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[PMID]:28470951
[Au] Autor:Posso M; Corominas JM; Serrano L; Román M; Torá-Rocamora I; Domingo L; Romero A; Quintana MJ; Vernet-Tomas M; Baré M; Vidal C; Sánchez M; Saladié F; Natal C; Ferrer J; Servitja S; Sala M; Castells X; BELE Study Group
[Ad] Endereço:Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
[Ti] Título:Biomarkers expression in benign breast diseases and risk of subsequent breast cancer: a case-control study.
[So] Source:Cancer Med;6(6):1482-1489, 2017 Jun.
[Is] ISSN:2045-7634
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Women with benign breast diseases (BBD) have a high risk of breast cancer. However, no biomarkers have been clearly established to predict cancer in these women. Our aim was to explore whether estrogen receptor (ER), progesterone receptor (PR), and Ki67 expression stratify risk of breast cancer in screened women with BBD. We conducted a nested case-control study. Women with breast cancer and prior BBDs (86 cases) were matched to women with prior BBDs who were free from breast cancer (172 controls). The matching factors were age at BBD diagnosis, type of BBD, and follow-up time since BBD diagnosis. ER, PR, and Ki67 expression were obtained from BBDs' specimens. Conditional logistic regression was used to estimate odds ratios (ORs), and 95% confidence intervals (CIs) of breast cancer risk according to ER, PR, and Ki67 expression. Women with >90% of ER expression had a higher risk of breast cancer (OR = 2.63; 95% CI: 1.26-5.51) than women with ≤70% of ER expression. Similarly, women with >80% of PR expression had a higher risk of breast cancer (OR = 2.22; 95% CI: 1.15-4.27) than women with ≤40% of PR expression. Women with proliferative disease and ≥1% of Ki67 expression had a nonsignificantly increased risk of breast cancer (OR = 1.16; 95% CI: 0.46-2.90) than women with <1% of Ki67 expression. A high expression of ER and PR in BBD is associated with an increased risk of subsequent breast cancer. In proliferative disease, high Ki67 expression may also have an increased risk. This information is helpful to better characterize BBD and is one more step toward personalizing the clinical management of these women.
[Mh] Termos MeSH primário: Doenças Mamárias/epidemiologia
Doenças Mamárias/metabolismo
Receptores Estrogênicos/metabolismo
Receptores de Progesterona/metabolismo
[Mh] Termos MeSH secundário: Idoso
Biomarcadores/metabolismo
Mama/metabolismo
Estudos de Casos e Controles
Feminino
Seres Humanos
Antígeno Ki-67/metabolismo
Meia-Idade
Razão de Chances
Fatores de Risco
Espanha/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 0 (Ki-67 Antigen); 0 (Receptors, Estrogen); 0 (Receptors, Progesterone)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1002/cam4.1080


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[PMID]:28465449
[Au] Autor:Geller BM; Nelson HD; Weaver DL; Frederick PD; Allison KH; Onega T; Carney PA; Tosteson ANA; Elmore JG
[Ad] Endereço:Department of Family Medicine, University of Vermont, Burlington, Vermont, USA.
[Ti] Título:Characteristics associated with requests by pathologists for second opinions on breast biopsies.
[So] Source:J Clin Pathol;70(11):947-953, 2017 Nov.
[Is] ISSN:1472-4146
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: Second opinions in pathology improve patient safety by reducing diagnostic errors, leading to more appropriate clinical treatment decisions. Little objective data are available regarding the factors triggering a request for second opinion despite second opinion consultations being part of the diagnostic system of pathology. Therefore we sought to assess breast biopsy cases and interpreting pathologists characteristics associated with second opinion requests. METHODS: Collected pathologist surveys and their interpretations of 60 test set cases were used to explore the relationships between case characteristics, pathologist characteristics and case perceptions, and requests for second opinions. Data were evaluated by logistic regression and generalised estimating equations. RESULTS: 115 pathologists provided 6900 assessments; pathologists requested second opinions on 70% (4827/6900) of their assessments 36% (1731/4827) of these would not have been required by policy. All associations between case characteristics and requesting second opinions were statistically significant, including diagnostic category, breast density, biopsy type, and number of diagnoses noted per case. Exclusive of institutional policies, pathologists wanted second opinions most frequently for atypia (66%) and least frequently for invasive cancer (20%). Second opinion rates were higher when the pathologist had lower assessment confidence, in cases with higher perceived difficulty, and cases with borderline diagnoses. CONCLUSIONS: Pathologists request second opinions for challenging cases, particularly those with atypia, high breast density, core needle biopsies, or many co-existing diagnoses. Further studies should evaluate whether the case characteristics identified in this study could be used as clinical criteria to prompt system-level strategies for mandating second opinions.
[Mh] Termos MeSH primário: Biópsia
Doenças Mamárias/patologia
Mama/patologia
Patologistas
Encaminhamento e Consulta
[Mh] Termos MeSH secundário: Adulto
Idoso
Atitude do Pessoal de Saúde
Competência Clínica
Estudos Transversais
Diagnóstico Diferencial
Erros de Diagnóstico/prevenção & controle
Feminino
Conhecimentos, Atitudes e Prática em Saúde
Seres Humanos
Modelos Logísticos
Masculino
Meia-Idade
Variações Dependentes do Observador
Patologistas/psicologia
Valor Preditivo dos Testes
Reprodutibilidade dos Testes
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1136/jclinpath-2016-204231


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[PMID]:29326237
[Au] Autor:Qiao J; Zhou S; Fang H
[Ad] Endereço:Department of Dermatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China.
[Ti] Título:An ulcer on the nipple.
[So] Source:BMJ;360:j5850, 2018 01 11.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Doenças Mamárias/diagnóstico
Mamilos/microbiologia
Sífilis/diagnóstico
Treponema pallidum
Úlcera/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Doenças Mamárias/microbiologia
Diagnóstico Diferencial
Feminino
Seres Humanos
Sífilis/microbiologia
Úlcera/microbiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180113
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j5850


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[PMID]:29391087
[Au] Autor:Abou-Zamzam A; Somers S; Cora C; Pairawan S; Lum S
[Ad] Endereço:Department Surgery, Loma Linda University Medical Center, Loma Linda, California, USA.
[Ti] Título:Percutaneous Needle Biopsies of the Breast in Women Younger than 35 Years: Minimally or Excessively Invasive?
[So] Source:Am Surg;83(10):1019-1023, 2017 Oct 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Percutaneous needle biopsy (PNB) of the breast is commonly used for diagnosis of breast pathology, but has been less studied in young women. We sought to determine the effectiveness and necessity of PNB in patients younger than 35 years of age. The charts of sequential patients <35 years who underwent PNB between February 2013 and May 2016 were reviewed; 181 PNB were performed in 127 patients. Median age was 30 years (13-34). Indications for PNB were Breast Imaging Reporting and Data System (BIRADS) ≥4 in 137 (75.7%) cases, with mass on imaging in 139 (76.8%). Carcinoma was diagnosed in 12 (6.6%), PNB in eight unique patients (6.3%). Other PNB pathology included atypia in four (2.2%) patients; papillary lesion, five (2.8%); benign lymph node, 10 (5.5%); fibroepithelial lesion, 15 (8.3%); benign breast tissue, 63 (34.8%); and fibroadenoma, 72 (39.8%). Women with atypia or malignancy were older than those with benign findings (30.9 vs 28.0 years, P = 0.002). No other patient or imaging factors were significantly associated with pathologic diagnosis on PNB. Routine PNB for all BIRADS 4 findings may be over-used in young women as most results are benign and subsequent surgical findings are concordant. Improved diagnostic accuracy of breast imaging is warranted to reduce unnecessary procedures.
[Mh] Termos MeSH primário: Doenças Mamárias/diagnóstico
Doenças Mamárias/patologia
Mama/patologia
Procedimentos Desnecessários
[Mh] Termos MeSH secundário: Adolescente
Adulto
Fatores Etários
Biópsia por Agulha
Feminino
Seres Humanos
Estudos Retrospectivos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE


  5 / 10626 MEDLINE  
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[PMID]:29211392
[Au] Autor:Buck ML; Eckereder G; Amir LH
[Ti] Título:Low level laser therapy for breastfeeding problems.
[So] Source:Breastfeed Rev;24(2):27-31, 2016 Jul.
[Is] ISSN:0729-2759
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:Breast and nipple pain, nipple damage and mastitis are common reasons given by women for their early cessation of breastfeeding. There are a limited number of effective therapies available to support healing of damaged nipples during lactation. Low level laser therapy is a painless treatment, which appears to accelerate wound healing and ease pain. We present two case studies, which demonstrate the use of low level laser therapy in clinical practice.
[Mh] Termos MeSH primário: Doenças Mamárias/radioterapia
Aleitamento Materno/efeitos adversos
Terapia com Luz de Baixa Intensidade/métodos
Mamilos/efeitos da radiação
[Mh] Termos MeSH secundário: Adulto
Doenças Mamárias/etiologia
Feminino
Seres Humanos
Manejo da Dor/métodos
Medição da Dor
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171227
[Lr] Data última revisão:
171227
[Sb] Subgrupo de revista:K
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE


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[PMID]:29187920
[Au] Autor:Kane Gueye SM; Gueye M; Coulibaly MT; Mahtouk D; Moreau JC
[Ad] Endereço:Unité de Sénologie du Centre Hospitalier Universitaire Aristide Le Dantec de Dakar, Sénégal.
[Ti] Título:[Benign tumors of the breast in the department of senology at the University Hospital Aristide Le Dantec, Dakar (Senegal)].
[Ti] Título:Tumeurs bénignes du sein à l'unité de sénologie du Centre Hospitalier Universitaire Aristide Le Dantec de Dakar (Sénégal)..
[So] Source:Pan Afr Med J;27:251, 2017.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:fre
[Ab] Resumo:Introduction: This study aimed to identify the epidemiological, clinical and therapeutic features of benign tumors of the breast treated in the department of senology at the university hospital Aristide Le Dantec, Dakar. Methods: We conducted a cross-sectional, descriptive and analytical study of 220 patients treated in the Department of Senology at the University Hospital Aristide Le Dantec, Dakar over the period from 1 January 2008 to 31 December 2013. Results: 220 patients out of 984 consultants had benign tumor of the breast (22.5%). Benign tumors of the breast accounted for 58.2% of tumor pathologies. The average age was 24 years. The age group 11-30 years was the most represented (70%). The quasi-totality of patients were women of childbearing age (95%), 58.6% were nulliparous women. The main reason for consultation was a breast mass in 94.5% of cases. The left side was most often affected (49.5%), especially the upper outer quadrant (41.6%). 145 patients (65.9% of cases) underwent ultrasound. Cytologic examination showed conjunctival epithelial hyperplasia in almost all cases (96.1%). 44 women underwent histologic examination, which confirmed the histologic nature of the lesions. Fibroadenoma and fibrocystic changes were the most retained diagnoses, accounting for 86.3% and 5.9% respectively. 28 patients (12.7%) underwent lumpectomy, all tumor types were taken together. The majority of patients had follow-up appointments within 3 months, with favorable outcome. Conclusion: Benign tumors are very frequent in senology consultations. The recommended diagnostic approach combines the clinico-radio-cytological triad and, in case of doubt or discrepancy, biopsy or surgical resection are essential. Surgery is not always the treatment of choice. This is based on the nature of the tumor.
[Mh] Termos MeSH primário: Doenças Mamárias/diagnóstico
Neoplasias da Mama/diagnóstico
Fibroadenoma/diagnóstico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Doenças Mamárias/patologia
Doenças Mamárias/cirurgia
Neoplasias da Mama/patologia
Neoplasias da Mama/cirurgia
Criança
Estudos Transversais
Feminino
Fibroadenoma/patologia
Fibroadenoma/cirurgia
Seguimentos
Hospitais Universitários
Seres Humanos
Hiperplasia
Mastectomia Segmentar/métodos
Meia-Idade
Senegal
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171219
[Lr] Data última revisão:
171219
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.2017.27.251.12262


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[PMID]:29183079
[Au] Autor:Engelhardt KE; Barnard C; Bilimoria KY
[Ad] Endereço:Department of Surgery, Medical University of South Carolina, Charleston.
[Ti] Título:Wrong-Site Surgery.
[So] Source:JAMA;318(20):2033-2034, 2017 Nov 28.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Neoplasias da Mama/cirurgia
Carcinoma Intraductal não Infiltrante/cirurgia
Erros Médicos
Análise de Causa Fundamental
[Mh] Termos MeSH secundário: Doenças Mamárias/diagnóstico por imagem
Doenças Mamárias/patologia
Neoplasias da Mama/diagnóstico por imagem
Neoplasias da Mama/patologia
Carcinoma Intraductal não Infiltrante/patologia
Feminino
Seres Humanos
Mastectomia Segmentar
Estudos de Casos Organizacionais
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171213
[Lr] Data última revisão:
171213
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.17177


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[PMID]:29049174
[Au] Autor:Xue Y; Yao S; Li X; Zhang H
[Ad] Endereço:aDepartment of Ultrasonography, Linyi People's Hospital, Linyi City, Shandong bDepartment of Ultrasonography, Heze Municipal Hospital, Heze City, Shandong cDepartment of Radiology, Linyi People's Hospital, Linyi City, Shandong, China.
[Ti] Título:Value of shear wave elastography in discriminating malignant and benign breast lesions: A meta-analysis.
[So] Source:Medicine (Baltimore);96(42):e7412, 2017 Oct.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The analysis was aimed to evaluate the diagnostic accuracy of shear wave elastography (SWE) for malignant breast lesions through a meta-analysis.Related articles were searched from Pubmed, Embase, and Cochrane library. Overall sensitivity and specificity were analyzed with DerSimonian and Laird random effects model. Area under curve with corresponding 95% confidence interval (were calculated to evaluate the diagnostic accuracy of SWE. Sensitivity and publication bias were assessed as well.A total of 25 articles including 4128 patients and 4546 breast lesions were included in the pooled analysis. In the subgroup analysis, diagnostic sensitivity and specificity of SWE in Asian population were 0.84 (0.79-0.88) and 0.87 (0.84-0.90), respectively, whereas they were 0.92 (0.86-0.96) and 0.89 (0.84-0.92) in Caucasian population. The diagnostic accuracy of SWE was a little higher for Caucasians than for Asians (0.95 vs. 0.92). The diagnostic sensitivity and specificity of virtual touch tissue quantification were 0.85 (0.77-0.91) and 0.93 (0.88-0.96), respectively. It showed a little higher value in specificity and summary ROC curve than SWE (0.93 vs. 0.87; 0.95 vs. 0.93). In addition, maximum stiffness exhibited higher detection sensitivity than that of mean stiffness (0.91 vs. 0.85).SWE serves as an accurate diagnostic technology for discriminating between malignant and benign breast lesions.
[Mh] Termos MeSH primário: Doenças Mamárias/diagnóstico por imagem
Neoplasias da Mama/diagnóstico por imagem
Técnicas de Imagem por Elasticidade/estatística & dados numéricos
[Mh] Termos MeSH secundário: Área Sob a Curva
Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos
Mama/diagnóstico por imagem
Mama/patologia
Doenças Mamárias/patologia
Diagnóstico Diferencial
Técnicas de Imagem por Elasticidade/métodos
Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos
Feminino
Seres Humanos
Curva ROC
Reprodutibilidade dos Testes
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171122
[Lr] Data última revisão:
171122
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171020
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007412


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[PMID]:28854344
[Au] Autor:Tabbarah A; Voltaggio L
[Ti] Título:Giant Cell Arteritis of the Breast.
[So] Source:Arch Pathol Lab Med;141(9):1283-1287, 2017 Sep.
[Is] ISSN:1543-2165
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Giant cell arteritis is an inflammatory lesion of the large- and medium-sized arteries, usually involving the temporal arteries of older women. Rarely, the breast has been reported as the primary site of involvement. Patients usually present with breast masses that are tender or painful in most reported cases. The disease may be associated with constitutional symptoms that resemble polymyalgia rheumatica, but most reported cases do not have an established diagnosis of autoimmune disease. Clinically, giant cell arteritis of the breast may mimic breast carcinoma. Establishing the diagnosis is important because most patients achieve remission of symptoms after treatment with prednisone.
[Mh] Termos MeSH primário: Doenças Mamárias/diagnóstico
Doenças Mamárias/patologia
Arterite de Células Gigantes/diagnóstico
Arterite de Células Gigantes/patologia
[Mh] Termos MeSH secundário: Neoplasias da Mama/diagnóstico
Diagnóstico Diferencial
Feminino
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170831
[St] Status:MEDLINE
[do] DOI:10.5858/arpa.2016-0285-RS


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[PMID]:28841601
[Au] Autor:Gunnarsson GL; Bille C; Reitsma LC; Wamberg P; Thomsen JB
[Ad] Endereço:Skien, Norway; and Odense/Vejle, Denmark From the Department of Plastic Surgery, Telemark Hospital; the Department of Plastic Surgery, Odense University Hospital; and the Section for Breast Surgery, Department of Surgery, Vejle Lillebaelt Hospital.
[Ti] Título:Prophylactic Nipple-Sparing Mastectomy and Direct-to-Implant Reconstruction of the Large and Ptotic Breast: Is Preshaping of the Challenging Breast a Key to Success?
[So] Source:Plast Reconstr Surg;140(3):449-454, 2017 Sep.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Nipple-sparing mastectomy with simultaneous hammock technique direct-to-implant reconstruction is increasingly offered to patients opting for risk-reducing mastectomy. Despite this promising method, patients with macromastia and ptotic breasts remain a challenging group to treat satisfactorily and more often end up undergoing a difficult corrective procedure and experience an unacceptably high rate of failed reconstruction. The authors examined whether targeted preshaping mastopexy/reduction could prepare these patients for a successful nipple-sparing mastectomy/direct-to-implant reconstruction. METHODS: Patients seeking risk-reducing nipple-sparing mastectomy/direct-to-implant reconstruction at the authors' institutions deemed unfit for a one-stage procedure based on their previous experience were offered a targeted two-stage, risk-reducing mastopexy/reduction followed by a delayed secondary nipple-sparing mastectomy and direct-to-implant reconstruction. Patients were followed up at 3 weeks and 6 or 12 months. RESULTS: Forty-four reconstructions were performed in 22 patients aged 43 years (range, 26 to 57 years). All 44 procedures were completed successfully without any failure or nipple-areola complex losses. Patients' median body mass index was 30 kg/m (range, 22 to 44 kg/m). Six patients were smokers and one had hypertension. Two patients underwent reoperation because of hematoma and fat necrosis. CONCLUSIONS: The authors' results demonstrate that a targeted preshaping mastopexy/reduction followed by nipple-sparing mastectomy/direct-to-implant reconstruction can be safely planned in women who opt for a risk-reducing mastectomy and can be performed successfully with a 3- to 4-month time span between operations. On the basis of these results and the superior cosmetic outcome, the two-stage approach has become the authors' standard of care in all such settings. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
[Mh] Termos MeSH primário: Doenças Mamárias/cirurgia
Neoplasias da Mama/prevenção & controle
Mastectomia Subcutânea/métodos
Mamilos/cirurgia
[Mh] Termos MeSH secundário: Adulto
Mama/anormalidades
Mama/cirurgia
Feminino
Seres Humanos
Hipertrofia/cirurgia
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170826
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003621



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