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[PMID]: 29390338 [Au] Autor: Han J; Ji Y; Cao D; Kang Z; Zhu J [Ad] Endereço: Department of Neurology, Harrison International Peace Hospital. [Ti] Título: Miller Fisher syndrome with acute angle-closure glaucoma as the first manifestation: A case report. [So] Source: Medicine (Baltimore);96(50):e9201, 2017 Dec. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: RATIONALE: There were no reports of Miller Fisher syndrome (MFS) with acute angle-closure glaucoma as the first manifestation. PATIENT CONCERNS: A 78-year-old female patient was admitted to our hospital with pain in her left eye, blurred vision along with nausea, and vomiting for 2 days. It was extremely rare that ophthalmoplegia, loss of tendon reflexes, and ataxia, did not occur in the early stages of MFS, and initial presentation was only dilated pupis and an increase in intraocular pressure. DIAGNOSES: The final diagnosis of the patient was MFS. INTERVENTIONS: Intravenous immunoglobulins were administered. OUTCOMES: Ophthalmoplegia, walking instability, and ataxia gradually improved. At 3 months follow-up, there was no neurological deficit, and the patient could completely self-care. LESSONS: This is the first report of MFS patient with acute angle closure glaucoma as the first manifestation. Consideration should be given to the possibility of incorporating autonomic nervous system dysfunction, or even MFS, in patients with acute angle-closure glaucoma in order to reduce missed diagnosis rate. [Mh] Termos MeSH primário: Glaucoma de Ângulo Fechado/diagnóstico Glaucoma de Ângulo Fechado/tratamento farmacológico Imunoglobulinas Intravenosas/uso terapêutico Síndrome de Miller Fisher/diagnóstico Síndrome de Miller Fisher/tratamento farmacológico [Mh] Termos MeSH secundário: Doença Aguda Idoso Diagnóstico Diferencial Feminino Seres Humanos [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Nm] Nome de substância: 0 (Immunoglobulins, Intravenous) [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180301 [Lr] Data última revisão: 180301 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 180203 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000009201

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[PMID]: 29269696 [Au] Autor: Yokoi K; Ando T; Kawakami O [Ad] Endereço: Department of Neurology, Anjo Kosei Hospital. [Ti] Título: [Case of posterior reversible encephalopathy syndrome caused by Fisher syndrome]. [So] Source: Rinsho Shinkeigaku;58(1):45-48, 2018 Jan 26. [Is] ISSN: 1882-0654 [Cp] País de publicação: Japan [La] Idioma: jpn [Ab] Resumo: This report presents a case of a 71-year-old woman with Fisher syndrome who had posterior reversible encephalopathy syndrome (PRES) before the initiation of intravenous immunoglobulin (IVIg) treatment. She had symptoms of common cold 2 weeks before the onset of PRES. On the day of the onset, she began to stagger while walking. On day 2, she developed hypertension, vision impairment, and limb weakness and was admitted to the hospital. On day 3, she was provided steroid pulse therapy. On day 4, she developed convulsions and right imperfection single paralysis and was transferred to the our hospital. During the transfer, the patient was conscious. Her blood pressure was high at 198/107 mmHg. She had mild weakness in her limbs and face, light perception in both eyes, dilation of both pupils, total external ophthalmoplegia, no tendon reflexes, and limb and trunk ataxia. We diagnosed PRES because of the high signal intensities observed on T -weighted MRI on both sides of the parietal and occipital lobes. We also diagnosed Fisher syndrome because of a positive anti-GQ1b immunoglobulin G antibody test and albuminocytologic dissociation in the cerebrospinal fluid. PRES showed prompt improvement with antihypertensive therapy, whereas Fisher syndrome slowly improved over a course of 2 months. This case is the first report of PRES without IVIg suggesting that Fisher syndrome induces hypertension and causes PRES. [Mh] Termos MeSH primário: Síndrome de Miller Fisher/complicações Síndrome da Leucoencefalopatia Posterior/etiologia [Mh] Termos MeSH secundário: Idoso Anti-Hipertensivos/administração & dosagem Biomarcadores/sangue Biomarcadores/líquido cefalorraquidiano Proteínas do Líquido Cefalorraquidiano/líquido cefalorraquidiano Diltiazem/administração & dosagem Feminino Gangliosídeos/imunologia Seres Humanos Imunoglobulina G/sangue Imunoglobulinas Intravenosas Imagem por Ressonância Magnética Síndrome de Miller Fisher/diagnóstico Neuroimagem Síndrome da Leucoencefalopatia Posterior/diagnóstico por imagem Síndrome da Leucoencefalopatia Posterior/tratamento farmacológico Resultado do Tratamento Valsartana/administração & dosagem [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Nm] Nome de substância: 0 (Antihypertensive Agents); 0 (Biomarkers); 0 (Cerebrospinal Fluid Proteins); 0 (Gangliosides); 0 (Immunoglobulin G); 0 (Immunoglobulins, Intravenous); 68652-37-9 (GQ1b ganglioside); 80M03YXJ7I (Valsartan); EE92BBP03H (Diltiazem) [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180227 [Lr] Data última revisão: 180227 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171223 [St] Status: MEDLINE [do] DOI: 10.5692/clinicalneurol.cn-001089

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[PMID]: 28612899 [Au] Autor: Barbato F; Di Paolantonio A; Distefano M; Mastrorosa A; Sabatelli M; Servidei S; Luigetti M [Ad] Endereço: Institute of Neurology, Fondazione Policlinico Universitario Agostino Gemelli, Catholic University of Sacred Heart, Rome. [Ti] Título: Recurrent miller fisher: a new case report and a literature review. [So] Source: Clin Ter;168(3):e208-e213, 2017 May-Jun. [Is] ISSN: 1972-6007 [Cp] País de publicação: Italy [La] Idioma: eng [Ab] Resumo: Miller Fisher syndrome (MFS) is considered to be an uncommon variant of Guillain-Barré Syndrome. The disease is clinically characterized by acute ataxia of limbs, areflexia and ophthalmoplegia, although the set of symptoms and signs can be quite heterogeneous, with a benign and monophasic course. We describe a case of recurrent MFS where there have been four clinical episodes occurred with complete remission after each relapse. Last recurrence was treated with oral steroids. The reported frequency of recurrent MFS in literature is variable as well as the best treatment in these cases. We add a new case treated with steroid and we perform a review of the literature. [Mh] Termos MeSH primário: Síndrome de Miller Fisher [Mh] Termos MeSH secundário: Feminino Seres Humanos Masculino Síndrome de Miller Fisher/tratamento farmacológico Recidiva Esteroides/uso terapêutico [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE; REVIEW [Nm] Nome de substância: 0 (Steroids) [Em] Mês de entrada: 1711 [Cu] Atualização por classe: 171101 [Lr] Data última revisão: 171101 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170615 [St] Status: MEDLINE [do] DOI: 10.7417/T.2017.2008

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[PMID]: 28601853 [Au] Autor: Özdemir ZC; Kar YD; Yarar C; Þaylýsoy S; Bör Ö [Ad] Endereço: Division of Pediatric Hematology, #Department of Pediatrics, $Division of Pediatric Neurology, ‡Department of Radiology, and *Division of Pediatric Oncology; Eskiþehir Osmangazi University Faculty of Medicine,Turkey. Correspondence to: Dr Zeynep Canan Özdemir, Division of Pediatric Hematology/Oncology, Eskiºehir Osmangazi University Faculty of Medicine, 26480, Eskipehir, Turkey. efecanan@yahoo.com. [Ti] Título: Incomplete Miller-Fisher Syndrome with Advanced Stage Burkitt Lymphoma. [So] Source: Indian Pediatr;54(5):413-415, 2017 May 15. [Is] ISSN: 0974-7559 [Cp] País de publicação: India [La] Idioma: eng [Ab] Resumo: BACKGROUND: Lymphoma-associated incomplete Miller-Fisher syndrome is very rare. CASE CHARACTERISTICS: An 11-year-old boy who initially presented with headache, left ptosis, diplopia and weakness. Neurologic examination indicated left sided ptosis with ophthalmoplegia. OBSERVATIONS: Cerebral imaging and cerebrospinal fluid examinations were normal. Magnetic resonance imaging of the abdomen showed a mass lesion in the ileal loops. A bone marrow biopsy showed infiltration by Burkitt's lymphoma. MESSAGE: Burkitt lymphoma may present with incomplete Miller Fisher syndrome. [Mh] Termos MeSH primário: Linfoma de Burkitt Síndrome de Miller Fisher [Mh] Termos MeSH secundário: Criança Seres Humanos Masculino Oftalmoplegia [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1706 [Cu] Atualização por classe: 170623 [Lr] Data última revisão: 170623 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170612 [St] Status: MEDLINE

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[PMID]: 28284899 [Au] Autor: Hasler T; Stückelberger A; Ott E; Blum J [Ad] Endereço: Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland. [Ti] Título: Diplopia and ptosis after diarrhea - A diagnostic challenge. [So] Source: Travel Med Infect Dis;17:76, 2017 May - Jun. [Is] ISSN: 1873-0442 [Cp] País de publicação: Netherlands [La] Idioma: eng [Ab] Resumo: A woman developed transient diplopia and ptosis of the left eyelid after a Campylobacter infection. The symptoms were interpreted as a Miller Fisher syndrome, a variant of Guillain Barré syndrome. [Mh] Termos MeSH primário: Blefaroptose Infecções por Campylobacter Diarreia Diplopia Síndrome de Miller Fisher [Mh] Termos MeSH secundário: Campylobacter Fezes/microbiologia Feminino Seres Humanos Meia-Idade [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171024 [Lr] Data última revisão: 171024 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170313 [St] Status: MEDLINE

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[PMID]: 28214063 [Au] Autor: Muñiz AE [Ad] Endereço: 827 Via Del Sur, Mesquite, TX 77401. Electronic address: antonio.muniz2050@gmail.com. [Ti] Título: Multiple cranial nerve neuropathies, ataxia and, areflexia: Miller Fisher syndrome in a child and review. [So] Source: Am J Emerg Med;35(4):661.e1-661.e4, 2017 04. [Is] ISSN: 1532-8171 [Cp] País de publicação: United States [La] Idioma: eng [Mh] Termos MeSH primário: Ataxia/etiologia Doenças dos Nervos Cranianos/etiologia Síndrome de Miller Fisher/diagnóstico [Mh] Termos MeSH secundário: Ataxia/diagnóstico Pré-Escolar Doenças dos Nervos Cranianos/diagnóstico Serviço Hospitalar de Emergência Feminino Seres Humanos Síndrome de Miller Fisher/complicações Reflexo de Estiramento [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE; REVIEW [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170918 [Lr] Data última revisão: 170918 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170219 [St] Status: MEDLINE

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[PMID]: 28209311 [Au] Autor: Malhotra A; Zhang M; Wu X; Jindal S; Durand D; Makhani N [Ad] Endereço: Department of Diagnostic Radiology, Yale School of Medicine, Box 208042, Tompkins East 2, 333 Cedar St, New Haven, CT 06520-8042, United States. Electronic address: ajay.malhotra@yale.edu. [Ti] Título: MRI findings of optic pathway involvement in Miller Fisher syndrome in 3 pediatric patients and a review of the literature. [So] Source: J Clin Neurosci;39:63-67, 2017 May. [Is] ISSN: 1532-2653 [Cp] País de publicação: Scotland [La] Idioma: eng [Ab] Resumo: BACKGROUND: Miller Fisher syndrome (MFS) is a rare demyelinating condition which may have involvement of cranial nerves. There are a few case reports of optic pathway involvement in children. We describe 3 patients with optic pathway enhancement in pediatric patients with MFS. CASE SERIES: We retrospectively reviewed brain imaging findings in 17 pediatric patients with of Guillain-Barré syndrome (GBS) meeting Brighton criteria who had brain MRIs performed during their acute illness. Cranial nerve enhancement was seen in 6/17 patients and optic nerve/chiasm enhancement was seen in 3 patients. CONCLUSION: Cranial nerve enhancement and optic pathway in particular, can be seen in patients with MFS. Imaging findings do not always correlate with clinical manifestations of cranial nerve involvement. [Mh] Termos MeSH primário: Imagem por Ressonância Magnética Síndrome de Miller Fisher/diagnóstico por imagem Quiasma Óptico/diagnóstico por imagem [Mh] Termos MeSH secundário: Adolescente Tronco Encefálico/diagnóstico por imagem Criança Pré-Escolar Nervos Cranianos/diagnóstico por imagem Feminino Síndrome de Guillain-Barré/diagnóstico por imagem Síndrome de Guillain-Barré/terapia Seres Humanos Imagem por Ressonância Magnética/métodos Masculino Síndrome de Miller Fisher/terapia Neuroimagem/métodos Estudos Retrospectivos [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE; REVIEW [Em] Mês de entrada: 1705 [Cu] Atualização por classe: 170523 [Lr] Data última revisão: 170523 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170218 [St] Status: MEDLINE

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[PMID]: 28090073 [Au] Autor: Salehi N; Choi ED; Garrison RC [Ad] Endereço: Department of Medicine, Riverside University Health System, Moreno Valley, CA, USA. [Ti] Título: A Case of Miller Fisher Syndrome, Thromboembolic Disease, and Angioedema: Association or Coincidence? [So] Source: Am J Case Rep;18:52-59, 2017 Jan 16. [Is] ISSN: 1941-5923 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND Miller Fisher Syndrome is characterized by the clinical triad of ophthalmoplegia, ataxia, and areflexia, and is considered to be a variant of Guillain-Barre Syndrome. Miller Fisher Syndrome is observed in approximately 1-5% of all Guillain-Barre cases in Western countries. Patients with Miller Fisher Syndrome usually have good recovery without residual deficits. Venous thromboembolism is a common complication of Guillain-Barre Syndrome and has also been reported in Miller Fisher Syndrome, but it has generally been reported in the presence of at least one prothrombotic risk factor such as immobility. A direct correlation between venous thromboembolism and Miller Fisher Syndrome or Guillain-Barre Syndrome has not been previously described. CASE REPORT We report the case of a 32-year-old Hispanic male who presented with acute, severe thromboembolic disease and concurrently demonstrated characteristic clinical features of Miller Fisher Syndrome including ophthalmoplegia, ataxia, and areflexia. Past medical and family history were negative for thromboembolic disease, and subsequent hypercoagulability workup was unremarkable. During the course of hospitalization, the patient also developed angioedema. CONCLUSIONS We describe a possible association between Miller Fisher Syndrome, thromboembolic disease, and angioedema. [Mh] Termos MeSH primário: Angioedema/etiologia Síndrome de Miller Fisher/complicações Tromboembolia/etiologia Veia Cava Inferior [Mh] Termos MeSH secundário: Adulto Angioedema/diagnóstico Seres Humanos Masculino Síndrome de Miller Fisher/diagnóstico Tromboembolia/diagnóstico [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1703 [Cu] Atualização por classe: 170309 [Lr] Data última revisão: 170309 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170117 [St] Status: MEDLINE

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[PMID]: 28040387 [Au] Autor: Gill D; Liu K [Ad] Endereço: Department of Internal Medicine, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, USA. Electronic address: gillda@upstate.edu. [Ti] Título: Takotsubo cardiomyopathy associated with Miller-Fisher syndrome. [So] Source: Am J Emerg Med;35(7):1012, 2017 Jul. [Is] ISSN: 1532-8171 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: 51-year-old female who presented with progressive paresthesia, numbness of the lower extremities, double vision, and trouble walking. Physical exam was remarkable for areflexia, and ptosis. Her initial EKG showed nonspecific ST segment changes and her Troponin T was elevated to 0.41ng/mL which peaked at 0.66ng/mL. Echocardiogram showed a depressed left ventricular ejection fraction to 35% with severely hypokinetic anterior wall and left ventricular apex was severely hypokinetic. EMG nerve conduction study showed severely decreased conduction velocity and prolonged distal latency in all nerves consistent with demyelinating disease. She was treated with 5days of intravenous immunoglobulin therapy to which she showed significant improvement in strength in her lower extremities. Echocardiogram repeated 4days later showing an improved left ventricular ejection fraction of 55% and no left ventricular wall motion abnormalities. Takotsubo cardiomyopathy is a rare complication of Miller-Fisher syndrome and literature review did not reveal any cases. Miller-Fisher syndrome is an autoimmune process that affects the peripheral nervous system causing autonomic dysfunction which may involve the heart. Due to significant autonomic dysfunction in Miller-Fisher syndrome, it could lead to arrhythmias, blood pressure changes, acute coronary syndrome and myocarditis, Takotsubo cardiomyopathy can be difficult to distinguish. The treatment of Takotsubo cardiomyopathy is supportive with beta-blockers and angiotensin-converting enzyme inhibitors are recommended until left ventricle ejection fraction improvement. Takotsubo cardiomyopathy is a rare complication during the acute phase of Miller-Fisher syndrome and must be distinguished from autonomic dysfunction as both diagnoses have different approaches to treatment. [Mh] Termos MeSH primário: Antagonistas Adrenérgicos beta/uso terapêutico Inibidores da Enzima Conversora de Angiotensina/uso terapêutico Síndrome de Miller Fisher/complicações Cardiomiopatia de Takotsubo/etiologia [Mh] Termos MeSH secundário: Ecocardiografia Feminino Seres Humanos Meia-Idade Síndrome de Miller Fisher/fisiopatologia Cardiomiopatia de Takotsubo/tratamento farmacológico Cardiomiopatia de Takotsubo/fisiopatologia Resultado do Tratamento Função Ventricular Esquerda [Pt] Tipo de publicação: CASE REPORTS; LETTER [Nm] Nome de substância: 0 (Adrenergic beta-Antagonists); 0 (Angiotensin-Converting Enzyme Inhibitors) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171004 [Lr] Data última revisão: 171004 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170102 [St] Status: MEDLINE

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[PMID]: 27923188 [Au] Autor: Kuwabara S; Sekiguchi Y; Misawa S [Ad] Endereço: Department of Neurology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan. Electronic address: kuwabara-s@faculty.chiba-u.jp. [Ti] Título: Electrophysiology in Fisher syndrome. [So] Source: Clin Neurophysiol;128(1):215-219, 2017 Jan. [Is] ISSN: 1872-8952 [Cp] País de publicação: Netherlands [La] Idioma: eng [Ab] Resumo: Fisher syndrome (FS), a variant of Guillain-Barré syndrome (GBS), is characterized by the clinical triad of ophthalmoplegia, ataxia, and areflexia. The lesion sites for these unique clinical features include the oculomotor nerves and group 1a neurons in the dorsal root ganglion, and the presence of FS is determined by the expression of ganglioside GQ1b in the human nervous system. Neurophysiological findings suggest that ataxia and areflexia are due to an impaired proprioceptive afferent system. Typically, the soleus H-reflex is absent and a body-sway analysis using posturography shows a 1-Hz peak, which indicates proprioception dysfunction. Sensory nerve action potentials and somatosensory-evoked potentials are abnormal in approximately 30% of FS patients, indicating the occasional involvement of cutaneous (group 2) afferents. During the disease course, approximately 15% of FS patients suffer an overlap of axonal GBS with nerve conduction abnormalities that reflect axonal dysfunction. This review summarizes electrophysiological abnormalities and their clinical significance in FS. [Mh] Termos MeSH primário: Fenômenos Eletrofisiológicos/fisiologia Síndrome de Miller Fisher/diagnóstico Síndrome de Miller Fisher/fisiopatologia Condução Nervosa/fisiologia [Mh] Termos MeSH secundário: Ataxia/diagnóstico Ataxia/fisiopatologia Potenciais Somatossensoriais Evocados/fisiologia Reflexo H/fisiologia Seres Humanos Nervo Oculomotor/fisiopatologia Propriocepção/fisiologia Reflexo Anormal/fisiologia [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: 161207 [St] Status: MEDLINE

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