241;ola de Endocrinolog&#237;a Pedi&#225;trica &#40;SEEP&#41;"
          ]
        ]
        "afiliaciones" => array:10 [
          0 => array:3 [
            "entidad" => "Unidad de Endocrinolog&#237;a&#44; Servicio de Pediatr&#237;a&#44; Hospital Universitario Nuestra Se&#241;ora de Candelaria&#44; Santa Cruz de Tenerife&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Unidad de Endocrinolog&#237;a Pedi&#225;trica&#44; Hospital Universitario Miguel Servet&#44; Zaragoza&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Unidad de Endocrinolog&#237;a Pedi&#225;trica&#44; Hospital Universitari Arnau de Vilanova&#44; Universidad de Lleida&#44; Lleida&#44; Spain"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Unidad de Endocrinolog&#237;a Pedi&#225;trica&#44; Crecimiento y Adolescencia&#44; Departamento de Pediatr&#237;a&#44; Hospital Cl&#237;nico Universitario de Santiago de Compostela&#44; Santiago de Compostela&#44; A Coru&#241;a&#44; Spain"
            "etiqueta" => "d"
            "identificador" => "aff0020"
          ]
          4 => array:3 [
            "entidad" => "Unidad de Endocrinolog&#237;a Pedi&#225;trica&#44; Hospital Universitario Reina Sof&#237;a&#44; C&#243;rdoba&#44; Spain"
            "etiqueta" => "e"
            "identificador" => "aff0025"
          ]
          5 => array:3 [
            "entidad" => "Unidad de Endocrinolog&#237;a Pedi&#225;trica&#44; OSI-Araba&#44; Hospital Universitario Araba&#44; Departamento de Pediatr&#237;a&#44; Universidad del Pa&#237;s Vasco&#44; Vitoria&#44; &#193;lava&#44; Spain"
            "etiqueta" => "f"
            "identificador" => "aff0030"
          ]
          6 => array:3 [
            "entidad" => "Servicio de Pediatr&#237;a&#44; Hospital Infanta Sof&#237;a&#44; San Sebasti&#225;n de los Reyes&#44; Madrid&#44; Spain"
            "etiqueta" => "g"
            "identificador" => "aff0035"
          ]
          7 => array:3 [
            "entidad" => "Unidad de Endocrinolog&#237;a Pedi&#225;trica&#44; Hospital Materno-Infantil Carlos Haya&#44; M&#225;laga&#44; Spain"
            "etiqueta" => "h"
            "identificador" => "aff0040"
          ]
          8 => array:3 [
            "entidad" => "Unidad de Endocrinolog&#237;a Pedi&#225;trica&#44; Hospital San Agust&#237;n&#44; Avil&#233;s&#44; Asturias&#44; Spain"
            "etiqueta" => "i"
            "identificador" => "aff0045"
          ]
          9 => array:3 [
            "entidad" => "Unidad de Endocrinolog&#237;a&#44; Hospital Sant Joan de D&#233;u&#44; Universidad de Barcelona&#44; Barcelona&#44; Centro de Investigaci&#243;n Biom&#233;dica en Red de Diabetes y Enfermedades Metab&#243;licas Asociadas &#40;CIBERDEM&#41;&#44; Instituto de Salud Carlos III&#44; Madrid&#44; Spain"
            "etiqueta" => "j"
            "identificador" => "aff0050"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Tratamiento con hormona de crecimiento en peque&#241;os para la edad gestacional en Espa&#241;a"
      ]
    ]
    "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" => 807
            "Ancho" => 1588
            "Tamanyo" => 55004
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Changes in stature &#40;SD&#41;&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The term small for gestational age comprehends all newborns whose birth weight or birth crown-heel length is 2 sd below the mean for their sex and gestational age based on a reference population&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">1</span></a> Since 2003&#44; when the European Medicines Agency approved the use of recombinant human growth hormone &#40;rhGH&#41; for the treatment of children small for gestational age &#40;SGA&#41; or with intrauterine growth restriction &#40;IUGR&#41; without postnatal catchup growth&#44; a large number of patients have received this treatment in Spain&#46; However&#44; we do not know the exact number of patients&#44; their geographical distribution&#44; the age at treatment initiation&#44; the clinical response and the potential adverse effects that have been observed&#46; Much of this information can be found in the registers of the advisory committees that authorise rhGH treatment in the different autonomous communities &#40;regions&#41; of Spain&#46; In order to obtain an objective understanding of the characteristics of the use of rhGH in children born SGA in Spain&#44; we collected the data from these registers in several autonomous communities as a preliminary phase for a nationwide study&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">After analysing the data and correcting potential errors in the calculated values&#44; we compared the results with those of domestic and international studies on the use of rhGH for the treatment of SGA children&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><p id="par0015" class="elsevierStylePara elsevierViewall">We collected all the data contained in the registers of the advisory committees that regulate the distribution of rhGH by the Department of Public Health of the different autonomous communities on the patients in whom treatment was authorised&#44; with the exception of confidential personal information&#46; The collected data included parental heights&#44; gestational age&#44; birth weight and birth length&#46; We also recorded the age&#44; weight&#44; height&#44; pubertal stage of development and growth velocity of patients at the time of treatment initiation and in subsequent checkups&#44; as well as the prescribed doses of rhGH and the final height achieved by those that completed treatment during the period under study&#46; We also recorded the age at menarche in female patients&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">We assessed auxologic measurements using the charts of the Estudio Colaborativo Espa&#241;ol 2008<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">2</span></a> and pubertal development by means of Tanner scale&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">3</span></a> We summarised the data as means and standard deviations &#40;SDs&#41;&#46; We used the IBM SPSS 19&#46;0 software for Windows for the statistical analysis&#46; We conducted two-tailed Student&#39;s <span class="elsevierStyleItalic">t</span> tests and paired-sample <span class="elsevierStyleItalic">t</span> tests&#46; We defined statistical significance for all the analysed variables as a <span class="elsevierStyleItalic">p</span>-value of less than 0&#46;05 for a 95&#37; confidence interval&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0025" class="elsevierStylePara elsevierViewall">We analysed the treatments &#40;number&#41; registered from 2004 to 2014 in the autonomous communities of Arag&#243;n &#40;76&#41;&#44; Basque Country &#40;87&#41;&#44; Navarra &#40;56&#41;&#44; Catalonia &#40;525&#41;&#44; Cantabria &#40;69&#41; and Galicia &#40;161&#41;&#46; We obtained valid data for a total of 974 patients &#40;48&#37; male&#41;&#46; These patients amounted to approximately 21&#37; of the total rhGH treatments authorised in those autonomous communities&#46; Five percent of the patients were born from multiple gestations and 23&#37; born preterm&#44; and the gestational age for the overall sample was 38<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3 weeks&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The mean birth weight was &#8722;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1 SD and the mean birth length was &#8722;2&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;9 SD&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">At birth&#44; the length of 81&#37; of the patients was at least 2 SDs below the mean and the weight of 54&#37; at least 2 SDs below the mean&#44; and both were at least 2 SDs below the mean in 42&#37; of the patients&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">In 27&#37; of the patients&#44; the target heights &#40;&#91;father&#39;s height<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>mother&#39;s height<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#93;&#47;2&#41; were at least 2 SDs below the mean&#46; The mean target height was &#8722;1&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1 SD&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Patients started receiving treatment with rhGH at an age of 7&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;8 years&#46; During the period under study&#44; the age at treatment initiation did not change significantly in the more recent patients&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The height at treatment initiation was &#8722;3&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;8 SD&#44; and the baseline growth velocity was &#8722;1&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;5 SD&#46; The stage of pubertal development at initiation of treatment was Tanner I in 89&#37;&#44; Tanner II in 7&#37; and Tanner III in 2&#37;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The initial dose of rhGH was 35<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6<span class="elsevierStyleHsp" style=""></span>&#956;g&#47;kg&#47;day&#44; and we found no significant changes at follow up or depending of the year in which treatment was initiated&#59; the initial dose was also independent of age and stage of pubertal development at initiation&#46; All patients received uninterrupted treatment&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The height gains associated with treatment corresponded to 0&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;2 SDs in the first year&#44; and 1&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;8 SDs in the first two years&#46; Approximately 30&#37; of patients achieved height <span class="elsevierStyleItalic">z</span>-scores greater than &#8722;2 SD in the first year of treatment&#44; and another 60&#37; of patients achieved them in the second year &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; In the fifth year of treatment&#44; heights had increased by 2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;9 SDs compared to baseline&#46; Growth velocity increased by 3&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;3 SDs compared to the year before treatment initiation&#46; We did not find statistically significant differences in treatment response based on gestational age&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Fourteen percent of patients exhibited a response in the first year of treatment that was more than 2 SDs below the mean for the sample&#44; corresponding to height gains of less than 0&#46;3 SD&#44; which can serve as the threshold for defining nonresponders&#46; Up to 24&#37; had height gains of less than 0&#46;5 SD and 55&#37; had growth velocity increases of less than 3<span class="elsevierStyleHsp" style=""></span>cm&#47;year&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">The response in the first year of treatment was negatively correlated with initial height &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#46;40&#41; and the age at initiation of treatment &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#46;36&#41;&#44; and positively correlated with the rhGH dose &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;24&#41;&#44; associations that were statistically significant &#40;<span class="elsevierStyleItalic">P<span class="elsevierStyleHsp" style=""></span>&#60;</span><span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Eight percent of the patients reached their final heights during the follow-up&#44; corresponding to a mean of &#8722;1&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;7 SD&#44; very similar to the target height&#44; with a difference of &#8722;0&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1 SD&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">The age at menarche&#44; available for 13&#37; of female patients&#44; was 13&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2 years&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0085" class="elsevierStylePara elsevierViewall">Several studies conducted abroad on the use of rhGH in SGA children with no postnatal catchup growth support its efficacy and safety&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">4&#44;5</span></a> Following its approval by EMA&#44; the Spanish Ministry of Health introduced its indication under the category of intrauterine growth restriction&#46; In the past few years&#44; several publications have reported the outcomes of treatment in different case series that included patients from different hospitals&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">6&#8211;10</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">However&#44; until now we had no data on the number of SGA patients treated with rhGH and their proportion compared to other indications for the use of rhGH&#44; their geographical distribution&#44; and the details concerning their followup&#46; Our study analysed data for all SGA children treated with rhGH in a specific geographical area that comprised six autonomous communities in the north of Spain&#44; a preliminary phase in a nationwide study&#44; and included 974 patients that received this treatment in the 2004&#8211;2014 period&#46; Our study has the limitations imposed by the source of the data&#44; as the registers do not collect exhaustive information on obstetric factors&#44; comorbidities&#44; side effects or adherence to treatment&#46; However&#44; given the considerable number of patients included and the absence of selection bias &#40;they were treated in different hospitals and received rhGH made by different manufacturers&#41;&#44; our study is representative of the use of rhGH for the treatment of SGA children &#40;IUGR&#41; in Spain&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Our results reveal a characteristic profile in the patients in whom treatment with rhGH is authorised&#58; target height below the mean&#44; smaller birth lengths compared to birth weights&#44; and in nearly 25&#37;&#44; preterm&#46; This profile could be used to identify SGA children whose growth should be monitored more closely in the early years of life&#46; Other series have also described target heights of approximately 1 SD below the mean&#44;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">11&#44;12</span></a> but in our series 27&#37; of the target heights were at least 2 SDs below the mean&#44; suggesting a marked genetic component in the short stature of this group of patients&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Children born preterm&#44; who amount to 5&#37; to 9&#37; of births in Europe&#44;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">13</span></a> were disproportionally represented in our sample&#44; amounting to 23&#37; of the patients&#44; although this proportion was similar to the one found by another study conducted in Spain&#44; the DATAC study&#44; in which 27&#37; of patients had been born preterm&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">10</span></a> The response to treatment of children born preterm was comparable to that of children born at term&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">14</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">Although treatment is approved by the EMA starting at age 4 years&#44; the mean age at initiation in our patients was 7&#46;2 years&#44; a delay that did not improve during the period under study&#46; Other studies conducted in Spain reported similar ages&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">6&#44;7&#44;9&#44;10</span></a> We hypothesise that the reason for this is that the practise of referring all SGA children that do not experience catchup growth in the early years to paediatric endocrinology services is not yet widespread&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">The response to rhGH&#44; expressed as an increase in height SDs&#44; is greater the younger the age at initiation&#44; a finding that was confirmed in our study with a strong negative correlation between age and height gain in the first year of treatment&#46; The findings of other series are similar&#46;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">8&#44;11&#44;12</span></a> An adequate follow-up of SGA children from birth would allow initiation of treatment and the normalisation of stature at earlier ages&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">15</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">We found that patients had uniformly received a mean dose of 35<span class="elsevierStyleHsp" style=""></span>&#956;g&#47;kg&#47;day&#44; which did not change during the follow-up nor based on age or the time to initiation of treatment&#46; Although the dose adjustment during puberty remains controversial&#44;<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">16&#44;17</span></a> we also found no evidence of dose adjustment based on the stage of pubertal development&#46; On the other hand&#44; different doses of rhGH do not lead to significantly different outcomes in the long term&#46;<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">18&#44;19</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">Our study corroborated that treatment with rhGH in children SGA is generally efficacious&#44; both in the early stages and in patients reaching their final heights&#44; with the latter achieving values within the range of the target height&#44; a goal that has not always been achieved in previous studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">18&#44;20&#8211;22</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">However&#44; there was variability in the response to treatment&#44; with 14&#37; of nonrespondents&#44; which in our study was defined as a height increase of less than 0&#46;3 SD in the first year&#44; and up to 24&#37; if we were to apply the criteria of height gain less than 0&#46;5 SD&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">23</span></a> Some studies have defined inadequate response as an increase of less than 3<span class="elsevierStyleHsp" style=""></span>cm in the growth velocity&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">24</span></a> Based on this criterion&#44; 55&#37; of the patients in our sample would be categorised as nonrespondents&#46; In any case&#44; the mean response values in our patients are consistent with those reported in other studies&#44;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">25</span></a> both in Spain &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41; and internationally &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; Higher doses were used in the series of Carrascosa et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">7</span></a> Argente et al&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">8</span></a> and Boguszewski et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">26</span></a> and the last two included younger patients&#46; The meta-analysis conducted by Maiorana and Cianfarani&#44;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">27</span></a> which included several European studies&#44; found that patients failed to achieve their target heights&#44; despite the use of higher doses compared to our study&#44; possibly due to initiation of treatment at older ages&#46; The largest series published to date&#44; in the context of the KIGS study and funded by Pfizer<span class="elsevierStyleSup">&#174;</span>&#44; with 900 patients and a mean dose of 40<span class="elsevierStyleHsp" style=""></span>&#956;g&#47;kg&#47;day&#44; found a height gain of 0&#46;7 SD in the first year&#44; as did our study&#44; but had final heights around &#8722;2 SD&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">11</span></a> In the series of Ridder et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">28</span></a> the final height was far below the target height&#44; despite the use of doses of up to 67<span class="elsevierStyleHsp" style=""></span>&#956;g&#47;kg&#47;day&#46; The height catchup observed in our sample was similar to that observed in patients treated for growth hormone deficiency&#46;<a class="elsevierStyleCrossRefs" href="#bib0300"><span class="elsevierStyleSup">25&#44;29</span></a></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0130" class="elsevierStylePara elsevierViewall">The response observed in the first year of treatment is a predictor of final height&#46;<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">30&#44;31</span></a> In our sample&#44; the determinants of the initial response were the age at initiation of treatment&#44; the initial height and the dose of rhGH&#44; which was consistent with other studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">28&#44;31</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">Although we did not have detailed information on the onset of puberty&#44; the age at menarche in 13&#37; of the female patients was 13 years&#46; While treatment with rhGH does not seem to affect the onset and development of puberty in general&#44;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">32</span></a> a longer followup period is required for confirmation&#46; The SGA population enters puberty at an age close to the mean for the general population&#44; although girls with low birth weights that experience rapid weight and height catchup tend to reach puberty at earlier ages<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">33</span></a> and may present with pronounced adrenarche and hyperandrogenism associated with hyperinsulinism&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">34</span></a></p><p id="par0140" class="elsevierStylePara elsevierViewall">The analysis of the data obtained from the official registers of the autonomous communities did not allow us to draw conclusions regarding the safety of treatment with rhGH in SGA patients&#46; However&#44; the evidence in the existing literature consistently suggests that there are no significant risks&#8212;at least in the intermediate term&#8212;with frequent elevation of blood insulin levels that resolves spontaneously&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">1&#44;4&#44;5&#44;35</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conclusions</span><p id="par0145" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">&#40;1&#41;</span><p id="par0150" class="elsevierStylePara elsevierViewall">We present a study based on a population of SGA children managed with rhGH in Spain&#44; with no bias from the use of a specific brand of recombinant hormone&#44; treated in several different hospitals following the criteria of the EMA with the approval the advisory committees of the specific autonomous communities&#46; It includes cases from the initial authorisation for its use in IUGR&#47;SGA to the recent past&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">&#40;2&#41;</span><p id="par0155" class="elsevierStylePara elsevierViewall">The sample of 974 patients was the largest studied to date&#44; and comparable to those of international studies that included patients from different countries&#46; We believe that this study is representative of the use of rhGH for the treatment of IUGR&#47;SGA in Spain&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">&#40;3&#41;</span><p id="par0160" class="elsevierStylePara elsevierViewall">We found that most patients responded well to treatment from the first year&#44; achieving final heights that were close to the genetic potential or target height&#46; Twenty-four percent of the patients responded poorly&#44; with height gains of less than 0&#46;5 SD in the first year&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">&#40;4&#41;</span><p id="par0165" class="elsevierStylePara elsevierViewall">The information pertaining to adverse effects and pubertal development was not recorded in the database with adequate accuracy&#44; and should be investigated with different methods&#46;</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">&#40;5&#41;</span><p id="par0170" class="elsevierStylePara elsevierViewall">The data underscore the importance of starting treatment with rhGH early with the purpose of achieving normal heights in children born SGA&#46; Small for gestational age children whose length was more affected than weight at birth&#44; whose parents have short statures or born preterm should be monitored closely in the first three years of life to initiate treatment promptly if they do not exhibit spontaneous catch-up growth&#46;</p></li></ul></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflicts of interests</span><p id="par0175" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:11 [
        0 => array:3 [
          "identificador" => "xres833063"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Introduction"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Methods"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec828986"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres833064"
          "titulo" => "Resumen"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Introducci&#243;n"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "M&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Conclusiones"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec828987"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Methods"
        ]
        6 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Results"
        ]
        7 => array:2 [
          "identificador" => "sec0020"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0025"
          "titulo" => "Conclusions"
        ]
        9 => array:2 [
          "identificador" => "sec0030"
          "titulo" => "Conflicts of interests"
        ]
        10 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2016-02-15"
    "fechaAceptado" => "2016-04-12"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec828986"
          "palabras" => array:4 [
            0 => "Small for gestational age"
            1 => "Growth hormone"
            2 => "Treatment outcome"
            3 => "Public hospitals"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec828987"
          "palabras" => array:4 [
            0 => "Peque&#241;o para la edad gestacional"
            1 => "Hormona de crecimiento"
            2 => "Respuesta terap&#233;utica"
            3 => "Hospitales p&#250;blicos"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Since its approval by the European Medicines Agency&#44; a great number of patients born small for gestational date have received recombinant growth hormone treatment in Spain&#46; The aim of this study is to analyse its outcome in the setting of ordinary clinical practice&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Information was gathered from the registers of the assessment boards that authorise all growth hormone treatments prescribed in public hospitals in six autonomic communities &#40;regions&#41;&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Valid data from 974 patients was obtained&#46; All of them complied with criteria established by the European Medicines Agency&#46; Patients in the sample were smaller in length than weight at birth&#44; with their median target height being below 1 standard deviation &#40;SD&#41;&#44; and 23&#37; of them had been delivered prematurely&#46; Treatment was started at 7&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;8 years &#40;mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD&#41;&#46; The mean patient height at start was &#8722;3&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;8 SD&#46; They gained 0&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;2 SD in the first year&#44; and 1&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;8 SD after two years&#46; Final height was attained by 8&#37; of the sample&#44; reaching &#8722;1&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;7 SD&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">These results are similar to other Spanish and international published studies&#44; and are representative of the current practice in Spain&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Despite treatment being started at a late age&#44; adequate growth is observed in the short term and in the final height&#46; Up to a 24&#37; of patients show a poor response in the first year&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Desde su aprobaci&#243;n por la Agencia Europea del Medicamento&#44; el tratamiento con hormona de crecimiento recombinante ha sido empleado en un gran n&#250;mero de pacientes nacidos peque&#241;os para la edad gestacional en Espa&#241;a&#46; El prop&#243;sito de este estudio es conocer objetivamente los resultados del mismo en la pr&#225;ctica habitual&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se ha recogido informaci&#243;n procedente de los registros existentes en los comit&#233;s asesores que autorizan dichos tratamientos en los hospitales p&#250;blicos de 6 comunidades aut&#243;nomas&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Se han obtenido datos v&#225;lidos de 974 pacientes&#46; Todos ellos cumpl&#237;an los criterios exigidos por la Agencia Europea del Medicamento&#46; Los pacientes que recibieron el tratamiento se caracterizaron por tener la longitud al nacer m&#225;s afectada que el peso&#44; talla diana inferior a &#8211;1 desviaci&#243;n est&#225;ndar &#40;DE&#41; y un 23&#37; con antecedentes de prematuridad&#46; La talla al iniciar el tratamiento fue de &#8722;3&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;8 DE &#40;media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DE&#41; y la edad de comienzo 7&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;8 a&#241;os&#46; La ganancia de talla en el primer a&#241;o fue de 0&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;2 DE&#44; y de 1&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;8 DE hasta los 2 a&#241;os&#46; La talla final&#44; alcanzada por un 8&#37; de pacientes&#44; fue de &#8211;1&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;7 DE&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Los resultados concuerdan con las series nacionales e internacionales publicadas y son representativos de la pr&#225;ctica habitual en nuestro pa&#237;s&#46;</p><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Se constata un inicio tard&#237;o del tratamiento&#44; observ&#225;ndose&#44; sin embargo&#44; un adecuado crecimiento&#44; tanto a corto plazo como en la talla final&#46; En el primer a&#241;o se identifica un 24&#37; de pacientes con respuesta deficiente&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "M&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as&#58; Rial Rodr&#237;guez JM&#44; de Arriba Mu&#241;oz A&#44; Bosch Mu&#241;oz J&#44; Cabanas Rodr&#237;guez P&#44; Ca&#241;ete Estrada R&#44; D&#237;ez L&#243;pez I&#44; et al&#46; Tratamiento con hormona de crecimiento en peque&#241;os para la edad gestacional en Espa&#241;a&#46; An Pediatr &#40;Barc&#41;&#46; 2017&#59;86&#58;249&#8211;254&#46;</p>"
      ]
    ]
    "multimedia" => array:3 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 807
            "Ancho" => 1588
            "Tamanyo" => 55004
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Changes in stature &#40;SD&#41;&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">STUDY&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Luzuriaga Tom&#225;s et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">6</span></a> 2003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Carrascosa et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">7</span></a> 2006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Argente et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">8</span></a> 2007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">L&#243;pez Siguero et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">9</span></a> 2013&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Number of patients&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">147&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Target height<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> &#40;<span class="elsevierStyleItalic">z</span>-score&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;1&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;1&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age at initiation &#40;years&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Baseline height<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> &#40;<span class="elsevierStyleItalic">z</span>-score&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;2&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;3&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;3&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;3&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Height at 1 year<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> &#40;<span class="elsevierStyleItalic">z</span>-score&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;1&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;2&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;1&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;2&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#916; Height in 1st year &#40;<span class="elsevierStyleItalic">z</span>-score&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dose &#40;&#956;g&#47;kg&#47;day&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1403214.png"
              ]
            ]
          ]
          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Values expressed as mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Studies conducted in Spain&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Values are expressed as means&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">KIGS&#44;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">11</span></a> 2007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">De Ridder et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">28</span></a> 2008&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Kristr&#246;m et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">30</span></a> 2009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Boguszewski et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">26</span></a> 2014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Maiorana and Cianfarani<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">27</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Current series&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Number of patients&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">900&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">150&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">367&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">156&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">391&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">974&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Target height &#40;<span class="elsevierStyleItalic">z</span>-score&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;1&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;0&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;0&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;0&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;1&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;1&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age at initiation &#40;years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Baseline height &#40;<span class="elsevierStyleItalic">z</span>-score&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;3&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;3&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;2&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;3&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;2&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;3&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Height at 1 year &#40;<span class="elsevierStyleItalic">z</span>-score&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;2&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;2&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;2&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#916; Height in 1st year &#40;<span class="elsevierStyleItalic">z</span>-score&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dose &#40;&#956;g&#47;kg&#47;day&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33&#47;67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33&#8211;67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Final height &#40;<span class="elsevierStyleItalic">z</span>-score&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;2&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;1&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;1&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;1&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1403213.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">International studies&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:35 [
            0 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "International Small for Gestational Age Advisory Board International Small for Gestational Age Advisory Board consensus development conference statement&#58; management of short children born small for gestational age&#44; April 24-October 1&#44; 2001"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "P&#46;A&#46; Lee"
                            1 => "S&#46;D&#46; Chernausek"
                            2 => "A&#46;C&#46; Hokken-Koelega"
                            3 => "P&#46; Czernichow"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatrics"
                        "fecha" => "2003"
                        "volumen" => "111"
                        "paginaInicial" => "1253"
                        "paginaFinal" => "1261"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12777538"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estudio transversal espa&#241;ol de crecimiento 2008&#46; Parte II&#58; valores de talla&#44; peso e &#237;ndice de masa corporal desde el nacimiento a la talla adulta"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Carrascosa Lezcano"
                            1 => "J&#46;M&#46; Fern&#225;ndez Garc&#237;a"
                            2 => "C&#46; Fern&#225;ndez Ramos"
                            3 => "A&#46; Ferr&#225;ndez Long&#225;s"
                            4 => "J&#46;P&#46; L&#243;pez-Siguero"
                            5 => "E&#46; S&#225;nchez Gonz&#225;lez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "An Pediatr &#40;Barc&#41;"
                        "fecha" => "2008"
                        "volumen" => "68"
                        "paginaInicial" => "544"
                        "paginaFinal" => "551"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Variations in pattern of pubertal changes in girls"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "W&#46;A&#46; Marshall"
                            1 => "J&#46;M&#46; Tanner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dis Child"
                        "fecha" => "1969"
                        "volumen" => "44"
                        "paginaInicial" => "291"
                        "paginaFinal" => "303"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/5785179"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Efficacy and safety of long-term continuous growth hormone treatment of children born small for gestational age"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Hokken-Koelega"
                            1 => "Y&#46; van Pareren"
                            2 => "N&#46; Arends"
                            3 => "V&#46; Boonstra"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000080518"
                      "Revista" => array:7 [
                        "tituloSerie" => "Horm Res"
                        "fecha" => "2004"
                        "volumen" => "62"
                        "numero" => "Suppl&#46; 3"
                        "paginaInicial" => "149"
                        "paginaFinal" => "154"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15539818"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Safety and efficacy of growth hormone treatment in small for gestational age children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Poduval"
                            1 => "P&#46; Saenger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/MED.0b013e3283081911"
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Opin Endocrinol Diabetes Obes"
                        "fecha" => "2008"
                        "volumen" => "15"
                        "paginaInicial" => "376"
                        "paginaFinal" => "382"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18594280"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "La hormona de crecimiento &#40;GH&#41; es eficaz y segura en el tratamiento de los ni&#241;os con talla baja y antecedentes de retraso de crecimiento intrauterino con independencia de la secreci&#243;n de GH"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Luzuriaga Tom&#225;s"
                            1 => "M&#46; Oyarzabal Irigoyen"
                            2 => "J&#46; Bel i Comos"
                            3 => "M&#46;L&#46; Granada Ybern"
                            4 => "A&#46; Tejerina Puente"
                            5 => "M&#46; Chueca Guindulain"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Inv Clin Farm"
                        "fecha" => "2003"
                        "paginaInicial" => "13"
                        "paginaFinal" => "23"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The d3&#47;fl-Growth Hormone &#40;GH&#41; receptor polymorphism does not influence the effect of GH treatment &#40;66<span class="elsevierStyleHsp" style=""></span>mcg&#47;kg per Day&#41; or the spontaneous growth in short non-GH deficient small-for-gestational-age children&#58; results from a two-year controlled prospective study in 170 spanish patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Carrascosa"
                            1 => "C&#46; Esteban"
                            2 => "R&#46; Espadero"
                            3 => "R&#46; Fern&#225;ndez-Cancio"
                            4 => "P&#46; Andaluz"
                            5 => "M&#46; Clemente"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1210/jc.2006-0685"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "2006"
                        "volumen" => "91"
                        "paginaInicial" => "3281"
                        "paginaFinal" => "3286"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16804042"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Improvement in growth after two years of growth hormone therapy in very young children born small for gestational age and without spontaneous catch-up growth&#58; results of a multi-center&#44; controlled&#44; randomized&#44; open clinical trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Argente"
                            1 => "R&#46; Gracia"
                            2 => "L&#46; Ib&#225;&#241;ez"
                            3 => "A&#46; Oliver"
                            4 => "E&#46; Borrajo"
                            5 => "A&#46; Vela"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1210/jc.2007-0078"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "2007"
                        "volumen" => "92"
                        "paginaInicial" => "3095"
                        "paginaFinal" => "3101"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17536000"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Eficacia y seguridad del tratamiento con hormona de crecimiento en ni&#241;os peque&#241;os para su edad gestacional&#58; An&#225;lisis intermedio a 3 a&#241;os&#46; Estudio multic&#233;ntrico"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;P&#46; L&#243;pez Siguero"
                            1 => "M&#46;J&#46; Mart&#237;nez Aedo"
                            2 => "J&#46;A&#46; Berm&#250;dez"
                            3 => "N&#46; Cabrinety"
                            4 => "J&#46;L&#46; Lechuga"
                            5 => "A&#46; Guti&#233;rrez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Rev Esp Endocrinol Pediatr"
                        "fecha" => "2013"
                        "volumen" => "4"
                        "paginaInicial" => "175"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The DATAC study&#58; a new growth database description of the epidemiology diagnosis and therapeutic attitude in a group of Spanish children with short stature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46;D&#46; Rodr&#237;guez Arnao"
                            1 => "A&#46; Rodr&#237;guez S&#225;nchez"
                            2 => "C&#46; Garc&#237;a-Rey"
                            3 => "F&#46; Arroyo D&#237;ez"
                            4 => "R&#46; Ca&#241;ete Estrada"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1515/jpem-2013-0394"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr Endocrinol Metab"
                        "fecha" => "2014"
                        "volumen" => "27"
                        "paginaInicial" => "1201"
                        "paginaFinal" => "1208"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25210749"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "KIGS 20 years&#58; children born small for gestational age"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D&#46; Dunger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:4 [
                        "titulo" => "Growth hormone therapy in pediatrics&#46; 20 years of KIGS"
                        "paginaInicial" => "400"
                        "paginaFinal" => "406"
                        "serieFecha" => "2007"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Final height in short children born small for gestational age treated with growth hormone"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; Dahlgren"
                            1 => "K&#46; Albertsson Wikland"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1203/01.PDR.0000148716.71231.81"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Res"
                        "fecha" => "2005"
                        "volumen" => "57"
                        "paginaInicial" => "216"
                        "paginaFinal" => "222"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15585685"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology and causes of preterm birth"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46;L&#46; Goldenberg"
                            1 => "J&#46;F&#46; Culhane"
                            2 => "J&#46;D&#46; Iams"
                            3 => "R&#46; Romero"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(08)60074-4"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2008"
                        "volumen" => "371"
                        "paginaInicial" => "75"
                        "paginaFinal" => "84"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18177778"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Growth hormone treatment in short children born prematurely &#8212; data from KIGS"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46;C&#46;S&#46; Boguszewski"
                            1 => "H&#46; Karlsson"
                            2 => "H&#46;A&#46; Wollmann"
                            3 => "P&#46; Wilton"
                            4 => "J&#46; Dahlgren"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1210/jc.2010-1829"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "2011"
                        "volumen" => "96"
                        "paginaInicial" => "1687"
                        "paginaFinal" => "1694"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21430029"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Early diagnosis and treatment referral of children born small for gestational age without catch-up growth are critical for optimal growth outcomes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46;P&#46; Houk"
                            1 => "P&#46;A&#46; Lee"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1687-9856-2012-11"
                      "Revista" => array:5 [
                        "tituloSerie" => "Int J Pediatr Endocrinol"
                        "fecha" => "2012"
                        "volumen" => "2012"
                        "paginaInicial" => "11"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22559301"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Spontaneous growth hormone secretion increases during puberty in normal girls and boys"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;R&#46; Rose"
                            1 => "G&#46; Municchi"
                            2 => "K&#46;M&#46; Barnes"
                            3 => "G&#46;A&#46; Kamp"
                            4 => "M&#46;M&#46; Uriarte"
                            5 => "J&#46;L&#46; Ross"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1210/jcem-73-2-428"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "1991"
                        "volumen" => "73"
                        "paginaInicial" => "428"
                        "paginaFinal" => "435"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1856268"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An analysis of the clinical and cost effectiveness of growth hormone replacement therapy before and during puberty&#58; should we increase the dose&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46;R&#46; Howard"
                            1 => "G&#46;E&#46; Butler"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000346687"
                      "Revista" => array:6 [
                        "tituloSerie" => "Horm Res Paediatr"
                        "fecha" => "2013"
                        "volumen" => "79"
                        "paginaInicial" => "75"
                        "paginaFinal" => "82"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23406656"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Growth hormone therapy for children born small for gestational age&#58; height gain is less dose dependent over the long term than over the short term"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "F&#46; De Zegher"
                            1 => "A&#46; Hokken-Koelega"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1542/peds.2004-1934"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatrics"
                        "fecha" => "2005"
                        "volumen" => "115"
                        "paginaInicial" => "e458"
                        "paginaFinal" => "e462"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15805349"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Height after long-term&#44; continuous growth hormone &#40;GH&#41; treatment in short children born small for gestational age&#58; results of a randomized&#44; double-blind&#44; dose-response GH trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "Y&#46; Van Pareren"
                            1 => "P&#46; Mulder"
                            2 => "M&#46; Houdijk"
                            3 => "M&#46; Jansen"
                            4 => "M&#46; Reeser"
                            5 => "A&#46; Hokken-Koelega"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1210/jc.2002-021172"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "2003"
                        "volumen" => "88"
                        "paginaInicial" => "3584"
                        "paginaFinal" => "3590"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12915640"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Adult height of prepubertal short children born small for gestational age treated with GH"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "on behalf of the 0908 Lilly Study Group"
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Rosilio"
                            1 => "J&#46;C&#46; Carel"
                            2 => "E&#46; Ecosse"
                            3 => "J&#46;L&#46; Chaussain"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1530/eje.1.01916"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Endocrinol"
                        "fecha" => "2005"
                        "volumen" => "152"
                        "paginaInicial" => "835"
                        "paginaFinal" => "843"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15941922"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Final height of short subjects of low birth weight with and without growth hormone treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Zucchini"
                            1 => "E&#46; Cacciari"
                            2 => "A&#46; Balsamo"
                            3 => "A&#46; Cicognani"
                            4 => "D&#46; Tassinari"
                            5 => "E&#46; Barbieri"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dis Child"
                        "fecha" => "2001"
                        "volumen" => "84"
                        "paginaInicial" => "340"
                        "paginaFinal" => "343"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11259236"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Short stature associated with intrauterine growth retardation&#58; final height of untreated and growth hormone-treated children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Coutant"
                            1 => "J&#46;C&#46; Carel"
                            2 => "M&#46; Letrait"
                            3 => "C&#46; Bouvattier"
                            4 => "P&#46; Chatelain"
                            5 => "J&#46; Coste"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1210/jcem.83.4.4750"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "1998"
                        "volumen" => "83"
                        "paginaInicial" => "1070"
                        "paginaFinal" => "1074"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9543119"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Height velocity targets from the National Cooperative Growth Study for first year growth hormone responses in short children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "B&#46; Bakker"
                            1 => "J&#46; Frane"
                            2 => "H&#46; Anhalt"
                            3 => "B&#46; Lippe"
                            4 => "R&#46;G&#46; Rosenfeld"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1210/jc.2007-1581"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "2008"
                        "volumen" => "93"
                        "paginaInicial" => "352"
                        "paginaFinal" => "357"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18000092"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A comparison of different definitions of growth response in short prepubertal children treated with growth hormone"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Bang"
                            1 => "R&#46; Bjerknes"
                            2 => "J&#46; Dahlgren"
                            3 => "L&#46; Dunkel"
                            4 => "J&#46; Gustafsson"
                            5 => "A&#46; Juul"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000322878"
                      "Revista" => array:6 [
                        "tituloSerie" => "Horm Res Paediatr"
                        "fecha" => "2011"
                        "volumen" => "75"
                        "paginaInicial" => "335"
                        "paginaFinal" => "345"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21228552"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of response to 2-years&#8217; growth hormone treatment in children with isolated growth hormone deficiency&#44; born small for gestational age&#44; idiopathic short stature&#44; or multiple pituitary hormone deficiency&#58; combined results from two large observational studies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46;A&#46; Lee"
                            1 => "L&#46; S&#228;vendahl"
                            2 => "I&#46; Oliver"
                            3 => "M&#46; Tauber"
                            4 => "O&#46; Blankenstein"
                            5 => "J&#46; Ross"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1687-9856-2012-22"
                      "Revista" => array:5 [
                        "tituloSerie" => "Int J Pediatr Endocrinol"
                        "fecha" => "2012"
                        "volumen" => "2012"
                        "paginaInicial" => "22"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22788856"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0305"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Three-year growth response to growth hormone treatment in very young children born small for gestational age &#8212; data from KIGS"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;C&#46;S&#46; Boguszewski"
                            1 => "A&#46; Lindberg"
                            2 => "H&#46;A&#46; Wollmann"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1210/jc.2013-4117"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "2014"
                        "volumen" => "99"
                        "paginaInicial" => "2683"
                        "paginaFinal" => "2688"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24758180"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0310"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Impact of growth hormone therapy on adult height of children born small for gestational age"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Maiorana"
                            1 => "S&#46; Cianfarani"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1542/peds.2009-0293"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatrics"
                        "fecha" => "2009"
                        "volumen" => "124"
                        "paginaInicial" => "e519"
                        "paginaFinal" => "e531"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19706577"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0315"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prediction model for adult height of SGA children at start of growth hormone treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;A&#46;J&#46; De Ridder"
                            1 => "T&#46;H&#46; Stijnen"
                            2 => "A&#46;C&#46;S&#46; Hokken-Koelega"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1210/jc.2007-1381"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "2008"
                        "volumen" => "93"
                        "paginaInicial" => "477"
                        "paginaFinal" => "483"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18000093"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0320"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Adult height in children with growth hormone deficiency who are treated with biosynthetic growth hormone&#58; the National Cooperative Growth Study experience"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "G&#46;P&#46; August"
                            1 => "J&#46;R&#46; Julius"
                            2 => "S&#46;L&#46; Blethen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatrics"
                        "fecha" => "1998"
                        "volumen" => "102"
                        "paginaInicial" => "512"
                        "paginaFinal" => "516"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9685455"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0325"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The first-year growth response to growth hormone treatment predicts the long-term prepubertal growth response in children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "B&#46; Kristr&#246;m"
                            1 => "J&#46; Dahlgren"
                            2 => "A&#46; Niklasson"
                            3 => "A&#46;F&#46;M&#46; Nierop"
                            4 => "K&#46; Albertsson-Wikland"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1472-6947-9-1"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMC Med Inform Decis Mak"
                        "fecha" => "2009"
                        "volumen" => "9"
                        "paginaInicial" => "1"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19138407"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0330"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prediction of response to growth hormone treatment in short children born small for gestational age&#58; analysis of data from KIGS &#40;Pharmacia International Growth Database&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;B&#46; Ranke"
                            1 => "A&#46; Lindberg"
                            2 => "C&#46;T&#46; Cowell"
                            3 => "K&#46; Albertsson-Wikland"
                            4 => "E&#46;O&#46; Reiter"
                            5 => "P&#46; Wilton"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1210/jc.2002-020867"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "2003"
                        "volumen" => "88"
                        "paginaInicial" => "125"
                        "paginaFinal" => "131"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12519840"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0335"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Puberty in growth hormone-treated children born small for gestational age &#40;SGA&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "V&#46; Boonstra"
                            1 => "Y&#46; van Pareren"
                            2 => "P&#46; Mulder"
                            3 => "A&#46; Hokken-Koelega"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1210/jc.2003-030512"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "2003"
                        "volumen" => "88"
                        "paginaInicial" => "5753"
                        "paginaFinal" => "5758"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14671164"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0340"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Influence of perinatal factors on the onset of puberty in boys and girls&#58; implications for interpretation of link with risk of long term diseases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "I&#46; Persson"
                            1 => "F&#46; Ahlsson"
                            2 => "U&#46; Ewald"
                            3 => "T&#46; Tuvemo"
                            4 => "M&#46; Qingyuan"
                            5 => "D&#46; von Rosen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Epidemiol"
                        "fecha" => "1999"
                        "volumen" => "150"
                        "paginaInicial" => "747"
                        "paginaFinal" => "755"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10512428"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0345"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Precocious pubarche&#44; hyperinsulinism&#44; and ovarian hyperandrogenism in girls&#58; relation to reduced fetal growth"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "L&#46; Iba&#241;ez"
                            1 => "N&#46; Potau"
                            2 => "I&#46; Francois"
                            3 => "F&#46; de Zegher"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1210/jcem.83.10.5205"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "1998"
                        "volumen" => "83"
                        "paginaInicial" => "3558"
                        "paginaFinal" => "3562"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9768664"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0350"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Management of the child born small for gestational age through infancy to adulthood&#58; a consensus statement of the international societies of pediatric endocrinology and the Growth Hormone Research Society"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "P&#46;E&#46; Clayton"
                            1 => "S&#46; Cianfarani"
                            2 => "P&#46; Czernichow"
                            3 => "G&#46; Johannsson"
                            4 => "R&#46; Rapaport"
                            5 => "A&#46; Rogol"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1210/jc.2006-2017"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "2007"
                        "volumen" => "92"
                        "paginaInicial" => "804"
                        "paginaFinal" => "810"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17200164"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:3 [
        "titulo" => "Acknowledgments"
        "texto" => "<p id="par0180" class="elsevierStylePara elsevierViewall">We thank the prescribing paediatricians in Arag&#243;n&#44; Cantabria&#44; Catalonia&#44; Basque Country&#44; Galicia and Navarra&#44; as well as the advisory boards and committees on growth hormone of those autonomous communities&#44; for providing the data analysed in the study&#46;</p>"
        "vista" => "all"
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/23412879/0000008600000005/v1_201704260029/S2341287917300716/v1_201704260029/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "26005"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original Articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/23412879/0000008600000005/v1_201704260029/S2341287917300716/v1_201704260029/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287917300716?idApp=UINPBA00005H"
]

Article information

ISSN: 23412879
Original language: English

DOI:10.1016/j.anpede.2016.04.008

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 November	14	9	23
2024 October	86	40	126
2024 September	62	37	99
2024 August	97	62	159
2024 July	89	28	117
2024 June	111	28	139
2024 May	99	26	125
2024 April	85	43	128
2024 March	74	24	98
2024 February	79	31	110
2024 January	89	30	119
2023 December	90	23	113
2023 November	89	30	119
2023 October	93	24	117
2023 September	86	32	118
2023 August	69	20	89
2023 July	56	24	80
2023 June	61	32	93
2023 May	58	19	77
2023 April	47	17	64
2023 March	74	22	96
2023 February	60	15	75
2023 January	46	48	94
2022 December	81	35	116
2022 November	91	28	119
2022 October	73	38	111
2022 September	60	36	96
2022 August	66	46	112
2022 July	49	45	94
2022 June	35	49	84
2022 May	53	40	93
2022 April	61	49	110
2022 March	76	64	140
2022 February	66	45	111
2022 January	85	51	136
2021 December	73	38	111
2021 November	79	51	130
2021 October	104	87	191
2021 September	56	40	96
2021 August	44	57	101
2021 July	43	42	85
2021 June	52	49	101
2021 May	52	55	107
2021 April	104	67	171
2021 March	43	28	71
2021 February	27	20	47
2021 January	29	26	55
2020 December	40	23	63
2020 November	32	15	47
2020 October	22	21	43
2020 September	50	22	72
2020 August	26	13	39
2020 July	27	18	45
2020 June	28	6	34
2020 May	26	13	39
2020 April	22	18	40
2020 March	33	19	52
2020 February	19	15	34
2020 January	18	14	32
2019 December	55	18	73
2019 November	24	8	32
2019 October	40	22	62
2019 September	43	14	57
2019 August	67	18	85
2019 July	37	22	59
2019 June	31	19	50
2019 May	46	31	77
2019 April	33	19	52
2019 March	31	22	53
2019 February	28	11	39
2019 January	33	23	56
2018 December	43	19	62
2018 November	90	26	116
2018 October	152	13	165
2018 September	55	14	69
2018 August	1	0	1
2018 June	8	0	8
2018 May	13	0	13
2018 April	18	0	18
2018 March	17	0	17
2018 February	6	0	6
2018 January	12	0	12
2017 December	20	0	20
2017 November	20	0	20
2017 October	22	0	22
2017 September	17	0	17
2017 August	14	0	14
2017 July	22	0	22
2017 June	35	8	43
2017 May	51	44	95
2017 April	24	145	169

Show all

Indexed in:

Follow us:

Subscribe:

Statistics

Indexed in:

Follow us:

Subscribe:

Statistics

Subscribe to our newsletter