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[PMID]: 28468146 [Au] Autor: Jin Y; Hua C; Hu X; Chen H; Ma G; Zou Y; Chen B; Lyu D; Tremp M; Lin X [Ad] Endereço: *Department of Plastic and Reconstructive Surgery, School of Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, Shanghai, China †Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Basel, Switzerland. [Ti] Título: Microsurgical Replantation of Total Avulsed Scalp: Extending the Limits. [So] Source: J Craniofac Surg;28(3):670-674, 2017 May. [Is] ISSN: 1536-3732 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: Avulsion of the scalp is a rare but severe trauma and challenging to the reconstructive surgeon. It poses not only physical concussion but also significant persisting psychological distress to the patients. METHODS: Medical records from 5 patients who suffered scalp avulsion were reviewed retrospectively. The following data and methods were assessed: age, number of vessels repaired, method of replantation, vein grafts required, blood transfusion, ischemia time, total operating time, and percentage of scalp survival. RESULTS: In 4 patients, the replantation was performed at the anatomic site. Two arteries and 2 veins were anastomosed in 2 patients; a single artery and a single vein were anastomosed in 2 patients. The middle temporal vein was chosen for anastomosis as a recipient vessel in 2 patients. In the fifth patient with simultaneous cervical fracture that makes primarily replantation technically not possible, the scalp was implanted ectopically in the forearm for the purpose of secondary replantation at the anatomic site. After a mean follow-up of 22.6 months (range 13-29 months), 4 of 5 patients exhibited successful survival of the replanted scalp. CONCLUSIONS: The success of scalp replantation is determined by a comprehensive management of the trauma and well-trained microsurgical technique. The middle temporal vein can be used as a reliable alternative recipient vessel for microvascular anastomosis when replanting the avulsed scalp. In patients in whom primary replantation is not possible, temporary ectopic implantation of the avulsed scalp and anatomic replantation at a second stage is considerable. [Mh] Termos MeSH primário: Traumatismos Craniocerebrais/cirurgia Desenluvamentos Cutâneos/cirurgia Microcirurgia/métodos Reimplante/métodos Couro Cabeludo/lesões Couro Cabeludo/cirurgia [Mh] Termos MeSH secundário: Adulto Anastomose Cirúrgica Artérias/cirurgia Feminino Seguimentos Sobrevivência de Enxerto Seres Humanos Masculino Meia-Idade Couro Cabeludo/irrigação sanguínea Veias/cirurgia [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1801 [Cu] Atualização por classe: 180126 [Lr] Data última revisão: 180126 [Sb] Subgrupo de revista: D [Da] Data de entrada para processamento: 170505 [St] Status: MEDLINE [do] DOI: 10.1097/SCS.0000000000003487

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[PMID]: 28076017 [Au] Autor: McLean K; Popovic S [Ad] Endereço: From the Departments of Radiology (K.M.) and Pathology and Molecular Medicine (S.P.), McMaster University, 1200 Main St W, Room 2S23-1, Hamilton, ON, Canada L8S 4L8. [Ti] Título: Morel-Lavallée Lesion: AIRP Best Cases in Radiologic-Pathologic Correlation. [So] Source: Radiographics;37(1):190-196, 2017 Jan-Feb. [Is] ISSN: 1527-1323 [Cp] País de publicação: United States [La] Idioma: eng [Mh] Termos MeSH primário: Nádegas/diagnóstico por imagem Nádegas/lesões Desenluvamentos Cutâneos/diagnóstico por imagem Necrose Gordurosa/diagnóstico por imagem Imagem Multimodal/métodos [Mh] Termos MeSH secundário: Idoso Desenluvamentos Cutâneos/patologia Diagnóstico Diferencial Necrose Gordurosa/patologia Seres Humanos Imagem por Ressonância Magnética/métodos Masculino Estatística como Assunto Tomografia Computadorizada por Raios X/métodos Ultrassonografia/métodos [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170926 [Lr] Data última revisão: 170926 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170112 [St] Status: MEDLINE [do] DOI: 10.1148/rg.2017160169

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[PMID]: 28060002 [Ti] Título: Incidence of Skin Tears and Risk Factors: A Systematic Literature Review. [So] Source: J Wound Ostomy Continence Nurs;44(1):E1, 2017 Jan/Feb. [Is] ISSN: 1528-3976 [Cp] País de publicação: United States [La] Idioma: eng [Mh] Termos MeSH primário: Incidência Pele/lesões [Mh] Termos MeSH secundário: Desenluvamentos Cutâneos/epidemiologia Seres Humanos Fatores de Risco [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Em] Mês de entrada: 1708 [Cu] Atualização por classe: 170828 [Lr] Data última revisão: 170828 [Sb] Subgrupo de revista: N [Da] Data de entrada para processamento: 170107 [St] Status: MEDLINE [do] DOI: 10.1097/WON.0000000000000304

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[PMID]: 28060001 [Au] Autor: Strazzieri-Pulido KC; Peres GR; Campanili TC; de Gouveia Santos VL [Ad] Endereço: Kelly Cristina Strazzieri-Pulido, PhD, ETN, Graduate Program in Adult Health Nursing, University of São Paulo School of Nursing (PROESA-EEUSP), Sao Paulo, SP, Brazil. Giovana Ribau Picolo Peres, MSN, ETN, São Camilo Hospital, Sao Paulo, SP, Brazil. Ticiane Carolina Gonçalves Faustino Campanili, MSN, ETN, University of São Paulo School of Medicine (FMUSP), Sao Paulo, SP, Brazil. Vera Lúcia Conceição de Gouveia Santos, PhD, CETN (TiSOBEST), Medical-Surgical Nursing Department, University of São Paulo School of Nursing (EE-USP), Sao Paulo, SP, Brazil. [Ti] Título: Incidence of Skin Tears and Risk Factors: A Systematic Literature Review. [So] Source: J Wound Ostomy Continence Nurs;44(1):29-33, 2017 Jan/Feb. [Is] ISSN: 1528-3976 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Skin tears are traumatic wounds resulting from friction and shearing forces. Clinical practice strongly indicates that skin tears are a prevalent problem but their incidence is not well established in the literature. This systematic literature review identified and evaluated the available literature on the incidence and risk factors for skin tears in adults and the elderly. Inclusion criteria were epidemiological studies published in English, Spanish, or Portuguese languages from January 1990 through June 2014 and available in full text. Study quality was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement and the Guidelines for Critically Appraising Studies of Prevalence or Incidence of a Health Problem. Five studies reporting incidence of skin tears met the selection criteria. Reported incidence rates of skin tears ranged from 2.23% to 92% in long-term care facilities and varied from 2.1% among men to 4.6% among women living in the community. The most prevalent risk factor for skin tears was old age, followed by impaired mobility, falls and accidental injuries, previous skin tears, cognitive deficit/dementia, dependence in transfers, and upper limbs. Further epidemiological studies on skin tears are necessary to elucidate the cause of these injuries and identify the profile of people at risk for skin tears, contributing to the development and implementation of appropriate preventive interventions. [Mh] Termos MeSH primário: Desenluvamentos Cutâneos/epidemiologia Incidência Pele/lesões [Mh] Termos MeSH secundário: Idoso Idoso de 80 Anos ou mais Seres Humanos Assistência de Longa Duração/normas Assistência de Longa Duração/estatística & dados numéricos Fatores de Risco Estados Unidos/epidemiologia [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Em] Mês de entrada: 1708 [Cu] Atualização por classe: 170828 [Lr] Data última revisão: 170828 [Sb] Subgrupo de revista: N [Da] Data de entrada para processamento: 170107 [St] Status: MEDLINE [do] DOI: 10.1097/WON.0000000000000288

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[PMID]: 28060000 [Au] Autor: Yates S; McNichol L; Heinecke SB; Gray M [Ad] Endereço: Stephanie Yates, MSN, RN, ANP-BC, CWOCN, NP/WOC Nurse, Center for Advanced Practice, Duke University Medical Center, Durham, North Carolina. Laurie McNichol, MSN, RN, GNP, CWOCN, CWON-AP, CNS/WOC Nurse, Cone Health, Greensboro, North Carolina. Steven B. Heinecke, BS, Division Scientist, 3M Critical and Chronic Care Solutions Division, St Paul, Minnesota. Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, School of Medicine, Department of Urology, and School of Nursing, Department of Acute and Specialty Care, University of Virginia, Charlottesville, Virginia. [Ti] Título: Embracing the Concept, Defining the Practice, and Changing the Outcome: Setting the Standard for Medical Adhesive-Related Skin Injury Interventions in WOC Nursing Practice. [So] Source: J Wound Ostomy Continence Nurs;44(1):13-17, 2017 Jan/Feb. [Is] ISSN: 1528-3976 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Medical adhesive-related skin injury (MARSI) is a comparatively new category of skin damage. Our current understanding of MARSI originates from an interdisciplinary consensus conference held in 2012 that generated and disseminated 25 statements pertaining to the assessment, prevention, and management of MARSI, along with gaps in research and knowledge related to this area. The 2012 MARSI Consensus Group also challenged each organization to refine the original statements to make them more relevant to their particular area of practice. In order to accomplish this refinement for WOC specialty nursing practice, the WOCN Society appointed a task force to create statements that extended recommendations to patients with an acute or chronic wound, ostomy, or incontinence. This article describes the formal consensus process used to generate consensus statements concerning MARSI in our specialty practice, presents the 8 statements, and provides a brief overview of the advances that underlie the medical adhesive end products used by WOC and other clinicians practicing in all health care settings. [Mh] Termos MeSH primário: Adesivos/efeitos adversos Desenluvamentos Cutâneos/etiologia Literatura de Revisão como Assunto Pele/lesões [Mh] Termos MeSH secundário: Adesivos/administração & dosagem Desenluvamentos Cutâneos/complicações Seres Humanos Estomia/efeitos adversos Estomia/enfermagem Prevalência Higiene da Pele/métodos Higiene da Pele/enfermagem [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Adhesives) [Em] Mês de entrada: 1708 [Cu] Atualização por classe: 170828 [Lr] Data última revisão: 170828 [Sb] Subgrupo de revista: N [Da] Data de entrada para processamento: 170107 [St] Status: MEDLINE [do] DOI: 10.1097/WON.0000000000000290

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[PMID]: 27058345 [Au] Autor: Khodaee M; Deu RS [Ad] Endereço: Department of Family Medicine, University of Colorado School of Medicine, Denver, CO, USA - morteza.khodaee@ucdenver.edu. [Ti] Título: Ankle Morel-Lavallée lesion in a recreational racquetball player. [So] Source: J Sports Med Phys Fitness;57(6):822-824, 2017 Jun. [Is] ISSN: 1827-1928 [Cp] País de publicação: Italy [La] Idioma: eng [Ab] Resumo: Unilateral ankle swelling is a relatively common presenting complaint among athletes and non-athletes. Due to its broad differential diagnosis, a comprehensive evaluation beginning with history and physical examination are recommended. Imaging including plain radiography, ultrasound (US), and magnetic resonance imaging (MRI) are preferred modalities. Aspiration of a local fluctuating mass may help with the diagnosis and management of some of these conditions. Morel-Lavallée lesion (MLL) is a rare condition consisting of a closed degloving injury caused by forces of pressure and shear stress between the subcutaneous tissue and the superficial fascia or bone. Most commonly MLL is found over the greater trochanter and sacrum, but in rare cases can be found in other regions of the body. In most cases concurrent severe injury mechanisms like motor vehicle accidents are present. MLL due to sports injuries are rare. Depending on the stage and type of MLL, therapeutic strategies may vary from compression wraps and aspiration to surgical evacuation. We present a case of a 65-year-old gentleman with ankle MLL with no known history of a major trauma as a result of playing racquetball 6 weeks earlier. Physical examination revealed a transilluminating lesion in the lateral aspect of his left ankle which was successfully treated with one time aspiration of a serosanguinous fluid. We propose less aggressive methods for management of low-impact sports-related MLL. [Mh] Termos MeSH primário: Traumatismos do Tornozelo/diagnóstico Desenluvamentos Cutâneos/diagnóstico Exame Físico/métodos Esportes com Raquete/lesões Lesões dos Tecidos Moles/diagnóstico [Mh] Termos MeSH secundário: Idoso Traumatismos do Tornozelo/terapia Diagnóstico Diferencial Seres Humanos Imagem por Ressonância Magnética Masculino Radiografia Transiluminação Ultrassonografia [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171010 [Lr] Data última revisão: 171010 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 160409 [St] Status: MEDLINE [do] DOI: 10.23736/S0022-4707.16.06386-6

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[PMID]: 26425931 [Au] Autor: Deutsch SA; Long CJ; Srinivasan AK; Wood JN [Ad] Endereço: From the *Division of General Pediatrics, †Urology, and ‡General Pediatrics and Policy Lab, Perelman School of Medicine, University of Pennsylvania, The Children's Hospital of Philadelphia, Philadelphia, PA. [Ti] Título: Child Abuse Mimic: Avulsion Injury in a Child With Penoscrotal Webbing. [So] Source: Pediatr Emerg Care;33(4):265-267, 2017 Apr. [Is] ISSN: 1535-1815 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Sexual abuse of children is prevalent in today's society. In 2012, approximately 686,000 children (9.2 per 1000) in the United States were determined to be victims of substantiated child abuse and neglect, according to national data compiled by child protective service agencies; victimization rates were highest for children younger than 1 year. Nearly 9.3% of maltreated children were victims of sexual abuse, this finding was reported by US Department of Health and Human Services (http://www.acf.hhs.gov/programs/cb/research-data-technology/statistics-research/child-maltreatment). Previous research has shown that as many as 1 in 3 girls and 1 in 7 boys will be sexually abused during childhood (Child Abuse Negl. 2003;27:1205-1222). Although sexual abuse seems to be less common in boys than girls, this may be partly due to underdiagnosis and underreporting of sexual abuse in boys (Arch Dis Child. 2007;92:328-331). Clinicians should therefore consider the possibility of sexual abuse when boys present with genital injuries, because failing to recognize and diagnose sexual abuse can pose an ongoing safety risk to a child. However, an erroneous diagnosis of sexual abuse can have equally hazardous repercussions, including removal of a child from their caregivers or prosecution of an innocent individual. A number of medical conditions can mimic child sexual abuse injuries, including anal fissures, failure of midline fusion, perianal streptococcal dermatitis, and straddle injury (J Pediatr Health Care. 2009;23:283-288 and Acta Paediatr. 2011;100:590-593). The following case involves a 5-week-old male infant who presented to the pediatric emergency department with an avulsion injury to his penis concerning for sexual abuse. He was ultimately diagnosed with a relatively rare anatomic variant of the genitalia and determined to have sustained an accidental injury whose appearance mimicked abuse. [Mh] Termos MeSH primário: Desenluvamentos Cutâneos/congênito Pênis/lesões Escroto/lesões [Mh] Termos MeSH secundário: Abuso Sexual na Infância/diagnóstico Diagnóstico Diferencial Gerenciamento Clínico Seres Humanos Lactente Masculino Estados Unidos [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170915 [Lr] Data última revisão: 170915 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 151002 [St] Status: MEDLINE [do] DOI: 10.1097/PEC.0000000000000524

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[PMID]: 28088938 [Au] Autor: Chen Y; Liu L [Ad] Endereço: Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, China. [Ti] Título: Clinical analysis of 54 cases of large area soft tissue avulsion in the lower limb. [So] Source: Chin J Traumatol;19(6):337-341, 2016 Dec 01. [Is] ISSN: 1008-1275 [Cp] País de publicação: China [La] Idioma: eng [Ab] Resumo: OBJECTIVE: To assess the clinical curative effect of different treatment methods for large area avulsion injury in the lower limb. METHODS: Between January 2010 and December 2013, 54 patients with large area avulsion injury in the lower limb were treated in the trauma center of our hospital, including 34 males and 20 females with a mean age of 35.7 years (range, 16-65 years). The injury mechanism was traffic accident in 44 cases, hitting by heavy objects in 8 cases, and fall from height in 2 cases, involving 31 thighs, 19 legs and 4 feet involved. The sizes of the avulsed wounds ranged from 10 cm ×15 cm to 50 cm ×30 cm. There were 16 cases combined with hemorrhagic shock, 5 with femoral fractures, and 7 with tibiofibula fractures. Averagely the patients were sent to our hospital within 3.5 h (range, 1.5-10 h) after injury. For the 54 patients, three different surgical strategies were performed based on the wound area and condition of the avulsed skin: in Group A, 24 patients were treated by debridement and preservation of subcutaneous vascular network â�º vertical mattress suture of full thickness skin flap â�º tube drainage; in Group B, 25 patients were treated by split-thickness skin flap meshing and grafting â�º vacuum sealing drainage (VSD); and in Group C, the other 5 patients were treated by debridement and VSD at stage I â�º reattachment of autologous reserved frozen split-thickness skin graft at stage II. RESULTS: All the 54 patients recovered and were discharged eventually, without any deaths or amputees. In each group, there were no statistical differences (all p > 0.05) among different injury sites in terms of survival rate and length of hospital stay, except for the infection rate, which was much higher (p =0.000) at the leg area than that at the thigh (32.54% ± 2.97% vs. 2.32% ± 2.34% in Group A and 50.00% ± 0.00% vs. 0 in Group C) or the foot (50.00% ± 0.00% vs. 0 in Group C). Moreover comparison of the three surgical methods showed a significant different (all p < 0.05) between each other for all the three assessed parameters, i.e. flap survival rate, length of hospital stay, and infection rate. CONCLUSION: Treatment choices for skin avulsion on the lower limb should be based on the viability of the avulsed skin flap and the location of the wound. Proper choice can not only reduce the economic burden caused by using VSD, but also shorten the long hospital stay due to repeated wound dressing change or second stage surgery. [Mh] Termos MeSH primário: Desenluvamentos Cutâneos/cirurgia Extremidade Inferior/lesões [Mh] Termos MeSH secundário: Adolescente Adulto Idoso Desbridamento Desenluvamentos Cutâneos/mortalidade Feminino Seres Humanos Tempo de Internação Masculino Meia-Idade Retalhos Cirúrgicos Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1708 [Cu] Atualização por classe: 170815 [Lr] Data última revisão: 170815 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170117 [St] Status: MEDLINE

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[PMID]: 27841813 [Au] Autor: Khodaee M; Deu RS; Mathern S; Bravman JT [Ad] Endereço: 1Division of Sports Medicine, Department of Family Medicine, University of Colorado School of Medicine, AFW Clinic, Denver, CO; 2Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD; 3Department of Family Medicine, University of Colorado School of Medicine, Denver, CO; 4Division of Sports Medicine and Shoulder Surgery, Department of Orthopaedic Surgery, University of Colorado School of Medicine, Aurora, CO. [Ti] Título: Morel-Lavallée Lesion in Sports. [So] Source: Curr Sports Med Rep;15(6):417-422, 2016 Nov/Dec. [Is] ISSN: 1537-8918 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Posttraumatic soft tissue swelling is a relatively common presenting complaint among athletes. Due to its broad differential diagnosis, a comprehensive evaluation beginning with history and physical examination are recommended. Imaging including radiography, ultrasound, and magnetic resonance imaging (MRI) are preferred modalities. Aspiration of a fluid collection, preferably under ultrasound guidance, may help with the diagnosis and management of some of these conditions. Morel-Lavallée lesion (MLL) is an uncommon condition consisting of a closed degloving injury caused by forces that create pressure and shear stress between the subcutaneous tissue and the superficial fascia or bone. Most commonly, MLL is found over the greater trochanter and sacrum, but in rare cases can be found in other regions of the body. In most cases, concurrent severe injury mechanisms are present. Sports-related MLL are rare and underreported. Depending on the stage and type of MLL, therapeutic strategies may vary from compression wraps and aspiration to surgical evacuation. [Mh] Termos MeSH primário: Traumatismos em Atletas/diagnóstico Traumatismos em Atletas/terapia Bandagens Compressivas Desenluvamentos Cutâneos/diagnóstico Desenluvamentos Cutâneos/terapia Sucção/métodos [Mh] Termos MeSH secundário: Terapia Combinada/métodos Diagnóstico Diferencial Drenagem/métodos Medicina Baseada em Evidências Seres Humanos Resultado do Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Em] Mês de entrada: 1707 [Cu] Atualização por classe: 170713 [Lr] Data última revisão: 170713 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161115 [St] Status: MEDLINE

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[PMID]: 27717838 [Au] Autor: Zhang G; Ju J; Jin G; Tang L; Fu Y; Hou R [Ad] Endereço: Department of Hand Surgery, Ruihua Affiliated Hospital of Soochow University, No. 5 Tayun Road, Suzhou, Jiangsu 215104, China. [Ti] Título: Replantation or revascularization for the treatment of hand degloving injuries. [So] Source: J Plast Reconstr Aesthet Surg;69(12):1669-1675, 2016 Dec. [Is] ISSN: 1878-0539 [Cp] País de publicação: Netherlands [La] Idioma: eng [Ab] Resumo: PURPOSE: The purpose of this study was to explore effective strategies of replantation or revascularization for the treatment of hand degloving injuries. METHODS: Ten patients who had received replantation or revascularization surgery for hand degloving injury between 2002 and 2014 were included for this study. The average age at the time of surgery was 34.5 years (range 18-49 years). There were nine left and one right hand replantations. The cause of injury was an industrial machine press in all of them. The skin was avulsed from the palm to the distal phalangeal level in five patients, to the middle phalangeal level in four patients, and avulsed from the wrist crease level completely in one patient. All the degloved flaps were revascularized. RESULTS: Both the degloved flap and phalanges survived completely in one patient, and partial survival of the flap occurred in the remaining patients. The patients were followed up from 15 months to 78 months (average, 38.1 months). Sensory recovery of the finger pulp ranged from S2 to S3+. Michigan Hand outcome Questionnaire (MHQ) score ranged from 29 to 96 with an average of 69.5. CONCLUSIONS: Midlateral incision to reduce the secondary damage to the capillaries, repair of more vessels for circulation, application of full-thickness skin grafts to enlarge the survival area, and use of anticoagulation protocols during and postsurgery may be beneficial to improve the replantation survival of the degloved skin. [Mh] Termos MeSH primário: Desenluvamentos Cutâneos/cirurgia Dedos Traumatismos da Mão/cirurgia Reimplante Transplante de Pele [Mh] Termos MeSH secundário: Adulto China Feminino Dedos/irrigação sanguínea Dedos/cirurgia Seguimentos Seres Humanos Masculino Meia-Idade Reimplante/efeitos adversos Reimplante/métodos Transplante de Pele/efeitos adversos Transplante de Pele/métodos Sobrevivência de Tecidos Resultado do Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1704 [Cu] Atualização por classe: 170817 [Lr] Data última revisão: 170817 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161009 [St] Status: MEDLINE

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