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1.
Toxicon ; 235: 107314, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37857004

RESUMEN

Sodium monensin is the most frequently used ionophore as a growth promoter in ruminant diets. It has numerous benefits; however its toxic effects have also been observed in several animal species. Naturally occurring cases have not yet been reported in goats. This study describes an outbreak of accidental poisoning, characterizing its clinical, laboratory and pathological findings. Thirty-seven of 40 Anglo Nubian goat kids became intoxicated after receiving a diet that was erroneously supplemented with sodium monensin. They ingested an estimated toxic dose between 25 and 39 mg/kg BW. Clinical evolution was monitored (n = 27), followed by serum creatine kinase (CK) and aspartate aminotransferase (AST) activities measurements, and blood gas analysis. Postmortem examinations were performed between 1 and 8 days of evolution (n = 14). Clinical signs began 5 h after ingestion and included reticuloruminal hypomotility, lethargy, anorexia, tachycardia, cardiac arrhythmia, wet cough, pulmonary and tracheal crackles, and serous nasal discharge. The morbidity and lethality rates were 92.5 and 62.1%, respectively. CK and AST activities increased, reaching median values of 10,860 and 1596 U/L, respectively; the hyperchloremic metabolic acidosis was mild. The lesions were characterized by degeneration and necrosis of the cardiac and skeletal muscles, pulmonary congestion and edema, and passive liver congestion. The kids essentially developed cardiomyopathy with left and right congestive heart failures. Unlike in other ruminant species, skeletal muscle functional disability was infrequent. It can be concluded that monensin is toxic to goats and should be used with caution in their diet.


Asunto(s)
Cabras , Monensina , Animales , Monensina/farmacología , Corazón , Músculo Esquelético/patología , Sodio/farmacología
2.
J Public Health (Oxf) ; 44(4): 753-760, 2022 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-34156087

RESUMEN

BACKGROUND: This study aims to verify the association between neck circumference (NC) and metabolic syndrome and establish NC cut-off points to predict metabolic syndrome. METHODS: Weight, height, NC, waist circumference, body mass index, fasting plasma glucose, HDL cholesterol, triglycerides and blood pressure were measured in a cross-sectional and population-based study with 966 adults. The association between NC and the burden of metabolic syndrome disease was evaluated by multinomial logistic regression. Receiver operating characteristic curves were used to acquire gender-specific cut-off values and predict metabolic syndrome. The NC is a simple anthropometric measurement, has low evaluation costs, can estimate the subcutaneous fat in the upper body and is related to cardiometabolic risks. RESULTS: NC is an independent predictor of metabolic syndrome burden with high association to women. The syndrome components stratification indicated that the NC of individuals with one component was lower than those with three or more (P = 0.001). Metabolic syndrome prediction cut-off point was a NC of 39.5 cm for men and 33.3 cm for women. CONCLUSIONS: Increased NC was associated with higher metabolic syndrome risks. This anthropometric parameter can be used as an additional marker for screening cardiovascular risk diseases.


Asunto(s)
Enfermedades Cardiovasculares , Síndrome Metabólico , Adulto , Masculino , Femenino , Humanos , Síndrome Metabólico/diagnóstico , Síndrome Metabólico/epidemiología , Estudios Transversales , Factores de Riesgo , Circunferencia de la Cintura , Índice de Masa Corporal , Antropometría , Curva ROC
3.
Arq. bras. med. vet. zootec. (Online) ; 71(1): 53-60, jan.-fev. 2019. tab
Artículo en Inglés | LILACS, VETINDEX | ID: biblio-989379

RESUMEN

The aim of this study was to assess the magnitude and duration of blood and urine changes and the side effects of hyperchloremic acidosis induced by the intravenous administration of hydrochloric acid in sheep. Five healthy, crossbred adult ewes, with a mean body weight of 44±2.9kg were used. The hydrochloric acid solution was administered intravenously at a rate of 25mL/kg/h for 4 hours continuously. Venous blood and urine samples were collected and pH values, blood carbon dioxide partial pressure, bicarbonate, base excess, strong ion difference, anion gap, total concentration of nonvolatile buffers, creatinine, plasma L-lactate, plasma and urine sodium, potassium, and chloride were determined. The experimental protocol induced severe hyperchloremic acidosis at the end of the infusion, with a decreased plasma strong ion difference. The fractional excretion of sodium and chloride remained increased during 4 hours after the infusion. Aciduria was observed at approximately 24 hours. Twenty-four hours after the infusion, the animals showed mild and compensated metabolic acidosis. This protocol was effective in inducing severe and long-lasting hyperchloremic acidosis and did not cause serious side effects. Therefore, this protocol can be used safely in adult sheep for studies on the treatment of this condition.(AU)


O objetivo deste estudo foi avaliar a magnitude e a duração das alterações sanguíneas e urinárias, bem como os efeitos colaterais da acidose hiperclorêmica induzida por administração intravenosa de ácido clorídrico, em ovinos. Foram utilizadas cinco ovelhas mestiças, adultas, sadias, com peso médio de 44±2,9kg. A solução de ácido clorídrico foi administrada por via intravenosa, na velocidade de 25mL/kg/h, totalizando quatro horas de administração contínua. Amostras de sangue venoso e de urina foram colhidas, e determinaram-se os valores de pH, pressão parcial de dióxido de carbono, bicarbonato, excesso de bases, diferença dos íons fortes, ânion-gap, creatinina, lactato L, sódio, potássio e cloro. O protocolo de indução experimental foi capaz de induzir acidose hiperclorêmica grave ao término da infusão, com diminuição da diferença dos íons fortes plasmáticos. Houve aumento da excreção fracionada de sódio e cloro por até quatro horas após o término da infusão. A acidúria foi observada por cerca de 24 horas. Após 24 horas do início da infusão, os animais apresentaram acidose metabólica leve e compensada. Esse protocolo foi eficaz na indução da acidose hiperclorêmica grave e duradoura e não causou efeitos colaterais. Conclui-se que o protocolo pode ser usado com segurança em ovelhas adultas, para estudos sobre tratamento dessa condição.(AU)


Asunto(s)
Animales , Ovinos/metabolismo , Administración Intravenosa/estadística & datos numéricos , Ácido Clorhídrico/clasificación , Cetosis
4.
Public Health ; 166: 140-147, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30500570

RESUMEN

OBJECTIVES: Many factors are associated with the increase in total and central body adiposity in children, especially eating habits. This has led to an increasing number of studies analysing food patterns, which consider the synergistic effect of food and nutrient intake on the nutritional status. The objective of this study was to identify the dietary patterns of children aged 4-7 years and associate these with different indicators of total and central body adiposity. STUDY DESIGN: Cross-sectional study METHODS: The study consisted of 403 children from a retrospective cohort in Minas Geraes, Brazil. Four indicators of body adiposity were evaluated: body mass index (BMI), waist-to-height ratio (WHtR) and percentages of total and central body fat (assessed by dual-energy X-ray absorptiometry). The dietary habits of the children were evaluated by identifying the dietary patterns using principal component analysis. The adjustment predictor variables were related to the socio-economic characteristics, lifestyle and duration of exclusive breastfeeding. Food patterns were identified by factor analysis. Linear regression was used to estimate the regression coefficient and the confidence interval, considering statistical significance of α = 5%. RESULTS: Five dietary patterns were identified, which explained 42.3% of the data variance: 'Traditional', 'Unhealthy', 'Milk and chocolate', 'Snack' and 'Healthy'. The multiple linear regression model showed that a greater adherence to the 'Traditional' and 'Unhealthy' patterns was related to higher BMI, WHtR, and total and central body adiposity. CONCLUSION: Children with a higher intake of food from the 'Traditional' and 'Unhealthy' patterns showed an increase in total and central body adiposity.


Asunto(s)
Adiposidad , Conducta Alimentaria , Obesidad Infantil/epidemiología , Índice de Masa Corporal , Brasil/epidemiología , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Masculino , Obesidad Abdominal/epidemiología , Estudios Retrospectivos , Relación Cintura-Estatura
5.
Phys Chem Chem Phys ; 20(3): 1923-1937, 2018 Jan 17.
Artículo en Inglés | MEDLINE | ID: mdl-29297523

RESUMEN

The present joint experimental and theoretical work provides in-depth understanding on the morphology and structural, electronic, and optical properties of ZnWO4 nanocrystals. Monoclinic ZnWO4 nanocrystals were prepared at three different temperatures (140, 150, and 160 °C) by a microwave hydrothermal method. Then, the samples were investigated by X-ray diffraction with Rietveld refinement analysis, field-emission scanning electron microscopy, transmission electronic microscopy, micro-Raman and Fourier transform infrared spectroscopy, ultraviolet-visible spectroscopy, and photoluminescence measurements. First-principles theoretical calculations within the framework of density functional theory were employed to provide information at the atomic level. The band structure diagram, density of states, Raman and infrared spectra were calculated to understand the effect of structural order-disorder on the properties of ZnWO4. The effects of the synthesis temperature on the above properties were rationalized. The band structure revealed direct allowed transitions between the VB and CB and the experimental results in the ultraviolet-visible region were consistent with the theoretical results. Moreover, the surface calculations allowed the association of the surface energy stabilization with the temperature used in the synthesis of the ZnWO4 nanocrystals. The photoluminescence properties of the ZnWO4 nanocrystals prepared at 140, 150, and 160 °C were attributed to oxygen vacancies in the [WO6] and [ZnO6] clusters, causing a red shift of the spectra. The ZnWO4 nanocrystals obtained at 160 °C exhibited excellent photodegradation of Rhodamine under ultraviolet light irradiation, which was found to be related to the surface energy and the types of clusters formed on the surface of the catalyst.

6.
Arq. bras. med. vet. zootec. (Online) ; 70(3): 773-778, maio-jun. 2018. tab
Artículo en Portugués | LILACS, VETINDEX | ID: biblio-911314

RESUMEN

Este estudo objetivou avaliar o comportamento sexual e a dinâmica ovulatória de cabras da raça Toggenburg após a indução do estro com dispositivo intravaginal de progesterona durante seis, nove e 12 dias de permanência. No momento da inserção do dispositivo e 24 horas antes da retirada do dispositivo, foi administrado 5mg de dinoprost e 200UI de eCG, respectivamente. A dinâmica ovulatória foi acompanhada por ultrassonografia a cada oito horas, enquanto o estro foi observado a cada 12 horas. Todas as cabras apresentaram estro. O intervalo da retirada do dispositivo ao início do estro foi de 29,5 ± 9,6 para G6dias; 34,0 ± 6,0 e 32,4 ± 7,7h, G9dias e G12dias, respectivamente. Igualmente, foi encontrada diferença (P<0,05) entre o G6dias e os outros grupos. A duração do estro diferiu (P<0,05) entre o G6dias (36,0 ± 12,6) e os outros dois grupos (G9dias: 31,2 ± 14,3; G12dias: 33,4 ± 8,6). A taxa de ovulação (81%; 89,5% e; 71,4%), intervalo da retirada do dispositivo à ovulação (50,5 ± 11,4; 46,3 ± 5,9 e; 46,7 ± 8,3), diâmetro do maior folículo (6,6 ± 0,3; 6,6 ± 0,9 e; 6,9 ± 0,8) diâmetro do segundo maior folículo (6,4 ± 0,7; 6,6 ± 0,8 e; 6,8 ± 0,6) e o número de folículos ovulados (1,5 ± 0,6; 1,7 ± 0,6 e 2,0 ± 0,9) para G6dias, G9dias e G12dias, respectivamente, foram semelhantes (P>0,05). Todos os protocolos foram eficientes em induzir o estro sincronizado em cabras da raça Toggenburg, trabalhando em conjunto com a eficiência reprodutiva e produtiva desses animais.(AU)


This study aimed to evaluate the sexual behavior and the ovulatory dynamics of Toggenburg goats after induction of synchronized estrus by an intravaginal progesterone device for six, nine and twelve days. At the device insertion and 24 h before the device removal, 5mg of dinoprost and 200 UI of eCG was administered, respectively. The ovulatory dynamics was assessed by ultrasound every 8 h, while the sexual behavior was observed every 12 h. All goats showed estrus. The intervals from device removal to estrus were 29.5 ± 9.7, 34.0 ± 6.0 and 32.4 ± 7.7h to G6days, G9days and G12days, respectively. Iqually, it was found difference (P<0.05) among G6days and the other groups. The duration of estrus differed (P<0.05) among the G6days (36.0 ± 12.6) and the other two groups (G9days: 31.2 ± 14.3; G12days: 33.4 ± 8.6). The ovulation rate (81.0%; 89.5% and; 71.4%); the interval from device removal to ovulation (50.5 ± 11.4; 46.3 ± 5.9 and; 46.7 ± 8.3), the diameter of the largest follicle (6.6 ± 0.3; 6.6 ± 0.9 and; 6.9 ± 0.8), diameter of the second largest follicle (6.4 ± 0.7; 6.6 ± 0.8 and; 6.8 ± 0.6) and the number of ovulations (1.5 ± 0.6; 1.7 ± 0.6 and; 2.0 ± 0.9) for G6days, G9days and G12days, respectively, were similar (P>0.05). All treatments were effective for the induction of synchronized estrus in Toggenburg goats, working jointly with the reproductive and productive efficiency of these animals.(AU)


Asunto(s)
Animales , Estro/fisiología , Cabras/anatomía & histología , Conducta Reproductiva/fisiología
7.
Equine Vet J ; 49(1): 87-93, 2017 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-26509916

RESUMEN

REASONS FOR PERFORMING STUDY: Treatment of metabolic acidosis using sodium bicarbonate solutions is safe when blood gas analysis is available. The evidence that solutions containing metabolisable buffers can be used as an alternative for treatment of metabolic acidosis in horses is of practical interest. OBJECTIVES: To investigate the safety and efficacy of a polyionic solution containing 84 mEq/l of lactate (L84) for the correction of induced hyperchloraemic metabolic acidosis. STUDY DESIGN: Non-randomised crossover design. METHODS: Five healthy, adult, crossbred horses were used. A solution containing 100 mmol/l of HCl was infused intravenously (100 ml/kg bwt) for 5 h to induce metabolic acidosis. Metabolic acidosis was induced in each horse twice, with a minimum 15-day interval after recovery from the first induction: the first time no treatment was administered (control group) and the second time horses were treated with an intravenous infusion of L84 solution, 100 ml/kg bwt for 5 h, beginning 3 h after the end of HCl infusion. Venous blood samples were taken at 0, 2.5, 5, 8, 10.5, 13, 24 and 48 h; and urine at 0, 5, 8 and 13 h. Laboratory data included pH (blood and urine), PCO2 , HCO3- , base excess, total plasma protein concentration, l-lactate, Na+ , K+ , Cl- , strong ion difference (SID4 ), anion gap, change in plasma volume and fractional excretions of Na+ , K+ and Cl- . Effects of time and treatment were tested by 2-way repeated measures ANOVA. RESULTS: Severe hyperchloraemic metabolic acidosis was induced. In the untreated horses, correction of the imbalance occurred gradually, and mild acidosis was still present at 48 h. In horses treated with the L84 solution, acidosis was corrected by the end of the infusion. There were no adverse effects with the administration of the L84 solution. CONCLUSIONS: A polyionic solution containing 84 mEq/l of lactate effectively corrected induced metabolic acidosis in horses within 5 h.


Asunto(s)
Acidosis/veterinaria , Electrólitos/farmacología , Enfermedades de los Caballos/inducido químicamente , Ácido Clorhídrico/toxicidad , Ácido Láctico/uso terapéutico , Desequilibrio Ácido-Base , Acidosis/inducido químicamente , Acidosis/tratamiento farmacológico , Animales , Estudios Cruzados , Electrólitos/administración & dosificación , Femenino , Enfermedades de los Caballos/tratamiento farmacológico , Caballos , Inyecciones Intravenosas , Ácido Láctico/administración & dosificación , Masculino
8.
Braz J Biol ; 76(1): 218-27, 2016 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-26909639

RESUMEN

This study aimed to evaluate the variation in the levels of proline, oxidative metabolism and photosynthetic pigments in plants of Pitcairnia encholirioides grown in vitro under different conditions and after acclimatization. The analyses were performed after 150 days of in vitro cultivation in MS media supplemented with 10 µM GA3 or 0.2 µM NAA, sucrose at 15 or 30 g L-1, in test tubes which allowed gas exchange or in a hermetically sealed system, and 180 days after acclimatization. The in vitro maintenance in hermetically sealed flasks, with GA3 and 15 g L-1 sucrose had adverse metabolic effects, which was demonstrated by the lower proline and photosynthetic pigments accumulation and by the increase in antioxidant enzymes activities. After acclimatization, differences for proline and photosynthetic pigments were no longer found and the enzymatic activities ranged unevenly. The results suggest that the in vitro cultivation in media with 0.2 µM NAA and 30 g L-1 sucrose, in test tubes capped with closures which allowed gas exchange, is more suitable for micropropagation of P. encholirioides, providing a prolonged maintenance of in vitro cultures and plantlets with superior quality for ex vitro development.


Asunto(s)
Bromeliaceae/fisiología , Fotosíntesis , Prolina/metabolismo , Aclimatación , Bromeliaceae/crecimiento & desarrollo , Especies en Peligro de Extinción , Oxidación-Reducción
9.
Braz. j. biol ; 76(1): 218-227, Feb. 2016. tab, graf
Artículo en Inglés | LILACS | ID: lil-774510

RESUMEN

Abstract This study aimed to evaluate the variation in the levels of proline, oxidative metabolism and photosynthetic pigments in plants of Pitcairnia encholirioides grown in vitro under different conditions and after acclimatization. The analyses were performed after 150 days of in vitro cultivation in MS media supplemented with 10 µM GA3 or 0.2 µM NAA, sucrose at 15 or 30 g L–1, in test tubes which allowed gas exchange or in a hermetically sealed system, and 180 days after acclimatization. The in vitro maintenance in hermetically sealed flasks, with GA3 and 15 g L–1 sucrose had adverse metabolic effects, which was demonstrated by the lower proline and photosynthetic pigments accumulation and by the increase in antioxidant enzymes activities. After acclimatization, differences for proline and photosynthetic pigments were no longer found and the enzymatic activities ranged unevenly. The results suggest that the in vitro cultivation in media with 0.2 µM NAA and 30 g L–1 sucrose, in test tubes capped with closures which allowed gas exchange, is more suitable for micropropagation of P. encholirioides, providing a prolonged maintenance of in vitro cultures and plantlets with superior quality for ex vitro development.


Resumo Este trabalho objetivou avaliar a contribuição da prolina, do metabolismo oxidativo e dos pigmentos fotossintéticos na propagação in vitro e aclimatização de Pitcairnia encholirioides, uma bromélia criticamente ameaçada de extinção. As análises foram realizadas após 150 dias de cultivo in vitro em meio MS suplementado com 10 µM de GA3 ou 0,2 µM de ANA, 15 ou 30 g L–1 de sacarose, em tubos de ensaio que permitiam trocas gasosas ou em sistema hermeticamente vedado, e também 180 dias após aclimatização. A manutenção in vitro em frascos hermeticamente fechados, com GA3 e 15 g L–1 de sacarose apresentou efeito metabólico adverso, demonstrado pelo menor acúmulo de prolina e pigmentos fotossintéticos e também pelo aumento das atividades de enzimas antioxidantes. Após aclimatização, as diferenças para prolina e pigmentos fotossintéticos não foram mais encontradas e as atividades enzimáticas variaram de maneira desuniforme. Os resultados sugerem que o cultivo in vitro em meio com 0,2 µM de ANA e 30 g L–1 de sacarose, em tubos fechados com tampas que permitem trocas gasosas, é mais adequado para a micropropagação de P. encholirioides, proporcionando uma manutenção prolongada das culturas in vitro e plântulas com qualidade superior para o desenvolvimento ex vitro.


Asunto(s)
Bromeliaceae/fisiología , Fotosíntesis , Prolina/metabolismo , Aclimatación , Bromeliaceae/crecimiento & desarrollo , Especies en Peligro de Extinción , Oxidación-Reducción
10.
Arq. bras. med. vet. zootec ; 67(3): 855-863, May-Jun/2015. graf
Artículo en Portugués | LILACS | ID: lil-753916

RESUMEN

O estudo teve o objetivo de testar a hipótese de que o efeito alcalinizante da solução de Ringer com lactato (SRL) pode ser maior nos animais portadores de acidose metabólica do que nos sadios, como consequência da necessidade de retorno ao equilíbrio. Seis ovelhas receberam a SRL em volume correspondente a 10% do peso corporal, administrada por infusão contínua intravenosa, durante quatro horas, em duas condições definidas: enquanto eram saudáveis e após a indução experimental de acidose láctica ruminal aguda (ALRA). Amostras de sangue venoso e de urina foram colhidas em quatro momentos: antes do início da infusão, na metade do volume infundido, ao término da infusão e duas horas após. Foram determinados valores de pH sanguíneo e urinário, de pCO2, HCO3 - e BE no sangue, de Na+, K+, Cl-, SID, AG, PPT, Atot e lactato L no plasma, e das excreções fracionadas urinárias de Na+, K+, Cl- e lactato L. A SRL provocou hemodiluição, mas não interferiu nos equilíbrios eletrolítico e acidobase das ovelhas sadias. Apesar de eficaz para reverter a desidratação, não foi capaz de corrigir a acidose metabólica presente após a indução da ALRA.


The aim of this study was to investigate if the alkalinizing effect of lactated Ringer's solution (LRS) is greater in animals with metabolic acidosis than in healthy ones, as a result of the need to restore acid-base balance. LRS was intravenously infused in a volume corresponding to 10% of body weight, continously during four hours, in two definite conditions in the same six ewes: when they were healthy and after experimentally induced acute rumen lactic acidosis (ARLA). Venous blood and urine samples were taken in four moments: before the beginning, in the middle, at the end of the infusion and two hours after. Blood and urine pH, blood pCO2, HCO3 - and BE, and plasma Na+, K+, Cl-, TP and L lactate were measured. Na+, K+, Cl- and L lactate fractional clearance and plasma SID, AG, and Atot were calculated. LRS caused hemodilution but didn't change electrolyte and acid-base balances in healthy ewes. When ewes were affected by ARLA, the infusion of this solution was effective for dehydration reversion but was unable to correct metabolic acidosis.


Asunto(s)
Animales , Ácido Láctico/uso terapéutico , Cetosis/terapia , Cetosis/veterinaria , Ovinos/metabolismo , Soluciones Isotónicas/uso terapéutico , Desequilibrio Ácido-Base/veterinaria , Desequilibrio Hidroelectrolítico/veterinaria , Espectrofotometría/veterinaria , Refractometría/veterinaria , Pruebas Serológicas/veterinaria
11.
Histopathology ; 40(6): 505-9, 2002 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-12047760

RESUMEN

AIMS: We sought to delineate and describe three cases of a distinctive mesenchymal neoplasm of the vulva showing adipocytic differentiation and affecting young patients. METHODS AND RESULTS: In three patients between 13 and 38 years of age, the vulvar tumours had well-circumscribed borders and ranged in size from 35 to 100 mm. Histologically, they were well circumscribed and lobulated. The lobules were separated by thin fibroconnective tissue septa and were composed of slender spindle cells showing slightly eosinophilic cytoplasm with indistinct boundaries, uniform nuclei with finely granular chromatin, and no nucleoli. The cells were embedded in a richly myxoid stroma. The background in all three tumours was a 'chicken-wire', capillary vascular network resembling that seen in myxoid liposarcomas. Two tumours had scattered signet-ring-type lipoblasts and the third a large number of such lipoblasts. Clusters of mature adipocytes were entrapped in the tumours. None had mitotic figures, necrosis, or pleomorphism. The neoplastic cells stained positively for vimentin and were negative for other immunohistochemical markers. Treatment for all three tumours was enucleation alone. After follow-up of 10 years, 7 years, and 1 year, all patients are well with no evidence of disease. CONCLUSIONS: The benign behaviour of these neoplasms militates against the diagnosis of liposarcoma. We believe these are benign lesions of adipocytic differentiation akin to infantile lipoblastomas.


Asunto(s)
Lipoma/patología , Neoplasias de la Vulva/patología , Adipocitos/química , Adipocitos/patología , Adolescente , Adulto , Diferenciación Celular , Femenino , Estudios de Seguimiento , Humanos , Inmunohistoquímica , Lipoma/metabolismo , Mesenquimoma/metabolismo , Mesenquimoma/patología , Vimentina/análisis , Neoplasias de la Vulva/metabolismo
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