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Id: biblio-915200
Autor: Jensen, Daniela; Domínguez, José Miguel; Mosso, Lorena; Fardella, Carlos; Campino J, Carmen.
Título: Discrepancia en concentraciones de hormonas tiroideas libres medidas por distintos inmunoensayos / Discrepancy in concentrations of free thyroid hormones measured by different immunoassays
Fonte: Rev. chil. endocrinol. diabetes;11(3):103-107, jul. 2018. tab, ilus.
Idioma: es.
Resumo: Abstract: Thyroid function is assessed by measuring thyrotropin and free and total thyroid hormone concentrations. There are interferences with the results of immunoassays that can lead to an incorrect diagnosis, of which the most frequent are the binding of thyroid hormones to heterophile antibodies, rheumatoid factor, anti-Ruthenium antibodies, the intake of biotin and anti-streptavidin antibodies. We present three cases of clinically euthyroid patients, with normal TSH, high free T4 and T3, and normal total T4 and T3 performed in a Roche Diagnostics ® COBAS 8000 device. When the test was repeated on a Siemens® Immulite device, the free and total hormones were within normal ranges. In the Roche Diagnostics ® assay, the presence of biotin or anti-Ruthenium or anti-streptavidin antibodies interferes with the formation of the complex responsible for the emission of light that allows inferring concentrations of thyroid hormones. The Siemens test works differently since the emission of light depends on the binding of T4 to an antibody conjugated with alkaline phosphatase not participating in the process biotin, streptavidin or ruthenium so this interference is avoided. This possible interference in immunoassays should be taken into account in case clinical manifestations differ from these laboratory determinations, to avoid a diagnosis and potential inappropriate treatment.

Resumen: La función tiroidea se evalúa midiendo tirotropina y concentraciones de hormonas tiroideas libres y totales. Existen interferencias con los resultados de inmunoensayos que pueden llevar a un diagnóstico incorrecto, de ellas, las más frecuentes son la unión de hormonas tiroideas a anticuerpos heterófilos, el factor reumatoide, anticuerpos anti Rutenio, la ingesta de biotina y anticuerpos anti estreptavidina. Se presentan tres casos de pacientes clínicamente eutiroideos, con TSH normal, T4 y T3 libres elevadas, y T4 y T3 totales normales realizadas en un equipo COBAS 8000 de Roche Diagnostics®. Cuando se repitió el ensayo en un equipo Immulite de Siemens®, las hormonas libres y totales estaban dentro de rangos normales. En el ensayo de Roche Diagnostics ®, la presencia de biotina o anticuerpos anti Rutenio o anti estreptavidina, interfiere con la formación del complejo responsable de la emisión de luz que permite inferir las concentraciones de las hormonas tiroideas. El ensayo de Siemens funciona de manera diferente ya que la emisión de luz depende de la unión de la T4 a un anticuerpo conjugado con fosfatasa alcalina no participando en el proceso biotina, estreptavidina o Rutenio por lo que se evita esta interferencia. Esta posible interferencia en inmunoensayos debe ser tenida en cuenta en caso de que las manifestaciones clínicas difieran de estas determinaciones de laboratorio, para evitar un diagnóstico y potencial tratamiento inadecuado.
Descritores: Hormônios Tireóideos/imunologia
Hormônios Tireóideos/sangue
Imunoensaio/métodos
-Tireotropina/imunologia
Tireotropina/sangue
Reações Falso-Positivas
Limites: Humanos
Feminino
Adulto
Pessoa de Meia-Idade
Tipo de Publ: Relatos de Casos
Responsável: CL1.1 - Biblioteca Central


  2 / 432 LILACS  
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Id: lil-782150
Autor: Halpern, Bruno.
Título: Elevated irisin and alanine aminotransferase levels in hypothyroidism: role of oxidative stress?
Fonte: Arch. endocrinol. metab. (Online);60(2):89-91, Apr. 2016.
Idioma: en.
Descritores: Fibronectinas/sangue
Estresse Oxidativo/fisiologia
Alanina Transaminase/sangue
Hipotireoidismo/metabolismo
-Tireotropina/sangue
Fígado Gorduroso/metabolismo
Hipotireoidismo/sangue
Limites: Humanos
Responsável: BR1.1 - BIREME


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Id: lil-782153
Autor: Silva, Nathanael de Oliveira e; Ronsoni, Marcelo Fernando; Colombo, Bruno da Silveira; Corrêa, Carina Gabriela; Hatanaka, Simone Aiko; Canalli, Maria Heloisa Büsi da Silva; Schiavon, Leonardo de Lucca; Narciso-Schiavon, Janaína Luz.
Título: Clinical and laboratory characteristics of patients with thyroid diseases with and without alanine aminotransferase levels above the upper tertile – Cross-sectional analytical study
Fonte: Arch. endocrinol. metab. (Online);60(2):101-107, Apr. 2016. tab, graf.
Idioma: en.
Resumo: Objective Thyroid disease affects 6.6% of the general population. The liver is fundamental in metabolizing thyroid hormones, and hepatocytes are often affected in thyroid disease. We aimed to compare clinical and laboratory parameters among thyroid disease patients with alanine aminotransferase (ALT) levels above vs. below the upper tertile. Subjects and methods A retrospective cross-sectional analytical study was conducted in the endocrinology clinic at Polydoro Ernani de São Thiago University Hospital. Patients with thyroid disease between August 2012 and January 2014 were included in the study. Clinical and laboratory parameters were collected from medical records. Results One hundred patients were included, of which 14.0% were male, with a mean age of 49.1 ± 14.4 years. ALT levels ranged from 9 to 90 U/L, and the ALT upper tertile was defined as 0,64 times the upper normal limit (xUNL). Patients with ALT levels above the upper tertile exhibited a higher proportion of systemic arterial hypertension (SAH), a higher mean abdominal circumference and a higher frequency of elevated TSH levels than did patients with ALT levels below the upper tertile. In multivariate analysis, ALT ≥ 0.64 (xUNL) was independently associated with abdominal circumference (odds ratio [OR] = 0.087, 95% confidence interval [CI] 0012-0167, P = 0.022). ALT (xUNL) correlated positively with total cholesterol (r = 0.213, P = 0.042). Conclusions In patients with thyroid diseases, it was observed that those with ALT above the upper tertile are associated with abdominal circumference and ALT levels correlate with total cholesterol.
Descritores: Doenças da Glândula Tireoide/sangue
Alanina Transaminase/sangue
-Valores de Referência
Tireotropina/sangue
Índice de Massa Corporal
Colesterol/sangue
Estudos Transversais
Estudos Retrospectivos
Fatores de Risco
Dislipidemias/sangue
Circunferência da Cintura
Hipertensão/sangue
Hepatopatias/sangue
Limites: Humanos
Masculino
Feminino
Adulto
Pessoa de Meia-Idade
Responsável: BR1.1 - BIREME


  4 / 432 LILACS  
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Vaisman, Mario
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Id: lil-785228
Autor: Chachamovitz, Dhiãnah Santini de Oliveira; Vigário, Patrícia dos Santos; Carvalho, Rafael Cavalcante; Silvestre, Diego Henrique da Silva; Moerbeck, Ana Eduarda Vieira; Soffientini, Mariana Guimarães; Luna, Érika Luciana Gomes; Rosemberg, Clara Werner; Mainenti, Míriam Raquel Meira; Vaisman, Mário; Teixeira, Patricia de Fátima dos Santos.
Título: Does low serum TSH within the normal range have negative impact on physical exercise capacity and quality of life of healthy elderly people?
Fonte: Arch. endocrinol. metab. (Online);60(3):236-245tab, graf.
Idioma: en.
Resumo: Objective Investigate the differences in cardiopulmonary (CP) capacity and Quality of Life (QOL) between healthy elderly (≥ 65 years) with different TSH levels (< 1.0 and ≥ 1.0 μIU/mL) both within the normal range. Also, evaluate the effects of TSH elevation on CP test and QOL, by administering methimazole to subjects with initial lower-normal TSH, in order to elevate it to superior-normal limit. Materials and methods Initially, a cross-sectional study was performed to compare CP capacity at peak exercise and QOL (using WHOQOL-OLD questionnaire) between healthy seniors (age ≥ 65 years) with TSH < 1.0 μIU/mL vs. TSH ≥1.0 μIU/mL. In the second phase, participants with TSH < 1.0 μIU/mL were included in a non-controlled-prospective-interventional study to investigate the effect of TSH elevation, using methimazole, on QOL and CP capacity at peak exercise. Results From 89 elderly evaluated, 75 had TSH ≥ 1 μIU/mL and 14 TSH < 1 μIU/mL. The two groups had similar basal clinical characteristics. No difference in WHOQOL-OLD scores was observed between groups and they did not differ in terms of CP function at peak exercise. QOL and CP variables were not correlated with TSH levels. Twelve of 14 participants with TSH < 1.0 μIU/mL entered in the prospective study. After one year, no significant differences in clinical caracteristics, QOL, and CP variables were detected in paired analysis before and after methimazole intervention. Conclusions We found no differences in CP capacity and QOL between health elderly with different TSH levels within normal range and no impact after one year of methimazole treatment. More prospective-controlled-randomized studies are necessary to confirm or not the possible harm effect in normal low TSH.
Descritores: Qualidade de Vida
Antitireóideos/uso terapêutico
Tireotropina/sangue
Tolerância ao Exercício/fisiologia
Metimazol/uso terapêutico
-Consumo de Oxigênio/efeitos dos fármacos
Consumo de Oxigênio/fisiologia
Valores de Referência
Tiroxina/sangue
Envelhecimento/sangue
Tireotropina/efeitos dos fármacos
Estudos Transversais
Estudos Prospectivos
Inquéritos e Questionários
Fatores Etários
Tolerância ao Exercício/efeitos dos fármacos
Estatísticas não Paramétricas
Frequência Cardíaca/fisiologia
Hipertireoidismo/fisiopatologia
Hipertireoidismo/sangue
Limites: Humanos
Masculino
Feminino
Idoso
Responsável: BR1.1 - BIREME


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Maciel, Lea Maria Zanini
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Id: lil-792941
Autor: Maciel, Léa Maria Zanini.
Título: Are TSH normal reference ranges adequate for pregnant women?
Fonte: Arch. endocrinol. metab. (Online);60(4):303-306, Aug. 2016. tab.
Idioma: en.
Descritores: Glândula Tireoide/metabolismo
Gravidez/sangue
Tireotropina/sangue
-Trimestres da Gravidez/sangue
Valores de Referência
Testes de Função Tireóidea
Idade Gestacional
Globulina de Ligação a Tiroxina/análise
Gonadotropina Coriônica/sangue
Iodo/deficiência
Limites: Humanos
Feminino
Tipo de Publ: Editorial
Responsável: BR1.1 - BIREME


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Id: lil-792946
Autor: Fu, Chunyun; Zheng, Haiyang; Zhang, Shujie; Chen, Yun; Su, Jiasun; Wang, Jin; Xie, Bobo; Hu, Xuyun; Fan, Xin; Luo, Jingsi; Li, Chuan; Chen, Rongyu; Shen, Yiping; Chen, Shaoke.
Título: Mutation screening of the SLC26A4 gene in a cohort of 192 Chinese patients with congenital hypothyroidism
Fonte: Arch. endocrinol. metab. (Online);60(4):323-327, Aug. 2016. tab, graf.
Idioma: en.
Projeto: National Natural Science Foundation of China; . Key Projects of Guangxi Health Department.
Resumo: ABSTRACT Objective Pendred syndrome (PS) is an autosomal recessive disorder characterised by sensorineural hearing loss and thyroid dyshormonogenesis. It is caused by biallelic mutations in the SLC26A4 gene encoding for pendrin. Hypothyroidism in PS can be present from birth and therefore diagnosed by neonatal screening. The aim of this study was to examine the SLC26A4 mutation spectrum and prevalence among congenital hypothyroidism (CH) patients in the Guangxi Zhuang Autonomous Region of China and to establish how frequently PS causes hearing impairment in our patients with CH. Subjects and methods Blood samples were collected from 192 CH patients in Guangxi Zhuang Autonomous Region, China, and genomic DNA was extracted from peripheral blood leukocytes. All exons of the SLC26A4 gene together with their exon-intron boundaries were screened by next-generation sequencing. Patients with SLC26A4 mutations underwent a complete audiological evaluation including otoscopic examination, audiometry and morphological evaluation of the inner ear. Results Next generation sequencing analysis of SLC26A4 in 192 CH patients revealed five different heterozygous variations in eight individuals (8/192, 4%). The prevalence of SLC26A4 mutations was 4% among studied Chinese CH. Three of the eight were diagnosed as enlargement of the vestibular aqueduct (EVA), no PS were found in our 192 CH patients. The mutations included one novel missense variant p.P469S, as well as four known missense variants, namely p.V233L, p.M147I, p.V609G and p.D661E. Of the eight patients identified with SLC26A4 variations in our study, seven patients showed normal size/location of thyroid gland, and one patients showed a decreased size one. Conclusions The prevalence of SLC26A4 pathogenic variants was 4% among studied Chinese patients with CH. Our study expanded the SLC26A4 mutation spectrum, provided the best estimation of SLC26A4 mutation rate for Chinese CH patients and indicated the rarity of PS as a cause of CH.
Descritores: Proteínas de Membrana Transportadoras/genética
Testes Genéticos/métodos
Bócio Nodular/genética
Perda Auditiva Neurossensorial/genética
Mutação
-Tiroxina/sangue
Aqueduto Vestibular/anormalidades
Tireotropina/sangue
China/epidemiologia
Prevalência
Estudos de Coortes
Triagem Neonatal/métodos
Transportadores de Sulfato
Bócio Nodular/epidemiologia
Perda Auditiva Neurossensorial/epidemiologia
Limites: Humanos
Masculino
Feminino
Recém-Nascido
Responsável: BR1.1 - BIREME


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Id: lil-792948
Autor: Rosario, Pedro Weslley; Carvalho, Marina; Calsolari, Maria Regina.
Título: TSH reference values in the first trimester of gestation and correlation between maternal TSH and obstetric and neonatal outcomes: a prospective Brazilian study
Fonte: Arch. endocrinol. metab. (Online);60(4):314-318, Aug. 2016. tab, graf.
Idioma: en.
Resumo: ABSTRACT Objective To define the normal range of TSH in the first trimester of gestation and to evaluate the correlation between maternal TSH and obstetric and neonatal outcomes. Subjects and methods Prospective study. Women without known or clinically suspected thyroid disease and without risk factors for thyroid dysfunction, who became pregnant spontaneously and were initially evaluated up to week 12 of gestation, were included. Women with positive anti-thyroperoxidase antibodies, twin pregnancy, hyperemesis gravidarum, and trophoblastic disease were excluded. Results In the 660 pregnant women, the mean, median, and 2.5th and 97.5th percentiles of TSH were 0.9, 0.96, 0.04 and 2.68 mIU/L, respectively. TSH was undetectable in 2%, < 0.5 mIU/L in 17.4%, > 2 mIU/L in 9.7%, > 2.5 mIU/L in 4.7%, and > 3 mIU/L in 1%. None of the women received levothyroxine or antithyroid drugs during pregnancy. In addition, there was no difference in obstetric or neonatal outcomes when women with TSH ≤ 0.1, between 0.1 and 2.5, and between 2.5 and 4 mIU/L were compared. Conclusion In the population studied, the TSH value corresponding to the 97.5th percentile was 2.68 mIU/L in the first trimester of gestation.
Descritores: Primeiro Trimestre da Gravidez/sangue
Gravidez/sangue
Tireotropina/sangue
Resultado da Gravidez
-Padrões de Referência
Valores de Referência
Antitireóideos
Doenças da Glândula Tireoide/sangue
Testes de Função Tireóidea
Fatores de Tempo
Brasil
Estudos Prospectivos
Limites: Humanos
Feminino
Adolescente
Adulto
Adulto Jovem
Responsável: BR1.1 - BIREME


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Id: lil-798184
Autor: Matos, Diana M; Ramalho, Roberto J R; Carvalho, Bruno M; Almeida, Maria Augusta C T; Passos, Luciana F D; Vasconcelos, Talmay T S; Melo, Enaldo V; Oliveira, Carla R P; Santos, Elenilde G; Resende, Karla F; Aguiar-Oliveira, Manuel H.
Título: Evolution to permanent or transient conditions in children with positive neonatal TSH screening tests in Sergipe, Brazil
Fonte: Arch. endocrinol. metab. (Online);60(5):450-456, Oct. 2016. tab, graf.
Idioma: en.
Resumo: ABSTRACT Objectives To assess the evolution to permanent or transient conditions in children with positive neonatal TSH tests in Sergipe, Brazil, from 2004 to 2010. Subjects and methods Out of 193,794 screened newborns, 713 presented a neonatal TSH level higher than the local cutoff (5.2 µU/mL). From the confirmatory serum TSH values, the children were diagnosed with initial congenital hypothyroidism (CH) or suspect CH. From the evolution, they were classified as permanent CH, hyperthyrotropinemia, or transient TSH elevation. The mean incidence of each final condition was calculated for the total period of time. Results The initial diagnosis included 37 CH (18.1%) and 167 suspect CH (81.9%) cases. The final diagnosis included 46 cases of permanent CH (22.5%), 56 of hyperthyrotropinemia (27.5%), and 102 of transient TSH elevation (50.0%). Out of the 37 cases of initial CH, 23 (62.2%) had permanent CH, nine (24.3%) had hyperthyrotropinemia, and five (13.5%) had transient TSH elevation. Out of the 167 suspect CH cases, 23 (13.8%) had permanent CH, 47 (28.1%) had hyperthyrotropinemia and 97 (58.1%) had transient TSH elevation. The mean incidence after the follow up was 1:4,166 for permanent CH, 1:3,448 for hyperthyrotropinemia, and 1:1,887 for transient TSH elevation. Eighty-six percent of the children with an initial diagnosis of CH and 41.9% with suspect CH had a permanent condition (CH or hyperthyrotropinemia). Conclusions The follow-up of children with an initial diagnosis of CH or suspect CH is necessary to determine whether the disorder is permanent because predicting the evolution of the condition is difficult.
Descritores: Tireotropina/sangue
Triagem Neonatal/métodos
Hipotireoidismo Congênito/diagnóstico
Hipotireoidismo Congênito/sangue
-Padrões de Referência
Valores de Referência
Tiroxina/sangue
Fatores de Tempo
Brasil/epidemiologia
Incidência
Valor Preditivo dos Testes
Estudos Retrospectivos
Seguimentos
Progressão da Doença
Hipotireoidismo Congênito/fisiopatologia
Hipotireoidismo Congênito/epidemiologia
Limites: Humanos
Masculino
Feminino
Recém-Nascido
Responsável: BR1.1 - BIREME


  9 / 432 LILACS  
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Id: biblio-827785
Autor: Kaminski, Juliana; Miasaki, Fabíola Yukiko; Paz-Filho, Gilberto; Graf, Hans; Carvalho, Gisah Amaral de.
Título: Treatment of hypothyroidism with levothyroxine plus liothyronine: a randomized, double-blind, crossover study
Fonte: Arch. endocrinol. metab. (Online);60(6):562-572, Nov.-Dec. 2016. tab, graf.
Idioma: en.
Resumo: ABSTRACT Objective To compare the effects of a unique fixed combination levothyroxine/liothyronine (LT4/LT3) therapy in patients with primary hypothyroidism. Subjects and methods This is a randomized, double-blind, crossover study. Adults with primary hypothyroidism (n = 32, age 42.6 ± 13.3, 30 females) on stable doses of LT4 for ≥ 6 months (125 or 150 μg/day) were randomized to continue LT4 treatment (G1) or to start LT4/LT3 therapy (75/15 μg/day; G2). After 8 weeks, participants switched treatments for 8 more weeks. Thyroid function, lipid profile, plasma glucose, body weight, electrocardiogram, vital signs, and quality of life (QoL) were evaluated at weeks 0, 8 and 16. Results Free T4 levels were significantly lower while on LT4/LT3 (G1: 1.07 ± 0.29 vs. 1.65 ± 0.46; G2: 0.97 ± 0.26 vs. 1.63 ± 0.43 ng/dL; P < 0.001). TSH and T3 levels were not affected by type of therapy. More patients on LT4/LT3 had T3 levels above the upper limit (15% vs. 3%). The combination therapy led to an increase in heart rate, with no significant changes in electrocardiogram or arterial blood pressure. Lipid profile, body weight and QoL remained unchanged. Conclusions The combination therapy yielded significantly lower free T4 levels, with no changes in TSH or T3 levels. More patients on LT4/T3 had elevated T3 levels, with no significant alterations in the evaluated outcomes. No clear clinical benefit of the studied formulation could be observed. Future trials need to evaluate different formulations and the impact of the combined therapy in select populations with genetic polymorphisms.
Descritores: Tiroxina/uso terapêutico
Tri-Iodotironina/uso terapêutico
Hipotireoidismo/tratamento farmacológico
-Qualidade de Vida
Testes de Função Tireóidea
Tiroxina/sangue
Tiroxina/farmacologia
Tri-Iodotironina/sangue
Tri-Iodotironina/farmacologia
Glicemia/análise
Peso Corporal/efeitos dos fármacos
Tireotropina/efeitos dos fármacos
Colesterol/sangue
Método Duplo-Cego
Estudos Cross-Over
Combinação de Medicamentos
Hipotireoidismo/sangue
Limites: Humanos
Masculino
Feminino
Adulto
Pessoa de Meia-Idade
Tipo de Publ: Ensaio Clínico Controlado Aleatório
Responsável: BR1.1 - BIREME


  10 / 432 LILACS  
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Id: biblio-827794
Autor: Guo, Man-Li; Zheng, Xiao; Yang, Liu-Xue; Qiu, Ya-Li; Cheng, Liang; Ma, Shao-Gang.
Título: Coexistence of resistance to thyroid hormone and ectopic thyroid: ten-year follow-up
Fonte: Arch. endocrinol. metab. (Online);60(6):601-604, Nov.-Dec. 2016. tab, graf.
Idioma: en.
Projeto: Social Development Project of Huai’an City; . Maternal and Child Health Research Project; . Guangxi University.
Resumo: SUMMARY Resistance to thyroid hormone (RTH) coexisting with ectopic thyroid is rare. Here we report a case of RTH with ectopic thyroid. A ten-year-old girl had been misdiagnosed as congenital hypothyroidism and treated with levothyroxine since she was born. Ten-year follow-up showed that the elevated thyrotropin was never suppressed by levothyroxine and no signs indicating hyperthyroidism or hypothyroidism despite elevated FT3 and FT4 levels. Therefore the girl developed no defects in physical and cognitive development. Pituitary adenoma was excluded by magnetic resonance imaging. Ultrasonography did not find the thyroid gland in the normal place, while the thyroid scan found a large lingual thyroid gland. The octreotide inhibition test showed a reduction in thyrotropin by 41.98%. No mutation was detected in the thyroid hormone receptor (THR) β, THRα, thyrotropin receptor (TSHR), and GNAS1 genes. To our knowledge, it is an interesting RTH case coexisting with lingual thyroid.
Descritores: Receptores dos Hormônios Tireóideos/genética
Síndrome da Resistência aos Hormônios Tireóideos/complicações
Disgenesia da Tireoide/complicações
-Tiroxina/uso terapêutico
Fatores de Tempo
Doenças da Língua/diagnóstico por imagem
DNA/isolamento & purificação
Tireotropina/análise
Análise Mutacional de DNA
Seguimentos
Síndrome da Resistência aos Hormônios Tireóideos/genética
Hipotireoidismo Congênito/diagnóstico
Erros de Diagnóstico
Disgenesia da Tireoide/genética
Disgenesia da Tireoide/diagnóstico por imagem
Limites: Humanos
Feminino
Criança
Tipo de Publ: Relatos de Casos
Responsável: BR1.1 - BIREME



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