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faixa et&#225;ria e gravidade&#44; indo desde o uso de hidratantes&#44; corticoides t&#243;picos e inibidores de calcineurina para casos leves e moderados at&#233; o uso de medicamentos sist&#234;micos como ciclosporina&#44; metotrexato&#44; azatioprina&#44; imunobiol&#243;gicos &#40;dupilumabe&#41; e&#44; mais recentemente&#44; inibidores da Janus Kinase &#40;baricitinibe e upadacitinibe&#41; para o tratamento de casos graves&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Doen&#231;as inflamat&#243;rias cr&#244;nicas&#44; como a DA&#44; t&#234;m sido associadas de maneira inconsistente a doen&#231;as cardiovasculares &#40;DCV&#41; e acidente vascular encef&#225;lico &#40;AVE&#41; ou derrame em estudos epidemiol&#243;gicos&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">4</span></a> Foi demonstrado que a psor&#237;ase e a artrite reumatoide apresentam aumento do risco cardiovascular &#40;RCV&#41; em compara&#231;&#227;o com a popula&#231;&#227;o em geral&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">A crescente preval&#234;ncia da DA em adultos torna indispens&#225;vel a investiga&#231;&#227;o de comorbidades associadas&#46; A avalia&#231;&#227;o do RCV &#233; necess&#225;ria para o manejo adequado da DA e ado&#231;&#227;o de medidas preventivas&#46; O Escore de Risco de Framingham &#40;FRS&#41; &#233; um dos instrumentos mais estudados para indiv&#237;duos na aten&#231;&#227;o prim&#225;ria &#224; sa&#250;de&#44;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">6</span></a> tornando&#8208;o de grande import&#226;ncia na an&#225;lise de correla&#231;&#227;o da DA e RCV&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Entre junho de 2020 e julho de 2021&#44; foi realizado um estudo observacional anal&#237;tico&#44; no Hospital do Servidor P&#250;blico Estadual de S&#227;o Paulo &#40;IAMSPE&#41;&#44; em S&#227;o Paulo&#44; Brasil&#44; e no Complexo Hospitalar Padre Bento &#40;CHPB&#41;&#44; em Guarulhos&#44; Brasil&#46; Esse estudo foi aprovado pelo Comit&#234; de &#201;tica do IAMSPE &#40;parecer n&#176; 4&#46;909&#46;476&#41; no qual 60 indiv&#237;duos foram distribu&#237;dos igualmente em ambos os grupos&#44; pareados quanto &#224; distribui&#231;&#227;o por g&#234;nero&#44; m&#233;dia de idade e comorbidades associadas&#46; A distribui&#231;&#227;o em rela&#231;&#227;o &#224; etnia ocorreu de acordo com a popula&#231;&#227;o geral participante do estudo&#44; para representar a preval&#234;ncia relatada na literatura sobre doen&#231;as cardiovasculares na popula&#231;&#227;o brasileira&#46; Entretanto&#44; essa preval&#234;ncia pode variar em rela&#231;&#227;o a outros estudos j&#225; publicados&#44; uma vez que depende diretamente de algumas particularidades&#44; como pa&#237;s de dimens&#227;o continental e casamentos interraciais&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">7</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Os principais objetivos deste estudo foram avaliar o RCV em adultos com 30 anos ou mais com DA&#44; comparando&#8208;os com indiv&#237;duos controle&#44; e correlacionar a gravidade da DA com o RCV&#46; A estratifica&#231;&#227;o do RCV&#44; que estima a probabilidade de desfechos como infarto agudo do mioc&#225;rdio e AVE nos pr&#243;ximos 10 anos&#44; foi aplicada por meio do escore FRS&#44; que considera par&#226;metros como g&#234;nero&#44; idade&#44; n&#237;veis s&#233;ricos de colesterol total e HDL&#44; hipertens&#227;o&#44; diabetes e tabagismo&#46; Os participantes do grupo caso foram selecionados de acordo com os crit&#233;rios diagn&#243;sticos para DA propostos pelo <span class="elsevierStyleItalic">United Kingdom Working Party</span>&#44;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">8</span></a> e a gravidade da doen&#231;a foi avaliada pelo &#237;ndice <span class="elsevierStyleItalic">Scoring Atopic Dermatitis</span> &#40;SCORAD&#41;&#44; que avalia a extens&#227;o e a intensidade das les&#245;es&#44; al&#233;m da presen&#231;a de sintomas subjetivos&#44; como prurido e perda de sono&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">9</span></a> O uso prolongado de terapia sist&#234;mica para manejo dos sintomas de DA em pacientes que n&#227;o obtiveram controle adequado ap&#243;s tratamento t&#243;pico das les&#245;es tamb&#233;m foi levado em considera&#231;&#227;o como crit&#233;rio complementar na estimativa da gravidade&#46; Os medicamentos considerados para an&#225;lise conjunta foram ciclosporina&#44; metotrexato&#44; azatioprina e dupilumabe&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Os resultados das an&#225;lises mostraram que n&#227;o houve diferen&#231;a significante no RCV entre os grupos estudados &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;941&#41; e que as vari&#225;veis avaliadas foram estatisticamente independentes &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46; Contudo&#44; a idade apresentou forte correla&#231;&#227;o com o aumento do RCV nos participantes do grupo caso &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; assim como a press&#227;o arterial sist&#243;lica &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; e diast&#243;lica &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;028&#59; <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#41;&#46; N&#227;o foi observada rela&#231;&#227;o direta entre gravidade da DA e RCV ao utilizar o SCORAD &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;388&#59; <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a> e <a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">Ao dividir o grupo caso em grave e n&#227;o grave&#44; adotando como crit&#233;rio de gravidade o tratamento prolongado com medicamentos sist&#234;micos&#44; comparando&#8208;os ao grupo controle&#44; n&#227;o foi observada diferen&#231;a estat&#237;stica em rela&#231;&#227;o ao RCV &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;485&#59; <a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">Estudos recentes em pacientes com DA mostraram resultados divergentes em rela&#231;&#227;o ao aumento do RCV&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> Em 2022&#44; Ribeiro publicou revis&#227;o abrangente que avaliou uma s&#233;rie de estudos em que a rela&#231;&#227;o entre DA grave foi avaliada em rela&#231;&#227;o aos seus mecanismos inflamat&#243;rios e o risco de desenvolver DCV&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> Um total de 52 ensaios foram inclu&#237;dos nessa revis&#227;o&#44; abrangendo metan&#225;lises&#44; coortes&#44; revis&#245;es e estudos transversais&#46; Trinta e seis estudos encontraram correla&#231;&#227;o entre DA e DCV&#44; enquanto 16 n&#227;o encontraram&#46; Os autores conclu&#237;ram que n&#227;o h&#225; evid&#234;ncias suficientes de que a DA por si s&#243; seja fator de risco para DCV&#44; e que o RCV em DA moderada a grave pode ser uma vari&#225;vel de confus&#227;o&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">At&#233; hoje foram criados numerosos instrumentos de avalia&#231;&#227;o de risco para o desenvolvimento de doen&#231;as cardiovasculares&#46; N&#227;o foi encontrado nenhum estudo avaliando RCV utilizando o escore de risco global de Framingham&#44; que &#233; um dos instrumentos de estratifica&#231;&#227;o de RCV mais estudados e validados para uso na popula&#231;&#227;o geral na aten&#231;&#227;o prim&#225;ria &#224; sa&#250;de&#46; Utilizando o <span class="elsevierStyleItalic">Global Risk Score</span>&#44; verificou&#8208;se que apesar de o grupo caso apresentar RCV m&#233;dio superior ao grupo controle&#44; n&#227;o houve diferen&#231;a estatisticamente significante entre eles &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;941&#41;&#46; Utilizando o SCORAD para mensurar a gravidade de DA&#44; n&#227;o foi observada correla&#231;&#227;o significante com RCV &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;388&#41;&#46; Ao classificar a gravidade da DA&#44; levando&#8208;se em considera&#231;&#227;o o uso de medicamentos sist&#234;micos e comparando indiv&#237;duos com doen&#231;a grave&#44; doen&#231;a n&#227;o grave e grupo controle&#44; n&#227;o foi observada diferen&#231;a estatisticamente significante &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;485&#41;&#44; sugerindo que a gravidade da DA n&#227;o implica diretamente no aumento do RCV&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Diante do exposto&#44; os achados prim&#225;rios do presente estudo corroboram as diretrizes atuais da <span class="elsevierStyleItalic">American Academy of Dermatology</span>&#44;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">11</span></a> que&#44; ao avaliar uma s&#233;rie de estudos com grande n&#250;mero de participantes com DA associada e RCV aumentado&#44; n&#227;o identificou evid&#234;ncias que demonstrassem magnitude de associa&#231;&#227;o suficiente para estabelecer uma rela&#231;&#227;o direta&#44; concluindo que a avalia&#231;&#227;o para RCV em pacientes com DA n&#227;o seria necess&#225;ria&#46; Embora exista correla&#231;&#227;o entre o processo inflamat&#243;rio endotelial e a presen&#231;a de biomarcadores associados &#224; resposta de Th2&#44; e algumas evid&#234;ncias que demonstrem pequenas associa&#231;&#245;es da DA e RCV elevado&#44; ou algumas doen&#231;as que a predisp&#245;em&#44; atualmente n&#227;o h&#225; indica&#231;&#245;es para avalia&#231;&#227;o cardiovascular adicional e tratamento de pacientes com DA al&#233;m do que j&#225; &#233; recomendado para a popula&#231;&#227;o em geral&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Conclui&#8208;se&#44; portanto&#44; que embora a press&#227;o arterial e a idade estejam fortemente relacionadas com a eleva&#231;&#227;o do RCV nos indiv&#237;duos do grupo caso&#44; ainda n&#227;o s&#227;o consideradas suficientes para afirmar que indiv&#237;duos adultos com DA t&#234;m maior probabilidade de desenvolver DCV do que indiv&#237;duos do grupo controle&#46; A gravidade da DA&#44; medida pelo SCORAD&#44; bem como o uso de terapia sist&#234;mica&#44; n&#227;o apresentaram associa&#231;&#227;o direta com o aumento do RCV&#59; desse modo&#44; n&#227;o h&#225; necessidade de medidas adicionais de avalia&#231;&#227;o para DCV nessa popula&#231;&#227;o e portanto&#44; a DA n&#227;o deve ser considerada fator independente para RCV&#46; Assim&#44; acredita&#8208;se que a avalia&#231;&#227;o do RCV para pacientes com DA deva ser realizada de acordo com protocolos baseados na idade e em outros fatores associados&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Suporte financeiro</span><p id="par0060" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Contribui&#231;&#227;o dos autores</span><p id="par0065" class="elsevierStylePara elsevierViewall">Lucas Pires Ventura&#58; Contribui&#231;&#245;es substanciais na concep&#231;&#227;o ou planejamento do estudo&#59; obten&#231;&#227;o e interpreta&#231;&#227;o dos dados para o estudo&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; e concorda em ser respons&#225;vel por todos os aspectos do estudo&#44; garantindo que quest&#245;es relacionadas &#224; precis&#227;o ou integridade de qualquer parte do trabalho sejam adequadamente investigadas e resolvidas&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Mario Cezar Pires&#58; An&#225;lise e interpreta&#231;&#227;o dos dados do estudo&#59; aprova&#231;&#227;o da vers&#227;o a ser publicada&#59; e concorda em ser respons&#225;vel por todos os aspectos do estudo&#44; garantindo que quest&#245;es relacionadas &#224; precis&#227;o ou integridade de qualquer parte do trabalho sejam adequadamente investigadas e resolvidas&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Adilson da Costa&#58; Contribui&#231;&#245;es substanciais na concep&#231;&#227;o ou planejamento do estudo&#59; interpreta&#231;&#227;o dos dados do estudo&#59; reda&#231;&#227;o do manuscrito e revis&#227;o cr&#237;tica de conte&#250;do intelectual importante&#59; aprova&#231;&#227;o da vers&#227;o a ser publicada&#59; concorda em ser respons&#225;vel por todos os aspectos do estudo&#44; garantindo que quest&#245;es relacionadas &#224; precis&#227;o ou integridade de qualquer parte do trabalho sejam adequadamente investigadas e resolvidas&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflito de interesses</span><p id="par0080" class="elsevierStylePara elsevierViewall">Lucas Pires Ventura&#58; Bolsista CAPES&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Mario Cezar Pires&#58; FQM &#40;palestrante&#41;&#44; Pfizer &#40;palestrante e consultor&#41;&#44; Sanofi &#40;investigador&#41;&#44; Lilly &#40;investigador&#41;&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Adilson da Costa&#58; Nenhum&#46;</p></span></span>"
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " rowspan="2" align="left" valign="\n
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                  \t\t\t\t">PAS</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Caso&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;285</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Controle&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Controle&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Controle&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">11&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
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                  \t\t\t\t">&#37;Risco CV</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Caso&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;66&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;941</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Controle&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                0 => "xTab3644942.png"
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          "pt" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Compara&#231;&#227;o de par&#226;metros associados ao aumento do risco cardiovascular entre os grupos</p>"
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          "leyenda" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">PAS&#44; press&#227;o arterial sist&#243;lica&#59; PAD&#44; press&#227;o arterial diast&#243;lica&#59; HDL&#44; lipoprote&#237;na de alta densidade&#8208;colesterol&#59; SCORAD&#44; <span class="elsevierStyleItalic">Scoring Atopic Dermatitis</span>&#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="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col"></th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Risco CV</th></tr><tr title="table-row"><th class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Corr &#40;r&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">p&#8208;valor&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;800&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;580&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PAD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;401&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;028&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Colesterol&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;299&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;115&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HDL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;0&#44;307&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;105&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SCORAD&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;164&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;388&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "pt" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Correla&#231;&#227;o do risco cardiovascular com os principais par&#226;metros avaliados no grupo caso</p>"
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          "leyenda" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Risco CV&#44; risco cardiovascular&#59; Caso grave&#44; pacientes com dermatite at&#243;pica grave classificados por uso prolongado de terapia sist&#234;mica&#59; Caso n&#227;o grave&#44; pacientes com dermatite at&#243;pica que n&#227;o utilizam terapia sist&#234;mica&#46;</p>"
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            0 => array:2 [
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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="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"></th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">M&#233;dia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mediana&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Desvio&#8208;padr&#227;o&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Q1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Q3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">IC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&#8208;valor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Risco CV em &#37;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Caso grave&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#44;63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;485</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Caso n&#227;o grave&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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Cartas ‐ Investigação
Análise de risco cardiovascular em pacientes com dermatite atópica
Lucas Pires Venturaa,b,
Corresponding author
lpiresventura@gmail.com

Autor para correspondência.
, Mario Cezar Piresa,b, Adilson da Costaa
a Instituto de Assistência Médica, Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, Brasil
b Departamento de Dermatologia, Complexo Hospitalar Padre Bento de Guarulhos, São Paulo, SP, Brasil
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faixa et&#225;ria e gravidade&#44; indo desde o uso de hidratantes&#44; corticoides t&#243;picos e inibidores de calcineurina para casos leves e moderados at&#233; o uso de medicamentos sist&#234;micos como ciclosporina&#44; metotrexato&#44; azatioprina&#44; imunobiol&#243;gicos &#40;dupilumabe&#41; e&#44; mais recentemente&#44; inibidores da Janus Kinase &#40;baricitinibe e upadacitinibe&#41; para o tratamento de casos graves&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Doen&#231;as inflamat&#243;rias cr&#244;nicas&#44; como a DA&#44; t&#234;m sido associadas de maneira inconsistente a doen&#231;as cardiovasculares &#40;DCV&#41; e acidente vascular encef&#225;lico &#40;AVE&#41; ou derrame em estudos epidemiol&#243;gicos&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">4</span></a> Foi demonstrado que a psor&#237;ase e a artrite reumatoide apresentam aumento do risco cardiovascular &#40;RCV&#41; em compara&#231;&#227;o com a popula&#231;&#227;o em geral&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">A crescente preval&#234;ncia da DA em adultos torna indispens&#225;vel a investiga&#231;&#227;o de comorbidades associadas&#46; A avalia&#231;&#227;o do RCV &#233; necess&#225;ria para o manejo adequado da DA e ado&#231;&#227;o de medidas preventivas&#46; O Escore de Risco de Framingham &#40;FRS&#41; &#233; um dos instrumentos mais estudados para indiv&#237;duos na aten&#231;&#227;o prim&#225;ria &#224; sa&#250;de&#44;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">6</span></a> tornando&#8208;o de grande import&#226;ncia na an&#225;lise de correla&#231;&#227;o da DA e RCV&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Entre junho de 2020 e julho de 2021&#44; foi realizado um estudo observacional anal&#237;tico&#44; no Hospital do Servidor P&#250;blico Estadual de S&#227;o Paulo &#40;IAMSPE&#41;&#44; em S&#227;o Paulo&#44; Brasil&#44; e no Complexo Hospitalar Padre Bento &#40;CHPB&#41;&#44; em Guarulhos&#44; Brasil&#46; Esse estudo foi aprovado pelo Comit&#234; de &#201;tica do IAMSPE &#40;parecer n&#176; 4&#46;909&#46;476&#41; no qual 60 indiv&#237;duos foram distribu&#237;dos igualmente em ambos os grupos&#44; pareados quanto &#224; distribui&#231;&#227;o por g&#234;nero&#44; m&#233;dia de idade e comorbidades associadas&#46; A distribui&#231;&#227;o em rela&#231;&#227;o &#224; etnia ocorreu de acordo com a popula&#231;&#227;o geral participante do estudo&#44; para representar a preval&#234;ncia relatada na literatura sobre doen&#231;as cardiovasculares na popula&#231;&#227;o brasileira&#46; Entretanto&#44; essa preval&#234;ncia pode variar em rela&#231;&#227;o a outros estudos j&#225; publicados&#44; uma vez que depende diretamente de algumas particularidades&#44; como pa&#237;s de dimens&#227;o continental e casamentos interraciais&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">7</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Os principais objetivos deste estudo foram avaliar o RCV em adultos com 30 anos ou mais com DA&#44; 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a idade apresentou forte correla&#231;&#227;o com o aumento do RCV nos participantes do grupo caso &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; assim como a press&#227;o arterial sist&#243;lica &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; e diast&#243;lica &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;028&#59; <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#41;&#46; N&#227;o foi observada rela&#231;&#227;o direta entre gravidade da DA e RCV ao utilizar o SCORAD &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;388&#59; <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a> e <a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">Ao dividir o grupo caso em grave e n&#227;o grave&#44; adotando como crit&#233;rio de gravidade o tratamento prolongado com medicamentos sist&#234;micos&#44; comparando&#8208;os ao grupo controle&#44; n&#227;o foi observada diferen&#231;a estat&#237;stica em rela&#231;&#227;o ao RCV &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;485&#59; <a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">Estudos recentes em pacientes com DA mostraram resultados divergentes em rela&#231;&#227;o ao aumento do RCV&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> Em 2022&#44; Ribeiro publicou revis&#227;o abrangente que avaliou uma s&#233;rie de estudos em que a rela&#231;&#227;o entre DA grave foi avaliada em rela&#231;&#227;o aos seus mecanismos inflamat&#243;rios e o risco de desenvolver DCV&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> Um total de 52 ensaios foram inclu&#237;dos nessa revis&#227;o&#44; abrangendo metan&#225;lises&#44; coortes&#44; revis&#245;es e estudos transversais&#46; Trinta e seis estudos encontraram correla&#231;&#227;o entre DA e DCV&#44; enquanto 16 n&#227;o encontraram&#46; Os autores conclu&#237;ram que n&#227;o h&#225; evid&#234;ncias suficientes de que a DA por si s&#243; seja fator de risco para DCV&#44; e que o RCV em DA moderada a grave pode ser uma vari&#225;vel de confus&#227;o&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">At&#233; hoje foram criados numerosos instrumentos de avalia&#231;&#227;o de risco para o desenvolvimento de doen&#231;as cardiovasculares&#46; N&#227;o foi encontrado nenhum estudo avaliando RCV utilizando o escore de risco global de Framingham&#44; que &#233; um dos instrumentos de estratifica&#231;&#227;o de RCV mais estudados e validados para uso na popula&#231;&#227;o geral na aten&#231;&#227;o prim&#225;ria &#224; sa&#250;de&#46; Utilizando o <span class="elsevierStyleItalic">Global Risk Score</span>&#44; verificou&#8208;se que apesar de o grupo caso apresentar RCV m&#233;dio superior ao grupo controle&#44; n&#227;o houve diferen&#231;a estatisticamente significante entre eles &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;941&#41;&#46; Utilizando o SCORAD para mensurar a gravidade de DA&#44; n&#227;o foi observada correla&#231;&#227;o significante com RCV &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;388&#41;&#46; Ao classificar a gravidade da DA&#44; levando&#8208;se em considera&#231;&#227;o o uso de medicamentos sist&#234;micos e comparando indiv&#237;duos com doen&#231;a grave&#44; doen&#231;a n&#227;o grave e grupo controle&#44; n&#227;o foi observada diferen&#231;a estatisticamente significante &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;485&#41;&#44; sugerindo que a gravidade da DA n&#227;o implica diretamente no aumento do RCV&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Diante do exposto&#44; os achados prim&#225;rios do presente estudo corroboram as diretrizes atuais da <span class="elsevierStyleItalic">American Academy of Dermatology</span>&#44;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">11</span></a> que&#44; ao avaliar uma s&#233;rie de estudos com grande n&#250;mero de participantes com DA associada e RCV aumentado&#44; n&#227;o identificou evid&#234;ncias que demonstrassem magnitude de associa&#231;&#227;o suficiente para estabelecer uma rela&#231;&#227;o direta&#44; concluindo que a avalia&#231;&#227;o para RCV em pacientes com DA n&#227;o seria necess&#225;ria&#46; Embora exista correla&#231;&#227;o entre o processo inflamat&#243;rio endotelial e a presen&#231;a de biomarcadores associados &#224; resposta de Th2&#44; e algumas evid&#234;ncias que demonstrem pequenas associa&#231;&#245;es da DA e RCV elevado&#44; ou algumas doen&#231;as que a predisp&#245;em&#44; atualmente n&#227;o h&#225; indica&#231;&#245;es para avalia&#231;&#227;o cardiovascular adicional e tratamento de pacientes com DA al&#233;m do que j&#225; &#233; recomendado para a popula&#231;&#227;o em geral&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Conclui&#8208;se&#44; portanto&#44; que embora a press&#227;o arterial e a idade estejam fortemente relacionadas com a eleva&#231;&#227;o do RCV nos indiv&#237;duos do grupo caso&#44; ainda n&#227;o s&#227;o consideradas suficientes para afirmar que indiv&#237;duos adultos com DA t&#234;m maior probabilidade de desenvolver DCV do que indiv&#237;duos do grupo controle&#46; A gravidade da DA&#44; medida pelo SCORAD&#44; bem como o uso de terapia sist&#234;mica&#44; n&#227;o apresentaram associa&#231;&#227;o direta com o aumento do RCV&#59; desse modo&#44; n&#227;o h&#225; necessidade de medidas adicionais de avalia&#231;&#227;o para DCV nessa popula&#231;&#227;o e portanto&#44; a DA n&#227;o deve ser considerada fator independente para RCV&#46; Assim&#44; acredita&#8208;se que a avalia&#231;&#227;o do RCV para pacientes com DA deva ser realizada de acordo com protocolos baseados na idade e em outros fatores associados&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Suporte financeiro</span><p id="par0060" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Contribui&#231;&#227;o dos autores</span><p id="par0065" class="elsevierStylePara elsevierViewall">Lucas Pires Ventura&#58; Contribui&#231;&#245;es substanciais na concep&#231;&#227;o ou planejamento do estudo&#59; obten&#231;&#227;o e interpreta&#231;&#227;o dos dados para o estudo&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; e concorda em ser respons&#225;vel por todos os aspectos do estudo&#44; garantindo que quest&#245;es relacionadas &#224; precis&#227;o ou integridade de qualquer parte do trabalho sejam adequadamente investigadas e resolvidas&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Mario Cezar Pires&#58; An&#225;lise e interpreta&#231;&#227;o dos dados do estudo&#59; aprova&#231;&#227;o da vers&#227;o a ser publicada&#59; e concorda em ser respons&#225;vel por todos os aspectos do estudo&#44; garantindo que quest&#245;es relacionadas &#224; precis&#227;o ou integridade de qualquer parte do trabalho sejam adequadamente investigadas e resolvidas&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Adilson da Costa&#58; Contribui&#231;&#245;es substanciais na concep&#231;&#227;o ou planejamento do estudo&#59; interpreta&#231;&#227;o dos dados do estudo&#59; reda&#231;&#227;o do manuscrito e revis&#227;o cr&#237;tica de conte&#250;do intelectual importante&#59; aprova&#231;&#227;o da vers&#227;o a ser publicada&#59; concorda em ser respons&#225;vel por todos os aspectos do estudo&#44; garantindo que quest&#245;es relacionadas &#224; precis&#227;o ou integridade de qualquer parte do trabalho sejam adequadamente investigadas e resolvidas&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflito de interesses</span><p id="par0080" class="elsevierStylePara elsevierViewall">Lucas Pires Ventura&#58; Bolsista CAPES&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Mario Cezar Pires&#58; FQM &#40;palestrante&#41;&#44; Pfizer &#40;palestrante e consultor&#41;&#44; Sanofi &#40;investigador&#41;&#44; Lilly &#40;investigador&#41;&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Adilson da Costa&#58; Nenhum&#46;</p></span></span>"
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                  \t\t\t\t">0&#44;285</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Controle&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Controle&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Controle&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t  " rowspan="2" align="left" valign="\n
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                  \t\t\t\t">&#37;Risco CV</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " rowspan="2" align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Controle&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">6&#44;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab3644942.png"
              ]
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          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Compara&#231;&#227;o de par&#226;metros associados ao aumento do risco cardiovascular entre os grupos</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Tabela 2"
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          0 => array:3 [
            "identificador" => "at2"
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          "leyenda" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">PAS&#44; press&#227;o arterial sist&#243;lica&#59; PAD&#44; press&#227;o arterial diast&#243;lica&#59; HDL&#44; lipoprote&#237;na de alta densidade&#8208;colesterol&#59; SCORAD&#44; <span class="elsevierStyleItalic">Scoring Atopic Dermatitis</span>&#46;</p>"
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            0 => array:2 [
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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="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col"></th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Risco CV</th></tr><tr title="table-row"><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Corr &#40;r&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">p&#8208;valor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Idade&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;800&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;580&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PAD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;401&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;028&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Colesterol&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;299&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;115&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HDL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;0&#44;307&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;105&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SCORAD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;164&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;388&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "pt" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Correla&#231;&#227;o do risco cardiovascular com os principais par&#226;metros avaliados no grupo caso</p>"
        ]
      ]
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          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Tabela "
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          "leyenda" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Risco CV&#44; risco cardiovascular&#59; Caso grave&#44; pacientes com dermatite at&#243;pica grave classificados por uso prolongado de terapia sist&#234;mica&#59; Caso n&#227;o grave&#44; pacientes com dermatite at&#243;pica que n&#227;o utilizam terapia sist&#234;mica&#46;</p>"
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            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"></th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">M&#233;dia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mediana&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Desvio&#8208;padr&#227;o&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Q1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Q3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">IC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&#8208;valor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Risco CV em &#37;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Caso grave&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#44;63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;485</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Caso n&#227;o grave&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Controle&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab3644943.png"
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ISSN: 26662752
Original language: Portuguese
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