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[PMID]:27581469
[Au] Autor:Ru Y; Pressman EK; Cooper EM; Guillet R; Katzman PJ; Kent TR; Bacak SJ; O'Brien KO
[Ad] Endereço:Division of Nutritional Sciences, Cornell University, Ithaca, NY; and.
[Ti] Título:Iron deficiency and anemia are prevalent in women with multiple gestations.
[So] Source:Am J Clin Nutr;104(4):1052-1060, 2016 Oct.
[Is] ISSN:1938-3207
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Little attention has been placed on the unique iron demands that may exist in women with multiple gestations. This merits attention because iron deficiency (ID) during pregnancy is associated with adverse pregnancy outcomes that are known to be more prevalent in multiple births. OBJECTIVE: We characterized longitudinal changes in iron status across pregnancy in a cohort of healthy women with multiple gestations and identified determinants of maternal ID and anemia. DESIGN: A group of 83 women carrying twins, triplets, or quadruplets (aged 20-46 y) was recruited from 2011 to 2014. Blood samples obtained during pregnancy (∼24 wk; n = 73) and at delivery (∼35 wk; n = 61) were used to assess hemoglobin, serum ferritin (SF), soluble transferrin receptor (sTfR), hepcidin, serum iron, erythropoietin, serum folate, vitamin B-12, C-reactive protein, and interleukin-6. RESULTS: The prevalence of tissue ID (sTfR >8.5 mg/L) increased significantly from pregnancy to delivery (9.6% compared with 23%, P = 0.03). Women with depleted iron stores (SF <12 µg/L, n = 20) during pregnancy had a 2-fold greater risk of anemia at delivery, and 25% (n = 5) developed iron deficiency anemia (IDA). Overall, 44.6% of women studied (n = 37/83) were anemic at delivery, and 18% of women (n = 11/61) had IDA. Erythropoietin during pregnancy was significantly negatively associated with hemoglobin at delivery. Women with erythropoietin >75th percentile during pregnancy exhibited a 3-fold greater risk of anemia, suggesting that erythropoietin is a sensitive predictor of anemia at delivery. Inflammation was present at delivery, which limited the utility of ferritin or hepcidin as iron-status indicators at delivery. CONCLUSIONS: ID and anemia are highly prevalent in women with multiple gestations. Additional screening and iron supplementation may be warranted in this high-risk population given the known associations between ID anemia and adverse maternal and neonatal outcomes. This trial was registered at clinicaltrials.gov as NCT01582802.
[Mh] Termos MeSH primário: Anemia Ferropriva/etiologia
Inflamação/etiologia
Ferro/deficiência
Necessidades Nutricionais
Estado Nutricional
Complicações na Gravidez/etiologia
Gravidez Múltipla/sangue
[Mh] Termos MeSH secundário: Adulto
Anemia Ferropriva/epidemiologia
Proteína C-Reativa/metabolismo
Eritropoetina/sangue
Feminino
Ferritinas/sangue
Hemoglobinas/metabolismo
Hepcidinas/sangue
Seres Humanos
Inflamação/sangue
Interleucina-6/sangue
Ferro/metabolismo
Estudos Longitudinais
Gravidez
Complicações na Gravidez/sangue
Prevalência
Quadrigêmeos
Trigêmeos
Gêmeos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Hemoglobins); 0 (Hepcidins); 0 (Interleukin-6); 11096-26-7 (Erythropoietin); 9007-41-4 (C-Reactive Protein); 9007-73-2 (Ferritins); E1UOL152H7 (Iron)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170609
[Lr] Data última revisão:
170609
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160902
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE


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[PMID]:26960828
[Au] Autor:Mihanovic J; Juric I; Pogorelic Z; Mrklic I; Jukic M; Furlan D
[Ad] Endereço:Department of Surgery, General Hospital Zadar, Zadar, Croatia.
[Ti] Título:Pneumoperitoneum in in-vitro Conceived Quadruplet Neonate: Rare Manifestation of Hirschsprung's Disease--Report of a Case.
[So] Source:Acta Medica (Hradec Kralove);58(4):144-6, 2015.
[Is] ISSN:1211-4286
[Cp] País de publicação:Czech Republic
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Hirschsprung's disease is a congenital colonic aganglionosis, usually presented as inability or difficulty in passing of meconium, chronic and persistent obstipation, maleficent feeding, vomiting, distension and lethargy. CASE PRESENTATION: We presented a case of an in-vitro conceived quadruplet premature neonate who presented with pneumoperitoneum caused by transverse colon spontaneous perforation and microcolon appearance of distal bowel, treated by resection and temporary colostomy turns to be a rare manifestation of Hirschsprung's disease. CONCLUSION: Assisted reproductive technologies increases chances for multiple pregnancies and may increase chance for major congenital anomalies. Rare manifestation of Hirschsprung's disease is spontaneous pneumoperitoneum which remains a surgical emergency. Delay in recognizing and treatment can significantly worsen prognosis. In neonate with intestinal perforation one should consider Hirschsprung's disease.
[Mh] Termos MeSH primário: Doença de Hirschsprung/complicações
Pneumoperitônio/etiologia
Quadrigêmeos
[Mh] Termos MeSH secundário: Fertilização In Vitro
Doença de Hirschsprung/diagnóstico
Doença de Hirschsprung/cirurgia
Seres Humanos
Recém-Nascido
Recém-Nascido Prematuro
Masculino
Pneumoperitônio/diagnóstico
Pneumoperitônio/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1607
[Cu] Atualização por classe:161021
[Lr] Data última revisão:
161021
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160311
[St] Status:MEDLINE
[do] DOI:10.14712/18059694.2016.7


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[PMID]:25419323
[Au] Autor:Fouelifack FY; Fouedjio JH; Dingom MA; Fouogue JT; Enow RM
[Ad] Endereço:Unité de Gynécologie-Obstétrique de l'Hôpital Central de Yaoundé, Cameroun.
[Ti] Título:[Fortuitous discovery of quadruplets during childbirth: illustration of a case at Yaounde Central Hospital (Cameroon)].
[Ti] Título:Découverte fortuite de quadruplets au cours d'un accouchement: illustration d'un cas à l'Hôpital Central de Yaoundé (Cameroun)..
[So] Source:Pan Afr Med J;18:196, 2014.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:fre
[Mh] Termos MeSH primário: Parto Obstétrico/métodos
Erros de Diagnóstico
Gravidez Múltipla
Quadrigêmeos
[Mh] Termos MeSH secundário: Aborto Espontâneo
Adulto
Camarões
Diagnóstico Tardio
Feminino
Fraturas do Fêmur/etiologia
Seres Humanos
Recém-Nascido
Nascimento Vivo
Masculino
Complicações do Trabalho de Parto
Paridade
Gravidez
Ultrassonografia Pré-Natal
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1507
[Cu] Atualização por classe:170220
[Lr] Data última revisão:
170220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:141125
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.2014.18.196.4819


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[PMID]:24685490
[Au] Autor:Cavaco H; Wu K; Christodoulou L
[Ad] Endereço:Department of Paediatric Neurology, Chelsea and Westminster Hospital NHS Trust, London, UK.
[Ti] Título:An uninvited guest.
[So] Source:Pediatr Neurol;50(6):658-9, 2014 Jun.
[Is] ISSN:1873-5150
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Hemorragia Cerebral/diagnóstico por imagem
Hidrocefalia/diagnóstico por imagem
Doenças do Prematuro/diagnóstico por imagem
[Mh] Termos MeSH secundário: Hemorragia Cerebral/terapia
Ecoencefalografia
Evolução Fatal
Feminino
Seres Humanos
Hidrocefalia/terapia
Recém-Nascido
Recém-Nascido Prematuro
Quadrigêmeos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1501
[Cu] Atualização por classe:161125
[Lr] Data última revisão:
161125
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:140402
[St] Status:MEDLINE


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[PMID]:24605397
[Au] Autor:Naimer SA; Carni A
[Ad] Endereço:Division of Health in the Community, Department of Family Medicine, Siaal Research Center for Family Medicine and Primary Care-Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel. sodyna@clalit.org.il
[Ti] Título:[Safe quadruplet gestation following peripartum discectomy for massive disc prolapse].
[So] Source:Harefuah;153(1):6-7, 66, 2014 Jan.
[Is] ISSN:0017-7768
[Cp] País de publicação:Israel
[La] Idioma:heb
[Ab] Resumo:INTRODUCTION: We would Like to present a rare case of multiple gestation following a severe event of spinal cord morbidity during a previous singleton gestation. The medical literature carries a paucity of evidence regarding the future fate of pregnancies following gestational induced intervertebral disc prolapse. CASE HISTORY: A 21 year old mother delivered a healthy boy after unbearable back pain. She subsequently developed urinary retention with laxity of the anal sphincter and underwent urgent L5-S1 discectomy. Following in vitro fertilization for infertility she conceived and was warned of the dangers of a gestation with quadruplets. The parents decided to continue the gestation regularly without intervention despite possible complications. At 31 weeks of gestation the mother delivered four normal male babies, each weighing over 1200 grams after a normal (supervised) pregnancy devoid of any back symptoms. This case demonstrates a novel clinical scenario of hitherto unreported major challenges to an established vulnerable vertebral column. DISCUSSION: To the best of our knowledge this is the first report of a multiple gestation following severe spinal column pathology demanding surgical intervention in order to prevent long term handicap. We could not even locate a series of singleton gestations following such a clinical scenario. The favorable outcome observed in this case is very encouraging and can serve to reassure potential mothers who have experienced a similar previous episode as demonstrated here. CONCLUSION: Special caution must be taken when consulting pregnant patients. From this case history we may learn that precautions such as indefinite contraception after a previous incident of massive disc prolapse may be widely unnecessary.
[Mh] Termos MeSH primário: Fertilização In Vitro
Deslocamento do Disco Intervertebral/cirurgia
Complicações na Gravidez/cirurgia
Gravidez Múltipla
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Deslocamento do Disco Intervertebral/etiologia
Deslocamento do Disco Intervertebral/patologia
Masculino
Gravidez
Complicações na Gravidez/patologia
Resultado da Gravidez
Quadrigêmeos
Índice de Gravidade de Doença
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Mês de entrada:1404
[Cu] Atualização por classe:140310
[Lr] Data última revisão:
140310
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:140311
[St] Status:MEDLINE


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[PMID]:24373946
[Au] Autor:Gee RE; Dickey RP; Xiong X; Clark LS; Pridjian G
[Ad] Endereço:Louisiana State University Department of Obstetrics and Gynecology, and School of Public Health, New Orleans, LA; Louisiana State University School of Medicine, and School of Public Health, New Orleans, LA.
[Ti] Título:Impact of monozygotic twinning on multiple births resulting from in vitro fertilization in the United States, 2006-2010.
[So] Source:Am J Obstet Gynecol;210(5):468.e1-6, 2014 May.
[Is] ISSN:1097-6868
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To determine the contribution of monozygotic twining to in vitro fertilization multiple births. STUDY DESIGN: We performed a retrospective analysis of the incidence of monozygotic twining in multiple births resulting from fresh embryo transfers using 2006-2010 data from the Society for Reproductive Technology Clinic Outcome Reporting System. RESULTS: The number of embryos transferred were fewer than the number of births in 0.5% (223/40950) of twin, 29% (659/2289) of triplet, and 64% (43/67) of quadruplet births resulting from transfer of fresh embryos from 2006 to 2010. In 2010, 37% of triplets and 100% of quadruplet births occurred when fewer than 3 and fewer than 4 embryos respectively were transferred. CONCLUSION: Monozygotic twinning plays a key role in the development of triplet and quadruplet pregnancies achieved through in vitro fertilization.
[Mh] Termos MeSH primário: Transferência Embrionária
Gravidez Múltipla/estatística & dados numéricos
Gêmeos Monozigóticos
[Mh] Termos MeSH secundário: Transferência Embrionária/estatística & dados numéricos
Transferência Embrionária/tendências
Feminino
Fertilização In Vitro
Seres Humanos
Gravidez
Quadrigêmeos
Estudos Retrospectivos
Transferência de Embrião Único
Trigêmeos
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1409
[Cu] Atualização por classe:140505
[Lr] Data última revisão:
140505
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:131231
[St] Status:MEDLINE


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[PMID]:23793775
[Au] Autor:Disanto G; Vcelakova J; Pakpoor J; Elangovan RI; Sumnik Z; Ulmannova T; Ebers GC; Ramagopalan SV; Stechová K
[Ti] Título:DNA methylation in monozygotic quadruplets affected by type 1 diabetes.
[So] Source:Diabetologia;56(9):2093-5, 2013 Sep.
[Is] ISSN:1432-0428
[Cp] País de publicação:Germany
[La] Idioma:eng
[Mh] Termos MeSH primário: Metilação de DNA/genética
Diabetes Mellitus Tipo 1/genética
Quadrigêmeos/genética
[Mh] Termos MeSH secundário: Pré-Escolar
Feminino
Seres Humanos
[Pt] Tipo de publicação:LETTER; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1405
[Cu] Atualização por classe:170917
[Lr] Data última revisão:
170917
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:130625
[St] Status:MEDLINE
[do] DOI:10.1007/s00125-013-2972-3


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[PMID]:23510071
[Au] Autor:Fajolu IB; Ezeaka VC; Adeniyi OF; Iroha EO; Egri-Okwaji MT
[Ad] Endereço:Department of Paediatrics, College of Medicine, University of Lagos, Nigeria.
[Ti] Título:Prevalence and outcome of higher order multiple pregnancies in Lagos, Nigeria.
[So] Source:J Matern Fetal Neonatal Med;26(13):1342-5, 2013 Sep.
[Is] ISSN:1476-4954
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To determine the prevalence and outcome of higher order multiple (HOM) pregnancies in Lagos, Nigeria. METHODS: The mode of delivery, gestational age, pregnancy and neonatal outcome of babies delivered from HOM pregnancies were reviewed retrospectively from the labor ward and theater registers, neonatal unit admission records and medical notes in a tertiary referral centre from April 2009 to March 2012. RESULTS: Twenty-two (15, 6 and 1 set of triplets, quadruplets and quintuplet, respectively) of 6521 pregnancies delivered during the period were HOM pregnancies giving a prevalence of 3.37/1000. All the 74 babies except 12 were delivered by cesarean section. There were 18 perinatal deaths giving a perinatal mortality rate of 243 per 1000. Overall mortality was significantly associated with no antenatal booking (21 versus 5, OR: 21.0, 95% CI: 2.1-72.3, p = 0.000), gestational age ≤30 weeks (21 versus 5, OR: 46.2, 95% CI: 11.2-189.9, p = 0.000) and birth weight <1000 g for live births (p = 0.000). Mode of delivery and number of fetuses >3 were however not significantly associated with mortality. CONCLUSION: Reduction of early preterm births by proper antenatal care and close feto-maternal monitoring of HOM pregnancies will significantly reduce the resultant immediate poor outcomes for these pregnancies and their newborns.
[Mh] Termos MeSH primário: Resultado da Gravidez/epidemiologia
Gravidez Múltipla/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Parto Obstétrico/métodos
Parto Obstétrico/mortalidade
Parto Obstétrico/estatística & dados numéricos
Feminino
Seres Humanos
Recém-Nascido
Nigéria/epidemiologia
Mortalidade Perinatal
Gravidez
Prevalência
Quadrigêmeos/estatística & dados numéricos
Quíntuplos/estatística & dados numéricos
Trigêmeos/estatística & dados numéricos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1403
[Cu] Atualização por classe:130805
[Lr] Data última revisão:
130805
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:130321
[St] Status:MEDLINE
[do] DOI:10.3109/14767058.2013.784260


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Texto completo
[PMID]:22108602
[Au] Autor:Stechova K; Halbhuber Z; Hubackova M; Kayserova J; Petruzelkova L; Vcelakova J; Kolouskova S; Ulmannova T; Faresjö M; Neuwirth A; Spisek R; Sediva A; Filipp D; Sumnik Z
[Ad] Endereço:Department of Paediatrics, 2nd Medical Faculty of Charles University and University Hospital Motol, Prague, Czech Republic. katerina.stechova@lfmotol.cuni.cz
[Ti] Título:Case report: type 1 diabetes in monozygotic quadruplets.
[So] Source:Eur J Hum Genet;20(4):457-62, 2012 Apr.
[Is] ISSN:1476-5438
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Type 1 diabetes (T1D) is an autoimmune disease characterized by the lack of insulin due to an autoimmune destruction of pancreatic beta cells. Here, we report a unique case of a family with naturally conceived quadruplets in which T1D was diagnosed in two quadruplets simultaneously. At the same time, the third quadruplet was diagnosed with the pre-diabetic stage. Remarkably, all four quadruplets were positive for anti-islet cell antibodies, GAD65 and IA-A2. Monozygotic status of the quadruplets was confirmed by testing 14 different short tandem repeat polymorphisms. Serological examination confirmed that all quadruplets and their father suffered from a recent enteroviral infection of EV68-71 serotype. To assess the nature of the molecular pathological processes contributing to the development of diabetes, immunocompetent cells isolated from all family members were characterized by gene expression arrays, immune-cell enumerations and cytokine-production assays. The microarray data provided evidence that viral infection, and IL-27 and IL-9 cytokine signalling contributed to the onset of T1D in two of the quadruplets. The propensity of stimulated immunocompetent cells from non-diabetic members of the family to secrete high level of IFN-α further corroborates this conclusion. The number of T regulatory cells as well as plasmacytoid and/or myeloid dendritic cells was found diminished in all family members. Thus, this unique family is a prime example for the support of the so-called 'fertile-field' hypothesis proposing that genetic predisposition to anti-islet autoimmunity is 'fertilized' and precipitated by a viral infection leading to a fully blown T1D.
[Mh] Termos MeSH primário: Diabetes Mellitus Tipo 1/imunologia
Quadrigêmeos
[Mh] Termos MeSH secundário: Autoimunidade
Pré-Escolar
Diabetes Mellitus Tipo 1/genética
Feminino
Seres Humanos
Linfócitos T Reguladores/imunologia
Linfócitos T Reguladores/metabolismo
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1208
[Cu] Atualização por classe:170220
[Lr] Data última revisão:
170220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:111124
[St] Status:MEDLINE
[do] DOI:10.1038/ejhg.2011.212


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[PMID]:22028058
[Au] Autor:Maier B; Reitsamer-Tontsch S; Weisser C; Schreiner B
[Ad] Endereço:Ambulanz für gynäkologische Endokrinologie und assistierte Reproduktion, Universitätsklinik für Frauenheilkunde und Geburtshilfe, Paracelsus Medizinische Privatuniversität (PMU)/Salzburger Landeskliniken (SALK), Salzburg, Österreich. b.maier@salk.at
[Ti] Título:[Births and children after assisted reproductive technologies. A retrospective analysis with special regard to multiple pregnancies at the Department of Obstetrics and Gynecology, Paracelsus Medical University Salzburg (2000-2009) with an extrapolation for Austria].
[Ti] Título:Geburten und Kinder nach assistierter Fortpflanzungshilfe. Eine retrospektive Analyse unter besonderer Berücksichtigung von Mehrlingsschwangerschaften an der Universitätsklinik für Frauenheilkunde und Geburtshilfe Salzburg (2000-2009) mit einer Hochrechnung für Österreich..
[So] Source:Z Geburtshilfe Neonatol;215(5):187-93, 2011 Oct.
[Is] ISSN:1439-1651
[Cp] País de publicação:Germany
[La] Idioma:ger
[Ab] Resumo:BACKGROUND: Austria still lacks a baby-take-home rate after assisted reproductive technologies (ART) and therefore an adequate quality management of ART. PATIENTS AND METHODS: This paper extrapolates data about births/infants after ART at the University Clinic of Obstetrics and Gynaecology (PMU/SALK) in Salzburg for Austria, especially in regard to multiple births/infants collected between 2000 and 2009. RESULTS: On average 2 271 infants were born per year during the last 10 years. Among them, 76 infants (3.34% of all children) were born after ART. Of all children conceived by ART and born (759) at the University Clinic of Obstetrics and Gynaecology 368 are multiples. This is 48.5% of all children born after ART. 31.6% of all multiples born were conceived through ART. DISCUSSION: The extrapolation of data concerning multiples results in 1 255 multiples/year after ART for Austria. CONCLUSION: Without a baby-take-home rate, serious quality management of reproductive medicine is impossible. Online registration of deliveries and infants is the only adequate approach. The data of this statistical extrapolation from a single perinatal center not only provide a survey about the situation in Austria, but also support the claim of a quantitative (numbers) as well as qualitative (condition of infants) baby-take-home rate after ART.
[Mh] Termos MeSH primário: Gravidez Múltipla/estatística & dados numéricos
Técnicas de Reprodução Assistida/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Áustria
Estudos Transversais
Transferência Embrionária/estatística & dados numéricos
Feminino
Maternidades/estatística & dados numéricos
Hospitais Universitários/estatística & dados numéricos
Seres Humanos
Recém-Nascido
Idade Materna
Gravidez
Quadrigêmeos/estatística & dados numéricos
Estudos Retrospectivos
Trigêmeos/estatística & dados numéricos
Gêmeos/estatística & dados numéricos
[Pt] Tipo de publicação:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Mês de entrada:1206
[Cu] Atualização por classe:111026
[Lr] Data última revisão:
111026
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:111027
[St] Status:MEDLINE
[do] DOI:10.1055/s-0031-1291212



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