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[PMID]:28582805
[Au] Autor:Lupián-Angulo AI; Ortíz-Reyes LA; Castillo-Martínez L; Serralde-Zúñiga AE
[Ad] Endereço:National Institute of Medical Sciences and Nutrition (Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán), Mexico City.
[Ti] Título:Enteral nutritional support in non-ICU hospitalized patients: current practice in Mexico.
[So] Source:Asia Pac J Clin Nutr;26(4):586-590, 2017.
[Is] ISSN:0964-7058
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND OBJECTIVES: Patients receiving >=80% of their energy requirements by enteral nutrition (EN) have better clinical outcomes; unfortunately, there are discrepancies between the amount prescribed and amount received. The aim of this study was to explore the nutritional clinical practice, determine the adequacy and identify reasons for underfeeding. METHODS AND STUDY DESIGN: A retrospective study was conducted in hospitalized, non-intensive care unit, adult patients receiving EN for >=72 h. The following data were recorded: the prescribed target of energy and protein per day, daily energy intake, and the percentage of adequacy of the energy and protein requirement up to hospital day seven. Complications during administration or reasons for interruption and the proportion of patients who received >=80% of the energy goals on days four and seven were also recorded. RESULTS: In total, 52 patients were included (61.5% women), with a median age of 57.5 years; 20.4% and 6.1% of the patients received >=80% of their energy and protein goals, respectively, on day four, which improved to 28% (p<0.005) and 19% (p<0.001), respectively, on day seven. During the first seven days, a statistically significant (p<0.001) difference was observed between the amount of prescribed and administered energy over 24 h. The patients who received <80% of their total energy requirement remained hospitalized for 29 days (IQR 16.5-45.5), while those who received >=80% were hospitalized for 18 days (IQR 13.3-28.8) (p<0.05). CONCLUSIONS: Significant energy and protein deficits were documented. Furthermore, it is necessary to use strategies such as the implementation of an algorithm to optimize EN.
[Mh] Termos MeSH primário: Nutrição Enteral/estatística & dados numéricos
Pacientes Internados
[Mh] Termos MeSH secundário: Adulto
Coleta de Dados
Feminino
Seres Humanos
Masculino
México
Meia-Idade
Julgamento Moral Retrospectivo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170831
[Lr] Data última revisão:
170831
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170606
[St] Status:MEDLINE
[do] DOI:10.6133/apjcn.072016.05


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[PMID]:28032696
[Au] Autor:Wallach JC; García JL; Cardinali PS; Seijo AP; Benchetrit AG; Echazarreta SE; Garro SL; Deodato B; Baldi PC
[Ad] Endereço:'Francisco J. Muñiz' Hospital, Buenos Aires, Argentina.
[Ti] Título:High Incidence of Respiratory Involvement in a Cluster of Brucella suis-Infected Workers from a Pork Processing Plant in Argentina.
[So] Source:Zoonoses Public Health;64(7):550-553, 2017 Nov.
[Is] ISSN:1863-2378
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Epidemiological and clinical aspects of Brucella suis infection in 17 workers from a pork processing plant in Argentina occurring between January 2014 and July 2015 are presented. All patients reported working 9 h daily without adequate personal protection garment. Blood cultures were positive for Brucella spp. in 14 of the 17 patients (82.3%). All isolates were identified as B. suis biovar 1. Although fever, sweats, asthenia, myalgia and hepatic involvement were the most frequent clinical manifestations, an unusually high incidence of respiratory involvement was found. From 13 patients in which chest radiography was performed, four (30%) had radiological abnormalities, including lobar pneumonia in two cases (one with pleural effusion) and interstitial involvement in other two. The high frequency of respiratory involvement in our series makes necessary to consider brucellosis in the differential diagnosis of respiratory diseases in pork processing plant employees.
[Mh] Termos MeSH primário: Brucella suis
Brucelose/etiologia
Brucelose/patologia
Surtos de Doenças
Carne/microbiologia
Exposição Ocupacional
Infecções Respiratórias/microbiologia
[Mh] Termos MeSH secundário: Adulto
Animais
Argentina/epidemiologia
Manipulação de Alimentos
Seres Humanos
Incidência
Masculino
Meia-Idade
Julgamento Moral Retrospectivo
Suínos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161230
[St] Status:MEDLINE
[do] DOI:10.1111/zph.12339


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[PMID]:28007685
[Au] Autor:Liu J; Cao F; Dong XM; Li PY; Li HC; Qi BJ; Li F
[Ad] Endereço:Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, PR China; 2Department of General Surgery, Daxing teaching Hospital, Capital Medical University, Beijing, PR China. lifei_2016@yeah.net.
[Ti] Título:Early prediction of organ failure under the revised Atlanta classification.
[So] Source:Turk J Gastroenterol;28(1):46-52, 2017 Jan.
[Is] ISSN:2148-5607
[Cp] País de publicação:Turkey
[La] Idioma:eng
[Ab] Resumo:BACKGROUND/AIMS: This study aimed to compare the ability of conventional laboratory markers and scoring systems to early predict organ failure (OF) and to differentiate between transient and persistent OF in patients with acute pancreatitis (AP) using the revised Atlanta classification. MATERIALS AND METHODS: We retrospectively analyzed the medical records of 214 patients with AP between January 2014 and July 2015. The predictive values of laboratory markers were analyzed. The predictive accuracy of individual markers, extrapancreatic inflammation on computed tomography (EPIC), acute physiology and chronic health evaluation II (APACHE II), and bedside index for severity in acute pancreatitis (BISAP) scores were measured using the area under the receiver operating characteristic curve (AUROC). RESULTS: OF was diagnosed in 32 (15%) patients and persistent OF in 14 (6.5%). There were statistically significant differences between patients with and without OF with respect to white blood cell count, creatinine, blood urea nitrogen, lactate dehydrogenase, C-reactive protein, calcium (Ca), arterial partial pressure of oxygen (PaO2), base excess (BE), APACHE II, BISAP scores, and EPIC scores. Logistic regression analysis identified Ca, PaO2, and BE as independent predictors of OF. Using AUROC, the EPIC score had the highest accuracy for the early prediction of OF, which was 0.82. No significant differences were detected between patients with transient and persistent OF. CONCLUSION: Several laboratory markers and score systems were useful for the early prediction of OF in patients with AP, of which Ca, PaO2, and BE had highest predicting value, and EPIC score had the highest accuracy. We could not predict the duration of OF using laboratory markers.
[Mh] Termos MeSH primário: Escores de Disfunção Orgânica
Pâncreas/fisiopatologia
Pancreatite/classificação
Pancreatite/fisiopatologia
[Mh] Termos MeSH secundário: APACHE
Desequilíbrio Ácido-Base/sangue
Adulto
Idoso
Área Sob a Curva
Biomarcadores/sangue
Nitrogênio da Ureia Sanguínea
Proteína C-Reativa/metabolismo
Cálcio/sangue
Creatina/sangue
Feminino
Seres Humanos
L-Lactato Desidrogenase/sangue
Contagem de Leucócitos
Masculino
Meia-Idade
Oxigênio/sangue
Pressão Parcial
Valor Preditivo dos Testes
Curva ROC
Julgamento Moral Retrospectivo
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 9007-41-4 (C-Reactive Protein); EC 1.1.1.27 (L-Lactate Dehydrogenase); MU72812GK0 (Creatine); S88TT14065 (Oxygen); SY7Q814VUP (Calcium)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171011
[Lr] Data última revisão:
171011
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161224
[St] Status:MEDLINE
[do] DOI:10.5152/tjg.2016.0378


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[PMID]:27903725
[Au] Autor:McCormick C; Rosenthal CR; Miller TD; Maguire EA
[Ad] Endereço:Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, London WC1N 3BG, United Kingdom, and c.mccormick@ucl.ac.uk e.maguire@ucl.ac.uk.
[Ti] Título:Hippocampal Damage Increases Deontological Responses during Moral Decision Making.
[So] Source:J Neurosci;36(48):12157-12167, 2016 Nov 30.
[Is] ISSN:1529-2401
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Complex moral decision making is associated with the ventromedial prefrontal cortex (vmPFC) in humans, and damage to this region significantly increases the frequency of utilitarian judgments. Since the vmPFC has strong anatomical and functional links with the hippocampus, here we asked how patients with selective bilateral hippocampal damage would derive moral decisions on a classic moral dilemmas paradigm. We found that the patients approved of the utilitarian options significantly less often than control participants, favoring instead deontological responses-rejecting actions that harm even one person. Thus, patients with hippocampal damage have a strikingly opposite approach to moral decision making than vmPFC-lesioned patients. Skin-conductance data collected during the task showed increased emotional arousal in the hippocampal-damaged patients and they stated that their moral decisions were based on emotional instinct. By contrast, control participants made moral decisions based on the integration of an adverse emotional response to harming others, visualization of the consequences of one's action, and the rational re-evaluation of future benefits. This integration may be disturbed in patients with either hippocampal or vmPFC damage. Hippocampal lesions decreased the ability to visualize a scenario and its future consequences, which seemed to render the adverse emotional response overwhelmingly dominant. In patients with vmPFC damage, visualization might also be reduced alongside an inability to detect the adverse emotional response, leaving only the utilitarian option open. Overall, these results provide insights into the processes involved in moral decision making and highlight the complementary roles played by two closely connected brain regions. SIGNIFICANCE STATEMENT: The ventromedial prefrontal cortex (vmPFC) is closely associated with the ability to make complex moral judgements. When this area is damaged, patients become more utilitarian (the ends justify the means) and have decreased emotional arousal during moral decision making. The vmPFC is closely connected with another brain region-the hippocampus. In this study we found that patients with selective bilateral hippocampal damage show a strikingly opposite response pattern to those with vmPFC damage when making moral judgements. They rejected harmful actions of any kind (thus their responses were deontological) and showed increased emotional arousal. These results provide new insights into the processes involved in moral decision making and highlight the complementary roles played by two closely connected brain regions.
[Mh] Termos MeSH primário: Tomada de Decisões/ética
Tomada de Decisões/fisiologia
Hipocampo/lesões
Hipocampo/fisiopatologia
Princípios Morais
Julgamento Moral Retrospectivo
[Mh] Termos MeSH secundário: Adulto
Idoso
Lesões Encefálicas/fisiopatologia
Emoções
Teoria Ética
Feminino
Seres Humanos
Masculino
Meia-Idade
Rede Nervosa/lesões
Rede Nervosa/fisiopatologia
Vias Neurais/fisiopatologia
Córtex Pré-Frontal/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161202
[St] Status:MEDLINE


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[PMID]:27632379
[Au] Autor:Yudkin DA; Rothmund T; Twardawski M; Thalla N; Van Bavel JJ
[Ad] Endereço:Department of Psychology.
[Ti] Título:Reflexive intergroup bias in third-party punishment.
[So] Source:J Exp Psychol Gen;145(11):1448-1459, 2016 Nov.
[Is] ISSN:1939-2222
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Humans show a rare tendency to punish norm-violators who have not harmed them directly-a behavior known as third-party punishment. Research has found that third-party punishment is subject to intergroup bias, whereby people punish members of the out-group more severely than the in-group. Although the prevalence of this behavior is well-documented, the psychological processes underlying it remain largely unexplored. Some work suggests that it stems from people's inherent predisposition to form alliances with in-group members and aggress against out-group members. This implies that people will show reflexive intergroup bias in third-party punishment, favoring in-group over out-group members especially when their capacity for deliberation is impaired. Here we test this hypothesis directly, examining whether intergroup bias in third-party punishment emerges from reflexive, as opposed to deliberative, components of moral cognition. In 3 experiments, utilizing a simulated economic game, we varied participants' group relationship to a transgressor, measured or manipulated the extent to which they relied on reflexive or deliberative judgment, and observed people's punishment decisions. Across group-membership manipulations (American football teams, nationalities, and baseball teams) and 2 assessments of reflexive judgment (response time and cognitive load), reflexive judgment heightened intergroup bias, suggesting that such bias in punishment is inherent to human moral cognition. We discuss the implications of these studies for theories of punishment, cooperation, social behavior, and legal practice. (PsycINFO Database Record
[Mh] Termos MeSH primário: Preconceito/psicologia
Punição/psicologia
Identificação Social
Normas Sociais
[Mh] Termos MeSH secundário: Adulto
Agressão/psicologia
Comportamento Cooperativo
Feminino
Seres Humanos
Masculino
Julgamento Moral Retrospectivo
Comportamento Social
Esportes/psicologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171108
[Lr] Data última revisão:
171108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160916
[St] Status:MEDLINE


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[PMID]:27444316
[Au] Autor:Dyer C
[Ad] Endereço:The BMJ.
[Ti] Título:Surgeon is suspended for altering dead patient's notes retrospectively.
[So] Source:BMJ;354:i4059, 2016 Jul 20.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Registros Médicos/normas
Julgamento Moral Retrospectivo
Cirurgiões/ética
[Mh] Termos MeSH secundário: Seres Humanos
Reino Unido
[Pt] Tipo de publicação:NEWS
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160723
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.i4059


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[PMID]:27142996
[Au] Autor:Knowlton AR; Weir B; Fields J; Cochran G; McWilliams J; Wissow L; Lawner BJ
[Ti] Título:Pediatric Use of Emergency Medical Services: The Role of Chronic Illnesses and Behavioral Health Problems.
[So] Source:Prehosp Emerg Care;20(3):362-8, 2016 May-Jun.
[Is] ISSN:1545-0066
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The increasing use of prehospital emergency medical services (EMS) and its contribution to rising emergency department use and healthcare costs point to the need for better understanding factors associated with EMS use to inform preventive interventions. Understanding patient factors associated with pediatric use of EMS will inform pediatric-specific intervention. We examined pediatric patient demographic and health factors associated with one-time and repeat use of EMS. METHODS: We reviewed data from Baltimore City Fire Department EMS patient records over a 23-month period (2008-10) for patients under 21 years of age (n = 24,760). Repeat use was defined as involvement in more than one EMS incident during the observation period. Analyses compared demographics of EMS users to the city population and demographics and health problems of repeat and one-time EMS users. Health comparisons were conducted at the patient and incident levels of analysis. RESULTS: Repeat users (n = 1,931) accounted for 9.0% of pediatric users and 20.8% of pediatric incidents, and were over-represented among the 18-20 year age group and among females. While trauma accounted for approximately one-quarter of incidents, repeat versus one-time users had a lower proportion of trauma-related incidents (7.2% vs. 26.7%) and higher proportion of medical-related incidents (92.6% vs. 71.4%), including higher proportions of incidents related to asthma, seizures, and obstetric/gynecologic issues. In patient-level analysis, based on provider or patient reports, greater proportions of repeat compared to one-time users had asthma, behavioral health problems (mental, conduct and substance use problems), seizures, and diabetes. CONCLUSIONS: Chronic somatic conditions and behavioral health problems appear to contribute to a large proportion of the repeat pediatric use of this EMS system. Interventions may be needed to engage repeat users in primary care and behavioral health services, to train EMS providers on the recognition and management of behavioral health emergencies, and to improve family care and self-management of pediatric asthma and other chronic conditions.
[Mh] Termos MeSH primário: Comportamento Infantil
Doença Crônica
Serviços Médicos de Emergência/utilização
[Mh] Termos MeSH secundário: Adolescente
Baltimore
Criança
Pré-Escolar
Feminino
Seres Humanos
Lactente
Masculino
Auditoria Médica
Julgamento Moral Retrospectivo
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171011
[Lr] Data última revisão:
171011
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160505
[St] Status:MEDLINE
[do] DOI:10.3109/10903127.2015.1115928


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[PMID]:25563567
[Au] Autor:Kinghorn W
[Ad] Endereço:From Duke University School of Medicine and Duke Divinity School.
[Ti] Título:Moral engagement, combat trauma, and the lure of psychiatric dualism: why psychiatry is more than a technical discipline.
[So] Source:Harv Rev Psychiatry;23(1):28-37, 2015 Jan-Feb.
[Is] ISSN:1465-7309
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Psychiatry is not only a technical discipline concerned with matching appropriate means to pre-specified ends; it is also a discipline of moral engagement and discernment in which clinicians and patients explore the ends that patients will pursue. Moral engagement is intrinsic to psychiatric practice, particularly when psychiatrists engage issues such as combat trauma in which patients' moral self-evaluations are relevant to the perpetuation of psychological distress. Relative to technical models of practice, however, the space of moral engagement and discernment conveys risk for psychiatrists as it is less "scientific," more prone to exploitation and abuse, and the occasion for social-political critiques of psychiatry. Three prevalent forms of psychiatric dualism, each manifest in the care of combat veterans, seem to allow psychiatrists to avoid this contested moral space: dualism of the self and the self's body, dualism of the self and the self's quantifiable experience and behavior, and dualism of the self and the self's "values." Each of these dualisms is alluring but ultimately unable to protect psychiatrists from the space of moral engagement. Psychiatrists must rather cultivate practices for inhabiting that space in a morally transparent, self-questioning, and responsible way.
[Mh] Termos MeSH primário: Distúrbios de Guerra
Princípios Morais
Relações Médico-Paciente/ética
Processos Psicoterapêuticos
[Mh] Termos MeSH secundário: Distúrbios de Guerra/diagnóstico
Distúrbios de Guerra/psicologia
Distúrbios de Guerra/terapia
Seres Humanos
Relações Metafísicas Mente-Corpo
Assistência Centrada no Paciente/ética
Psiquiatria/ética
Psiquiatria/métodos
Julgamento Moral Retrospectivo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1509
[Cu] Atualização por classe:150107
[Lr] Data última revisão:
150107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150108
[St] Status:MEDLINE
[do] DOI:10.1097/HRP.0000000000000042


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[PMID]:25472625
[Au] Autor:Mooijman M; Van Dijk WW
[Ad] Endereço:a Department of Social and Organisational Psychology , Leiden University , Leiden , the Netherlands.
[Ti] Título:The self in moral judgement: How self-affirmation affects the moral condemnation of harmless sexual taboo violations.
[So] Source:Cogn Emot;29(7):1326-34, 2015.
[Is] ISSN:1464-0600
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:People frequently condemn harmless sexual taboo behaviours. Based on self-affirmation theory, we predicted that providing an opportunity to self-affirm decreases the tendency to morally condemn harmless sexual taboos. In Experiment 1, we found evidence that self-affirmation decreases the moral condemnation of harmless sexual taboos and ruled out that this was due to a decrease in how disgusting participants considered taboo acts. In Experiment 2, we replicated this effect and demonstrated the mediating role of self-directed threat emotions. These results demonstrate that the tendency to morally condemn harmless sexual taboos arises in part from the need to protect self-integrity. We discuss the implications for the role of the self and emotions in moral judgements and interventions aimed at increasing the acceptability of harmless sexual taboos.
[Mh] Termos MeSH primário: Julgamento Moral Retrospectivo
Autoimagem
Comportamento Sexual/psicologia
Tabu/psicologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Mecanismos de Defesa
Feminino
Perdão
Seres Humanos
Individualidade
Masculino
Países Baixos
Valores Sociais
Estudantes/psicologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1605
[Cu] Atualização por classe:150805
[Lr] Data última revisão:
150805
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:141205
[St] Status:MEDLINE
[do] DOI:10.1080/02699931.2014.985187


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[PMID]:25345768
[Au] Autor:Reverby SM
[Ti] Título:Enemy of the people/enemy of the state: two great(lyiInfamous) doctors, passions, and the judgment of history.
[So] Source:Bull Hist Med;88(3):403-30, 2014.
[Is] ISSN:0007-5140
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:If the aphorism "history will be the judge" is deployed, the active agent of this formulation is the historian. Comparing two great(ly infamous) doctors,John C. Cutler and Alan Berkman, the article considers how historians balance digging for sources, creating meaningful narrative, and acknowledging our own beliefs that embed in the judgments we make. The article explores our responsibility for balance and moral judgment at the same time. Cutler, admonished for his role in the infamous sexually transmitted diseases studies in Tuskegee and Guatemala, also was a well-respected researcher and teacher. Berkman, renowned for his success in global HIV/AIDs activism, was also only the second physician in U.S. history to be charged with accessory to murder after the fact and who served seven hard years for bombings and robbery. The author considers her relationship to these physicians and the effort to create a passionate historical practice.
[Mh] Termos MeSH primário: Direitos do Paciente/história
Médicos/história
Julgamento Moral Retrospectivo
Sífilis/história
[Mh] Termos MeSH secundário: Guatemala
História do Século XX
História do Século XXI
Mississippi
Direitos do Paciente/ética
Médicos/ética
Política
África do Sul
Sífilis/tratamento farmacológico
[Pt] Tipo de publicação:ADDRESSES; BIOGRAPHY; HISTORICAL ARTICLE; JOURNAL ARTICLE
[Ps] Nome de pessoa como assunto:Cutler JC; Berkman A
[Em] Mês de entrada:1411
[Cu] Atualização por classe:141027
[Lr] Data última revisão:
141027
[Sb] Subgrupo de revista:IM; QIS
[Da] Data de entrada para processamento:141028
[St] Status:MEDLINE
[do] DOI:10.1353/bhm.2014.0062



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