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superior a 16 a&#241;os en el var&#243;n y 14 en las chicas&#46; Sin embargo&#44; en DGH puede prolongarse a la edad adulta por las acciones metab&#243;licas de la misma<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">7&#44;8</span></a>&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">La GH supone un gasto elevado para el sistema sanitario&#44; por lo que ser&#237;a beneficioso definir los factores predictores de respuesta&#44; para as&#237; optimizar la eficacia y seguridad del tratamiento&#46; Este hecho justifica la necesidad de estudios a largo plazo con GH&#44; para proveer a los cl&#237;nicos la informaci&#243;n necesaria para elegir qu&#233; pacientes podr&#237;an beneficiarse m&#225;s del tratamiento sin riesgos a largo plazo<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">9</span></a>&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Planteamos un estudio de nuestra poblaci&#243;n para definir DGH y las variables que influyen en la talla adulta&#59; ya que si bien ya se han realizado estudios similares en pa&#237;ses como Italia&#44; Francia o EEUU&#44; no hay nada publicado en la literatura de nuestro &#225;mbito geogr&#225;fico al respecto<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">10&#44;11</span></a>&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Por tanto&#44; tomando como hip&#243;tesis que la GH aumenta la talla adulta en la poblaci&#243;n espa&#241;ola con DGH aislado&#44; sin relacionarse con un n&#250;mero significativo de efectos adversos&#44; nos planteamos como objetivo evaluar la eficacia y seguridad del tratamiento con GH en pacientes con DGH idiop&#225;tico aislada&#44; determinando la influencia del desarrollo puberal durante el tratamiento&#44; las variables de eficacia&#44; y qu&#233; pacientes contin&#250;an manteniendo este d&#233;ficit en edad adulta&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Material y metodolog&#237;a</span><p id="par0050" class="elsevierStylePara elsevierViewall">Se realiz&#243; un estudio longitudinal descriptivo ambispectivo de ni&#241;os de ambos sexos&#44; diagnosticados de DGH&#44; entre 0-14 a&#241;os&#44; mediante 2 pruebas de est&#237;mulo&#44; y tratados con GH hasta el momento actual o la edad adulta&#44; en un hospital terciario durante 14 a&#241;os&#46; Adem&#225;s&#44; al suspender el tratamiento en talla adulta&#44; se realiz&#243; reevaluaci&#243;n en todos los casos mediante factor de crecimiento insul&#237;nico tipo 1 &#40;IGF-1<span class="elsevierStyleSmallCaps">&#41;</span> y prueba de est&#237;mulo&#44; previa firma de consentimiento informado&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Todas las medidas fueron realizadas 3 veces&#44; en ropa interior y descalzos&#44; con una b&#225;scula manual Seca&#44; con una precisi&#243;n de 0&#44;1<span class="elsevierStyleHsp" style=""></span>kg&#44; y un tall&#237;metro fijo de pared Holtain Stadiometer&#44; con precisi&#243;n de 0&#44;1<span class="elsevierStyleHsp" style=""></span>cm&#44; que era calibrado diariamente&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Se realizaron para el diagn&#243;stico&#44; en 2 d&#237;as diferentes&#44; el test de ejercicio&#44; por sus escasos efectos adversos&#44; y el test de est&#237;mulo con clonidina&#59; y para la reevaluaci&#243;n&#44; el test est&#237;mulo con insulina&#46; No se realiz&#243; cebamiento con esteroides sexuales&#46; Los puntos de corte escogidos fueron 7&#44;4<span class="elsevierStyleHsp" style=""></span>ng&#47;ml para el diagn&#243;stico y 5&#44;6<span class="elsevierStyleHsp" style=""></span>ng&#47;ml en la reevaluaci&#243;n&#44; bas&#225;ndonos en la bibliograf&#237;a actual<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">12</span></a>&#46; Los resultados anal&#237;ticos de GH e IGF-1 fueron procesados por personal cualificado mediante m&#233;todos de quimioluminiscencia inmune &#40;IMMULITE 2000&#41;&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">La cohorte fue monitorizada desde el diagnostico hasta la talla adulta&#44; recogiendo variables como la edad al diagn&#243;stico&#44; DE de peso&#44; talla e &#237;ndice de masa corporal al inicio&#44; al a&#241;o&#44; 2&#44; 3 y 4 a&#241;os de tratamiento&#44; cociente EO&#47;edad cronol&#243;gica &#40;EO&#47;EC&#41; inicial y al a&#241;o&#44; pron&#243;stico de talla adulta &#40;PTA&#41; seg&#250;n m&#233;todo de Bayley Pinneau inicial y al a&#241;o&#44; IGF-1 inicial y al a&#241;o&#44; talla diana&#44; edad puberal&#44; talla al inicio de la pubertad &#40;TIP&#41;&#44; ganancia puberal total &#40;GPT&#41;&#44; talla adulta y niveles de GH e IGF-1 en la reevaluaci&#243;n&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Todos los valores que lo permit&#237;an fueron ajustados en DE seg&#250;n el estudio transversal de crecimiento espa&#241;ol por el software antropom&#233;trico AUXOTEC<span class="elsevierStyleSup">&#174;</span><a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">13</span></a>&#44; mientras que el IGF-1 fue ajustado por edad y sexo de acuerdo al software facilitado por IMMULITE&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Finalmente se procedi&#243; al c&#225;lculo estad&#237;stico de los datos recogidos mediante el paquete estad&#237;stico SPSS versi&#243;n 22&#44; utilizando t student en la comparaci&#243;n de 2 medias de muestras normales y U-Mann Whitney en aquellas no normales&#44; ANOVA en la comparaci&#243;n de varias medias de muestras normales y Kruskal Wallis en muestras no normales&#44; as&#237; como correlaci&#243;n de Pearson en la comparaci&#243;n de muestras cuantitativas&#46; Adem&#225;s&#44; se us&#243; regresi&#243;n m&#250;ltiple en las variables estad&#237;sticamente significativas respecto a la talla adulta&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Resultados</span><p id="par0080" class="elsevierStylePara elsevierViewall">Se estudiaron 97 pacientes de ambos sexos diagnosticados de DGH&#44; los cuales recibieron durante 5 a&#241;os &#40;desde diagn&#243;stico hasta edad adulta&#41; una dosis mediana de GH de 0&#44;028<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;d&#237;a &#40;0&#44;025-0&#44;03&#41;&#46; La mediana de edad al diagn&#243;stico fue de 10&#44;5 a&#241;os &#40;8&#44;26-11&#44;7&#41;&#46; El 69&#37; eran varones&#46; El 89&#44;58&#37; alcanzaron la talla adulta&#46; No se observ&#243; patolog&#237;a tumoral en ning&#250;n caso&#44; y ning&#250;n paciente present&#243; efectos secundarios con el tratamiento&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Las principales caracter&#237;sticas descriptivas se muestran en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">El incremento medio de talla en el primer a&#241;o de tratamiento fue de 0&#44;49DE&#46; El PTA de acuerdo a EO&#47;EC mejor&#243; 0&#44;6DE&#46; La mejor&#237;a de talla progresiva se refleja en la <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a>&#46; Hubo una ganancia de talla de 0&#44;79DE desde el inicio hasta la pubertad en ambos sexos&#44; y desde la pubertad a talla final de 0&#44;43DE en varones y de 0&#44;29DE en mujeres&#46; La ganancia total hasta la edad adulta fue mayor en varones que en mujeres&#58; 1&#44;22DE y 1&#44;08DE&#44; respectivamente &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41; La ganancia sobre la talla adulta respecto al PTA inicial fue de 0&#44;1DE&#44; y respecto a la talla diana de 0&#44;28DE&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">Se identificaron diferencias estad&#237;sticamente significativas entre el sexo y las variables mostradas en la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">La talla adulta se ve influenciada por el sexo masculino con mayor talla durante todo el tratamiento&#44; mayor talla diana&#44; PTA y GPT&#44; as&#237; como&#44; un inicio puberal m&#225;s temprano&#44; y menor EO&#47;EC&#44; e IGF-1 y GH en la reevaluaci&#243;n &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">Finalmente&#44; tambi&#233;n es constatada una relaci&#243;n lineal entre el &#237;ndice de masa corporal y la dosis de GH&#44; siendo la dosis mayor al final del tratamiento que al principio del mismo &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46;</p><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Reevaluaci&#243;n</span><p id="par0110" class="elsevierStylePara elsevierViewall">Se reevaluaron 69 pacientes en edad adulta &#40;71&#44;13&#37;&#41;&#44; manteniendo el d&#233;ficit el 39&#44;4&#37;&#46; El 69&#37; de los pacientes con permanencia del d&#233;ficit eran varones&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Se realiz&#243; la IGF-1 en la reevaluaci&#243;n de talla adulta en 87 pacientes &#40;89&#44;58&#37;&#41;&#44; con una media de 0&#44;023DE&#44; y una IGF-1 deficitaria en el 11&#44;11&#37; de los pacientes&#44; definida como &#8722;2DE&#44; todos ellos con GH en reevaluaci&#243;n tambi&#233;n deficitaria &#40;GH<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>5&#44;4<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41; &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; Aunque no se hallaron diferencias estad&#237;sticamente significativas&#44; los DGH permanentes presentaron un diagn&#243;stico m&#225;s temprano&#44; un IGF-1 inicial menor&#44; un peso y talla al diagn&#243;stico menor&#44; y una mejor respuesta al tratamiento&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Si en lugar de &#8722;2DE utiliz&#225;ramos un punto de corte de &#8722;3&#44;22DE de IGF-1 en la reevaluaci&#243;n&#44; este nuevo punto de corte mostrar&#237;a un &#225;rea bajo la curva ROC de 0&#44;8&#44; que supone que se trata de un buen test&#44; y una mayor correlaci&#243;n con GH &#40;<a class="elsevierStyleCrossRef" href="#fig0015">fig&#46; 3</a>&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Discusi&#243;n</span><p id="par0125" class="elsevierStylePara elsevierViewall">Aunque la GH ha sido empleada para tratar la talla baja durante m&#225;s de 40 a&#241;os&#44; no existe unanimidad a la hora de definir los criterios que determinen unos objetivos de respuesta satisfactorios<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">14</span></a>&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Uno de los puntos de inter&#233;s de nuestro trabajo es que casi el 90&#37; de los menores reclutados han alcanzado la talla adulta&#44; pudiendo reevaluarse un n&#250;mero significativo de pacientes&#44; para as&#237; establecer su evoluci&#243;n durante el tratamiento y tras el fin del mismo&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Todos los estudios&#44; al igual que nosotros&#44; presentan ni&#241;os prepuberales con predominio masculino&#44; pero con una edad al diagn&#243;stico 2 a&#241;os menor al nuestro que muestra una edad mediana de 10&#44;5 a&#241;os&#44; lo que podr&#237;a suponer una peor respuesta al tratamiento<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">15</span></a>&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Existe heterogeneidad en cuanto al inicio de la pubertad&#44; afirmando en algunos estudios que existe un retraso frente a otros que no encuentran diferencia&#44; como es en nuestro caso&#46; Por otro lado&#44; las publicaciones actuales establecen una correlaci&#243;n positiva entre la edad al diagn&#243;stico y la pubertad&#59; y entre la talla inicial&#44; el crecimiento al a&#241;o&#44; la edad&#44; sexo&#44; tiempo de tratamiento&#44; EO&#47;EC y talla adulta&#44; de las cuales solo son confirmadas en nuestro estudio la relaci&#243;n entre la edad al diagn&#243;stico y edad puberal&#59; y entre el sexo&#44; la talla inicial y al a&#241;o&#44; y la talla adulta<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">11&#44;15&#8211;18</span></a>&#46; Maghnie et al&#46;&#44; adem&#225;s&#44; relacionan la talla adulta con la GPT<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">19</span></a>&#44; hecho no nombrado por otros autores hasta el momento&#44; pero s&#237; corroborado en nuestro estudio&#44; lo que responde a nuestro objetivo sobre la influencia de la pubertad sobre la talla final&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Adicionalmente&#44; en nuestro estudio tambi&#233;n se establece una correlaci&#243;n negativa entre la edad al diagn&#243;stico y la TIP&#59; entre la dosis y la TIP&#59; y entre el IGF-1 inicial y el PTA al a&#241;o&#44; la TIP y la talla adulta&#44; no nombradas hasta el momento&#46; A esto se a&#241;ade que en nuestro caso la EO respecto a la talla adulta presenta significaci&#243;n como correlaci&#243;n negativa&#44; no positiva&#44; lo que parece l&#243;gico puesto que cuanto m&#225;s retrasada sea la EO&#44; mayor ser&#225; el tiempo de crecimiento&#44; lo que en los estudios publicados se relaciona positivamente con la talla adulta&#44; o no lo relaciona como ocurre en el estudio Kabi International Growth Study &#40;estudio KIGS&#41;<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">20&#8211;22</span></a>&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Aunque no hay acuerdo acerca de la relaci&#243;n del inicio de pubertad con la talla adulta&#59; y entre el inicio de tratamiento y la talla adulta&#44; estas relaciones no se observan en nuestro caso<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">11&#44;15&#8211;19&#44;23&#44;24</span></a>&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">En cuanto a las diferencias significativas en la talla seg&#250;n sexo cabe decir que aunque en las publicaciones y en nuestra muestra se ha establecido una relaci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">11&#44;14</span></a>&#44; estas se podr&#237;an deber al crecimiento puberal de acuerdo al sexo&#44; as&#237; como al hecho de que la talla diana es menor en el sexo femenino&#44; y que parte de nuestra muestra femenina se encontraba en periodo peripuberal al diagn&#243;stico &#40;el 38&#37; inici&#243; pubertad en un a&#241;o&#41;&#46; A lo que se une que en nuestro estudio se establece una correlaci&#243;n negativa entre la edad puberal y la duraci&#243;n de la pubertad&#44; con la GPT&#44; al igual que lo reflejado en otros estudios<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">11&#44;20&#44;21</span></a>&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">El estudio KIGS refiere influencias estad&#237;sticamente significativas entre la GPT y el sexo&#44; talla diana&#44; dosis de GH&#44; EO&#47;EC&#44; TIP&#44; y edad de inicio y fin de pubertad<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">20&#44;22</span></a>&#44; mientras que en nuestro estudio solo se establecen diferencias estad&#237;sticamente significativas entre la GPT y el sexo masculino&#46; Tambi&#233;n enuncia que a pesar de la variabilidad interindividual del crecimiento con tratamiento entre ambos sexos en edad prep&#250;ber&#44; las diferencias entre sexos en cuanto a ganancia de talla y vc no son observables en los 3 primeros a&#241;os de tratamiento<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">21&#44;25</span></a>&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Adem&#225;s&#44; establece una relaci&#243;n negativa respecto a la diferencia de talla inicial y talla diana&#59; y entre el pico de GH&#44; la edad al diagn&#243;stico y la talla final&#46; Su correlaci&#243;n entre el pico de GH y talla final tambi&#233;n coincide con nuestros resultados de los niveles de GH iniciales&#44; edad al diagn&#243;stico y talla final mayor&#44; a pesar de no haberse establecido relaci&#243;n estad&#237;stica en nuestro caso<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">11&#44;16&#8211;19&#44;23&#44;24</span></a>&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">El estudio KIGS tambi&#233;n refiere influencia del n&#250;mero de pinchazos&#44; dosis de GH&#44; la vc durante el a&#241;o previo&#44; el peso actual y al nacimiento&#44; y la severidad del d&#233;ficit sobre la talla adulta&#59; la cual no ha sido observada en nuestro estudio ni en estudios previos&#44; por lo que ser&#237;an necesarios m&#225;s estudios al respecto<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">11&#44;15&#8211;19&#44;23</span></a>&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">A esto&#44; nuestro trabajo a&#241;ade una relaci&#243;n entre la talla adulta&#44; el PTA inicial&#44; la talla diana y las distintas tallas entre s&#237;&#44; incluidas desde el inicio hasta la TIP&#59; lo que hasta el momento no se hab&#237;a establecido de forma clara&#46; Por tanto&#44; la talla final se relaciona con la respuesta a lo largo de todos los a&#241;os de tratamiento&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">Por &#250;ltimo&#44; mientras que la mayor&#237;a afirman que la talla diana no influye en la talla final&#44; debido a que posiblemente incluyan en sus muestras pacientes que podr&#237;an presentar talla baja idiop&#225;tica&#44; el The Nordinet International Outcome Study &#40;estudio IOS&#41; y el estudio KIGS la correlacionan positivamente con la misma&#44; al igual que sucede en nuestro estudio<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">11&#44;15&#8211;19&#44;23&#8211;25</span></a>&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Aimaretti et al&#46; aprecian al igual que nosotros un aumento de IGF-1 con el tratamiento&#46; Adem&#225;s&#44; en la reevaluaci&#243;n comentan cierta concordancia entre los test de est&#237;mulo&#44; IGF-1 y el diagn&#243;stico<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">26</span></a>&#46; Ante esto&#44; destacar nuestros resultados de IGF-1 y GH en la reevaluaci&#243;n&#44; que apoyar&#237;a la concordancia indicada por este grupo y podr&#237;a asignarle un papel concomitante al IGF-1 en la reevaluaci&#243;n del d&#233;ficit de GH&#46; Siempre que el IGF-1 fue deficitario en la reevaluaci&#243;n&#44; lo era tambi&#233;n el test de est&#237;mulo con GH&#59; sin embargo&#44; no todos los casos con valores de d&#233;ficit en la prueba de est&#237;mulo con GH presentaban IGF-1 deficiente en la reevaluaci&#243;n&#44; hecho no claramente descrito hasta el momento actual en la literatura<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">27</span></a>&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">Por tanto&#44; de acuerdo a nuestros objetivos&#44; los datos publicados y nuestra experiencia&#44; la talla diana&#44; el PTA inicial&#44; la TIP&#44; la edad puberal&#44; la GPT&#44; la progresi&#243;n de la talla durante los a&#241;os de tratamiento&#44; la EO&#47;EC y el IGF-1 podr&#237;an ser factores predictores para la respuesta al tratamiento con GH&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">En cuanto a la eficacia&#44; las publicaciones establecen con el tratamiento una ganancia de talla entre &#43;0&#44;4DE y &#43;1&#44;5DE&#44; que es acorde a nuestra ganancia de &#43;1&#44;17DE<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">11&#44;15&#44;17&#44;24</span></a>&#46; Adem&#225;s Ranke et al&#46; refieren una ganancia de &#43;1&#44;2<span class="elsevierStyleHsp" style=""></span>cm y &#43;0&#44;2DE al a&#241;o de tratamiento<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">28</span></a>&#44; frente a nuestros datos de ganancia algo superiores &#40;&#43;0&#44;49DE&#41;&#46; Esta mejor&#237;a de talla supone en nuestra cohorte una talla adulta dentro de los rangos normales de nuestra poblaci&#243;n nacional&#44; al igual que lo reflejado por el estudio KIGS<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">29</span></a>&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Acerca de la GPT las publicaciones establecen una ganancia de &#43;0&#44;8DE&#44; frente a nuestros &#43;0&#44;43DE&#44; pudiendo deberse a la EO&#47;EC y el inicio de la pubertad no muy retrasados&#44; resistencias al tratamiento&#44; o falta de cumplimiento&#44; sin poder confirmarlo<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">15&#44;30</span></a>&#46; Kirk tambi&#233;n comenta que existe una mejora de talla respecto a la talla diana de entre &#43;0&#44;2 y &#43;0&#44;8DE<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">16</span></a>&#44; y Blethen et al&#46; refieren una mejora respecto al PTA de &#43;0&#44;7DE<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">11</span></a>&#44; consecuente con nuestra mejor&#237;a de &#43;0&#44;28DE respecto a la talla diana&#44; pero con una diferencia marcada respecto a nuestra mejor&#237;a conforme el PTA de tan solo &#43;0&#44;1DE&#44; probablemente en relaci&#243;n con la EO escasamente retrasada de nuestra muestra&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">Por &#250;ltimo&#44; destacar que en la literatura se encuentra en la reevaluaci&#243;n una permanencia del d&#233;ficit del 44&#44;4-71&#44;9&#37;&#44; frente a nuestro 39&#44;4&#37;<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">12&#44;26&#44;31</span></a>&#46; Por otro lado&#44; nosotros hemos hallado en nuestro estudio una edad m&#225;s temprana al diagn&#243;stico&#44; un IGF-1 inicial y talla inicial menor&#44; y una mejor respuesta al tratamiento en aquellos con permanencia del d&#233;ficit&#46; Asimismo destaca el predominio masculino&#44; probablemente relacionado con que tambi&#233;n presentaron m&#225;s hallazgos en la resonancia al diagn&#243;stico&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">Aunque se han descrito efectos adversos con el tratamiento&#44; Sotos y Tokar aportan que sus pacientes no presentaron efectos adversos con el tratamiento<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">32</span></a>&#44; lo que apoya nuestros resultados con GH y nuestra hip&#243;tesis&#44; aunque podr&#237;a ser debido al tama&#241;o de nuestra muestra&#46; Sin embargo&#44; estos resultados son compatibles con aquellos obtenidos en el estudio Safety and Appropriateness of Growth Hormone treatment in Europe &#40;SAGhE&#41; y en el estudio IOS&#44; con muestras y seguimientos mayores&#44; en los que refieren una baja incidencia de efectos adversos en estos pacientes&#46; A&#250;n as&#237;&#44; es necesario un seguimiento a largo plazo de los ni&#241;os tratados para vigilar los posibles efectos secundarios tard&#237;os que a&#250;n no conocemos<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">25&#44;31&#44;33&#8211;35</span></a>&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">Finalmente&#44; acerca de los estudios publicados hasta el momento sobre ni&#241;os con DGH aislado tratados con GH&#44; salvo Ranke et al&#46; que presenta un ensayo cl&#237;nico controlado<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">36</span></a>&#44; todos se tratan de estudios observacionales no controlados de entre 20 y 2&#46;852 ni&#241;os de ambos sexos&#44; seguidos durante uno y 9 a&#241;os&#44; lo que supone un tiempo de seguimiento menor al nuestro&#46; Solo el 40&#37; de los estudios presentaron m&#225;s pacientes que nosotros&#44; y en algunas ocasiones por muy pocos&#46; En cualquier caso&#44; cabe decir que la mayor&#237;a de los estudios que superaban nuestra muestra estaban patrocinados por empresas farmac&#233;uticas&#44; hecho que no ocurre en nuestro caso&#44; ya que no contamos con ninguna colaboraci&#243;n ni conflicto de inter&#233;s&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">Dicho esto&#44; la solidez de nuestro estudio queda avalada por una n elevada&#44; el car&#225;cter unic&#233;ntrico&#44; una metodolog&#237;a cuidada y la significaci&#243;n estad&#237;stica confirmada con diversas pruebas&#46;</p><p id="par0225" class="elsevierStylePara elsevierViewall">Por otro lado&#44; las principales limitaciones del estudio son la p&#233;rdida de informaci&#243;n en los datos obtenidos retrospectivamente&#44; y el hecho de que aunque la mayor&#237;a ha alcanzado la talla adulta&#44; no es el 100&#37; de la muestra&#46; Adem&#225;s&#44; siempre hay que contar con los posibles errores interobservador y de medici&#243;n&#46; Adem&#225;s&#44; el DGH podr&#237;a haber sido sobrediagnosticado debido a las limitaciones de los test actuales para su diagn&#243;stico&#44; incluyendo que no hicimos primaci&#243;n esteroidea&#46;</p><p id="par0230" class="elsevierStylePara elsevierViewall">En resumen&#44; en nuestra poblaci&#243;n&#44; la talla adulta tras el tratamiento con GH es similar a la talla diana&#44; lo que avala nuestra hip&#243;tesis de eficacia&#46; El 39&#44;4&#37; mostraron permanencia del d&#233;ficit de GH en la reevaluaci&#243;n&#44; de los cuales 11&#44;1&#37; asociaron d&#233;ficit de IGF-1 en la reevaluaci&#243;n&#46; Adem&#225;s&#44; aquellos con d&#233;ficit permanente mostraron un diagn&#243;stico m&#225;s precoz&#44; un IGF-1 y talla al diagn&#243;stico menores&#44; y una mejor respuesta al tratamiento&#44; lo que apoyar&#237;a que los permanentes podr&#237;an ser los verdaderos casos de DGH&#44; aunque ser&#237;an necesarios m&#225;s estudios y encontrar mejores pruebas diagn&#243;sticas&#46;</p><p id="par0235" class="elsevierStylePara elsevierViewall">Durante el tiempo de seguimiento ninguno de estos pacientes presentaron efectos adversos con las dosis utilizadas de tratamiento&#59; y aunque no podemos establecer por completo la seguridad del tratamiento con GH&#44; nuestros resultados son avalados por otros estudios publicados&#46;</p><p id="par0240" class="elsevierStylePara elsevierViewall">Finalmente&#44; al relacionar las distintas variables con la respuesta se vislumbran posibles datos pron&#243;sticos para la eficacia del tratamiento&#44; como puede ser&#58; la talla diana&#44; el PTA inicial&#44; la edad puberal&#44; la GPT&#44; las tallas durante el tratamiento&#44; y la TIP&#44; que se correlacionan positivamente&#59; mientras que la EO&#47;EC y el IGF-1 inicial mantienen una correlaci&#243;n negativa sobre la talla adulta&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflicto de intereses</span><p id="par0245" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El crecimiento en pacientes con d&#233;ficit aislado de hormona del crecimiento &#40;GH&#41; es heterog&#233;neo a pesar del tratamiento&#44; debido a la baja especificidad de las pruebas diagn&#243;sticas&#44; por lo que es necesario definir las variables de eficacia&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Evaluar la eficacia de la terapia de reemplazo hormonal en ni&#241;os con d&#233;ficit aislado de GH&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional-ambispectivo de pacientes tratados en nuestro servicio en los &#250;ltimos 14 a&#241;os por d&#233;ficit aislado de GH&#44; definido como GH inferior a 7&#44;4<span class="elsevierStyleHsp" style=""></span>mg&#47;dl en 2 pruebas de est&#237;mulo&#44; en pacientes con talla<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#8722;2DE y velocidad de crecimiento disminuida&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Se estudiaron 97 pacientes&#46; El 69&#37; eran varones&#46; Con el tratamiento hubo una ganancia de talla de 1&#44;17DE&#46; El 79&#44;31&#37; alcanzaron la talla diana&#46; El 71&#44;13&#37; fueron reevaluados en la edad adulta&#44; de los cuales el 39&#44;4&#37; mantuvo el d&#233;ficit&#46; La talla diana&#44; el pron&#243;stico de talla adulta y la ganancia puberal total se correlacionaron positivamente con la talla adulta&#44; mientras que la relaci&#243;n edad &#243;sea&#47;edad cronol&#243;gica y factor de crecimiento insul&#237;nico tipo 1 inicial mostraron una correlaci&#243;n negativa&#46; Ninguno tuvo efectos secundarios&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusiones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La mayor&#237;a de los pacientes alcanzaron la talla diana&#44; aunque no todos mostraron permanencia del d&#233;ficit en edad adulta&#46; La talla diana&#44; el pron&#243;stico de talla adulta y las variables de pubertad est&#225;n directamente relacionados con la talla adulta&#59; mientras que la edad &#243;sea&#47;edad cronol&#243;gica y factor de crecimiento insul&#237;nico tipo 1 est&#225;n inversamente relacionadas&#44; pudiendo utilizarse estas como variables de eficacia&#46; No se han observado efectos adversos en la muestra con las dosis utilizadas&#46;</p></span>"
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        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introduction</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Growth in patients with isolated growth hormone &#40;GH&#41; deficiency is heterogeneous despite treatment due to the low specificity of diagnostic tests&#44; making it necessary to define efficacy variables&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Aims</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">To evaluate efficacy of hormone replacement therapy in children with isolated GH deficiency&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Observational-ambispective study of patients treated in our department in the last 14 years for isolated GH deficiency&#46; This was defined as a GH level less than 7&#46;4<span class="elsevierStyleHsp" style=""></span>mg&#47;dl in response to 2 stimulation tests in patients with height<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>2SD and a decreased growth rate&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">The study included a total 97 patients&#44; of whom 69&#37; were boys&#46; The large majority &#40;89&#46;58&#37;&#41; achieved final height&#46; None of them had side effects&#46; The median dose of GH used was 0&#46;028<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;day &#40;0&#46;03-0&#46;025&#41;&#46; There was a gain of 1&#46;17 SD in final height&#46; Around three-quarters &#40;71&#46;13&#37;&#41; of the patients were reassessed in adulthood&#44; of whom 39&#46;4&#37; maintained the deficiency&#44; and 79&#46;31&#37; achieved target range height&#46; Target height&#44; estimated height&#44; and the total pubertal gain were positively correlated with final height&#44; while the bone age&#47;chronological age ratio and the initial insulin-like growth factor-1 showed a negative correlation&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">A majority of patients reached target size&#44; although only a few of them maintained the deficiency in adulthood&#46; Target size&#44; estimated adult height&#44; and pubertal variables are directly related to adult height&#44; while bone age&#47;chronological age and insulin-like growth factor-1 were inversely related&#44; and these can be used as efficacy variables&#46; No adverse effects were observed in the sample with the doses used for the treatment&#46;</p></span>"
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                  \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">Talla inicial &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;5&#44;91&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&#44;78&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&#44;80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;62&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">Peso inicial &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&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&#44;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;83&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&#44;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;65&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">IMC inicial &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&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&#44;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;56&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&#44;44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;92&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">Dosis tratamiento &#40;mg&#47;kg&#47;d&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;020&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;036&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">IGF-1 inicial &#40;ng&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">646&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">181&#44;68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">116&#44;59&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">IGF-1 inicial &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;5&#44;68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;59&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&#44;82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;72&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">Talla diana &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">94&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&#44;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;33&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&#44;37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Edad &#243;sea&#47;edad cronol&#243;gica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;17&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">Pron&#243;stico talla adulta inicial &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;4&#44;28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;99&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&#44;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;44&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">Talla primer a&#241;o de tratamiento &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&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&#44;31&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&#44;19&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&#44;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Peso primer a&#241;o de tratamiento &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&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&#44;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;63&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&#44;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;59&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">IMC primer a&#241;o de tratamiento &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&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&#44;63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;16&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&#44;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;83&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">Edad &#243;sea&#47;Edad cronol&#243;gica primer a&#241;o tratamiento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&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&#44;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;19&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">IGF-1 primer a&#241;o tratamiento &#40;ng&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&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">1347&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">378&#44;54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">228&#44;17&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">IGF-1 primer a&#241;o tratamiento &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;4&#44;46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;60&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">Pron&#243;stico talla adulta primer a&#241;o tratamiento &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&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&#44;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;87&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&#44;95&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;52&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">Talla segundo a&#241;o tratamiento &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&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&#44;66&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;32&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&#44;98&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;60&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">Talla tercer a&#241;o tratamiento &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&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&#44;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;77&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&#44;71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;67&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">Talla cuarto a&#241;o tratamiento &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">96&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&#44;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;28&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&#44;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;78&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">Talla adulta &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">82&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&#44;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;93&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&#44;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;86&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">GH reevaluaci&#243;n &#40;ng&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33&#44;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;63&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">IGF-1 reevaluaci&#243;n &#40;ng&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1045&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">362&#44;51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">173&#44;37&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">IGF-1 reevaluaci&#243;n &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;7&#44;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2022084.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Estad&#237;stica descriptiva de las variables cuantitativas recogidas durante el seguimiento a talla adulta de ni&#241;os con d&#233;ficit aislado de GH</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Tabla 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">DE&#58; desviaci&#243;n est&#225;ndar&#59; GH&#58; hormona del crecimiento&#59; IGF-1&#58; factor de crecimiento insul&#237;nico tipo 1&#59; IMC&#58; &#237;ndice de masa corporal&#59; NS&#58; no significativo&#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="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Ni&#241;os</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Ni&#241;as</th><th class="td" title="table-head  " rowspan="2" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">N&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">Media&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&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">N&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">Media&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&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">Edad al diagn&#243;stico &#40;a&#241;os&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;989&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;696&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;154&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">Talla inicial &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&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&#44;771&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;659&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&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&#44;863&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;511&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">Peso inicial &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&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&#44;259&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;681&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&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&#44;246&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;598&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">IMC inicial &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&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&#44;418&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;941&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&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&#44;478&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;873&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">Dosis tratamiento &#40;mg&#47;kg&#47;d&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#44;0278&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;028&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">IGF-1 inicial &#40;ng&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">164&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">123&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">219&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">90&#44;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">IGF-1 inicial &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&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&#44;209&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;849&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;026&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;951&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;010&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">Talla diana &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&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&#44;253&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;773&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&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&#44;618&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;700&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;027&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">Edad &#243;sea&#47;edad cronol&#243;gica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;683&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;171&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;777&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;147&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pron&#243;stico talla adulta inicial &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&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&#44;236&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;368&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&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&#44;237&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;366&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Talla primer a&#241;o tratamiento &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&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&#44;327&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;523&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&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&#44;256&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;421&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">Peso primer a&#241;o tratamiento &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&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&#44;135&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;554&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&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&#44;133&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;669&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">IMC primer a&#241;o tratamiento &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&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&#44;464&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;830&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&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&#44;553&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;844&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">Edad &#243;sea&#47;Edad cronol&#243;gica primer a&#241;o tratamiento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;750&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;201&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;813&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;160&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">IGF-1 primer a&#241;o tratamiento &#40;ng&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">335&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">199&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">473&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">260&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;016&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">IGF-1 primer a&#241;o tratamiento &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;183&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;697&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;367&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;975&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pron&#243;stico talla adulta primer a&#241;o tratamiento &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&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&#44;707&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;265&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&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&#44;499&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;879&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Talla segundo a&#241;o tratamiento &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&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&#44;959&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;643&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&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&#44;037&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;503&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">Talla tercer a&#241;o tratamiento &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&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&#44;689&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;744&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&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&#44;759&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;458&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">Talla cuarto a&#241;o tratamiento &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&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&#44;548&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;835&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29&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&#44;690&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;655&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">Edad puberal &#40;a&#241;os&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#44;54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;197&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;084&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Talla puberal &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&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&#44;964&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;689&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&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&#44;127&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;630&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">Talla adulta &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">59&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&#44;533&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;937&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&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&#44;834&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;596&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;034&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">Ganancia puberal total &#40;cm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#44;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;432&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&#44;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;617&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;010&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">GH reevaluaci&#243;n &#40;ng&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;142&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;433&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;419&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;284&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">IGF-1 reevaluaci&#243;n &#40;ng&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">352&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">167&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">384&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">187&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">IGF-1 reevaluaci&#243;n &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">59&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&#44;146&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;251&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;403&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;293&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                0 => "xTab2022086.png"
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        "descripcion" => array:1 [
          "es" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Diferencias estad&#237;sticas de acuerdo al sexo en el seguimiento a talla adulta de ni&#241;os con d&#233;ficit aislado de GH</p>"
        ]
      ]
      5 => array:8 [
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        "etiqueta" => "Tabla 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
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            "rol" => "short"
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">DE&#58; desviaci&#243;n est&#225;ndar&#59; GH&#58; hormona del crecimiento&#59; IGF-1&#58; factor de crecimiento insul&#237;nico tipo 1&#59; IMC&#58; &#237;ndice de masa corporal&#59; NS&#58; no significativo&#46;</p>"
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                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">Variables&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">p&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">Edad al diagn&#243;stico &#40;a&#241;os&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">Talla inicial &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">Peso inicial &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">IMC inicial &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">Dosis tratamiento &#40;mg&#47;kg&#47;d&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">IGF-1 inicial &#40;ng&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">IGF-1 inicial &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">Talla diana &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&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">Edad &#243;sea&#47;Edad cronol&#243;gica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pron&#243;stico talla adulta inicial &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
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Eficacia y seguridad del tratamiento sustitutivo en el déficit aislado de hormona del crecimiento
Efficacy and safety of replacement treatment in isolated growth hormone deficiency
Ana Belén Ariza Jiménez
Autor para correspondencia
micodemas@hotmail.com

Autor para correspondencia.
, María José Martínez-Aedo Ollero, Juan Pedro López-Siguero
Hospital Materno-infantil de Málaga, Málaga, España
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es puls&#225;til&#44; no se puede confiar en sus niveles basales&#44; por lo que se estimula la hip&#243;fisis para observar c&#243;mo responde su secreci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">3&#44;4</span></a>&#46; La ausencia de respuesta debe confirmarse con una segunda prueba con distinto est&#237;mulo&#44; por su alto ratio de falsos positivos<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">4&#44;5</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Una vez diagnosticado&#44; cuando la talla es inferior a &#8722;2DE y la vc a &#8722;1DE&#44; se trata con GH recombinante<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">1</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">En Espa&#241;a los tratamientos est&#225;n restringidos a hospitales&#44; y son supervisados por el Comit&#233; Asesor para la Hormona del crecimiento de cada comunidad aut&#243;noma<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">6</span></a>&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">El tratamiento se mantiene hasta que la vc es inferior a 2<span class="elsevierStyleHsp" style=""></span>cm&#47;a&#241;o y la edad &#243;sea &#40;EO&#41; superior a 16 a&#241;os en el var&#243;n y 14 en las chicas&#46; Sin embargo&#44; en DGH puede prolongarse a la edad adulta por las acciones metab&#243;licas de la misma<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">7&#44;8</span></a>&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">La GH supone un gasto elevado para el sistema sanitario&#44; por lo que ser&#237;a beneficioso definir los factores predictores de respuesta&#44; para as&#237; optimizar la eficacia y seguridad del tratamiento&#46; Este hecho justifica la necesidad de estudios a largo plazo con GH&#44; para proveer a los cl&#237;nicos la informaci&#243;n necesaria para elegir qu&#233; pacientes podr&#237;an beneficiarse m&#225;s del tratamiento sin riesgos a largo plazo<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">9</span></a>&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Planteamos un estudio de nuestra poblaci&#243;n para definir DGH y las variables que influyen en la talla adulta&#59; ya que si bien ya se han realizado estudios similares en pa&#237;ses como Italia&#44; Francia o EEUU&#44; no hay nada publicado en la literatura de nuestro &#225;mbito geogr&#225;fico al respecto<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">10&#44;11</span></a>&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Por tanto&#44; tomando como hip&#243;tesis que la GH aumenta la talla adulta en la poblaci&#243;n espa&#241;ola con DGH aislado&#44; sin relacionarse con un n&#250;mero significativo de efectos adversos&#44; nos planteamos como objetivo evaluar la eficacia y seguridad del tratamiento con GH en pacientes con DGH idiop&#225;tico aislada&#44; determinando la influencia del desarrollo puberal durante el tratamiento&#44; las variables de eficacia&#44; y qu&#233; pacientes contin&#250;an manteniendo este d&#233;ficit en edad adulta&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Material y metodolog&#237;a</span><p id="par0050" class="elsevierStylePara elsevierViewall">Se realiz&#243; un estudio longitudinal descriptivo ambispectivo de ni&#241;os de ambos sexos&#44; diagnosticados de DGH&#44; entre 0-14 a&#241;os&#44; mediante 2 pruebas de est&#237;mulo&#44; y tratados con GH hasta el momento actual o la edad adulta&#44; en un hospital terciario durante 14 a&#241;os&#46; Adem&#225;s&#44; al suspender el tratamiento en talla adulta&#44; se realiz&#243; reevaluaci&#243;n en todos los casos mediante factor de crecimiento insul&#237;nico tipo 1 &#40;IGF-1<span class="elsevierStyleSmallCaps">&#41;</span> y prueba de est&#237;mulo&#44; previa firma de consentimiento informado&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Todas las medidas fueron realizadas 3 veces&#44; en ropa interior y descalzos&#44; con una b&#225;scula manual Seca&#44; con una precisi&#243;n de 0&#44;1<span class="elsevierStyleHsp" style=""></span>kg&#44; y un tall&#237;metro fijo de pared Holtain Stadiometer&#44; con precisi&#243;n de 0&#44;1<span class="elsevierStyleHsp" style=""></span>cm&#44; que era calibrado diariamente&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Se realizaron para el diagn&#243;stico&#44; en 2 d&#237;as diferentes&#44; el test de ejercicio&#44; por sus escasos efectos adversos&#44; y el test de est&#237;mulo con clonidina&#59; y para la reevaluaci&#243;n&#44; el test est&#237;mulo con insulina&#46; No se realiz&#243; cebamiento con esteroides sexuales&#46; Los puntos de corte escogidos fueron 7&#44;4<span class="elsevierStyleHsp" style=""></span>ng&#47;ml para el diagn&#243;stico y 5&#44;6<span class="elsevierStyleHsp" style=""></span>ng&#47;ml en la reevaluaci&#243;n&#44; bas&#225;ndonos en la bibliograf&#237;a actual<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">12</span></a>&#46; Los resultados anal&#237;ticos de GH e IGF-1 fueron procesados por personal cualificado mediante m&#233;todos de quimioluminiscencia inmune &#40;IMMULITE 2000&#41;&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">La cohorte fue monitorizada desde el diagnostico hasta la talla adulta&#44; recogiendo variables como la edad al diagn&#243;stico&#44; DE de peso&#44; talla e &#237;ndice de masa corporal al inicio&#44; al a&#241;o&#44; 2&#44; 3 y 4 a&#241;os de tratamiento&#44; cociente EO&#47;edad cronol&#243;gica &#40;EO&#47;EC&#41; inicial y al a&#241;o&#44; pron&#243;stico de talla adulta &#40;PTA&#41; seg&#250;n m&#233;todo de Bayley Pinneau inicial y al a&#241;o&#44; IGF-1 inicial y al a&#241;o&#44; talla diana&#44; edad puberal&#44; talla al inicio de la pubertad &#40;TIP&#41;&#44; ganancia puberal total &#40;GPT&#41;&#44; talla adulta y niveles de GH e IGF-1 en la reevaluaci&#243;n&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Todos los valores que lo permit&#237;an fueron ajustados en DE seg&#250;n el estudio transversal de crecimiento espa&#241;ol por el software antropom&#233;trico AUXOTEC<span class="elsevierStyleSup">&#174;</span><a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">13</span></a>&#44; mientras que el IGF-1 fue ajustado por edad y sexo de acuerdo al software facilitado por IMMULITE&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Finalmente se procedi&#243; al c&#225;lculo estad&#237;stico de los datos recogidos mediante el paquete estad&#237;stico SPSS versi&#243;n 22&#44; utilizando t student en la comparaci&#243;n de 2 medias de muestras normales y U-Mann Whitney en aquellas no normales&#44; ANOVA en la comparaci&#243;n de varias medias de muestras normales y Kruskal Wallis en muestras no normales&#44; as&#237; como correlaci&#243;n de Pearson en la comparaci&#243;n de muestras cuantitativas&#46; Adem&#225;s&#44; se us&#243; regresi&#243;n m&#250;ltiple en las variables estad&#237;sticamente significativas respecto a la talla adulta&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Resultados</span><p id="par0080" class="elsevierStylePara elsevierViewall">Se estudiaron 97 pacientes de ambos sexos diagnosticados de DGH&#44; los cuales recibieron durante 5 a&#241;os &#40;desde diagn&#243;stico hasta edad adulta&#41; una dosis mediana de GH de 0&#44;028<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;d&#237;a &#40;0&#44;025-0&#44;03&#41;&#46; La mediana de edad al diagn&#243;stico fue de 10&#44;5 a&#241;os &#40;8&#44;26-11&#44;7&#41;&#46; El 69&#37; eran varones&#46; El 89&#44;58&#37; alcanzaron la talla adulta&#46; No se observ&#243; patolog&#237;a tumoral en ning&#250;n caso&#44; y ning&#250;n paciente present&#243; efectos secundarios con el tratamiento&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Las principales caracter&#237;sticas descriptivas se muestran en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">El incremento medio de talla en el primer a&#241;o de tratamiento fue de 0&#44;49DE&#46; El PTA de acuerdo a EO&#47;EC mejor&#243; 0&#44;6DE&#46; La mejor&#237;a de talla progresiva se refleja en la <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a>&#46; Hubo una ganancia de talla de 0&#44;79DE desde el inicio hasta la pubertad en ambos sexos&#44; y desde la pubertad a talla final de 0&#44;43DE en varones y de 0&#44;29DE en mujeres&#46; La ganancia total hasta la edad adulta fue mayor en varones que en mujeres&#58; 1&#44;22DE y 1&#44;08DE&#44; respectivamente &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41; La ganancia sobre la talla adulta respecto al PTA inicial fue de 0&#44;1DE&#44; y respecto a la talla diana de 0&#44;28DE&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">Se identificaron diferencias estad&#237;sticamente significativas entre el sexo y las variables mostradas en la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">La talla adulta se ve influenciada por el sexo masculino con mayor talla durante todo el tratamiento&#44; mayor talla diana&#44; PTA y GPT&#44; as&#237; como&#44; un inicio puberal m&#225;s temprano&#44; y menor EO&#47;EC&#44; e IGF-1 y GH en la reevaluaci&#243;n &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">Finalmente&#44; tambi&#233;n es constatada una relaci&#243;n lineal entre el &#237;ndice de masa corporal y la dosis de GH&#44; siendo la dosis mayor al final del tratamiento que al principio del mismo &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46;</p><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Reevaluaci&#243;n</span><p id="par0110" class="elsevierStylePara elsevierViewall">Se reevaluaron 69 pacientes en edad adulta &#40;71&#44;13&#37;&#41;&#44; manteniendo el d&#233;ficit el 39&#44;4&#37;&#46; El 69&#37; de los pacientes con permanencia del d&#233;ficit eran varones&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Se realiz&#243; la IGF-1 en la reevaluaci&#243;n de talla adulta en 87 pacientes &#40;89&#44;58&#37;&#41;&#44; con una media de 0&#44;023DE&#44; y una IGF-1 deficitaria en el 11&#44;11&#37; de los pacientes&#44; definida como &#8722;2DE&#44; todos ellos con GH en reevaluaci&#243;n tambi&#233;n deficitaria &#40;GH<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>5&#44;4<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41; &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; Aunque no se hallaron diferencias estad&#237;sticamente significativas&#44; los DGH permanentes presentaron un diagn&#243;stico m&#225;s temprano&#44; un IGF-1 inicial menor&#44; un peso y talla al diagn&#243;stico menor&#44; y una mejor respuesta al tratamiento&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Si en lugar de &#8722;2DE utiliz&#225;ramos un punto de corte de &#8722;3&#44;22DE de IGF-1 en la reevaluaci&#243;n&#44; este nuevo punto de corte mostrar&#237;a un &#225;rea bajo la curva ROC de 0&#44;8&#44; que supone que se trata de un buen test&#44; y una mayor correlaci&#243;n con GH &#40;<a class="elsevierStyleCrossRef" href="#fig0015">fig&#46; 3</a>&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Discusi&#243;n</span><p id="par0125" class="elsevierStylePara elsevierViewall">Aunque la GH ha sido empleada para tratar la talla baja durante m&#225;s de 40 a&#241;os&#44; no existe unanimidad a la hora de definir los criterios que determinen unos objetivos de respuesta satisfactorios<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">14</span></a>&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Uno de los puntos de inter&#233;s de nuestro trabajo es que casi el 90&#37; de los menores reclutados han alcanzado la talla adulta&#44; pudiendo reevaluarse un n&#250;mero significativo de pacientes&#44; para as&#237; establecer su evoluci&#243;n durante el tratamiento y tras el fin del mismo&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Todos los estudios&#44; al igual que nosotros&#44; presentan ni&#241;os prepuberales con predominio masculino&#44; pero con una edad al diagn&#243;stico 2 a&#241;os menor al nuestro que muestra una edad mediana de 10&#44;5 a&#241;os&#44; lo que podr&#237;a suponer una peor respuesta al tratamiento<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">15</span></a>&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Existe heterogeneidad en cuanto al inicio de la pubertad&#44; afirmando en algunos estudios que existe un retraso frente a otros que no encuentran diferencia&#44; como es en nuestro caso&#46; Por otro lado&#44; las publicaciones actuales establecen una correlaci&#243;n positiva entre la edad al diagn&#243;stico y la pubertad&#59; y entre la talla inicial&#44; el crecimiento al a&#241;o&#44; la edad&#44; sexo&#44; tiempo de tratamiento&#44; EO&#47;EC y talla adulta&#44; de las cuales solo son confirmadas en nuestro estudio la relaci&#243;n entre la edad al diagn&#243;stico y edad puberal&#59; y entre el sexo&#44; la talla inicial y al a&#241;o&#44; y la talla adulta<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">11&#44;15&#8211;18</span></a>&#46; Maghnie et al&#46;&#44; adem&#225;s&#44; relacionan la talla adulta con la GPT<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">19</span></a>&#44; hecho no nombrado por otros autores hasta el momento&#44; pero s&#237; corroborado en nuestro estudio&#44; lo que responde a nuestro objetivo sobre la influencia de la pubertad sobre la talla final&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Adicionalmente&#44; en nuestro estudio tambi&#233;n se establece una correlaci&#243;n negativa entre la edad al diagn&#243;stico y la TIP&#59; entre la dosis y la TIP&#59; y entre el IGF-1 inicial y el PTA al a&#241;o&#44; la TIP y la talla adulta&#44; no nombradas hasta el momento&#46; A esto se a&#241;ade que en nuestro caso la EO respecto a la talla adulta presenta significaci&#243;n como correlaci&#243;n negativa&#44; no positiva&#44; lo que parece l&#243;gico puesto que cuanto m&#225;s retrasada sea la EO&#44; mayor ser&#225; el tiempo de crecimiento&#44; lo que en los estudios publicados se relaciona positivamente con la talla adulta&#44; o no lo relaciona como ocurre en el estudio Kabi International Growth Study &#40;estudio KIGS&#41;<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">20&#8211;22</span></a>&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Aunque no hay acuerdo acerca de la relaci&#243;n del inicio de pubertad con la talla adulta&#59; y entre el inicio de tratamiento y la talla adulta&#44; estas relaciones no se observan en nuestro caso<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">11&#44;15&#8211;19&#44;23&#44;24</span></a>&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">En cuanto a las diferencias significativas en la talla seg&#250;n sexo cabe decir que aunque en las publicaciones y en nuestra muestra se ha establecido una relaci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">11&#44;14</span></a>&#44; estas se podr&#237;an deber al crecimiento puberal de acuerdo al sexo&#44; as&#237; como al hecho de que la talla diana es menor en el sexo femenino&#44; y que parte de nuestra muestra femenina se encontraba en periodo peripuberal al diagn&#243;stico &#40;el 38&#37; inici&#243; pubertad en un a&#241;o&#41;&#46; A lo que se une que en nuestro estudio se establece una correlaci&#243;n negativa entre la edad puberal y la duraci&#243;n de la pubertad&#44; con la GPT&#44; al igual que lo reflejado en otros estudios<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">11&#44;20&#44;21</span></a>&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">El estudio KIGS refiere influencias estad&#237;sticamente significativas entre la GPT y el sexo&#44; talla diana&#44; dosis de GH&#44; EO&#47;EC&#44; TIP&#44; y edad de inicio y fin de pubertad<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">20&#44;22</span></a>&#44; mientras que en nuestro estudio solo se establecen diferencias estad&#237;sticamente significativas entre la GPT y el sexo masculino&#46; Tambi&#233;n enuncia que a pesar de la variabilidad interindividual del crecimiento con tratamiento entre ambos sexos en edad prep&#250;ber&#44; las diferencias entre sexos en cuanto a ganancia de talla y vc no son observables en los 3 primeros a&#241;os de tratamiento<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">21&#44;25</span></a>&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Adem&#225;s&#44; establece una relaci&#243;n negativa respecto a la diferencia de talla inicial y talla diana&#59; y entre el pico de GH&#44; la edad al diagn&#243;stico y la talla final&#46; Su correlaci&#243;n entre el pico de GH y talla final tambi&#233;n coincide con nuestros resultados de los niveles de GH iniciales&#44; edad al diagn&#243;stico y talla final mayor&#44; a pesar de no haberse establecido relaci&#243;n estad&#237;stica en nuestro caso<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">11&#44;16&#8211;19&#44;23&#44;24</span></a>&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">El estudio KIGS tambi&#233;n refiere influencia del n&#250;mero de pinchazos&#44; dosis de GH&#44; la vc durante el a&#241;o previo&#44; el peso actual y al nacimiento&#44; y la severidad del d&#233;ficit sobre la talla adulta&#59; la cual no ha sido observada en nuestro estudio ni en estudios previos&#44; por lo que ser&#237;an necesarios m&#225;s estudios al respecto<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">11&#44;15&#8211;19&#44;23</span></a>&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">A esto&#44; nuestro trabajo a&#241;ade una relaci&#243;n entre la talla adulta&#44; el PTA inicial&#44; la talla diana y las distintas tallas entre s&#237;&#44; incluidas desde el inicio hasta la TIP&#59; lo que hasta el momento no se hab&#237;a establecido de forma clara&#46; Por tanto&#44; la talla final se relaciona con la respuesta a lo largo de todos los a&#241;os de tratamiento&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">Por &#250;ltimo&#44; mientras que la mayor&#237;a afirman que la talla diana no influye en la talla final&#44; debido a que posiblemente incluyan en sus muestras pacientes que podr&#237;an presentar talla baja idiop&#225;tica&#44; el The Nordinet International Outcome Study &#40;estudio IOS&#41; y el estudio KIGS la correlacionan positivamente con la misma&#44; al igual que sucede en nuestro estudio<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">11&#44;15&#8211;19&#44;23&#8211;25</span></a>&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Aimaretti et al&#46; aprecian al igual que nosotros un aumento de IGF-1 con el tratamiento&#46; Adem&#225;s&#44; en la reevaluaci&#243;n comentan cierta concordancia entre los test de est&#237;mulo&#44; IGF-1 y el diagn&#243;stico<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">26</span></a>&#46; Ante esto&#44; destacar nuestros resultados de IGF-1 y GH en la reevaluaci&#243;n&#44; que apoyar&#237;a la concordancia indicada por este grupo y podr&#237;a asignarle un papel concomitante al IGF-1 en la reevaluaci&#243;n del d&#233;ficit de GH&#46; Siempre que el IGF-1 fue deficitario en la reevaluaci&#243;n&#44; lo era tambi&#233;n el test de est&#237;mulo con GH&#59; sin embargo&#44; no todos los casos con valores de d&#233;ficit en la prueba de est&#237;mulo con GH presentaban IGF-1 deficiente en la reevaluaci&#243;n&#44; hecho no claramente descrito hasta el momento actual en la literatura<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">27</span></a>&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">Por tanto&#44; de acuerdo a nuestros objetivos&#44; los datos publicados y nuestra experiencia&#44; la talla diana&#44; el PTA inicial&#44; la TIP&#44; la edad puberal&#44; la GPT&#44; la progresi&#243;n de la talla durante los a&#241;os de tratamiento&#44; la EO&#47;EC y el IGF-1 podr&#237;an ser factores predictores para la respuesta al tratamiento con GH&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">En cuanto a la eficacia&#44; las publicaciones establecen con el tratamiento una ganancia de talla entre &#43;0&#44;4DE y &#43;1&#44;5DE&#44; que es acorde a nuestra ganancia de &#43;1&#44;17DE<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">11&#44;15&#44;17&#44;24</span></a>&#46; Adem&#225;s Ranke et al&#46; refieren una ganancia de &#43;1&#44;2<span class="elsevierStyleHsp" style=""></span>cm y &#43;0&#44;2DE al a&#241;o de tratamiento<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">28</span></a>&#44; frente a nuestros datos de ganancia algo superiores &#40;&#43;0&#44;49DE&#41;&#46; Esta mejor&#237;a de talla supone en nuestra cohorte una talla adulta dentro de los rangos normales de nuestra poblaci&#243;n nacional&#44; al igual que lo reflejado por el estudio KIGS<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">29</span></a>&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Acerca de la GPT las publicaciones establecen una ganancia de &#43;0&#44;8DE&#44; frente a nuestros &#43;0&#44;43DE&#44; pudiendo deberse a la EO&#47;EC y el inicio de la pubertad no muy retrasados&#44; resistencias al tratamiento&#44; o falta de cumplimiento&#44; sin poder confirmarlo<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">15&#44;30</span></a>&#46; Kirk tambi&#233;n comenta que existe una mejora de talla respecto a la talla diana de entre &#43;0&#44;2 y &#43;0&#44;8DE<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">16</span></a>&#44; y Blethen et al&#46; refieren una mejora respecto al PTA de &#43;0&#44;7DE<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">11</span></a>&#44; consecuente con nuestra mejor&#237;a de &#43;0&#44;28DE respecto a la talla diana&#44; pero con una diferencia marcada respecto a nuestra mejor&#237;a conforme el PTA de tan solo &#43;0&#44;1DE&#44; probablemente en relaci&#243;n con la EO escasamente retrasada de nuestra muestra&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">Por &#250;ltimo&#44; destacar que en la literatura se encuentra en la reevaluaci&#243;n una permanencia del d&#233;ficit del 44&#44;4-71&#44;9&#37;&#44; frente a nuestro 39&#44;4&#37;<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">12&#44;26&#44;31</span></a>&#46; Por otro lado&#44; nosotros hemos hallado en nuestro estudio una edad m&#225;s temprana al diagn&#243;stico&#44; un IGF-1 inicial y talla inicial menor&#44; y una mejor respuesta al tratamiento en aquellos con permanencia del d&#233;ficit&#46; Asimismo destaca el predominio masculino&#44; probablemente relacionado con que tambi&#233;n presentaron m&#225;s hallazgos en la resonancia al diagn&#243;stico&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">Aunque se han descrito efectos adversos con el tratamiento&#44; Sotos y Tokar aportan que sus pacientes no presentaron efectos adversos con el tratamiento<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">32</span></a>&#44; lo que apoya nuestros resultados con GH y nuestra hip&#243;tesis&#44; aunque podr&#237;a ser debido al tama&#241;o de nuestra muestra&#46; Sin embargo&#44; estos resultados son compatibles con aquellos obtenidos en el estudio Safety and Appropriateness of Growth Hormone treatment in Europe &#40;SAGhE&#41; y en el estudio IOS&#44; con muestras y seguimientos mayores&#44; en los que refieren una baja incidencia de efectos adversos en estos pacientes&#46; A&#250;n as&#237;&#44; es necesario un seguimiento a largo plazo de los ni&#241;os tratados para vigilar los posibles efectos secundarios tard&#237;os que a&#250;n no conocemos<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">25&#44;31&#44;33&#8211;35</span></a>&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">Finalmente&#44; acerca de los estudios publicados hasta el momento sobre ni&#241;os con DGH aislado tratados con GH&#44; salvo Ranke et al&#46; que presenta un ensayo cl&#237;nico controlado<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">36</span></a>&#44; todos se tratan de estudios observacionales no controlados de entre 20 y 2&#46;852 ni&#241;os de ambos sexos&#44; seguidos durante uno y 9 a&#241;os&#44; lo que supone un tiempo de seguimiento menor al nuestro&#46; Solo el 40&#37; de los estudios presentaron m&#225;s pacientes que nosotros&#44; y en algunas ocasiones por muy pocos&#46; En cualquier caso&#44; cabe decir que la mayor&#237;a de los estudios que superaban nuestra muestra estaban patrocinados por empresas farmac&#233;uticas&#44; hecho que no ocurre en nuestro caso&#44; ya que no contamos con ninguna colaboraci&#243;n ni conflicto de inter&#233;s&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">Dicho esto&#44; la solidez de nuestro estudio queda avalada por una n elevada&#44; el car&#225;cter unic&#233;ntrico&#44; una metodolog&#237;a cuidada y la significaci&#243;n estad&#237;stica confirmada con diversas pruebas&#46;</p><p id="par0225" class="elsevierStylePara elsevierViewall">Por otro lado&#44; las principales limitaciones del estudio son la p&#233;rdida de informaci&#243;n en los datos obtenidos retrospectivamente&#44; y el hecho de que aunque la mayor&#237;a ha alcanzado la talla adulta&#44; no es el 100&#37; de la muestra&#46; Adem&#225;s&#44; siempre hay que contar con los posibles errores interobservador y de medici&#243;n&#46; Adem&#225;s&#44; el DGH podr&#237;a haber sido sobrediagnosticado debido a las limitaciones de los test actuales para su diagn&#243;stico&#44; incluyendo que no hicimos primaci&#243;n esteroidea&#46;</p><p id="par0230" class="elsevierStylePara elsevierViewall">En resumen&#44; en nuestra poblaci&#243;n&#44; la talla adulta tras el tratamiento con GH es similar a la talla diana&#44; lo que avala nuestra hip&#243;tesis de eficacia&#46; El 39&#44;4&#37; mostraron permanencia del d&#233;ficit de GH en la reevaluaci&#243;n&#44; de los cuales 11&#44;1&#37; asociaron d&#233;ficit de IGF-1 en la reevaluaci&#243;n&#46; Adem&#225;s&#44; aquellos con d&#233;ficit permanente mostraron un diagn&#243;stico m&#225;s precoz&#44; un IGF-1 y talla al diagn&#243;stico menores&#44; y una mejor respuesta al tratamiento&#44; lo que apoyar&#237;a que los permanentes podr&#237;an ser los verdaderos casos de DGH&#44; aunque ser&#237;an necesarios m&#225;s estudios y encontrar mejores pruebas diagn&#243;sticas&#46;</p><p id="par0235" class="elsevierStylePara elsevierViewall">Durante el tiempo de seguimiento ninguno de estos pacientes presentaron efectos adversos con las dosis utilizadas de tratamiento&#59; y aunque no podemos establecer por completo la seguridad del tratamiento con GH&#44; nuestros resultados son avalados por otros estudios publicados&#46;</p><p id="par0240" class="elsevierStylePara elsevierViewall">Finalmente&#44; al relacionar las distintas variables con la respuesta se vislumbran posibles datos pron&#243;sticos para la eficacia del tratamiento&#44; como puede ser&#58; la talla diana&#44; el PTA inicial&#44; la edad puberal&#44; la GPT&#44; las tallas durante el tratamiento&#44; y la TIP&#44; que se correlacionan positivamente&#59; mientras que la EO&#47;EC y el IGF-1 inicial mantienen una correlaci&#243;n negativa sobre la talla adulta&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflicto de intereses</span><p id="par0245" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El crecimiento en pacientes con d&#233;ficit aislado de hormona del crecimiento &#40;GH&#41; es heterog&#233;neo a pesar del tratamiento&#44; debido a la baja especificidad de las pruebas diagn&#243;sticas&#44; por lo que es necesario definir las variables de eficacia&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Evaluar la eficacia de la terapia de reemplazo hormonal en ni&#241;os con d&#233;ficit aislado de GH&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional-ambispectivo de pacientes tratados en nuestro servicio en los &#250;ltimos 14 a&#241;os por d&#233;ficit aislado de GH&#44; definido como GH inferior a 7&#44;4<span class="elsevierStyleHsp" style=""></span>mg&#47;dl en 2 pruebas de est&#237;mulo&#44; en pacientes con talla<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#8722;2DE y velocidad de crecimiento disminuida&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Se estudiaron 97 pacientes&#46; El 69&#37; eran varones&#46; Con el tratamiento hubo una ganancia de talla de 1&#44;17DE&#46; El 79&#44;31&#37; alcanzaron la talla diana&#46; El 71&#44;13&#37; fueron reevaluados en la edad adulta&#44; de los cuales el 39&#44;4&#37; mantuvo el d&#233;ficit&#46; La talla diana&#44; el pron&#243;stico de talla adulta y la ganancia puberal total se correlacionaron positivamente con la talla adulta&#44; mientras que la relaci&#243;n edad &#243;sea&#47;edad cronol&#243;gica y factor de crecimiento insul&#237;nico tipo 1 inicial mostraron una correlaci&#243;n negativa&#46; Ninguno tuvo efectos secundarios&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusiones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La mayor&#237;a de los pacientes alcanzaron la talla diana&#44; aunque no todos mostraron permanencia del d&#233;ficit en edad adulta&#46; La talla diana&#44; el pron&#243;stico de talla adulta y las variables de pubertad est&#225;n directamente relacionados con la talla adulta&#59; mientras que la edad &#243;sea&#47;edad cronol&#243;gica y factor de crecimiento insul&#237;nico tipo 1 est&#225;n inversamente relacionadas&#44; pudiendo utilizarse estas como variables de eficacia&#46; No se han observado efectos adversos en la muestra con las dosis utilizadas&#46;</p></span>"
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        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introduction</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Growth in patients with isolated growth hormone &#40;GH&#41; deficiency is heterogeneous despite treatment due to the low specificity of diagnostic tests&#44; making it necessary to define efficacy variables&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Aims</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">To evaluate efficacy of hormone replacement therapy in children with isolated GH deficiency&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Observational-ambispective study of patients treated in our department in the last 14 years for isolated GH deficiency&#46; This was defined as a GH level less than 7&#46;4<span class="elsevierStyleHsp" style=""></span>mg&#47;dl in response to 2 stimulation tests in patients with height<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>2SD and a decreased growth rate&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">The study included a total 97 patients&#44; of whom 69&#37; were boys&#46; The large majority &#40;89&#46;58&#37;&#41; achieved final height&#46; None of them had side effects&#46; The median dose of GH used was 0&#46;028<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;day &#40;0&#46;03-0&#46;025&#41;&#46; There was a gain of 1&#46;17 SD in final height&#46; Around three-quarters &#40;71&#46;13&#37;&#41; of the patients were reassessed in adulthood&#44; of whom 39&#46;4&#37; maintained the deficiency&#44; and 79&#46;31&#37; achieved target range height&#46; Target height&#44; estimated height&#44; and the total pubertal gain were positively correlated with final height&#44; while the bone age&#47;chronological age ratio and the initial insulin-like growth factor-1 showed a negative correlation&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">A majority of patients reached target size&#44; although only a few of them maintained the deficiency in adulthood&#46; Target size&#44; estimated adult height&#44; and pubertal variables are directly related to adult height&#44; while bone age&#47;chronological age and insulin-like growth factor-1 were inversely related&#44; and these can be used as efficacy variables&#46; No adverse effects were observed in the sample with the doses used for the treatment&#46;</p></span>"
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                  \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">Talla inicial &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;5&#44;91&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&#44;78&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&#44;80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;62&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">Peso inicial &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&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&#44;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;83&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&#44;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;65&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">IMC inicial &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&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&#44;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;56&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&#44;44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;92&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">Dosis tratamiento &#40;mg&#47;kg&#47;d&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;020&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;036&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">IGF-1 inicial &#40;ng&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">646&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">181&#44;68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">116&#44;59&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">IGF-1 inicial &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;5&#44;68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;59&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&#44;82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;72&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">Talla diana &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">94&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&#44;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;33&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&#44;37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Edad &#243;sea&#47;edad cronol&#243;gica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;17&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">Pron&#243;stico talla adulta inicial &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;4&#44;28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;99&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&#44;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;44&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">Talla primer a&#241;o de tratamiento &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&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&#44;31&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&#44;19&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&#44;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Peso primer a&#241;o de tratamiento &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&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&#44;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;63&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&#44;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;59&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">IMC primer a&#241;o de tratamiento &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&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&#44;63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;16&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&#44;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;83&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">Edad &#243;sea&#47;Edad cronol&#243;gica primer a&#241;o tratamiento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&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&#44;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;19&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">IGF-1 primer a&#241;o tratamiento &#40;ng&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&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">1347&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">378&#44;54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">228&#44;17&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">IGF-1 primer a&#241;o tratamiento &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;4&#44;46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;60&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">Pron&#243;stico talla adulta primer a&#241;o tratamiento &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&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&#44;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;87&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&#44;95&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;52&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">Talla segundo a&#241;o tratamiento &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&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&#44;66&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;32&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&#44;98&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;60&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">Talla tercer a&#241;o tratamiento &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&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&#44;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;77&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&#44;71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;67&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">Talla cuarto a&#241;o tratamiento &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">96&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&#44;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;28&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&#44;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;78&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">Talla adulta &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">82&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&#44;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;93&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&#44;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;86&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">GH reevaluaci&#243;n &#40;ng&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33&#44;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;63&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">IGF-1 reevaluaci&#243;n &#40;ng&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1045&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">362&#44;51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">173&#44;37&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">IGF-1 reevaluaci&#243;n &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;7&#44;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2022084.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Estad&#237;stica descriptiva de las variables cuantitativas recogidas durante el seguimiento a talla adulta de ni&#241;os con d&#233;ficit aislado de GH</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Tabla 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">DE&#58; desviaci&#243;n est&#225;ndar&#59; GH&#58; hormona del crecimiento&#59; IGF-1&#58; factor de crecimiento insul&#237;nico tipo 1&#59; IMC&#58; &#237;ndice de masa corporal&#59; NS&#58; no significativo&#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="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Ni&#241;os</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Ni&#241;as</th><th class="td" title="table-head  " rowspan="2" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">N&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">Media&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&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">N&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">Media&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&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">Edad al diagn&#243;stico &#40;a&#241;os&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;989&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;696&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;154&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">Talla inicial &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&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&#44;771&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;659&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&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&#44;863&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;511&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">Peso inicial &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&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&#44;259&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;681&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&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&#44;246&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;598&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">IMC inicial &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&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&#44;418&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;941&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&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&#44;478&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;873&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">Dosis tratamiento &#40;mg&#47;kg&#47;d&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#44;0278&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;028&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">IGF-1 inicial &#40;ng&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">164&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">123&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">219&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">90&#44;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">IGF-1 inicial &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&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&#44;209&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;849&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;026&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;951&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;010&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">Talla diana &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&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&#44;253&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;773&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&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&#44;618&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;700&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;027&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">Edad &#243;sea&#47;edad cronol&#243;gica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;683&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;171&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;777&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;147&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pron&#243;stico talla adulta inicial &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&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&#44;236&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;368&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&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&#44;237&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;366&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Talla primer a&#241;o tratamiento &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&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&#44;327&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;523&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&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&#44;256&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;421&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">Peso primer a&#241;o tratamiento &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&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&#44;135&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;554&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&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&#44;133&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;669&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">IMC primer a&#241;o tratamiento &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&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&#44;464&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;830&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&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&#44;553&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;844&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">Edad &#243;sea&#47;Edad cronol&#243;gica primer a&#241;o tratamiento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;750&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;201&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;813&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;160&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">IGF-1 primer a&#241;o tratamiento &#40;ng&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">335&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">199&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">473&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">260&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;016&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">IGF-1 primer a&#241;o tratamiento &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;183&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;697&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;367&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;975&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pron&#243;stico talla adulta primer a&#241;o tratamiento &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&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&#44;707&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;265&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&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&#44;499&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;879&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Talla segundo a&#241;o tratamiento &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&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&#44;959&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;643&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&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&#44;037&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;503&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">Talla tercer a&#241;o tratamiento &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&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&#44;689&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;744&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&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&#44;759&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;458&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">Talla cuarto a&#241;o tratamiento &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&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&#44;548&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;835&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29&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&#44;690&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;655&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">Edad puberal &#40;a&#241;os&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#44;54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;197&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;084&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Talla puberal &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&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&#44;964&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;689&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&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&#44;127&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;630&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">Talla adulta &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">59&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&#44;533&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;937&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&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&#44;834&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;596&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;034&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">Ganancia puberal total &#40;cm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#44;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;432&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&#44;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;617&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;010&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">GH reevaluaci&#243;n &#40;ng&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;142&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;433&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;419&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;284&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">IGF-1 reevaluaci&#243;n &#40;ng&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">352&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">167&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">384&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">187&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">IGF-1 reevaluaci&#243;n &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">59&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&#44;146&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;251&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;403&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;293&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                0 => "xTab2022086.png"
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        "descripcion" => array:1 [
          "es" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Diferencias estad&#237;sticas de acuerdo al sexo en el seguimiento a talla adulta de ni&#241;os con d&#233;ficit aislado de GH</p>"
        ]
      ]
      5 => array:8 [
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        "etiqueta" => "Tabla 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
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            "rol" => "short"
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">DE&#58; desviaci&#243;n est&#225;ndar&#59; GH&#58; hormona del crecimiento&#59; IGF-1&#58; factor de crecimiento insul&#237;nico tipo 1&#59; IMC&#58; &#237;ndice de masa corporal&#59; NS&#58; no significativo&#46;</p>"
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                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">Variables&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">p&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">Edad al diagn&#243;stico &#40;a&#241;os&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">Talla inicial &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">Peso inicial &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">IMC inicial &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">Dosis tratamiento &#40;mg&#47;kg&#47;d&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">IGF-1 inicial &#40;ng&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">IGF-1 inicial &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&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">Talla diana &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&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">Edad &#243;sea&#47;Edad cronol&#243;gica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pron&#243;stico talla adulta inicial &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
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Información del artículo
ISSN: 16954033
Idioma original: Español
Datos actualizados diariamente
año/Mes Html Pdf Total
2024 Noviembre 10 11 21
2024 Octubre 80 29 109
2024 Septiembre 90 36 126
2024 Agosto 107 65 172
2024 Julio 98 32 130
2024 Junio 123 35 158
2024 Mayo 85 35 120
2024 Abril 64 37 101
2024 Marzo 75 28 103
2024 Febrero 62 24 86
2024 Enero 79 37 116
2023 Diciembre 96 24 120
2023 Noviembre 84 39 123
2023 Octubre 101 32 133
2023 Septiembre 49 35 84
2023 Agosto 29 17 46
2023 Julio 55 30 85
2023 Junio 37 30 67
2023 Mayo 68 23 91
2023 Abril 60 28 88
2023 Marzo 80 41 121
2023 Febrero 65 28 93
2023 Enero 45 27 72
2022 Diciembre 57 31 88
2022 Noviembre 92 40 132
2022 Octubre 100 68 168
2022 Septiembre 90 50 140
2022 Agosto 74 53 127
2022 Julio 65 58 123
2022 Junio 81 52 133
2022 Mayo 111 37 148
2022 Abril 143 37 180
2022 Marzo 146 62 208
2022 Febrero 146 38 184
2022 Enero 122 56 178
2021 Diciembre 85 53 138
2021 Noviembre 84 52 136
2021 Octubre 55 78 133
2021 Septiembre 46 41 87
2021 Agosto 56 54 110
2021 Julio 48 47 95
2021 Junio 78 58 136
2021 Mayo 79 56 135
2021 Abril 148 84 232
2021 Marzo 90 39 129
2021 Febrero 103 34 137
2021 Enero 82 41 123
2020 Diciembre 76 49 125
2020 Noviembre 61 49 110
2020 Octubre 56 28 84
2020 Septiembre 61 23 84
2020 Agosto 75 20 95
2020 Julio 78 25 103
2020 Junio 50 30 80
2020 Mayo 69 46 115
2020 Abril 49 20 69
2020 Marzo 62 40 102
2020 Febrero 61 21 82
2020 Enero 54 18 72
2019 Diciembre 61 33 94
2019 Noviembre 55 19 74
2019 Octubre 75 27 102
2019 Septiembre 68 27 95
2019 Agosto 78 21 99
2019 Julio 119 40 159
2019 Junio 100 44 144
2019 Mayo 507 189 696
2019 Abril 67 21 88
2019 Marzo 44 18 62
2019 Febrero 41 29 70
2019 Enero 40 29 69
2018 Diciembre 57 23 80
2018 Noviembre 122 31 153
2018 Octubre 90 29 119
2018 Septiembre 32 19 51
2018 Julio 0 4 4
2018 Junio 0 3 3
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