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[PMID]:28452050
[Au] Autor:Schless SH; Desloovere K; Bar-On L
[Ad] Endereço:Clinical Motion Analysis Laboratory, University Hospital Leuven, Leuven, Belgium.
[Ti] Título:In vivo muscle behaviour in cerebral palsy with an equinus gait: are we on track?
[So] Source:Dev Med Child Neurol;59(8):781-782, 2017 08.
[Is] ISSN:1469-8749
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Paralisia Cerebral
Transtornos Neurológicos da Marcha
[Mh] Termos MeSH secundário: Pé Equino
Marcha
Seres Humanos
Músculo Esquelético
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171209
[Lr] Data última revisão:
171209
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1111/dmcn.13447


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[PMID]:28984769
[Au] Autor:Chen W; Liu X; Pu F; Yang Y; Wang L; Liu H; Fan Y
[Ad] Endereço:aKey Laboratory of Rehabilitation Technical Aids, Ministry of Civil Affair, School of Biological Science and Medical Engineering, Beihang University bState Key Laboratory of Virtual Reality Technology and Systems, Beihang University cNational Research Center for Rehabilitation Technical Aids dRokab Pedorthic Center, Beijing, P.R. China.
[Ti] Título:Conservative treatment for equinus deformity in children with cerebral palsy using an adjustable splint-assisted ankle-foot orthosis.
[So] Source:Medicine (Baltimore);96(40):e8186, 2017 Oct.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: A novel splint, the assisting ankle-foot orthoses (AFO), was developed to provide adjustable sustained stretching to improve conservative treatment for equinus deformities in children with cerebral palsy (CP). The treatment effect was validated by follow-up visits. METHODS: This study involved subjects between 2 and 12 years old, including 28 CP children treated with splint-assisted AFO correction, 30 CP children treated with static AFO correction, and 30 normal children with typical development (TD). Quantitative pedobarographic measurements were taken to evaluate the effect of splint-assisted AFO correction. The heel/forefoot ratio was introduced to indicate the degree of the equinus deformity during treatment. RESULTS: The results showed that the heel/forefoot ratios were 1.41 ±â€Š0.26 for the TD children; 0.65 ±â€Š0.41, 1.02 ±â€Š0.44, and 1.24 ±â€Š0.51 for the splint-assisted AFO correction before and after 6-month and 12-month treatments; 0.59 ±â€Š0.37, 0.67 ±â€Š0.44, and 0.66 ±â€Š0.42 for the static AFO correction before and after 6-month and 12-month treatments. CONCLUSIONS: This study suggests that correction with the adjustable splint-assisted AFO is an effective treatment for equinus deformity in CP Children.
[Mh] Termos MeSH primário: Paralisia Cerebral/complicações
Tratamento Conservador/instrumentação
Pé Equino/terapia
Órtoses do Pé
Contenções
[Mh] Termos MeSH secundário: Tornozelo/fisiopatologia
Estudos de Casos e Controles
Criança
Pré-Escolar
Tratamento Conservador/métodos
Pé Equino/etiologia
Pé Equino/fisiopatologia
Desenho de Equipamento
Feminino
/fisiopatologia
Calcanhar/fisiopatologia
Seres Humanos
Masculino
Estudos Prospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171007
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008186


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[PMID]:28367689
[Au] Autor:Kaplan N; Fowler X; Maqsoodi N; DiGiovanni B; Oh I
[Ad] Endereço:1 Department of Orthopaedics and Rehabilitation, University of Rochester Medical Center, Rochester, NY, USA.
[Ti] Título:Operative Anatomy of the Medial Gastrocnemius Recession vs the Proximal Medial Gastrocnemius Recession.
[So] Source:Foot Ankle Int;38(4):424-429, 2017 Apr.
[Is] ISSN:1944-7876
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Isolated gastrocnemius contracture (IGC) is associated with various foot and ankle pathologies. To address the problem of IGC, a number of gastrocnemius lengthening procedures have been described. Although proximal medial gastrocnemius recession (PMGR) has shown to be an effective operative treatment for IGC, it poses risks to various anatomic structures around the knee joint and requires the patient to be positioned prone. As an alternative, we proposed to release the medial gastrocnemius at the division between the proximal one-third and distal two-thirds of the gastrocnemius muscle to correct equinus contracture, while minimizing risk to other structures. The aim of this study was to describe an anatomic basis for a medial gastrocnemius recession (MGR) and to investigate the anatomic structures at risk in comparison to PMGR. METHODS: Eight cadaveric lower leg specimens were used in the study. The standard PMGR and the novel MGR were performed on each specimen. After completion of the 2 procedures, complete dissection was performed to investigate the distances between surgically released fascia margins and surrounding anatomic structures, including the greater saphenous vein, small saphenous vein, saphenous nerve, medial sural cutaneous nerve, semimembranosus tendon, tibial nerve, and popliteal artery. The mean distances were calculated and the shortest distances for each structure were reported. RESULTS: Proximities of anatomic structures to surgically released gastrocnemius fascia at the medial and lateral margins were notably different between the 2 techniques. For the PMGR, the semimembranosus tendon (95% confidence interval of 2.4-7.4 mm), small saphenous vein (3.4-10.0 mm), popliteal artery (3.9-9.3 mm), and tibial nerve (5.0-11.1 mm) were in greater proximity to the operative margin. For the MGR, the greater saphenous vein (5.3-17.6 mm) and saphenous nerve (5.1-18.6 mm) were at greater risk. CONCLUSIONS: MGR at the proximal one-third of the gastrocnemius muscle may be a safe alternative for operative treatment of IGC. CLINICAL RELEVANCE: We identified the major structures at risk when performing the proximal medial gastrocnemius release and propose a novel, possibly safer alternative for the medial gastrocnemius release.
[Mh] Termos MeSH primário: Articulação do Tornozelo/cirurgia
Tornozelo/cirurgia
Contratura/cirurgia
Pé Equino/cirurgia
/cirurgia
Articulação do Joelho/cirurgia
Músculo Esquelético/cirurgia
[Mh] Termos MeSH secundário: Tornozelo/patologia
Articulação do Tornozelo/patologia
Dissecação
/patologia
Seres Humanos
Articulação do Joelho/patologia
Músculo Esquelético/patologia
Procedimentos Ortopédicos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170913
[Lr] Data última revisão:
170913
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170404
[St] Status:MEDLINE
[do] DOI:10.1177/1071100716682993


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[PMID]:28259030
[Au] Autor:Gatt A; De Giorgio S; Chockalingam N; Formosa C
[Ad] Endereço:Faculty of Health Sciences, University of Malta, Msida, MSD 2080, Malta; Faculty of Health Sciences, Staffordshire University, Stoke on Trent ST4 2DF, United Kingdom.
[Ti] Título:A pilot investigation into the relationship between static diagnosis of ankle equinus and dynamic ankle and foot dorsiflexion during stance phase of gait: Time to revisit theory?
[So] Source:Foot (Edinb);30:47-52, 2017 Mar.
[Is] ISSN:1532-2963
[Cp] País de publicação:Scotland
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Although the clinical assessment of ankle dorsiflexion has traditionally been measured utilising various goniometric means, the validity of this static examination has never been investigated. Since any impairment in ankle flexibility is likely to result in injuries, it is imperative that the correct examination technique is conducted. HYPOTHESIS/PURPOSE: To determine whether a clinical diagnosis of ankle equinus, or limited ankle dorsiflexion, correlates with a decreased dorsiflexion range of movement of the foot and ankle during gait. METHODS: Twenty participants with a clinical diagnosis of ankle equinus underwent optoelectronic motion capture utilising the Rizzoli foot model. Participants were divided into two groups, Group A with <-5° of dorsiflexion and Group B with -5° to 0° of ankle dorsiflexion. RESULTS: Participants in Group B had a mean dynamic ankle dorsiflexion angle of 13.9°, while those in Group A had a mean dorsiflexion angle of 4.4°, resulting in a significant difference (p=0.004) between the two groups. Likewise, foot mean dynamic dorsiflexion angle of Group B was 17.13° and Group A 8.6° (p=0.006). CONCLUSION: There is no relationship between a static diagnosis of ankle dorsiflexion at 0° with dorsiflexion during gait. On the other hand, those subjects with less than -5° of dorsiflexion during static examination did exhibit reduced ankle range of motion during gait.
[Mh] Termos MeSH primário: Articulação do Tornozelo/fisiopatologia
Pé Equino/fisiopatologia
Marcha/fisiologia
[Mh] Termos MeSH secundário: Adulto
Articulação do Tornozelo/anormalidades
Feminino
Seres Humanos
Masculino
Projetos Piloto
Amplitude de Movimento Articular/fisiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170305
[St] Status:MEDLINE


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[PMID]:28257680
[Au] Autor:Ramanujam CL; Zgonis T
[Ad] Endereço:Division of Podiatric Medicine and Surgery, Department of Orthopaedics, University of Texas Health Science Center San Antonio, 7703 Floyd Curl Drive, MSC 7776, San Antonio, TX 78229, USA.
[Ti] Título:Surgical Correction of the Achilles Tendon for Diabetic Foot Ulcerations and Charcot Neuroarthropathy.
[So] Source:Clin Podiatr Med Surg;34(2):275-280, 2017 Apr.
[Is] ISSN:1558-2302
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Achilles tendon pathologic conditions are implicated in contributing to the development of many diabetic foot complications including diabetic foot ulceration and Charcot neuroarthropathy. Surgical correction of the diabetic equinus deformity has been studied as an isolated or adjunctive treatment when dealing with difficult-to-close diabetic foot ulcerations or when surgically addressing the diabetic Charcot neuroarthropathy foot or ankle. This article reviews the most common indications, complications, and surgical procedures for equinus correction by either a tendo-Achilles lengthening or gastrocnemius recession for the management of diabetic foot conditions.
[Mh] Termos MeSH primário: Tendão do Calcâneo/cirurgia
Artropatia Neurogênica/cirurgia
Pé Diabético/cirurgia
Pé Equino/cirurgia
Procedimentos Ortopédicos/métodos
Tenotomia/métodos
[Mh] Termos MeSH secundário: Tendão do Calcâneo/fisiopatologia
Idoso
Artrodese/métodos
Artropatia Neurogênica/diagnóstico por imagem
Comorbidade
Pé Diabético/diagnóstico por imagem
Pé Diabético/epidemiologia
Pé Equino/diagnóstico por imagem
Pé Equino/epidemiologia
Fixadores Externos
Feminino
Seres Humanos
Masculino
Meia-Idade
Prognóstico
Recuperação de Função Fisiológica
Medição de Risco
Resultado do Tratamento
Cicatrização/fisiologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170305
[St] Status:MEDLINE


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[PMID]:28257675
[Au] Autor:DeHeer PA
[Ad] Endereço:Surgery Department, Indiana University Health North Hospital, Carmel, IN, USA; Surgery Department, Johnson Memorial Hospital, Franklin, IN, USA; Department of Podiatric Medicine and Radiology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA. Electronic address: padeheer@sbcglobal.net.
[Ti] Título:Equinus and Lengthening Techniques.
[So] Source:Clin Podiatr Med Surg;34(2):207-227, 2017 Apr.
[Is] ISSN:1558-2302
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Equinus is linked to most lower extremity biomechanically related disorders. Defining equinus as ankle joint dorsiflexion less than 5° of dorsiflexion with the knee extended is the basis for evaluation and management of the deformity. Consistent evaluation methodology using a goniometer with the subtalar joint in neutral position and midtarsal joint supinated while dorsiflexing the ankle with knee extended provides a consistent clinical examination. For equinus deformity with an associated disorder, comprehensive treatment mandates treatment of the equinus deformity. Surgical treatment of equinus offers multiple procedures but the Baumann gastrocnemius recession is preferred based on deformity correction without weakness.
[Mh] Termos MeSH primário: Tendão do Calcâneo/cirurgia
Pé Equino/cirurgia
Exame Físico/métodos
Recuperação de Função Fisiológica
Tenotomia/métodos
[Mh] Termos MeSH secundário: Tendão do Calcâneo/fisiopatologia
Articulação do Tornozelo/fisiopatologia
Articulação do Tornozelo/cirurgia
Pé Equino/diagnóstico
Feminino
Seres Humanos
Masculino
Procedimentos Ortopédicos/métodos
Medição da Dor
Cuidados Pré-Operatórios/métodos
Amplitude de Movimento Articular/fisiologia
Índice de Gravidade de Doença
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170305
[St] Status:MEDLINE


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[PMID]:28167057
[Au] Autor:Benirschke SK; Kramer PA
[Ad] Endereço:Department of Orthopaedics and Sports Medicine, Harborview Medical Center, University of Washington, Box 359798, Seattle, WA 98195-9798, USA.
[Ti] Título:Gastrocnemius or Achilles Lengthening at Time of Trauma Fixation.
[So] Source:Foot Ankle Clin;22(1):117-124, 2017 Mar.
[Is] ISSN:1558-1934
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Gastrocnemius equinus is a frequent comorbidity with traumatic injuries of the foot and ankle. Gastrocnemius lengthening at the time of definitive treatment facilitates obtaining and maintaining an anatomic reduction of the injury. The lengthening procedure is accomplished in 5 steps and results in fewer long-term, problematic sequelae.
[Mh] Termos MeSH primário: Tendão do Calcâneo/cirurgia
Pé Equino/cirurgia
Traumatismos do Pé/cirurgia
Músculo Esquelético/cirurgia
Tendões/cirurgia
[Mh] Termos MeSH secundário: Pé Equino/etiologia
Traumatismos do Pé/complicações
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170606
[Lr] Data última revisão:
170606
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170208
[St] Status:MEDLINE


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[PMID]:27866886
[Au] Autor:Ryu DJ; Kim JM; Kim BS
[Ad] Endereço:Orthopaedic Surgeon, Department of Orthopaedic Surgery, Inha University Hospital, Incheon, Korea.
[Ti] Título:Concomitant Contracture of the Knee and Ankle Joint After Gastrocnemius Muscle Rupture: A Case Report.
[So] Source:J Foot Ankle Surg;56(1):87-91, 2017 Jan - Feb.
[Is] ISSN:1542-2224
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Injury of the medial head of the gastrocnemius, also called "tennis leg," is known to heal uneventfully in most cases with compression and immobilization therapy. Failure to heal or long-term complications, including ongoing pain and pes equinus, have been documented in only a limited number of case reports. To the best of our knowledge, a severe concomitant contracture of the knee and ankle joint as a consequence of a maltreated gastrocnemius muscle rupture has not been previously reported in English-language reports. The purpose of the present study was to report a serious complication of neglected tennis leg with a review of the published data.
[Mh] Termos MeSH primário: Articulação do Tornozelo
Contratura/etiologia
Articulação do Joelho
Músculo Esquelético/lesões
Procedimentos Cirúrgicos Reconstrutivos/métodos
Ruptura/complicações
[Mh] Termos MeSH secundário: Adulto
Traumatismos em Atletas/complicações
Traumatismos em Atletas/diagnóstico
Biópsia por Agulha
Contratura/diagnóstico por imagem
Contratura/cirurgia
Progressão da Doença
Pé Equino/diagnóstico por imagem
Pé Equino/etiologia
Pé Equino/cirurgia
Seguimentos
Futebol Americano/lesões
Seres Humanos
Imuno-Histoquímica
Imagem por Ressonância Magnética/métodos
Masculino
Músculo Esquelético/cirurgia
Recuperação de Função Fisiológica
Ruptura/diagnóstico por imagem
Ruptura/reabilitação
Contenções
Tomografia Computadorizada por Raios X
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170807
[Lr] Data última revisão:
170807
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161122
[St] Status:MEDLINE


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[PMID]:27865313
[Au] Autor:Capobianco CM
[Ad] Endereço:Orthopaedic Associates of Southern Delaware, 1539 Savannah Road, Suite 203, Lewes, DE 19958, USA. Electronic address: ccapobianco@delawarebonedocs.com.
[Ti] Título:Surgical Equinus Correction for the Diabetic Charcot Foot: What the Evidence Reveals.
[So] Source:Clin Podiatr Med Surg;34(1):33-41, 2017 Jan.
[Is] ISSN:1558-2302
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Triceps surae contracture, or equinus, is a known deforming force in the foot and ankle. Biomechanical studies have shown that ankle equinus significantly alters gait and plantar pressures, and in the diabetic neuropathic patient population, this can propagate plantar ulceration and/or Charcot neuroarthropathy (CN). Surgical correction of equinus is globally and frequently used to aid in plantar wound healing in the neuropathic diabetic patient, with and without CN. Treatment guidelines for equinus correction in this medically complex population are undefined and lack evidence from high-quality published peer-reviewed studies.
[Mh] Termos MeSH primário: Artropatia Neurogênica/cirurgia
Pé Diabético/cirurgia
Pé Equino/cirurgia
[Mh] Termos MeSH secundário: Articulação do Tornozelo
Artropatia Neurogênica/complicações
Pé Diabético/complicações
Pé Equino/etiologia
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170531
[Lr] Data última revisão:
170531
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161121
[St] Status:MEDLINE


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[PMID]:27631386
[Au] Autor:Dursun N; Gokbel T; Akarsu M; Dursun E
[Ad] Endereço:From the Department of Physical Medicine and Rehabilitation, Kocaeli University, Kocaeli, Turkey.
[Ti] Título:Randomized Controlled Trial on Effectiveness of Intermittent Serial Casting on Spastic Equinus Foot in Children with Cerebral Palsy After Botulinum Toxin-A Treatment.
[So] Source:Am J Phys Med Rehabil;96(4):221-225, 2017 Apr.
[Is] ISSN:1537-7385
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Physical therapy (PT) and botulinum toxin-A (BTX-A) injections are widely used in the treatment of spastic equinus foot due to cerebral palsy. The aim of this study was to show effects of intermittent serial casting (SC) in addition to standard treatment on spasticity, passive range of motion (PROM), and gait. DESIGN: Fifty-one ambulatory patients, treated by BTX-A to plantar flexor muscles, were randomly assigned to casting or control groups in a 2:1 ratio. Both groups received PT for 3 weeks. Casting group additionally received intermittent SC during 3 consecutive weekends. Assessments included Modified Ashworth Scale (MAS), Tardieu Scale, Observational Gait Scale (OGS), and Physician Global Assessment at baseline and posttreatment weeks 4 and 12. RESULTS: Significant improvements in PROM, MAS, Tardieu Scale, and OGS were recorded in both groups (P < 0.001 for all). Average changes in MAS, PROM, angle of catch, spasticity angle, and OGS of the casting group were significantly higher than those of the controls at week 4 (P = 0.006, P = 0.002, P < 0.001, P = 0.005, P = 0.011), and 12 (P = 0.013, P < 0.001, P < 0.001, P = 0.011, P < 0.001). Follow-up Physician Global Assessment also favored casting group (P < 0.001 for both). CONCLUSIONS: Combining intermittent SC with BTX-A injections and PT might provide additional benefits for spastic equinus foot. TO CLAIM CME CREDITS: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) identify treatment options for spastic equinus goot in children with cerebral palsy; (2) explain different approaches of serial casting with an additional model of intermittent casting; and (3) describe the potential benefits of combined treatment modalities, including intermittent serial casting, for spastic equinus foot in children with cerebral palsy. LEVEL: Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
[Mh] Termos MeSH primário: Toxinas Botulínicas Tipo A/uso terapêutico
Moldes Cirúrgicos
Paralisia Cerebral/reabilitação
Pé Equino/reabilitação
Fármacos Neuromusculares/uso terapêutico
[Mh] Termos MeSH secundário: Paralisia Cerebral/fisiopatologia
Criança
Terapia Combinada
Pé Equino/fisiopatologia
Feminino
Seres Humanos
Masculino
Modalidades de Fisioterapia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Neuromuscular Agents); EC 3.4.24.69 (Botulinum Toxins, Type A)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170807
[Lr] Data última revisão:
170807
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160916
[St] Status:MEDLINE
[do] DOI:10.1097/PHM.0000000000000627



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