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[PMID]: 28449973 [Au] Autor: Sandhu SK; Hua W; MaCurdy TE; Franks RL; Avagyan A; Kelman J; Worrall CM; Ball R; Nguyen M [Ad] Endereço: Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA. Electronic address: sukhminder.sandhu@fda.hhs.gov. [Ti] Título: Near real-time surveillance for Guillain-Barré syndrome after influenza vaccination among the Medicare population, 2010/11 to 2013/14. [So] Source: Vaccine;35(22):2986-2992, 2017 05 19. [Is] ISSN: 1873-2518 [Cp] País de publicação: Netherlands [La] Idioma: eng [Ab] Resumo: BACKGROUND: Guillain-Barré syndrome (GBS) is a serious acute demyelinating disease that causes weakness and paralysis. The Food and Drug Administration (FDA) began collaborating with the Centers for Medicare and Medicaid Services (CMS) to develop near real-time vaccine safety surveillance capabilities in 2006 and has been monitoring for the risk of GBS after influenza vaccination for every influenza season since 2008. METHODS: We present results from the 2010/11 to 2013/14 influenza seasons using the Updating Sequential Probability Ratio Test (USPRT), with an overall 1-sided α of 0.05 apportioned equally using a constant alpha-spending plan among 20 consecutive weekly tests, 5 ad hoc tests, and a 26th final end of season test. Observed signals were investigated using the self-controlled risk interval (SCRI) design. RESULTS: Over 15 million people were vaccinated in each influenza season. In the 2010/11 influenza season, we observed an elevated GBS risk during the season, with an end of season SCRI analysis finding a nonsignificant increased risk (RR=1.25, 95% CI: 0.96-1.63). A sensitivity analysis applying the positive predictive value of the ICD-9 code for GBS from the 2009/10 season estimated a RR=1.98 (95% CI: 1.42-2.76). Although the 2010/11 influenza vaccine suggested an increased GBS risk, surveillance of the identical vaccine in the 2011/12 influenza season did not find an increased GBS risk after vaccination. No signal was observed in the subsequent three influenza seasons. CONCLUSIONS: Conducting near real-time surveillance using USPRT has proven to be an excellent method for near real-time GBS surveillance after influenza vaccination, as demonstrated by our surveillance efforts during the 2010/11-2013/14 influenza seasons. In the 2010/2011 influenza season, in addition to the 2009 H1N1 influenza pandemic, using near real-time surveillance we were able to observe a signal early in the influenza season and the method has now become routine. [Mh] Termos MeSH primário: Síndrome de Guillain-Barré/epidemiologia Vacinas contra Influenza/efeitos adversos Medicare Vigilância da População/métodos [Mh] Termos MeSH secundário: Idoso Idoso de 80 Anos ou mais Centers for Medicare and Medicaid Services (U.S.) Sistemas de Computação Feminino Síndrome de Guillain-Barré/etiologia Seres Humanos Vacinas contra Influenza/administração & dosagem Masculino Medição de Risco Estados Unidos/epidemiologia United States Food and Drug Administration Vacinação [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Influenza Vaccines) [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180308 [Lr] Data última revisão: 180308 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170429 [St] Status: MEDLINE

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[PMID]: 29494568 [Au] Autor: Bolu O; Nnadi C; Damisa E; Braka F; Siddique A; Archer WR; Bammeke P; Banda R; Higgins J; Edukugo A; Nganda GW; Forbi JC; Liu H; Gidado S; Soghaier M; Franka R; Waziri N; Burns CC; Vertefeuille J; Wiesen E; Adamu U [Ti] Título: Progress Toward Poliomyelitis Eradication - Nigeria, January-December 2017. [So] Source: MMWR Morb Mortal Wkly Rep;67(8):253-256, 2018 Mar 02. [Is] ISSN: 1545-861X [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Nearly three decades after the World Health Assembly launched the Global Polio Eradication Initiative in 1988, four of the six World Health Organization (WHO) regions have been certified polio-free (1). Nigeria is one of three countries, including Pakistan and Afghanistan, where wild poliovirus (WPV) transmission has never been interrupted. In September 2015, after >1 year without any reported WPV cases, Nigeria was removed from WHO's list of countries with endemic WPV transmission (2); however, during August and September 2016, four type 1 WPV (WPV1) cases were reported from Borno State, a state in northeastern Nigeria experiencing a violent insurgency (3). The Nigerian government, in collaboration with partners, launched a large-scale coordinated response to the outbreak (3). This report describes progress in polio eradication activities in Nigeria during January-December 2017 and updates previous reports (3-5). No WPV cases have been reported in Nigeria since September 2016; the latest case had onset of paralysis on August 21, 2016 (3). However, polio surveillance has not been feasible in insurgent-controlled areas of Borno State. Implementation of new strategies has helped mitigate the challenges of reaching and vaccinating children living in security-compromised areas, and other strategies are planned. Despite these initiatives, however, approximately 130,000-210,000 (28%-45%) of the estimated 469,000 eligible children living in inaccessible areas in 2016 have not been vaccinated. Sustained efforts to optimize surveillance and improve immunization coverage, especially among children in inaccessible areas, are needed. [Mh] Termos MeSH primário: Erradicação de Doenças Poliomielite/prevenção & controle Vacinas contra Poliovirus/administração & dosagem Vigilância da População [Mh] Termos MeSH secundário: Adolescente Criança Pré-Escolar Seres Humanos Programas de Imunização Lactente Nigéria/epidemiologia Poliomielite/epidemiologia Poliovirus/isolamento & purificação Vacinas contra Poliovirus/efeitos adversos Medidas de Segurança [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Poliovirus Vaccines) [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180306 [Lr] Data última revisão: 180306 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 180302 [St] Status: MEDLINE [do] DOI: 10.15585/mmwr.mm6708a5

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[PMID]: 28749331 [Au] Autor: Heil J; Ter Waarbeek HLG; Hoebe CJPA; Jacobs PHA; van Dam DW; Trienekens TAM; Cals JWL; van Loo IHM; Dukers-Muijrers NHTM [Ad] Endereço: Department of Sexual Health, Infectious Diseases and Environmental Health, South Limburg Public Health Service, Geleen, the Netherlands. [Ti] Título: Pertussis surveillance and control: exploring variations and delays in testing, laboratory diagnostics and public health service notifications, the Netherlands, 2010 to 2013. [So] Source: Euro Surveill;22(28), 2017 Jul 13. [Is] ISSN: 1560-7917 [Cp] País de publicação: Sweden [La] Idioma: eng [Ab] Resumo: Pertussis is most severe among unvaccinated infants (< 1 year of age), and still leads to several reported deaths in the Netherlands every year. In order to avoid pertussis-related infant morbidity and mortality, pertussis surveillance data are used to guide pertussis control measures. However, more insight into the accuracy of pertussis surveillance and control, and into the range of healthcare and public health-related factors that impede this are needed. We analysed a unique combination of data sources from one Dutch region of 1.1 million residents, including data from laboratory databases and local public health notifications between 2010 and 2013. This large study (n = 12,090 pertussis tests) reveals possible misdiagnoses, substantial under-notification (18%, 412/2,301 laboratory positive episodes) and a delay between patient symptoms and notification to the local public health services (median 34 days, interquartile range (IQR): 27-54). It is likely that the misdiagnoses, under-notification and overall delay in surveillance data are not unique to this area of the Netherlands, and are generalisable to other countries in Europe. In addition to preventive measures such as maternal immunisation, based on current findings, we further recommend greater adherence to testing guidelines, standardisation of test interpretation guidelines, use of automatic notification systems and earlier preventive measures. [Mh] Termos MeSH primário: Bordetella pertussis/isolamento & purificação Técnicas de Laboratório Clínico/métodos Notificação de Doenças/métodos Notificação Compulsória Prevenção Primária/métodos Coqueluche/diagnóstico [Mh] Termos MeSH secundário: Técnicas de Laboratório Clínico/normas Notificação de Doenças/normas Feminino Seres Humanos Imunização Incidência Lactente Masculino Países Baixos/epidemiologia Vigilância da População Garantia da Qualidade dos Cuidados de Saúde Vigilância de Evento Sentinela Inquéritos e Questionários Estados Unidos United States Public Health Service Coqueluche/epidemiologia Coqueluche/prevenção & controle Coqueluche/transmissão [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180306 [Lr] Data última revisão: 180306 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170728 [St] Status: MEDLINE

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[PMID]: 28741257 [Au] Autor: Joshi S; Rizzoli P; Loder E [Ad] Endereço: Clinical Pharmacy Practice, MCPHS University College of Pharmacy, Worcester, USA. [Ti] Título: The comorbidity burden of patients with cluster headache: a population-based study. [So] Source: J Headache Pain;18(1):76, 2017 Dec. [Is] ISSN: 1129-2377 [Cp] País de publicação: Italy [La] Idioma: eng [Ab] Resumo: BACKGROUND: Evidence is limited regarding the comorbidity burden of patients with cluster headache (CH). We aimed to characterize comorbid conditions in a cohort of CH patients diagnosed by headache experts, using electronic health record information from the Partners Research Patient Data Registry (RPDR). METHODS: We identified and reviewed the charts of unique patients diagnosed by headache specialists over an 11-year period, and a set of matched controls. Patients were categorized as having Definite, Unconfirmed or no CH. We calculated the prevalence of and tested for statistically significant differences of selected comorbid conditions in these populations. RESULTS: An RPDR query identified 170 patients with a free text or ICD diagnosis of cluster headache. 15 records belonging to Partners employees were excluded. 75 patients met diagnostic criteria for CH (Definite CH). 22 had headaches with some features of CH but the diagnosis was uncertain (Unconfirmed CH). In 58 the diagnosis was determined to be inaccurate due to data entry errors. Patients with Definite CH had an average age of 43.4 years; 80% were male. The average time from CH onset to diagnosis was 12.7 years (range 1-51). The average number of yearly emergency department and outpatient visits for the group of Definite CH patients was 4.5 and 25.4, respectively, compared with 1.1 and 6.9 in controls. Of the 55 examined conditions, four were statistically significantly less common in patients with definite CH compared with controls (diabetes, musculoskeletal/orthopaedic problems, "other gastrointestinal diagnoses" and skin conditions) and four were statistically significantly more common (smoking, depression, dental disorders and deviated septum). CONCLUSIONS: In this large population-based study, we identified a surprisingly small number of patients who met strict diagnostic criteria for CH. In these patients, however, we identified a distinct pattern of selected comorbidities. The pattern is somewhat but not entirely consistent with that of the "classic" CH patient depicted in the medical literature. CH patients are frequently diagnosed with sinus or dental problems. Many experience substantial delay in receiving a diagnosis. These things may in part explain the high frequency of medical visits in this population. It is difficult to distinguish conditions that are genuinely comorbid with CH from those that reflect misdiagnoses or medical scrutiny of patients in frequent contact with the healthcare system. [Mh] Termos MeSH primário: Cefaleia Histamínica/diagnóstico Cefaleia Histamínica/epidemiologia Efeitos Psicossociais da Doença Vigilância da População [Mh] Termos MeSH secundário: Adulto Idoso Estudos de Coortes Comorbidade Erros de Diagnóstico Registros Eletrônicos de Saúde/tendências Feminino Seres Humanos Masculino Transtornos Mentais/diagnóstico Transtornos Mentais/epidemiologia Meia-Idade Vigilância da População/métodos Prevalência Sistema de Registros Fumar/epidemiologia [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180306 [Lr] Data última revisão: 180306 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170726 [St] Status: MEDLINE [do] DOI: 10.1186/s10194-017-0785-3

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[PMID]: 29216960 [Au] Autor: Cao BY; Li CY; Xu FL; Liu XQ; Yang YX; Li J; Gao CY; Rong YM; Li RC; Li YL; Zheng S; Bai YN; Ye YC [Ad] Endereço: Institute of Epidemiology and Statistics, School of Public Health, Center for Cancer Prevent and Treatment, Lanzhou University, Lanzhou 730000, Gansu, China; Department of Cancer Epidemiology, Wuwei Cancer Registry, Gansu Wuwei Tumor Hospital, Wuwei 733000, Gansu, China. [Ti] Título: Estimation Study of New Cancer Cases and Deaths in Wuwei, Hexi Corridor Region, China, 2018. [So] Source: Biomed Environ Sci;30(11):829-833, 2017 Nov. [Is] ISSN: 0895-3988 [Cp] País de publicação: Netherlands [La] Idioma: eng [Ab] Resumo: Population-based cancer registration data were collected to estimate the cancer incidence and mortality in Wuwei, Hexi Corridor Region, China in 2018. We used the 2011-2013 data to predict the number of new cases and deaths in 2018 and the 2003-2013 data to analyze trends in cancer incidence and mortality. The goal is to enable cancer prevention and control directions. Our results indicated that stomach cancer is the most common cancer. For all cancers combined, the incidence and mortality rates showed significantly increasing trends (+2.63% per year; P < 0.05 and +1.9% per year; P < 0.05). This study revealed a significant cancer burden among the population of this area. Cancer screening and prevention should be performed after an epidemiological study of the cause of the cancer is completed. [Mh] Termos MeSH primário: Neoplasias/epidemiologia Neoplasias/mortalidade Sistema de Registros/estatística & dados numéricos [Mh] Termos MeSH secundário: China Feminino Seres Humanos Incidência Masculino Neoplasias/classificação Vigilância da População População Rural População Urbana [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180305 [Lr] Data última revisão: 180305 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171209 [St] Status: MEDLINE [do] DOI: 10.3967/bes2017.111

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[PMID]: 29193081 [Au] Autor: Zaidi MY; Canter R; Cardona K [Ad] Endereço: Division of Surgical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia. [Ti] Título: Post-operative surveillance in retroperitoneal soft tissue sarcoma: The importance of tumor histology in guiding strategy. [So] Source: J Surg Oncol;117(1):99-104, 2018 Jan. [Is] ISSN: 1096-9098 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Crafting effective surveillance strategies for retroperitoneal soft tissue sarcomas is difficult given the scarcity of literature on this rare disease. In this article, we will summarize the most recent literature on natural history and recurrence patterns of RPS compiled from multi-institutional collaborative studies and centers with extended follow-up data, and based on this evidence, propose principles for histology-based post-operative surveillance protocols. [Mh] Termos MeSH primário: Técnicas Histológicas/métodos Vigilância da População Complicações Pós-Operatórias/diagnóstico Neoplasias Retroperitoneais/patologia Sarcoma/patologia [Mh] Termos MeSH secundário: Terapia Combinada Seres Humanos Complicações Pós-Operatórias/epidemiologia Neoplasias Retroperitoneais/terapia Sarcoma/terapia [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180305 [Lr] Data última revisão: 180305 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171202 [St] Status: MEDLINE [do] DOI: 10.1002/jso.24927

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[PMID]: 28460434 [Au] Autor: Bai DS; Chen P; Qian JJ; Jin SJ; Jiang GQ [Ad] Endereço: Department of Department of Hepatobiliary and Pancreatic Surgery, Clinical Medical College of Yangzhou University, Yangzhou, China. [Ti] Título: Effect of marital status on the survival of patients with gallbladder cancer treated with surgical resection: a population-based study. [So] Source: Oncotarget;8(16):26404-26413, 2017 Apr 18. [Is] ISSN: 1949-2553 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Marital status has been reported as an independent prognostic factor for survival in various cancers, but it has been rarely studied in gallbladder cancer treated by surgical resection. We retrospectively studied Surveillance, Epidemiology, and End Results (SEER) population-based data and identified 9,041 cases of gallbladder cancer with surgical treatment between 1988 and 2013. The patients were categorized according to marital status, as "married," "never married," "widowed," or "divorced/separated." Patients in the widowed group had a higher proportion of women within-group comparisons, a higher rate of white race, a greater proportion of older (≥ 60 years) patients, more frequency of adenocarcinoma, a greater number of tumors at well/moderate pathological grading, and more prevalence at the localized SEER stage, all of which were statistically significant (P < 0.001). Marital status was confirmed to be an independent prognostic factor by multivariate analysis (P < 0.001). Married patients had higher 5-year gallbladder cancer cause-specific survival than unmarried patients (P < 0.001); conversely, widowed patients had the lowest gallbladder cancer cause-specific survival compared with all other patients. Conclusions marital status is an important prognostic risk factor for survival in patients with gallbladder cancer treated with surgical resection. Widowed patients have the highest risk of death compared with other groups. [Mh] Termos MeSH primário: Neoplasias da Vesícula Biliar/epidemiologia Estado Civil [Mh] Termos MeSH secundário: Adulto Idoso Feminino Neoplasias da Vesícula Biliar/mortalidade Neoplasias da Vesícula Biliar/cirurgia Seres Humanos Masculino Meia-Idade Gradação de Tumores Estadiamento de Neoplasias Vigilância da População Programa de SEER Análise de Sobrevida Carga Tumoral Estados Unidos/epidemiologia [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180305 [Lr] Data última revisão: 180305 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170503 [St] Status: MEDLINE [do] DOI: 10.18632/oncotarget.15476

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[PMID]: 28457202 [Au] Autor: Nguyen AH; Giuliano AR; Mbah AK; Sanchez-Anguiano A [Ad] Endereço: 1 Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL, USA. [Ti] Título: HIV/sexually transmitted infections and intimate partner violence: Results from the Togo 2013-2014 Demographic and Health Survey. [So] Source: Int J STD AIDS;28(14):1380-1388, 2017 12. [Is] ISSN: 1758-1052 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: Among clinic-based studies, intimate partner violence (IPV) has been shown to contribute to HIV/AIDS among young girls and women. Results from studies among the general population have been less consistent. This study evaluated the associations between HIV infection, any sexually transmitted infections (STIs), and IPV in a population-based sample of Togolese women. Data from the Togo 2013-2014 Demographic and Health Survey were utilized for these analyses. Women aged 15-49, who were currently married, had HIV test results, and answered the Domestic Violence Module were analyzed (n = 2386). Generalized linear mixed-models adjusting for sociodemographic variables, risk behaviors, and cluster effect were used to estimate HIV and STI risks with experience of IPV. HIV prevalence was 2.8%. Prevalence of IPV was 39% among HIV-positive women and 38% among HIV-negative women. Significant associations between IPV and HIV infection were not detected. Adjusted models found significant associations between experience of any IPV and having had STIs (OR 2.05, 95% CI 1.25-3.35). The high rates of violence in this setting warrant community-based interventions that address abuse and gender inequity. These interventions should also discuss the spectrum of STIs in relation to IPV. [Mh] Termos MeSH primário: Infecções por HIV/epidemiologia Violência por Parceiro Íntimo/estatística & dados numéricos Doenças Sexualmente Transmissíveis/epidemiologia Maus-Tratos Conjugais/estatística & dados numéricos [Mh] Termos MeSH secundário: Adulto Estudos Transversais Feminino Inquéritos Epidemiológicos Seres Humanos Meia-Idade Vigilância da População Prevalência Fatores de Risco Togo/epidemiologia Adulto Jovem [Pt] Tipo de publicação: EVALUATION STUDIES; JOURNAL ARTICLE [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180306 [Lr] Data última revisão: 180306 [Sb] Subgrupo de revista: IM; X [Da] Data de entrada para processamento: 170502 [St] Status: MEDLINE [do] DOI: 10.1177/0956462417705970

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[PMID]: 28460766 [Au] Autor: Feinberg L; Menon J; Smith R; Rajeev JG; Kumar RK; Banerjee A [Ad] Endereço: University of Birmingham, Medical School, Birmingham, United Kingdom. Electronic address: XF132@student.bham.ac.uk. [Ti] Título: Potential for mobile health (mHealth) prevention of cardiovascular diseases in Kerala: A population-based survey. [So] Source: Indian Heart J;69(2):182-199, 2017 Mar - Apr. [Is] ISSN: 0019-4832 [Cp] País de publicação: India [La] Idioma: eng [Ab] Resumo: BACKGROUND: India's southern state of Kerala stands at the forefront of India's epidemic of cardiovascular disease (CVD), among other non-communicable diseases (NCDs). Mobile phone use in healthcare (mHealth) has shown promise in India, including NCDs. However, suitability and acceptability of m-Health interventions is poorly researched, particularly in rural settings. OBJECTIVES: METHODS: A questionnaire regarding mobile phone usage and possible use in healthcare was verbally administered in five primary health centres and by home visits in five village councils ("panchayats") of Ernakulam, Kerala. Adults who spoke Malayalam or English, with access to a mobile phone were recruited by convenience sampling in partnership with accredited social health activists (ASHAs). Quantitative data analysis was conducted using SPSS software. RESULTS: 262 participants were recruited. 87% routinely used and 88% owned a mobile phone. 92% were willing to receive mHealth advice, and 94% favoured mobile medication reminders. 70.3% and 73% preferred voice calls over short messaging service (SMS) for delivering health information and medication reminders, respectively. 85.9% would send home recorded information on their blood pressure, weight, medication use and lifestyle to a doctor or ASHA. 75.2% trusted the confidentiality of mHealth data, while 77.1% had no concerns about the privacy of their information. CONCLUSIONS: The majority of this population approve mHealth interventions. While further investigation of mHealth as a health education tool is warranted, SMS interventions may fail to maximise equity and penetration across all patient groups. [Mh] Termos MeSH primário: Doenças Cardiovasculares/prevenção & controle Vigilância da População/métodos Saúde da População Rural População Rural Telemedicina [Mh] Termos MeSH secundário: Adulto Doenças Cardiovasculares/epidemiologia Feminino Seres Humanos Índia/epidemiologia Masculino Meia-Idade Morbidade/tendências Inquéritos e Questionários [Pt] Tipo de publicação: JOURNAL ARTICLE; MULTICENTER STUDY [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180301 [Lr] Data última revisão: 180301 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170503 [St] Status: MEDLINE

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[PMID]: 29258990 [Au] Autor: Dyer O [Ad] Endereço: Montreal. [Ti] Título: Police in Xinjiang province gather biometric data under guise of health programme. [So] Source: BMJ;359:j5865, 2017 12 19. [Is] ISSN: 1756-1833 [Cp] País de publicação: England [La] Idioma: eng [Mh] Termos MeSH primário: Identificação Biométrica/métodos Tipagem e Reações Cruzadas Sanguíneas/métodos Programas Nacionais de Saúde/ética Vigilância da População/métodos [Mh] Termos MeSH secundário: Adolescente Adulto Idoso Tipagem e Reações Cruzadas Sanguíneas/estatística & dados numéricos Criança China/epidemiologia DNA/genética DNA/normas Seres Humanos Iris Meia-Idade Adulto Jovem [Pt] Tipo de publicação: NEWS [Nm] Nome de substância: 9007-49-2 (DNA) [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180223 [Lr] Data última revisão: 180223 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 171221 [St] Status: MEDLINE [do] DOI: 10.1136/bmj.j5865

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