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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Introdu&#231;&#227;o</span><p id="par0005" class="elsevierStylePara elsevierViewall">Ros&#225;cea &#233; dermatose cr&#244;nica prevalente entre adultos&#44; especialmente do sexo feminino&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">1</span></a> A ros&#225;cea &#233; atualmente dividida em quatro subtipos&#44; incluindo ros&#225;cea erit&#234;mato&#8208;telangiect&#225;sica &#40;ETR&#44; do ingl&#234;s <span class="elsevierStyleItalic">erythematotelangiectatic rosacea</span>&#41;&#44; ros&#225;cea papulopustular &#40;PPR&#44; do ingl&#234;s <span class="elsevierStyleItalic">papulopustular rosacea</span>&#41;&#44; ros&#225;cea fimatosa &#40;PHY&#44; do ingl&#234;s <span class="elsevierStyleItalic">phymatous rosacea</span>&#41; e ros&#225;cea ocular &#40;OR&#44; do ingl&#234;s <span class="elsevierStyleItalic">ocular rosacea</span>&#41;&#46; O subtipo mais prevalente &#233; o ETR&#44;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">2</span></a> no qual os sintomas mais comuns s&#227;o eritema persistente e rubor&#44; trazendo impacto negativo consider&#225;vel aos pacientes com ros&#225;cea&#46; Nos &#250;ltimos anos&#44; a ros&#225;cea come&#231;ou a ocorrer nos indiv&#237;duos mais jovens&#44; o que pode resultar em consequ&#234;ncias mais prejudiciais&#44; como baixo entusiasmo no trabalho e ansiedade&#47;depress&#227;o&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">3</span></a> Entretanto&#44; com exce&#231;&#227;o da brimonidina t&#243;pica&#44; n&#227;o existem outros tratamentos aprovados em virtude do conhecimento deficiente do mecanismo da ros&#225;cea&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Embora o mecanismo n&#227;o seja totalmente compreendido&#44; os avan&#231;os atuais sugerem que a ros&#225;cea &#233; uma doen&#231;a complicada&#44; influenciada por fatores de risco multifacetados&#44; incluindo resposta imunol&#243;gica&#44; ansiedade&#47;depress&#227;o&#44; barreira cut&#226;nea comprometida e metabolismo lip&#237;dico local ou sist&#234;mico anormal&#46;<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">4&#8211;7</span></a> Especificamente&#44; a barreira de permeabilidade epid&#233;rmica comprometida induz a produ&#231;&#227;o e libera&#231;&#227;o de fatores inflamat&#243;rios e a infiltra&#231;&#227;o de c&#233;lulas imunol&#243;gicas&#44; consequentemente causando ressecamento da pele&#44; ard&#234;ncia e queima&#231;&#227;o em pacientes com ros&#225;cea&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">8</span></a> Al&#233;m disso&#44; um estudo anterior revelou que a composi&#231;&#227;o dos lip&#237;dios seb&#225;ceos est&#225; alterada em pacientes com ros&#225;cea em compara&#231;&#227;o com controles normais&#44;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">7</span></a> sugerindo o papel potencial do metabolismo lip&#237;dico na patog&#234;nese da ros&#225;cea&#46; Tamb&#233;m prop&#245;e&#8208;se que a ros&#225;cea seja doen&#231;a inflamat&#243;ria cr&#244;nica da pele&#44; e a ativa&#231;&#227;o da inflama&#231;&#227;o pode explicar muitos de seus sinais e sintomas&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">6</span></a> Um estudo anterior dos autores revelou que o estado de ansiedade&#47;depress&#227;o desempenha papel importante no desenvolvimento da ros&#225;cea&#44; e a regula&#231;&#227;o do estado de ansiedade&#47;depress&#227;o pode facilitar a efic&#225;cia terap&#234;utica dos medicamentos atuais&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">3</span></a> Assim&#44; visar essas m&#250;ltiplas vias pode ser um caminho para o al&#237;vio da ros&#225;cea&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">O &#225;cido gama linol&#234;nico &#40;GLA&#44; do ingl&#234;s <span class="elsevierStyleItalic">gamma linolenic acid</span>&#41; &#233; um &#225;cido graxo poli&#8208;insaturado n&#8208;6 end&#243;geno &#40;PUFA n&#8208;6&#41; que desempenha papel crucial na redu&#231;&#227;o dos n&#237;veis lip&#237;dicos&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">9</span></a> Um ensaio cl&#237;nico randomizado recente indicou que o GLA como suplemento pode melhorar os resultados cl&#237;nicos e reduzir os n&#237;veis lip&#237;dicos em pacientes com ros&#225;cea&#44;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">10</span></a> destacando que o GLA pode estar envolvido na patog&#234;nese da doen&#231;a&#46; Que seja de conhecimento dos autores&#44; poucos estudos foram realizados para elucidar a rela&#231;&#227;o entre o desenvolvimento da ros&#225;cea e os n&#237;veis de GLA end&#243;geno&#46; Portanto&#44; o objetivo do presente estudo foi investigar a altera&#231;&#227;o nos n&#237;veis s&#233;ricos de GLA e explorar a associa&#231;&#227;o desses n&#237;veis s&#233;ricos com o grau de eritema e o estado de ansiedade em pacientes com ETR&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Pacientes e m&#233;todos</span><p id="par0020" class="elsevierStylePara elsevierViewall">Todos os 62 pacientes com ros&#225;cea &#40;subtipo ETR&#41; e 14 controles normais &#40;CN&#41; pareados por idade foram recrutados consecutivamente no Southwestern Hospital&#46; Amostras de sangue foram coletadas e os n&#237;veis de GLA no sangue foram analisados&#46; Al&#233;m disso&#44; tamb&#233;m foram avaliados o grau de eritema e o estado de ansiedade e suas correla&#231;&#245;es com os n&#237;veis de GLA no sangue&#44; respectivamente&#46; As informa&#231;&#245;es detalhadas s&#227;o apresentadas nos dados suplementares&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Caracter&#237;sticas demogr&#225;ficas</span><p id="par0025" class="elsevierStylePara elsevierViewall">A <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a> mostra as caracter&#237;sticas demogr&#225;ficas dos pacientes com ros&#225;cea e CN&#46; Como mostrado&#44; n&#227;o houve diferen&#231;as significantes em rela&#231;&#227;o a idade&#44; sexo&#44; IMC&#44; preval&#234;ncia de hipertens&#227;o e diabetes&#44; bem como hipercolesterolemia entre pacientes com ros&#225;cea e CN &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#44; p<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; Al&#233;m disso&#44; os n&#237;veis s&#233;ricos de GLA em pacientes com ros&#225;cea no in&#237;cio do estudo foram inferiores aos dos CN &#40;24&#44;66<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#44;20 <span class="elsevierStyleItalic">vs</span>&#46; 15&#44;81<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#44;58 moL&#47;L&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Compara&#231;&#245;es dos escores de CEA e PSA entre o grupo com n&#237;vel baixo de GLA e o grupo com n&#237;vel alto de GLA em pacientes com ros&#225;cea</span><p id="par0030" class="elsevierStylePara elsevierViewall">Foi utilizado o valor da mediana das amostras dos CN como valor de corte para diferenciar o grupo com n&#237;vel alto de GLA e o grupo com n&#237;vel baixo de GLA &#40;26&#44;32<span class="elsevierStyleHsp" style=""></span>mol&#47;L&#41;&#46; Posteriormente&#44; os pacientes com ros&#225;cea foram divididos em grupo com n&#237;vel baixo de GLA e grupo com n&#237;vel alto de GLA&#44; de acordo com o valor de corte&#46; Em seguida&#44; foram comparados os escores de CEA e PSA entre o grupo de baixo n&#237;vel de GLA e o grupo de alto n&#237;vel de GLA em pacientes com ros&#225;cea&#46; Foi interessante descobrir que pacientes com ros&#225;cea e n&#237;vel mais baixo de GLA apresentavam escores de CEA e PSA mais elevados do que os pacientes com n&#237;vel de GLA mais elevado &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01 para todos&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Correla&#231;&#245;es dos n&#237;veis de GLA com os escores de PSA e CEA em pacientes com ros&#225;cea</span><p id="par0035" class="elsevierStylePara elsevierViewall">A ETR &#233; um subtipo prevalente de ros&#225;cea&#44; cujo sintoma mais comum &#233; o eritema&#46; Os escores de PSA e CEA s&#227;o geralmente aplicados para refletir a gravidade do eritema&#46; Para revelar com maior profundidade a associa&#231;&#227;o dos n&#237;veis de GLA com a gravidade da ros&#225;cea&#44; foi conduzida a an&#225;lise de correla&#231;&#227;o de Spearman&#46; Os n&#237;veis s&#233;ricos de GLA est&#227;o surpreendentemente associados aos escores de PSA&#44; bem como aos escores de CEA &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Valor preditivo dos n&#237;veis de GLA para escores de CEA e PSA ap&#243;s um m&#234;s de tratamento</span><p id="par0040" class="elsevierStylePara elsevierViewall">Para explorar os efeitos preditivos do n&#237;vel de GLA na linha de base para os escores de CEA e PSA ap&#243;s um m&#234;s de tratamento convencional&#44; foi conduzida a an&#225;lise de regress&#227;o linear com os escores de CEA ou PSA como vari&#225;vel independente&#44; respectivamente&#46; Os fatores contribuintes incluem idade&#44; sexo&#44; hiperlipidemia&#44; hipertens&#227;o&#44; DM&#44; escores de CEA e de PSA na linha de base&#46; &#201; evidente que os n&#237;veis de GLA na linha de base foram fator preditivo significante para os escores de CEA e PSA ap&#243;s um m&#234;s de seguimento&#44; respectivamente &#40;<a class="elsevierStyleCrossRefs" href="#tbl0010">tabelas 2 e 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Correla&#231;&#245;es dos n&#237;veis de GLA com os escores de GAD&#8208;7 e PHQ&#8208;9 em pacientes com ros&#225;cea</span><p id="par0045" class="elsevierStylePara elsevierViewall">Como ansiedade&#47;depress&#227;o t&#234;m impacto direto no desenvolvimento da ros&#225;cea&#44; foi investigada&#44; ainda&#44; a rela&#231;&#227;o entre os n&#237;veis s&#233;ricos de GLA e o escores no GAD&#8208;7&#44; bem como os escores do PHQ&#8208;9&#46; Inicialmente&#44; foram comparados os escores de GAD&#8208;7 e PHQ&#8208;9 entre o grupo com baixo n&#237;vel de GLA e o grupo com n&#237;vel elevado de GLA em pacientes com ros&#225;cea&#46; O grupo com baixo n&#237;vel de GLA apresentou escores de GAD&#8208;7 e PHQ&#8208;9 mais elevados do que o grupo com n&#237;vel elevado de GLA &#40;<a class="elsevierStyleCrossRef" href="#fig0015">fig&#46; 3A&#8208;B</a>&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; Al&#233;m disso&#44; a an&#225;lise de correla&#231;&#227;o de Spearman foi realizada para descobrir a associa&#231;&#227;o dos n&#237;veis de GLA com os escores de GAD&#8208;7 e PHQ&#8208;9&#46; Curiosamente&#44; os escores de GAD&#8208;7 e PHQ&#8208;9 foram negativamente correlacionados com os n&#237;veis de GLA em pacientes com ros&#225;cea &#40;<a class="elsevierStyleCrossRef" href="#fig0015">fig&#46; 3C&#8208;D</a>&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discuss&#227;o</span><p id="par0050" class="elsevierStylePara elsevierViewall">O objetivo do presente estudo foi investigar a associa&#231;&#227;o dos n&#237;veis s&#233;ricos de GLA com eritema e estado de ansiedade&#47;depress&#227;o&#46; Foi observado que os pacientes com ros&#225;cea apresentavam n&#237;vel mais alto de GLA do que os CN&#44; e os escores de CEA e PSA&#44; bem como os escores de GAD&#8208;7 e PHQ&#8208;9 nos pacientes com baixo n&#237;vel de GLA foram notavelmente mais altos do que aqueles no grupo com n&#237;vel elevado de GLA&#46; No geral&#44; os n&#237;veis s&#233;ricos de GLA foram surpreendentemente correlacionados com a gravidade do eritema e estado de ansiedade&#47;depress&#227;o&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">O GLA &#233; um PUFA bioativo biossintetizado por meio da dessatura&#231;&#227;o do &#225;cido linoleico no f&#237;gado pela enzima &#916;6&#8208;dessaturase&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">11</span></a> Estudos anteriores revelaram que n&#237;veis alterados de GLA aumentariam o risco de diversas doen&#231;as humanas&#44; como diabetes&#44; dist&#250;rbios metab&#243;licos e dist&#250;rbios neuropsiqui&#225;tricos<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">12</span></a> Al&#233;m de sua fun&#231;&#227;o no metabolismo lip&#237;dico&#44; o GLA tamb&#233;m apresenta efeito anti&#8208;inflamat&#243;rio&#44; capacidade de reparar a barreira cut&#226;nea e efeito anticancer&#237;geno&#46; Foi relatado anteriormente que pacientes com dermatite at&#243;pica apresentam n&#237;veis mais baixos de GLA&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">11</span></a> &#201; importante ressaltar que um estudo anterior revelou que a suplementa&#231;&#227;o de GLA pode melhorar os resultados cl&#237;nicos da ros&#225;cea&#44; demonstrando o poss&#237;vel papel do GLA na doen&#231;a&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">10</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">A ros&#225;cea &#233; doen&#231;a de pele altamente prevalente em adultos&#44; especialmente em mulheres mais jovens&#44;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">3</span></a> e apesar dos avan&#231;os no estudo da doen&#231;a nas &#250;ltimas d&#233;cadas&#44; seus mecanismos ainda s&#227;o pouco compreendidos&#46; Que seja de conhecimento dos autores&#44; poucos estudos enfocam a rela&#231;&#227;o entre as altera&#231;&#245;es nos n&#237;veis s&#233;ricos de GLA e a ros&#225;cea&#46; Os presentes resultados demonstraram pela primeira vez que pacientes com ros&#225;cea apresentavam n&#237;veis mais baixos de GLA s&#233;rico&#46; O subtipo mais comum de ros&#225;cea &#233; a ETR&#44; que apresenta de maneira marcante o eritema avaliado pelas escalas PSA e CEA&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">13</span></a> A an&#225;lise de subgrupo revelou que os pacientes com n&#237;veis mais elevados de GLA apresentaram escores mais baixos de PSA e CEA do que aqueles com n&#237;veis mais baixos de GLA&#46; Al&#233;m disso&#44; vale ressaltar que foi observado que os n&#237;veis s&#233;ricos de GLA estavam negativamente associados ao eritema&#44; o sintoma mais comum da ros&#225;cea&#46; Paralelamente aos resultados do presente estudo&#44; um ensaio cl&#237;nico randomizado descobriu que a suplementa&#231;&#227;o de GLA pode melhorar os resultados cl&#237;nicos da ros&#225;cea&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">10</span></a> Al&#233;m disso&#44; o tratamento atual para ros&#225;cea&#44; com brimonidina t&#243;pica&#44; apresenta baixa efic&#225;cia&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">14</span></a> Para avaliar se o n&#237;vel s&#233;rico de GLA poderia influenciar a efic&#225;cia do tratamento com brimonidina t&#243;pica&#44; tamb&#233;m foi investigado o valor preditivo dos n&#237;veis s&#233;ricos de GLA para o progn&#243;stico da ros&#225;cea&#44; utilizando modelo de regress&#227;o linear&#46; Mecanicamente&#44; a an&#225;lise de regress&#227;o identificou que o n&#237;vel de GLA &#233; fator preditivo para o progn&#243;stico da ros&#225;cea&#44; com n&#237;veis mais elevados de GLA acompanhados de melhores resultados cl&#237;nicos&#46; Tomados em conjunto&#44; o presente estudo e outros forneceram evid&#234;ncias de que os n&#237;veis s&#233;ricos de GLA est&#227;o associados ao grau de eritema em pacientes com ros&#225;cea&#46; O mecanismo subjacente &#224; associa&#231;&#227;o pode ser multifacetado&#46; Al&#233;m de regular o metabolismo lip&#237;dico&#44; o GLA pode participar na patog&#234;nese da ros&#225;cea por meio da anti&#8208;inflama&#231;&#227;o e da restaura&#231;&#227;o da barreira cut&#226;nea&#44; o que foi validado por estudos anteriores&#46;<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">10&#44;15</span></a> Na inflama&#231;&#227;o sist&#234;mica&#44; foi sugerido que o GLA suprime a regula&#231;&#227;o positiva da prostaglandina E2&#44; que desempenha papel crucial no avan&#231;o da resposta inflamat&#243;ria&#44;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">16</span></a> destacando o papel potencialmente negativo do GLA na inflama&#231;&#227;o sist&#234;mica&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Sugere&#8208;se tamb&#233;m que a ros&#225;cea esteja associada a dist&#250;rbios psicol&#243;gicos&#44; especialmente ansiedade e depress&#227;o&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">17</span></a> De fato&#44; um estudo anterior dos autores tamb&#233;m demonstrou que a ros&#225;cea &#233; influenciada pelo estado de ansiedade&#47;depress&#227;o&#44; e a interven&#231;&#227;o no estado de ansiedade&#47;depress&#227;o pode fortalecer os benef&#237;cios do tratamento medicamentoso&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">3</span></a> Como mencionamos&#44; o GLA est&#225; associado ao desenvolvimento da ros&#225;cea&#44; embora ainda n&#227;o esteja claro se tem associa&#231;&#227;o com o estado psicol&#243;gico&#46; No presente estudo&#44; foram utilizadas as escalas GAD&#8208;7 e PHQ&#8208;9 para avaliar o estado de ansiedade e depress&#227;o&#44; respectivamente&#46; Surpreendentemente&#44; semelhante &#224; gravidade da doen&#231;a&#44; o grupo de baixo n&#237;vel de GLA apresentou piora do estado de ansiedade&#47;depress&#227;o&#44; o que tamb&#233;m foi correlacionado com os n&#237;veis de GLA&#46; No entanto&#44; mais estudos s&#227;o necess&#225;rios para decifrar o mecanismo subjacente &#224;s correla&#231;&#245;es&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">O desenvolvimento da ros&#225;cea &#233; atribu&#237;do a m&#250;ltiplos fatores&#44; incluindo resposta imune anormal&#44; dist&#250;rbio no metabolismo lip&#237;dico e barreira cut&#226;nea comprometida&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">18&#44;19</span></a> Com base nos fatores multifacetados&#44; diversos estudos&#44; incluindo o presente&#44; encontraram melhoras limitadas em pacientes com ros&#225;cea&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">3</span></a> Portanto&#44; ter como alvo as principais vias de sinaliza&#231;&#227;o compartilhadas pode ser mais eficaz do que ter como alvo os receptores individuais isoladamente&#46; Como o GLA est&#225; envolvido em m&#250;ltiplas vias compartilhadas&#44; pode ser promissor no tratamento da ros&#225;cea&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conclus&#227;o</span><p id="par0075" class="elsevierStylePara elsevierViewall">O presente estudo indica que n&#237;veis mais baixos de GLA s&#233;rico em pacientes com ros&#225;cea est&#227;o negativamente associados &#224; gravidade do eritema e ao estado de ansiedade&#47;depress&#227;o&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Suporte financeiro</span><p id="par0085" class="elsevierStylePara elsevierViewall">Este estudo recebeu suporte financeiro de Chongqing Science e Health Joint Medical Research Project &#40;N&#250;mero de refer&#234;ncia&#58; 2023MSXM015&#41;&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Contribui&#231;&#227;o dos autores</span><p id="par0090" class="elsevierStylePara elsevierViewall">Jin&#8208;Yi Tang&#58; Contribuiu para a revis&#227;o cr&#237;tica da literatura e concep&#231;&#227;o e planejamento do estudo&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; Participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa e an&#225;lise estat&#237;stica&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Mei&#8208;Ling Chen&#58; Contribuiu com a revis&#227;o cr&#237;tica da literatura e participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; Obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Mei Wan&#58; Manejo dos casos estudados&#59; Obten&#231;&#227;o dos dados&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Jin&#8208;Yu Wei&#58; Conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Tian Qian&#58; Revis&#227;o cr&#237;tica do manuscrito e da literatura&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Kun&#8208;Yu Fan&#58; Conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Zhi Yang&#58; Conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Jian Fu&#58; Conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; Participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Jian Li&#58; Contribuiu para a revis&#227;o cr&#237;tica da literatura e concep&#231;&#227;o e planejamento do estudo&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; Participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa e aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conflito de interesses</span><p id="par0135" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Fundamentos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Acredita&#8208;se que o desenvolvimento da ros&#225;cea esteja intimamente associado ao metabolismo lip&#237;dico&#44; inflama&#231;&#227;o e ansiedade&#47;depress&#227;o&#46; O &#225;cido gama linol&#234;nico &#40;GLA&#41; &#233; fator&#8208;chave que participa do metabolismo lip&#237;dico&#44; e tamb&#233;m regula a resposta inflamat&#243;ria&#46; Entretanto&#44; a associa&#231;&#227;o dos n&#237;veis s&#233;ricos de GLA com a gravidade da ros&#225;cea e o estado psicol&#243;gico ainda permanece incerta&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">O presente estudo teve como objetivo investigar a associa&#231;&#227;o do &#225;cido gama linol&#234;nico &#40;GLA&#41;&#44; um fator&#8208;chave que participa do metabolismo lip&#237;dico e da resposta inflamat&#243;ria&#44; com a gravidade da ros&#225;cea e o estado psicol&#243;gico&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Limita&#231;&#245;es do estudo</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">O presente estudo teve algumas limita&#231;&#245;es&#46; Primeiro&#44; o estudo &#233; transversal e n&#227;o fornece evid&#234;ncias longitudinais sobre a rela&#231;&#227;o entre GLA e ros&#225;cea&#46; Em segundo lugar&#44; a coorte do presente estudo tamb&#233;m &#233; relativamente pequena&#44; e uma coorte maior &#233; necess&#225;ria na investiga&#231;&#227;o adicional para revelar o papel potencial do metabolismo lip&#237;dico na patog&#234;nese da ros&#225;cea&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">M&#233;todos</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Um total de 62 pacientes com ros&#225;cea foi recrutado consecutivamente&#46; A escala de autoavalia&#231;&#227;o do paciente &#40;PSA&#44; do ingl&#234;s <span class="elsevierStyleItalic">patient self&#8208;assessment</span>&#41; e a avalia&#231;&#227;o do eritema pelo m&#233;dico &#40;CEA&#44; do ingl&#234;s <span class="elsevierStyleItalic">clinician erythema assessment</span>&#41;&#44; bem como a escala <span class="elsevierStyleItalic">Generalized Anxiety Disorder</span> &#40;GAD&#8208;7&#41; de sete itens e o question&#225;rio <span class="elsevierStyleItalic">Patient Health Questionnaire</span> de nove itens &#40;PHQ&#8208;9&#41; foram utilizados para avaliar o grau de gravidade do eritema e o estado de ansiedade&#47;depress&#227;o&#44; respectivamente&#46; Os n&#237;veis s&#233;ricos de GLA foram determinados por cromatografia gasosa de massa&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Resultados</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Foram observados n&#237;veis s&#233;ricos mais baixos de GLA em pacientes com ros&#225;cea &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; e a an&#225;lise de subgrupo revelou que pacientes com n&#237;veis mais elevados de GLA apresentaram escores mais baixos de PSA&#44; CEA&#44; GAD&#8208;7 e PHQ&#8208;9&#46; Al&#233;m disso&#44; a an&#225;lise de correla&#231;&#227;o de Spearman revelou que os n&#237;veis s&#233;ricos de GLA estavam negativamente associados aos escores de PSA&#44; CEA&#44; GAD&#8208;7 e PHQ&#8208;9&#44; respectivamente&#46; O modelo de regress&#227;o linear revelou que os n&#237;veis s&#233;ricos de GLA no in&#237;cio do estudo foram fator preditivo para o progn&#243;stico dos resultados cl&#237;nicos ap&#243;s um m&#234;s de tratamento convencional&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclus&#227;o</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">O presente estudo indica que n&#237;veis s&#233;ricos mais baixos de GLA em pacientes com ros&#225;cea est&#227;o negativamente associados ao grau de eritema e ao estado de ansiedade&#47;depress&#227;o&#46;</p></span>"
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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">Idade &#40;anos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&#44;64<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#44;38&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">34&#44;19<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#44;92&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">t<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;140&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;889&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">Masculino&#47;feminino&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">9&#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;42&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#967;<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;62&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;804&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">IMC &#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#44;21<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;19&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">22&#44;98<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#44;34&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">t<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;337&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;737&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">N&#237;vel de escolaridade &#40;anos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#44;34<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>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">11&#44;84<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;97&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">t<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;130&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;260&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">Hipertens&#227;o &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;6&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;16&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#967;<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;177&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;278&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">Diabetes &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;7&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;9&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#967;<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;088&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;767&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">N&#237;veis de GLA &#40;mol&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&#44;66<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#44;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#44;81<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#44;58&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">t<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;933&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;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Escore CEA&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">NA&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;58<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Escore PSA&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">NA&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;90<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Escore GAD&#8208;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">NA&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;56<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;98&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Escore PHQ&#8208;9&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">NA&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&#44;10<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        "tipo" => "MULTIMEDIATABLA"
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            "rol" => "short"
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><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">Vari&#225;veis&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  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Coeficientes n&#227;o&#8208;padronizados</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">Coeficientes Padronizados&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">P&#8208;valor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&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">B&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">DP&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">Beta&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&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">Constante&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;131&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;720&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><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;122&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">N&#237;veis de GLA&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">&#8208;0&#44;059&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;014&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">&#8208;0&#44;457&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;000&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">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;016&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;018&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;126&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;375&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">Sexo&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;275&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;300&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;095&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;362&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">Diabetes&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;386&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;514&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;085&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;456&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">Hipertens&#227;o&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">&#8208;1&#44;302&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;472&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">&#8208;0&#44;355&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;008&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">CEA basal&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;423&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;133&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;332&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;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3610258.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Valor preditivo dos n&#237;veis de GLA para escores CEA ap&#243;s um m&#234;s de tratamento</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Tabela 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Tabela "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Nota&#58; DP significa Desvio&#8208;padr&#227;o&#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-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">Vari&#225;veis&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  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Coeficientes n&#227;o&#8208;padronizados</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">Coeficientes Padronizados&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">P&#8208;valor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&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">B&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">DP&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">Beta&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&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">Constante&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;066&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">&#44;920&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><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;122&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">N&#237;veis de GLA&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">&#8208;&#44;051&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">&#44;014&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">&#8208;&#44;448&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">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;059&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;017&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;533&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">Sexo&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">&#8208;0&#44;415&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;030&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">&#8208;0&#44;162&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;171&nbsp;\t\t\t\t\t\t\n
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Associações dos níveis séricos de ácido gama‐linolênico com gravidade do eritema e estado de ansiedade/depressão em pacientes com rosácea
Jin‐Yi Tanga,1, Mei‐Ling Chenb,1, Mei Wanc, Jin‐Yu Weid, Tian Qiane, Kun‐Yu Fane, Zhi Yange, Jian Fuf,
Autor para correspondência
xingzhu007@163.com

Autor para correspondência.
, Jian Lic,
Autor para correspondência
leejian860@126.com

Autor para correspondência.
a Escritório de Administração de Pesquisa Científica, Division of Medical Affairs, Southwest Hospital, Third Military Medical University, Chongqing, China
b Departamento de Medicina Nuclear, Southwest Hospital, Third Military Medical University, Chongqing, China
c Departamento de Dermatologia, Southwest Hospital, Third Military Medical University, Chongqing, China
d Departamento de Dermatologia, The 920th Hospital of Joint Logistics Support Force of PLA, Kunming, China
e Departamento de Dermatologia, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
f Urologia, Southwest Hospital, Third Military Medical University, Chongqing, China
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          "pt" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Correla&#231;&#245;es dos n&#237;veis de GLA com os escores de PSA e CEA em pacientes com ros&#225;cea&#46; &#40;A&#41; Correla&#231;&#227;o dos n&#237;veis s&#233;ricos com os escores de CEA&#46; &#40;B&#41; Correla&#231;&#227;o dos n&#237;veis s&#233;ricos com os escores de PSA &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>62 para cada an&#225;lise&#41;&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Introdu&#231;&#227;o</span><p id="par0005" class="elsevierStylePara elsevierViewall">Ros&#225;cea &#233; dermatose cr&#244;nica prevalente entre adultos&#44; especialmente do sexo feminino&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">1</span></a> A ros&#225;cea &#233; atualmente dividida em quatro subtipos&#44; incluindo ros&#225;cea erit&#234;mato&#8208;telangiect&#225;sica &#40;ETR&#44; do ingl&#234;s <span class="elsevierStyleItalic">erythematotelangiectatic rosacea</span>&#41;&#44; ros&#225;cea papulopustular &#40;PPR&#44; do ingl&#234;s <span class="elsevierStyleItalic">papulopustular rosacea</span>&#41;&#44; ros&#225;cea fimatosa &#40;PHY&#44; do ingl&#234;s <span class="elsevierStyleItalic">phymatous rosacea</span>&#41; e ros&#225;cea ocular &#40;OR&#44; do ingl&#234;s <span class="elsevierStyleItalic">ocular rosacea</span>&#41;&#46; O subtipo mais prevalente &#233; o ETR&#44;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">2</span></a> no qual os sintomas mais comuns s&#227;o eritema persistente e rubor&#44; trazendo impacto negativo consider&#225;vel aos pacientes com ros&#225;cea&#46; Nos &#250;ltimos anos&#44; a ros&#225;cea come&#231;ou a ocorrer nos indiv&#237;duos mais jovens&#44; o que pode resultar em consequ&#234;ncias mais prejudiciais&#44; como baixo entusiasmo no trabalho e ansiedade&#47;depress&#227;o&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">3</span></a> Entretanto&#44; com exce&#231;&#227;o da brimonidina t&#243;pica&#44; n&#227;o existem outros tratamentos aprovados em virtude do conhecimento deficiente do mecanismo da ros&#225;cea&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Embora o mecanismo n&#227;o seja totalmente compreendido&#44; os avan&#231;os atuais sugerem que a ros&#225;cea &#233; uma doen&#231;a complicada&#44; influenciada por fatores de risco multifacetados&#44; incluindo resposta imunol&#243;gica&#44; ansiedade&#47;depress&#227;o&#44; barreira cut&#226;nea comprometida e metabolismo lip&#237;dico local ou sist&#234;mico anormal&#46;<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">4&#8211;7</span></a> Especificamente&#44; a barreira de permeabilidade epid&#233;rmica comprometida induz a produ&#231;&#227;o e libera&#231;&#227;o de fatores inflamat&#243;rios e a infiltra&#231;&#227;o de c&#233;lulas imunol&#243;gicas&#44; consequentemente causando ressecamento da pele&#44; ard&#234;ncia e queima&#231;&#227;o em pacientes com ros&#225;cea&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">8</span></a> Al&#233;m disso&#44; um estudo anterior revelou que a composi&#231;&#227;o dos lip&#237;dios seb&#225;ceos est&#225; alterada em pacientes com ros&#225;cea em compara&#231;&#227;o com controles normais&#44;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">7</span></a> sugerindo o papel potencial do metabolismo lip&#237;dico na patog&#234;nese da ros&#225;cea&#46; Tamb&#233;m prop&#245;e&#8208;se que a ros&#225;cea seja doen&#231;a inflamat&#243;ria cr&#244;nica da pele&#44; e a ativa&#231;&#227;o da inflama&#231;&#227;o pode explicar muitos de seus sinais e sintomas&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">6</span></a> Um estudo anterior dos autores revelou que o estado de ansiedade&#47;depress&#227;o desempenha papel importante no desenvolvimento da ros&#225;cea&#44; e a regula&#231;&#227;o do estado de ansiedade&#47;depress&#227;o pode facilitar a efic&#225;cia terap&#234;utica dos medicamentos atuais&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">3</span></a> Assim&#44; visar essas m&#250;ltiplas vias pode ser um caminho para o al&#237;vio da ros&#225;cea&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">O &#225;cido gama linol&#234;nico &#40;GLA&#44; do ingl&#234;s <span class="elsevierStyleItalic">gamma linolenic acid</span>&#41; &#233; um &#225;cido graxo poli&#8208;insaturado n&#8208;6 end&#243;geno &#40;PUFA n&#8208;6&#41; que desempenha papel crucial na redu&#231;&#227;o dos n&#237;veis lip&#237;dicos&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">9</span></a> Um ensaio cl&#237;nico randomizado recente indicou que o GLA como suplemento pode melhorar os resultados cl&#237;nicos e reduzir os n&#237;veis lip&#237;dicos em pacientes com ros&#225;cea&#44;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">10</span></a> destacando que o GLA pode estar envolvido na patog&#234;nese da doen&#231;a&#46; Que seja de conhecimento dos autores&#44; poucos estudos foram realizados para elucidar a rela&#231;&#227;o entre o desenvolvimento da ros&#225;cea e os n&#237;veis de GLA end&#243;geno&#46; Portanto&#44; o objetivo do presente estudo foi investigar a altera&#231;&#227;o nos n&#237;veis s&#233;ricos de GLA e explorar a associa&#231;&#227;o desses n&#237;veis s&#233;ricos com o grau de eritema e o estado de ansiedade em pacientes com ETR&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Pacientes e m&#233;todos</span><p id="par0020" class="elsevierStylePara elsevierViewall">Todos os 62 pacientes com ros&#225;cea &#40;subtipo ETR&#41; e 14 controles normais &#40;CN&#41; pareados por idade foram recrutados consecutivamente no Southwestern Hospital&#46; Amostras de sangue foram coletadas e os n&#237;veis de GLA no sangue foram analisados&#46; Al&#233;m disso&#44; tamb&#233;m foram avaliados o grau de eritema e o estado de ansiedade e suas correla&#231;&#245;es com os n&#237;veis de GLA no sangue&#44; respectivamente&#46; As informa&#231;&#245;es detalhadas s&#227;o apresentadas nos dados suplementares&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Caracter&#237;sticas demogr&#225;ficas</span><p id="par0025" class="elsevierStylePara elsevierViewall">A <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a> mostra as caracter&#237;sticas demogr&#225;ficas dos pacientes com ros&#225;cea e CN&#46; Como mostrado&#44; n&#227;o houve diferen&#231;as significantes em rela&#231;&#227;o a idade&#44; sexo&#44; IMC&#44; preval&#234;ncia de hipertens&#227;o e diabetes&#44; bem como hipercolesterolemia entre pacientes com ros&#225;cea e CN &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#44; p<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; Al&#233;m disso&#44; os n&#237;veis s&#233;ricos de GLA em pacientes com ros&#225;cea no in&#237;cio do estudo foram inferiores aos dos CN &#40;24&#44;66<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#44;20 <span class="elsevierStyleItalic">vs</span>&#46; 15&#44;81<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#44;58 moL&#47;L&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Compara&#231;&#245;es dos escores de CEA e PSA entre o grupo com n&#237;vel baixo de GLA e o grupo com n&#237;vel alto de GLA em pacientes com ros&#225;cea</span><p id="par0030" class="elsevierStylePara elsevierViewall">Foi utilizado o valor da mediana das amostras dos CN como valor de corte para diferenciar o grupo com n&#237;vel alto de GLA e o grupo com n&#237;vel baixo de GLA &#40;26&#44;32<span class="elsevierStyleHsp" style=""></span>mol&#47;L&#41;&#46; Posteriormente&#44; os pacientes com ros&#225;cea foram divididos em grupo com n&#237;vel baixo de GLA e grupo com n&#237;vel alto de GLA&#44; de acordo com o valor de corte&#46; Em seguida&#44; foram comparados os escores de CEA e PSA entre o grupo de baixo n&#237;vel de GLA e o grupo de alto n&#237;vel de GLA em pacientes com ros&#225;cea&#46; Foi interessante descobrir que pacientes com ros&#225;cea e n&#237;vel mais baixo de GLA apresentavam escores de CEA e PSA mais elevados do que os pacientes com n&#237;vel de GLA mais elevado &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01 para todos&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Correla&#231;&#245;es dos n&#237;veis de GLA com os escores de PSA e CEA em pacientes com ros&#225;cea</span><p id="par0035" class="elsevierStylePara elsevierViewall">A ETR &#233; um subtipo prevalente de ros&#225;cea&#44; cujo sintoma mais comum &#233; o eritema&#46; Os escores de PSA e CEA s&#227;o geralmente aplicados para refletir a gravidade do eritema&#46; Para revelar com maior profundidade a associa&#231;&#227;o dos n&#237;veis de GLA com a gravidade da ros&#225;cea&#44; foi conduzida a an&#225;lise de correla&#231;&#227;o de Spearman&#46; Os n&#237;veis s&#233;ricos de GLA est&#227;o surpreendentemente associados aos escores de PSA&#44; bem como aos escores de CEA &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Valor preditivo dos n&#237;veis de GLA para escores de CEA e PSA ap&#243;s um m&#234;s de tratamento</span><p id="par0040" class="elsevierStylePara elsevierViewall">Para explorar os efeitos preditivos do n&#237;vel de GLA na linha de base para os escores de CEA e PSA ap&#243;s um m&#234;s de tratamento convencional&#44; foi conduzida a an&#225;lise de regress&#227;o linear com os escores de CEA ou PSA como vari&#225;vel independente&#44; respectivamente&#46; Os fatores contribuintes incluem idade&#44; sexo&#44; hiperlipidemia&#44; hipertens&#227;o&#44; DM&#44; escores de CEA e de PSA na linha de base&#46; &#201; evidente que os n&#237;veis de GLA na linha de base foram fator preditivo significante para os escores de CEA e PSA ap&#243;s um m&#234;s de seguimento&#44; respectivamente &#40;<a class="elsevierStyleCrossRefs" href="#tbl0010">tabelas 2 e 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Correla&#231;&#245;es dos n&#237;veis de GLA com os escores de GAD&#8208;7 e PHQ&#8208;9 em pacientes com ros&#225;cea</span><p id="par0045" class="elsevierStylePara elsevierViewall">Como ansiedade&#47;depress&#227;o t&#234;m impacto direto no desenvolvimento da ros&#225;cea&#44; foi investigada&#44; ainda&#44; a rela&#231;&#227;o entre os n&#237;veis s&#233;ricos de GLA e o escores no GAD&#8208;7&#44; bem como os escores do PHQ&#8208;9&#46; Inicialmente&#44; foram comparados os escores de GAD&#8208;7 e PHQ&#8208;9 entre o grupo com baixo n&#237;vel de GLA e o grupo com n&#237;vel elevado de GLA em pacientes com ros&#225;cea&#46; O grupo com baixo n&#237;vel de GLA apresentou escores de GAD&#8208;7 e PHQ&#8208;9 mais elevados do que o grupo com n&#237;vel elevado de GLA &#40;<a class="elsevierStyleCrossRef" href="#fig0015">fig&#46; 3A&#8208;B</a>&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; Al&#233;m disso&#44; a an&#225;lise de correla&#231;&#227;o de Spearman foi realizada para descobrir a associa&#231;&#227;o dos n&#237;veis de GLA com os escores de GAD&#8208;7 e PHQ&#8208;9&#46; Curiosamente&#44; os escores de GAD&#8208;7 e PHQ&#8208;9 foram negativamente correlacionados com os n&#237;veis de GLA em pacientes com ros&#225;cea &#40;<a class="elsevierStyleCrossRef" href="#fig0015">fig&#46; 3C&#8208;D</a>&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discuss&#227;o</span><p id="par0050" class="elsevierStylePara elsevierViewall">O objetivo do presente estudo foi investigar a associa&#231;&#227;o dos n&#237;veis s&#233;ricos de GLA com eritema e estado de ansiedade&#47;depress&#227;o&#46; Foi observado que os pacientes com ros&#225;cea apresentavam n&#237;vel mais alto de GLA do que os CN&#44; e os escores de CEA e PSA&#44; bem como os escores de GAD&#8208;7 e PHQ&#8208;9 nos pacientes com baixo n&#237;vel de GLA foram notavelmente mais altos do que aqueles no grupo com n&#237;vel elevado de GLA&#46; No geral&#44; os n&#237;veis s&#233;ricos de GLA foram surpreendentemente correlacionados com a gravidade do eritema e estado de ansiedade&#47;depress&#227;o&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">O GLA &#233; um PUFA bioativo biossintetizado por meio da dessatura&#231;&#227;o do &#225;cido linoleico no f&#237;gado pela enzima &#916;6&#8208;dessaturase&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">11</span></a> Estudos anteriores revelaram que n&#237;veis alterados de GLA aumentariam o risco de diversas doen&#231;as humanas&#44; como diabetes&#44; dist&#250;rbios metab&#243;licos e dist&#250;rbios neuropsiqui&#225;tricos<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">12</span></a> Al&#233;m de sua fun&#231;&#227;o no metabolismo lip&#237;dico&#44; o GLA tamb&#233;m apresenta efeito anti&#8208;inflamat&#243;rio&#44; capacidade de reparar a barreira cut&#226;nea e efeito anticancer&#237;geno&#46; Foi relatado anteriormente que pacientes com dermatite at&#243;pica apresentam n&#237;veis mais baixos de GLA&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">11</span></a> &#201; importante ressaltar que um estudo anterior revelou que a suplementa&#231;&#227;o de GLA pode melhorar os resultados cl&#237;nicos da ros&#225;cea&#44; demonstrando o poss&#237;vel papel do GLA na doen&#231;a&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">10</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">A ros&#225;cea &#233; doen&#231;a de pele altamente prevalente em adultos&#44; especialmente em mulheres mais jovens&#44;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">3</span></a> e apesar dos avan&#231;os no estudo da doen&#231;a nas &#250;ltimas d&#233;cadas&#44; seus mecanismos ainda s&#227;o pouco compreendidos&#46; Que seja de conhecimento dos autores&#44; poucos estudos enfocam a rela&#231;&#227;o entre as altera&#231;&#245;es nos n&#237;veis s&#233;ricos de GLA e a ros&#225;cea&#46; Os presentes resultados demonstraram pela primeira vez que pacientes com ros&#225;cea apresentavam n&#237;veis mais baixos de GLA s&#233;rico&#46; O subtipo mais comum de ros&#225;cea &#233; a ETR&#44; que apresenta de maneira marcante o eritema avaliado pelas escalas PSA e CEA&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">13</span></a> A an&#225;lise de subgrupo revelou que os pacientes com n&#237;veis mais elevados de GLA apresentaram escores mais baixos de PSA e CEA do que aqueles com n&#237;veis mais baixos de GLA&#46; Al&#233;m disso&#44; vale ressaltar que foi observado que os n&#237;veis s&#233;ricos de GLA estavam negativamente associados ao eritema&#44; o sintoma mais comum da ros&#225;cea&#46; Paralelamente aos resultados do presente estudo&#44; um ensaio cl&#237;nico randomizado descobriu que a suplementa&#231;&#227;o de GLA pode melhorar os resultados cl&#237;nicos da ros&#225;cea&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">10</span></a> Al&#233;m disso&#44; o tratamento atual para ros&#225;cea&#44; com brimonidina t&#243;pica&#44; apresenta baixa efic&#225;cia&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">14</span></a> Para avaliar se o n&#237;vel s&#233;rico de GLA poderia influenciar a efic&#225;cia do tratamento com brimonidina t&#243;pica&#44; tamb&#233;m foi investigado o valor preditivo dos n&#237;veis s&#233;ricos de GLA para o progn&#243;stico da ros&#225;cea&#44; utilizando modelo de regress&#227;o linear&#46; Mecanicamente&#44; a an&#225;lise de regress&#227;o identificou que o n&#237;vel de GLA &#233; fator preditivo para o progn&#243;stico da ros&#225;cea&#44; com n&#237;veis mais elevados de GLA acompanhados de melhores resultados cl&#237;nicos&#46; Tomados em conjunto&#44; o presente estudo e outros forneceram evid&#234;ncias de que os n&#237;veis s&#233;ricos de GLA est&#227;o associados ao grau de eritema em pacientes com ros&#225;cea&#46; O mecanismo subjacente &#224; associa&#231;&#227;o pode ser multifacetado&#46; Al&#233;m de regular o metabolismo lip&#237;dico&#44; o GLA pode participar na patog&#234;nese da ros&#225;cea por meio da anti&#8208;inflama&#231;&#227;o e da restaura&#231;&#227;o da barreira cut&#226;nea&#44; o que foi validado por estudos anteriores&#46;<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">10&#44;15</span></a> Na inflama&#231;&#227;o sist&#234;mica&#44; foi sugerido que o GLA suprime a regula&#231;&#227;o positiva da prostaglandina E2&#44; que desempenha papel crucial no avan&#231;o da resposta inflamat&#243;ria&#44;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">16</span></a> destacando o papel potencialmente negativo do GLA na inflama&#231;&#227;o sist&#234;mica&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Sugere&#8208;se tamb&#233;m que a ros&#225;cea esteja associada a dist&#250;rbios psicol&#243;gicos&#44; especialmente ansiedade e depress&#227;o&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">17</span></a> De fato&#44; um estudo anterior dos autores tamb&#233;m demonstrou que a ros&#225;cea &#233; influenciada pelo estado de ansiedade&#47;depress&#227;o&#44; e a interven&#231;&#227;o no estado de ansiedade&#47;depress&#227;o pode fortalecer os benef&#237;cios do tratamento medicamentoso&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">3</span></a> Como mencionamos&#44; o GLA est&#225; associado ao desenvolvimento da ros&#225;cea&#44; embora ainda n&#227;o esteja claro se tem associa&#231;&#227;o com o estado psicol&#243;gico&#46; No presente estudo&#44; foram utilizadas as escalas GAD&#8208;7 e PHQ&#8208;9 para avaliar o estado de ansiedade e depress&#227;o&#44; respectivamente&#46; Surpreendentemente&#44; semelhante &#224; gravidade da doen&#231;a&#44; o grupo de baixo n&#237;vel de GLA apresentou piora do estado de ansiedade&#47;depress&#227;o&#44; o que tamb&#233;m foi correlacionado com os n&#237;veis de GLA&#46; No entanto&#44; mais estudos s&#227;o necess&#225;rios para decifrar o mecanismo subjacente &#224;s correla&#231;&#245;es&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">O desenvolvimento da ros&#225;cea &#233; atribu&#237;do a m&#250;ltiplos fatores&#44; incluindo resposta imune anormal&#44; dist&#250;rbio no metabolismo lip&#237;dico e barreira cut&#226;nea comprometida&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">18&#44;19</span></a> Com base nos fatores multifacetados&#44; diversos estudos&#44; incluindo o presente&#44; encontraram melhoras limitadas em pacientes com ros&#225;cea&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">3</span></a> Portanto&#44; ter como alvo as principais vias de sinaliza&#231;&#227;o compartilhadas pode ser mais eficaz do que ter como alvo os receptores individuais isoladamente&#46; Como o GLA est&#225; envolvido em m&#250;ltiplas vias compartilhadas&#44; pode ser promissor no tratamento da ros&#225;cea&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conclus&#227;o</span><p id="par0075" class="elsevierStylePara elsevierViewall">O presente estudo indica que n&#237;veis mais baixos de GLA s&#233;rico em pacientes com ros&#225;cea est&#227;o negativamente associados &#224; gravidade do eritema e ao estado de ansiedade&#47;depress&#227;o&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Suporte financeiro</span><p id="par0085" class="elsevierStylePara elsevierViewall">Este estudo recebeu suporte financeiro de Chongqing Science e Health Joint Medical Research Project &#40;N&#250;mero de refer&#234;ncia&#58; 2023MSXM015&#41;&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Contribui&#231;&#227;o dos autores</span><p id="par0090" class="elsevierStylePara elsevierViewall">Jin&#8208;Yi Tang&#58; Contribuiu para a revis&#227;o cr&#237;tica da literatura e concep&#231;&#227;o e planejamento do estudo&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; Participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa e an&#225;lise estat&#237;stica&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Mei&#8208;Ling Chen&#58; Contribuiu com a revis&#227;o cr&#237;tica da literatura e participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; Obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Mei Wan&#58; Manejo dos casos estudados&#59; Obten&#231;&#227;o dos dados&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Jin&#8208;Yu Wei&#58; Conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Tian Qian&#58; Revis&#227;o cr&#237;tica do manuscrito e da literatura&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Kun&#8208;Yu Fan&#58; Conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Zhi Yang&#58; Conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Jian Fu&#58; Conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; Participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Jian Li&#58; Contribuiu para a revis&#227;o cr&#237;tica da literatura e concep&#231;&#227;o e planejamento do estudo&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; Participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa e aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conflito de interesses</span><p id="par0135" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Fundamentos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Acredita&#8208;se que o desenvolvimento da ros&#225;cea esteja intimamente associado ao metabolismo lip&#237;dico&#44; inflama&#231;&#227;o e ansiedade&#47;depress&#227;o&#46; O &#225;cido gama linol&#234;nico &#40;GLA&#41; &#233; fator&#8208;chave que participa do metabolismo lip&#237;dico&#44; e tamb&#233;m regula a resposta inflamat&#243;ria&#46; Entretanto&#44; a associa&#231;&#227;o dos n&#237;veis s&#233;ricos de GLA com a gravidade da ros&#225;cea e o estado psicol&#243;gico ainda permanece incerta&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">O presente estudo teve como objetivo investigar a associa&#231;&#227;o do &#225;cido gama linol&#234;nico &#40;GLA&#41;&#44; um fator&#8208;chave que participa do metabolismo lip&#237;dico e da resposta inflamat&#243;ria&#44; com a gravidade da ros&#225;cea e o estado psicol&#243;gico&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Limita&#231;&#245;es do estudo</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">O presente estudo teve algumas limita&#231;&#245;es&#46; Primeiro&#44; o estudo &#233; transversal e n&#227;o fornece evid&#234;ncias longitudinais sobre a rela&#231;&#227;o entre GLA e ros&#225;cea&#46; Em segundo lugar&#44; a coorte do presente estudo tamb&#233;m &#233; relativamente pequena&#44; e uma coorte maior &#233; necess&#225;ria na investiga&#231;&#227;o adicional para revelar o papel potencial do metabolismo lip&#237;dico na patog&#234;nese da ros&#225;cea&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">M&#233;todos</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Um total de 62 pacientes com ros&#225;cea foi recrutado consecutivamente&#46; A escala de autoavalia&#231;&#227;o do paciente &#40;PSA&#44; do ingl&#234;s <span class="elsevierStyleItalic">patient self&#8208;assessment</span>&#41; e a avalia&#231;&#227;o do eritema pelo m&#233;dico &#40;CEA&#44; do ingl&#234;s <span class="elsevierStyleItalic">clinician erythema assessment</span>&#41;&#44; bem como a escala <span class="elsevierStyleItalic">Generalized Anxiety Disorder</span> &#40;GAD&#8208;7&#41; de sete itens e o question&#225;rio <span class="elsevierStyleItalic">Patient Health Questionnaire</span> de nove itens &#40;PHQ&#8208;9&#41; foram utilizados para avaliar o grau de gravidade do eritema e o estado de ansiedade&#47;depress&#227;o&#44; respectivamente&#46; Os n&#237;veis s&#233;ricos de GLA foram determinados por cromatografia gasosa de massa&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Resultados</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Foram observados n&#237;veis s&#233;ricos mais baixos de GLA em pacientes com ros&#225;cea &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; e a an&#225;lise de subgrupo revelou que pacientes com n&#237;veis mais elevados de GLA apresentaram escores mais baixos de PSA&#44; CEA&#44; GAD&#8208;7 e PHQ&#8208;9&#46; Al&#233;m disso&#44; a an&#225;lise de correla&#231;&#227;o de Spearman revelou que os n&#237;veis s&#233;ricos de GLA estavam negativamente associados aos escores de PSA&#44; CEA&#44; GAD&#8208;7 e PHQ&#8208;9&#44; respectivamente&#46; O modelo de regress&#227;o linear revelou que os n&#237;veis s&#233;ricos de GLA no in&#237;cio do estudo foram fator preditivo para o progn&#243;stico dos resultados cl&#237;nicos ap&#243;s um m&#234;s de tratamento convencional&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclus&#227;o</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">O presente estudo indica que n&#237;veis s&#233;ricos mais baixos de GLA em pacientes com ros&#225;cea est&#227;o negativamente associados ao grau de eritema e ao estado de ansiedade&#47;depress&#227;o&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Como citar este artigo&#58; Tang J&#8208;Y&#44; Chen M&#8208;L&#44; Wan M&#44; Wei J&#8208;Y&#44; Qian T&#44; Fan K&#8208;Y&#44; et al&#46; Associations of serum gamma&#8208;linolenic acid levels with erythema severity and anxiety&#47;depression status in patients with rosacea&#46; An Bras Dermatol&#46; 2024&#59;99&#58;189&#8211;95&#46;</p>"
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                  \t\t\t\t">34&#44;19<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#44;92&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">20 &#40;42&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">IMC &#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " 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">0&#44;260&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">&#967;<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;177&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;278&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1 &#40;7&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">6 &#40;9&#44;7&#41;&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">&#967;<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;088&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#44;767&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</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;004&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">Escore CEA&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">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Escore PSA&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">NA&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;90<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Escore GAD&#8208;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">NA&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;56<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;98&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Escore PHQ&#8208;9&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">NA&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&#44;10<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "pt" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas demogr&#225;ficas</p>"
        ]
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                  <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-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">Vari&#225;veis&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  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Coeficientes n&#227;o&#8208;padronizados</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">Coeficientes Padronizados&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">P&#8208;valor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&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">B&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">DP&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">Beta&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&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">Constante&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;131&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;720&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><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;122&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">N&#237;veis de GLA&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">&#8208;0&#44;059&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;014&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">&#8208;0&#44;457&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;000&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">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;016&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;018&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;126&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;375&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">Sexo&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;275&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;300&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;095&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;362&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">Diabetes&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;386&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;514&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;085&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;456&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">Hipertens&#227;o&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">&#8208;1&#44;302&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;472&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">&#8208;0&#44;355&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;008&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">CEA basal&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;423&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;133&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;332&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;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                  <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-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">Vari&#225;veis&nbsp;\t\t\t\t\t\t\n
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                  \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" style="border-bottom: 2px solid black">Coeficientes n&#227;o&#8208;padronizados</th><th class="td" title="\n
                  \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">Coeficientes Padronizados&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col">P&#8208;valor&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">B&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">DP&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Beta&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Constante&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;066&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">&#44;920&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;122&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">N&#237;veis de GLA&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">&#8208;&#44;051&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#44;014&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#8208;&#44;448&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Idade&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">Sexo&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;030&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">Diabetes&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
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8208;0&#44;604&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">PSA basal&nbsp;\t\t\t\t\t\t\n
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          "pt" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Valor preditivo dos n&#237;veis de GLA para escores PSA ap&#243;s um m&#234;s de tratamento</p>"
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Informação do artigo
ISSN: 26662752
Idioma original: Português
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