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1.
J Am Dent Assoc ; 153(8): 761-768.e3, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35367048

RESUMO

BACKGROUND: The purpose of this study was to determine how often dental patients request extraction for nondental reasons and how dentists handle such requests. METHODS: The authors conducted a survey among 800 Dutch dentists from November 17, 2019, through January 5, 2020. The questionnaire contained 17 items, including a hypothetical case vingette. RESULTS: A total of 242 dentists responded to the survey (response rate was 30.3%, 48.3% of respondents were women, and mean [standard deviation] age was 45.3 [11.8] years). Sixty-eight percent of respondents reported that they had been confronted with a request for extraction on nondental grounds in the past 3 years. One-half of these dentists received such a request 5 times or fewer, 21.3% received such a request 6 through 10 times, 11.3% received such a request 11 through 20 times, and 8.8% received such a request 21 through 30 times. Their most recent request concerned a financial reason (49.7%), a combination of psychological and financial reasons (27.7%), a psychological reason (18.2%), or another reason (4.4%). Most dentists (87.5%) evaluated the patient's competency to make health care decisions. Of all nondental extraction requests, 75.6% (n = 114) were granted. Only 4.0% (n = 6) of the dentists regretted the extraction. Most dentists (82.0%, n = 191) would have refused the extraction in the hypothetical case vignette. CONCLUSIONS: Nondental requests for extraction are relatively common. Although dentists are reluctant in theory, they are likely to grant such requests in everyday practice, particularly if the patient cannot afford an indicated conservative treatment. PRACTICAL IMPLICATIONS: Dentists should keep in mind that they cannot ethically or legally be required to perform an intervention deemed harmful, even if an autonomous patient made the request.


Assuntos
Extração Dentária , Beneficência , Modificação Corporal não Terapêutica , Criança , Feminino , Humanos , Masculino , Autonomia Pessoal , Inquéritos e Questionários , Extração Dentária/economia , Extração Dentária/psicologia
3.
Afr Health Sci ; 18(2): 359-368, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30602963

RESUMO

BACKGROUND: The term Infant Oral Mutilation (IOM) refers to the aggressive cultural rituals where primary canine tooth germs of infants are enucleated for therapeutic reasons. OBJECTIVES: To determine the prevalence and risk factors for IOM among inner city pre-school children in Khartoum. METHODS: In this cross-sectional study, 212 randomly selected children from twelve government pre-schools in Khartoum were examined for the presence of IOM. Socio-demographic, feeding and teething-related data were collected by self-administered questionnaires. RESULTS: The mean age of the sample was 4.7 years. The prevalence of clinical IOM was 10.8%. Multivariable regression analysis revealed that children who suffered from diarrhea during teething were 7.15 times more likely to have clinical IOM over their counterparts (p<0.0001). Mothers who were educated below elementary school level were 2.69 times more likely to have children showing clinical IOM (p= 0.0369). CONCLUSION: The present study showed that the practice of IOM is common among inner city children. Certain teething-related symptoms especially diarrhea and maternal education could be strong determinants of the malpractice of IOM.


Assuntos
Modificação Corporal não Terapêutica , Dente Canino/cirurgia , Extração Dentária/estatística & dados numéricos , Germe de Dente/cirurgia , Dente Decíduo/cirurgia , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Medicinas Tradicionais Africanas , Prevalência , Fatores Socioeconômicos , Sudão/epidemiologia , Extração Dentária/efeitos adversos
4.
Rev Gaucha Enferm ; 38(4): e2016-3, 2017.
Artigo em Inglês, Português | MEDLINE | ID: mdl-29791534

RESUMO

OBJECTIVE To evaluate the knowledge and biosafety practices adopted by professionals of the beauty segment. METHODS Descriptive study, of survey type. 238 professionals of the beauty segment were interviewed between August 2014 and 2015. The variables were expressed by means of absolute and relative frequencies, as well as average and standard deviation. RESULTS 62.6% of the interviwed professionals reported having had contact with blood from customers when they were not wearing gloves; 74.4% said they washed their hands before and after each service, and only 16.8% of the respondents reported reusing nonsterilizable materials. None of them was able to inform the correct number of sets of tools needed , and 32.8% of the respondents did not use Personal Protective Equipment during their work activities. CONCLUSIONS The most frequently reported diseases associated with the risk of infection and transmission in the work activities were viral hepatitis, HIV and fungi. Regarding the biosafety procedures adopted, autoclave is the least used method for sterilizing devices.


Assuntos
Indústria da Beleza , Modificação Corporal não Terapêutica , Contenção de Riscos Biológicos , Conhecimentos, Atitudes e Prática em Saúde , Controle de Infecções , Saúde Ocupacional , Adulto , Indústria da Beleza/instrumentação , Indústria da Beleza/métodos , Líquidos Corporais , Brasil , Doenças Transmissíveis/transmissão , Desinfecção/métodos , Equipamentos Descartáveis/estatística & dados numéricos , Contaminação de Equipamentos/prevenção & controle , Feminino , Luvas Protetoras/estatística & dados numéricos , Higiene das Mãos/estatística & dados numéricos , Humanos , Controle de Infecções/métodos , Controle de Infecções/estatística & dados numéricos , Masculino , Doenças Profissionais/prevenção & controle , Utilização de Procedimentos e Técnicas , Fatores Socioeconômicos , Esterilização/instrumentação , Esterilização/métodos , Inquéritos e Questionários
5.
Rev. gaúch. enferm ; 38(4): e2016-3, 2017. tab, graf
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-901686

RESUMO

Resumo OBJETIVO Avaliar o conhecimento e as práticas de biossegurança adotadas por profissionais do segmento da beleza. MÉTODOS Pesquisa descritiva do tipo survey. Foram entrevistados 238 profissionais de serviços de embelezamento entre agosto de 2014 e 2015. As variáveis foram apresentadas por meio de frequências absolutas e relativas, bem como média e desvio padrão. RESULTADOS 62,6% dos profissionais tiveram contato com sangue de clientes sem uso de luvas; instrumentais para o atendimento e 32,8% dos entrevistados não utilizaram equipamentos de proteção individual durante suas atividades laborais. CONCLUSÕES As doenças mais citadas quanto ao risco de contágio e de transmissão na prática laboral foram as hepatites virais, HIV e fungos. Quanto aos procedimentos de biossegurança adotados, o autoclave é o equipamento menos usado na esterilização dos instrumentos.


Resumen OBJETIVO Evaluar el conocimiento y las prácticas de bioseguridad adoptadas por profesionales del segmento del embellecimiento. MÉTODOS Evaluar el conocimiento y las prácticas de bioseguridad adoptadas por profesionales del segmento del embellecimiento. RESULTADOS: 62,6% de los profesionales tuvieron contacto con sangre de clientes sin el uso de guantes; el 74,4% higienizaban las manos entre los atendimientos, el 16,8% reutilizaban materiales desechables. Ningún profesional informó la cantidad adecuada de instrumentos y el 32,8% de los entrevistados no utilizaban equipos de protección individual durante sus actividades laborales. CONCLUSIONES Las enfermedades más citadas con respecto al riesgo de contagio y de transmisión en la práctica laboral fueron las hepatitis virales, el VIH y los hongos. Acerca de los procedimientos de bioseguridad adoptados, el autoclave fue el aparato menos utilizado en la esterilización de los instrumentos.


Abstract OBJECTIVE To evaluate the knowledge and biosafety practices adopted by professionals of the beauty segment. METHODS Descriptive study, of survey type. 238 professionals of the beauty segment were interviewed between August 2014 and 2015. The variables were expressed by means of absolute and relative frequencies, as well as average and standard deviation. RESULTS 62.6% of the interviwed professionals reported having had contact with blood from customers when they were not wearing gloves; 74.4% said they washed their hands before and after each service, and only 16.8% of the respondents reported reusing nonsterilizable materials. None of them was able to inform the correct number of sets of tools needed , and 32.8% of the respondents did not use Personal Protective Equipment during their work activities. CONCLUSIONS The most frequently reported diseases associated with the risk of infection and transmission in the work activities were viral hepatitis, HIV and fungi. Regarding the biosafety procedures adopted, autoclave is the least used method for sterilizing devices. Keywords: Beauty and aesthetics centers. Exposure to biological agents. Prevention of diseases.


Assuntos
Humanos , Masculino , Feminino , Adulto , Conhecimentos, Atitudes e Prática em Saúde , Saúde Ocupacional , Contenção de Riscos Biológicos , Modificação Corporal não Terapêutica , Fatores Socioeconômicos , Indústria da Beleza/instrumentação , Indústria da Beleza/métodos , Líquidos Corporais , Brasil , Esterilização/instrumentação , Esterilização/métodos , Desinfecção/métodos , Contaminação de Equipamentos/prevenção & controle , Inquéritos e Questionários , Controle de Infecções/métodos , Controle de Infecções/estatística & dados numéricos , Luvas Protetoras/estatística & dados numéricos , Equipamentos Descartáveis/estatística & dados numéricos , Higiene das Mãos/estatística & dados numéricos , Doenças Profissionais/prevenção & controle
6.
Hum Nat ; 27(4): 501-532, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27778301

RESUMO

The incorporation of niche construction theory (NCT) and epigenetics into an extended evolutionary synthesis (EES) increases the explanatory power of evolutionary analyses of human history. NCT allows identification of distinct social inheritance and cultural inheritance and can thereby account for how an existing-but-dynamic social system yields variable influences across individuals and also how these individuals' microlevel actions can feed back to alter the dynamic heterogeneously across time and space. An analysis of Chinese footbinding, as it was ending during the first half of the twentieth century and China was industrializing, illustrates the evolutionary dynamics of niche construction across inheritance tracks and explains regional heterogeneity as well as the persistence of a cultural belief that was socially inaccurate. Incorporating anthropological and sociological insights into an EES with NCT has the potential to proffer source laws for relationships between individual actions and macro-patterns in beliefs, structures, climate, and demography.


Assuntos
Modificação Corporal não Terapêutica , Características Culturais , Evolução Cultural , Desenvolvimento Industrial , Mulheres , China/etnologia , Humanos
8.
Reprod Health ; 11: 46, 2014 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-24952584

RESUMO

BACKGROUND: Every social grouping in the world has its own cultural practices and beliefs which guide its members on how they should live or behave. Harmful traditional practices that affect children are Female genital mutilation, Milk teeth extraction, Food taboo, Uvula cutting, keeping babies out of exposure to sun, and Feeding fresh butter to new born babies. The objective of this study was to assess factors associated with harmful traditional practices among children less than 5 years of age in Axum town, North Ethiopia. METHODS: Community based cross sectional study was conducted in 752 participants who were selected using multi stage sampling; Simple random sampling method was used to select ketenas from all kebelles of Axum town. After proportional allocation of sample size, systematic random sampling method was used to get the study participants. Data was collected using interviewer administered Tigrigna version questionnaire, it was entered and analyzed using SPSS version 16. Descriptive statistics was calculated and logistic regressions were used to analyze the data. RESULTS: Out of the total sample size 50.7% children were females, the mean age of children was 26.28 months and majority of mothers had no formal education. About 87.8% mothers had performed at least one traditional practice to their children; uvula cutting was practiced on 86.9% children followed by milk teeth extraction 12.5% and eye borrows incision 2.4% children. Fear of swelling, pus and rapture of the uvula was the main reason to perform uvula cutting. CONCLUSION: The factors associated with harmful traditional practices were educational status, occupation, religion of mothers and harmful traditional practices performed on the mothers.


Assuntos
Modificação Corporal não Terapêutica , Adulto , Criança , Circuncisão Feminina , Estudos Transversais , Escolaridade , Etiópia , Feminino , Humanos , Modelos Logísticos , Masculino , Mães , Religião , Fatores Socioeconômicos
9.
Ann Dermatol Venereol ; 141(2): 122-9, 2014 Feb.
Artigo em Francês | MEDLINE | ID: mdl-24507206

RESUMO

The adult film industry nowadays represents a legal multi-billion dollar business. The main health risks of adult performers are well known. They mainly include the transmission of sexually transmitted diseases such as HIV, hepatitis, gonorrhoea, Chlamydia, herpes and papillomavirus. However, despite regular follow-up, the frequency of STD remains significant in this high-risk population since a large part of the industry continues to reject systematic use of condoms. Besides, performers are also exposed to other physical and mental health issues often not known to the public. This article provides a comprehensive review of what is known about STD and other risks among the community of performers in the adult film industry.


Assuntos
Literatura Erótica , Filmes Cinematográficos , Doenças Profissionais/epidemiologia , Infecções Sexualmente Transmissíveis/epidemiologia , Adulto , Modificação Corporal não Terapêutica , Brasil , Preservativos/economia , Preservativos/estatística & dados numéricos , Literatura Erótica/legislação & jurisprudência , Feminino , Seguimentos , Promoção da Saúde , Humanos , Internet , Masculino , Programas de Rastreamento , Transtornos Mentais/epidemiologia , Transtornos Mentais/etiologia , Filmes Cinematográficos/economia , Filmes Cinematográficos/legislação & jurisprudência , Doenças Profissionais/etiologia , Doenças Profissionais/prevenção & controle , Doenças Profissionais/psicologia , Distância Psicológica , Risco , Salários e Benefícios , Comportamento Sexual , Infecções Sexualmente Transmissíveis/prevenção & controle , Estados Unidos/epidemiologia , Sexo sem Proteção
10.
J Environ Health ; 76(3): 52-7, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24288852

RESUMO

The NEHA Government Affairs program has a long and productive association with the National Conference of State Legislatures (NCSL). The organizations have worked together on any number of legislative and policy areas that directly impact the environmental health profession. One of the keys to the successes of the NEHA/NCSL collaboration has been the recognition of the fact that often some of the most significant legislation and policy initiatives related to environmental public health occur in state legislatures. The states have, in a very real sense, been the innovators in developing new programs and practices. In recognition of this fact, we have asked NCSL to provide occasional overviews of state environmental public health legislative activity, covering topics that are of the most pressing public concern. Doug Farquhar, program director for NCSI's Environmental Health Program, has worked with NCSL since 1990. Mr. Farquhar directs development, management, and research for the Environmental Health Program. These projects encompass consultation and policy analysis of state and federal policies and statutes, regulations, and programs regarding environmental and related topics for state legislatures and administrative programs. Amy Ellis is a law clerk for NCSL within the Environment, Energy, and Transportation Group. As a law clerk she has researched a wide variety of environmental health policies. She is expected to obtain her JD from the University of Colorado Law School in 2015.


Assuntos
Exposição Ambiental/legislação & jurisprudência , Saúde Ambiental/legislação & jurisprudência , Política de Saúde/legislação & jurisprudência , Serviços de Saúde Escolar/legislação & jurisprudência , Poluição do Ar em Ambientes Fechados/legislação & jurisprudência , Poluição do Ar em Ambientes Fechados/prevenção & controle , Amianto , Asma/tratamento farmacológico , Asma/prevenção & controle , Modificação Corporal não Terapêutica/legislação & jurisprudência , Água Potável/normas , Exposição Ambiental/prevenção & controle , Saúde Ambiental/organização & administração , Monitoramento Ambiental/legislação & jurisprudência , Epinefrina/uso terapêutico , Inocuidade dos Alimentos , Substâncias Perigosas/normas , Humanos , Governo Estadual , Piscinas/legislação & jurisprudência , Estados Unidos
11.
Body Image ; 10(2): 226-31, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23394967

RESUMO

The purpose of this paper was to describe pubic hair grooming behaviors (shaving, waxing, trimming or dyeing) and the extent to which grooming was related to demographic characteristics and sexual history among low-income Hispanic, Black, and White women. Data were collected from 1677 women aged 16-40 years between July 2010 and August 2011 as part of a larger study. Participants completed a cross-sectional written survey. Multivariable analyses were used to identify correlates of pubic hair grooming. Being a current groomer was associated with being White, a younger age, under or normal weight, having a yearly household income >$30,000, and having 5 or more lifetime sexual partners. Overall, we discovered pubic hair grooming was extremely common among women of varying demographics. It is important for health and research professionals to understand pubic hair grooming practices so they can address behavioral and clinical concerns.


Assuntos
Negro ou Afro-Americano/estatística & dados numéricos , Modificação Corporal não Terapêutica/estatística & dados numéricos , Hispânico ou Latino/estatística & dados numéricos , Pobreza/estatística & dados numéricos , Vulva , População Branca/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Análise de Variância , Imagem Corporal , Peso Corporal , Estudos Transversais , Feminino , Remoção de Cabelo/métodos , Remoção de Cabelo/estatística & dados numéricos , Humanos , Prevalência , Autoimagem , Comportamento Sexual/estatística & dados numéricos , Fatores Socioeconômicos , Estados Unidos , Adulto Jovem
12.
Med Health Care Philos ; 15(1): 31-40, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21132536

RESUMO

Gender Identity Disorder (GID) is regarded as a mental illness and included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). It will also appear in the DSM-V, due to be published in 2013. The classification of GID as a mental illness is contentious. But what would happen to sufferers if it were removed from the diagnostic manuals? Would people lose their entitlement to funded medical care, or to reimbursement under insurance schemes? On what basis should medical treatment for GID be provided? What are the moral arguments for and against funded or reimbursed medical care for GID? This paper starts out with a fiction: GID is removed from the diagnostic manuals. Then the paper splits in two, as in happened in the Howitt's 1998 film Sliding Doors. The two scenarios run parallel. In one, it is argued that GID is on a par with other body modifications, such as cosmetic and racial surgery, and that, for ethical reasons, treatment for GID should be privately negotiated by applicants and professionals and privately paid for. In the other scenario, it is argued that the comparison between GID and other body modifications is misleading. Whether or not medical treatment should be funded or reimbursed is independent of whether GID is on a par with other forms of body dissatisfaction.


Assuntos
Modificação Corporal não Terapêutica/ética , Identidade de Gênero , Cirurgia de Readequação Sexual/ética , Modificação Corporal não Terapêutica/economia , Feminino , Financiamento Governamental/ética , Financiamento Pessoal/ética , Humanos , Masculino , Cirurgia de Readequação Sexual/economia
14.
Rio de Janeiro; s.n; 2011. 147 p. ilus.
Tese em Português | LILACS | ID: lil-616508

RESUMO

O objeto desta disertação é explorar os discursos militantes relativos à diferenciação entre identidades coletivas de travestis e transexuais no âmbito do movimento de travestis e transexuais brasileiro e sua repercussão nas demandas e proposições de políticas públicas de saúde, mais especificamente no que tange às transformações corporais. Realizei entrevistas semi-estruturadas com ativistas reconhecidas como lideranças desse movimento, tendo como principais eixos: trajetória militante, diferenciação entre travestis e transexuais, organização do movimento, agenda política, transformações corporais e demandas relativas à saúde. Além disso, realizei etnografias em encontros gerais do movimento LGBT, assim como nos específicos de travestis e transexuais, com destaque para o XVI e XVII encontro Nacional de Travestis e Transexuais (ENTLAIDS), realizados no Rio de Janeiro em 2009 e em Aracajuem 2010; a V Conferência Regional para América Latina e Caribe da ILGA (International Lesbian and Gay Association), realizada em Curitiba em 2009; e a I Marcha Nacional Contraa Homofobia, realizada em 19 de maio de 2010 em Brasília. A partir dos resultados das entrevistas e das etnografias, busco construir um histórico do movimento de travestis e transexuais no Brasil, no qual é possível localizar a emergência das categorias identitárias eseus conflitos. Assim, minha investigação passa pela análise da relação com categorias estigmatizantes como a prostituição e, especialmente, das capacidades de incorporação ou deapropriação de discursos médicos e psiquiátricos na construção de identidades, o que inclui a influência de fatores de classe e de acesso a serviços de saúde especializados, notoriamente o processo transexualizador no SUS...


Assuntos
Humanos , Saúde de Gênero , Identidade de Gênero , Desigualdades de Saúde , Saúde de Grupos Específicos , Acessibilidade aos Serviços de Saúde , Política de Saúde , Direito à Saúde , Fatores Epidemiológicos , Modificação Corporal não Terapêutica/tendências
15.
Neurosurg Focus ; 29(6): E2, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21121716

RESUMO

Induced deformation of the cranial vault is one form of permanent alteration of the body that has been performed by human beings from the beginning of history as a way of differentiating from others. These procedures have been observed in different cultures, but were particularly widespread in Mesoamerica. The authors examined and reviewed the historical and anthropological literature of intentional deformation practices in Mayan culture. The Mayans performed different types of cranial deformations and used different techniques and instruments to deform children's heads. The most remarkable morphological alteration is seen in the flattening of the frontal bone. Some archeological investigations link deformation types with specific periods. This article provides a glance at the cultural environment of the Mayans and demonstrates the heterogeneity of this interesting cultural phenomenon, which has changed over time.


Assuntos
Modificação Corporal não Terapêutica/história , Indígenas Centro-Americanos/história , Indígenas Sul-Americanos/história , Crânio/patologia , Cultura , Etnicidade , História Antiga , Humanos , México , Paleopatologia , Plagiocefalia/história , Classe Social
16.
Rev. colomb. bioét ; 4(2)dic. 2009.
Artigo em Espanhol | LILACS | ID: lil-614470

RESUMO

La preservación y evolución de la especie humana han estado ligadas, e incluso condicionadas, al desarrollo y uso de la técnica, la ciencia y la tecnología. Esto no afecta la condición de ser humano, la cual, por el contrario, se conserva, pero con importantes transformaciones, y permite la superación de las circunstancias adversas que pueden poner en peligro la misma existencia de la humanidad. La interacción de la investigación y el desarrollo tecnocientíficos continuos y sus aplicaciones en los seres humanos con la evolución multicultural en la sociedad actual, plantea problemas para la bioética que requieren reflexiones y deliberaciones plurales y pluridisciplinarias. Con el objetivo de aclarar estos problemas, se presenta una revisión acerca de las transformaciones que genera la investigación científica y tecnológica sobre la vida humana y que cuestionan conceptos acerca del cuerpo, de la dignidad y la libertad de los seres humanos así como de los fines mismos de la medicina, que se debaten, en la actualidad, entre la necesidad y el deseo. La pluralidad de valores, visiones y perspectivas académicas, públicas y vivenciales requiere una aproximación desde la bioética.


Assuntos
Humanos , Bioética , Biotecnologia , Modificação Corporal não Terapêutica , Corpo Humano , Pesquisa Científica e Desenvolvimento Tecnológico
17.
J Am Dent Assoc ; 139(4): 442-50, 2008 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-18385028

RESUMO

BACKGROUND: Ebinyo is a form of infant oral mutilation (IOM), widely practiced in rural areas of eastern Africa, in which traditional healers and other village elders extirpate the primary canine tooth follicles of infants by using crude, often unsterilized, instruments or utensils. Traditional folklore suggests that the underlying tooth follicles, thought to resemble worms, are the cause of high temperature, vomiting, loss of appetite and diarrhea in infants. In addition to the serious and potentially fatal immediate postsurgical complications, many of those who undergo this practice exhibit characteristic long-term adverse dentoalveolar effects. Children in these families also may be at greater risk of undergoing other mutilation rituals because of their cultural background. CASE DESCRIPTION: We report on the clinical and radiographic findings in five siblings who apparently were subjected to IOM as infants before immigrating to the United States. CLINICAL IMPLICATIONS: Although the practice of IOM is believed to be exceedingly rare in developed countries, it is important that dentists and allied dental personnel who treat refugees from areas of the world in which IOM is endemic be aware of the social factors behind this practice as well as be able to recognize its dental and psychological sequelae.


Assuntos
Modificação Corporal não Terapêutica , Dente Canino/cirurgia , Saco Dentário/cirurgia , Dente Decíduo/cirurgia , Perda do Osso Alveolar/etiologia , Modificação Corporal não Terapêutica/efeitos adversos , Criança , Pré-Escolar , Dente Canino/anormalidades , Feminino , Humanos , Lactente , Masculino , Medicina Tradicional , Refugiados , Sudão/etnologia , Dente Decíduo/anormalidades
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