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Id: biblio-1058605
Autor: Veas, Nicolás; Hameau, René; Nava, Stefano; Winter, José; Soriano, Francesco; Oreglia, Jacopo.
Título: Implante concomitante de MitraClip y cierre de orejuela izquierda: importancia de la puncoón transeptal y sus implicancias técnicas: caso clínico / Concomitant deployment of MitraClip devices and left atrial appendage closure: report of one case
Fonte: Rev. méd. Chile;147(10):1350-1354, oct. 2019. graf.
Idioma: es.
Resumo: We report a 65-years old woman with a history of permanent atrial fibrillation with high risk for ischemic and bleeding events. She developed a heart failure with severely impaired left ventricular ejection fraction and severe secondary mitral regurgitation. Given her high surgical risk, using transesophageal echocardiography guidance, a concomitant deployment of two MitraClip devices using a high-posterior septal puncture and a left atrial appendage closure with an Amplatzer Amulet occluder were performed through the same access.
Descritores: Fibrilação Atrial/cirurgia
Implante de Prótese de Valva Cardíaca/métodos
Apêndice Atrial/cirurgia
Dispositivo para Oclusão Septal
Insuficiência da Valva Mitral/cirurgia
-Índice de Gravidade de Doença
Angiografia/métodos
Fatores de Risco
Resultado do Tratamento
Ecocardiografia Transesofagiana
Limites: Humanos
Feminino
Idoso
Tipo de Publ: Relatos de Casos
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-1058604
Autor: Jara, Natalia; Solé Z, Sebastián.
Título: Fibroxantoma atípico: caso clínico / Scalp atypical fibroxanthoma: report of one case
Fonte: Rev. méd. Chile;147(10):1346-1349, oct. 2019. graf.
Idioma: es.
Resumo: Atypical Fibroxanthoma is an unusual dermal mesenchymal tumor. It especially affects older adults and occurs in areas of sun exposure. We report a 75 years old male with a history of sun exposure without using a hat presenting with a scalp nodule. An incisional biopsy showed an atypical fibroxantoma. In a new surgical procedure, the tumor was completely excised. The tumor relapsed in two occasions after subsequent excisions and the patient was treated with adjuvant radiotherapy avoiding new relapses.
Descritores: Couro Cabeludo/patologia
Neoplasias Cutâneas/patologia
Xantomatose/patologia
-Neoplasias Cutâneas/radioterapia
Biópsia
Xantomatose/radioterapia
Resultado do Tratamento
Limites: Humanos
Masculino
Idoso
Tipo de Publ: Relatos de Casos
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-1058597
Autor: Sepúlveda, Edgardo; Ibáñez, Aníbal; Baeza, Cristian; Espíndola, Manuel; Sepúlveda, Gustavo; Maureira, Mauricio; Uribe, Juan Pablo; Salas, Cristian.
Título: Reparación de válvula mitral y cierre de comunicación interauricular, asistida por robot: experiencia inicial / Robotic mitral valve repair and closure of atrial septal defect: report of 13 procedures
Fonte: Rev. méd. Chile;147(10):1303-1307, oct. 2019. tab, graf.
Idioma: es.
Resumo: Background Robot-assisted minimally invasive heart surgery is an effective alternative when compared with classical approaches. It has a low mortality and postoperative complications and its long-term durability is comparable with conventional techniques. Aim: To report short- and long-term results with the use of a robot-assisted transthoracic approach. Patients and Methods: Review of patients undergoing heart surgery between 2015 and 2019 using a robot assisted minimally invasive technique in a single center. We analyzed demographic characteristics, surgical and early ultrasound results. Results: Thirteen procedures were reviewed, nine mitral valve repairs (MVR) in patients aged 61 ± 21 years (seven males) and four atrial septal defect (ASD) closures in patients aged from 24 to 52 years (three men). For MVR, the average extracorporeal circulation and myocardial ischemia times were 120 ± 20.9 and 89 ± 21 minutes, respectively. The median hospitalization was four days. Two cases of MVR had postoperative complications. There was no mortality. All cases showed improvement in their symptoms. Ultrasound findings showed no postoperative mitral insufficiency except in one case. Conclusions: We report very good results in both complex mitral repair and CIA closure, comparable to centers with high standards in minimally invasive robot-assisted heart surgery.
Descritores: Procedimentos Cirúrgicos Robóticos/métodos
Comunicação Interatrial/cirurgia
Valva Mitral/cirurgia
Insuficiência da Valva Mitral/cirurgia
-Fatores de Tempo
Reprodutibilidade dos Testes
Resultado do Tratamento
Circulação Extracorpórea
Limites: Humanos
Masculino
Feminino
Adulto
Pessoa de Meia-Idade
Adulto Jovem
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-1011931
Autor: Departamento de FonoaudiologiaCosta, Danila Rodrigues; Departamento de FonoaudiologiaSilva-Arone, Marcela Maria Alves da; Departamento Cirurgia, EstomatologiaRubira, Cassia Maria Fischer; Departamento Cirurgia, EstomatologiaSantos, Paulo Sérgio da Silva; Departamento de FonoaudiologiaBerretin-Felix, Giédre.
Título: Efeito imediato da estimulação elétrica neuromuscular na deglutição após tratamento do câncer de laringe: relato de caso / Immediate effect of neuromuscular electrical stimulation on deglutition after treatment of laryngeal cancer: a case report
Fonte: CoDAS;31(3):e20180100, 2019. tab.
Idioma: pt.
Resumo: RESUMO Este trabalho teve por objetivo verificar o efeito imediato da Estimulação Elétrica Neuromuscular (EENM) sensorial e motora, nas fases oral e faríngea da deglutição, em um homem de 64 anos, após tratamento de câncer de laringe. Foi realizado exame de videofluoroscopia durante a deglutição de 5 ml de mel e pudim, em três condições: sem estimulação, com EENM sensorial, com EENM motora, definidas de forma randomizada. Foi classificado o grau da disfunção da deglutição (DOSS), a presença de estase de alimentos (escala de Eisenhuber), de penetração laríngea e aspiração laringotraqueal (PAS), além da medida do tempo de trânsito oral e faríngeo, realizadas por uma avaliadora sem conhecimento sobre o estímulo aplicado. Na escala DOSS, houve melhora com a estimulação sensorial e motora. Na escala PAS, verificou-se melhora, tanto para o estímulo sensorial quanto motor na consistência mel, porém observou-se piora no estímulo motor para a consistência pudim. Houve diminuição dos resíduos em base de língua com estímulo sensorial e motor para as consistências pudim e mel; piora no estímulo motor na parede posterior da faringe para a consistência mel. Em relação ao tempo de trânsito oral e faríngeo, não foi observada diferença entre os níveis de estimulações. Os resultados demonstraram que a EENM em nível sensorial e motor melhorou o grau da disfagia em um indivíduo após o tratamento de câncer de laringe, com maiores benefícios do nível sensorial em relação ao motor no que diz respeito à presença de penetração e resíduos.

ABSTRACT The objective of this study was to verify the immediate effect of sensory and motor neuromuscular electrical stimulation (NMES), in the oral and pharyngeal phases of deglutition, in a 64 year male patient after laryngeal cancer treatment. Videofluoroscopy was performed during deglutition of 5 ml of honey and pudding, under three conditions: without stimulation, with sensory NMES, with motor NMES, randomly defined. The degree of dysfunction of deglutition (DOSS), the presence of food stasis (Eisenhuber scale), laryngeal penetration and laryngotracheal aspiration (PAS) and oral and pharyngeal transit time were evaluated. An evaluator without knowing about the applied stimulus. On the DOSS scale there was improvement with sensory and motor stimulation. In the PAS scale, there was improvement, both for the sensorial and motor stimulus in the honey consistency, but the worsening of the motor stimulus for the pudding consistency was observed. There was reduction of the residues in the base of the tongue with sensorial and motor stimulus for the consistency of pudding and honey; worsening motor stimulus in the posterior wall of the pharynx for honey consistency. There was no difference between stimulation levels regarding to oral and pharyngeal transit time. The results showed that NMES at the sensory and motor levels improved the degree of dysphagia in an individual after the treatment of laryngeal cancer, with greater benefits of the sensory level in relation to the motor regarding to the presence of penetration and residues.
Descritores: Transtornos de Deglutição/etiologia
Transtornos de Deglutição/terapia
Neoplasias Laríngeas/complicações
Terapia por Estimulação Elétrica/métodos
-Neoplasias Laríngeas/terapia
Resultado do Tratamento
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Tipo de Publ: Relatos de Casos
Responsável: BR1.1 - BIREME


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Id: biblio-1133514
Autor: Matos, Izabella Lima de; Ferreira, Maria Carolina; Mondelli, Maria Fernanda Capoani Garcia.
Título: Análise da percepção da fala com uso de dispositivos de amplificação em indivíduos com malformação de orelha e perda auditiva unilateral / Analysis of speech perception with amplification devices in subjects with ear malformation and unilateral hearing loss
Fonte: CoDAS;32(4):e20190047, 2020. tab.
Idioma: pt.
Resumo: RESUMO Objetivo: Verificar a percepção da fala de indivíduos com malformação de orelha e perda auditiva unilateral utilizando dois tipos de amplificação: amplificação sonora individual (AASI) convencional e softband (faixa com vibrador ósseo). Método: Foram selecionados 15 indivíduos, de ambos os sexos, com malformação congênita de orelha externa e/ou orelha média, diagnóstico de perda auditiva unilateral do tipo condutiva ou mista de grau moderado a severo, idade entre 15 e 25 anos, e encaminhamento para amplificação realizado pelo médico otorrinolaringologista. Após a adaptação com AASI e softband, foi realizada avaliação da percepção da fala sem uso da amplificação, com AASI acoplado ao arco e vibrador ósseo (convencional) e com uso do softband (faixa com vibrador). Os indivíduos foram avaliados por meio do Hearing in Noise Test (HINT) nas condições de silêncio e de ruído. Resultados: Foram avaliados sete indivíduos com malformação de orelha unilateral, sendo 57,1% na orelha direita e 42,9% na orelha esquerda. Quanto ao tipo e grau da perda, 71, 4% da amostra possuía perda auditiva condutiva moderada. No teste de percepção de fala na condição de silêncio, ruído frontal e ruído lateral, em três situações: sem amplificação, com o uso do AASI convencional e com o uso do softband, os resultados com uso de dispositivos de amplificação apresentaram-se melhores em todas as condições. Conclusão: Os indivíduos apresentaram melhora sutil, porém não significativa, na percepção de fala tanto em situações de silêncio, ruído frontal e lateral independentemente do tipo de amplificação.

ABSTRACT Purpose: To verify the speech perception in subjects with ear malformation and unilateral hearing loss, fitted with two types of amplification as follows: conventional hearing aids and softband (band with vibrator bone). Method: The study included fifteen subjects of both sexes who presented congenital malformation of the middle or outer ear, diagnosed with unilateral conductive or mixed hearing loss, moderate to severe hearing loss, age range between 15 to 25 years and, prescription from a specialist doctor for hearing device fitting. We performed the speech perception assessment without amplification after the hearing aid and softband fitting, with the hearing aid linked to the bone vibrator (conventional) and the softband (band with the bone vibrator). The subjects were evaluated using the Hearing in Noise Test (HINT), in silence and in noise. Results: Seven subjects with unilateral ear malformation were evaluated, 57.1 % had impairment in the right ear and 42.9 % in the left ear. Regarding the type and the level of hearing loss, 71 % of all subjects included in the sample presented moderate conductive hearing loss. The assessment of speech perception was performed during silence, frontal noise, lateral noise and, during three specifics situations: no amplification, with conventional hearing aid and with the softband. The results with the amplification devices were positive in all evaluated conditions. Conclusion: Evaluated subjects presented improvement in speech perception, in silence, frontal noise and lateral noise situations, regardless of the type of amplification; however, the difference was not statistically significant.
Descritores: Percepção da Fala/fisiologia
Perda Auditiva Unilateral/reabilitação
Auxiliares de Audição
Ruído/efeitos adversos
-Resultado do Tratamento
Perda Auditiva Unilateral/diagnóstico
Perda Auditiva Condutiva
Limites: Humanos
Masculino
Feminino
Adolescente
Adulto
Adulto Jovem
Responsável: BR1.1 - BIREME


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Id: biblio-902547
Autor: Ahumada, Vanessa; Tejos, Rodrigo; Moraga, Felipe; Achurra, Pablo; Godoy, Iván; Loyola, Soledad; Torres, Javiera; Kolbach, Marianne; Benítez, Carlos; Guerra, Juan Francisco; Jarufe, Nicolás; Martínez, Jorge.
Título: Trasplante hepático por insuficiencia cardíaca secundaria a telangiectasia hemorrágica hereditaria o enfermedad de Rendu Osler Weber: caso clínico / Liver transplant as treatment for cardiac failure secondary to hereditary hemorrhagic telangiectasia: report of one case
Fonte: Rev. méd. Chile;145(6):799-803, June 2017. tab, graf.
Idioma: es.
Resumo: Liver involvement by multiple arterio-venous shunts in hereditary hemorrhagic telangiectasia can lead to severe heart failure. Total hepatectomy with liver transplantation has emerged as a therapeutic option for severe cases where other therapies have failed. We report a 51-year-old male who underwent a liver transplant for this condition, with full cardiac recovery within the first year after receiving the allograft. Nine years after transplantation, he remains with normal functional capacity and normal liver function tests.
Descritores: Telangiectasia Hemorrágica Hereditária/complicações
Transplante de Fígado/métodos
Insuficiência Cardíaca/cirurgia
-Anastomose Cirúrgica
Resultado do Tratamento
Insuficiência Cardíaca/etiologia
Fígado/patologia
Limites: Humanos
Masculino
Pessoa de Meia-Idade
Tipo de Publ: Relatos de Casos
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-902550
Autor: Quilodrán, Javier A; Peña, Camila; Valladares, Ximena.
Título: Plasmocitoma extramedular: una rara causa de masa mediastínica / Extramedullary mediastinal plasmacytoma: report of one case
Fonte: Rev. méd. Chile;145(6):812-815, June 2017. graf.
Idioma: es.
Resumo: Solitary extramedullary plasmacytomas represent 3% of plasma cell neoplasms. Their most common locations are the upper gastrointestinal and respiratory tract. We report a 70-year-old male presenting with progressive dyspnea and cough. A chest radiography showed widened mediastinum. Chest computed tomography showed a mediastinal mass. A bronchoscopy showed an extrinsic compression and complete occlusion of the primary bronchus. A self-expandable prosthesis was installed in left bronchus. A population of plasmacytoid cells was evidenced in the mass biopsy. Immunohistochemistry revealed CD20+ and CD138+. These tumor cells stained positively for lambda light chains, but negatively for kappa chains. Therefore an extramedullary plasmacytoma was diagnosed. A multiple myeloma was discarded with a normal blood count, serum calcium and creatinine levels. Serum protein electrophoresis had a monoclonal spike, serum IgG was 1963 mg/dl. Bone marrow aspiration had 1% of plasma cells. Bone x-rays were normal. Computed tomographies of the neck, thorax, abdomen and pelvis ruled out other plasmacytomas. Eight cycles of chemotherapy with thalidomide, melphalan and prednisone were indicated, obtaining complete remission of the tumor. The review of the literature shows that mediastinal extramedullary plasmacytomas are extremely rare. They generally appear in men aged between 50 and 60 years. The treatment of choice is radiotherapy, but given the location in the present case, chemotherapy was considered the best option. Recurrence is approximately 10 to 30% and 10% of patients progress to myeloma, thus requiring close monitoring.
Descritores: Plasmocitoma/tratamento farmacológico
Plasmocitoma/diagnóstico por imagem
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Neoplasias do Mediastino/tratamento farmacológico
Neoplasias do Mediastino/diagnóstico por imagem
-Talidomida/uso terapêutico
Prednisona/uso terapêutico
Tomografia
Resultado do Tratamento
Mediastinoscopia
Melfalan/uso terapêutico
Limites: Humanos
Masculino
Idoso
Tipo de Publ: Relatos de Casos
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-1292509
Autor: Wilson Bravo, César; Pizarro Amigo, Felipe; Jara Barril, Hernán; Pareschi Pasten, Stefano.
Título: Resultados a tres años de seguimiento de Fasciotomía percutánea con aguja en enfermedad de Dupuytren / Results after three years of follow-up of percutaneous fasciotomy with needle in Dupuytren's disease
Fonte: Rev. méd. Maule;33(2):25-30, sept. 2018. ilus, graf.
Idioma: es.
Resumo: Dupuytren's disease is the abnormal and progressive proliferation of the palmar fascia, its etiology remains unknown. Percutaneous needle fasciotomy is a minimally invasive procedure, where hypodermic needles are used as a scalpel blade to break the pathological cord in Dupuytren's disease. OBJECTIVE: To evaluate the results of percutaneous needle fasciotomy in patients with 3-year follow-up METHODS: Percutaneous needle fasciotomy was performed in patients from the regional hospital of Talca from January 2014 to January 2017, pre and post-procedure contracture measurement was performed, followed up at 6 weeks, 3 months and annually up to three years. there was a registry of complications, recurrence and functional results with the QuickDASH scale. RESULTS: Of the 17 patients chosen, 13 completed the follow-up. 15 fingers (5 little fingers, 9 ring fingers, 1 middle) and 23 joints. The metacarpophalangeal joints achieved an immediate correction of 89%, maintaining a correction of 48% at three years. The proximal interphalangeal joint achieved a correction of 62%, maintaining 32% at the end of the follow-up. The QuickDash managed to descend from 39.4 to 21.5 points. There was recurrence of 35.7% in the metacarpophalangeal joints and 42.8% in proximal interphalangeal joints. We found that percutaneous fasciotomy is a treatment option.
Descritores: Contratura de Dupuytren/cirurgia
Fasciotomia
Agulhas
-Recidiva
Amplitude de Movimento Articular/fisiologia
Resultado do Tratamento
Contratura de Dupuytren/fisiopatologia
Articulação Metacarpofalângica
Limites: Humanos
Masculino
Feminino
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-1153525
Autor: Shao, D; Zhao, Z N; Zhang, Y Q; Zhou, X Y; Zhao, L B; Dong, M; Xu, F H; Xiang, Y J; Luo, H Y.
Título: Efficacy of repetitive transcranial magnetic stimulation for post-stroke depression: a systematic review and meta-analysis of randomized clinical trials
Fonte: Braz. j. med. biol. res = Rev. bras. pesqui. méd. biol;54(3):e10010, 2021. tab, graf.
Idioma: en.
Projeto: NSFC; . Health Appropriate Technology Promotion Project of Chongqing.
Resumo: We aimed to conduct a meta-analysis to evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) in patients with post-stroke depression (PSD). Six relevant electronic databases (PubMed, CENTRAL, Embase, Web of Science, CINAHL, and PsycINFO) were searched. Randomized controlled trials (RCTs) that compared rTMS with control condition for PSD were included. The mean change in depression symptom scores was defined as the primary efficacy outcome. Secondary outcomes included the remission rate of depression, stroke recovery, and cognitive function recovery. In total, 7 RCTs with 351 participants were included. At post-treatment, rTMS was significantly more effective than the control condition, with a standardized mean difference (SMD) of -1.15 (95%CI: -1.62 to -0.69; P<0.001, I2=71%) and remission with an odds ratio (OR) of 3.46 (95%CI: 1.68 to 7.12; P<0.001; I2=11%). As for stroke recovery, rTMS was also better than the control condition (SMD=-0.67, 95%CI: -1.02 to -0.32; P<0.001). However, no significant difference was found for cognitive function recovery between the two groups (SMD=4.07, 95%CI: -1.41 to 9.55; P=0.15). To explore the potential moderators for the primary outcome, a series of subgroup and sensitivity analyses were performed. The results implied that rTMS may be more effective in Asian samples than in North American samples (P=0.03). In conclusion, from the current evidence in this study, rTMS could be an effective treatment for patients with PSD. Further clinical studies with larger sample sizes and clearer subgroup definitions are needed to confirm these outcomes.
Descritores: Acidente Vascular Cerebral/complicações
Estimulação Magnética Transcraniana
-Ensaios Clínicos Controlados Aleatórios como Assunto
Resultado do Tratamento
Recuperação de Função Fisiológica
Depressão/etiologia
Depressão/terapia
Limites: Humanos
Tipo de Publ: Metanálise
Revisão Sistemática
Responsável: BR1.1 - BIREME


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Id: biblio-1249599
Autor: Lima, Anna Letícia Xavier de; Dutra, Monique Ramos Paschoal.
Título: Influence of frenotomy on breastfeeding in newborns with ankyloglossia / Influência da frenotomia na amamentação em recém-nascidos com anquiloglossia
Fonte: CoDAS;33(1):e20190026, 2021. tab, graf.
Idioma: en.
Resumo: ABSTRACT Purpose: evaluate the influence of frenotomy on the breastfeeding of newborns diagnosed with ankyloglossia. Methods: this is an intervention study performed with 50 newborns diagnosed with ankyloglossia. It was conducted in three stages: diagnosis, intervention and reassessment. In the diagnostic phase, the Protocol for the Assessment of Speech Language with Scores for Babies was applied to diagnose ankyloglossia and a questionnaire assessing the symptoms and coordination of sucking, swallowing and breathing during breastfeeding. In the intervention, frenotomy was performed, and at reassessment, the diagnostic protocol and questionnaire in order to compare the post-surgical effects. Results: of the 50 babies participating in the study, 35 (70%) were boys and 15 (30%) girls. A total of 68% of ankyloglossia cases were reported in the family, a majority (38%) involving cousins. There was a statistically significant reduction in the average protocol score in the reassessment stage, from 8.38 (7-12 points) to 0.86 (0-5 points), as well as a statistically significant improvement in all variables related to the symptoms of breastfeeding. Conclusion: surgical intervention, known as frenotomy, made it possible to improve the negative symptoms of breastfeeding in newborns diagnosed with ankyloglossia.

RESUMO Objetivo: avaliar a influência da frenotomia sobre a amamentação de recém-nascidos com diagnóstico de anquiloglossia. Método: trata-se de um estudo de intervenção realizado com 50 recém-nascidos com diagnóstico de anquiloglossia. Foi realizado em três etapas: diagnóstico, intervenção e reavaliação. Na fase diagnóstica, foram aplicados o Protocolo de Avaliação do Frênulo da Língua com Escores para Bebês para o diagnóstico de anquiloglossia e um questionário de avaliação dos sintomas e coordenação de sucção, deglutição e respiração durante a amamentação. Na intervenção, foi realizada a frenotomia e, na reavaliação, foram reaplicados o protocolo de diagnóstico e o questionário para comparação dos efeitos pós-cirúrgicos. Resultados: dos 50 bebês participantes do estudo, 35 (70%) eram do gênero masculino e 15 (30%) do gênero feminino. Foram relatados 68% dos casos de anquiloglossia na família, sendo primo (a) o grau de parentesco na maioria desses casos (38%). Houve redução estatisticamente significativa na média de pontuação no protocolo de 8,38 (7-12 pontos) para 0,86 (0-5 pontos), na etapa de reavaliação, assim como melhora estatisticamente significante em todas as variáveis relacionadas aos sintomas da amamentação. Conclusão: a intervenção cirúrgica, denominada frenotomia, possibilitou a melhora dos sintomas negativos da amamentação em neonatos com diagnóstico de anquiloglossia.
Descritores: Anquiloglossia/cirurgia
-Aleitamento Materno
Inquéritos e Questionários
Resultado do Tratamento
Freio Lingual/cirurgia
Limites: Humanos
Masculino
Feminino
Recém-Nascido
Lactente
Responsável: BR1.1 - BIREME



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