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[PMID]:29317459
[Au] Autor:Battersby C; Santhalingam T; Costeloe K; Modi N
[Ad] Endereço:Department of Medicine, Neonatal Data Analysis Unit, Section of Neonatal Medicine, Chelsea and Westminster campus, Imperial College London, London, UK.
[Ti] Título:Incidence of neonatal necrotising enterocolitis in high-income countries: a systematic review.
[So] Source:Arch Dis Child Fetal Neonatal Ed;103(2):F182-F189, 2018 Mar.
[Is] ISSN:1468-2052
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To conduct a systematic review of neonatal necrotising enterocolitis (NEC) rates in high-income countries published in peer-reviewed journals. METHODS: We searched MEDLINE, Embase and PubMed databases for observational studies published in peer-reviewed journals. We selected studies reporting national, regional or multicentre rates of NEC in 34 Organisation for Economic Co-operation and Development countries. Two investigators independently screened studies against predetermined criteria. For included studies, we extracted country, year of publication in peer-reviewed journal, study time period, study population inclusion and exclusion criteria, case definition, gestation or birth weight-specific NEC and mortality rates. RESULTS: Of the 1888 references identified, 120 full manuscripts were reviewed, 33 studies met inclusion criteria, 14 studies with the most recent data from 12 countries were included in the final analysis. We identified an almost fourfold difference, from 2% to 7%, in the rate of NEC among babies born <32 weeks' gestation and an almost fivefold difference, from 5% to 22%, among those with a birth weight <1000 g but few studies covered the entire at-risk population. The most commonly applied definition was Bell's stage ≥2, which was used in seven studies. Other definitions included Bell's stage 1-3, definitions from the Centers for Disease Control and Prevention, International Classification for Diseases and combinations of clinical and radiological signs as specified by study authors. CONCLUSION: The reasons for international variation in NEC incidence are an important area for future research. Reliable inferences require clarity in defining population coverage and consistency in the case definition applied. PROSPERO INTERNATIONAL PROSPECTIVE REGISTER OF SYSTEMATIC REVIEWS REGISTRATION NUMBER: CRD42015030046.
[Mh] Termos MeSH primário: Países Desenvolvidos/estatística & dados numéricos
Enterocolite Necrosante/epidemiologia
Doenças do Recém-Nascido/epidemiologia
[Mh] Termos MeSH secundário: Seres Humanos
Incidência
Recém-Nascido
Recém-Nascido Prematuro
Doenças do Prematuro/epidemiologia
Recém-Nascido de muito Baixo Peso
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180111
[St] Status:MEDLINE
[do] DOI:10.1136/archdischild-2017-313880


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[PMID]:29296161
[Au] Autor:Orimadegun AE; Orimadegun BE; Bamgboye EA
[Ad] Endereço:Institute of Child Health, University of Ibadan, Ibadan, Nigeria.
[Ti] Título:Non-protective immunity against tetanus in primiparous women and newborns at birth in rural and urban settings in Ibadan, Nigeria.
[So] Source:Pan Afr Med J;27(Suppl 3):26, 2017.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:eng
[Ab] Resumo:Introduction: Nigeria remains among the few countries that are yet to achieve eradication of neonatal tetanus in the world despite the availability of an effective vaccine. This study investigated immunity against tetanus in primiparous mothers and neonates at birth, and identified associated factors. Methods: This cross-sectional study involved consecutive selection of 244 primiparous mother-neonate pairs (119 from rural areas, 125 from urban areas, 137 male neonates and 107 female neonates) delivered at primary healthcare facilities in Ibadan, Nigeria Socio-demographic characteristics, obstetric history, immunisation and birthweight were obtained from mothers by interview. A validated immunochromatographic rapid diagnostic test kit was used to test for immunity against tetanus. Positive and negative results were interpreted as protective immunity against tetanus (PIaT) and non-protective immunity against tetanus (NPIaT), respectively. Data were analysed using descriptive statistics, Chi-square and logistic regression at p = 0.05. Results: The mean age of mothers was 27.9±3.4 years (range: 20-33) and median birthweight was 2700g (range: 1760-3300). Of the 244 mothers, 198 (81.1%) received at least two doses of tetanus toxoid injection during pregnancy and prevalence of NPIaT and PIaT was 28.7% and 71.3%, respectively. The prevalence of PIaT was significantly higher among mothers in urban areas (n= 96; 80.7%) than rural (n=78; 62.4%), p<0.001.The prevalence of NPIaT among neonates was 36.5% (n= 89). Predictors of NPIaT among neonates were residence in rural LGA (OR = 2.22; 95% CI = 1.23-3.99) and maternal tetanus immunisation <2 doses (OR = 11.68; 95% CI = 4.05-21.75). Conclusion: Lack of protective immunity against tetanus among neonates of primiparous women in Ibadan is prevalent and a more conscientious enforcement of routine tetanus prevention practices is needed.
[Mh] Termos MeSH primário: Doenças do Recém-Nascido/prevenção & controle
Toxoide Tetânico/administração & dosagem
Tétano/prevenção & controle
Vacinação
[Mh] Termos MeSH secundário: Adulto
Estudos Transversais
Feminino
Seres Humanos
Imunocromatografia
Recém-Nascido
Doenças do Recém-Nascido/imunologia
Modelos Logísticos
Masculino
Nigéria
Gravidez
População Rural/estatística & dados numéricos
Tétano/imunologia
População Urbana/estatística & dados numéricos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Tetanus Toxoid)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180104
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.supp.2017.27.3.11869


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[PMID]:29296159
[Au] Autor:Ridpath AD; Scobie HM; Shibeshi ME; Yakubu A; Zulu F; Raza AA; Masresha B; Tohme R
[Ad] Endereço:Centers for Disease Control and Prevention, Global Immunization Division, Atlanta, GA, USA.
[Ti] Título:Progress towards achieving and maintaining maternal and neonatal tetanus elimination in the African region.
[So] Source:Pan Afr Med J;27(Suppl 3):24, 2017.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:eng
[Ab] Resumo:Despite the availability of effective tetanus prevention strategies, as of 2016, Maternal and Neonatal Tetanus Elimination (MNTE) has not yet been achieved in 18 countries globally. In this paper, we review the status of MNTE in the World Health Organization African Region (AFR),and provide recommendations for achieving and maintaining MNTE in AFR. As of November 2016, 37 (79%) AFR countries have achieved MNTE, with 10 (21%) countries remaining. DTP3 coverage increased from 52% in 2000 to 76% in 2015. In 2015, coverage with at least 2 doses of tetanus containing vaccine (TT2+) and proportion of newborns protected at birth (PAB) were 69% and 77%, compared with 44% and 62% in 2000, respectively. Since 1999, over 79 million women of reproductive age (WRA) have been vaccinated with TT2+ through supplementary immunization activities (SIAs). Despite the progress, only 54% of births were attended by skilled birth attendants (SBAs), 5 (11%) countries provided the 3 WHO-recommended booster doses to both sexes, and about 5.5 million WRA still need to be reached with SIAs. Coverage disparities still exist between countries that have achieved MNTE and those that have not. In 2015, coverage with DTP3 and PAB were higher in MNTE countries compared with those yet to achieve MNTE: 84% vs. 68% and 86% vs. 69%, respectively. Challenges to achieving MNTE in the remaining AFR countries include weak health systems, competing priorities, insufficient funding, insecurity, and sub-optimal neonatal tetanus (NT) surveillance. To achieve and maintain MNTE in AFR, increasing SBAs and tetanus vaccination coverage, integrating tetanus vaccination with other opportunities (e.g., polio and measles campaigns, mother and child health days), and providing appropriately spaced booster doses are needed. Strengthening NT surveillance and conducting serosurveys would ensure appropriate targeting of MNTE activities and high-quality information for validating the achievement and maintenance of elimination.
[Mh] Termos MeSH primário: Doenças do Recém-Nascido/prevenção & controle
Toxoide Tetânico/administração & dosagem
Tétano/prevenção & controle
[Mh] Termos MeSH secundário: África/epidemiologia
Erradicação de Doenças
Feminino
Seres Humanos
Esquemas de Imunização
Recém-Nascido
Masculino
Gravidez
Tétano/epidemiologia
Vacinação/estatística & dados numéricos
Cobertura Vacinal
Organização Mundial da Saúde
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Tetanus Toxoid)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180104
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.supp.2017.27.3.11783


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[PMID]:29390460
[Au] Autor:Martínez M; Romero MG; Guereta LG; Cabrera M; Regojo RM; Albajara L; Couce ML; Pipaon MS
[Ad] Endereço:Department of Neonatology-Pediatrics.
[Ti] Título:Infantile-onset Pompe disease with neonatal debut: A case report and literature review.
[So] Source:Medicine (Baltimore);96(51):e9186, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Infantile-onset Pompe disease, also known as glycogen storage disease type II, is a progressive and fatal disorder without treatment. Enzyme replacement therapy with recombinant human acid alpha-glucosidase (GAA) enhances survival; however, the best outcomes have been achieved with early treatment. PATIENT CONCERNS: We report a case of a newborn with infantile-onset Pompe disease diagnosed in the first days of life who did not undergo universal neonatal screening. The patient was asymptomatic, with a general physical examination revealing only a murmur. The clinical presentation was dominated by the neonatal detection of hypertrophic cardiomyopathy, without hypotonia or macroglossia. DIAGNOSES: Pompe disease was confirmed in the first week of life by GAA activity in dried blood spots, and a GAA genetic study showed the homozygous mutation p.Arg854X. INTERVENTIONS: Parents initially refused replacement therapy. OUTCOMES: The patient experienced recurrent episodes of ventricular fibrillation during central line placement and could not be resuscitated. LESSONS: Although Pompe disease is rare, and universal screening has not been established, neonatologists should be alerted to the diagnosis of Pompe in the presence of hypertrophic cardiomyopathy. Diagnosis is achieved in a few days with the aid of dried blood spots.
[Mh] Termos MeSH primário: Cardiomiopatia Hipertrófica/etiologia
Doença de Depósito de Glicogênio Tipo II/diagnóstico
Doença de Depósito de Glicogênio Tipo II/genética
Fibrilação Ventricular/diagnóstico
alfa-Glucosidases/genética
[Mh] Termos MeSH secundário: Biópsia por Agulha
Cardiomiopatia Hipertrófica/fisiopatologia
Cardiomiopatia Hipertrófica/terapia
Progressão da Doença
Evolução Fatal
Doença de Depósito de Glicogênio Tipo II/complicações
Homozigoto
Seres Humanos
Imuno-Histoquímica
Recém-Nascido
Doenças do Recém-Nascido/diagnóstico
Doenças do Recém-Nascido/terapia
Masculino
Mutação
Doenças Raras
Medição de Risco
Índice de Gravidade de Doença
Fibrilação Ventricular/etiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
EC 3.2.1.20 (GAA protein, human); EC 3.2.1.20 (alpha-Glucosidases)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009186


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[PMID]:29363924
[Au] Autor:Lukoyanova OL; Borovik TE
[Ti] Título:[Nutritional epigenetics and epigenetic effects of human breast milk].
[So] Source:Vopr Pitan;84(5):4-15, 2015.
[Is] ISSN:0042-8833
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:The article provides an overview of the current literature on nutritional epigenetics. There are currently actively studied hypothesis that nutrition especially in early life or in critical periods of the development, may have a role in modulating gene expression, and, therefore, have later effects on health in adults. Nutritional epigenetics concerns knowledge about the possible effects of nutrients on gene expression. Human breast milk is well-known for its ability in preventing necrotizing enterocolitis, infectious diseases, and also non-communicable diseases, such as obesity and related disorders. This paper discusses about presumed epigenetic effects of human breast milk and some its components. While evidence suggests that a direct relationship may exist of some components of human breast milk with epigenetic changes, the mechanisms involved are stillunclear.
[Mh] Termos MeSH primário: Aleitamento Materno
Epigênese Genética/fisiologia
Fenômenos Fisiológicos da Nutrição do Lactente
Leite Humano/metabolismo
Valor Nutritivo
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Recém-Nascido
Doenças do Recém-Nascido/genética
Doenças do Recém-Nascido/metabolismo
Doenças do Recém-Nascido/prevenção & controle
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180205
[Lr] Data última revisão:
180205
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180125
[St] Status:MEDLINE


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[PMID]:28470389
[Au] Autor:Merhar SL; Tkach JA; Woods JC; South AP; Wiland EL; Rattan MS; Dumoulin CL; Kline-Fath BM
[Ad] Endereço:Division of Neonatology, Cincinnati Children's Hospital Medical Center, Perinatal Institute, Cincinnati, OH, USA.
[Ti] Título:Neonatal imaging using an on-site small footprint MR scanner.
[So] Source:Pediatr Radiol;47(8):1001-1011, 2017 Jul.
[Is] ISSN:1432-1998
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:With its soft-tissue definition, multiplanar capabilities and advanced imaging techniques, magnetic resonance imaging (MRI) for neonatal care can provide better understanding of pathology, allowing for improved care and counseling to families. However, MR imaging in neonates is often difficult due to patient instability and the complex support necessary for survival. In our institution, we have installed a small footprint magnet in the neonatal intensive care unit (NICU) to minimize patient risks and provide the ability to perform MR imaging safely in this population. With this system, we have been able to provide more information with regard to central nervous system disorders, abdominal pathology, and pulmonary and airway abnormalities, and have performed postmortem imaging as an alternative or supplement to pathological autopsy. In our experience, an MR scanner situated within the NICU has allowed for safer and more expedited imaging of this vulnerable population.
[Mh] Termos MeSH primário: Doenças do Recém-Nascido/diagnóstico por imagem
Imagem por Ressonância Magnética/instrumentação
[Mh] Termos MeSH secundário: Desenho de Equipamento
Feminino
Seres Humanos
Recém-Nascido
Unidades de Terapia Intensiva Neonatal
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180201
[Lr] Data última revisão:
180201
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1007/s00247-017-3855-4


  7 / 28062 MEDLINE  
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[PMID]:28766840
[Au] Autor:Ambrose EE; Makani J; Chami N; Masoza T; Kabyemera R; Peck RN; Kamugisha E; Manjurano A; Kayange N; Smart LR
[Ad] Endereço:Department of Paediatrics and Child Health, Catholic University of Health & Allied Sciences and Bugando Medical Centre, Mwanza, Tanzania.
[Ti] Título:High birth prevalence of sickle cell disease in Northwestern Tanzania.
[So] Source:Pediatr Blood Cancer;65(1), 2018 Jan.
[Is] ISSN:1545-5017
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Worldwide, hemoglobinopathies affect millions of children. Identification of hemoglobin disorders in most sub-Saharan African countries is delayed until clinical signs of the disease are present. Limited studies have been conducted to understand their prevalence and clinical presentation among newborns in resource-limited settings. METHODOLOGY: This was a prospective cohort study. Newborns (aged 0-7 days) at two hospitals in Northwestern Tanzania were enrolled and followed prospectively for 6 months. Clinical and laboratory information were collected at baseline. Participants were screened for hemoglobinopathies using high-performance liquid chromatography. Clinical and laboratory follow-up was performed at 3 and 6 months for those with hemoglobinopathies as well as a comparison group of participants without hemoglobinopathies. RESULTS: A total of 919 newborns were enrolled. Among these, 1.4% (13/919) had sickle cell anemia or Hb S/ß -thalassemia (Hb FS), and 19.7% (181/919) had sickle cell trait or Hb S/ß thalassemia (Hb FAS). Furthermore, 0.2% (two of 919) had ß -thalassemia. Red cell indices compared between Hb FS, Hb FAS, and Hb FA were similar at baseline, but hemoglobin was lower and red cell distribution width was higher in children with Hb FS at 3- and 6-month follow-up. Febrile episodes were more common for children with Hb FS at 3- and 6-month follow-up. CONCLUSION: The prevalence of sickle cell disease among neonates born in Northwestern Tanzania is one of the highest in the world. Newborn screening is needed early in life to identify neonates with hemoglobinopathies so that clinical management may commence and morbidity and mortality related to hemoglobinopathies be reduced.
[Mh] Termos MeSH primário: Anemia Falciforme/epidemiologia
Doenças do Recém-Nascido/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Anemia Falciforme/sangue
Feminino
Seguimentos
Seres Humanos
Recém-Nascido
Doenças do Recém-Nascido/sangue
Masculino
Prevalência
Estudos Prospectivos
Tanzânia/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180131
[Lr] Data última revisão:
180131
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170803
[St] Status:MEDLINE
[do] DOI:10.1002/pbc.26735


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[PMID]:28744710
[Au] Autor:Vishnu Bhat B; Mondal N
[Ad] Endereço:Department of Neonatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, 605006, India. drvishnubhat@yahoo.com.
[Ti] Título:Outcome of Extreme Preterm Babies Treated with Ventriculo-Peritoneal Shunt for Post Hemorrhagic Hydrocephalus.
[So] Source:Indian J Pediatr;84(9):653-654, 2017 09.
[Is] ISSN:0973-7693
[Cp] País de publicação:India
[La] Idioma:eng
[Mh] Termos MeSH primário: Hidrocefalia/cirurgia
Derivação Ventriculoperitoneal
[Mh] Termos MeSH secundário: Seres Humanos
Lactente
Recém-Nascido
Doenças do Recém-Nascido
Doenças do Prematuro
[Pt] Tipo de publicação:EDITORIAL; COMMENT
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180129
[Lr] Data última revisão:
180129
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.1007/s12098-017-2427-9


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[PMID]:29236742
[Au] Autor:Cole BK; Scott E; Ilikj M; Bard D; Akins DR; Dyer DW; Chavez-Bueno S
[Ad] Endereço:Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America.
[Ti] Título:Route of infection alters virulence of neonatal septicemia Escherichia coli clinical isolates.
[So] Source:PLoS One;12(12):e0189032, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Escherichia coli is the leading cause of Gram-negative neonatal septicemia in the United States. Invasion and passage across the neonatal gut after ingestion of maternal E. coli strains produce bacteremia. In this study, we compared the virulence properties of the neonatal E. coli bacteremia clinical isolate SCB34 with the archetypal neonatal E. coli meningitis strain RS218. Whole-genome sequencing data was used to compare the protein coding sequences among these clinical isolates and 33 other representative E. coli strains. Oral inoculation of newborn animals with either strain produced septicemia, whereas intraperitoneal injection caused septicemia only in pups infected with RS218 but not in those injected with SCB34. In addition to being virulent only through the oral route, SCB34 demonstrated significantly greater invasion and transcytosis of polarized intestinal epithelial cells in vitro as compared to RS218. Protein coding sequences comparisons highlighted the presence of known virulence factors that are shared among several of these isolates, and revealed the existence of proteins exclusively encoded in SCB34, many of which remain uncharacterized. Our study demonstrates that oral acquisition is crucial for the virulence properties of the neonatal bacteremia clinical isolate SCB34. This characteristic, along with its enhanced ability to invade and transcytose intestinal epithelium are likely determined by the specific virulence factors that predominate in this strain.
[Mh] Termos MeSH primário: Bacteriemia/microbiologia
Infecções por Escherichia coli/microbiologia
Escherichia coli/patogenicidade
Doenças do Recém-Nascido/microbiologia
[Mh] Termos MeSH secundário: Escherichia coli/crescimento & desenvolvimento
Seres Humanos
Recém-Nascido
Virulência
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171214
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189032


  10 / 28062 MEDLINE  
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[PMID]:29217807
[Au] Autor:Chandrasekaran M; Swamy R; Ramji S; Shankaran S; Thayyil S
[Ad] Endereço:Centre for Perinatal Neuroscience, Department of Pediatrics, Imperial College London, UK; #Department of Neonatology, Maulana Azad Medical College, New Delhi, India; and $Department of Neonatal Perinatal Medicine, Wayne State University, USA. s.thayyil@imperial.ac.uk.
[Ti] Título:Therapeutic Hypothermia for Neonatal Encephalopathy in Indian Neonatal Units: A Survey of National Practices.
[So] Source:Indian Pediatr;54(11):969-970, 2017 Nov 15.
[Is] ISSN:0974-7559
[Cp] País de publicação:India
[La] Idioma:eng
[Ab] Resumo:This cross-sectional web-based survey suggests that cooling therapy is offered as standard of care for babies with neonatal encephalopathy in 10/25 (40%) of public and 37/68 (51%) of private level 2 or 3 neonatal units in India. 25 (53%) used locally improvised cooling methods, and the cooling practices differed from established protocols in high-income countries.
[Mh] Termos MeSH primário: Encefalopatias/terapia
Hipotermia Induzida/estatística & dados numéricos
Hipotermia Induzida/utilização
Doenças do Recém-Nascido/terapia
Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos
[Mh] Termos MeSH secundário: Seres Humanos
Índia
Recém-Nascido
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180105
[Lr] Data última revisão:
180105
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171209
[St] Status:MEDLINE



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