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1.
J Med Virol ; 90(6): 1063-1070, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-29446468

RESUMEN

In the present study, we evaluated the prevalence of occult hepatitis B (OBI) in a population from the Brazilian Amazon region, identify circulating genotypes, and mutations in the S gene. One hundred eighty-one patients with negative serology for HBsAg and anti-HBs and positive serology for anti-HBc participated in the study. Detection of viral DNA, genotyping by sequencing, and analysis of nucleotide sequences to detect possible mutations were performed. HBV DNA was detected in 14.36% of the patients. Genotyping revealed genotype A in 88.46% of HBV DNA-positive subjects, with subgenotype A1 being the most prevalent (78.26%) followed by subgenotype A2 (21.74%). Genotype F was detected in 11.54% (all of them subgenotype F2). Amino acid substitutions were observed in the amplified S gene in individuals with OBI compared to HBsAg-positive individuals (evident infection). In conclusion, the results show a high prevalence of OBI in the population studied, with a pattern of genotypes A and F that circulate in the Brazilian Amazon region. Amino acid substitutions were detected in part of the S gene in patients with OBI. Further studies on the molecular epidemiology of HBV in this region are important to identify patients considered healthy but who are potential transmitters of the disease.


Asunto(s)
ADN Viral/sangre , Antígenos de Superficie de la Hepatitis B/genética , Hepatitis B/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Sustitución de Aminoácidos , Brasil/epidemiología , Estudios Transversales , ADN Viral/genética , Femenino , Genotipo , Técnicas de Genotipaje , Hepatitis B/patología , Anticuerpos contra la Hepatitis B/sangre , Antígenos de Superficie de la Hepatitis B/sangre , Virus de la Hepatitis B/clasificación , Virus de la Hepatitis B/genética , Virus de la Hepatitis B/aislamiento & purificación , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Análisis de Secuencia de ADN , Adulto Joven
2.
Med Sci (Basel) ; 12(2)2024 05 06.
Artículo en Inglés | MEDLINE | ID: mdl-38804380

RESUMEN

Gastric cancer has been demonstrating a reduction in the number of cases over the past decades, largely attributed to advancements in public health practices and increased accessibility to educational initiatives for the general population. Nevertheless, it persists as the third leading cause of mortality globally among both men and women. These fatalities are typically associated with delayed disease detection. The current study assessed the levels of homocysteine, vitamin B12, and folic acid as a means of establishing a screening biomarker profile that could be integrated into routine testing protocols to facilitate swift diagnosis of the illness. A total of 207 control subjects and 207 individuals with gastric cancer were scrutinized, with biochemical measurements conducted using chemiluminescence for homocysteine, folic acid, and vitamin B12. The two groups were matched based on age, tumor location, subtype, tumor classification, presence of Epstein-Barr Virus infection (EBV), and Helicobacter pylori (H. pylori). Significant statistical variances were identified in the mean levels of the triad of substances among cancer patients when compared to the control group for all corresponding variables. In conclusion, our study indicated that analyzing the triad of homocysteine, vitamin B12, and folic acid holds diagnostic value for gastric cancer and could potentially serve as an effective screening marker for this type of cancer in the future.


Asunto(s)
Biomarcadores de Tumor , Detección Precoz del Cáncer , Ácido Fólico , Homocisteína , Neoplasias Gástricas , Vitamina B 12 , Humanos , Neoplasias Gástricas/diagnóstico , Vitamina B 12/sangre , Ácido Fólico/sangre , Homocisteína/sangre , Masculino , Femenino , Persona de Mediana Edad , Biomarcadores de Tumor/sangre , Anciano , Adulto , Estudios de Casos y Controles
3.
Cell Transplant ; 32: 9636897231195245, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37724822

RESUMEN

Cytomegalovirus (CMV) mutations associated with antiviral resistance have become a major problem related to high mortality in kidney transplant patients. The aim of the study was to investigate mutations in the CMV genes UL97 and UL54 associated with antiviral resistance. A retrospective observational cohort study was carried out at Hospital Ophir Loyola (HOL), a reference in Kidney Transplantation. A total of 81 patients who underwent kidney transplantation were followed up between 2016 and 2018 were monitored for CMV viral load by performing qPCR. Sanger sequencing was performed on 66 patients. All CMV-positive kidney transplant recipients were included. Mutations were observed in 15 samples (22.72%) from patients. Most cases involved UL97 mutations. Mutation in UL54 without mutation in UL97 was detected in only 2 cases. Resistance mutations in UL97 were identified, such as M460V, L595S, H520Q, two co-mutations D465R + Del524 and A594P + D413A and a 3 codon deletion (del598-601). The search for mutations in the CMV genes identified mutations that confer resistance to conventional antivirals, such as ganciclovir and cidofovir, used in the treatment of these patients. Confirmation of the association with increased CMV viral load in transplanted patients, due to mutation in resistance genes, requires phenotypic analysis for confirmation purposes. These were the first findings in patients in northern Brazil that we know of.


Asunto(s)
Infecciones por Citomegalovirus , Trasplante de Riñón , Humanos , Antivirales/farmacología , Citomegalovirus/genética , Infecciones por Citomegalovirus/tratamiento farmacológico , Infecciones por Citomegalovirus/genética , Ganciclovir/farmacología , Mutación/genética , Estudios Retrospectivos
4.
Genes (Basel) ; 14(2)2023 01 31.
Artículo en Inglés | MEDLINE | ID: mdl-36833294

RESUMEN

BACKGROUND: Rotator cuff disease is one of the leading causes of musculoskeletal pain and disability, and its etiology is most likely multifactorial but remains incompletely understood. Therefore, the objective of this research was to investigate the relationship of the single-nucleotide rs820218 polymorphism of the SAP30-binding protein (SAP30BP) gene with rotator cuff tears in the Amazonian population. METHODS: The case group consisted of patients who were operated on due to rotator cuff tears in a hospital in the Amazon region between 2010 and 2021, and the control group was composed of individuals who were selected after negative physical examinations for rotator cuff tears. Genomic DNA was obtained from saliva samples. For the genotyping and allelic discrimination of the selected single nucleotide polymorphism (rs820218) in the SAP30BP gene, real-time PCR was performed. RESULTS: The frequency of the A allele in the control group was four times as high as that in the case group (AA homozygotes); an association of the genetic variant rs820218 of the SAP30BP gene with rotator cuff tears was not established (p = 0.28 and 0.20), as the A allelic frequency is ordinarily low in the general population. CONCLUSIONS: The presence of the A allele indicates protection against rotator cuff tears.


Asunto(s)
Lesiones del Manguito de los Rotadores , Factores de Transcripción , Humanos , Alelos , Frecuencia de los Genes , Proteínas Nucleares/genética , Polimorfismo de Nucleótido Simple , Manguito de los Rotadores/cirugía , Lesiones del Manguito de los Rotadores/genética , Factores de Transcripción/genética
5.
Cancer Diagn Progn ; 2(3): 405-410, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35530639

RESUMEN

BACKGROUND: Colorectal cancer is a common cancer worldwide, with 5-10% of cases being hereditary. Familial adenomatous polyposis syndrome (FAP) is caused by germline mutations in the APC gene or rarely in the MUTYH gene. PATIENTS AND METHODS: This work did not identify germline mutations in the MUTYH, NTHL1, POLD1 and POLE genes in 15 individuals belonging to five families with classic FAP, who had the mutation in the APC gene confirmed in a previous study. Our results support mutations in the APC gene as the main genetic contribution of classical FAP with severe phenotype. In the family that had the most aggressive form of the disease, we performed an array-based Comparative Genomic Hybridization analysis and identified the germinal loss of an allele of the NOTCH2 and BMPR2 genes in the mother (proband) and daughter. In order to validate the involvement of these genes in the other four families of this study, we analyzed the DNA copy number variation in the peripheral blood of the 15 participants. RESULTS: FAP is a syndrome with considerable genetic and phenotypic heterogeneity and this phenomenon may explain the presence of secondary genetic alterations, such as the allelic loss of NOTCH2 and BMPR2 genes, found only in one family in this study. The CNV analysis confirmed that only the two members of the FAP2 family (patient 02H and 02F) had a deletion of these two genes, as the aCGH methodology had found. The other study participants did not show allelic loss for these two genes. CONCLUSION: Validation in a larger number of families could confirm the presence of these new genetic alterations in classic FAP and improve understanding of the different types of aggressiveness of the disease.

6.
Anticancer Agents Med Chem ; 22(17): 2927-2932, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35440317

RESUMEN

Gastric cancer (GC) is the fifth most common type of tumor and the third leading cause of cancer death worldwide. The evolution of gastric carcinogenesis is still poorly understood and, for this reason, preclinical research protocols were established that included the development of gastric cancer cell lines and the establishment of models of gastric carcinogenesis in non-human primates such as Sapajus apella. A comprehensive literature search was performed in relevant databases such as PubMed, ResearchGate, and Google Scholar to identify studies related to the topic. After an in-depth study of these reports, significant data were collected and compiled under appropriate headings. The main result of the studies carried out by the group on GC is the demonstration of the MYC gene overexpression as a common phenomenon in stomach carcinogenesis. Furthermore, we revealed that reducing the expression of the CDC25B gene, regulated by the MYC protein, is a therapeutic strategy against stomach tumors. This review article reveals preclinical evidence that treatment with menadione in experimental models of gastric tumorigenesis, in vivo and in vitro, inhibits the action of the phosphatase CDC25B and, consequently, prevents cell proliferation, invasion, and migration.


Asunto(s)
Neoplasias Gástricas , Animales , Carcinogénesis/genética , Línea Celular Tumoral , Proliferación Celular , Regulación Neoplásica de la Expresión Génica , Genes myc , Neoplasias Gástricas/metabolismo , Vitamina K 3/farmacología , Fosfatasas cdc25/genética , Fosfatasas cdc25/metabolismo
7.
Anticancer Res ; 40(11): 6355-6366, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33109573

RESUMEN

BACKGROUND/AIM: p16 and PTEN are tumor suppressor genes. Loss of these molecules in oral squamous cell carcinoma (OSCC) has been studied worldwide. In this study, we explored whether p16 cooperates with inactive PTEN during the pathogenesis of OSCC, especially in regard to tumor aggressiveness and proliferation. MATERIALS AND METHODS: Immunocytochemistry and western blot analysis were used to examine the levels of p16 and PTEN. Sequencing analysis was performed to identify mutations in the PTEN gene and HPV infection. Fluorescence in situ hybridization was used to examine the presence of the PTEN locus. RESULTS: PTEN analysis showed high positivity in T4 samples. HPV-positive tumors correlated with tabagism, tumor size 3 and 4, disease stages 3 and 4, presence of lymph node metastasis (N1) and poor differentiation. Immunoexpression of p16 was strongly correlated with the presence of HPV. CONCLUSION: PTEN demonstrated a higher reactivity in advanced disease stages and p16 was strongly associated with HPV. Viral presence decreases tumor aggressiveness. Patients with advanced stage lesions demonstrated lower survival rate.


Asunto(s)
Carcinoma de Células Escamosas/genética , Inhibidor p16 de la Quinasa Dependiente de Ciclina/genética , Neoplasias de la Boca/genética , Fosfohidrolasa PTEN/genética , Adulto , Biomarcadores de Tumor/genética , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/virología , Femenino , Regulación Neoplásica de la Expresión Génica/genética , Humanos , Hibridación Fluorescente in Situ , Pérdida de Heterocigocidad/genética , Metástasis Linfática , Masculino , Persona de Mediana Edad , Neoplasias de la Boca/patología , Neoplasias de la Boca/virología , Papillomaviridae/patogenicidad , Infecciones por Papillomavirus/genética , Infecciones por Papillomavirus/patología , Infecciones por Papillomavirus/virología
8.
Int J Biochem Cell Biol ; 115: 105592, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31454684

RESUMEN

Melanoma is the most aggressive type of cutaneous tumors due to its metastatic potential and high mortality. Increased levels of reactive oxygen species, including superoxide anion (O2-), and the consequent installation of a pro-oxidant environment are associated with melanoma development. The enzyme nitric oxide synthase (NOS), responsible for the production of nitric oxide (NO), when uncoupled is as a source of O2-, for example by the absence of its cofactor tetrahydrobiopterin (BH4). Western blot analysis showed increased expression of endothelial and inducible NOS in human melanoma cells, altering the stoichiometry between NOS levels and BH4 concentration and together with decreased BH4:BH2 ratio are contributing to NOS uncoupling. The treatment of melanoma cells with exogenous BH4 increased NO concentration and decreased O2- levels, leading to NOS coupling, which in turn reduced cell viability, cell proliferation and the ability of melanoma cells to form melanoma spheroids. Moreover, BH4 level restoration rendered melanoma cells more sensitive to apoptosis, demonstrating the role of dysfunctional NOS in melanoma genesis.


Asunto(s)
Carcinogénesis , Melanoma/patología , Óxido Nítrico Sintasa/metabolismo , Óxido Nítrico/metabolismo , Superóxidos/metabolismo , Caspasa 3/metabolismo , Caspasa 7/metabolismo , Línea Celular Tumoral , Supervivencia Celular , Activación Enzimática , Regulación Neoplásica de la Expresión Génica , Humanos , Melanocitos/patología , Melanoma/enzimología , Melanoma/metabolismo , Metástasis de la Neoplasia
9.
Clin Exp Med ; 18(4): 457-464, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-30006681

RESUMEN

Cancer is a genetic disease characterized by uncontrolled cell growth and metastasis. Cancer can have a number of causes, such the activation of oncogenes, the inactivation of tumor-suppressing genes, mutagenesis provoked by external factors, and epigenetic modifications. The development of diagnostic tools and treatments using a molecular biological approach permits the use of sensitive, low-cost, noninvasive tests for cancer patients. Biomarkers can be used to provide rapid, personalized oncology, in particular the molecular diagnosis of chronic myeloid leukemia, and gastric, colon, and breast cancers. Molecular tests based on DNA methylation can also be used to direct treatments or evaluate the toxic effects of chemotherapy. The adequate diagnosis, prognosis, and prediction of the response of cancer patients to treatment are essential to ensure the most effective therapy, reduce the damaging effects of treatment, and direct the therapy to specific targets, and in this context, molecular biology has become increasingly important in oncology. In this brief review, we will demonstrate the fundamental importance of molecular biology for the treatment of three types of cancer-chronic myeloid leukemia, hereditary diffuse gastric cancer, and astrocytomas (sporadic tumors of the central nervous system). In each of these three models, distinct biological mechanisms are involved in the transformation of the cells, but in all cases, molecular biology is fundamental to the development of personalized analyses for each patient and each type of neoplasia, and to guarantee the success of the treatment.


Asunto(s)
Biomarcadores de Tumor/genética , Neoplasias/tratamiento farmacológico , Metilación de ADN , Epigénesis Genética , Humanos , Terapia Molecular Dirigida , Mutación , Neoplasias/diagnóstico , Neoplasias/genética , Medicina de Precisión , Pronóstico
10.
Anticancer Res ; 38(11): 6317-6320, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-30396952

RESUMEN

BACKGROUND/AIM: The evolution of gastric carcinogenesis remains largely unknown, as the regulatory mechanisms involved in the aggressiveness of gastric cancer are still poorly understood. Kinases are downstream modulators and effectors of various cell signaling cascades and play key roles in the development of neoplastic diseases. The objective of this study was to evaluate the expression of genes and proteins of the SRC family, including FYN, YES, BLK, FGR, LYN and SRC, in a model of intestinal gastric carcinogenesis generated by treating Cebus apella, a New World non-human primate, with N-methyl nitrosourea (MNU). MATERIALS AND METHODS: mRNA expression of genes was measured by real-time reverse transcription quantitative PCR (RT-qPCR) and protein expression was measured by western blotting in six Cebus apella treated with N-methyl-nitrosourea (MNU) for about 2.5 years. RESULTS: Elevated mRNA and protein expression mainly of the SRC and LYN kinases was observed. Their expression was gradually increasing as non-atrophic gastritis was evolving to gastric cancer. CONCLUSION: SRC family kinases play a key role in tumor progression and metastasis and may be a promising target for the treatment of gastric cancer.


Asunto(s)
Metilnitrosourea/efectos adversos , Neoplasias Gástricas/metabolismo , Familia-src Quinasas/genética , Familia-src Quinasas/metabolismo , Animales , Cebus , Modelos Animales de Enfermedad , Progresión de la Enfermedad , Regulación Neoplásica de la Expresión Génica , Metástasis de la Neoplasia , Neoplasias Gástricas/inducido químicamente , Neoplasias Gástricas/genética , Regulación hacia Arriba
11.
Anticancer Res ; 38(4): 2149-2154, 2018 04.
Artículo en Inglés | MEDLINE | ID: mdl-29599333

RESUMEN

BACKGROUND/AIM: Individuals with type 2 Neurofibromatosis are predisposed for the appearance of schwannomas. In the present study we analyzed the loss of heterozygosity and mutations in the NF2 gene in patients with sporadic Schwannoma without Neurofibromatosis type 2. MATERIALS AND METHODS: We analyzed 39 patients with sporadic spinal schwannoma. We quantified the number of alleles by FISH and sequenced the NF2 gene. RESULTS: We identified 16/39 patients with point mutations and/or LOHs in the tumor samples analyzed. The LOHs were found in 7/39 patients. Two homozygous mutations were detected in 4/39 tumors, and the presence of the mutation in heterozygosis was revealed in 3/39 patients. In two tumors, we detected the loss of one allele of the NF2 gene, with no mutation. CONCLUSION: The genetic alterations observed in the NF2 gene indicated that spinal schwannomas are associated with genetic alterations also found in other schwannomas and type 2 Neurofibromatosis, which reinforces the etiological role of this gene.


Asunto(s)
Genes de la Neurofibromatosis 2 , Pérdida de Heterocigocidad , Neurilemoma/epidemiología , Neurilemoma/genética , Neoplasias de la Columna Vertebral/epidemiología , Neoplasias de la Columna Vertebral/genética , Adulto , Brasil/epidemiología , Femenino , Frecuencia de los Genes , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Neurofibromatosis 2/epidemiología , Neurofibromatosis 2/genética
12.
J. Health Biol. Sci. (Online) ; 10(1): 1-11, 01/jan./2022.
Artículo en Portugués | LILACS | ID: biblio-1411584

RESUMEN

Objetivos: Apresentar as características gerais da DH e os principais desafios encarados no cotidiano pelos portadores. Método: foi realizada uma revisão de literatura na qual foram considerados artigos científicos embasados em banco de dados (PubMed, Scielo, Lilacs e diretório Google Acadêmico), artigos entre anos de 2007 a 2022, publicados em todos os idiomas, e aplicados os seguintes descritores: Huntington's Disease Treatment; Genetics foram incluídos. Resultado: após a inclusão de 21 artigos utilizados, foi observado a significância de elevado índice mundial da DH, que acomete população em geral, porém há probabilidade que seja mais de herança paterna do que materna, devido à formação dos espermatozoides, principalmente quando se manifestam na fase juvenil de forma acelerada. Embora sejam desvendadas alternativas para terapia paliativa medicamentosa, há, também, a terapia física, o que auxilia a possibilidade de evolução na saúde desses indivíduos. Porém, prosseguem as pesquisas relacionadas às condutas melhores na qualidade de vida dessa população. Conclusão: Esta revisão evidencia a importância para doenças neurodegenerativas pouco vistas e comentadas, como a DH, mas que carece de esclarecimentos que auxiliem, com eficácia, tanto na recuperação, como no processo de habilidades da existência desses portadores com DH.


Objectives: to present the general characteristics of HD and the main challenges faced in daily life by patients. Method: a literature review was conducted in which scientific articles were considered based on databases (PubMed, Scielo, Lilacs, and Google Scholar directory), articles between 2007 and 2022, published in all languages, and the following descriptors were applied: Huntington's Disease Treatment; Genetics were included. Result: after the inclusion of 21 articles, it was observed the significance of the high worldwide HD index, which affects the general population, but there is a probability that it is more paternal than maternal inheritance due to sperm formation, especially when they manifest in the juvenile phase in an accelerated manner. Although alternatives for palliative drug therapy are unveiled, there is also physical therapy, which helps the possibility of evolution in the health of these individuals. However, the researches related to the best conducts in the quality of life of this population continue. Conclusion: this review highlights the importance of little-seen and commented neurodegenerative diseases, such as HD, but that lacks clarification that effectively assists, both in recovery and in the process of abilities of the existence of these patients with HD.


Asunto(s)
Humanos , Enfermedad de Huntington/fisiopatología , Calidad de Vida , Actividades Cotidianas/psicología , Enfermedad de Huntington/psicología
13.
Rev. epidemiol. controle infecç ; 11(1): 01-05, jan.-mar. 2021. ilus
Artículo en Inglés, Portugués | LILACS | ID: biblio-1361972

RESUMEN

Background and objectives: Infectious diseases are still a public health problem in Brazil. Therefore, this study aimed to determine the prevalence of infectious diseases in a reference hospital in the city of Belem, Para, Brazil. Methods: From May 2018 to August 2019, the number of cases of individuals with compulsory infections was observed. Results: Regarding the research period in which data were obtained from May 2018 to August 2019, a total of 263 cases were affected in the hospital and in 2019 there was an increase in the number of cases and 373 records were reported. The following results were obtained: in 2018, the highest rate of infection was caused by influenza at the rate of 17%, and in 2019 it remained at the same percentage rate and ranked secondly. Conclusion: These data are very important for the epidemiological knowledge of the population, elucidating the highest case rates and lowering other diseases related to this study, as well as their harms and treatment.(AU)


Justificativa e objetivos: As doenças infecciosas ainda são um problema de saúde pública no Brasil. Por isso, este estudo teve como objetivo determinar a prevalência de doenças infecciosas em um hospital de referência na cidade de Belém, Pará, Brasil. Métodos: Foi observado, no período de maio de 2018 a agosto de 2019, número de casos de indivíduos acometidos com infecções de caráter compulsório. Resultados: Em relação ao período da pesquisa, no qual foram obtidos os dados de maio de 2018 a agosto de 2019, os resultados apontam que, nos meses de maio a dezembro de 2018, foram acometidos 263 casos no hospital e, em 2019, houve o aumento do número de casos, sendo notificados 373 registros. Obtiveram-se os seguintes resultados: no ano de 2018, a maior taxa de infecção foi causada pela influenza, com a taxa de 17%; em 2019, se manteve com a mesma taxa de percentual, ficando em segundo lugar. Conclusão: Esses dados são de suma importância para o conhecimento epidemiológico da população, elucidando sobre os maiores índices de casos e o decréscimo de outras doenças relacionadas a este estudo, bem como seus agravos e tratamento.(AU)


Justificacción y objetivos: las enfermedades infecciosas si guen siendoun problema de salud pública en Brasil. Por lo tanto, este estudio tuvo como objetivo determinar la prevalencia de enfermedades infecciosas en un hospital de referencia en la ciudad de Belém, Pará, Brasil. Métodos: desde mayo de 2018 hasta agosto de 2019, se observó el número de casos de personas con infecciones obligatorias. Resultados: En cuanto al período de la encuesta en el que se obtuvieron datos de mayo de 2018 a agosto de 2019, los resultados indican que de mayo a diciembre de 2018, 263 casos fueron afectados en el hospital y en 2019 huboun aumento enel número de casos y se reportaron 373 registros. Se obtuvieron lo ssiguientes resultados: en 2018, la tasa más alta de infección fue causada por la influenza a una tasadel 17%, y en 2019 se mantuvoenlamismatasa porcentual y ocupó el segundo lugar. Seguido de tuberculosis, donde el 15% de los casos notificados se registraron en 2018. En comparación con 2019 (19%) hu boun aumento del 4% en el número de personas afectadas, ocupando el primer lugar enel ranking de enfermedades notificadas. Seguido por el virus del SIDA donde se registró el 8% de los casos registrados, en comparación con 2019 (6%) se observó hasta ahora una disminución del 2% en el número de casos. Conclusión: Estos datos son muy importantes para el conocimiento epidemiológico de la población, ya que dilucidan las tasas de casos más altas y disminuy en otras enfermedades relacionadas con este estudio, sus enfermedades y su tratamiento.(AU)


Asunto(s)
Humanos , Enfermedades Transmisibles/epidemiología , Hospitales Municipales , Salud Pública
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