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2.
Genet Test Mol Biomarkers ; 24(3): 150-155, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32119787

RESUMO

Purpose: The methylene tetrahydrofolate reductase (MTHFR) C677T, MTHFR A1298C, and the methionine synthase reductase (MTRR) A66G polymorphisms are the three most common folate metabolism-related loci in the Chinese population. They are associated with numerous birth defects or congenital diseases. To facilitate screening and genetic counseling, we established a method for the simultaneous detection of these three polymorphisms using the Luminex liquid suspension chip and multiple asymmetric polymerase chain reactions (PCRs). Materials and Methods: The three polymorphisms were amplified by multiplex PCR with biotinylated primers, followed by hybridization with six probe-linked magnetic microspheres. The mean fluorescent intensity value in each microsphere was detected by Luminex Magpix for polymorphism detection in 150 samples and confirmed by sequencing. Results: The consistency between the Luminex liquid suspension chip method and sequencing was 100%. Among the 150 randomized samples, the minor allele frequency (MAF) of MTHFR C677T was 0.41, which was the most common variant allele, followed by MTRR A66G (MAF = 0.24), and finally MTHFR A1298C (MAF = 0.19). Conclusion: The Luminex liquid suspension chip method can replace sequencing to analyze the MTHFR C677T, MTRR A1298C, and MTRR A66G loci simultaneously as a rapid, convenient, accurate, and stable method for large-scale testing.


Assuntos
Ferredoxina-NADP Redutase/genética , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Reação em Cadeia da Polimerase/métodos , Adulto , Alelos , Povo Asiático/genética , China , Primers do DNA/genética , Feminino , Ferredoxina-NADP Redutase/análise , Frequência do Gene/genética , Predisposição Genética para Doença/genética , Testes Genéticos/métodos , Genótipo , Humanos , Masculino , Metilenotetra-Hidrofolato Redutase (NADPH2)/análise , Polimorfismo de Nucleotídeo Único/genética
3.
Medicina (Kaunas) ; 56(2)2020 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-32079256

RESUMO

Background and objectives: Laryngeal squamous cell carcinoma (LSCC) is one of the most common head and neck tumors. The molecular mechanism of LSCC remains unclear. The aim of this study was to evaluate the prevalence of Human papillomavirus (HPV) and single nucleotide polymorphisms (SNPs) of TP53, MDM2, MDM4, MTHFR, CASP8, and CCR5 genes in LSCC, and to assess their correlations with patient survival. Materials and Methods: 49 LSCC patients were enrolled in this study. PCR and qRT-PCR were used to detect, identify, and quantify HPV. SNPs were genotyped using PCR and PCR-RFLP. Results: By analyzing the interactions of the SNPs of the genes with clinical parameters, the majority of patients with lymph node status (N1,2) were identified as carriers of MDM2 T/G, CASP8 ins/del, CCR5 wt/wt SNP. Cluster analysis showed that patients with MDM2 T/T SNP survive longer than patients identified as CASP8 ins/ins, MTHFR C/C, and MDM4 A/A variant carriers; meanwhile, LSCC patients with MDM2 T/T polymorphic variant had the best survival. Multivariate analysis showed that HPV-positive patients without metastasis in regional lymph nodes (N0) and harboring CASP8 ins/del variant had the best survival. Meanwhile, HPV-negative patients with identified metastasis in lymph nodes (N1 and N2) and CASP8 ins/del variant had poor survival. Conclusions: This finding suggests patients survival prognosis and tumor behavior are different according HPV status, SNP variants, and clinical characteristics of the LSCC.


Assuntos
Carcinoma de Células Escamosas/genética , Neoplasias Laríngeas/genética , Infecções por Papillomavirus/complicações , Adulto , Idoso , Caspase 8/análise , Proteínas de Ciclo Celular/análise , Feminino , Humanos , Neoplasias Laríngeas/patologia , Masculino , Metilenotetra-Hidrofolato Redutase (NADPH2)/análise , Pessoa de Meia-Idade , Infecções por Papillomavirus/genética , Polimorfismo de Nucleotídeo Único/genética , Prognóstico , Proteínas Proto-Oncogênicas/análise , Proteínas Proto-Oncogênicas c-mdm2/análise , Receptores CCR5/análise , Proteína Supressora de Tumor p53/análise
4.
Environ Health Perspect ; 127(8): 87002, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31393794

RESUMO

BACKGROUND: The sperm DNA methylation landscape is unique and critical for offspring health. If gamete-derived DNA methylation escapes reprograming in early embryos, epigenetic defects in sperm may be transmitted to the next generation. Current techniques to assess sperm DNA methylation show bias toward CpG-dense regions and do not target areas of dynamic methylation, those predicted to be environmentally sensitive and tunable regulatory elements. OBJECTIVES: Our goal was to assess variation in human sperm DNA methylation and design a targeted capture panel to interrogate the human sperm methylome. METHODS: To characterize variation in sperm DNA methylation, we performed whole genome bisulfite sequencing (WGBS) on an equimolar pool of sperm DNA from a wide cross section of 30 men varying in age, fertility status, methylenetetrahydrofolate reductase (MTHFR) genotype, and exposures. With our targeted capture panel, in individual samples, we examined the effect of MTHFR genotype ([Formula: see text] 677CC, [Formula: see text] 677TT), as well as high-dose folic acid supplementation ([Formula: see text], per genotype, before and after supplementation). RESULTS: Through WGBS we discovered nearly 1 million CpGs possessing intermediate methylation levels (20-80%), termed dynamic sperm CpGs. These dynamic CpGs, along with 2 million commonly assessed CpGs, were used to customize a capture panel for targeted interrogation of the human sperm methylome and test its ability to detect effects of altered folate metabolism. As compared with MTHFR 677CC men, those with the 677TT genotype (50% decreased MTHFR activity) had both hyper- and hypomethylation in their sperm. High-dose folic acid supplement treatment exacerbated hypomethylation in MTHFR 677TT men compared with 677CC. In both cases, [Formula: see text] of altered methylation was found in dynamic sperm CpGs, uniquely measured by our assay. DISCUSSION: Our sperm panel allowed the discovery of differential methylation following conditions affecting folate metabolism in novel dynamic sperm CpGs. Improved ability to examine variation in sperm DNA methylation can facilitate comprehensive studies of environment-epigenome interactions. https://doi.org/10.1289/EHP4812.


Assuntos
Metilação de DNA , Epigenoma , Ácido Fólico/metabolismo , Técnicas Genéticas/instrumentação , Metilenotetra-Hidrofolato Redutase (NADPH2)/análise , Espermatozoides/química , Adulto , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade
5.
Amino Acids ; 51(2): 193-204, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30264170

RESUMO

This study aimed to assess the effect of rehydration during and after acute aerobic submaximal exercise on total homocysteine (tHcy) concentrations and related parameters in physically active adult males. Twenty trained males (29.4 ± 7.9 years old) completed four exercise tests: two without rehydration during exercise (NH1 and NH2), one with rehydration during exercise using water (H1) and one with rehydration during exercise using an isotonic sports drink (H2). After finishing the exercise tests, subjects followed a rehydration protocol for 2 h. Serum tHcy, vitamin B12, folate, creatine and creatinine were analysed before, after and at 2, 6 and 24 h after exercise. Data were analysed with and without correcting for haemoconcentration to assess the changes in tHcy related. The methylenetetrahydrofolate reductase (MTHFR) 677TT genotype was also analysed. THcy (uncorrected by haemoconcentration) increased significantly after exercise (P < 0.05) in the NH1 and NH2 tests [mean increase ± SD: 1.55 ± 0.33 (15.18%) and 1.76 ± 0.25 (17.69%) µmol/L, respectively], while no significant differences were found in the H1 and H2 tests [mean increase: 0.65 (6.29%) and 0.90 (8.69%) µmol/L, respectively]. The increase was partly due to haemoconcentration and partly due to the metabolism underlying acute exercise. THcy concentrations recovered to baseline after 24 h in all tests. In conclusion, adequate rehydration during acute aerobic exercise using either water or a sports drink maintains tHcy concentrations at baseline and for up to 2 h after exercise in physically active male adults and prevents further increases when compared to no rehydration.


Assuntos
Água Potável , Exercício Físico/fisiologia , Hidratação , Homocisteína/sangue , Hiper-Homocisteinemia/prevenção & controle , Adulto , Creatina/sangue , Creatinina/sangue , Estudos Cross-Over , Ácido Fólico/sangue , Humanos , Soluções Isotônicas , Masculino , Metilenotetra-Hidrofolato Redutase (NADPH2)/análise , Vitamina B 12/sangue , Adulto Jovem
6.
Medicine (Baltimore) ; 97(50): e13332, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30557982

RESUMO

Methylenetetrahydrofolate reductase (MTHFR) catalyzes conversion of methylene tetrahydrofolate to methylte trahydrofolate. MTHFR C677T polymorphism has been regarded as a risk factor for various vascular diseases. Our study aimed to investigate the distribution frequencies of this polymorphism among Hakka population living in southern China. We retrospectively recruited 5102 unrelated Chinese Hakka subjects. MTHFR C677T polymorphism was tested using the polymerase chain reaction (PCR) and DNA sequencing. A total of 2358 males and 2744 females (aged from 10 years to 101 years) were included in this study. In total, 2835 (55.63%) subjects were homozygous for the C allele (CC), 1939 (38.00%) subjects were heterozygous (CT), and 325 (6.37%) subjects were homozygous for the T allele (TT). The allelic frequency of mutant T was 25.37% with 325 individual homozygous for this defective allele resulting in a frequency of about 6.37% for the TT genotype. According to the study results, the overall frequency of MTHFR C677T genotypes did not differ significantly among the gender and age groups. Our study showed the prevalence of MTHFR C677T polymorphism in a large ethnic Hakka population living in southern China. It would be important implications for the primary prevention of various vascular diseases.


Assuntos
Metilenotetra-Hidrofolato Redutase (NADPH2)/análise , Polimorfismo Genético/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , China , Feminino , Humanos , Masculino , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase/métodos , Estudos Retrospectivos , Fatores de Risco
7.
Per Med ; 14(3): 197-201, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-29767581

RESUMO

Some articles have reported severe toxicities induced by cisplatin/5-fluorouracil regimens, nevertheless, severe and lethal liver toxicity has not been previously reported. In this article, we report the case of a 72-year-old woman, who developed fulminant hepatitis, hypoglycemia and hypotension with atrial fibrillation not responding to treatment. After ruling out all other possible causes of hepatitis, the toxicity was more likely attributed to 5-fluorouracil. Genotyping was performed and the patient was found to be a homozygote carrier of the T variant of the MTHFR gene. The patient died two days later. Several factors, including genetic factors, could explain this severe toxicity. The present case discusses the importance of personalized medicine in oncology based on pharmacogenetic analysis of polymorphisms.


Assuntos
Cisplatino/toxicidade , Fluoruracila/toxicidade , Falência Hepática Aguda/induzido quimicamente , Idoso , Doença Hepática Induzida por Substâncias e Drogas/tratamento farmacológico , Cisplatino/efeitos adversos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/tratamento farmacológico , Feminino , Fluoruracila/efeitos adversos , Humanos , Metilenotetra-Hidrofolato Redutase (NADPH2)/análise , Metilenotetra-Hidrofolato Redutase (NADPH2)/sangue , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Farmacogenética , Testes Farmacogenômicos
8.
Gynecol Obstet Invest ; 78(4): 259-65, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25277375

RESUMO

BACKGROUND: Normal fetal development requires adequate folate levels during pregnancy. Although folate metabolic enzymes have important roles in the maintenance of normal fetal development, the location of folate metabolic enzymes, methionine synthase (MTR) and 5,10-methylenetetrahydrofolate reductase (MTHFR), has not been previously examined. METHODS: We investigated the expression of MTR and MTHFR in human term placenta obtained from normal and pregnancy-induced hypertension (PIH) patients. RESULTS: MTR is expressed in the villous syncytiotrophoblast and MTHFR is expressed in the extravillous trophoblast. There was no difference in the quantity and location of these enzymes between control and PIH patients. CONCLUSION: These results suggest that MTR in the villous trophoblast participates in the metabolism of homocysteine by using folate, and MTHFR in the extravillous trophoblast is associated with extratrophoblast invasion.


Assuntos
5-Metiltetra-Hidrofolato-Homocisteína S-Metiltransferase/análise , Hipertensão Induzida pela Gravidez/enzimologia , Metilenotetra-Hidrofolato Redutase (NADPH2)/análise , Placenta/enzimologia , 5-Metiltetra-Hidrofolato-Homocisteína S-Metiltransferase/genética , 5-Metiltetra-Hidrofolato-Homocisteína S-Metiltransferase/metabolismo , Western Blotting , Feminino , Ácido Fólico/metabolismo , Idade Gestacional , Homocisteína/metabolismo , Humanos , Imuno-Histoquímica , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Gravidez , RNA Mensageiro/análise , Trofoblastos/enzimologia , Trofoblastos/fisiologia
9.
Genet Test Mol Biomarkers ; 18(3): 183-6, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24401045

RESUMO

AIMS: To compare the performance of two assays used for the detection of mutations/polymorphisms in the Factor V, Factor II, and methylenetetrahydrofolate reductase genes among patients referred for the management of a thrombotic event. MATERIALS AND METHODS: We tested 40 different patient samples using two assays, the ViennaLab FV-PTH-MTHFR StripAssay and the Cepheid Xpert HemosIL. RESULTS: The two assays were 100% concordant in their produced results with no samples failing the testing procedures in both. CONCLUSION: This is the first report to evaluate the performance of the ViennaLab FV-PTH-MTHFR StripAssay and the Cepheid Xpert HemosIL. Both assays can be introduced to the operation of molecular diagnostic laboratories to cover the referrals from different disciplines, especially in tertiary care centers with emergency departments.


Assuntos
Análise Mutacional de DNA/métodos , Fator V/genética , Perfilação da Expressão Gênica/métodos , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Protrombina/genética , Kit de Reagentes para Diagnóstico , Trombofilia/diagnóstico , Fator V/análise , Técnicas de Genotipagem/métodos , Humanos , Metilenotetra-Hidrofolato Redutase (NADPH2)/análise , Técnicas de Diagnóstico Molecular/métodos , Polimorfismo Genético , Protrombina/análise , Fitas Reagentes , Trombofilia/genética
11.
Exp Gerontol ; 44(1-2): 10-9, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-18675334

RESUMO

Endocrine mutant mice have proven invaluable toward the quest to uncover mechanisms underlying longevity. Growth hormone (GH) and insulin-like growth factor (IGF) have been shown to be key players in physiological systems that contribute to aging processes including glucose metabolism, body composition and cellular protection. Examination of these mutant mice across several laboratories has revealed that differences exist in both the direction and magnitude of change, differences that may result in variation in life span. Growth hormone receptor knockout mice lack a functional GH receptor, therefore GH signaling is absent. These mice have been shown to lack the heightened oxidative defense mechanisms observed in other GH mutants yet live significantly longer than wild type mice. In this study, glutathione (GSH) and methionine (MET) metabolism was examined to determine the extent of variation in this mutant in comparison to the Ames dwarf, a mouse that exhibits delayed aging and life span extension of nearly 70%. Components of GSH and MET were altered in GHR KO compared to wild type controls. The results of these experiments suggest that these pathways may be partially responsible for differences observed in stress resistance and the capacity to respond to stressors, that in the long term, affect health and life span.


Assuntos
Envelhecimento/fisiologia , Receptores da Somatotropina/genética , Transdução de Sinais/fisiologia , Animais , Biomarcadores/análise , Química Encefálica , Cistationina gama-Liase/análise , Cistationina gama-Liase/metabolismo , Feminino , Expressão Gênica , Glutationa/análise , Glutationa/metabolismo , Dissulfeto de Glutationa/análise , Dissulfeto de Glutationa/metabolismo , Glutationa Transferase/análise , Glutationa Transferase/metabolismo , Rim/química , Rim/metabolismo , Fígado/química , Fígado/metabolismo , Masculino , Metionina/análise , Metionina/metabolismo , Metilenotetra-Hidrofolato Redutase (NADPH2)/análise , Metilenotetra-Hidrofolato Redutase (NADPH2)/metabolismo , Camundongos , Camundongos Knockout , Modelos Animais , Músculo Esquelético/química , Músculo Esquelético/metabolismo , Miocárdio/química , Miocárdio/metabolismo , Estresse Oxidativo , Receptores da Somatotropina/deficiência
12.
Exp Mol Pathol ; 83(1): 1-3, 2007 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-17275807

RESUMO

Single-nucleotide polymorphisms in the genes that code for coagulation factors V (factor V Leiden) and II (prothrombin, G20210A), as well as the methylenetetrahydrofolate reductase (MTHFR, C677T) gene, have been implicated in the majority of cases of hereditary thrombophilia. We have developed a multiplex PCR-RFLP assay based on MnlI endonuclease digestion for the simultaneous detection of mutations in the FV, FII, and MTHFR genes. Digested amplification products were analyzed by gel electrophoresis in a single gel lane and visualized by ethidium bromide. This approach is a rapid and convenient method, hence economic, that alternate to others described for the detection of FVL, G20210A and C677T mutations.


Assuntos
Primers do DNA/genética , Fator V/análise , Metilenotetra-Hidrofolato Redutase (NADPH2)/análise , Reação em Cadeia da Polimerase/métodos , Polimorfismo de Fragmento de Restrição , Protrombina/análise , Alelos , Citosina/metabolismo , Fator V/genética , Guanina/metabolismo , Humanos , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Mutação/genética , Protrombina/genética
13.
Mol Cell Biochem ; 294(1-2): 181-7, 2007 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-16855792

RESUMO

DNA methylation is an important epigenetic mechanism of transcriptional control, which plays an essential role in maintaining cellular function. Role of one-carbon transfer agents/methyl donors namely folate, choline and methionine in DNA methylation has been the subject of extensive investigation. The methylation pattern of DNA is established during embryogenesis by DNA methyltransferase 3 (dnmt3) and is subsequently maintained by maintenance methylation activity of the enzyme DNA methyltransferase 1 (dnmt1). Ionizing radiation is known to extensively damage the DNA. Sufficient dietary availability of methyl donors is known to contribute towards one-carbon transfer mediated repair of damaged DNA where folate is involved in nucleotide base synthesis. In the present study, modification in activities of dnmt1 and dnmt3 by methyl donor starvation followed by gamma-irradiation was observed. Assays were based on the catalytic transfer of (3)H-methyl groups from S-adenosyl-L: -methionine to a DNA substrate. Experiments showed a dose and methyl donors starvation dependent attenuation in dnmt1 activity. Attenuation of dnmt1 activity was most significant for diet deprived of all the three-methyl donors. No significant change in nuclear or cytoplasmic dnmt3 activity was observed when either or all the three possible source of dietary methyl group supply were removed. Ionizing radiation and methyl donor deficiency were observed to act synergistically towards inhibiting dnmt1 activity. Present results suggested possibility of interaction among folate, methionine and choline deficiency to potentiate symptoms of ionizing radiation stress. These enzymatic modifications might contribute to altered DNA methylation after chronic feeding of methyl donor free diets followed by gamma irradiation. These results suggested that dietary availability of methyl donors and gamma-radiation stress might significantly alter the dnmt1 profile.


Assuntos
DNA (Citosina-5-)-Metiltransferases/metabolismo , Dano ao DNA , Raios gama , Animais , Núcleo Celular/metabolismo , Colina/metabolismo , Ensaio Cometa , Citoplasma/metabolismo , Metilação de DNA , Reparo do DNA , Relação Dose-Resposta à Radiação , Ácido Fólico/metabolismo , Masculino , Metionina/metabolismo , Metilenotetra-Hidrofolato Redutase (NADPH2)/análise , Metilenotetra-Hidrofolato Redutase (NADPH2)/metabolismo , Camundongos , S-Adenosilmetionina/metabolismo
14.
Gynecol Obstet Invest ; 62(1): 28-32, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16514238

RESUMO

BACKGROUND: Thrombosis in placenta may lead to severe pregnancy complications. Most important inherited thrombophilias are factor V Leiden mutation, prothrombin mutation, and methylenetetrahydrofolate reductase mutation. The aim of our research was to evaluate the prevalence of inherited thrombophilias in severe pregnancy complications and in normal pregnancies. MATERIAL AND METHODS: The study subjects with severe preeclampsia, intrauterine growth restriction, placental abruption or fetal death were collected during the period 1999-2004 from Oulu University Hospital. We also collected during the same period voluntary parturients with normal pregnancy outcome as the control group. FVL, FII, and MTHFR gene mutations of the patients and controls were analyzed. RESULTS: We found a significant difference in the prevalence of FVL mutation between the groups. There were 9.5% FVL mutations in the study group compared to 1.8% in the control group; the observed difference between prevalences was 7.7% (95% CI 2.0-13.4). No statistical difference was found in the FII or MTHFR mutations between the groups. All FV and FII mutations were heterozygous and all the MTHFR mutations homozygous. CONCLUSION: Women with thrombophilia have a risk for severe pregnancy complications. Randomized controlled trials are needed to assess the influence of low-molecular-weight heparin in pregnant women with thrombophilia.


Assuntos
Fator V/genética , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Mutação , Complicações Hematológicas na Gravidez/etiologia , Protrombina/genética , Estudos de Casos e Controles , Fator V/análise , Feminino , Finlândia/epidemiologia , Heterozigoto , Homozigoto , Humanos , Metilenotetra-Hidrofolato Redutase (NADPH2)/análise , Pré-Eclâmpsia , Gravidez , Complicações Hematológicas na Gravidez/genética , Complicações Hematológicas na Gravidez/patologia , Complicações Hematológicas na Gravidez/fisiopatologia , Prevalência , Protrombina/análise , Estudos Retrospectivos , Índice de Gravidade de Doença
15.
Pediatr Hematol Oncol ; 20(3): 219-27, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-12637218

RESUMO

Thrombophilic risk factors are associated with thromboembolism in children but data in infants and neonates are not well established. The authors report a series of 9 infants with thrombotic events and the associated genetic risk factors. The clinical and laboratory records of newborns and infants with a history of thrombotic events were summarized, while patients with underlying diseases were excluded. The frequency of the genetic mutations was compared to a control group of 80 children from the same ethnic origin. In 6 patients a cerebrovascular accident was diagnosed and in 3 newborns, CT scan could diagnose antenatal brain infarct. In another 2 patients deep-vein thrombosis associated with femoral catheterization was diagnosed. Seven infants were factor V Leiden heterozygous and another one homozygous. Methylenetetrahydrofolate reductase genotype was found in 5 infants. Five cases were found to be double heterozygous for those two mutations, and another one double heterozygous for FVL and factor II. The results of this small series of patients indicate that cerebrovascular accident is the major thrombotic event in infants and the combination of more than one prothrombotic factors may be the cause of those events. The correct management, including anticoagulant therapy, is still under discussion and waiting for larger series and long-term follow-up results until accurate recommendations can be made.


Assuntos
Fator V/genética , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Protrombina/genética , Trombofilia/genética , Fator V/análise , Feminino , Seguimentos , Genótipo , Heterozigoto , Homozigoto , Humanos , Lactente , Recém-Nascido , Masculino , Metilenotetra-Hidrofolato Redutase (NADPH2)/análise , Mutação , Protrombina/análise , Fatores de Risco , Tromboembolia/sangue , Tromboembolia/diagnóstico , Trombofilia/sangue , Trombofilia/epidemiologia
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