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  1 / 3259 MEDLINE  
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[PMID]:29369194
[Au] Autor:Zhang L; Nan G; Mao Y; Chi L
[Ad] Endereço:Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, China.
[Ti] Título:Rapid improvement of angiostenosis due to isolated middle cerebral artery dissection: A case report.
[So] Source:Medicine (Baltimore);97(4):e9695, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Intracranial arterial dissection is a rare cause of ischemic stroke, and isolated middle cerebral artery dissection (MCAD) is extremely rare, having been described only in sparse case reports. The etiology, clinicoradiological features, and treatment strategies are not yet well understood. PATIENT CONCERNS: A 49-year-old man presented with rapidly progressive aphasia and motor disturbance of the right limbs. DIAGNOSES: Neuroimaging evaluation confirmed a diagnosis of MCAD and cerebral infarction. INTERVENTIONS: The patient underwent oral anti-platelet therapy (100 mg aspirin daily). OUTCOMES: The patient recovered to normal status within 2 weeks following antiplatelet treatment. During a follow-up period of 2 years, he remained neurologically asymptomatic and led a virtually normal life. LESSONS: It is crucial for clinicians to be aware of this entity, as the diagnosis of MCAD is quite challenging. Antiplatelet therapy is effective for treating this condition, and the prognosis can be favorable.
[Mh] Termos MeSH primário: Aneurisma Dissecante
Afasia/etiologia
Infarto Cerebral/etiologia
Aneurisma Intracraniano
Artéria Cerebral Média
[Mh] Termos MeSH secundário: Aneurisma Dissecante/complicações
Aneurisma Dissecante/diagnóstico por imagem
Aneurisma Dissecante/tratamento farmacológico
Revascularização Cerebral/métodos
Constrição Patológica
Seres Humanos
Aneurisma Intracraniano/complicações
Aneurisma Intracraniano/diagnóstico por imagem
Aneurisma Intracraniano/tratamento farmacológico
Masculino
Meia-Idade
Artéria Cerebral Média/diagnóstico por imagem
Inibidores da Agregação de Plaquetas/uso terapêutico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Platelet Aggregation Inhibitors)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180126
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009695


  2 / 3259 MEDLINE  
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[PMID]:29220356
[Au] Autor:Yeh SJ; Tang SC; Tsai LK; Lee CW; Chen YF; Liu HM; Yang SH; Kuo MF; Jeng JS
[Ad] Endereço:Stroke Center and Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan.
[Ti] Título:Color Doppler ultrasonography as an alternative tool for postoperative evaluation of collaterals after indirect revascularization surgery in Moyamoya disease.
[So] Source:PLoS One;12(12):e0188948, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The cerebral hypoperfusion caused by chronic progressive stenosis or occlusion of intracranial arteries in moyamoya disease can be treated by direct bypass or indirect revascularization procedures. The extent of collaterals from the external carotid artery (ECA) after indirect revascularization surgery is the key point of angiographic follow-up, and the invasiveness of angiography impelled us to investigate the role of ultrasonography in the evaluation of collaterals. We hypothesized that the collaterals shown on angiography might produce corresponding hemodynamic changes in color Doppler ultrasonography. We prospectively recruited moyamoya patients who underwent indirect revascularization surgery and received both preoperative and postoperative angiography and color Doppler ultrasound studies. The collaterals on angiography were graded according to Matsushima method. A total of 21 patients (age, 17 ± 10.2 years) with 24 operated hemispheres were enrolled. Patients who showed better collateral establishment by angiography had higher end-diastolic velocity (EDV), lower resistance index (RI), and larger flow volume in the superficial temporal artery (STA) and ECA (all p < 0.05). In STA, increase of EDV greater than 13.5 cm/sec or reduction of RI greater than 0.19 after operation corresponded to 94% of Matsushima grade A+B. In ECA, post-operative EDV greater than 22 cm/sec or increase of EDV greater than 6.4 cm/sec also corresponded to 94% of Matsushima grade A+B. Our findings revealed potential roles of color Doppler ultrasonography in identifying patients with poor collaterals after indirect revascularization procedures.
[Mh] Termos MeSH primário: Revascularização Cerebral/métodos
Doença de Moyamoya/cirurgia
Ultrassonografia Doppler em Cores/métodos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Criança
Pré-Escolar
Feminino
Seres Humanos
Masculino
Doença de Moyamoya/diagnóstico por imagem
Período Pós-Operatório
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180111
[Lr] Data última revisão:
180111
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171209
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0188948


  3 / 3259 MEDLINE  
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[PMID]:29179420
[Au] Autor:Tayebi Meybodi A; Benet A; Lawton MT
[Ad] Endereço:Department of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
[Ti] Título:In Reply to the Letter to the Editor "Feasibility of Using a Superficial Temporal Artery Graft in Internal Maxillary Artery Bypass".
[So] Source:World Neurosurg;108:973-974, 2017 12.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Artéria Maxilar/cirurgia
Artérias Temporais
[Mh] Termos MeSH secundário: Revascularização Cerebral
Seres Humanos
Artéria Cerebral Média/cirurgia
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171215
[Lr] Data última revisão:
171215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE


  4 / 3259 MEDLINE  
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[PMID]:29179419
[Au] Autor:Wang L; Shi X; Qian H
[Ad] Endereço:Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing, China.
[Ti] Título:Feasibility of Using a Superficial Temporal Artery Graft in Internal Maxillary Artery Bypass.
[So] Source:World Neurosurg;108:971-972, 2017 12.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Artéria Maxilar/cirurgia
Artérias Temporais/cirurgia
[Mh] Termos MeSH secundário: Revascularização Cerebral
Seres Humanos
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171214
[Lr] Data última revisão:
171214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE


  5 / 3259 MEDLINE  
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[PMID]:28939675
[Au] Autor:Chandler JV; George BP; Kelly AG; Holloway RG
[Ad] Endereço:From the Department of Neurology, University of Rochester, NY.
[Ti] Título:For-Profit Hospital Status and Carotid Artery Stent Utilization in US Hospitals Performing Carotid Revascularization.
[So] Source:Stroke;48(11):3161-3164, 2017 Nov.
[Is] ISSN:1524-4628
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: Carotid artery stenting may be an economically attractive procedure for hospitals and physicians. We sought to identify the association of hospital ownership (nonprofit versus for-profit) on carotid artery stenting (CAS) versus carotid endarterectomy utilization in US hospitals. METHODS: Using the Nationwide Inpatient Sample admissions for cerebrovascular disease from 2008 to 2011, we identified all private, nonfederal US hospitals performing at least 20 carotid revascularization procedures annually, including carotid artery stenting ( -Ninth Revision 00.63) or carotid endarterectomy ( -Ninth Revision 38.12). We used a multilevel multivariable logistic regression controlling for patient demographics, comorbidities, and hospital characteristics, to assess the effect of hospital ownership on CAS use. RESULTS: Across 723 hospitals (600 nonprofit, 123 for-profit), 66 731 carotid revascularization admissions were identified. Approximately 1 in 5 (n=11 641; 17.4%) revascularizations received CAS. The mean CAS rate among nonprofit hospitals was 17.5 per 100 revascularizations (median, 11.5; interquartile range, 5.2-24.5), and the mean CAS rate among for-profit hospitals was 24.2 per 100 revascularizations (median, 16.0; interquartile range, 6.7-33.3; <0.001). Adjusting for patient and hospital characteristics, for-profit hospital designation was associated with greater odds of CAS (adjusted odds ratio, 1.45; 95% confidence interval, 1.07-1.98). CONCLUSIONS: For-profit hospital ownership is associated with a higher rate of CAS compared to nonprofit hospitals in those receiving carotid revascularization. Further research is needed to understand the individual- and system-level factors driving this difference.
[Mh] Termos MeSH primário: Artérias Carótidas/cirurgia
Revascularização Cerebral/economia
Planos de Seguro com Fins Lucrativos
Hospitais
Stents
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Masculino
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171026
[Lr] Data última revisão:
171026
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170924
[St] Status:MEDLINE
[do] DOI:10.1161/STROKEAHA.117.017556


  6 / 3259 MEDLINE  
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[PMID]:28904228
[Au] Autor:Brinjikji W; Pasternak J; Murad MH; Cloft HJ; Welch TL; Kallmes DF; Rabinstein AA
[Ad] Endereço:From the Department of Radiology (W.B., H.J.C., D.F.K.), Department of Neurosurgery (W.B., D.F.K.), Department of Anesthesia (J.P., T.L.W.), Division of Preventive Medicine (M.H.M.), Knowledge and Evaluation Research Unit (M.H.M.), and Department of Neurology (A.A.R.), Mayo Clinic, Rochester, MN. br
[Ti] Título:Anesthesia-Related Outcomes for Endovascular Stroke Revascularization: A Systematic Review and Meta-Analysis.
[So] Source:Stroke;48(10):2784-2791, 2017 Oct.
[Is] ISSN:1524-4628
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: There is currently controversy on the ideal anesthesia strategy during mechanical thrombectomy for acute ischemic stroke. We performed a systematic review and meta-analysis of studies comparing clinical and angiographic outcomes of patients undergoing general anesthesia (GA group) and those receiving either local anesthesia or conscious sedation (non-GA group). METHODS: A literature search on anesthesia and endovascular treatment of acute ischemic stroke was performed. Using random-effects meta-analysis, we evaluated the following outcomes: recanalization rate, good functional outcome at 90 days (modified Rankin Score≤2), symptomatic intracranial hemorrhage, death, vascular complications, respiratory complications, procedure time, and time to groin puncture. RESULTS: Twenty-two studies (3 randomized controlled trials and 19 observational studies), including 4716 patients (1819 GA and 2897 non-GA) were included. In the nonadjusted analysis, patients in the GA group had higher odds of death (odds ratio [OR], 2.02; 95% confidence interval [CI], 1.66-2.45) and respiratory complications (OR, 1.70; 95% CI, 1.22-2.37) and lower odds of good functional outcome (OR, 0.58; 95% CI, 0.48-0.64) compared with the non-GA group. There was no difference in procedure time between the 2 primary comparison groups. When adjusting for baseline National Institutes of Health Stroke Scale, GA was still associated with lower odds of good functional outcome (OR, 0.59; 95% CI, 0.29-0.94). When considering studies performed in the stent-retriever/aspiration era, there was no significant difference in good neurological outcome rates (OR, 0.84; 95% CI, 0.67-1.06). CONCLUSIONS: Acute ischemic stroke patients undergoing intra-arterial therapy may have worse outcomes when treated with GA as compared with conscious sedation/local anesthesia. However, major limitations of current evidence (ie, retrospective studies and selection bias) indicate a need for adequately powered, multicenter randomized controlled trials to answer this question.
[Mh] Termos MeSH primário: Anestesia Geral/tendências
Anestesia Local/tendências
Isquemia Encefálica/cirurgia
Revascularização Cerebral/tendências
Procedimentos Endovasculares/tendências
Acidente Vascular Cerebral/cirurgia
[Mh] Termos MeSH secundário: Anestesia Geral/efeitos adversos
Anestesia Geral/mortalidade
Anestesia Local/efeitos adversos
Anestesia Local/mortalidade
Isquemia Encefálica/diagnóstico
Isquemia Encefálica/mortalidade
Revascularização Cerebral/mortalidade
Procedimentos Endovasculares/mortalidade
Seres Humanos
Estudos Observacionais como Assunto
Ensaios Clínicos Controlados Aleatórios como Assunto
Acidente Vascular Cerebral/diagnóstico
Acidente Vascular Cerebral/mortalidade
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171009
[Lr] Data última revisão:
171009
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170915
[St] Status:MEDLINE
[do] DOI:10.1161/STROKEAHA.117.017786


  7 / 3259 MEDLINE  
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[PMID]:28887396
[Au] Autor:Chen C; Parsons MW; Clapham M; Oldmeadow C; Levi CR; Lin L; Cheng X; Lou M; Kleinig TJ; Butcher KS; Dong Q; Bivard A
[Ad] Endereço:From the Department of Neurology, John Hunter Hospital, University of Newcastle, Australia (C.C., M.P., C.L., L.L., A.B.); Public Health Stream, Hunter Medical Research Institute, Newcastle, Australia (M.C., C.O.); Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China (X.C., Q
[Ti] Título:Influence of Penumbral Reperfusion on Clinical Outcome Depends on Baseline Ischemic Core Volume.
[So] Source:Stroke;48(10):2739-2745, 2017 Oct.
[Is] ISSN:1524-4628
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: In alteplase-treated patients with acute ischemic stroke, we investigated the relationship between penumbral reperfusion at 24 hours and clinical outcomes, with and without adjustment for baseline ischemic core volume. METHODS: Data were collected from consecutive acute ischemic stroke patients with baseline and follow-up perfusion imaging presenting to hospital within 4.5 hours of symptom onset at 7 hospitals. Logistic regression models were used for predicting the effect of the reperfused penumbral volume on the dichotomized modified Rankin Scale (mRS) at 90 days and improvement of National Institutes of Health Stroke Scale at 24 hours, both adjusted for baseline ischemic core volume. RESULTS: This study included 1507 patients. Reperfused penumbral volume had moderate ability to predict 90-day mRS 0 to 1 (area under the curve, 0.77; , 0.28; <0.0001). However, after adjusting for baseline ischemic core volume, the reperfused penumbral volume was a strong predictor of good functional outcome (area under the curve, 0.946; , 0.55; <0.0001). For every 1% increase in penumbral reperfusion, the odds of achieving mRS 0 to 1 at day 90 increased by 7.4%. Improvement in acute 24-hour National Institutes of Health Stroke Scale was also significantly related to the degree of reperfused penumbra ( , 0.31; P<0.0001). This association was again stronger after adjustment for baseline ischemic core volume ( , 0.41; <0.0001). For each 1% of penumbra that was reperfused, the 24-hour National Institutes of Health Stroke Scale decreased by 0.069 compared with baseline. CONCLUSIONS: In patients treated with alteplase, the extent of the penumbra that is reperfused is a powerful predictor of early and late clinical outcomes, particularly when baseline ischemic core is taken into account.
[Mh] Termos MeSH primário: Isquemia Encefálica/diagnóstico por imagem
Isquemia Encefálica/cirurgia
Revascularização Cerebral
Acidente Vascular Cerebral/diagnóstico por imagem
Acidente Vascular Cerebral/cirurgia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Isquemia Encefálica/epidemiologia
Revascularização Cerebral/métodos
Circulação Cerebrovascular/fisiologia
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Estudos Prospectivos
Sistema de Registros
Acidente Vascular Cerebral/epidemiologia
Ativador de Plasminogênio Tecidual/uso terapêutico
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
EC 3.4.21.68 (Tissue Plasminogen Activator)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171009
[Lr] Data última revisão:
171009
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170910
[St] Status:MEDLINE
[do] DOI:10.1161/STROKEAHA.117.018587


  8 / 3259 MEDLINE  
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[PMID]:28732427
[Au] Autor:Ge P; Zhang Q; Zhao J
[Ad] Endereço:Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China; Beijing Translational Engineering Center for 3D Printer in Clinical Neuroscience, Beijing, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.
[Ti] Título:In Reply To "Moyamoya Disease: From Hypoperfusion to Network Disruption".
[So] Source:World Neurosurg;104:1038-1039, 2017 08.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Revascularização Cerebral
Doença de Moyamoya
[Mh] Termos MeSH secundário: Angiografia Cerebral
Seres Humanos
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170904
[Lr] Data última revisão:
170904
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170723
[St] Status:MEDLINE


  9 / 3259 MEDLINE  
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[PMID]:28732426
[Au] Autor:Lanterna LA
[Ad] Endereço:Department of Neuroscience and Surgery of the Nervous System, Papa Giovanni XXIII Hospital, Bergamo, Italy. Electronic address: l.lanterna@gmail.com.
[Ti] Título:Moyamoya Disease: From Hypoperfusion to Network Disruption.
[So] Source:World Neurosurg;104:1036-1037, 2017 08.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Revascularização Cerebral
Doença de Moyamoya
[Mh] Termos MeSH secundário: Angiografia Cerebral
Seres Humanos
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170904
[Lr] Data última revisão:
170904
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170723
[St] Status:MEDLINE


  10 / 3259 MEDLINE  
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[PMID]:28686127
[Au] Autor:Yang W; Xu R; Porras JL; Takemoto CM; Khalid S; Garzon-Muvdi T; Caplan JM; Colby GP; Coon AL; Tamargo RJ; Huang J; Ahn ES
[Ad] Endereço:Department of Neurosurgery and.
[Ti] Título:Effectiveness of surgical revascularization for stroke prevention in pediatric patients with sickle cell disease and moyamoya syndrome.
[So] Source:J Neurosurg Pediatr;20(3):232-238, 2017 Sep.
[Is] ISSN:1933-0715
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE Sickle cell disease (SCD) in combination with moyamoya syndrome (MMS) represents a rare complication of SCD, with potentially devastating neurological outcomes. The effectiveness of surgical revascularization in this patient population is currently unclear. The authors' aim was to determine the effectiveness of surgical intervention in their series of SCD-MMS patients by comparing stroke recurrence in those undergoing revascularization and those undergoing conservative transfusion therapy. METHODS The authors performed a retrospective chart review of patients with MMS who were seen at the Johns Hopkins Medical Institution between 1990 and 2013. Pediatric patients (age < 18 years) with confirmed diagnoses of SCD and MMS were included. Intracranial stroke occurrence during the follow-up period was compared between surgically and conservatively managed patients. RESULTS A total of 15 pediatric SCD-MMS patients (28 affected hemispheres) were included in this study, and all were African American. Seven patients (12 hemispheres) were treated with indirect surgical revascularization. The average age at MMS diagnosis was 9.0 ± 4.0 years, and 9 patients (60.0%) were female. Fourteen patients (93.3%) had strokes before diagnosis of MMS, with an average age at first stroke of 6.6 ± 3.9 years. During an average follow-up period of 11.6 years, 4 patients in the conservative treatment group experienced strokes in 5 hemispheres, whereas no patient undergoing the revascularization procedure had any strokes at follow-up (p = 0.029). Three patients experienced immediate postoperative transient ischemic attacks, but all recovered without subsequent strokes. CONCLUSIONS Indirect revascularization is suggested as a safe and effective alternative to the best medical therapy alone in patients with SCD-MMS. High-risk patients managed on a regimen of chronic transfusion should be considered for indirect revascularization to maximize the effect of stroke prevention.
[Mh] Termos MeSH primário: Anemia Falciforme/complicações
Anemia Falciforme/cirurgia
Revascularização Cerebral
Doença de Moyamoya/complicações
Doença de Moyamoya/cirurgia
Acidente Vascular Cerebral/prevenção & controle
[Mh] Termos MeSH secundário: Adolescente
Transfusão de Sangue
Criança
Pré-Escolar
Tratamento Conservador
Intervalo Livre de Doença
Feminino
Seguimentos
Seres Humanos
Ataque Isquêmico Transitório/etiologia
Ataque Isquêmico Transitório/terapia
Estimativa de Kaplan-Meier
Masculino
Estudos Retrospectivos
Acidente Vascular Cerebral/etiologia
Síndrome
[Pt] Tipo de publicação:CASE REPORTS; COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170708
[St] Status:MEDLINE
[do] DOI:10.3171/2017.1.PEDS16576



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