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Função sexual de mulheres com infertilidade 不孕症妇女的性功能
IF 1.2 Q3 Medicine Pub Date : 2016-08-01 DOI: 10.11606/D.17.2017.TDE-10012017-101301
Priscilla Bianchini Salomão
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引用次数: 1
[Determinants of maternal near miss in an obstetric intensive care unit]. [产科重症监护病房产妇差点漏诊的决定因素]。
IF 1.2 Q3 Medicine Pub Date : 2015-11-01 DOI: 10.1590/SO100-720320150005286
Maria Aparecida Cardoso De Souza, Tházio Henrique Soares Cardoso De Souza, A. K. Gonçalves
PURPOSETo evaluate the risk factors for morbidity and mortality in an obstetric intensive care unit at a university hospital.METHODSObservational cross-sectional study with 492 pregnant/puerperal women. Patients were admitted to the obstetric intensive care unit over a period of one year, being informed about the proposals of the study and a questionnaire was applied. The analysis was performed using Microsoft Excel 2013 and GraphPad Prism 6. To evaluate risk factors, χ2 tests were used.RESULTSThe main risk factors to near miss were: non-white race (OR=2.5; PR=2.3); marital status (married women) (OR=7.9; PR=7.1), schooling (primary) (OR=3.1; PR=2.8), being from the countryside (OR=4.6; PR=4.0), low income (OR=70; PR=5.5), gestational hypertensive disorders (OR=16.3; PR=13.2), receiving prenatal care (OR=5.0; PR=4.254) and C-section before labor (OR=39.2; PR=31.2).CONCLUSIONSThe prevalence of near miss was associated with socioeconomic/clinical factors and care issues, revealing the importance of interventions to improve these indicators. Additionally, we suggest a better curriculum insertion of this subject in the discipline of the medical course due to the importance of avoiding the near miss using adequate medical education. The importance of correct prenatal care is emphasized in order to identify potential risks, to provide nutritional support to pregnant women, to treat potential diseases and to establish a maternal immunization program, as well as providing better care regarding the clinical features of the patients, in order to reduce obstetrical and neonatal risk.
目的评价某大学附属医院产科重症监护病房发病和死亡的危险因素。方法对492例孕妇/产褥期妇女进行观察性横断面研究。患者在一年的时间里住进产科重症监护室,被告知研究的建议,并使用了一份问卷。使用Microsoft Excel 2013和GraphPad Prism 6进行分析。为评价危险因素,采用χ2检验。结果近漏的主要危险因素为:非白种人(OR=2.5;公关= 2.3);婚姻状况(已婚女性)(OR=7.9;PR=7.1),学校教育(小学)(OR=3.1;PR=2.8),来自农村(OR=4.6;PR=4.0),低收入(OR=70;PR=5.5),妊娠期高血压疾病(OR=16.3;PR=13.2),接受产前护理(OR=5.0;PR=4.254)和产前剖腹产(OR=39.2;公关= 31.2)。结论近漏发生率与社会经济/临床因素和护理问题有关,表明干预措施对改善这些指标的重要性。此外,我们建议在医学课程的学科中更好地插入这一主题,因为利用充分的医学教育避免侥幸的重要性。强调正确的产前护理的重要性,以便确定潜在风险,为孕妇提供营养支持,治疗潜在疾病,制定孕产妇免疫方案,并根据患者的临床特征提供更好的护理,以减少产科和新生儿风险。
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引用次数: 16
[Limitations and controversies in determining the predictive value of oocyte and embryo morphology criteria]. [确定卵母细胞和胚胎形态学标准预测价值的局限性和争议]。
IF 1.2 Q3 Medicine Pub Date : 2015-11-01 DOI: 10.1590/SO100-720320150005330
R. Figueira, T. Aoki, E. Borges Júnior
In order to increase the success rate of in vitro fertilization cycles, several studies have focused on the identification of the embryo with higher implantation potential. Despite recent advances in the reproductive medicine, based on the OMICs technology, routinely applicable methodologies are still needed. Thus, in most fertilization centers embryo selection for transfer is still based on morphological parameters evaluated under light microscopy. Several morphological parameters may be evaluated, ranging from the pronuclear to blastocyst stage. In general, despite the day of transfer, some criteria are suggested to present a predictive value for embryo viability when analyzed independently or combined. However, the subjectivity of morphological evaluation, as well as the wide diversity of embryo classification systems used by different fertilization centers shows contrasting results, making the implementation of a consensus regarding different morphological criteria and their predictive value a difficult task. The optimization of embryo selection represents a large potential to increase treatment success rates, allowing the transfer of a reduced number of embryos and minimizing the risks of multiple pregnancy.
为了提高体外受精周期的成功率,一些研究集中在鉴定具有较高着床潜力的胚胎上。尽管基于组学技术的生殖医学最近取得了进展,但仍然需要常规适用的方法。因此,在大多数受精中心,胚胎移植的选择仍然是基于光学显微镜下评估的形态参数。从原核到囊胚阶段,可以评估几个形态学参数。一般来说,尽管移植日期不同,但建议在单独或联合分析时,一些标准对胚胎活力具有预测价值。然而,形态学评价的主观性以及不同受精中心使用的胚胎分类系统的多样性导致了结果的差异,使得对不同形态学标准及其预测价值的共识的实现成为一项艰巨的任务。胚胎选择的优化代表了提高治疗成功率的巨大潜力,允许移植数量减少的胚胎,并将多胎妊娠的风险降至最低。
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引用次数: 3
Efeito do exercício físico sobre os parâmetros hemodinâmicos 运动对血流动力学参数的影响
IF 1.2 Q3 Medicine Pub Date : 2014-11-01 DOI: 10.1590/SO100-720320140005229
Camila Pigatto, Caroline Mombaque dos Santos, W. Santos, Walter Santos Neme, L. Portela, Edson Nunes de Moraes, F.M.P. Gallarreta
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引用次数: 0
Expressão proteica do gene HOXA10 e dos receptores de estrogênio e progesterona no epitélio, estroma e tecido muscular liso perilesional de endometriose do reto-sigmoide 直肠乙状结肠子宫内膜异位症上皮、间质和病灶周围平滑肌组织中HOXA10基因及雌激素和孕酮受体的蛋白表达
IF 1.2 Q3 Medicine Pub Date : 2014-08-01 DOI: 10.1590/SO100-72032014T0002
A. Zanatta, P. C. Serafini
INTRODUCAO: A patogenese da endometriose profunda (EPF) e incerta. O fator de transcricao homeoboxA10 (HOXA10) regula a conferencia de identidade tecidual de utero ao ducto paramesonefrico indiferenciado. HOXA10 e expresso em endometriose ovariana, peritoneal, pulmonar e reto-vaginal, relacionando-o a patogenese da endometriose. Estradiol e progesterona ativam a transcricao do gene HOXA10. Nesse estudo, avaliamos a expressao proteica de HOXA10, das isoformas α (ER-α) e β (ER-β) dos receptores de estrogenio, e do receptor de progesterona AB (PR-AB) e sua isoforma B (PR-B) na lesao (LES) e no tecido muscular liso perilesional (TMLP) de endometriose de reto-sigmoide (ERS), durante as fases proliferativa e secretora do ciclo.METODOS: Amostras de LES e TMLP de ERS de 18 pacientes (9 operadas em cada fase) foram agrupadas em blocos de microarranjos de tecidos (tissue microarray). Apos preparacao imunoistoquimica, avaliamos as amostras por microscopia otica (MO) e por um softwareespecifico, a analise morfometrica (AM).RESULTADOS: HOXA10 foi expresso no estroma de LES de ERS durante a fase secretora. ER-α e ER-β foram expressos em glândulas e estroma de LES e TMLP de ERS durante ambas as fases do ciclo. PR-AB e PR-B foram expressos em glândulas e estroma de LES de ERS durante ambas as fases do ciclo. A expressao de HOXA10 correlacionou-se diretamente com PR-AB e PR-B na ERS. Nao houve correlacao entre ER-α e ER-β com HOXA10, PR-AB ou PR-B em nenhuma fase do ciclo ou local de expressao de ERS.CONCLUSOES: HOXA10 e expresso em ERS, fora do seu eixo espacial de expressao. HOXA10 pode ser necessario para conferir a identidade "de novo" na EPF, incluindo ERS, favorecendo a hipotese da origem embrionaria da doenca. A progesterona pode ativar o gene HOXA10 e regular esta acao, possivelmente mediada por PR-B. A acao mitogena do estradiol na ERS e mediada por ER-α e ER-β.
引言:深层子宫内膜异位症(EPF)的发病机制尚不确定。同源盒A10转录因子(HOXA10)调节从子宫到未分化的肾旁管的组织身份会议。HOXA10,表达于卵巢、腹膜、肺和直肠阴道子宫内膜异位症,与子宫内膜异位的发病机制有关。雌二醇和孕酮激活HOXA10基因转录。在本研究中,我们评估了HOXA10、雌激素受体的同种型α(ER-α)和β(ER-β)以及孕激素受体AB(PR-AB)及其同种型B(PR-B)在直肠乙状结肠子宫内膜异位症(ERS)病变(SLE)和病变周围平滑肌组织(TMLP)中的蛋白表达,在该周期的增殖和分泌阶段。方法:将18例SLE和SLE患者(每个期9例)的样本分为组织微阵列块。免疫组化制备后,我们用光学显微镜(OM)和特异性软件形态计量分析(AM)对样品进行评估。结果:HOXA10在分泌期的ERS的SLE间质中表达。在周期的两个阶段,ER-α和ER-β在SLE的腺体和间质以及ERS TMLP中均有表达。在周期的两个阶段,PR-AB和PR-B在SLE的腺体和ERS的基质中均有表达。HOXA10的表达与ERS中的PR-AB和PR-B直接相关。在ERS周期的任何阶段或表达位置,ER-α和ER-β与HOXA10、PR-AB或PR-B均无相关性。结论:HOXA10在ERS中表达,在其空间表达轴之外。HOXA10可能有必要验证EPF(包括ERS)中的“从头”身份,支持疾病胚胎起源的假设。孕酮可以激活HOXA10基因并调节这种作用,可能是由PR-B介导的。雌二醇在ERS中的促有丝分裂作用是由ER-α和ER-β介导的。
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引用次数: 0
Causas de morte materna no Estado do Pará, Brasil 巴西帕拉州孕产妇死亡原因
IF 1.2 Q3 Medicine Pub Date : 2014-07-01 DOI: 10.1590/SO100-720320140004892
N. Botelho, Italo Fernando Mendonça Mota Silva, J. Tavares, Lorena Oliveira Lima
PURPOSE: To identify the major causes of maternal death in the State of Para, Brazil. METHODS: A descriptive, observational and retrospective study was conducted using data from the Mortality Information System (SIM) of the State Department of Public Health of Para. SIM information was obtained using the TabWin 3.2 software and recorded in a research protocol developed by the investigators. The sample included 383 maternal deaths of 10-49-year-old women, which occurred from 2006 to 2010. Data were analyzed using non-parametric tests (χ2 and G-tests). The BioStat(r) 5.0 software was used for statistical analysis and Microsoft(r) Excel 2007 for the preparation of database and tables. RESULTS: The Maternal Mortality Ratio was 51.9 and did not decrease significantly during the period. Most deaths occurred during the postpartum period (up to 42 days) (51.7%), and some diagnostic confirmation was used. Direct obstetric causes were dominant (90.6%), mainly hypertension (34.6%), with emphasis on eclampsia (70%), and hemorrhage (22.2%). All of these maternal deaths were avoidable (100%). CONCLUSION: Maternal death in Para is characterized by occurring during the puerperium (up to 42 days), due mainly to direct obstetric causes, such as hypertension, with emphasis on eclampsia, and hemorrhage. This evidences the need for complete attention with good quality for pregnant women, from prenatal care to puerperium, in the state of Para.
目的:确定巴西帕拉州产妇死亡的主要原因。方法:采用来自纽约州公共卫生部死亡率信息系统(SIM)的数据进行描述性、观察性和回顾性研究。使用TabWin 3.2软件获取SIM信息,并记录在研究者制定的研究方案中。样本包括2006年至2010年期间死亡的383名10-49岁妇女。数据分析采用非参数检验(χ2和g检验)。采用BioStat(r) 5.0软件进行统计分析,Microsoft(r) Excel 2007进行数据库和表格的编制。结果:产妇死亡率为51.9,在此期间无明显下降。大多数死亡发生在产后(最长42天)(51.7%),并使用了一些诊断确认。直接产科原因占主导地位(90.6%),主要是高血压(34.6%),其次是子痫(70%)和出血(22.2%)。所有这些孕产妇死亡都是可以避免的(100%)。结论:帕拉州产妇死亡的特点是发生在产褥期(最长42天),主要是由于直接的产科原因,如高血压,重点是子痫和出血。这证明,在帕拉州,从产前护理到产褥期,孕妇需要得到高质量的全面关注。
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引用次数: 17
Influence of body mass index, body fat percentage and age at menarche on aerobic capacity (VO2 max) of elementary school female students 体质指数、体脂率及初潮年龄对小学生有氧能力(VO2 max)的影响
IF 1.2 Q3 Medicine Pub Date : 2014-02-01 DOI: 10.1590/S0100-72032014000200007
T. Capel, M. Vaisberg, M. Araujo, R. Paiva, Juliana M. B. Santos, Z. Bella
PURPOSE To identify and relate body fat percentage (skin fold measures), body mass index (BMI) and age at menarcheto aerobic capacity using the indirect VO₂ maximum value (VO₂ max) of girls in the second cycle of primary school. METHODS A total of 197 girls aged 13.0 ± 1.2 years on average, students from two public schools in the city of Atibaia in Sao Paulo, were evaluated. Anthropometric evaluation of skin folds was performed using the Slaughter protocol for teenage girls, and BMI (kg/m²) was based on "Z score" (graphic of percentile) according to WHO recommendations. The Leger protocol was used to determine VO₂ max. Pearson linear regression and the Student t-test were used for statistical analysis. RESULTS 22.3% of the girls were overweight and 3.5% were obese according to the classification proposed by the WHO; 140 (71.1%) girls reported menarche. The average age at menarche was 12.0 ± 1.0 years and was significantly higher in the group with normal BMI (12.2 ± 0.9 years) than in the overweight or obese groups (11.6 ± 1.0 years). The average indirect VO₂ max value was 39.6 ± 3.7 mL/kg/min, ranging from 30.3 to 50.5 mL/kg/min. The advance of chronological age and early age at menarche were positively correlated with lower VO₂ max values. CONCLUSIONS This study showed that 25.8% of the girls had aBMI value above WHO recommendations. Girls with higher BMI and higher body fat percentage had lower VO₂ max. The earlier age at menarche and the advance of chronological age were the most important factors for the reduction of aerobic capacity. The ageat menarche was higher in girls with adequate BMI compared tooverweight or obese girls.
目的利用间接VO 2最大值(VO 2 max)测定小学二年级女生的体脂率(皮肤褶皱测量)、体重指数(BMI)和月经初潮年龄与有氧能力之间的关系。方法对圣保罗市阿提巴亚市两所公立学校197名女生(平均年龄13.0±1.2岁)进行评价。使用Slaughter方案对少女进行皮肤褶皱的人体测量学评估,BMI (kg/m²)根据世卫组织建议基于“Z分数”(百分位数图形)。采用Leger协议测定vo2max。采用Pearson线性回归和学生t检验进行统计分析。结果按世界卫生组织(WHO)分类,超重占22.3%,肥胖占3.5%;140名(71.1%)女孩报告初潮。平均初潮年龄为12.0±1.0岁,BMI正常组(12.2±0.9岁)明显高于超重或肥胖组(11.6±1.0岁)。平均间接vo2最大值为39.6±3.7 mL/kg/min,范围为30.3 ~ 50.5 mL/kg/min。年龄越早、初潮年龄越早与vo2max值越低呈正相关。结论:25.8%的女童aBMI值高于WHO推荐值。BMI和体脂率越高的女孩,其vo2max越低。初潮年龄的提前和实足年龄的提前是有氧能力降低的最重要因素。与超重或肥胖的女孩相比,BMI足够的女孩的初潮年龄更高。
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引用次数: 4
Sintomas depressivos em mulheres com dor pélvica crônica 慢性盆腔疼痛女性的抑郁症状
IF 1.2 Q3 Medicine Pub Date : 2014-02-01 DOI: 10.1590/S0100-72032014000200006
Rosângela Nunes da Luz, Flávia Melo Rodrigues, Vanessa da Silva Carvalho Vila, José Miguel de Deus, K. P. Lima
PURPOSE: To investigate the presence of depressive symptoms in women with chronic pelvic pain. METHODS: This descriptive cross-sectional study was performed with women aged 18 years or older, diagnosed with chronic pelvic pain, with no pregnancy history in the previous year, and with no cancer history. The sample was established by calculating the representative sample, estimated as 50 women. All women were undergoing treatment at a gynecology outpatient clinic, referred by the primary health care network of the Brazilian national health system. Data collection was performed from October2009 to May 2010. The women's sociodemographic, economic and clinical characteristics were analyzed. Pain intensity was evaluated using a visual analogue scale. The depressive symptoms were investigated using Beck's Depression Inventory. Statistical analysis was performed using position measures (mean, median), dispersion (standard deviation) and the χ2 test. Values of p≤ .05 were considered statistically significant. RESULTS: The participants' mean age was 41.6±9.4 years. The following features predominated: secondary education level; pardo (brown) skin color; Catholic religion; and living with a steady partner. Most (98%) were economically active and worked with general domestic services. Regarding the participants' subjective perception of pain, 52% reported experiencing intense pain, while 48% reported experiencing moderate pain. Most women (52%) had been living with pain for five years or less, and 30%, for over 11 years. The mean BDI score was 17.4 (±9.4). It was observed that 58% of the women presented mild, moderate and severe depressive symptoms according to the BDI. The most frequent depressive symptoms were fatigability, loss of libido, irritability, difficulty to work, somatic preoccupations, crying, dissatisfaction, sadness, and insomnia. CONCLUSION: Depressive symptoms were frequent among these women suffering with chronic pelvic pain.
目的:探讨慢性盆腔疼痛女性患者是否存在抑郁症状。方法:这项描述性横断面研究是对年龄在18岁或以上、诊断为慢性盆腔疼痛、前一年无妊娠史、无癌症史的女性进行的。该样本是通过计算代表性样本建立的,估计为50名女性。所有妇女都在巴西国家卫生系统初级卫生保健网络转诊的妇科门诊接受治疗。数据收集时间为2009年10月至2010年5月。分析妇女的社会人口学、经济和临床特征。采用视觉模拟量表评估疼痛强度。采用贝克抑郁量表调查抑郁症状。采用位置测量(均数、中位数)、离散度(标准差)和χ2检验进行统计学分析。p≤0.05认为有统计学意义。结果:参与者平均年龄为41.6±9.4岁。以下特征占主导地位:中等教育水平;棕黄(褐色)肤色;天主教的宗教;和一个稳定的伴侣一起生活。大多数(98%)从事经济活动并从事一般家政服务。关于参与者对疼痛的主观感知,52%的人报告经历了剧烈疼痛,48%的人报告经历了中度疼痛。大多数女性(52%)的疼痛生活时间不超过5年,30%的女性疼痛生活时间超过11年。BDI平均评分为17.4(±9.4)分。据观察,根据BDI, 58%的妇女表现出轻度、中度和重度抑郁症状。最常见的抑郁症状是疲劳、性欲减退、易怒、工作困难、躯体关注、哭泣、不满、悲伤和失眠。结论:慢性盆腔疼痛患者中抑郁症状较为常见。
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引用次数: 0
Creast cancer in man: analysis of epidemiological, clinical and therapeutic aspects in brazilian formal service 男性乳腺癌:巴西正规服务业流行病学、临床和治疗方面的分析
IF 1.2 Q3 Medicine Pub Date : 2013-11-01 DOI: 10.1590/S0100-72032013001100009
R. Bonfim
Dissertacao de Mestrado apresentada ao Programa de Pos-Graduacao em Saude Materno – Infantil, Universidade Federal do Maranhao e Instituto Maranhense de Oncologia Aldenora Bello – IMOAB, em 26 de fevereiro de 2013. Introducao: O câncer de mama em homem e uma doenca rara, representando cerca de 1% entre os tumores malignos que comprometem o homem, cuja incidencia aumenta com a idade. A proporcao e de que a cada 150 mulheres diagnosticadas com câncer de mama haja um caso no genero masculino. Objetivos: Descrever os aspectos epidemiologicos, clinicos e terapeuticos do câncer de mama no homem em servico habilitado. Metodos: A metodologia consistiu em revisao de prontuarios, pesquisa fundamentada em dados retrospectivos coletados nos arquivos do Instituto Maranhense de Oncologia Aldenora Bello (IMOAB) em Sao Luis, Maranhao no periodo de 2000 a 2011. Os dados foram submetidos a analise descritiva. Resultados: Foram encontrados 16 casos de câncer de mama masculino. A faixa etaria predominante foi 61–75 anos. Quanto as caracteristicas sociais, predominou pacientes casados, analfabetos, lavradores e a procedencia do interior do Maranhao (62,5%). A localizacao preferencial foi na regiao retroareolar de ambas as mamas, medindo entre 1,5–17 cm de diâmetro. O tipo histologico predominante foi carcinoma ductal infiltrante (75,0%). O grau histologico moderado (62,5%) foi o mais frequente. A maioria dos pacientes (56,2%) encontrava-se em estadiamentos iniciais. Quanto ao tratamento evidenciou-se que 81,2% foram submetidos ao tratamento cirurgico por mastectomia radical e subsequente radioterapia, quimioterapia e hormonioterapia. Conclusoes: A analise dos aspectos epidemiologicos, clinicos e terapeuticos favoreceu a compreensao do comportamento desta enfermidade em homens, no periodo estudado. Pesquisas sobre esta doenca em homens contribuirao para a compreensao do comportamento biologico, melhorando o prognostico nestes pacientes. Male breast cancer Epidemiology Clinic Staging Diagnosis Therapy Maranhao
2013年2月26日向Maranhao联邦大学和Maranhao肿瘤研究所Aldenora Bello - IMOAB母婴健康研究生项目提交的硕士论文。简介:男性乳腺癌是一种罕见的疾病,约占男性恶性肿瘤的1%,发病率随年龄增长而增加。这一比例是,每150名女性中就有1名男性被诊断患有乳腺癌。目的:描述男性乳腺癌的流行病学、临床和治疗方面的服务。方法:该方法包括回顾医疗记录,这是一项基于2000年至2011年在Maranhao州圣路易斯的Maranhense de Oncologia Aldenora Bello研究所(IMOAB)档案中收集的回顾性数据的研究。对数据进行描述性分析。结果:共发现16例男性乳腺癌。主要的经济活动是农业和工业。在社会特征方面,主要是已婚患者、文盲、农民和Maranhao内陆地区(62.5%)。优先定位在两个乳房的乳晕后区域,直径在1.5 - 17厘米之间。组织学类型主要为浸润性导管癌(75.0%)。组织学中度(62.5%)是最常见的。大多数患者(56.2%)处于早期分期。在治疗方面,81.2%的患者接受了根治性乳房切除术、放疗、化疗和激素治疗的手术治疗。结论:对流行病学、临床和治疗方面的分析有助于了解研究期间男性的该病行为。对男性该病的研究有助于了解其生物学行为,改善这些患者的预后。男性乳腺癌流行病学诊所分期诊断治疗
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引用次数: 1
O impacto no resultado perinatal do acompanhamento pré-natal de gestantes com hipertensão arterial em centro de referência 参考中心高血压孕妇产前随访对围产期结果的影响
IF 1.2 Q3 Medicine Pub Date : 2013-07-01 DOI: 10.1590/S0100-72032013000700009
Luciano Antonio Marcolino
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引用次数: 0
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Revista Brasileira de Ginecologia e Obstetricia
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