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  1 / 19195 MEDLINE  
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PMID:29231007
Autor:Du YL; Zhang WL
Dirección:Nine-three Reclamation Public Security Bureau, Nenjiang 161441, China.
Título:[Automobile Traffic Accident Death Case Analysis of Characteristics of Driver Injury].
Fuente:Fa Yi Xue Za Zhi; 33(1):36-37, 2017 Feb.
ISSN:1004-5619
País de publicación:China
Idioma:chi
Resumen:OBJECTIVES: To distinguish the injury characteristic changes on the drivers between the injuries of drivers and passengers in traffic accidents, and to provide scientific evidence for confirming the identity of driver in traffic accidents. METHODS: Data of 126 automobile traffic accident death cases in the reclamation areas of Heilongjiang province from 2006-2014 were retrospectively studied. The injury characteristics on the drivers of automobile traffic accident death cases were analyzed and the forensic identification problem in the injuries of drivers and passengers were discussed. RESULTS: Injuries were frequently observed on driver's neck, chest and abdomen. The characteristic injuries caused by auto parts were also found, which appeared at the places of passenger's head, face and limbs contacted with automobile. Such characteristic injuries were not found at other places. CONCLUSIONS: The location and type of injury are associated with the identity of the deceased.
Tipo de publicación:JOURNAL ARTICLE


  2 / 19195 MEDLINE  
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PMID:29429158
Autor:Sun M; Liu JG; Weng QY; Yu L; Wang J
Dirección:Department of Pathology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
Título:[Pleomorphic and dedifferentiated leiomyosarcoma: a clinicopathologic analysis].
Fuente:Zhonghua Bing Li Xue Za Zhi; 47(2):87-93, 2018 Feb 08.
ISSN:0529-5807
País de publicación:China
Idioma:chi
Resumen:To investigate the clinicopathologic features, differential diagnosis and biological behavior of pleomorphic leiomyosarcoma (PLMS) and dedifferentiated leiomyosarcoma (DLMS). Forty-nine cases were collected from November 2007 to December 2016, including eight that diagnosed at Fudan University Shanghai Cancer Center, and 41 consultation cases. The clinical findings and pathologic features were reviewed. Immunophenotype was obtained in 33 cases and follow-up information was available in 38 cases. There were 22 males and 27 females with ages ranging from 24 to 83 years (mean 52.5 years). Fifteen cases occurred in extremities, 14 in deep body cavity, 11 in the trunk, 4 in the head and neck, 2 in the bladder, and 1 each in the inguinal region, perineum and femoral vein, respectively. Tumor sizes ranged from 3 to 30 cm (mean 9.1 cm). The tumors were composed of at least small foci of typical leiomyosarcoma (LMS) and areas of high-grade pleomorphic/undifferentiated sarcoma. The typical LMS component showed the characteristic morphology of smooth muscle differentiation and was low to intermediate grade in most cases. Pleomorphic areas were mainly composed of atypical spindle and polygonal cells admixed with variable large, bizarre atypical cells and multinuclear giant cells, mostly mimicking undifferentiated pleomorphic sarcoma. The pleomorphic and leiomyosarcomatous areas were usually intermixed, but the demarcation may be distinct or gradual in some cases. The classical LMS component was positive for at least one myogenic marker: α-SMA in 97.0%(32/33), desmin in 72.7%(24/33), H-caldesmon in 90.9% (20/22), MSA in 14/16, and calponin in 15/15 of cases. The pleomorphic sarcoma component was reactive for at least one myogenic marker in 87.9% (29/33) of cases, usually showing focal and less intense immunoreactivity than classical LMS component: α-SMA was positive in 81.8%(27/33), desmin in 48.5%(16/33), H-caldesmon in 72.7% (16/22), MSA in 12/16, and calponin in 11/15 of cases. Based on staining for muscle markers in the pleomorphic component, 29 cases were designated as PLMS, 4 as DLMS. Ki-67 index ranged from 15% to 70% (mean 40%). Follow-up data was available in 38 cases (77.6%), of which 11 patients (28.9%) died of disease, 12 patients were alive with unresectable or recurrent disease, 14 patients were alive with no evidence of disease and another one died of unrelated cause. The median disease-free and overall survival was 6 and 10 months respectively. Twelve patients exhibited local recurrence and 11 developed metastases. The median interval to progression was 8 months. The identification of areas of typical LMS is crucial for accurate diagnosis of PLMS and DLMS. Both PLMS and DLMS show more aggressive behavior and poorer prognosis than ordinary LMS.
Tipo de publicación:JOURNAL ARTICLE
Nombre de substancia:0 (ACTA2 protein, human); 0 (Actins); 0 (Biomarkers, Tumor); 0 (Calcium-Binding Proteins); 0 (Calmodulin-Binding Proteins); 0 (Desmin); 0 (Microfilament Proteins); 0 (calponin)


  3 / 19195 MEDLINE  
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PMID:29384879
Autor:Jung KJ; Nho JH; Cho HK; Hong S; Won SH; Chun DI; Kim B
Dirección:Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Cheonan-si.
Título:Amputation of multiple limbs caused by use of inotropics: Case report, a report of 4 cases.
Fuente:Medicine (Baltimore); 97(5):e9800, 2018 Feb.
ISSN:1536-5964
País de publicación:United States
Idioma:eng
Resumen:RATIONALE: We present 4 cases of symmetrical peripheral gangrene (SPG) associated with use of inotropic agent to elevate blood pressure. SPG is a relatively rare phenomenon characterized by symmetrical distal ischemic damage that leads to gangrene of 2 or more sites in the absence of large blood vessel obstruction, where vasoconstriction rather than thrombosis is implicated as the underlying pathophysiology. We present 4 SPG cases of the multiple limbs amputation, associated with inevitable use of inotropic agents. PATIENT CONCERNS: Inotropic agents including dopamine and norepinephrine are used frequently in the treatment of hypotension, and its effectiveness in treating shock is firmly established. However, it can be caused peripheral gangrene by prolonged administration of high dose inotropics, inducing the constant contraction of the peripheral blood vessels. DIAGNOSIS: These 4 patients had different clinical histories and background factors, but each experienced sepsis. The level of amputation is determined by the line of demarcation in concert with considerations of the biomechanics of stump stability, weight bearing, and ambulation. INTERVENTIONS: After recovering of general conditions and completion of demarcation, these 4 patients underwent the amputation of multiple limbs.(bilateral amputations of upper extremities or bilateral amputations of lower extremities). OUTCOMES: In each patient, there was no additional amputation caused by extension of SPG, and the rehabilitation with appropriate orthosis was performed. Treatment of underlying disease were continued too. LESSONS: It is important to alert the possibility of amputations, according to the use of inevitable inotropics. We recommended the careful use of the inotropic agents to the physicians in treating septic shock.
Tipo de publicación:CASE REPORTS; JOURNAL ARTICLE
Nombre de substancia:0 (Cardiotonic Agents); 0 (Vasoconstrictor Agents); VTD58H1Z2X (Dopamine); X4W3ENH1CV (Norepinephrine)


  4 / 19195 MEDLINE  
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PMID:28463470
Autor:Andrews RM; Skewes SA
Dirección:Department of Biological Sciences, Virginia Tech, Blacksburg, Virginia.
Título:Developmental origin of limb size variation in lizards.
Fuente:Evol Dev; 19(3):136-146, 2017 05.
ISSN:1525-142X
País de publicación:United States
Idioma:eng
Resumen:In many respects, reptile hatchlings are fully functional, albeit miniature, adults. This means that the adult morphology must emerge during embryonic development. This insight emphasizes the connection between the mechanisms that generate phenotypic variation during embryonic development and the action of selection on post-hatching individuals. To determine when species-specific differences in limb and tail lengths emerge during embryonic development, we compared allometric patterns of early limb growth of four distantly related species of lizards. The major questions addressed were whether early embryonic limb and tail growth is characterized by the gradual (continuous allometry) or by the abrupt emergence (transpositional allometry) of size differences among species. Our observations supported transpositional allometry of both limbs and tails. Species-specific differences in limb and tail length were exhibited when limb and tail buds first protruded from the body wall. Genes known to be associated with early limb development of tetrapods are obvious targets for studies on the genetic mechanisms that determine interspecific differences in relative limb length. Broadly comparative studies of gene regulation would facilitate understanding of the mechanisms underlying adaptive variation in limb size, including limb reduction and loss, of squamate reptiles.
Tipo de publicación:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; RESEARCH SUPPORT, U.S. GOV'T, NON-P.H.S.


  5 / 19195 MEDLINE  
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PMID:27777135
Autor:Haddad J; Kalbacher E; Piccard M; Aubry S; Chaigneau L; Pauchot J
Dirección:Service de chirurgie orthopédique, traumatologique et plastique, chirurgie de la main, CHU Jean-Minjoz, 1, boulevard Flemming, 25030 Besançon, France.
Título:[Evaluation of the management of soft tissue sarcomas in Franche-Comté since the establishment of a multidisciplinary meeting at University Hospital. About 47 cases].
Título:Évaluation de la prise en charge des sarcomes des tissus mous en Franche-Comté depuis l'instauration d'une réunion de concertation pluridisciplinaire au CHRU. À propos de 47 cas..
Fuente:Ann Chir Plast Esthet; 62(1):15-22, 2017 Feb.
ISSN:1768-319X
País de publicación:France
Idioma:fre
Resumen:GOALS OF STUDY: A multidisciplinary meeting (RCP) dedicated to the treatment of sarcoma was established in Franche-Comte in 2010. The goals of the study are: (a) To evaluate the treatment of sarcomas by confrontation with the existing literature; (b) To evaluate the influence of the multidisciplinary meeting on the management of sarcomas by hospitals at the regional level. MATERIALS AND METHODS: This is a retrospective single center study from 2010 to 2015 on patients with sarcoma and peripheral soft tissue drawn from a Netsarc database (National Network of sarcomas) and communicating cancer record. A database Cleanweb especially dedicated is created. RESULTS: Forty-seven patients were included: ten sarcomas at the upper member 26 to the lower limbs, 11 on the trunk. Forty patients were operated on: ten out of the university hospital, 28 at the university hospital and two in a coordinating center. Ninety percent of patients treated at the university hospital were in accordance with the recommandations. None of the patients operated out of the university hospital benefited from medical care in accordance to the recommendations. There is an increase in the number of files sent by the hospitals out of the university hospital discussed in multidisciplinary meeting, before treatment. CONCLUSION: The creation of a dedicated multidisciplinary meeting sarcoma improves the medical management of these tumors and decreases inappropriate medical managements thanks to a better education of the regional physicians.
Tipo de publicación:JOURNAL ARTICLE


  6 / 19195 MEDLINE  
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PMID:28454909
Autor:Yamashita D; Fujii K; Yoshioka S; Isaka T; Kouzaki M
Dirección:Japan Institute of Sports Sciences, Tokyo, Japan. Electronic address: daichi.yamashita@jpnsport.go.jp.
Título:Asymmetric interlimb role-sharing in mechanical power during human sideways locomotion.
Fuente:J Biomech; 57:79-86, 2017 05 24.
ISSN:1873-2380
País de publicación:United States
Idioma:eng
Resumen:Sideways movement at a wide variety of speeds is required in daily life and sports. The purpose of this study was to identify the characteristics of asymmetry in power output between lower limbs during sideways gait patterns. Seven healthy men performed steady-state sideways locomotion at various speeds. The mechanical external power of each limb was calculated and decomposed to the lateral and vertical components by the center of mass velocity and ground reaction force. We acquired data from 126 steps of sideways walking at 0.44-1.21m/s, and from 41 steps of sideways galloping at 1.04-3.00m/s. The results showed asymmetric power production between the limbs during sideways locomotion. During sideways walking, the trailing limb predominantly produced positive external power and the leading limb produced predominantly negative external power, and these amplitudes increased with step speed. In contrast, during sideways galloping, negative and subsequent positive power production was observed in both limbs. These differences in asymmetric interlimb role-sharing were mainly due to the vertical component. During sideways galloping, the trailing limb absorbs vertical power produced by the leading limb due to the longer flight time. This characteristic of vertical power production in the trailing limb may explain the presence of a double-support phase, which is not observed during forward running, even at high speeds. Our results will help to elucidate the asymmetric movements of the limbs in lateral directions at various speeds.
Tipo de publicación:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T


  7 / 19195 MEDLINE  
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PMID:29265660
Autor:Brimacombe CS
Dirección:Human Evolutionary Studies Program and Department of Archaeology, Simon Fraser University, Burnaby, BC, Canada.
Título:The enigmatic relationship between epiphyseal fusion and bone development in primates.
Fuente:Evol Anthropol; 26(6):325-335, 2017 Nov.
ISSN:1520-6505
País de publicación:United States
Idioma:eng
Resumen:Epiphyseal fusion in primates is a process that occurs in a regular sequence spanning a period of years and thus provides biological anthropologists with a useful marker of maturity that can be used to assess age and stage of development. Despite the many studies that have catalogued fusion timing and sequence pattern, comparatively little research has been devoted to understanding why these sequences exist in the first place. Answering this question is not necessarily intuitive; indeed, given that neither taxonomic affinities nor recent adaptations have been clearly defined, it is a challenge to explain this process in evolutionary terms. In all mammals, there is a tendency for the fusion of epiphyses at joints to occur close in sequence, and this has been proposed to relate to locomotor adaptations. Further consideration of the evidence suggests that linking locomotor behavior to sequence data alone is difficult to prove and may require a different type of evidence. Epiphyseal fusion should be considered in the context of other parameters that affect the developing skeleton, including how joint morphology relates to growth in length, as well as other possible morphological constraints. In recent years, developmental biology has been providing a better understanding of the molecular regulators of epiphyseal fusion. At some point in the near future, we may be able to link our understanding of the genetics of fusion timing to the possible selective mechanisms that are responsible for these sequences.
Tipo de publicación:JOURNAL ARTICLE


  8 / 19195 MEDLINE  
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PMID:29275616
Autor:Li SJ; Wang ZL; Zhu WP; Xiang Y; Lin J; Yu YJ; Li P
Dirección:Department of Radiology, Shanghai Electric Power Hospital, Shanghai 200050, China.
Título:[Clinical research of features of magnetic resonance imaging of high-voltage electrical burns in limbs at early stage].
Fuente:Zhonghua Shao Shang Za Zhi; 33(12):750-756, 2017 Dec 20.
ISSN:1009-2587
País de publicación:China
Idioma:chi
Resumen:To analyze the features of magnetic resonance imaging (MRI) of patients with high-voltage electrical burns in limbs at early stage. Thirty-eight patients with high-voltage electrical burns, conforming to the study criteria, were hospitalized in our unit from March 2013 to August 2016. T(1) weighted imaging (T(1)WI), T(2)WI, fat-suppression T(2)WI plain scan, and fat-suppression T(1)WI enhanced scan of MRI were performed in 78 limbs, including 56 upper limbs and 22 lower limbs at post injury hour 72. The MRI signal characteristics of electrical burns in skin and subcutaneous tissue, skeletal muscle, tendon, joint ligament, and skeleton of limbs were analyzed. " Sandwich-like" necrosis and injury in skeletal muscle, injuries of tendon, joint ligament, and skeleton were observed. MRI signal characteristics of amputated upper limbs and salvaged limbs were also analyzed. All patients underwent surgery within 24 h after MRI examination, and the muscle vitality was judged during operation. Muscle tissue without reaction to electrical stimulation which was completely necrotic as shown by MRI, muscle tissue with weak reaction to electrical stimulation which was injured with blood supply as shown by MRI, and muscle tissue with edema as shown by MRI were collected, and then the pathological characteristics of muscle tissue were observed with HE staining. (1) The defect area of patients at entrance of current was bigger than that at exit. The skin and subcutaneous tissue extensively unevenly thickened. T(2)WI manifested hyperintensity, and T(1)WI manifested isointensity, while fat-suppression enhanced T(1)WI manifested uneven enhancement. Zonal effusion was seen in the region of serious subcutaneous edema. (2) For complete necrosis of skeletal muscle, T(2)WI manifested hypointense, isointensity, or slight hyperintensity, and T(1)WI manifested isointensity, slight hyperintensity, or mixed signal of isointensity and slight hyperintensity, while fat-suppression enhanced T(1)WI manifested most no enhancement area with clear boundary. The MRI signals of injured skeletal muscle could be divided into two types. Type â…  signal was for partial necrotic muscle adjacent to the completely necrotic zone. T(2)WI manifested uneven hyperintensity or slight hyperintensity, with unclear boundary. T(1)WI manifested isointensity or slight hyperintensity. Fat-suppression enhanced T(1)WI manifested significant banding or laciness enhancement. Type â…¡ signal was for deep muscle tissue far from the complete necrotic zone. T(2)WI manifested hyperintensity, and T(1)WI manifested isointensity or main isointensity mixed with hyperintensity, while fat-suppression enhanced T(1)WI manifested uneven moderate or slight enhancement. Normal muscle signal, type â…  signal, and type â…¡ signal were all mixed with necrotic signal, showing " sandwich-like" change. For skeletal muscle edema, T(2)WI manifested slight hyperintensity and unclear boundary, and T(1)WI manifested hypointense, while fat-suppression enhanced T(1)WI manifested no obvious enhancement. (3) For complete necrosis of tendon, T(2)WI manifested isointensity or slight hyperintensity, and T(1)WI manifested isointensity, while fat-suppression enhanced T(1)WI manifested no enhancement. For tendon injury, T(2)WI manifested isointensity, and T(1)WI manifested isointensity or hypointense, while fat-suppression enhanced T(1)WI manifested slight enhancement. (4) Severe injury of wrist joint were manifested as complete necrosis of soft tissue around joint. T(2)WI manifested slight hyperintensity or isointensity, and T(1)WI manifested isointensity, while fat-suppression enhanced T(1)WI manifested no enhancement or slightly uneven enhancement. For completely destroyed wrist joints, the structures were not clear from outside to inside. T(2)WI manifested slight hyperintensity or isointensity, and T(1)WI manifested hypointense or isointensity, while fat-suppression enhanced T(1)WI manifested no enhancement. For elbow injury, T(2)WI manifested hyperintensity, and T(1)WI manifested isointensity or hypointense, while fat-suppression enhanced T(1)WI manifested uneven enhancement. For knee injury, T(2)WI manifested hyperintensity, and T(1)WI manifested hypointense, while fat-suppression enhanced T(1)WI manifested slight enhancement. (5) For bone edema, T(2)WI manifested isointensity, while fat-suppression T(2)WI manifested slight hyperintensity. T(1)WI manifested isointensity, and fat-suppression enhanced T(1)WI manifested patchy enhancement. (6) MRI of amputated upper limbs showed necrosis signals, type â…  signals, type â…¡ signals, and mixed signals of type â…  and type â…¡ in skeletal muscle. The necrosis signal and type â…  signal area of the distal end were more than 50% greater than those of the lesion. The scope of the ecological tissue was large and the boundary was not clear. There were diffuse injuries in both anterior and posterior muscles, and the ulnar and radial artery pulsation disappeared in the upper limbs. The MRI of salvaged limbs were type â…  signal, type â…¡ signal, mixed signals of type â…  and type â…¡, and local necrosis signals of skeletal muscle. The type â…  signal was the main type, and the distal end showed type â…¡ signal. (7) For completely necrotic skeletal muscle as shown by MRI, surgical exploration showed loss of muscle viability, and pathological examination showed complete necrosis of striated muscle tissue. For injury area of skeletal muscle as shown by MRI, surgical exploration showed interecological muscle with activity worse than mormal muscle, and pathological examination showed normal muscle cells and muscle fiber mixed with necrotic striated muscle cells having karyopyknosis, with different degree of injury. For edema area of skeletal muscle as shown by MRI, surgical exploration showed swelling skeletal muscle and normal muscle vitality, and pathological examination showed striated muscle interstitial edema with a large number of inflammatory cells infiltration. The manifestions of MRI were consistent with the results of surgical exploration and pathological examination. Skeletal muscle complete necrosis, injury, and edema could be preferably differentiated by MRI, and the definite scope and depth of electrical injury, the injury of skin, tendon, joint ligament, and bone could also be displayed well on MRI. It can provide objective imaging basis for the diagnosis of high-voltage electrical burns in limbs at early stage, the establishment of clinical operation plan, and the judgment of intraoperative tissue vitality.
Tipo de publicación:JOURNAL ARTICLE


  9 / 19195 MEDLINE  
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PMID:29224656
Autor:O Dell MC; Shah J; Martin JG; Kies D
Dirección:Department of Radiology and Imaging Science, Emory University Hospital, Atlanta, GA. Electronic address: mcodell@email.emory.edu.
Título:Emergent Endovascular Treatment of Penetrating Trauma: Solid Organ and Extremity.
Fuente:Tech Vasc Interv Radiol; 20(4):243-247, 2017 Dec.
ISSN:1557-9808
País de publicación:United States
Idioma:eng
Resumen:Penetrating injuries can result in acute or subacute arterial injuries of the solid organs or extremities. Although most penetrating injuries are managed conservatively, some patients require endovascular or surgical treatment. Often, the best method for management is controversial and the level of urgency for clinical decision-making is high. Once the decision has been made to intervene, the operator must also determine the best embolization material and technique to use. Not unfrequently, these decisions are made during the course of the procedure. There are numerous embolization agents, each of which serves a very specific purpose, depending on the clinical scenario. Within this article, we will review endovascular treatment indications, contraindications, and endovascular techniques for the treatment of penetrating trauma of the solid organs or extremities.
Tipo de publicación:CASE REPORTS; JOURNAL ARTICLE; REVIEW


  10 / 19195 MEDLINE  
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PMID:27773569
Autor:Leal F; Cohn MJ
Dirección:Howard Hughes Medical Institute, UF Genetics Institute, University of Florida, P.O. Box 103610, University of Florida, Gainesville, FL 32610, USA; Department of Biology, UF Genetics Institute, University of Florida, P.O. Box 103610, University of Florida, Gainesville, FL 32610, USA.
Título:Loss and Re-emergence of Legs in Snakes by Modular Evolution of Sonic hedgehog and HOXD Enhancers.
Fuente:Curr Biol; 26(21):2966-2973, 2016 Nov 07.
ISSN:1879-0445
País de publicación:England
Idioma:eng
Resumen:Limb reduction and loss are hallmarks of snake evolution. Although advanced snakes are completely limbless, basal and intermediate snakes retain pelvic girdles and small rudiments of the femur. Moreover, legs may have re-emerged in extinct snake lineages [1-5], suggesting that the mechanisms of limb development were not completely lost in snakes. Here we report that hindlimb development arrests in python embryos as a result of mutations that abolish essential transcription factor binding sites in the limb-specific enhancer of Sonic hedgehog (SHH). Consequently, SHH transcription is weak and transient in python hindlimb buds, leading to early termination of a genetic circuit that drives limb outgrowth. Our results suggest that degenerate evolution of the SHH limb enhancer played a role in reduction of hindlimbs during snake evolution. By contrast, HOXD digit enhancers are conserved in pythons, and HOXD gene expression in the hindlimb buds progresses to the distal phase, forming an autopodial (digit) domain. Python hindlimb buds then develop transitory pre-chondrogenic condensations of the tibia, fibula, and footplate, raising the possibility that re-emergence of hindlimbs during snake evolution did not require de novo re-evolution of lost structures but instead could have resulted from persistence of embryonic legs. VIDEO ABSTRACT.
Tipo de publicación:JOURNAL ARTICLE
Nombre de substancia:0 (Hedgehog Proteins); 0 (Reptilian Proteins)



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