Base de dados : LILACS
Pesquisa : G08.852.880 [Categoria DeCS]
Referências encontradas : 157 [refinar]
Mostrando: 1 .. 10   no formato [Detalhado]

página 1 de 16 ir para página                         

  1 / 157 LILACS  
              next record last record
seleciona
para imprimir
Fotocópia
Texto completo SciELO Brasil
Texto completo
Id: biblio-1059096
Autor: Güven, Esref Oguz; Selvi, Ismail; Karaismailoglu, Eda.
Título: Association between benign prostate enlargement-related storage and voiding symptoms and systolic blood pressure: a single-center cross-sectional study
Fonte: Säo Paulo med. j;137(5):446-453, Sept.-Oct. 2019. tab, graf.
Idioma: en.
Resumo: ABSTRACT BACKGROUND: Lower urinary tract symptoms significantly worsen quality of life. The hypothesis that they might lead to serious systolic blood pressure alterations through inducing sympathetic nervous activity has not been studied so far. OBJECTIVES: To investigate the relationship between benign prostate enlargement-related storage and voiding symptoms and systolic blood pressure. DESIGN AND SETTING: Cross-sectional single-center study on data from a hospital patient record system. METHODS: We evaluated the medical records of all consecutive patients with benign prostate enlargement-related lower urinary tract symptoms admitted between January 2012 and December 2017. Storage and voiding symptoms were assessed separately. International Prostate Symptom Score, uroflowmetry, postvoiding residual urine volume and systolic blood pressure were recorded. Pearson correlation and linear regression analysis were used. RESULTS: Positive correlations were found between systolic blood pressure and all of the storage symptoms. Among these, urgency had the most significant effect. There were 166 patients (41.4%) with urgency for urination, which increased mean systolic blood pressure from 124.88 mmHg (average value in elevated blood pressure group) to 132.28 mmHg (average value in stage-1 hypertension group). Hesitancy in urinating and feeling of incomplete bladder emptying had weak positive correlations with systolic blood pressure. There was a negative correlation between systolic blood pressure and intermittency of urination. CONCLUSIONS: With increasing numbers of urine storage symptoms, systolic blood pressure also increases, while the opposite occurs for voiding symptoms in patients with benign prostate enlargement. We conjecture that storage symptoms may lead to this increase through inducing sympathetic hyperactivity. Further prospective studies with larger groups are needed to confirm these findings.
Descritores: Hiperplasia Prostática/complicações
Micção/fisiologia
Pressão Sanguínea/fisiologia
Sintomas do Trato Urinário Inferior/complicações
Hipertensão/complicações
-Tamanho do Órgão
Próstata/fisiopatologia
Índice de Gravidade de Doença
Estudos Transversais
Sintomas do Trato Urinário Inferior/fisiopatologia
Hipertensão/fisiopatologia
Limites: Masculino
Pessoa de Meia-Idade
Idoso
Responsável: BR1.1 - BIREME


  2 / 157 LILACS  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
Texto completo
Id: biblio-1281736
Autor: Moraes, Arianne Tiemi Jyoboji; Zulim, Marilena Infiesta; Bottini, Dayane Aparecida Moisés Caetano; Higa Júnior, Minoru German; De Assis, Peterson Vieira; Pegorare, Ana Beatriz Gomes de Souza.
Título: Treinamento do assoalho pélvico na retenção urinária decorrente de encefalomielite aguda disseminada / Pelvic floor muscle training in neurogenic bladder due to acute disseminated encephalomyelitis syndrome
Fonte: Fisioter. Bras;20(5):675-680, Outubro 24, 2019.
Idioma: pt.
Resumo: A dengue pode desencadear manifestações neurológicas como a Síndrome de Encefalomielite Aguda Disseminada (ADEM), de caráter inflamatório, desmielinizante, que pode ter dentre as consequências déficits motores e sensitivos, neurite ótica e disfunções vesicais, como a retenção urinária, tornando o indivíduo dependente da realização do cateterismo vesical intermitente (CVI). Desta forma, o objetivo deste estudo é descrever o tratamento fisioterapêutico de uma paciente com retenção urinária, decorrente de Síndrome de ADEM pós-dengue. Paciente do sexo feminino, 52 anos, internada em hospital de média complexidade com diagnóstico de ADEM. Na avaliação inicial apresentava grau de força muscular 3 de membros inferiores e 4 de membros superiores, 2 de musculatura do assoalho pélvico (MAP) e retenção urinária, necessitando realizar CVI. Foram realizados 32 atendimentos com duração de uma hora, incluindo o treinamento do assoalho pélvico em diferentes posturas e eletroestimulação de superfície da MAP com equipamento da marca Ibramed. Paciente recebeu alta hospitalar com evidente melhora da força muscular global e sem necessidade de CVI, apresentando micção voluntária e sem resíduo pós-miccional, favorecendo a prevenção de agravos do trato urinário inferior e superior. (AU)

Dengue can trigger neurological manifestations such as Acute Disseminated Encephalomyelitis (ADEM), with inflammatory, demyelinating condition, which may have, among the consequences, motor and sensory deficits, optic neuritis and bladder dysfunctions, such as urinary retention, making the individual dependent on intermittent bladder catheterization (IBC). Therefore, the objective of this study was to describe the physiotherapeutic treatment of a patient with urinary retention, due to ADEM syndrome after dengue. A 52-year-old female patient admitted to a hospital of medium complexity with a diagnosis of ADEM. In the initial evaluation, she presented a degree 3 of muscular strength in the lower limbs and 4 in the upper limbs, 2 in pelvic floor musculature (PFM) and urinary retention, requiring IBC. We performed 32 one hour sessions, including pelvic floor muscle training in different positions and surface electrostimulation of PFM with Ibramed brand equipment. Patient was discharged with evident improvement of global muscle strength and without IBC, presenting voluntary voiding and without post void residual, favoring the prevention of lower and upper urinary tract injuries. (AU)
Descritores: Retenção Urinária
Diafragma da Pelve
Encefalomielite Aguda Disseminada
-Micção
Bexiga Urinaria Neurogênica
Dengue
Força Muscular
Limites: Humanos
Tipo de Publ: Relatos de Casos
Responsável: BR1561.1 - Biblioteca Virtual AMMG


  3 / 157 LILACS  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
Id: lil-510166
Autor: Kohn Loncarica, G; López, J C; Dávila, M T G; Chantada, G.
Título: Haga su diagnótico / Your diagnosis, please
Fonte: Med. infant;14(2):170-172, jun. 2007. ilus.
Idioma: es.
Descritores: Micção
Rabdomiossarcoma Embrionário/diagnóstico
Limites: Adolescente
Tipo de Publ: Relatos de Casos
Responsável: AR94.1 - Centro de Información Pediatrica


  4 / 157 LILACS  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo SciELO Brasil
Rocha, Jeová Nina
Texto completo
Id: lil-796875
Autor: Rocha, Jeová Nina.
Título: Effect of S-methyl-l-thiocitrulline dihydrochloride on rat micturition reflex
Fonte: Int. braz. j. urol;42(5):1018-1027, Sept.-Oct. 2016. tab, graf.
Idioma: en.
Resumo: ABSTRACT Objective: To evaluate the effect of neuronal nitric oxide synthase on the striated urethral sphincter and the urinary bladder. Materials and Methods: A coaxial catheter was implanted in the proximal urethra and another one in the bladder of female rats, which were anesthetized with subcutaneous injection of urethane. The urethral pressure with saline continuous infusion and bladder isovolumetric pressure were simultaneously recorded. Two groups of rats were formed. In group I, an intrathecal catheter was implanted on the day of the experiment at the L6-S1 level of the spinal cord; in group II, an intracerebroventricular cannula was placed 5-6 days before the experiment. Results: It was verified that the group treated with S-methyl-L-thio-citrulline, via intrathecal pathway, showed complete or partial inhibition of the urethral sphincter relaxation and total inhibition of the micturition reflexes. The urethral sphincter and the detrusor functions were recovered after L-Arginine administration. When S-methyl-L-thio-citrulline was administered via intracerebroventricular injection, there was a significant increase of urethral sphincter tonus while preserving the sphincter relaxation and the detrusor contractions, at similar levels as before the use of the drugs. Nevertheless there was normalization of the urethral tonus when L-Arginine was applied. Conclusions: The results indicate that, in female rats anaesthetized with urethane, the nNOS inhibitor administrated through the intrathecal route inhibits urethral sphincter relaxation, while intracerebroventricular injection increases the sphincter tonus, without changing bladder function. These changes were reverted by L-Arginine administration. These findings suggest that the urethral sphincter and detrusor muscle function is modulated by nitric oxide.
Descritores: Tioureia/análogos & derivados
Uretra/efeitos dos fármacos
Micção/efeitos dos fármacos
Bexiga Urinária/efeitos dos fármacos
Citrulina/análogos & derivados
Inibidores Enzimáticos/farmacologia
Óxido Nítrico Sintase Tipo I/farmacologia
-Arginina/farmacologia
Pressão
Valores de Referência
Tioureia/farmacologia
Fatores de Tempo
Uretana/farmacologia
Uretra/fisiologia
Micção/fisiologia
Bexiga Urinária/fisiologia
Injeções Espinhais
Citrulina/farmacologia
Ratos Wistar
Anestésicos Intravenosos
Contração Muscular/efeitos dos fármacos
Contração Muscular/fisiologia
Limites: Animais
Feminino
Tipo de Publ: Estudo de Avaliação
Responsável: BR1.1 - BIREME


  5 / 157 LILACS  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo SciELO Brasil
Texto completo
Id: lil-794678
Autor: Wei, Yong; Xu, Ning; Chen, Shao-Hao; Li, Xiao-Dong; Zheng, Qing-Shui; Lin, Yun-Zhi; Xue, Xue-Yi.
Título: Bipolar transurethral enucleation and resection of the prostate versus bipolar resection of the prostate for prostates larger than 60gr: A retrospective study at a single academic tertiary care center
Fonte: Int. braz. j. urol;42(4):747-756, July-Aug. 2016. tab, graf.
Idioma: en.
Resumo: ABSTRACT Objective: To evaluate the efficacy and safety of bipolar transurethral enucleation and resection of the prostate (B-TUERP) versus bipolar transurethral resection of the prostate (B-TURP) in the treatment of prostates larger than 60g. Material and Methods: Clinical data for 270 BPH patients who underwent B-TUERP and 204 patients who underwent B-TURP for BPH from May 2007 to May 2013 at our center were retrospectively analyzed. Outcome measures included operative time, decreased hemoglobin level, total prostate specific antigen (TPSA), International Prostate Symptom Score (IPSS), maximal urinary flow rate (Qmax), quality of life (QoL) score, post void residual urine volume (RUV), bladder irrigation duration, hospital stay, and the weight of resected prostatic tissue. Other measures included perioperative complications including transurethral resection syndrome (TURS), hyponatremia, blood transfusion, bleeding requiring surgery, postoperative acute urinary retention, urine incontinence and urinary sepsis. Patients in both groups were followed for two years. Results: Compared with the B-TURP group, the B-TUERP group had shorter operative time, postoperative bladder irrigation duration and hospital stay, a greater amount of resected prostatic tissue, less postoperative hemoglobin decrease, better postoperative IPSS and Qmax, as well as lower incidences of hyponatremia, urinary sepsis, blood transfusion requirement, urine incontinence and reoperation (P<0.05 for all). Conclusions: B-TUERP is superior to B-TURP in the management of large volume BPH in terms of efficacy and safety, but this finding needs to be validated in further prospective, randomized, controlled studies.
Descritores: Próstata/cirurgia
Hiperplasia Prostática/cirurgia
Ressecção Transuretral da Próstata/métodos
-Período Pós-Operatório
Qualidade de Vida
Micção
Estudos Retrospectivos
Seguimentos
Retenção Urinária/etiologia
Resultado do Tratamento
Antígeno Prostático Específico/sangue
Ressecção Transuretral da Próstata/efeitos adversos
Duração da Cirurgia
Centros de Atenção Terciária
Irrigação Terapêutica
Tempo de Internação
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Idoso
Responsável: BR1.1 - BIREME


  6 / 157 LILACS  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo SciELO Brasil
Texto completo
Id: lil-794677
Autor: Konstantinidis, Charalampos; Kratiras, Zisis; Samarinas, Michael; Skriapas, Konstantinos.
Título: Optimal bladder diary duration for patients with suprapontine neurogenic lower urinary tract dysfunction
Fonte: Int. braz. j. urol;42(4):766-772, July-Aug. 2016. tab.
Idioma: en.
Resumo: ABSTRACT Purpose: To identify the minimum bladder diary's length required to furnish reliable documentation of LUTS in a specific cohort of patients suffering from neurogenic urinary dysfunction secondary to suprapontine pathology. Materials and Methods: From January 2008 to January 2014, patients suffering from suprapontine pathology and LUTS were requested to prospectively complete a bladder diary form for 7 consecutive days. Micturitions per day, excreta per micturition, urgency and incontinence episodes and voided volume per day were evaluated from the completed diaries. We compared the averaged records of consecutive days (2-6 days) to the total 7 days records for each patient's diary, seeking the minimum diary's length that could provide records comparable to the 7 days average, the reference point in terms of reliability. Results: From 285 subjects, 94 male and 69 female patients enrolled in the study. The records of day 1 were significantly different from the average of the 7 days records in every parameter, showing relatively small correlation and providing insufficient documentation. Correlations gradually increased along the increase in diary's duration. According to our results a 3-day duration bladder diary is efficient and can provide results comparable to a 7 day length for four of our evaluated parameters. Regarding incontinence episodes, 3 days seems inadequate to furnish comparable results, showing a borderline difference. Conclusions: A 3-day diary can be used, as its reliability is efficient regarding number of micturition per day, excreta per micturition, episodes of urgency and voided volume per day.
Descritores: Bexiga Urinária/fisiopatologia
Bexiga Urinaria Neurogênica/fisiopatologia
Registros Médicos
Sintomas do Trato Urinário Inferior/fisiopatologia
-Fatores de Tempo
Micção
Estudos Prospectivos
Bexiga Urinária Hiperativa/urina
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Feminino
Adulto
Idoso
Adulto Jovem
Responsável: BR1.1 - BIREME


  7 / 157 LILACS  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo SciELO Brasil
Texto completo
Id: lil-785734
Autor: Yu, Tian; Liao, Limin; Wyndaele, Jean Jacques.
Título: Can intraurethral stimulation inhibit micturition reflex in normal female rats?
Fonte: Int. braz. j. urol;42(3):608-613graf.
Idioma: en.
Resumo: ABSTRACT Objective The study was designed to determine the effect of low frequency (2.5Hz) intraurethral electrical stimulation on bladder capacity and maximum voiding pressures. Materials and Methods The experiments were conducted in 15 virgin female Sprague-Dawley rats (220–250g). The animals were anesthetized by intraperitoneal injection of urethane (1.5g/kg). Animal care and experimental procedures were reviewed and approved by the Institutional Animal Care and Use Committee of Antwerp University (code: 2013-50). Unipolar square pulses of 0.06mA were used to stimulate urethra at frequency of 2.5Hz (0.2ms pulse width) in order to evaluate the ability of intraurethral stimulation to inhibit bladder contractions. Continuous stimulation and intermittent stimulation with 5sec ‘‘on’’ and 5sec ‘‘off’’ duty cycle were applied during repeated saline cystometrograms (CMGs). Maximum voiding pressures (MVP) and bladder capacity were investigated to determine the inhibitory effect on bladder contraction induced by intraurethral stimulation. Results The continuous stimulation and intermittent stimulation significantly (p<0.05) decreased MVP and increased bladder capacity. There was no significant difference in MVP and bladder capacity between continuous and intermittent stimulation group. Conclusions The present results suggest that 2.5Hz continuous and intermittent intraurethral stimulation can inhibit micturition reflex, decrease MVP and increase bladder capacity. There was no significant difference in MVP and bladder capacity between continuous and intermittent stimulation group.
Descritores: Reflexo/fisiologia
Uretra/fisiologia
Micção/fisiologia
Terapia por Estimulação Elétrica/métodos
-Pressão
Valores de Referência
Fatores de Tempo
Urodinâmica
Bexiga Urinária/fisiologia
Ratos Sprague-Dawley
Bexiga Urinária Hiperativa/fisiopatologia
Bexiga Urinária Hiperativa/terapia
Nervo Pudendo/fisiopatologia
Contração Muscular/fisiologia
Limites: Animais
Feminino
Tipo de Publ: Estudo de Avaliação
Responsável: BR1.1 - BIREME


  8 / 157 LILACS  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo SciELO Brasil
Pompeo, Antônio Carlos Lima
Texto completo
Id: lil-785725
Autor: Lima, João Paulo Cunha; Pompeo, Antonio Carlos Lima; Bezerra, Carlos Alberto.
Título: Argus T® versus advance® sling for postprostatectomy urinary incontinence: a randomized clinical trial
Fonte: Int. braz. j. urol;42(3):531-539tab, graf.
Idioma: en.
Resumo: ABSTRACT Objective To compare the results of two slings, Argus T® and Advance®, for the treatment of postprostatectomy urinary incontinence (PPUI). Material and Methods: From December 2010 to December 2011, 22 patients with PPUI were randomized as follows: 11 (mean age 62.09(±5.30)) underwent treatment with Advance® and 11 (mean age 62.55(±8.54)) with Argus T®. All patients were evaluated preoperatively with urodynamic testing, quality of life questionnaire (ICIQ-SF), voiding diary and 24-hour pad test. Exclusion criteria were: neurological diseases, severe detrusor overactivity and urethral stenosis. Evaluation was performed at 6, 12 and 18 months after the surgery. After implantation of the Argus T® sling, patients who experienced urine leakage equal to or greater than the initial volume underwent adjustment of the sling tension. Results were statistically analyzed using the Fisher’s test, Kolmogorov-Smirnov test, Friedman’s non-parametric test or the Mann-Whitney test. Results Significant improvement of the 24-hour pad test was observed with the Argus T® sling (p=0.038) , With regard to the other parameters, there was no significant difference between the two groups. Removal of the Argus T® device due to perineal pain was performed in one patient (9%). Despite non uniform results, both devices were considered useful to improve quality of life (ICIQ-SF): Argus T® (p=0.018) and Advance® (p=0.017). Conclusions Better results were observed in the 24h pad test and in levels of satisfaction with the Argus T® device. Both slings contributed to improve quality of life (ICIQ-SF), with acceptable side effects.
Descritores: Prostatectomia/efeitos adversos
Incontinência Urinária/cirurgia
Incontinência Urinária/etiologia
Slings Suburetrais
-Complicações Pós-Operatórias
Qualidade de Vida
Fatores de Tempo
Micção
Urodinâmica
Inquéritos e Questionários
Seguimentos
Resultado do Tratamento
Satisfação do Paciente
Estatísticas não Paramétricas
Escala Visual Analógica
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Idoso
Idoso de 80 Anos ou mais
Tipo de Publ: Ensaio Clínico Controlado Aleatório
Responsável: BR1.1 - BIREME


  9 / 157 LILACS  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo SciELO Brasil
Texto completo
Id: lil-782844
Autor: Malik, Rena D; Cohn, Joshua A; Fedunok, Pauline A; Chung, Doreen E; Bales, Gregory T.
Título: Assessing variability of the 24-hour pad weight test in men with post-prostatectomy incontinence
Fonte: Int. braz. j. urol;42(2):327-333, Mar.-Apr. 2016. tab, graf.
Idioma: en.
Resumo: ABSTRACT Purpose: Decision-making regarding surgery for post-prostatectomy incontinence (PPI) is challenging. The 24-hour pad weight test is commonly used to objectively quantify PPI. However, pad weight may vary based upon activity level. We aimed to quantify variability in pad weights based upon patient-reported activity. Materials and Methods: 25 patients who underwent radical prostatectomy were prospectively enrolled. All patients demonstrated clinical stress urinary incontinence without clinical urgency urinary incontinence. On three consecutive alternating days, patients submitted 24-hour pad weights along with a short survey documenting activity level and number of pads used. Results: Pad weights collected across the three days were well correlated to the individual (ICC 0.85 (95% CI 0.74–0.93), p<0.001). The mean difference between the minimum pad weight leakage and maximum leakage per patient was 133.4g (95% CI 80.4–186.5). The mean increase in 24-hour leakage for a one-point increase in self-reported activity level was 118.0g (95% CI 74.3–161.7, p<0.001). Pad weights also varied significantly when self-reported activity levels did not differ (mean difference 51.2g (95% CI 30.3–72.1), p<0.001). Conclusions: 24-hour pad weight leakage may vary significantly on different days of collection. This variation is more pronounced with changes in activity level. Taking into account patient activity level may enhance the predictive value of pad weight testing.
Descritores: Prostatectomia/efeitos adversos
Incontinência Urinária por Estresse/etiologia
Incontinência Urinária por Estresse/fisiopatologia
Micção/fisiologia
Tampões Absorventes para a Incontinência Urinária
-Valores de Referência
Fatores de Tempo
Incontinência Urinária por Estresse/cirurgia
Incontinência Urinária por Estresse/diagnóstico
Atividades Cotidianas
Modelos Lineares
Estudos Prospectivos
Reprodutibilidade dos Testes
Técnicas de Diagnóstico Urológico
Autoavaliação Diagnóstica
Autorrelato
Tomada de Decisão Clínica
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Idoso
Responsável: BR1.1 - BIREME


  10 / 157 LILACS  
              first record previous record
seleciona
para imprimir
Fotocópia
Texto completo SciELO Brasil
Texto completo
Id: lil-782861
Autor: Memon, Mazhar A; Ather, M. Hammad.
Título: Relationship between visual prostate score (VPSS) and maximum flow rate (Qmax) in men with urinary tract symptoms
Fonte: Int. braz. j. urol;42(2):321-326, Mar.-Apr. 2016. tab, graf.
Idioma: en.
Resumo: ABSTRACT Objective: To evaluate correlation between visual prostate score (VPSS) and maximum flow rate (Qmax) in men with lower urinary tract symptoms. Material and Methods: This is a cross sectional study conducted at a university Hospital. Sixty-seven adult male patients>50 years of age were enrolled in the study after signing an informed consent. Qmax and voided volume recorded at uroflowmetry graph and at the same time VPSS were assessed. The education level was assessed in various defined groups. Pearson correlation coefficient was computed for VPSS and Qmax. Results: Mean age was 66.1±10.1 years (median 68). The mean voided volume on uroflowmetry was 268±160mL (median 208) and the mean Qmax was 9.6±4.96mLs/sec (median 9.0). The mean VPSS score was 11.4±2.72 (11.0). In the univariate linear regression analysis there was strong negative (Pearson's) correlation between VPSS and Qmax (r=848, p<0.001). In the multiple linear regression analyses there was a significant correlation between VPSS and Qmax (β-http://www.blogapaixonadosporviagens.com.br/p/caribe.html after adjusting the effect of age, voided volume (V.V) and level of education. Multiple linear regression analysis done for independent variables and results showed that there was no significant correlation between the VPSS and independent factors including age (p=0.27), LOE (p=0.941) and V.V (p=0.082). Conclusion: There is a significant negative correlation between VPSS and Qmax. The VPSS can be used in lieu of IPSS score. Men even with limited educational background can complete VPSS without assistance.
Descritores: Próstata/fisiopatologia
Micção/fisiologia
Sintomas do Trato Urinário Inferior/diagnóstico
Sintomas do Trato Urinário Inferior/fisiopatologia
Avaliação de Sintomas/métodos
-Valores de Referência
Fatores de Tempo
Urodinâmica
Índice de Gravidade de Doença
Modelos Lineares
Estudos Transversais
Estudos Prospectivos
Reprodutibilidade dos Testes
Fatores Etários
Técnicas de Diagnóstico Urológico
Escolaridade
Limites: Humanos
Masculino
Idoso
Tipo de Publ: Estudo de Avaliação
Responsável: BR1.1 - BIREME



página 1 de 16 ir para página                         
   


Refinar a pesquisa
  Base de dados : Formulário avançado   

    Pesquisar no campo  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde