Factors that influence bone mass of healthy children and adolescents measured by quantitative ultrasound at the hand phalanges: a systematic review<a class="elsevierStyleCrossRef" href="#fn1">*</a> | Revista Paulista de Pediatria (English Edition)

array:24 ["pii" => "S235934821530021X" "issn" => "23593482" "doi" => "10.1016/S2359-3482(15)30021-X" "estado" => "S300" "fechaPublicacion" => "2014-09-01" "aid" => "30021" "copyright" => "Sociedade de Pediatria de São Paulo. Published by Elsevier Editora Ltda. All rights reserved.. All rights reserved" "copyrightAnyo" => "2014" "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "rev" "cita" => "Rev Paul Ped. 2014;32:266-72" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 199 "formatos" => array:3 [ "EPUB" => 11 "HTML" => 110 "PDF" => 78 ] ] "itemSiguiente" => array:19 [ "pii" => "S2359348215300221" "issn" => "23593482" "doi" => "10.1016/S2359-3482(15)30022-1" "estado" => "S300" "fechaPublicacion" => "2014-09-01" "aid" => "30022" "copyright" => "Sociedade de Pediatria de São Paulo. Published by Elsevier Editora Ltda. All rights reserved." "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "rev" "cita" => "Rev Paul Ped. 2014;32:273-81" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 192 "formatos" => array:3 [ "EPUB" => 10 "HTML" => 112 "PDF" => 70 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Review Article" "titulo" => "Waist circumference, waist/height ratio, and neck circumference as parameters of central obesity assessment in children<a class="elsevierStyleCrossRef" href="#fn1">*</a>" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "273" "paginaFinal" => "281" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Perímetro da cintura, relação cintura/estatura e perímetro do pescoço como parâmetros na avaliação da obesidade central em crianças" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig1" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 832 "Ancho" => 1000 "Tamanyo" => 88941 ] ] "descripcion" => array:1 [ "en" => "Flow chart of article search and obtained results." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Elma Izze da Silva Magalhães, Luciana Ferreira da Rocha Sant'Ana, Silvia Eloiza Priore, Sylvia do Carmo Castro Franceschini" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Elma Izze" "apellidos" => "da Silva Magalhães" ] 1 => array:2 [ "nombre" => "Luciana Ferreira da Rocha" "apellidos" => "Sant'Ana" ] 2 => array:2 [ "nombre" => "Silvia Eloiza" "apellidos" => "Priore" ] 3 => array:2 [ "nombre" => "Sylvia do Carmo Castro" "apellidos" => "Franceschini" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2359348215300221?idApp=UINPBA00004N" "url" => "/23593482/0000003200000003/v1_201507170117/S2359348215300221/v1_201507170117/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2359348215300208" "issn" => "23593482" "doi" => "10.1016/S2359-3482(15)30020-8" "estado" => "S300" "fechaPublicacion" => "2014-09-01" "aid" => "30020" "copyright" => "Sociedade de Pediatria de São Paulo. Published by Elsevier Editora Ltda. All rights reserved." "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "rev" "cita" => "Rev Paul Ped. 2014;32:257-65" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 258 "formatos" => array:3 [ "EPUB" => 13 "HTML" => 122 "PDF" => 123 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Review Article" "titulo" => "Mother-child bonding assessment tools<a class="elsevierStyleCrossRef" href="#fn1">*</a>" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "257" "paginaFinal" => "265" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Instrumentos de avaliação do vínculo entre mãe e bebê" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig1" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1918 "Ancho" => 2068 "Tamanyo" => 435380 ] ] "descripcion" => array:1 [ "en" => "Flowchart for article selection" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Jaqueline Galdino Albuquerque Perrelli, Carla Fonseca Zambaldi, Amaury Cantilino, Everton Botelho Sougey" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Jaqueline Galdino Albuquerque" "apellidos" => "Perrelli" ] 1 => array:2 [ "nombre" => "Carla Fonseca" "apellidos" => "Zambaldi" ] 2 => array:2 [ "nombre" => "Amaury" "apellidos" => "Cantilino" ] 3 => array:2 [ "nombre" => "Everton Botelho" "apellidos" => "Sougey" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2359348215300208?idApp=UINPBA00004N" "url" => "/23593482/0000003200000003/v1_201507170117/S2359348215300208/v1_201507170117/en/main.assets" ] "en" => array:21 [ "idiomaDefecto" => true "cabecera" => "Review Article" "titulo" => "Factors that influence bone mass of healthy children and adolescents measured by quantitative ultrasound at the hand phalanges: a systematic review<a class="elsevierStyleCrossRef" href="#fn1">*</a>" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "266" "paginaFinal" => "272" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Tathyane Krahenbühl, Ezequiel Moreira Gonçalves, Eduardo Tavares Costa, Antonio de Azevedo Barros Filho" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Tathyane" "apellidos" => "Krahenbühl" "email" => array:1 [ 0 => "tathy04n@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor1" ] ] ] 1 => array:2 [ "nombre" => "Ezequiel Moreira" "apellidos" => "Gonçalves" ] 2 => array:2 [ "nombre" => "Eduardo Tavares" "apellidos" => "Costa" ] 3 => array:2 [ "nombre" => "Antonio de Azevedo Barros" "apellidos" => "Filho" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil" "identificador" => "aff1" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Corresponding author" ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Fatores que influenciam a massa óssea de crianças e adolescentes saudáveis mensurada pelo ultrassom quantitativo de falanges: revisão sistemática" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig1" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1328 "Ancho" => 999 "Tamanyo" => 139161 ] ] "descripcion" => array:1 [ "en" => "Prisma Fluxograma" ] ] ] "textoCompleto" => "IntroductionChildhood and adolescence are important phases for the development of peak bone mass, as it is the time when there is a gradual increase in bone tissue, with the predominance of formation in relation to absorption.<a class="elsevierStyleCrossRef" href="#bib1">1</a> Several aspects may influence the process of increasing bone mass, such as genetic, hormonal, and nutritional factors, as well as physical activity.<a class="elsevierStyleCrossRefs" href="#bib1">1,2</a>There are several methods to measure bone mass in pediatric age ranges, which are different regarding the techniques and assessed anatomical sites, and all present advantages and disadvantages. The method considered to be the gold standard is dual-energy x-ray absorptiometry (DXA),<a class="elsevierStyleCrossRef" href="#bib3">3</a> but this method is influenced by changes in bone size during growth and may underestimate bone mineral density (BMD) in small individuals and overestimate it in larger individuals, in addition to not providing information regarding bone quality.<a class="elsevierStyleCrossRef" href="#bib2">2</a> In recent years, quantitative ultrasound (QUS) of the phalanges has been widely used as it is an easily accessible, low-cost, non-invasive, non-ionizing, and portable technology,<a class="elsevierStyleCrossRefs" href="#bib4">4–6</a> which uses the speed of sound as a principle to assess bone mass in the proximal phalanges of the hand, a site sensitive to bone alterations that occur during growth<a class="elsevierStyleCrossRefs" href="#bib7">7–9</a> and is less influenced by bone size.<a class="elsevierStyleCrossRefs" href="#bib9">9,10</a>Understanding the factors that determine the process of acquisition during bone tissue maturation and which techniques can be used to properly assess bone mass allows for the creation of strategies for intervention and prevention of disorders and alterations in that tissue, preventing early onset of osteogenic diseases. However, it is yet to be determined which factors are more important or show more interference during these periods. Thus, this study aimed to analyze the main factors that influence bone mass in children and adolescents assessed by QUS of the phalanges.MethodsThis is a systematic review of the literature on the QUS of the phalanges method in healthy children and adolescents. The Prism Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISM) <a class="elsevierStyleCrossRef" href="#bib11">11</a> method was used as a reference.Initially, it was done an article research in PubMed, Bireme, and SciELO databases, between 2001 and 2012. The search was performed by two authors (TK and EMG) at different times, guided by a librarian, in English and Portuguese. The keywords used for the search were: children, adolescent, ultrasonography finger phalanges, quantitative ultrasound of phalanges, phalangeal quantitative ultrasound, using “and” or “or”.Based on the analysis of titles and abstracts, 69 articles were identified in the databases, of which 48 were excluded and 21 were included in this study. The inclusion criteria for selecting the articles were: studies with QUS of the phalanges with healthy children and/or adolescents in Portuguese or English, from 2001 to the date of the survey.The criteria for excluding articles were: studies with individuals with disorders or diseases (n=33); in languages other than English or Portuguese (n=04); assessing individuals outside the specified age range, such as newborns and adults (n=3), or with physical disabilities (n=1); review articles (n=1); response letters (n=1); and others who did not meet the inclusion criteria (n=5), as shown in <a class="elsevierStyleCrossRef" href="#fig1">Fig. 1</a>.<elsevierMultimedia ident="fig1"></elsevierMultimedia>Results and DiscussionThe summaries of the articles are presented in <a class="elsevierStyleCrossRef" href="#tbl1">Table 1</a>. All selected articles were published between 2001 and 2012. These articles showed an association between ultrasound parameters and variables such as gender (10), physical activity (one), ethnicity (two), genetics (two), anthropometric data (21), caloric intake (two), socioeconomic profile (two), and pubertal stage (10).<elsevierMultimedia ident="tbl1"></elsevierMultimedia>GenderMost of the studies reported measures of amplitude-dependent speed of sound (AD-SoS) that were higher for females when compared to males.<a class="elsevierStyleCrossRefs" href="#bib4">4,5,8,10,12–15</a> These differences are mainly found between 11 and 16 years.<a class="elsevierStyleCrossRefs" href="#bib4">4,5,7,8,10,16</a> Studies comparing pubertal development using the pubertal stage also observed higher values of AD-SoS for females at stages II, III, IV,<a class="elsevierStyleCrossRefs" href="#bib5">5,10,12</a> and V<a class="elsevierStyleCrossRef" href="#bib16">16</a> when compared to males. Moreover, females aged 11-13 years had higher values of bone transmission time (BTT)<a class="elsevierStyleCrossRefs" href="#bib5">5,14</a> when compared with males of the same age. However, males showed higher BTT values at ages 6-8, 15-21,<a class="elsevierStyleCrossRef" href="#bib14">14</a> and at 18 years;<a class="elsevierStyleCrossRef" href="#bib10">10</a> regarding pubertal development, males showed higher values at stages I, II, and V.<a class="elsevierStyleCrossRef" href="#bib14">14</a>In contrast, studies with DXA presented higher BMD values primarily in males, who had higher values at the femoral neck, full body, hip, and arm,<a class="elsevierStyleCrossRefs" href="#bib17">17–20</a> whereas females presented higher BMD values for the lumbar spine.<a class="elsevierStyleCrossRefs" href="#bib18">18,20</a> After the end of the growth phase, with increasing age, the curve obtained by DXA is significantly higher for males, with higher BMD values after the age of 19 years.<a class="elsevierStyleCrossRef" href="#bib21">21</a>It was observed that females often showed higher values of AD-SoS compared to males at ages where there is greater influence of puberty. At the observed ages, the former are usually at the stage of early development due to the earlier start of the maturation process,<a class="elsevierStyleCrossRefs" href="#bib22">22–24</a> which may explain the results obtained by phalanges QUS, as this bone site is sensitive to changes in growth and maturation.MaturationMaturation assessment through the stages of pubertal development is divided into pre-puberty (stage I), puberty (stages II and III), and late puberty (stages IV and V).Most studies evidenced an increase in bone mass according to pubertal development. Females showed an increase in AD-SoS values at all pubertal stages<a class="elsevierStyleCrossRefs" href="#bib7">7,10,14,23</a> or at least from one stage to another.<a class="elsevierStyleCrossRefs" href="#bib5">5,12,24,25</a> As for BTT, most studies showed an increase in relation to all pubertal stages.<a class="elsevierStyleCrossRefs" href="#bib5">5,10,14</a> In males, AD-SoS progressively increased with puberty<a class="elsevierStyleCrossRefs" href="#bib10">10,25</a> or at some stage.<a class="elsevierStyleCrossRefs" href="#bib5">5,7,12,24</a> BTT increased significantly in all pubertal stages,<a class="elsevierStyleCrossRefs" href="#bib10">10,14</a> in stages I through IV,<a class="elsevierStyleCrossRef" href="#bib5">5</a> and in late puberty.<a class="elsevierStyleCrossRef" href="#bib24">24</a> Only two studies found no association between pubertal stages and QUS parameters.<a class="elsevierStyleCrossRefs" href="#bib15">15,26</a>Regarding maturational stages, the results of DXA are quite similar to those of the BTT. In all pubertal stages, males present higher BMD values than females for total body, radio, hip, and femur.<a class="elsevierStyleCrossRef" href="#bib18">18</a>When the groups were compared by pubertal stage, females showed higher values of AD-SoS in stages III and IV when compared to males. This result can be explained by the fact that the period of childhood and adolescence is characterized by a high rate of bone formation and, therefore, by gain in the amount of bone tissue. As the phalanges are more sensitive to general hormonal and osteometabolic changes for having large amounts of trabecular bone,<a class="elsevierStyleCrossRef" href="#bib16">16</a>the fact that females mature earlier can directly influence the results found in studies with QUS of the phalanges.The results of the ultrasound are similar to those found by DXA when comparing the maturational stages between individuals of the same gender. BMD progressively increases between maturational stages in both genders in the different sites analyzed, such as the lumbar spine, femur, and whole body,<a class="elsevierStyleCrossRefs" href="#bib19">19,20,27–29</a> corroborating the results of the QUS. That is, the data indicate that pubertal development is one of the factors that influence bone mass, and is positively associated with age, weight, height, and BMI, confirming that the development and increase of bone mass are directly associated with maturation and growth aspects.The studies also demonstrated that, after a period of increase in peak bone mass, males showed higher values of the ultrasound parameters, indicating greater amount of bone mass, as observed in studies using DXA.Anthropometrics and body compositionStudies have demonstrated that both AD-SoS and BTT increased progressively with age and height in both genders.<a class="elsevierStyleCrossRefs" href="#bib4">4,10,12–14,23,25,30</a> Studies have also reported a positive correlation between AD-SoS and anthropometric variables, such as weight and height,<a class="elsevierStyleCrossRefs" href="#bib4">4,13,15,16,25,31–33</a> BMI,<a class="elsevierStyleCrossRefs" href="#bib15">15,16</a> mean width of the fingers,<a class="elsevierStyleCrossRef" href="#bib12">12</a> waist and hip circumference,<a class="elsevierStyleCrossRef" href="#bib16">16</a> lean body mass,<a class="elsevierStyleCrossRefs" href="#bib10">10,15</a> fat mass, fat mass index, and body fat percentage.<a class="elsevierStyleCrossRef" href="#bib16">16</a> BTT showed a positive correlation with age, weight, height, BMI,<a class="elsevierStyleCrossRefs" href="#bib5">5,14,25</a> and lean mass.<a class="elsevierStyleCrossRef" href="#bib10">10</a> Likewise, studies that analyzed the association between BMD, evaluated at several sites using DXA and anthropometric parameters (age, weight, height, and BMI), observed a positive correlation in both genders,<a class="elsevierStyleCrossRefs" href="#bib19">19,21,27</a> noting that lean mass exerts influence on BMD of the lumbar spine<a class="elsevierStyleCrossRef" href="#bib20">20</a> and is related to the BMD of arms and legs in both genders.<a class="elsevierStyleCrossRef" href="#bib34">34</a>Physical activityOnly one study observed that the values of AD-SoS, T-score, and Z-score were significantly higher for men who practiced karate, and AD-SoS positively related them to time and weekly frequency of training.<a class="elsevierStyleCrossRef" href="#bib35">35</a>In a similar study using DXA, a group of wrestling athletes had higher BMD values of the whole body, lumbar spine, legs, and arms than the sedentary group.<a class="elsevierStyleCrossRef" href="#bib34">34</a> When assessing physical activity and bone mass by DXA, physical activity has a positive correlation with BMD of the femoral neck, hip, and whole body<a class="elsevierStyleCrossRef" href="#bib29">29</a>. Studies with children and adolescent athletes suggest that physical exercise is positively associated with the individuals' BMD results.<a class="elsevierStyleCrossRefs" href="#bib36">36,37</a>Due to the scarce number of studies that address the assessment of QUS with physical activity, it is not possible to establish parameters concerning the data presented. Therefore, more studies are necessary involving physical activity and QUS evaluation of phalanges to elucidate the reliability of its use.GeneticsTwo studies involving genetic factors were retrieved. Drozdzowska et al<a class="elsevierStyleCrossRef" href="#bib31">31</a>and Guglielmi et al<a class="elsevierStyleCrossRef" href="#bib38">38</a> found that the differences between monozygotic and dizygotic twins are influenced mainly by environmental factors and lifestyle, and that AD-SoS significantly increased with age for both genders. The authors also observed that the intra-pair correlation coefficient of AD-SoS is stronger in monozygotic than in dizygotic twins.When DXA was used, similar results were found, with a higher correlation of BMD among monozygotic twins and a lower correlation between parents and children, showing that 51% to 76% of the variation in BMD is hereditary.<a class="elsevierStyleCrossRef" href="#bib39">39</a> More studies are needed in relation to genetic factors, as there is an apparent genetic affinity in relation to bone mass in monozygotic and dizygotic twins, and differences are predicted by anthropometric variables.EthnicityRegarding ethnic classification, two studies showed differences between the groups classified as blacks or whites. When divided into blacks and whites, regardless of gender, the former showed lower values of AD-SoS. When divided by ethnicity and gender, white females had higher values of AD-SoS than the other three groups. White males showed higher values of AD-SoS when compared to black males.<a class="elsevierStyleCrossRefs" href="#bib23">23,40</a>Differently from the results of QUS of the phalanges, Fonseca et al<a class="elsevierStyleCrossRef" href="#bib27">27</a> observed a negative correlation of BMD with skin pigmentation in adolescent females. However, the author reports that this correlation is incorrect, because of the great diversity of the Brazilian population. Another study demonstrated that white, non-Hispanic individuals are more likely to have fractures than non-white individuals with lower BMD values of whole body, lumbar spine, forearm and femur. Furthermore, studies present significantly higher BMD values in black males when compared to whites.<a class="elsevierStyleCrossRefs" href="#bib41">41,42</a>Additionally, in studies with DXA, it was observed that Asians had lower BMD values than whites of similar age and gender.<a class="elsevierStyleCrossRef" href="#bib43">43</a> However, the differences found in the results may be more related to hereditary and environmental factors, as the studies were conducted in different countries and ethnic groups, with great diversity in the gene pool of populations, preventing comparisons.Socioeconomic profileTwo studies assessed the socioeconomic profile, but the classification was used solely to describe the groups, not comparing with the QUS parameters.<a class="elsevierStyleCrossRefs" href="#bib16">16,23</a> Thus, further studies using the QUS of phalanges to assess bone mass in different socioeconomic profiles are suggested, as the DXA results demonstrated that groups of lower socioeconomic status had lower BMD.<a class="elsevierStyleCrossRef" href="#bib18">18</a>Nutrient intakeTwo studies assessed the association between caloric intake and the parameters of QUS of the phalanges. Dib et al<a class="elsevierStyleCrossRef" href="#bib10">10</a> evaluated the intake of calcium and vitamin D and found no significant correlation between calcium intake and ultrasound parameters in both genders. Lavado-Garcia et al<a class="elsevierStyleCrossRef" href="#bib15">15</a> demonstrated that AD-SoS was negatively correlated with the intake of calcium, iron, magnesium, and calcium/protein ratio in females, with no association between nutrient intake and ultrasound parameters in males.Although nutrition has great influence on bone health of individuals, there have been few studies investigating the association between caloric intake and parameters of QUS of the phalanges. The authors suggest further studies in this area.Limitations and conclusionsThe first important limitation is that the studies included in this systematic review were mostly cross-sectional, and only two were longitudinal studies, with a follow-up of one and two years. Furthermore, the studies differed regarding the dominance of the evaluated limb and had different numbers of evaluated subjects, which may be a bias in their findings.Despite the limitations described above, it can be concluded that the QUS of phalanges is a good method to evaluate the progressive acquisition of bone mass during the growth and maturation of school-age individuals, by monitoring alterations that occur with increasing age and pubertal stage. A positive influence was observed, especially of the variables gender, maturation, height, weight, and BMI, and data was similar when compared to DXA, which is the gold standard method. However, there is only a small number of studies that compared both methods. The scientific literature is scarce regarding physical activity, hormone levels, ethnicity, genetics, and caloric intake, and therefore it is not possible to clarify the influence of these factors on the parameters of QUS of the phalanges.Moreover, there were few studies comparing the QUS and DXA methods, without clarifying the difference in results when comparing the parameters of bone mass in relation to gender.Despite the advantages already described for the QUS of the phalanges, and the fact that it is an accessible, low cost, portable, and non-invasive method, further studies are needed regarding its use in regular bone assessment of children and adolescents.Conflicts of interestThe authors declare no conflicts of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:19 [ 0 => array:3 [ "identificador" => "xres533994" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "ceabs10" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "ceabs20" "titulo" => "Data source" ] 2 => array:2 [ "identificador" => "ceabs30" "titulo" => "Data synthesis" ] 3 => array:2 [ "identificador" => "ceabs40" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec554373" "titulo" => "KEYWORDS" ] 2 => array:3 [ "identificador" => "xres533995" "titulo" => "Resumo" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "ceabs50" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "ceabs60" "titulo" => "Fonte de dados" ] 2 => array:2 [ "identificador" => "ceabs70" "titulo" => "Síntese dos dados" ] 3 => array:2 [ "identificador" => "ceabs80" "titulo" => "Conclusões" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec554374" "titulo" => "PALAVRAS-CHAVE" ] 4 => array:2 [ "identificador" => "cesec10" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "cesec20" "titulo" => "Methods" ] 6 => array:2 [ "identificador" => "cesec30" "titulo" => "Results and Discussion" ] 7 => array:2 [ "identificador" => "cesec40" "titulo" => "Gender" ] 8 => array:2 [ "identificador" => "cesec50" "titulo" => "Maturation" ] 9 => array:2 [ "identificador" => "cesec60" "titulo" => "Anthropometrics and body composition" ] 10 => array:2 [ "identificador" => "cesec70" "titulo" => "Physical activity" ] 11 => array:2 [ "identificador" => "cesec80" "titulo" => "Genetics" ] 12 => array:2 [ "identificador" => "cesec90" "titulo" => "Ethnicity" ] 13 => array:2 [ "identificador" => "cesec100" "titulo" => "Socioeconomic profile" ] 14 => array:2 [ "identificador" => "cesec110" "titulo" => "Nutrient intake" ] 15 => array:2 [ "identificador" => "cesec120" "titulo" => "Limitations and conclusions" ] 16 => array:2 [ "identificador" => "cesec130" "titulo" => "Conflicts of interest" ] 17 => array:2 [ "identificador" => "xack181148" "titulo" => "Acknowledgements" ] 18 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2013-12-19" "fechaAceptado" => "2014-03-05" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "KEYWORDS" "identificador" => "xpalclavsec554373" "palabras" => array:6 [ 0 => "Children" 1 => "Adolescent" 2 => "Finger phalanges" 3 => "Ultrasonography" 4 => "Bone development" 5 => "Bone density" ] ] ] "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "PALAVRAS-CHAVE" "identificador" => "xpalclavsec554374" "palabras" => array:6 [ 0 => "Criança" 1 => "Adolescente" 2 => "Falanges dos dedos da mão" 3 => "Ultrassonografia" 4 => "Desenvolvimento ósseo" 5 => "Densidade óssea" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "ObjectiveTo analyze the main factors that influence bone mass in children and teenagers assessed by quantitative ultrasound (QUS) of the phalanges. Data sourceA systematic literature review was performed according to the PRISMA method with searches in databases Pubmed/Medline, SciELO and Bireme for the period 2001-2012, in English and Portuguese languages, using the keywords: children, teenagers, adolescent, ultrasound finger phalanges, quantitative ultrasound of phalanges, phalangeal quantitative ultrasound. Data synthesis21 articles were included. Girls had, in QUS, Amplitude Dependent Speed of Sound (AD-SoS) values higher than boys during pubertal development. The values of the parameters of QUS of the phalanges and dual-energy X-ray Absorptiometry (DXA) increased with the increase of the maturational stage. Anthropometric variables such as age, weight, height, body mass index (BMI), lean mass showed positive correlations with the values of QUS of the phalanges. Physical activity has also been shown to be positively associated with increased bone mass. Factors such as ethnicity, genetics, caloric intake and socioeconomic profile have not yet shown a conclusive relationship and need a larger number of studies. ConclusionsQUS of the phalanges is a method used to evaluate the progressive acquisition of bone mass during growth and maturation of individuals in school phase, by monitoring changes that occur with increasing age and pubertal stage. There were mainly positive influences variables of sex, maturity, height, weight and BMI, with similar data when compared to the gold standard method, the DXA." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "ceabs10" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "ceabs20" "titulo" => "Data source" ] 2 => array:2 [ "identificador" => "ceabs30" "titulo" => "Data synthesis" ] 3 => array:2 [ "identificador" => "ceabs40" "titulo" => "Conclusions" ] ] ] "pt" => array:3 [ "titulo" => "Resumo" "resumen" => "ObjetivoAnalisar quais os principais fatores que influenciam na massa óssea de crianças e adolescentes avaliada pelo ultrassom quantitativo (QUS) de falanges. Fonte de dadosFoi realizada revisão sistemática da literatura, de acordo com o método Prisma, com buscas nas bases de dados do Pubmed/Medline, Bireme e Scielo, referente ao período de 2001 a 2012, nos idiomas inglês e português, utilizando os descritores children, adolescent, ultrassonography finger phalanges, quantitative ultrasound of phalanges, phalangeal quantitative ultrasound. Síntese dos dadosForam incluídos 21 artigos. As meninas apresentaram no QUS valores de Amplitude Dependent Speed of Sound (AD-SoS) superiores aos meninos durante o desenvolvimento puberal. Os valores dos parâmetros do QUS de falanges aumentaram com o incremento do estádio maturacional, assim como ocorre com o Dual-energy X-ray Absorptiometry (DXA). Variáveis antropométricas, como idade, peso, estatura, índice de massa corporal (IMC) e massa magra, demonstraram correlações positivas com os valores do QUS de falanges. A atividade física também demonstrou estar positivamente relacionada ao aumento da massa óssea. Fatores como etnia, genética, ingestão calórica e perfil socioeconômico ainda não mostraram relação conclusiva e necessitam um número maior de estudos. ConclusõesO QUS de falanges é um método indicado para avaliar a progressiva aquisição da massa óssea durante o crescimento e a maturação dos indivíduos em fase escolar, por acompanhar as alterações que ocorrem com o aumento da idade e do estádio puberal. Observou-se influência positiva, principalmente das variáveis de sexo, maturação, estatura, peso e IMC, sendo seus dados semelhantes quando comparados ao método padrão-ouro, o DXA." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "ceabs50" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "ceabs60" "titulo" => "Fonte de dados" ] 2 => array:2 [ "identificador" => "ceabs70" "titulo" => "Síntese dos dados" ] 3 => array:2 [ "identificador" => "ceabs80" "titulo" => "Conclusões" ] ] ] ] "NotaPie" => array:1 [ 0 => array:3 [ "etiqueta" => "*" "nota" => "Study conducted at Faculdade de Ciências Médicas da Universidade Estadual de Campinas, Campinas, SP, Brazil." "identificador" => "fn1" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig1" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1328 "Ancho" => 999 "Tamanyo" => 139161 ] ] "descripcion" => array:1 [ "en" => "Prisma Fluxograma" ] ] 1 => array:7 [ "identificador" => "tbl1" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Study \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sample \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Design \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Parameters \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Hand \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Results \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">04 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1,328 Germans (M/F) 3 to 17 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross–sectional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AD–SoS BTT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Right \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Both increased with age and height. Higher values of AD–SoS in females. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">256 Lebanese (M/F) 11 to 18 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross–sectional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AD–SoS BTT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Non–dominant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Increased with age and pubertal stage, positive correlation with age, height, and lean mass. Higher AD–SoS in females \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1,083 Italians (M/F) 3 to 21 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross–sectional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AD–SoS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Non–dominant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Increased with age and pubertal stage. Higher values in females. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1,020 Polish (M/F) 7 to 19 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross–sectional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AD–SoS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Dominant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Increased with age. Higher values in females. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">245 Spanish (M/F) 4 to 16 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross–sectional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AD–SoS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Non– dominant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Higher values in females. Increased with age. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">05 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1,227 Italians (M/F) 3 a 16 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross–sectional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AD–SoS BTT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Non– dominant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Increased with age and pubertal stage. Higher values in females. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">08 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">150 Polish (M/F) 14 to 19 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross–sectional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AD–SoS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Dominant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Higher values for females. Positively correlated with age, height, and pubertal stage. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3,044 Italians (M/F) 2 to 21 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross–sectional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AD–SoS BTT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Non–dominant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Both increased with age, weight, height, BMI, and pubertal stage. Higher AD–SoS in females and BTT in males. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">267 Brazilians (M/F) 8 to 18 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross–sectional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AD–SoS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Non–dominant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Positive correlation with age, weight, height, BMI, lean mass, waist circumference, and hip circumference. Negative correlation with waist–to–hip ratio. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1,775 Brazilians (F) 8 to 17 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross–sectional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AD–SoS BTT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Non–dominant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Increased with age and pubertal stage. Positive correlation with age, height, and pubertal stage. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2,850 Polish (F) 7 to 77 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross–sectional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AD–SoS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Dominant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Significant increase from 11–16 years. Peak at 19 years. From 7 to 11 years, age and height positive and weight negative. From 12 to 19 years, is age–dependent. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">32 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1,175 Polish (M) 7 to 80 years. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross–sectional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AD–SoS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Dominant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Significant increase after 13 years. Correlation with weight and height. From 14 to 28 years, it is highly dependent on age. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">38 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">106 Monozygotic twins (M/F) – 5 to 71 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross– sectional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AD–SoS, UBPI SDy, BTT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Non–dominant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Age and height are predictors of differences between pairs. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">31 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><ul class="elsevierStyleList" id="celist10"><li class="elsevierStyleListItem" id="celistitem10">83 mono and dizygotic</li><li class="elsevierStyleListItem" id="celistitem20">Polish twins (M/F)– 15 to 23 years</li></ul> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross– sectional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AD–SoS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Dominant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><ul class="elsevierStyleList" id="celist20"><li class="elsevierStyleListItem" id="celistitem30">Stronger correlation in monozygotic twins.</li><li class="elsevierStyleListItem" id="celistitem40">Intra–pair difference influenced by age.</li></ul> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">35 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">226 Polish Karate fighters and 44 sedentary individuals (M) – 8 to 62 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross–sectional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AD–SoS T–Score Z–Score \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Dominant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Higher values in karate fighters. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">26 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><ul class="elsevierStyleList" id="celist30"><li class="elsevierStyleListItem" id="celistitem50">38 preterm and 50 full–term</li><li class="elsevierStyleListItem" id="celistitem60">Polish (M/F) – 9 to 11 years</li></ul> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross–sectional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AD–SoS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Dominant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">There were no statistical differences between groups. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1,356 Brazilians (M/F) 6 to 11 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross–sectional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AD–SoS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Non– dominant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Increased with age. Higher values in white females. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1,356 Brazilians (M/F) – 6 to 11 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross– sectional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AD–SoS UBPI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Non– dominant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Increased with age and pubertal stage. Both higher in white females than African–descendants. UBPI higher in whites females than in African–descendants. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">33 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">50 Austrians with fractures and 154 with no fractures, (M/F) – 8 to 12 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cross–sectional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">SOS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Dominant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Lower value in the fracture group. In the control group, higher values in females. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">662 Italians (M/F) 3 to 16 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Longitudinal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AD–SoS BTT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Non–dominant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Increased with age and pubertal stage. Higher values in males with delayed puberty. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">07 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">269 Polish (M/F) 7 to 12 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Longitudinal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AD–SoS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Dominant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Higher values in females. Increased significantly after 1 year. Increased with pubertal stage. \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab858153.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Main characteristics and results of articles with quantitative ultrasound (QUS) of the phalanges." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "cebibsec10" "bibliografiaReferencia" => array:43 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Establishment of peak bone mass" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => """ S Mora \n \t\t\t\t\t\t\t\t """ 1 => """ V Gilsanz \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Endocrinol Metab Clin North Am" "fecha" => "2003" "volumen" => "32" "paginaInicial" => "39" "paginaFinal" => "63" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12699292" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Methods for measurement of pediatric bone" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => """ TL Binkley \n \t\t\t\t\t\t\t\t """ 1 => """ R Berry \n \t\t\t\t\t\t\t\t """ 2 => """ BL Specker \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11154-008-9073-5" "Revista" => array:6 [ "tituloSerie" => "Rev Endocr Metab Disord" "fecha" => "2008" "volumen" => "9" "paginaInicial" => "95" "paginaFinal" => "106" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18247119" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "titulo" => "International Atomic Energy Angency – IAEA [homepage on the Internet]. Viena: Dual energy x-ray absorptiometry for bone mineral density and body composition assessment. IAEA Human Health Series [cited 2013 July 28]" ] ] "host" => array:1 [ 0 => array:1 [ "WWW" => array:1 [ "link" => "Available from: http://www.iaea.org/Publications/index.html" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "German pediatric reference data for quantitative transverse transmission ultrasound of finger phalanges" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ R Barkmann \n \t\t\t\t\t\t\t\t """ 1 => """ W Rohrschneider \n \t\t\t\t\t\t\t\t """ 2 => """ M Vierling \n \t\t\t\t\t\t\t\t """ 3 => """ J Tröger \n \t\t\t\t\t\t\t\t """ 4 => """ F de Terlizzi \n \t\t\t\t\t\t\t\t """ 5 => """ R Cadossi \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Osteoporos Int" "fecha" => "2002" "volumen" => "13" "paginaInicial" => "55" "paginaFinal" => "61" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11878455" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Influence of age, sex and growth variables on phalangeal quantitative ultrasound measures: a study in health children and adolescent" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => """ M Vignolo \n \t\t\t\t\t\t\t\t """ 1 => """ A Brignone \n \t\t\t\t\t\t\t\t """ 2 => """ A Mascagni \n \t\t\t\t\t\t\t\t """ 3 => """ B Ravera \n \t\t\t\t\t\t\t\t """ 4 => """ B Biasotti \n \t\t\t\t\t\t\t\t """ 5 => """ G Aicardi \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Calcif Tissue Int" "fecha" => "2003" "volumen" => "72" "paginaInicial" => "681" "paginaFinal" => "688" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14562996" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => """ O Ianneta \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:4 [ "titulo" => "Osteoporose: uma ex-enfermidade silenciosa" "fecha" => "2006" "editorial" => "Tecmedd" "editorialLocalizacion" => "Ribeirão Preto" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Quantitative ultrasound measurements at hand phalanges in children and adolescents: a longitudinal study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => """ ZP Halaba \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ultrasmedbio.2008.03.007" "Revista" => array:6 [ "tituloSerie" => "Ultrasound Med Biol" "fecha" => "2008" "volumen" => "34" "paginaInicial" => "1547" "paginaFinal" => "1553" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18485570" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison of phalangeal ultrasound and dual energy x-ray absorptiometry in health male and female adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => """ ZP Halaba \n \t\t\t\t\t\t\t\t """ 1 => """ J Konstantynowicz \n \t\t\t\t\t\t\t\t """ 2 => """ W Pluskiewicz \n \t\t\t\t\t\t\t\t """ 3 => """ M Kaczmarski \n \t\t\t\t\t\t\t\t """ 4 => """ J Piotrowska-Jastrzebska \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ultrasmedbio.2005.07.013" "Revista" => array:6 [ "tituloSerie" => "Ultrasound Med Biol" "fecha" => "2005" "volumen" => "31" "paginaInicial" => "1617" "paginaFinal" => "1622" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16344124" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Preliminary comparison between phalangeal quantitative ultrassonography and bone densitometry for bone mass evaluation in adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ SB Duarte \n \t\t\t\t\t\t\t\t """ 1 => """ WR Carvalho \n \t\t\t\t\t\t\t\t """ 2 => """ EM Gonçalves \n \t\t\t\t\t\t\t\t """ 3 => """ RR Ribeiro \n \t\t\t\t\t\t\t\t """ 4 => """ ES Farias \n \t\t\t\t\t\t\t\t """ 5 => """ O Magro D de \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Arq Bras Endocrinol Metab" "fecha" => "2012" "volumen" => "56" "paginaInicial" => "19" "paginaFinal" => "24" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Impact of anthropometric, lifestyle, and body composition variables on ultrasound measurements in school children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => """ L Dib \n \t\t\t\t\t\t\t\t """ 1 => """ A Arabi \n \t\t\t\t\t\t\t\t """ 2 => """ J Maalouf \n \t\t\t\t\t\t\t\t """ 3 => """ M Nabulsi \n \t\t\t\t\t\t\t\t """ 4 => """ GF EiI-Hajj \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.bone.2005.01.009" "Revista" => array:6 [ "tituloSerie" => "Bone" "fecha" => "2005" "volumen" => "36" "paginaInicial" => "736" "paginaFinal" => "742" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15784188" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The prisma statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ A Liberati \n \t\t\t\t\t\t\t\t """ 1 => """ DG Altman \n \t\t\t\t\t\t\t\t """ 2 => """ J Tetzlaff \n \t\t\t\t\t\t\t\t """ 3 => """ C Mulrow \n \t\t\t\t\t\t\t\t """ 4 => """ PC Gøtzsch \n \t\t\t\t\t\t\t\t """ 5 => """ JP Loannidis \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Plos Med" "fecha" => "2009" "volumen" => "6" "paginaInicial" => "1" "paginaFinal" => "28" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bone quality assessment by quantitative ultrasound of proximal phalanxes of the hand in healthy subjects aged 3-21 years" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => """ G Baroncelli \n \t\t\t\t\t\t\t\t """ 1 => """ G Federico \n \t\t\t\t\t\t\t\t """ 2 => """ S Bertelloni \n \t\t\t\t\t\t\t\t """ 3 => """ F De Terlizz \n \t\t\t\t\t\t\t\t """ 4 => """ R Cadossi \n \t\t\t\t\t\t\t\t """ 5 => """ G Saggese \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1203/00006450-200105000-00017" "Revista" => array:6 [ "tituloSerie" => "Pediatr Res" "fecha" => "2001" "volumen" => "49" "paginaInicial" => "713" "paginaFinal" => "718" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11328957" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Quantitative ultrasound in the assessment of skeletal status in children and adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => """ ZP Halaba \n \t\t\t\t\t\t\t\t """ 1 => """ W Pluskiewicz \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ultrasmedbio.2003.10.023" "Revista" => array:6 [ "tituloSerie" => "Ultrasound Med Biol" "fecha" => "2004" "volumen" => "30" "paginaInicial" => "239" "paginaFinal" => "243" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14998676" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cross-sectional reference data for phalangeal quantitative ultrasound from early childhood to young-adulthood according to gender, age, skeletal growth, and pubertal development" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ GI Baroncelli \n \t\t\t\t\t\t\t\t """ 1 => """ G Federico \n \t\t\t\t\t\t\t\t """ 2 => """ M Vignolo \n \t\t\t\t\t\t\t\t """ 3 => """ G Valerio \n \t\t\t\t\t\t\t\t """ 4 => """ A del Puente \n \t\t\t\t\t\t\t\t """ 5 => """ M Maghnie \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.bone.2005.12.010" "Revista" => array:6 [ "tituloSerie" => "Bone" "fecha" => "2006" "volumen" => "39" "paginaInicial" => "159" "paginaFinal" => "173" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16473568" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bone mass of Spanish school children: impact of anthropometric, dietary and body composition factors" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => """ JM Lavado-Garcia \n \t\t\t\t\t\t\t\t """ 1 => """ JF Calderon-Garcia \n \t\t\t\t\t\t\t\t """ 2 => """ JM Moran \n \t\t\t\t\t\t\t\t """ 3 => """ ML Canal-Macias \n \t\t\t\t\t\t\t\t """ 4 => """ T Rodriguez-Dominguez \n \t\t\t\t\t\t\t\t """ 5 => """ JD Pedrera-Zamorano \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00774-011-0301-9" "Revista" => array:6 [ "tituloSerie" => "J Bone Miner Metab" "fecha" => "2012" "volumen" => "30" "paginaInicial" => "193" "paginaFinal" => "201" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21822585" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib16" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Influence of body composition on bone mass in children and adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => """ WR Carvalho \n \t\t\t\t\t\t\t\t """ 1 => """ EM Gonçalves \n \t\t\t\t\t\t\t\t """ 2 => """ RR Ribeiro \n \t\t\t\t\t\t\t\t """ 3 => """ ES Farias \n \t\t\t\t\t\t\t\t """ 4 => """ SSP Carvalho \n \t\t\t\t\t\t\t\t """ 5 => """ G Guerra-Junior \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Assoc Med Bras" "fecha" => "2011" "volumen" => "57" "paginaInicial" => "662" "paginaFinal" => "667" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22249546" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib17" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A longitudinal analysis of sex differences in bone mineral accrual in health 8-19 year old boys and girls" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => """ AD Baxter-Jones \n \t\t\t\t\t\t\t\t """ 1 => """ RL Mirwald \n \t\t\t\t\t\t\t\t """ 2 => """ HA McKay \n \t\t\t\t\t\t\t\t """ 3 => """ DA Bailey \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Hum Biol" "fecha" => "2003" "volumen" => "30" "paginaInicial" => "160" "paginaFinal" => "175" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12637192" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib18" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bone mineral density by age, gender, pubertal stages, and socioeconomic status in health Lebanese children and adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => """ A Arabi \n \t\t\t\t\t\t\t\t """ 1 => """ M Nabulsi \n \t\t\t\t\t\t\t\t """ 2 => """ J Maalou \n \t\t\t\t\t\t\t\t """ 3 => """ M Choucair \n \t\t\t\t\t\t\t\t """ 4 => """ H Khalifé \n \t\t\t\t\t\t\t\t """ 5 => """ R Vieth \n \t\t\t\t\t\t\t\t """ 6 => """ GF El-Hajj \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Bone" "fecha" => "2004" "paginaInicial" => "1169" "paginaFinal" => "1179" ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib19" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bone mineral density of proximal femur and spine in Korean children between 2 and 18 years of age" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ SH Lee \n \t\t\t\t\t\t\t\t """ 1 => """ SS Desai \n \t\t\t\t\t\t\t\t """ 2 => """ G Shetty \n \t\t\t\t\t\t\t\t """ 3 => """ HR Song \n \t\t\t\t\t\t\t\t """ 4 => """ SH Lee \n \t\t\t\t\t\t\t\t """ 5 => """ CY Hur \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00774-007-0775-7" "Revista" => array:6 [ "tituloSerie" => "J Bone Miner Metab" "fecha" => "2007" "volumen" => "25" "paginaInicial" => "423" "paginaFinal" => "430" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17968496" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib20" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Determinants of bone mineral density, bone mineral content and body composition in a cohort od health children: influence of sex, age puberty and physical activity" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ E Ausili \n \t\t\t\t\t\t\t\t """ 1 => """ D Rigante \n \t\t\t\t\t\t\t\t """ 2 => """ E Savaggio \n \t\t\t\t\t\t\t\t """ 3 => """ B Focarelli \n \t\t\t\t\t\t\t\t """ 4 => """ C Rendeli \n \t\t\t\t\t\t\t\t """ 5 => """ V Ansuini \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00296-011-2059-8" "Revista" => array:6 [ "tituloSerie" => "Rheumatol Int" "fecha" => "2012" "volumen" => "32" "paginaInicial" => "2737" "paginaFinal" => "2743" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21809005" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib21" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Gender differences in bone density at different skeletal sites of acquisition with age in Chinese children and adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ XP Wu \n \t\t\t\t\t\t\t\t """ 1 => """ YH Yang \n \t\t\t\t\t\t\t\t """ 2 => """ H Zhang \n \t\t\t\t\t\t\t\t """ 3 => """ LQ Yuan \n \t\t\t\t\t\t\t\t """ 4 => """ XH Luo \n \t\t\t\t\t\t\t\t """ 5 => """ XZ Cao \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00774-004-0592-1" "Revista" => array:6 [ "tituloSerie" => "J Bone Miner Metab" "fecha" => "2005" "volumen" => "23" "paginaInicial" => "253" "paginaFinal" => "260" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15838629" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib22" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => """ RM Malina \n \t\t\t\t\t\t\t\t """ 1 => """ C Bouchard \n \t\t\t\t\t\t\t\t """ 2 => """ O Bar-Or \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:5 [ "edicion" => "2nd ed." "titulo" => "Crescimento, maturação e atividade física" "fecha" => "2009" "editorial" => "Phorte" "editorialLocalizacion" => "São Paulo" ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib23" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bone mass in school children in Brazil: the effect of racial miscegenation, pubertal stage, and socioeconomic differences" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => """ RR Ribeiro \n \t\t\t\t\t\t\t\t """ 1 => """ G Guerra-Junior \n \t\t\t\t\t\t\t\t """ 2 => """ AA Barros-Filho \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00774-009-0062-x" "Revista" => array:6 [ "tituloSerie" => "J Bone Miner Metab" "fecha" => "2009" "volumen" => "27" "paginaInicial" => "494" "paginaFinal" => "501" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19283337" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib24" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Longitudinal assement of bone quality by quantitative ultrasonography in children and adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => """ M Vignolo \n \t\t\t\t\t\t\t\t """ 1 => """ A Parodi \n \t\t\t\t\t\t\t\t """ 2 => """ A Mascagni \n \t\t\t\t\t\t\t\t """ 3 => """ C Torrisi \n \t\t\t\t\t\t\t\t """ 4 => """ F de Terlizze \n \t\t\t\t\t\t\t\t """ 5 => """ G Aicardi \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ultrasmedbio.2006.02.1429" "Revista" => array:6 [ "tituloSerie" => "Ultrasound Med Biol" "fecha" => "2006" "volumen" => "32" "paginaInicial" => "1003" "paginaFinal" => "1010" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16829314" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib25" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bone quantity and quality in Brazilian female schoolchildren and adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => """ KD Santos \n \t\t\t\t\t\t\t\t """ 1 => """ EL Petroski \n \t\t\t\t\t\t\t\t """ 2 => """ RR Ribeiro \n \t\t\t\t\t\t\t\t """ 3 => """ G Guerra-Junior \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00774-009-0067-5" "Revista" => array:6 [ "tituloSerie" => "J Bone Miner Metab" "fecha" => "2009" "volumen" => "27" "paginaInicial" => "507" "paginaFinal" => "512" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19326046" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib26" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Phalangeal quantitative ultrasound measurements in former pre-term children aged 9–11 years" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => """ ZP Halaba \n \t\t\t\t\t\t\t\t """ 1 => """ J Bursa \n \t\t\t\t\t\t\t\t """ 2 => """ UK Kaplon \n \t\t\t\t\t\t\t\t """ 3 => """ W Pluskiewicz \n \t\t\t\t\t\t\t\t """ 4 => """ S Marciniak \n \t\t\t\t\t\t\t\t """ 5 => """ U Drzewiecka \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1259/bjr/55460700" "Revista" => array:6 [ "tituloSerie" => "Br J Radiol" "fecha" => "2007" "volumen" => "80" "paginaInicial" => "401" "paginaFinal" => "405" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17068013" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib27" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bone mineral density associated with physical traits and lifestyle in adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => """ RM Fonseca \n \t\t\t\t\t\t\t\t """ 1 => """ RJ de Oliveira \n \t\t\t\t\t\t\t\t """ 2 => """ RW Pereira \n \t\t\t\t\t\t\t\t """ 3 => """ NM França \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Bras Med Esp" "fecha" => "2012" "volumen" => "18" "paginaInicial" => "381" "paginaFinal" => "384" ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib28" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bone mass acquisition in female rhythmic gymnasts during puberty: no direct role for leptin" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => """ L Maïmoun \n \t\t\t\t\t\t\t\t """ 1 => """ O Coste \n \t\t\t\t\t\t\t\t """ 2 => """ A Jaussent \n \t\t\t\t\t\t\t\t """ 3 => """ D Mariano-Goulart \n \t\t\t\t\t\t\t\t """ 4 => """ C Sultan \n \t\t\t\t\t\t\t\t """ 5 => """ F Paris \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clin Endocrinol" "fecha" => "2010" "volumen" => "72" "paginaInicial" => "604" "paginaFinal" => "611" ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib29" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bone mineral density in girls and boys at different pubertal stages: relation with gonadal steroids, bone formation markers, and growth parameters" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => """ D Yilmaz \n \t\t\t\t\t\t\t\t """ 1 => """ B Ersoy \n \t\t\t\t\t\t\t\t """ 2 => """ E Bilgin \n \t\t\t\t\t\t\t\t """ 3 => """ G Gümüser \n \t\t\t\t\t\t\t\t """ 4 => """ E Onur \n \t\t\t\t\t\t\t\t """ 5 => """ ED Pinar \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00774-005-0631-6" "Revista" => array:6 [ "tituloSerie" => "J Bone Miner Metab" "fecha" => "2005" "volumen" => "23" "paginaInicial" => "476" "paginaFinal" => "482" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16261455" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib30" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "quantitative ultrasound at the hand phalanges in 2850 females aged 7 to 77 yr: a cross-sectional study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => """ B Drozdzowska \n \t\t\t\t\t\t\t\t """ 1 => """ W Pluskiewicz \n \t\t\t\t\t\t\t\t """ 2 => """ Z Halaba \n \t\t\t\t\t\t\t\t """ 3 => """ H Misiolek \n \t\t\t\t\t\t\t\t """ 4 => """ B Beck \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Clin Densitom" "fecha" => "2005" "volumen" => "8" "paginaInicial" => "216" "paginaFinal" => "221" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15908710" "web" => "Medline" ] ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib31" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Quantitative ultrasound at the hand phalanges in monozygotic twins: a preliminary report" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => """ B Drozdzowska \n \t\t\t\t\t\t\t\t """ 1 => """ W Pluskiewicz \n \t\t\t\t\t\t\t\t """ 2 => """ T de Terlizzi \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ultrasound Med Biol" "fecha" => "2002" "volumen" => "28" "paginaInicial" => "1153" "paginaFinal" => "1156" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12401385" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib32" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Skeletal status in males aged 7–80 years assessed by quantitative ultrasound at the hand phalanges" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => """ B Drozdzowska \n \t\t\t\t\t\t\t\t """ 1 => """ W Pluskiewicz \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00198-002-1355-2" "Revista" => array:6 [ "tituloSerie" => "Osteoporos Int" "fecha" => "2003" "volumen" => "14" "paginaInicial" => "295" "paginaFinal" => "300" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12730791" "web" => "Medline" ] ] ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib33" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Quantitative ultrasound assessment in children with fractures" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => """ J Schalamon \n \t\t\t\t\t\t\t\t """ 1 => """ G Singer \n \t\t\t\t\t\t\t\t """ 2 => """ G Schwantzer \n \t\t\t\t\t\t\t\t """ 3 => """ Y Nierosvaara \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1359/JBMR.040401" "Revista" => array:6 [ "tituloSerie" => "J Bone Miner Res" "fecha" => "2004" "volumen" => "19" "paginaInicial" => "1276" "paginaFinal" => "1279" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15231014" "web" => "Medline" ] ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib34" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Grip strenght is a predictor of bone mineral density among adolescent combat sport athletes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:8 [ 0 => """ R Nasri \n \t\t\t\t\t\t\t\t """ 1 => """ SH Zrour \n \t\t\t\t\t\t\t\t """ 2 => """ H Rebai \n \t\t\t\t\t\t\t\t """ 3 => """ MF Najjar \n \t\t\t\t\t\t\t\t """ 4 => """ F Neffeti \n \t\t\t\t\t\t\t\t """ 5 => """ N Bergaoui \n \t\t\t\t\t\t\t\t """ 6 => """ H Mejdoub \n \t\t\t\t\t\t\t\t """ 7 => """ Z Tabka \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jocd.2012.07.011" "Revista" => array:6 [ "tituloSerie" => "J Clin Densitom" "fecha" => "2013" "volumen" => "16" "paginaInicial" => "92" "paginaFinal" => "97" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22980488" "web" => "Medline" ] ] ] ] ] ] ] ] 34 => array:3 [ "identificador" => "bib35" "etiqueta" => "35" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Skeleteal status assessed by quantitative ultrasound at the hand phalanges in karate training males" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => """ B Drozdzowaska \n \t\t\t\t\t\t\t\t """ 1 => """ U Münzer \n \t\t\t\t\t\t\t\t """ 2 => """ P Adamczyk \n \t\t\t\t\t\t\t\t """ 3 => """ W Pluskiewicz \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ultrasmedbio.2010.10.023" "Revista" => array:6 [ "tituloSerie" => "Ultrasound Med Biol" "fecha" => "2011" "volumen" => "37" "paginaInicial" => "214" "paginaFinal" => "219" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21208731" "web" => "Medline" ] ] ] ] ] ] ] ] 35 => array:3 [ "identificador" => "bib36" "etiqueta" => "36" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sport and its implications on the bone health of adolescent athletes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => """ CC Silva \n \t\t\t\t\t\t\t\t """ 1 => """ AS Teixeira \n \t\t\t\t\t\t\t\t """ 2 => """ TB Goldberg \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Bras Med Esp" "fecha" => "2003" "volumen" => "9" "paginaInicial" => "433" "paginaFinal" => "438" ] ] ] ] ] ] 36 => array:3 [ "identificador" => "bib37" "etiqueta" => "37" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effects of the physical activity on the bone mineral density and bone remodelation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => """ EL Cadore \n \t\t\t\t\t\t\t\t """ 1 => """ MA Brentano \n \t\t\t\t\t\t\t\t """ 2 => """ LF Kruel \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Bras Med Esporte" "fecha" => "2005" "volumen" => "11" "paginaInicial" => "373" "paginaFinal" => "379" ] ] ] ] ] ] 37 => array:3 [ "identificador" => "bib38" "etiqueta" => "38" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Quantitative ultrasound of the hand phalanges in a cohort of monozygotic twins: influence of genetic and environmental factors" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => """ G Guglielmi \n \t\t\t\t\t\t\t\t """ 1 => """ F de Terlizzi \n \t\t\t\t\t\t\t\t """ 2 => """ I Torrente \n \t\t\t\t\t\t\t\t """ 3 => """ R Mingarelli \n \t\t\t\t\t\t\t\t """ 4 => """ B Dallapiccola \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00256-005-0933-8" "Revista" => array:6 [ "tituloSerie" => "Skeletal Radiol" "fecha" => "2005" "volumen" => "34" "paginaInicial" => "727" "paginaFinal" => "735" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15999282" "web" => "Medline" ] ] ] ] ] ] ] ] 38 => array:3 [ "identificador" => "bib39" "etiqueta" => "39" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Genetic influence on bone mineral density in Korean twins and families: the healthy twin study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => """ JH Park \n \t\t\t\t\t\t\t\t """ 1 => """ YM Song \n \t\t\t\t\t\t\t\t """ 2 => """ J Sung \n \t\t\t\t\t\t\t\t """ 3 => """ K Lee \n \t\t\t\t\t\t\t\t """ 4 => """ YS Kim \n \t\t\t\t\t\t\t\t """ 5 => """ YS Park \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00198-011-1685-z" "Revista" => array:6 [ "tituloSerie" => "Osteoporos Int" "fecha" => "2012" "volumen" => "23" "paginaInicial" => "1343" "paginaFinal" => "1349" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21656262" "web" => "Medline" ] ] ] ] ] ] ] ] 39 => array:3 [ "identificador" => "bib40" "etiqueta" => "40" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison of bone quantity by ultrasound measurements of phalanges between white and black children living in Paraná, Brazil, with Europeans" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => """ RR Ribeiro \n \t\t\t\t\t\t\t\t """ 1 => """ D Santos-Ribeiro \n \t\t\t\t\t\t\t\t """ 2 => """ G Guerra-Junior \n \t\t\t\t\t\t\t\t """ 3 => """ AA Barros-Filho \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Braz J Med Biol Res" "fecha" => "2010" "volumen" => "43" "paginaInicial" => "976" "paginaFinal" => "981" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20802978" "web" => "Medline" ] ] ] ] ] ] ] ] 40 => array:3 [ "identificador" => "bib41" "etiqueta" => "41" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Demonstration that bone mass is greater in black than in white children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => """ NH Bell \n \t\t\t\t\t\t\t\t """ 1 => """ J Shary \n \t\t\t\t\t\t\t\t """ 2 => """ J Stevens \n \t\t\t\t\t\t\t\t """ 3 => """ M Garza \n \t\t\t\t\t\t\t\t """ 4 => """ L Gordon \n \t\t\t\t\t\t\t\t """ 5 => """ J Edwards \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/jbmr.5650060709" "Revista" => array:6 [ "tituloSerie" => "J Bone Miner Res" "fecha" => "1991" "volumen" => "6" "paginaInicial" => "719" "paginaFinal" => "723" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1950675" "web" => "Medline" ] ] ] ] ] ] ] ] 41 => array:3 [ "identificador" => "bib42" "etiqueta" => "42" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The accumulation of whole body skeletal mass in third- and fourth-grade children: effects of age, gender, ethnicity, and body composition" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => """ DA Nelson \n \t\t\t\t\t\t\t\t """ 1 => """ PM Simpson \n \t\t\t\t\t\t\t\t """ 2 => """ CC Johnson \n \t\t\t\t\t\t\t\t """ 3 => """ DA Barondess \n \t\t\t\t\t\t\t\t """ 4 => """ M Kleerekoper \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Bone" "fecha" => "1997" "volumen" => "20" "paginaInicial" => "73" "paginaFinal" => "78" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8988351" "web" => "Medline" ] ] ] ] ] ] ] ] 42 => array:3 [ "identificador" => "bib43" "etiqueta" => "43" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Longitudinal study of changes in hip bone mineral density in Caucasian and Africam-American woman" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:8 [ 0 => """ JA Cauley \n \t\t\t\t\t\t\t\t """ 1 => """ LY Lui \n \t\t\t\t\t\t\t\t """ 2 => """ KL Stone \n \t\t\t\t\t\t\t\t """ 3 => """ TA Hillier \n \t\t\t\t\t\t\t\t """ 4 => """ JM Zmuda \n \t\t\t\t\t\t\t\t """ 5 => """ M Hochberg \n \t\t\t\t\t\t\t\t """ 6 => """ TJ Beck \n \t\t\t\t\t\t\t\t """ 7 => """ KE Ensrud \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Am Geristr Soc" "fecha" => "2005" "volumen" => "53" "paginaInicial" => "183" "paginaFinal" => "189" ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack181148" "titulo" => "Acknowledgements" "texto" => "To the Faculdade de Ciências Médicas, Universidade Estadual de Campinas, and Laboratory of Growth and Body Composition, for the academic support, and to FAPESP (Fundação de Amparo à Pesquisa do Estado de São Paulo) (Process N. 2011/23460-1) for the financial support to one of the authors (EMG)." "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/23593482/0000003200000003/v1_201507170117/S235934821530021X/v1_201507170117/en/main.assets" "Apartado" => array:4 [ "identificador" => "42245" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Review Articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23593482/0000003200000003/v1_201507170117/S235934821530021X/v1_201507170117/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S235934821530021X?idApp=UINPBA00004N"]

Statistics

Review Article

Factors that influence bone mass of healthy children and adolescents measured by quantitative ultrasound at the hand phalanges: a systematic review*

Fatores que influenciam a massa óssea de crianças e adolescentes saudáveis mensurada pelo ultrassom quantitativo de falanges: revisão sistemática

Tathyane Krahenbühl

Corresponding author

tathy04n@gmail.com

Corresponding author

, Ezequiel Moreira Gonçalves, Eduardo Tavares Costa, Antonio de Azevedo Barros Filho

Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil

Read

1092

Times
was read the article

343

Total PDF

749

Total HTML

Share statistics

 array:24 [
  "pii" => "S235934821530021X"
  "issn" => "23593482"
  "doi" => "10.1016/S2359-3482(15)30021-X"
  "estado" => "S300"
  "fechaPublicacion" => "2014-09-01"
  "aid" => "30021"
  "copyright" => "Sociedade de Pediatria de S&#227;o Paulo&#46; Published by Elsevier Editora Ltda&#46; All rights reserved&#46;. All rights reserved"
  "copyrightAnyo" => "2014"
  "documento" => "article"
  "crossmark" => 0
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "rev"
  "cita" => "Rev Paul Ped. 2014;32:266-72"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 199
    "formatos" => array:3 [
      "EPUB" => 11
      "HTML" => 110
      "PDF" => 78
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2359348215300221"
    "issn" => "23593482"
    "doi" => "10.1016/S2359-3482(15)30022-1"
    "estado" => "S300"
    "fechaPublicacion" => "2014-09-01"
    "aid" => "30022"
    "copyright" => "Sociedade de Pediatria de S&#227;o Paulo&#46; Published by Elsevier Editora Ltda&#46; All rights reserved&#46;"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "rev"
    "cita" => "Rev Paul Ped. 2014;32:273-81"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 192
      "formatos" => array:3 [
        "EPUB" => 10
        "HTML" => 112
        "PDF" => 70
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Review Article</span>"
      "titulo" => "Waist circumference&#44; waist&#47;height ratio&#44; and neck circumference as parameters of central obesity assessment in children<a class="elsevierStyleCrossRef" href="#fn1"><span class="elsevierStyleSup">&#42;</span></a>"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "273"
          "paginaFinal" => "281"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Per&#237;metro da cintura&#44; rela&#231;&#227;o cintura&#47;estatura e per&#237;metro do pesco&#231;o como par&#226;metros na avalia&#231;&#227;o da obesidade central em crian&#231;as"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "pt" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig1"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 832
              "Ancho" => 1000
              "Tamanyo" => 88941
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spara10" class="elsevierStyleSimplePara elsevierViewall">Flow chart of article search and obtained results&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Elma Izze da Silva Magalh&#227;es, Luciana Ferreira da Rocha Sant&#39;Ana, Silvia Eloiza Priore, Sylvia do Carmo Castro Franceschini"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Elma Izze"
              "apellidos" => "da Silva Magalh&#227;es"
            ]
            1 => array:2 [
              "nombre" => "Luciana Ferreira da Rocha"
              "apellidos" => "Sant&#39;Ana"
            ]
            2 => array:2 [
              "nombre" => "Silvia Eloiza"
              "apellidos" => "Priore"
            ]
            3 => array:2 [
              "nombre" => "Sylvia do Carmo Castro"
              "apellidos" => "Franceschini"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2359348215300221?idApp=UINPBA00004N"
    "url" => "/23593482/0000003200000003/v1_201507170117/S2359348215300221/v1_201507170117/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S2359348215300208"
    "issn" => "23593482"
    "doi" => "10.1016/S2359-3482(15)30020-8"
    "estado" => "S300"
    "fechaPublicacion" => "2014-09-01"
    "aid" => "30020"
    "copyright" => "Sociedade de Pediatria de S&#227;o Paulo&#46; Published by Elsevier Editora Ltda&#46; All rights reserved&#46;"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "rev"
    "cita" => "Rev Paul Ped. 2014;32:257-65"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 258
      "formatos" => array:3 [
        "EPUB" => 13
        "HTML" => 122
        "PDF" => 123
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Review Article</span>"
      "titulo" => "Mother-child bonding assessment tools<a class="elsevierStyleCrossRef" href="#fn1"><span class="elsevierStyleSup">&#42;</span></a>"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "257"
          "paginaFinal" => "265"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Instrumentos de avalia&#231;&#227;o do v&#237;nculo entre m&#227;e e beb&#234;"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "pt" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig1"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1918
              "Ancho" => 2068
              "Tamanyo" => 435380
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spara10" class="elsevierStyleSimplePara elsevierViewall">Flowchart for article selection</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Jaqueline Galdino Albuquerque Perrelli, Carla Fonseca Zambaldi, Amaury Cantilino, Everton Botelho Sougey"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Jaqueline Galdino Albuquerque"
              "apellidos" => "Perrelli"
            ]
            1 => array:2 [
              "nombre" => "Carla Fonseca"
              "apellidos" => "Zambaldi"
            ]
            2 => array:2 [
              "nombre" => "Amaury"
              "apellidos" => "Cantilino"
            ]
            3 => array:2 [
              "nombre" => "Everton Botelho"
              "apellidos" => "Sougey"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2359348215300208?idApp=UINPBA00004N"
    "url" => "/23593482/0000003200000003/v1_201507170117/S2359348215300208/v1_201507170117/en/main.assets"
  ]
  "en" => array:21 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Review Article</span>"
    "titulo" => "Factors that influence bone mass of healthy children and adolescents measured by quantitative ultrasound at the hand phalanges&#58; a systematic review<a class="elsevierStyleCrossRef" href="#fn1"><span class="elsevierStyleSup">&#42;</span></a>"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "266"
        "paginaFinal" => "272"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Tathyane Krahenb&#252;hl, Ezequiel Moreira Gon&#231;alves, Eduardo Tavares Costa, Antonio de Azevedo Barros Filho"
        "autores" => array:4 [
          0 => array:4 [
            "nombre" => "Tathyane"
            "apellidos" => "Krahenb&#252;hl"
            "email" => array:1 [
              0 => "tathy04n&#64;gmail&#46;com"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor1"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "Ezequiel Moreira"
            "apellidos" => "Gon&#231;alves"
          ]
          2 => array:2 [
            "nombre" => "Eduardo Tavares"
            "apellidos" => "Costa"
          ]
          3 => array:2 [
            "nombre" => "Antonio de Azevedo Barros"
            "apellidos" => "Filho"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Universidade Estadual de Campinas &#40;UNICAMP&#41;&#44; Campinas&#44; SP&#44; Brazil"
            "identificador" => "aff1"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor1"
            "etiqueta" => "&#42;"
            "correspondencia" => "Corresponding author"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "Fatores que influenciam a massa &#243;ssea de crian&#231;as e adolescentes saud&#225;veis mensurada pelo ultrassom quantitativo de falanges&#58; revis&#227;o sistem&#225;tica"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig1"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1328
            "Ancho" => 999
            "Tamanyo" => 139161
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spara10" class="elsevierStyleSimplePara elsevierViewall">Prisma Fluxograma</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="cesec10" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle130">Introduction</span><p id="para70" class="elsevierStylePara elsevierViewall">Childhood and adolescence are important phases for the development of peak bone mass&#44; as it is the time when there is a gradual increase in bone tissue&#44; with the predominance of formation in relation to absorption&#46;<a class="elsevierStyleCrossRef" href="#bib1"><span class="elsevierStyleSup">1</span></a> Several aspects may influence the process of increasing bone mass&#44; such as genetic&#44; hormonal&#44; and nutritional factors&#44; as well as physical activity&#46;<a class="elsevierStyleCrossRefs" href="#bib1"><span class="elsevierStyleSup">1&#44;2</span></a></p><p id="para80" class="elsevierStylePara elsevierViewall">There are several methods to measure bone mass in pediatric age ranges&#44; which are different regarding the techniques and assessed anatomical sites&#44; and all present advantages and disadvantages&#46; The method considered to be the gold standard is dual-energy x-ray absorptiometry &#40;DXA&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib3"><span class="elsevierStyleSup">3</span></a> but this method is influenced by changes in bone size during growth and may underestimate bone mineral density &#40;BMD&#41; in small individuals and overestimate it in larger individuals&#44; in addition to not providing information regarding bone quality&#46;<a class="elsevierStyleCrossRef" href="#bib2"><span class="elsevierStyleSup">2</span></a> In recent years&#44; quantitative ultrasound &#40;QUS&#41; of the phalanges has been widely used as it is an easily accessible&#44; low-cost&#44; non-invasive&#44; non-ionizing&#44; and portable technology&#44;<a class="elsevierStyleCrossRefs" href="#bib4"><span class="elsevierStyleSup">4&#8211;6</span></a> which uses the speed of sound as a principle to assess bone mass in the proximal phalanges of the hand&#44; a site sensitive to bone alterations that occur during growth<a class="elsevierStyleCrossRefs" href="#bib7"><span class="elsevierStyleSup">7&#8211;9</span></a> and is less influenced by bone size&#46;<a class="elsevierStyleCrossRefs" href="#bib9"><span class="elsevierStyleSup">9&#44;10</span></a></p><p id="para90" class="elsevierStylePara elsevierViewall">Understanding the factors that determine the process of acquisition during bone tissue maturation and which techniques can be used to properly assess bone mass allows for the creation of strategies for intervention and prevention of disorders and alterations in that tissue&#44; preventing early onset of osteogenic diseases&#46; However&#44; it is yet to be determined which factors are more important or show more interference during these periods&#46; Thus&#44; this study aimed to analyze the main factors that influence bone mass in children and adolescents assessed by QUS of the phalanges&#46;</p></span><span id="cesec20" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle140">Methods</span><p id="para100" class="elsevierStylePara elsevierViewall">This is a systematic review of the literature on the QUS of the phalanges method in healthy children and adolescents&#46; The Prism Preferred Reporting Items for Systematic reviews and Meta-Analyses &#40;PRISM&#41; <a class="elsevierStyleCrossRef" href="#bib11"><span class="elsevierStyleSup">11</span></a> method was used as a reference&#46;</p><p id="para110" class="elsevierStylePara elsevierViewall">Initially&#44; it was done an article research in PubMed&#44; Bireme&#44; and SciELO databases&#44; between 2001 and 2012&#46; The search was performed by two authors &#40;TK and EMG&#41; at different times&#44; guided by a librarian&#44; in English and Portuguese&#46; The keywords used for the search were&#58; children&#44; adolescent&#44; ultrasonography finger phalanges&#44; quantitative ultrasound of phalanges&#44; phalangeal quantitative ultrasound&#44; using &#8220;and&#8221; or &#8220;or&#8221;&#46;</p><p id="para120" class="elsevierStylePara elsevierViewall">Based on the analysis of titles and abstracts&#44; 69 articles were identified in the databases&#44; of which 48 were excluded and 21 were included in this study&#46; The inclusion criteria for selecting the articles were&#58; studies with QUS of the phalanges with healthy children and&#47;or adolescents in Portuguese or English&#44; from 2001 to the date of the survey&#46;</p><p id="para130" class="elsevierStylePara elsevierViewall">The criteria for excluding articles were&#58; studies with individuals with disorders or diseases &#40;n&#61;33&#41;&#59; in languages other than English or Portuguese &#40;n&#61;04&#41;&#59; assessing individuals outside the specified age range&#44; such as newborns and adults &#40;n&#61;3&#41;&#44; or with physical disabilities &#40;n&#61;1&#41;&#59; review articles &#40;n&#61;1&#41;&#59; response letters &#40;n&#61;1&#41;&#59; and others who did not meet the inclusion criteria &#40;n&#61;5&#41;&#44; as shown in <a class="elsevierStyleCrossRef" href="#fig1">Fig&#46; 1</a>&#46;</p><elsevierMultimedia ident="fig1"></elsevierMultimedia></span><span id="cesec30" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle150">Results and Discussion</span><p id="para140" class="elsevierStylePara elsevierViewall">The summaries of the articles are presented in <a class="elsevierStyleCrossRef" href="#tbl1">Table 1</a>&#46; All selected articles were published between 2001 and 2012&#46; These articles showed an association between ultrasound parameters and variables such as gender &#40;10&#41;&#44; physical activity &#40;one&#41;&#44; ethnicity &#40;two&#41;&#44; genetics &#40;two&#41;&#44; anthropometric data &#40;21&#41;&#44; caloric intake &#40;two&#41;&#44; socioeconomic profile &#40;two&#41;&#44; and pubertal stage &#40;10&#41;&#46;</p><elsevierMultimedia ident="tbl1"></elsevierMultimedia></span><span id="cesec40" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle160">Gender</span><p id="para150" class="elsevierStylePara elsevierViewall">Most of the studies reported measures of amplitude-dependent speed of sound &#40;AD-SoS&#41; that were higher for females when compared to males&#46;<a class="elsevierStyleCrossRefs" href="#bib4"><span class="elsevierStyleSup">4&#44;5&#44;8&#44;10&#44;12&#8211;15</span></a> These differences are mainly found between 11 and 16 years&#46;<a class="elsevierStyleCrossRefs" href="#bib4"><span class="elsevierStyleSup">4&#44;5&#44;7&#44;8&#44;10&#44;16</span></a> Studies comparing pubertal development using the pubertal stage also observed higher values of AD-SoS for females at stages II&#44; III&#44; IV&#44;<a class="elsevierStyleCrossRefs" href="#bib5"><span class="elsevierStyleSup">5&#44;10&#44;12</span></a> and V<a class="elsevierStyleCrossRef" href="#bib16"><span class="elsevierStyleSup">16</span></a> when compared to males&#46; Moreover&#44; females aged 11-13 years had higher values of bone transmission time &#40;BTT&#41;<a class="elsevierStyleCrossRefs" href="#bib5"><span class="elsevierStyleSup">5&#44;14</span></a> when compared with males of the same age&#46; However&#44; males showed higher BTT values at ages 6-8&#44; 15-21&#44;<a class="elsevierStyleCrossRef" href="#bib14"><span class="elsevierStyleSup">14</span></a> and at 18 years&#59;<a class="elsevierStyleCrossRef" href="#bib10"><span class="elsevierStyleSup">10</span></a> regarding pubertal development&#44; males showed higher values at stages I&#44; II&#44; and V&#46;<a class="elsevierStyleCrossRef" href="#bib14"><span class="elsevierStyleSup">14</span></a></p><p id="para160" class="elsevierStylePara elsevierViewall">In contrast&#44; studies with DXA presented higher BMD values primarily in males&#44; who had higher values at the femoral neck&#44; full body&#44; hip&#44; and arm&#44;<a class="elsevierStyleCrossRefs" href="#bib17"><span class="elsevierStyleSup">17&#8211;20</span></a> whereas females presented higher BMD values for the lumbar spine&#46;<a class="elsevierStyleCrossRefs" href="#bib18"><span class="elsevierStyleSup">18&#44;20</span></a> After the end of the growth phase&#44; with increasing age&#44; the curve obtained by DXA is significantly higher for males&#44; with higher BMD values after the age of 19 years&#46;<a class="elsevierStyleCrossRef" href="#bib21"><span class="elsevierStyleSup">21</span></a></p><p id="para170" class="elsevierStylePara elsevierViewall">It was observed that females often showed higher values of AD-SoS compared to males at ages where there is greater influence of puberty&#46; At the observed ages&#44; the former are usually at the stage of early development due to the earlier start of the maturation process&#44;<a class="elsevierStyleCrossRefs" href="#bib22"><span class="elsevierStyleSup">22&#8211;24</span></a> which may explain the results obtained by phalanges QUS&#44; as this bone site is sensitive to changes in growth and maturation&#46;</p></span><span id="cesec50" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle170">Maturation</span><p id="para180" class="elsevierStylePara elsevierViewall">Maturation assessment through the stages of pubertal development is divided into pre-puberty &#40;stage I&#41;&#44; puberty &#40;stages II and III&#41;&#44; and late puberty &#40;stages IV and V&#41;&#46;</p><p id="para190" class="elsevierStylePara elsevierViewall">Most studies evidenced an increase in bone mass according to pubertal development&#46; Females showed an increase in AD-SoS values at all pubertal stages<a class="elsevierStyleCrossRefs" href="#bib7"><span class="elsevierStyleSup">7&#44;10&#44;14&#44;23</span></a> or at least from one stage to another&#46;<a class="elsevierStyleCrossRefs" href="#bib5"><span class="elsevierStyleSup">5&#44;12&#44;24&#44;25</span></a> As for BTT&#44; most studies showed an increase in relation to all pubertal stages&#46;<a class="elsevierStyleCrossRefs" href="#bib5"><span class="elsevierStyleSup">5&#44;10&#44;14</span></a> In males&#44; AD-SoS progressively increased with puberty<a class="elsevierStyleCrossRefs" href="#bib10"><span class="elsevierStyleSup">10&#44;25</span></a> or at some stage&#46;<a class="elsevierStyleCrossRefs" href="#bib5"><span class="elsevierStyleSup">5&#44;7&#44;12&#44;24</span></a> BTT increased significantly in all pubertal stages&#44;<a class="elsevierStyleCrossRefs" href="#bib10"><span class="elsevierStyleSup">10&#44;14</span></a> in stages I through IV&#44;<a class="elsevierStyleCrossRef" href="#bib5"><span class="elsevierStyleSup">5</span></a> and in late puberty&#46;<a class="elsevierStyleCrossRef" href="#bib24"><span class="elsevierStyleSup">24</span></a> Only two studies found no association between pubertal stages and QUS parameters&#46;<a class="elsevierStyleCrossRefs" href="#bib15"><span class="elsevierStyleSup">15&#44;26</span></a></p><p id="para200" class="elsevierStylePara elsevierViewall">Regarding maturational stages&#44; the results of DXA are quite similar to those of the BTT&#46; In all pubertal stages&#44; males present higher BMD values than females for total body&#44; radio&#44; hip&#44; and femur&#46;<a class="elsevierStyleCrossRef" href="#bib18"><span class="elsevierStyleSup">18</span></a></p><p id="para210" class="elsevierStylePara elsevierViewall">When the groups were compared by pubertal stage&#44; females showed higher values of AD-SoS in stages III and IV when compared to males&#46; This result can be explained by the fact that the period of childhood and adolescence is characterized by a high rate of bone formation and&#44; therefore&#44; by gain in the amount of bone tissue&#46; As the phalanges are more sensitive to general hormonal and osteometabolic changes for having large amounts of trabecular bone&#44;<a class="elsevierStyleCrossRef" href="#bib16"><span class="elsevierStyleSup">16</span></a>the fact that females mature earlier can directly influence the results found in studies with QUS of the phalanges&#46;</p><p id="para220" class="elsevierStylePara elsevierViewall">The results of the ultrasound are similar to those found by DXA when comparing the maturational stages between individuals of the same gender&#46; BMD progressively increases between maturational stages in both genders in the different sites analyzed&#44; such as the lumbar spine&#44; femur&#44; and whole body&#44;<a class="elsevierStyleCrossRefs" href="#bib19"><span class="elsevierStyleSup">19&#44;20&#44;27&#8211;29</span></a> corroborating the results of the QUS&#46; That is&#44; the data indicate that pubertal development is one of the factors that influence bone mass&#44; and is positively associated with age&#44; weight&#44; height&#44; and BMI&#44; confirming that the development and increase of bone mass are directly associated with maturation and growth aspects&#46;</p><p id="para230" class="elsevierStylePara elsevierViewall">The studies also demonstrated that&#44; after a period of increase in peak bone mass&#44; males showed higher values of the ultrasound parameters&#44; indicating greater amount of bone mass&#44; as observed in studies using DXA&#46;</p></span><span id="cesec60" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle180">Anthropometrics and body composition</span><p id="para240" class="elsevierStylePara elsevierViewall">Studies have demonstrated that both AD-SoS and BTT increased progressively with age and height in both genders&#46;<a class="elsevierStyleCrossRefs" href="#bib4"><span class="elsevierStyleSup">4&#44;10&#44;12&#8211;14&#44;23&#44;25&#44;30</span></a> Studies have also reported a positive correlation between AD-SoS and anthropometric variables&#44; such as weight and height&#44;<a class="elsevierStyleCrossRefs" href="#bib4"><span class="elsevierStyleSup">4&#44;13&#44;15&#44;16&#44;25&#44;31&#8211;33</span></a> BMI&#44;<a class="elsevierStyleCrossRefs" href="#bib15"><span class="elsevierStyleSup">15&#44;16</span></a> mean width of the fingers&#44;<a class="elsevierStyleCrossRef" href="#bib12"><span class="elsevierStyleSup">12</span></a> waist and hip circumference&#44;<a class="elsevierStyleCrossRef" href="#bib16"><span class="elsevierStyleSup">16</span></a> lean body mass&#44;<a class="elsevierStyleCrossRefs" href="#bib10"><span class="elsevierStyleSup">10&#44;15</span></a> fat mass&#44; fat mass index&#44; and body fat percentage&#46;<a class="elsevierStyleCrossRef" href="#bib16"><span class="elsevierStyleSup">16</span></a> BTT showed a positive correlation with age&#44; weight&#44; height&#44; BMI&#44;<a class="elsevierStyleCrossRefs" href="#bib5"><span class="elsevierStyleSup">5&#44;14&#44;25</span></a> and lean mass&#46;<a class="elsevierStyleCrossRef" href="#bib10"><span class="elsevierStyleSup">10</span></a> Likewise&#44; studies that analyzed the association between BMD&#44; evaluated at several sites using DXA and anthropometric parameters &#40;age&#44; weight&#44; height&#44; and BMI&#41;&#44; observed a positive correlation in both genders&#44;<a class="elsevierStyleCrossRefs" href="#bib19"><span class="elsevierStyleSup">19&#44;21&#44;27</span></a> noting that lean mass exerts influence on BMD of the lumbar spine<a class="elsevierStyleCrossRef" href="#bib20"><span class="elsevierStyleSup">20</span></a> and is related to the BMD of arms and legs in both genders&#46;<a class="elsevierStyleCrossRef" href="#bib34"><span class="elsevierStyleSup">34</span></a></p></span><span id="cesec70" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle190">Physical activity</span><p id="para250" class="elsevierStylePara elsevierViewall">Only one study observed that the values of AD-SoS&#44; T-score&#44; and Z-score were significantly higher for men who practiced karate&#44; and AD-SoS positively related them to time and weekly frequency of training&#46;<a class="elsevierStyleCrossRef" href="#bib35"><span class="elsevierStyleSup">35</span></a></p><p id="para260" class="elsevierStylePara elsevierViewall">In a similar study using DXA&#44; a group of wrestling athletes had higher BMD values of the whole body&#44; lumbar spine&#44; legs&#44; and arms than the sedentary group&#46;<a class="elsevierStyleCrossRef" href="#bib34"><span class="elsevierStyleSup">34</span></a> When assessing physical activity and bone mass by DXA&#44; physical activity has a positive correlation with BMD of the femoral neck&#44; hip&#44; and whole body<a class="elsevierStyleCrossRef" href="#bib29"><span class="elsevierStyleSup">29</span></a>&#46; Studies with children and adolescent athletes suggest that physical exercise is positively associated with the individuals&#39; BMD results&#46;<a class="elsevierStyleCrossRefs" href="#bib36"><span class="elsevierStyleSup">36&#44;37</span></a></p><p id="para270" class="elsevierStylePara elsevierViewall">Due to the scarce number of studies that address the assessment of QUS with physical activity&#44; it is not possible to establish parameters concerning the data presented&#46; Therefore&#44; more studies are necessary involving physical activity and QUS evaluation of phalanges to elucidate the reliability of its use&#46;</p></span><span id="cesec80" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle200">Genetics</span><p id="para280" class="elsevierStylePara elsevierViewall">Two studies involving genetic factors were retrieved&#46; Drozdzowska <span class="elsevierStyleItalic">et al</span><a class="elsevierStyleCrossRef" href="#bib31"><span class="elsevierStyleSup">31</span></a>and Guglielmi <span class="elsevierStyleItalic">et al</span><a class="elsevierStyleCrossRef" href="#bib38"><span class="elsevierStyleSup">38</span></a> found that the differences between monozygotic and dizygotic twins are influenced mainly by environmental factors and lifestyle&#44; and that AD-SoS significantly increased with age for both genders&#46; The authors also observed that the intra-pair correlation coefficient of AD-SoS is stronger in monozygotic than in dizygotic twins&#46;</p><p id="para290" class="elsevierStylePara elsevierViewall">When DXA was used&#44; similar results were found&#44; with a higher correlation of BMD among monozygotic twins and a lower correlation between parents and children&#44; showing that 51&#37; to 76&#37; of the variation in BMD is hereditary&#46;<a class="elsevierStyleCrossRef" href="#bib39"><span class="elsevierStyleSup">39</span></a> More studies are needed in relation to genetic factors&#44; as there is an apparent genetic affinity in relation to bone mass in monozygotic and dizygotic twins&#44; and differences are predicted by anthropometric variables&#46;</p></span><span id="cesec90" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle210">Ethnicity</span><p id="para300" class="elsevierStylePara elsevierViewall">Regarding ethnic classification&#44; two studies showed differences between the groups classified as blacks or whites&#46; When divided into blacks and whites&#44; regardless of gender&#44; the former showed lower values of AD-SoS&#46; When divided by ethnicity and gender&#44; white females had higher values of AD-SoS than the other three groups&#46; White males showed higher values of AD-SoS when compared to black males&#46;<a class="elsevierStyleCrossRefs" href="#bib23"><span class="elsevierStyleSup">23&#44;40</span></a></p><p id="para310" class="elsevierStylePara elsevierViewall">Differently from the results of QUS of the phalanges&#44; Fonseca <span class="elsevierStyleItalic">et al</span><a class="elsevierStyleCrossRef" href="#bib27"><span class="elsevierStyleSup">27</span></a> observed a negative correlation of BMD with skin pigmentation in adolescent females&#46; However&#44; the author reports that this correlation is incorrect&#44; because of the great diversity of the Brazilian population&#46; Another study demonstrated that white&#44; non-Hispanic individuals are more likely to have fractures than non-white individuals with lower BMD values of whole body&#44; lumbar spine&#44; forearm and femur&#46; Furthermore&#44; studies present significantly higher BMD values in black males when compared to whites&#46;<a class="elsevierStyleCrossRefs" href="#bib41"><span class="elsevierStyleSup">41&#44;42</span></a></p><p id="para320" class="elsevierStylePara elsevierViewall">Additionally&#44; in studies with DXA&#44; it was observed that Asians had lower BMD values than whites of similar age and gender&#46;<a class="elsevierStyleCrossRef" href="#bib43"><span class="elsevierStyleSup">43</span></a> However&#44; the differences found in the results may be more related to hereditary and environmental factors&#44; as the studies were conducted in different countries and ethnic groups&#44; with great diversity in the gene pool of populations&#44; preventing comparisons&#46;</p></span><span id="cesec100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle220">Socioeconomic profile</span><p id="para330" class="elsevierStylePara elsevierViewall">Two studies assessed the socioeconomic profile&#44; but the classification was used solely to describe the groups&#44; not comparing with the QUS parameters&#46;<a class="elsevierStyleCrossRefs" href="#bib16"><span class="elsevierStyleSup">16&#44;23</span></a> Thus&#44; further studies using the QUS of phalanges to assess bone mass in different socioeconomic profiles are suggested&#44; as the DXA results demonstrated that groups of lower socioeconomic status had lower BMD&#46;<a class="elsevierStyleCrossRef" href="#bib18"><span class="elsevierStyleSup">18</span></a></p></span><span id="cesec110" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle230">Nutrient intake</span><p id="para340" class="elsevierStylePara elsevierViewall">Two studies assessed the association between caloric intake and the parameters of QUS of the phalanges&#46; Dib <span class="elsevierStyleItalic">et al</span><a class="elsevierStyleCrossRef" href="#bib10"><span class="elsevierStyleSup">10</span></a> evaluated the intake of calcium and vitamin D and found no significant correlation between calcium intake and ultrasound parameters in both genders&#46; Lavado-Garcia <span class="elsevierStyleItalic">et al</span><a class="elsevierStyleCrossRef" href="#bib15"><span class="elsevierStyleSup">15</span></a> demonstrated that AD-SoS was negatively correlated with the intake of calcium&#44; iron&#44; magnesium&#44; and calcium&#47;protein ratio in females&#44; with no association between nutrient intake and ultrasound parameters in males&#46;</p><p id="para350" class="elsevierStylePara elsevierViewall">Although nutrition has great influence on bone health of individuals&#44; there have been few studies investigating the association between caloric intake and parameters of QUS of the phalanges&#46; The authors suggest further studies in this area&#46;</p></span><span id="cesec120" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle240">Limitations and conclusions</span><p id="para360" class="elsevierStylePara elsevierViewall">The first important limitation is that the studies included in this systematic review were mostly cross-sectional&#44; and only two were longitudinal studies&#44; with a follow-up of one and two years&#46; Furthermore&#44; the studies differed regarding the dominance of the evaluated limb and had different numbers of evaluated subjects&#44; which may be a bias in their findings&#46;</p><p id="para370" class="elsevierStylePara elsevierViewall">Despite the limitations described above&#44; it can be concluded that the QUS of phalanges is a good method to evaluate the progressive acquisition of bone mass during the growth and maturation of school-age individuals&#44; by monitoring alterations that occur with increasing age and pubertal stage&#46; A positive influence was observed&#44; especially of the variables gender&#44; maturation&#44; height&#44; weight&#44; and BMI&#44; and data was similar when compared to DXA&#44; which is the gold standard method&#46; However&#44; there is only a small number of studies that compared both methods&#46; The scientific literature is scarce regarding physical activity&#44; hormone levels&#44; ethnicity&#44; genetics&#44; and caloric intake&#44; and therefore it is not possible to clarify the influence of these factors on the parameters of QUS of the phalanges&#46;</p><p id="para380" class="elsevierStylePara elsevierViewall">Moreover&#44; there were few studies comparing the QUS and DXA methods&#44; without clarifying the difference in results when comparing the parameters of bone mass in relation to gender&#46;</p><p id="para390" class="elsevierStylePara elsevierViewall">Despite the advantages already described for the QUS of the phalanges&#44; and the fact that it is an accessible&#44; low cost&#44; portable&#44; and non-invasive method&#44; further studies are needed regarding its use in regular bone assessment of children and adolescents&#46;</p></span><span id="cesec130" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle250">Conflicts of interest</span><p id="para400" class="elsevierStylePara elsevierViewall">The authors declare no conflicts of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:19 [
        0 => array:3 [
          "identificador" => "xres533994"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "ceabs10"
              "titulo" => "Objective"
            ]
            1 => array:2 [
              "identificador" => "ceabs20"
              "titulo" => "Data source"
            ]
            2 => array:2 [
              "identificador" => "ceabs30"
              "titulo" => "Data synthesis"
            ]
            3 => array:2 [
              "identificador" => "ceabs40"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec554373"
          "titulo" => "KEYWORDS"
        ]
        2 => array:3 [
          "identificador" => "xres533995"
          "titulo" => "Resumo"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "ceabs50"
              "titulo" => "Objetivo"
            ]
            1 => array:2 [
              "identificador" => "ceabs60"
              "titulo" => "Fonte de dados"
            ]
            2 => array:2 [
              "identificador" => "ceabs70"
              "titulo" => "S&#237;ntese dos dados"
            ]
            3 => array:2 [
              "identificador" => "ceabs80"
              "titulo" => "Conclus&#245;es"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec554374"
          "titulo" => "PALAVRAS-CHAVE"
        ]
        4 => array:2 [
          "identificador" => "cesec10"
          "titulo" => "Introduction"
        ]
        5 => array:2 [
          "identificador" => "cesec20"
          "titulo" => "Methods"
        ]
        6 => array:2 [
          "identificador" => "cesec30"
          "titulo" => "Results and Discussion"
        ]
        7 => array:2 [
          "identificador" => "cesec40"
          "titulo" => "Gender"
        ]
        8 => array:2 [
          "identificador" => "cesec50"
          "titulo" => "Maturation"
        ]
        9 => array:2 [
          "identificador" => "cesec60"
          "titulo" => "Anthropometrics and body composition"
        ]
        10 => array:2 [
          "identificador" => "cesec70"
          "titulo" => "Physical activity"
        ]
        11 => array:2 [
          "identificador" => "cesec80"
          "titulo" => "Genetics"
        ]
        12 => array:2 [
          "identificador" => "cesec90"
          "titulo" => "Ethnicity"
        ]
        13 => array:2 [
          "identificador" => "cesec100"
          "titulo" => "Socioeconomic profile"
        ]
        14 => array:2 [
          "identificador" => "cesec110"
          "titulo" => "Nutrient intake"
        ]
        15 => array:2 [
          "identificador" => "cesec120"
          "titulo" => "Limitations and conclusions"
        ]
        16 => array:2 [
          "identificador" => "cesec130"
          "titulo" => "Conflicts of interest"
        ]
        17 => array:2 [
          "identificador" => "xack181148"
          "titulo" => "Acknowledgements"
        ]
        18 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2013-12-19"
    "fechaAceptado" => "2014-03-05"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "KEYWORDS"
          "identificador" => "xpalclavsec554373"
          "palabras" => array:6 [
            0 => "Children"
            1 => "Adolescent"
            2 => "Finger phalanges"
            3 => "Ultrasonography"
            4 => "Bone development"
            5 => "Bone density"
          ]
        ]
      ]
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "PALAVRAS-CHAVE"
          "identificador" => "xpalclavsec554374"
          "palabras" => array:6 [
            0 => "Crian&#231;a"
            1 => "Adolescente"
            2 => "Falanges dos dedos da m&#227;o"
            3 => "Ultrassonografia"
            4 => "Desenvolvimento &#243;sseo"
            5 => "Densidade &#243;ssea"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="ceabs10" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle20">Objective</span><p id="spara30" class="elsevierStyleSimplePara elsevierViewall">To analyze the main factors that influence bone mass in children and teenagers assessed by quantitative ultrasound &#40;QUS&#41; of the phalanges&#46;</p></span> <span id="ceabs20" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle30">Data source</span><p id="spara40" class="elsevierStyleSimplePara elsevierViewall">A systematic literature review was performed according to the PRISMA method with searches in databases Pubmed&#47;Medline&#44; SciELO and Bireme for the period 2001-2012&#44; in English and Portuguese languages&#44; using the keywords&#58; children&#44; teenagers&#44; adolescent&#44; ultrasound finger phalanges&#44; quantitative ultrasound of phalanges&#44; phalangeal quantitative ultrasound&#46;</p></span> <span id="ceabs30" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle40">Data synthesis</span><p id="spara50" class="elsevierStyleSimplePara elsevierViewall">21 articles were included&#46; Girls had&#44; in QUS&#44; Amplitude Dependent Speed of Sound &#40;AD-SoS&#41; values higher than boys during pubertal development&#46; The values of the parameters of QUS of the phalanges and dual-energy X-ray Absorptiometry &#40;DXA&#41; increased with the increase of the maturational stage&#46; Anthropometric variables such as age&#44; weight&#44; height&#44; body mass index &#40;BMI&#41;&#44; lean mass showed positive correlations with the values of QUS of the phalanges&#46; Physical activity has also been shown to be positively associated with increased bone mass&#46; Factors such as ethnicity&#44; genetics&#44; caloric intake and socioeconomic profile have not yet shown a conclusive relationship and need a larger number of studies&#46;</p></span> <span id="ceabs40" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle50">Conclusions</span><p id="spara60" class="elsevierStyleSimplePara elsevierViewall">QUS of the phalanges is a method used to evaluate the progressive acquisition of bone mass during growth and maturation of individuals in school phase&#44; by monitoring changes that occur with increasing age and pubertal stage&#46; There were mainly positive influences variables of sex&#44; maturity&#44; height&#44; weight and BMI&#44; with similar data when compared to the gold standard method&#44; the DXA&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "ceabs10"
            "titulo" => "Objective"
          ]
          1 => array:2 [
            "identificador" => "ceabs20"
            "titulo" => "Data source"
          ]
          2 => array:2 [
            "identificador" => "ceabs30"
            "titulo" => "Data synthesis"
          ]
          3 => array:2 [
            "identificador" => "ceabs40"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "pt" => array:3 [
        "titulo" => "Resumo"
        "resumen" => "<span id="ceabs50" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle70">Objetivo</span><p id="spara70" class="elsevierStyleSimplePara elsevierViewall">Analisar quais os principais fatores que influenciam na massa &#243;ssea de crian&#231;as e adolescentes avaliada pelo ultrassom quantitativo &#40;QUS&#41; de falanges&#46;</p></span> <span id="ceabs60" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle80">Fonte de dados</span><p id="spara80" class="elsevierStyleSimplePara elsevierViewall">Foi realizada revis&#227;o sistem&#225;tica da literatura&#44; de acordo com o m&#233;todo Prisma&#44; com buscas nas bases de dados do Pubmed&#47;Medline&#44; Bireme e Scielo&#44; referente ao per&#237;odo de 2001 a 2012&#44; nos idiomas ingl&#234;s e portugu&#234;s&#44; utilizando os descritores <span class="elsevierStyleItalic">children&#44; adolescent&#44; ultrassonography finger phalanges&#44; quantitative ultrasound of phalanges&#44; phalangeal quantitative ultrasound</span>&#46;</p></span> <span id="ceabs70" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle90">S&#237;ntese dos dados</span><p id="spara90" class="elsevierStyleSimplePara elsevierViewall">Foram inclu&#237;dos 21 artigos&#46; As meninas apresentaram no QUS valores de Amplitude Dependent Speed of Sound &#40;AD-SoS&#41; superiores aos meninos durante o desenvolvimento puberal&#46; Os valores dos par&#226;metros do QUS de falanges aumentaram com o incremento do est&#225;dio maturacional&#44; assim como ocorre com o Dual-energy X-ray Absorptiometry &#40;DXA&#41;&#46; Vari&#225;veis antropom&#233;tricas&#44; como idade&#44; peso&#44; estatura&#44; &#237;ndice de massa corporal &#40;IMC&#41; e massa magra&#44; demonstraram correla&#231;&#245;es positivas com os valores do QUS de falanges&#46; A atividade f&#237;sica tamb&#233;m demonstrou estar positivamente relacionada ao aumento da massa &#243;ssea&#46; Fatores como etnia&#44; gen&#233;tica&#44; ingest&#227;o cal&#243;rica e perfil socioecon&#244;mico ainda n&#227;o mostraram rela&#231;&#227;o conclusiva e necessitam um n&#250;mero maior de estudos&#46;</p></span> <span id="ceabs80" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle100">Conclus&#245;es</span><p id="spara100" class="elsevierStyleSimplePara elsevierViewall">O QUS de falanges &#233; um m&#233;todo indicado para avaliar a progressiva aquisi&#231;&#227;o da massa &#243;ssea durante o crescimento e a matura&#231;&#227;o dos indiv&#237;duos em fase escolar&#44; por acompanhar as altera&#231;&#245;es que ocorrem com o aumento da idade e do est&#225;dio puberal&#46; Observou-se influ&#234;ncia positiva&#44; principalmente das vari&#225;veis de sexo&#44; matura&#231;&#227;o&#44; estatura&#44; peso e IMC&#44; sendo seus dados semelhantes quando comparados ao m&#233;todo padr&#227;o-ouro&#44; o DXA&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "ceabs50"
            "titulo" => "Objetivo"
          ]
          1 => array:2 [
            "identificador" => "ceabs60"
            "titulo" => "Fonte de dados"
          ]
          2 => array:2 [
            "identificador" => "ceabs70"
            "titulo" => "S&#237;ntese dos dados"
          ]
          3 => array:2 [
            "identificador" => "ceabs80"
            "titulo" => "Conclus&#245;es"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:3 [
        "etiqueta" => "&#42;"
        "nota" => "<p class="elsevierStyleNotepara" id="cenpara10">Study conducted at Faculdade de Ci&#234;ncias M&#233;dicas da Universidade Estadual de Campinas&#44; Campinas&#44; SP&#44; Brazil&#46;</p>"
        "identificador" => "fn1"
      ]
    ]
    "multimedia" => array:2 [
      0 => array:7 [
        "identificador" => "fig1"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1328
            "Ancho" => 999
            "Tamanyo" => 139161
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spara10" class="elsevierStyleSimplePara elsevierViewall">Prisma Fluxograma</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "tbl1"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sample&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Design&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Parameters&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Hand&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Results&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;328 Germans &#40;M&#47;F&#41; 3 to 17 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross&#8211;sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AD&#8211;SoS BTT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Right&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Both increased with age and height&#46; Higher values of AD&#8211;SoS in females&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">256 Lebanese &#40;M&#47;F&#41; 11 to 18 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross&#8211;sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AD&#8211;SoS BTT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Non&#8211;dominant&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Increased with age and pubertal stage&#44; positive correlation with age&#44; height&#44; and lean mass&#46; Higher AD&#8211;SoS in females&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;083 Italians &#40;M&#47;F&#41; 3 to 21 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross&#8211;sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AD&#8211;SoS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Non&#8211;dominant&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Increased with age and pubertal stage&#46; Higher values in females&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;020 Polish &#40;M&#47;F&#41; 7 to 19 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross&#8211;sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AD&#8211;SoS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dominant&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Increased with age&#46; Higher values in females&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">245 Spanish &#40;M&#47;F&#41; 4 to 16 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross&#8211;sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AD&#8211;SoS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Non&#8211; dominant&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Higher values in females&#46; Increased with age&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;227 Italians &#40;M&#47;F&#41; 3 a 16 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross&#8211;sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AD&#8211;SoS BTT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Non&#8211; dominant&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Increased with age and pubertal stage&#46; Higher values in females&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">150 Polish &#40;M&#47;F&#41; 14 to 19 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross&#8211;sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AD&#8211;SoS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dominant&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Higher values for females&#46; Positively correlated with age&#44; height&#44; and pubertal stage&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;044 Italians &#40;M&#47;F&#41; 2 to 21 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross&#8211;sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AD&#8211;SoS BTT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Non&#8211;dominant&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Both increased with age&#44; weight&#44; height&#44; BMI&#44; and pubertal stage&#46; Higher AD&#8211;SoS in females and BTT in males&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">267 Brazilians &#40;M&#47;F&#41; 8 to 18 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross&#8211;sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AD&#8211;SoS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Non&#8211;dominant&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Positive correlation with age&#44; weight&#44; height&#44; BMI&#44; lean mass&#44; waist circumference&#44; and hip circumference&#46; Negative correlation with waist&#8211;to&#8211;hip ratio&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;775 Brazilians &#40;F&#41; 8 to 17 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross&#8211;sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AD&#8211;SoS BTT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Non&#8211;dominant&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Increased with age and pubertal stage&#46; Positive correlation with age&#44; height&#44; and pubertal stage&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;850 Polish &#40;F&#41; 7 to 77 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross&#8211;sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AD&#8211;SoS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dominant&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Significant increase from 11&#8211;16 years&#46; Peak at 19 years&#46; From 7 to 11 years&#44; age and height positive and weight negative&#46; From 12 to 19 years&#44; is age&#8211;dependent&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;175 Polish &#40;M&#41; 7 to 80 years&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross&#8211;sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AD&#8211;SoS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dominant&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Significant increase after 13 years&#46; Correlation with weight and height&#46; From 14 to 28 years&#44; it is highly dependent on age&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">106 Monozygotic twins &#40;M&#47;F&#41; &#8211; 5 to 71 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross&#8211; sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AD&#8211;SoS&#44; UBPI SDy&#44; BTT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Non&#8211;dominant&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Age and height are predictors of differences between pairs&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><ul class="elsevierStyleList" id="celist10"><li class="elsevierStyleListItem" id="celistitem10"><p id="para10" class="elsevierStylePara elsevierViewall">83 mono and dizygotic</p></li><li class="elsevierStyleListItem" id="celistitem20"><p id="para20" class="elsevierStylePara elsevierViewall">Polish twins &#40;M&#47;F&#41;&#8211; 15 to 23 years</p></li></ul>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross&#8211; sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AD&#8211;SoS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dominant&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><ul class="elsevierStyleList" id="celist20"><li class="elsevierStyleListItem" id="celistitem30"><p id="para30" class="elsevierStylePara elsevierViewall">Stronger correlation in monozygotic twins&#46;</p></li><li class="elsevierStyleListItem" id="celistitem40"><p id="para40" class="elsevierStylePara elsevierViewall">Intra&#8211;pair difference influenced by age&#46;</p></li></ul>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">226 Polish Karate fighters and 44 sedentary individuals &#40;M&#41; &#8211; 8 to 62 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross&#8211;sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AD&#8211;SoS T&#8211;Score Z&#8211;Score&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dominant&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Higher values in karate fighters&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><ul class="elsevierStyleList" id="celist30"><li class="elsevierStyleListItem" id="celistitem50"><p id="para50" class="elsevierStylePara elsevierViewall">38 preterm and 50 full&#8211;term</p></li><li class="elsevierStyleListItem" id="celistitem60"><p id="para60" class="elsevierStylePara elsevierViewall">Polish &#40;M&#47;F&#41; &#8211; 9 to 11 years</p></li></ul>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross&#8211;sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AD&#8211;SoS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dominant&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">There were no statistical differences between groups&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;356 Brazilians &#40;M&#47;F&#41; 6 to 11 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross&#8211;sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AD&#8211;SoS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Non&#8211; dominant&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Increased with age&#46; Higher values in white females&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;356 Brazilians &#40;M&#47;F&#41; &#8211; 6 to 11 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross&#8211; sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AD&#8211;SoS UBPI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Non&#8211; dominant&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Increased with age and pubertal stage&#46; Both higher in white females than African&#8211;descendants&#46; UBPI higher in whites females than in African&#8211;descendants&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50 Austrians with fractures and 154 with no fractures&#44; &#40;M&#47;F&#41; &#8211; 8 to 12 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cross&#8211;sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SOS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dominant&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Lower value in the fracture group&#46; In the control group&#44; higher values in females&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">662 Italians &#40;M&#47;F&#41; 3 to 16 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Longitudinal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AD&#8211;SoS BTT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Non&#8211;dominant&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Increased with age and pubertal stage&#46; Higher values in males with delayed puberty&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">269 Polish &#40;M&#47;F&#41; 7 to 12 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Longitudinal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AD&#8211;SoS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dominant&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Higher values in females&#46; Increased significantly after 1 year&#46; Increased with pubertal stage&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab858153.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spara20" class="elsevierStyleSimplePara elsevierViewall">Main characteristics and results of articles with quantitative ultrasound &#40;QUS&#41; of the phalanges&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "cebibsec10"
          "bibliografiaReferencia" => array:43 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Establishment of peak bone mass"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => """
                              S Mora \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              V Gilsanz \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Endocrinol Metab Clin North Am"
                        "fecha" => "2003"
                        "volumen" => "32"
                        "paginaInicial" => "39"
                        "paginaFinal" => "63"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12699292"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Methods for measurement of pediatric bone"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => """
                              TL Binkley \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              R Berry \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              BL Specker \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s11154-008-9073-5"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Endocr Metab Disord"
                        "fecha" => "2008"
                        "volumen" => "9"
                        "paginaInicial" => "95"
                        "paginaFinal" => "106"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18247119"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "titulo" => "International Atomic Energy Angency &#8211; IAEA &#91;homepage on the Internet&#93;&#46; Viena&#58; Dual energy x-ray absorptiometry for bone mineral density and body composition assessment&#46; IAEA Human Health Series &#91;cited 2013 July 28&#93;"
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "WWW" => array:1 [
                        "link" => "Available from&#58; http&#58;&#47;&#47;www&#46;iaea&#46;org&#47;Publications&#47;index&#46;html"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "German pediatric reference data for quantitative transverse transmission ultrasound of finger phalanges"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              R Barkmann \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              W Rohrschneider \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              M Vierling \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              J Tr&#246;ger \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              F de Terlizzi \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              R Cadossi \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Osteoporos Int"
                        "fecha" => "2002"
                        "volumen" => "13"
                        "paginaInicial" => "55"
                        "paginaFinal" => "61"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11878455"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Influence of age&#44; sex and growth variables on phalangeal quantitative ultrasound measures&#58; a study in health children and adolescent"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => """
                              M Vignolo \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              A Brignone \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              A Mascagni \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              B Ravera \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              B Biasotti \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              G Aicardi \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Calcif Tissue Int"
                        "fecha" => "2003"
                        "volumen" => "72"
                        "paginaInicial" => "681"
                        "paginaFinal" => "688"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14562996"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => """
                              O Ianneta \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:4 [
                        "titulo" => "Osteoporose&#58; uma ex-enfermidade silenciosa"
                        "fecha" => "2006"
                        "editorial" => "Tecmedd"
                        "editorialLocalizacion" => "Ribeir&#227;o Preto"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Quantitative ultrasound measurements at hand phalanges in children and adolescents&#58; a longitudinal study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => """
                              ZP Halaba \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ultrasmedbio.2008.03.007"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ultrasound Med Biol"
                        "fecha" => "2008"
                        "volumen" => "34"
                        "paginaInicial" => "1547"
                        "paginaFinal" => "1553"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18485570"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of phalangeal ultrasound and dual energy x-ray absorptiometry in health male and female adolescents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => """
                              ZP Halaba \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              J Konstantynowicz \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              W Pluskiewicz \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              M Kaczmarski \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              J Piotrowska-Jastrzebska \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ultrasmedbio.2005.07.013"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ultrasound Med Biol"
                        "fecha" => "2005"
                        "volumen" => "31"
                        "paginaInicial" => "1617"
                        "paginaFinal" => "1622"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16344124"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Preliminary comparison between phalangeal quantitative ultrassonography and bone densitometry for bone mass evaluation in adolescents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              SB Duarte \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              WR Carvalho \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              EM Gon&#231;alves \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              RR Ribeiro \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              ES Farias \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              O Magro D de \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Arq Bras Endocrinol Metab"
                        "fecha" => "2012"
                        "volumen" => "56"
                        "paginaInicial" => "19"
                        "paginaFinal" => "24"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Impact of anthropometric&#44; lifestyle&#44; and body composition variables on ultrasound measurements in school children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => """
                              L Dib \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              A Arabi \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              J Maalouf \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              M Nabulsi \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              GF EiI-Hajj \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.bone.2005.01.009"
                      "Revista" => array:6 [
                        "tituloSerie" => "Bone"
                        "fecha" => "2005"
                        "volumen" => "36"
                        "paginaInicial" => "736"
                        "paginaFinal" => "742"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15784188"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The prisma statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions&#58; explanation and elaboration"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              A Liberati \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              DG Altman \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              J Tetzlaff \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              C Mulrow \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              PC G&#248;tzsch \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              JP Loannidis \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Plos Med"
                        "fecha" => "2009"
                        "volumen" => "6"
                        "paginaInicial" => "1"
                        "paginaFinal" => "28"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bone quality assessment by quantitative ultrasound of proximal phalanxes of the hand in healthy subjects aged 3-21 years"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => """
                              G Baroncelli \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              G Federico \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              S Bertelloni \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              F De Terlizz \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              R Cadossi \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              G Saggese \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1203/00006450-200105000-00017"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Res"
                        "fecha" => "2001"
                        "volumen" => "49"
                        "paginaInicial" => "713"
                        "paginaFinal" => "718"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11328957"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Quantitative ultrasound in the assessment of skeletal status in children and adolescents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => """
                              ZP Halaba \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              W Pluskiewicz \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ultrasmedbio.2003.10.023"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ultrasound Med Biol"
                        "fecha" => "2004"
                        "volumen" => "30"
                        "paginaInicial" => "239"
                        "paginaFinal" => "243"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14998676"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cross-sectional reference data for phalangeal quantitative ultrasound from early childhood to young-adulthood according to gender&#44; age&#44; skeletal growth&#44; and pubertal development"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              GI Baroncelli \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              G Federico \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              M Vignolo \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              G Valerio \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              A del Puente \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              M Maghnie \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.bone.2005.12.010"
                      "Revista" => array:6 [
                        "tituloSerie" => "Bone"
                        "fecha" => "2006"
                        "volumen" => "39"
                        "paginaInicial" => "159"
                        "paginaFinal" => "173"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16473568"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bone mass of Spanish school children&#58; impact of anthropometric&#44; dietary and body composition factors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => """
                              JM Lavado-Garcia \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              JF Calderon-Garcia \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              JM Moran \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              ML Canal-Macias \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              T Rodriguez-Dominguez \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              JD Pedrera-Zamorano \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00774-011-0301-9"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Bone Miner Metab"
                        "fecha" => "2012"
                        "volumen" => "30"
                        "paginaInicial" => "193"
                        "paginaFinal" => "201"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21822585"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Influence of body composition on bone mass in children and adolescents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => """
                              WR Carvalho \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              EM Gon&#231;alves \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              RR Ribeiro \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              ES Farias \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              SSP Carvalho \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              G Guerra-Junior \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Assoc Med Bras"
                        "fecha" => "2011"
                        "volumen" => "57"
                        "paginaInicial" => "662"
                        "paginaFinal" => "667"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22249546"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A longitudinal analysis of sex differences in bone mineral accrual in health 8-19 year old boys and girls"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => """
                              AD Baxter-Jones \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              RL Mirwald \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              HA McKay \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              DA Bailey \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Hum Biol"
                        "fecha" => "2003"
                        "volumen" => "30"
                        "paginaInicial" => "160"
                        "paginaFinal" => "175"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12637192"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bone mineral density by age&#44; gender&#44; pubertal stages&#44; and socioeconomic status in health Lebanese children and adolescents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => """
                              A Arabi \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              M Nabulsi \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              J Maalou \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              M Choucair \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              H Khalif&#233; \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              R Vieth \n
                              \t\t\t\t\t\t\t\t
                              """
                            6 => """
                              GF El-Hajj \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Bone"
                        "fecha" => "2004"
                        "paginaInicial" => "1169"
                        "paginaFinal" => "1179"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bone mineral density of proximal femur and spine in Korean children between 2 and 18 years of age"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              SH Lee \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              SS Desai \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              G Shetty \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              HR Song \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              SH Lee \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              CY Hur \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00774-007-0775-7"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Bone Miner Metab"
                        "fecha" => "2007"
                        "volumen" => "25"
                        "paginaInicial" => "423"
                        "paginaFinal" => "430"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17968496"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Determinants of bone mineral density&#44; bone mineral content and body composition in a cohort od health children&#58; influence of sex&#44; age puberty and physical activity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              E Ausili \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              D Rigante \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              E Savaggio \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              B Focarelli \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              C Rendeli \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              V Ansuini \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00296-011-2059-8"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rheumatol Int"
                        "fecha" => "2012"
                        "volumen" => "32"
                        "paginaInicial" => "2737"
                        "paginaFinal" => "2743"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21809005"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gender differences in bone density at different skeletal sites of acquisition with age in Chinese children and adolescents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              XP Wu \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              YH Yang \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              H Zhang \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              LQ Yuan \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              XH Luo \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              XZ Cao \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00774-004-0592-1"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Bone Miner Metab"
                        "fecha" => "2005"
                        "volumen" => "23"
                        "paginaInicial" => "253"
                        "paginaFinal" => "260"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15838629"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => """
                              RM Malina \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              C Bouchard \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              O Bar-Or \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:5 [
                        "edicion" => "2<span class="elsevierStyleSup">nd</span> ed&#46;"
                        "titulo" => "Crescimento&#44; matura&#231;&#227;o e atividade f&#237;sica"
                        "fecha" => "2009"
                        "editorial" => "Phorte"
                        "editorialLocalizacion" => "S&#227;o Paulo"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bone mass in school children in Brazil&#58; the effect of racial miscegenation&#44; pubertal stage&#44; and socioeconomic differences"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => """
                              RR Ribeiro \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              G Guerra-Junior \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              AA Barros-Filho \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00774-009-0062-x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Bone Miner Metab"
                        "fecha" => "2009"
                        "volumen" => "27"
                        "paginaInicial" => "494"
                        "paginaFinal" => "501"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19283337"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Longitudinal assement of bone quality by quantitative ultrasonography in children and adolescents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => """
                              M Vignolo \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              A Parodi \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              A Mascagni \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              C Torrisi \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              F de Terlizze \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              G Aicardi \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ultrasmedbio.2006.02.1429"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ultrasound Med Biol"
                        "fecha" => "2006"
                        "volumen" => "32"
                        "paginaInicial" => "1003"
                        "paginaFinal" => "1010"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16829314"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bone quantity and quality in Brazilian female schoolchildren and adolescents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => """
                              KD Santos \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              EL Petroski \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              RR Ribeiro \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              G Guerra-Junior \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00774-009-0067-5"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Bone Miner Metab"
                        "fecha" => "2009"
                        "volumen" => "27"
                        "paginaInicial" => "507"
                        "paginaFinal" => "512"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19326046"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Phalangeal quantitative ultrasound measurements in former pre-term children aged 9&#8211;11 years"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => """
                              ZP Halaba \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              J Bursa \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              UK Kaplon \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              W Pluskiewicz \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              S Marciniak \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              U Drzewiecka \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1259/bjr/55460700"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Radiol"
                        "fecha" => "2007"
                        "volumen" => "80"
                        "paginaInicial" => "401"
                        "paginaFinal" => "405"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17068013"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bone mineral density associated with physical traits and lifestyle in adolescents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => """
                              RM Fonseca \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              RJ de Oliveira \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              RW Pereira \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              NM Fran&#231;a \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Bras Med Esp"
                        "fecha" => "2012"
                        "volumen" => "18"
                        "paginaInicial" => "381"
                        "paginaFinal" => "384"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib28"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bone mass acquisition in female rhythmic gymnasts during puberty&#58; no direct role for leptin"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => """
                              L Ma&#239;moun \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              O Coste \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              A Jaussent \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              D Mariano-Goulart \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              C Sultan \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              F Paris \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Clin Endocrinol"
                        "fecha" => "2010"
                        "volumen" => "72"
                        "paginaInicial" => "604"
                        "paginaFinal" => "611"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib29"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bone mineral density in girls and boys at different pubertal stages&#58; relation with gonadal steroids&#44; bone formation markers&#44; and growth parameters"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => """
                              D Yilmaz \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              B Ersoy \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              E Bilgin \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              G G&#252;m&#252;ser \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              E Onur \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              ED Pinar \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00774-005-0631-6"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Bone Miner Metab"
                        "fecha" => "2005"
                        "volumen" => "23"
                        "paginaInicial" => "476"
                        "paginaFinal" => "482"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16261455"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib30"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "quantitative ultrasound at the hand phalanges in 2850 females aged 7 to 77 yr&#58; a cross-sectional study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => """
                              B Drozdzowska \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              W Pluskiewicz \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              Z Halaba \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              H Misiolek \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              B Beck \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Densitom"
                        "fecha" => "2005"
                        "volumen" => "8"
                        "paginaInicial" => "216"
                        "paginaFinal" => "221"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15908710"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib31"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Quantitative ultrasound at the hand phalanges in monozygotic twins&#58; a preliminary report"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => """
                              B Drozdzowska \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              W Pluskiewicz \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              T de Terlizzi \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ultrasound Med Biol"
                        "fecha" => "2002"
                        "volumen" => "28"
                        "paginaInicial" => "1153"
                        "paginaFinal" => "1156"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12401385"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib32"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Skeletal status in males aged 7&#8211;80 years assessed by quantitative ultrasound at the hand phalanges"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => """
                              B Drozdzowska \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              W Pluskiewicz \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00198-002-1355-2"
                      "Revista" => array:6 [
                        "tituloSerie" => "Osteoporos Int"
                        "fecha" => "2003"
                        "volumen" => "14"
                        "paginaInicial" => "295"
                        "paginaFinal" => "300"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12730791"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib33"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Quantitative ultrasound assessment in children with fractures"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => """
                              J Schalamon \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              G Singer \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              G Schwantzer \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              Y Nierosvaara \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1359/JBMR.040401"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Bone Miner Res"
                        "fecha" => "2004"
                        "volumen" => "19"
                        "paginaInicial" => "1276"
                        "paginaFinal" => "1279"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15231014"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib34"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Grip strenght is a predictor of bone mineral density among adolescent combat sport athletes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:8 [
                            0 => """
                              R Nasri \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              SH Zrour \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              H Rebai \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              MF Najjar \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              F Neffeti \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              N Bergaoui \n
                              \t\t\t\t\t\t\t\t
                              """
                            6 => """
                              H Mejdoub \n
                              \t\t\t\t\t\t\t\t
                              """
                            7 => """
                              Z Tabka \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jocd.2012.07.011"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Densitom"
                        "fecha" => "2013"
                        "volumen" => "16"
                        "paginaInicial" => "92"
                        "paginaFinal" => "97"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22980488"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib35"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Skeleteal status assessed by quantitative ultrasound at the hand phalanges in karate training males"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => """
                              B Drozdzowaska \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              U M&#252;nzer \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              P Adamczyk \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              W Pluskiewicz \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ultrasmedbio.2010.10.023"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ultrasound Med Biol"
                        "fecha" => "2011"
                        "volumen" => "37"
                        "paginaInicial" => "214"
                        "paginaFinal" => "219"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21208731"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib36"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sport and its implications on the bone health of adolescent athletes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => """
                              CC Silva \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              AS Teixeira \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              TB Goldberg \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Bras Med Esp"
                        "fecha" => "2003"
                        "volumen" => "9"
                        "paginaInicial" => "433"
                        "paginaFinal" => "438"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib37"
              "etiqueta" => "37"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effects of the physical activity on the bone mineral density and bone remodelation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => """
                              EL Cadore \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              MA Brentano \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              LF Kruel \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Bras Med Esporte"
                        "fecha" => "2005"
                        "volumen" => "11"
                        "paginaInicial" => "373"
                        "paginaFinal" => "379"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib38"
              "etiqueta" => "38"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Quantitative ultrasound of the hand phalanges in a cohort of monozygotic twins&#58; influence of genetic and environmental factors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => """
                              G Guglielmi \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              F de Terlizzi \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              I Torrente \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              R Mingarelli \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              B Dallapiccola \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00256-005-0933-8"
                      "Revista" => array:6 [
                        "tituloSerie" => "Skeletal Radiol"
                        "fecha" => "2005"
                        "volumen" => "34"
                        "paginaInicial" => "727"
                        "paginaFinal" => "735"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15999282"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib39"
              "etiqueta" => "39"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Genetic influence on bone mineral density in Korean twins and families&#58; the healthy twin study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => """
                              JH Park \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              YM Song \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              J Sung \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              K Lee \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              YS Kim \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              YS Park \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00198-011-1685-z"
                      "Revista" => array:6 [
                        "tituloSerie" => "Osteoporos Int"
                        "fecha" => "2012"
                        "volumen" => "23"
                        "paginaInicial" => "1343"
                        "paginaFinal" => "1349"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21656262"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            39 => array:3 [
              "identificador" => "bib40"
              "etiqueta" => "40"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of bone quantity by ultrasound measurements of phalanges between white and black children living in Paran&#225;&#44; Brazil&#44; with Europeans"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => """
                              RR Ribeiro \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              D Santos-Ribeiro \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              G Guerra-Junior \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              AA Barros-Filho \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Braz J Med Biol Res"
                        "fecha" => "2010"
                        "volumen" => "43"
                        "paginaInicial" => "976"
                        "paginaFinal" => "981"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20802978"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            40 => array:3 [
              "identificador" => "bib41"
              "etiqueta" => "41"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Demonstration that bone mass is greater in black than in white children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => """
                              NH Bell \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              J Shary \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              J Stevens \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              M Garza \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              L Gordon \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              J Edwards \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/jbmr.5650060709"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Bone Miner Res"
                        "fecha" => "1991"
                        "volumen" => "6"
                        "paginaInicial" => "719"
                        "paginaFinal" => "723"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1950675"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            41 => array:3 [
              "identificador" => "bib42"
              "etiqueta" => "42"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The accumulation of whole body skeletal mass in third- and fourth-grade children&#58; effects of age&#44; gender&#44; ethnicity&#44; and body composition"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => """
                              DA Nelson \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              PM Simpson \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              CC Johnson \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              DA Barondess \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              M Kleerekoper \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Bone"
                        "fecha" => "1997"
                        "volumen" => "20"
                        "paginaInicial" => "73"
                        "paginaFinal" => "78"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8988351"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            42 => array:3 [
              "identificador" => "bib43"
              "etiqueta" => "43"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Longitudinal study of changes in hip bone mineral density in Caucasian and Africam-American woman"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:8 [
                            0 => """
                              JA Cauley \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              LY Lui \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              KL Stone \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              TA Hillier \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              JM Zmuda \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              M Hochberg \n
                              \t\t\t\t\t\t\t\t
                              """
                            6 => """
                              TJ Beck \n
                              \t\t\t\t\t\t\t\t
                              """
                            7 => """
                              KE Ensrud \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Am Geristr Soc"
                        "fecha" => "2005"
                        "volumen" => "53"
                        "paginaInicial" => "183"
                        "paginaFinal" => "189"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:4 [
        "identificador" => "xack181148"
        "titulo" => "Acknowledgements"
        "texto" => "<p id="para410" class="elsevierStylePara elsevierViewall">To the Faculdade de Ci&#234;ncias M&#233;dicas&#44; Universidade Estadual de Campinas&#44; and Laboratory of Growth and Body Composition&#44; for the academic support&#44; and to FAPESP &#40;Funda&#231;&#227;o de Amparo &#224; Pesquisa do Estado de S&#227;o Paulo&#41; &#40;Process N&#46; 2011&#47;23460-1&#41; for the financial support to one of the authors &#40;EMG&#41;&#46;</p>"
        "vista" => "all"
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/23593482/0000003200000003/v1_201507170117/S235934821530021X/v1_201507170117/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "42245"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Review Articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/23593482/0000003200000003/v1_201507170117/S235934821530021X/v1_201507170117/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S235934821530021X?idApp=UINPBA00004N"
]

Article information

ISSN: 23593482
Original language: English

DOI:10.1016/S2359-3482(15)30021-X

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 October	13	2	15
2024 September	43	1	44
2024 August	30	0	30
2024 July	26	5	31
2024 June	21	3	24
2024 May	19	3	22
2024 April	16	6	22
2024 March	26	2	28
2024 February	22	3	25
2024 January	17	2	19
2023 December	24	5	29
2023 November	14	2	16
2023 October	13	5	18
2023 September	10	1	11
2023 August	14	5	19
2023 July	3	5	8
2023 June	12	4	16
2023 May	8	2	10
2023 April	8	0	8
2023 March	11	2	13
2023 February	9	2	11
2023 January	7	1	8
2022 December	14	6	20
2022 November	14	4	18
2022 October	9	4	13
2022 September	7	6	13
2022 August	7	5	12
2022 July	9	4	13
2022 June	5	4	9
2022 May	8	7	15
2022 April	6	6	12
2022 March	8	5	13
2022 February	11	9	20
2022 January	5	3	8
2021 December	9	8	17
2021 November	8	7	15
2021 October	8	5	13
2021 September	8	9	17
2021 August	3	9	12
2021 July	5	3	8
2021 June	15	8	23
2021 May	7	7	14
2021 April	16	11	27
2021 March	22	10	32
2021 February	6	4	10
2021 January	4	7	11
2020 December	4	5	9
2020 November	4	3	7
2020 October	6	3	9
2020 September	7	6	13
2020 August	8	6	14
2020 July	8	8	16
2020 June	4	9	13
2020 May	7	9	16
2020 April	4	2	6
2020 March	1	1	2
2020 February	8	3	11
2020 January	8	2	10
2019 December	6	4	10
2019 November	5	4	9
2019 October	2	1	3
2019 September	2	1	3
2019 August	1	1	2
2019 July	8	6	14
2019 June	7	9	16
2019 May	4	10	14
2019 April	1	0	1
2018 November	1	0	1
2018 September	1	0	1
2017 June	1	0	1
2017 January	19	12	31
2016 December	11	10	21
2016 November	3	3	6
2016 October	5	7	12
2016 September	8	5	13
2016 August	9	1	10
2016 July	6	0	6

Show all

Indexed in:

Follow us:

Statistics

Indexed in:

Follow us:

Statistics

Subscribe to our newsletter