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1.
Mol Divers ; 26(1): 389-407, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34008129

RESUMO

The latest global outbreak of 2019 respiratory coronavirus disease (COVID-19) is triggered by the inception of novel coronavirus SARS-CoV2. If recent events are of any indicators of the epidemics of past, it is undeniable to state a fact that the SARS-CoV2 viral infection is highly transmissible with respect to its previously related SARS-CoV's. Papain-like protease (PLpro) is an enzyme that is required by the virus itself for replicating into the host system; and it does so by processing its polyproteins into a functional replicase complex. PLpro is also known for downregulating the genes responsible for producing interferons, an essential family of molecules produced in response to viral infection, thus making this protein an indispensable drug target. In this study, PLpro inhibitors were identified through high throughput structure-based virtual screening approach from NPASS natural product library possessing ~ 35,000 compounds. Top five hits were scrutinised based on structural aromaticity and ability to interact with a key active site residue of PLpro, Tyr268. For second level of screening, the MM-GBSA End-Point Binding Free Energy Calculation of the docked complexes was performed, which identified Caesalpiniaphenol A as the best hit. Caesalpiniaphenol A not only possess a double ring aromatic moiety but also has lowest minimum binding energy, which is at par with the control GRL0617, the only known inhibitor of SARS-CoV2 PLpro. Details of the Molecular Dynamics (MD) simulation and ADMET analysis helped to conclusively determine Caesalpiniaphenol A as potentially an inhibitor of SARS-CoV2 PLpro.


Assuntos
Tratamento Farmacológico da COVID-19 , Papaína , Compostos de Anilina , Benzamidas , Humanos , Naftalenos , Peptídeo Hidrolases , RNA Viral , SARS-CoV-2 , Fluxo de Trabalho
2.
J Biomol Struct Dyn ; 40(1): 348-360, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32875950

RESUMO

The novel SARS-CoV-2 is the etiological agent causing the Coronavirus disease 2019 (COVID-19), which continues to become an inevitable pandemic outbreak. Over a short span of time, the structures of therapeutic target proteins for SARS-CoV-2 were identified based on the homology modelled structure of similar virus, SARS-CoV that transmitted rapidly in 2003. Since the outset of the disease, the research community has been looking for a potential drug lead. Out of all the known resolved structures related to SARS-CoV-2; 3-chymotrypsin (3 C) like protease (3CLpro) is considered as an attractive anti-viral drug compound on the grounds of its role in viral replication and probable non-interactive competency to bind to any viral host protein. To the best of our knowledge, till date only one compound has been identified and tested in-vitro as a potent inhibitor of 3CLpro protein, addressed as N3 (PubChem Compound CID: 6323191) and is known to bind irreversibly to 3CLpro suppressing its activity. Using computational approach, we intend to identify a probable natural fungal metabolite to interact and inhibit 3CLpro. Here after performing docking and molecular dynamics of various small molecules derived as a secondary metabolite from fungi, we propose Flaviolin as potent inhibitor of 3CLpro of novel Coronavirus SARS-CoV-2.Communicated by Ramaswamy H. Sarma.


Assuntos
COVID-19 , Simulação de Dinâmica Molecular , Fungos , Humanos , Simulação de Acoplamento Molecular , Naftoquinonas , Inibidores de Proteases , SARS-CoV-2
3.
Mol Divers ; 26(1): 555-568, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33392967

RESUMO

Microbes possess a tremendous potential to interact with their surroundings and have continued to shape the future of all life forms existing on earth. Of all the groups of microbes, viruses are the most nefarious creatures which cannot be solely classified as living or non-living but still pose the greatest threats to the biosphere. Viruses are minuscule, diverse and are probably the only entities that exhibit non-mutualistic association with other lifeforms while retaining their ability to infect and hijack any of the existing living being on the planet. The latest global devastation, caused by novel SARS-CoV-2, is unparalleled in the last century. This review encompasses the mysterious origin of this virus by tracking its lineage, which may help to decode the conundrum of SARS-CoV-2 and shed more light on its epidemiology. The implications and the challenge posed by this virus to the scientific community to the medical community and the economy at large are reflected. Also discussed is the paradigm shift brought upon by the COVID-19 pandemic on the human psyche and their behaviour.


Assuntos
COVID-19 , Pandemias , COVID-19/epidemiologia , Humanos , SARS-CoV-2
4.
Sci Rep ; 11(1): 22421, 2021 11 17.
Artigo em Inglês | MEDLINE | ID: mdl-34789810

RESUMO

There persists a constant threat from multidrug resistance being acquired by all human pathogens that challenges the well-being of humans. This phenomenon is predominantly led by Pseudomonas aeruginosa which is already resistant to the current generations of antibiotic by altering its metabolic pathways to survive. Specifically for this microbe the phenomenon of quorum sensing (QS) plays a crucial role in acquiring virulence and pathogenicity. QS is simply the cross talk between the bacterial community driven by signals that bind to receptors, enabling the entire bacterial microcosm to function as a single unit which has led to control P. aeruginosa cumbersome even in presence of antibiotics. Inhibition of QS can, therefore, be of a significant importance to curb such virulent and pathogenic strains of P. aeruginosa. Natural compounds are well known for their antimicrobial properties, of which, information on their mode of action is scarce. There can be many antimicrobial phytochemicals that act by hindering QS-pathways. The rationale of the current study is to identify such natural compounds that can inhibit QS in P. aeruginosa driven by LasR, PhzR, and RhlR dependent pathways. To achieve this rationale, in silico studies were first performed to identify such natural compounds which were then validated by in vitro experiments. Gingerol and Curcumin were identified as QS-antagonists (QSA) which could further suppress the production of biofilm, EPS, pyocyanin, and rhamnolipid along with improving the susceptibility to antibiotics.


Assuntos
Antibacterianos/farmacologia , Proteínas de Bactérias/metabolismo , Catecóis/farmacologia , Curcumina/farmacologia , Álcoois Graxos/farmacologia , Compostos Fitoquímicos/farmacologia , Infecções por Pseudomonas/metabolismo , Pseudomonas aeruginosa/efeitos dos fármacos , Percepção de Quorum/efeitos dos fármacos , Transdução de Sinais/efeitos dos fármacos , Transativadores/metabolismo , Biofilmes/efeitos dos fármacos , Glicolipídeos/metabolismo , Testes de Sensibilidade Microbiana , Simulação de Dinâmica Molecular , Infecções por Pseudomonas/microbiologia , Pseudomonas aeruginosa/metabolismo , Pseudomonas aeruginosa/patogenicidade , Piocianina/metabolismo , Virulência/efeitos dos fármacos
5.
Microbiol Res ; 252: 126863, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34530246

RESUMO

Pseudomonas aeruginosa is recognized as a bacterium with many bullets in its armoury and the Achilles heel of the bacterium is that it exudes several pathways that lead to pathogenicity thereby making the application of the strain cautious since the bacterium is known as a 'superbug' ergo, being resistant to multiple antibiotics. The mechanisms of pathogenicity are mainly driven by quorum sensing (QS), a phenomenon that works on cell-cell communication through classical ligand-receptor interactions. QS-mediated pathways enable control of this organism impossible even with the use of antibiotics. Henceforth, interfering with the QS pathways serves as a new mode of action for futuristic antibiotics to decrease the distress of this microbe. We propose gingerol to interfere with various QS-receptors of P. aeruginosa (LasR, PhzR and RhlR) which were deduced using in silico approach and validated in vitro by assessing its impact on EPS, biofilm, pyocyanin and rhamnolipid of the microbe. Further, gingerol was found to increase the antibacterial potency of the antibiotic when applied in integration with ciprofloxacin. The findings provide an insight about preferring the integrated approach of using QS-inhibitors (QSI) in tandem with antibiotics for holistic strategy in fight against the phenomenon of antibiotic resistance acquired by microbes.


Assuntos
Catecóis , Farmacorresistência Bacteriana , Álcoois Graxos , Pseudomonas aeruginosa , Percepção de Quorum , Antibacterianos/farmacologia , Catecóis/farmacologia , Farmacorresistência Bacteriana/efeitos dos fármacos , Álcoois Graxos/farmacologia , Pseudomonas aeruginosa/efeitos dos fármacos , Percepção de Quorum/efeitos dos fármacos
6.
Sci Rep ; 11(1): 3189, 2021 02 04.
Artigo em Inglês | MEDLINE | ID: mdl-33542436

RESUMO

It is the acquisition of unique traits that adds to the enigma of microbial capabilities to carry out extraordinary processes. One such ecosystem is the soil exposed to radionuclides, in the vicinity of atomic power stations. With the aim to study thorium (Th) tolerance in the indigenous bacteria of such soil, the bacteria were isolated and screened for maximum thorium tolerance. Out of all, only one strain AM3, found to tolerate extraordinary levels of Th (1500 mg L-1), was identified to be belonging to genus Providencia and showed maximum genetic similarity with the type strain P. vermicola OP1T. This is the first report suggesting any bacteria to tolerate such high Th and we propose to term such microbes as 'thoriotolerant'. The medium composition for cultivating AM3 was optimized using response surface methodology (RSM) which also led to an improvement in its Th-tolerance capabilities by 23%. AM3 was found to be a good producer of EPS and hence one component study was also employed for its optimization. Moreover, the EPS produced by the strain showed interaction with Th, which was deduced by Fourier Transform Infrared (FTIR) spectroscopy.

7.
Microbiol Res ; 238: 126526, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32603934

RESUMO

The current study depicts the isolation of luminescent bacteria from fish and squid samples that were collected from Veraval fish harbour. From Indian mackerel, total 14 and from squid, total 23 bioluminescent bacteria were isolated using luminescence agar medium. Two bioluminescent bacteria with highest relative luminescence intensity PBR1 and PBL1 were selected. These two isolates were subjected to detailed biochemical characterization and were tested positive for 5 out of 13 biochemical tests. Furthermore, both PBR1 and PBL1 were able to ferment cellobiose, dextrose, fructose, galactose, maltose, mannose, sucrose and trehalose with acid production. Based on 16S rRNA partial gene sequence analysis, PBR1 was identified as Vibrio alginolyticus and PBL1 as V. rotiferianus. Antibiotic susceptibility test using paper-disc method showed that PBR1 and PBL1 were sensitive to chloramphenicol, ciprofloxacin, co-trimoxazole, gatifloxacin, levofloxacin, linezolid ad roxithromycin out of 18 antibiotics tested. Moreover, both strains were evaluated for their exopolysachharide (EPS) producing ability where PBR1 and PBL1 were able to yield 1.34 g% (w/v) and 2.45 g% (w/v) EPS respectively from 5 g% (v/v) sucrose concentration. Heavy metal toxicity assessment was carried out using agar well diffusion method with eight heavy metals and both the strains were sensitive to As(III), Cd(II), Ce(II), Cr(III), Cu(II), Hg(II) and while they showed resistance to Pb(II) and Sr(II). Based on these results, a study was conducted to demonstrate bio-removal of Pb and Sr by EPS of PBR1 and PBL1. Fourier transform infrared (FTIR) spectra revealed the functional groups of EPS involved in interaction with the heavy metals. Owing to the sensitivity for the remaining heavy metals, these bioluminescent bacteria can be used further for the development of luminescence-based biosensor.


Assuntos
Organismos Aquáticos/microbiologia , Metais Pesados/química , Polissacarídeos Bacterianos/química , Vibrio alginolyticus/efeitos dos fármacos , Vibrio/efeitos dos fármacos , Animais , Antibacterianos/farmacologia , Biodegradação Ambiental , DNA Bacteriano , Luminescência , Medições Luminescentes , Testes de Sensibilidade Microbiana , Tipagem Molecular , Filogenia , RNA Ribossômico 16S/genética , Espectroscopia de Infravermelho com Transformada de Fourier , Vibrio/classificação , Vibrio/isolamento & purificação , Vibrio alginolyticus/classificação , Vibrio alginolyticus/isolamento & purificação
8.
Biophys Chem ; 264: 106425, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32663708

RESUMO

The novel SARS-CoV-2 is the etiological agent causing the Coronavirus disease 2019 (COVID-19), which continues to become an inevitable pandemic outbreak. Over a short span of time, the structures of therapeutic target proteins for SARS-CoV-2 were identified based on the homology modelled structure of similar SARS-CoV transmission of 2003. Since the onset of the disease, the research community has been looking for a potential drug lead. Out of all the known resolved structures related to SARS-CoV, Main protease (Mpro) is considered an attractive anti-viral drug target on the grounds of its role in viral replication and probable non-interactive competency to bind to any viral host protein. To the best of our knowledge, till date only one compound has been identified and tested in-vivo as a potent inhibitor of Mpro protein, addressed as N3 (PubChem Compound CID: 6323191) and is known to bind irreversibly to Mpro suppressing its activity. Using computational approach, we intend to identify a probable natural fungal metabolite to interact and inhibit Mpro. After screening various small molecules for molecular docking and dynamics simulation, we propose Pyranonigrin A, a secondary fungal metabolite to possess potent inhibitory potential against the Main protease (Mpro) expressed in SARS-CoV-2 virus.


Assuntos
Antivirais/química , Betacoronavirus/enzimologia , Inibidores de Proteases/química , Pironas/química , Pirróis/química , Proteínas não Estruturais Virais/antagonistas & inibidores , Betacoronavirus/patogenicidade , Sítios de Ligação , Proteases 3C de Coronavírus , Cristalografia por Raios X , Cisteína Endopeptidases/química , Cisteína Endopeptidases/genética , Cisteína Endopeptidases/metabolismo , Descoberta de Drogas , Expressão Gênica , Ligação de Hidrogênio , Simulação de Acoplamento Molecular , Simulação de Dinâmica Molecular , Ligação Proteica , Conformação Proteica em alfa-Hélice , Conformação Proteica em Folha beta , Domínios e Motivos de Interação entre Proteínas , SARS-CoV-2 , Homologia de Sequência de Aminoácidos , Termodinâmica , Proteínas não Estruturais Virais/química , Proteínas não Estruturais Virais/genética , Proteínas não Estruturais Virais/metabolismo
9.
Bioorg Chem ; 99: 103823, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32283347

RESUMO

The phenomenon of bioluminescence is the most widely investigated model of quorum sensing (QS) that occurs in various strains of Vibrio. Of lately, most of the virulence exhibited by other microbes is also attributed by similar quorum sensing pathways. Any leap towards blocking of such mechanisms is the need of the hour which is hypothesized to be achieved by interfering with normal QS interactions between ligands and their receptors. Gingerol, a pungent oil easily available from ginger is a structural analog of N-acylhomoserine lactone (AHL), which is an actual signalling ligand of QS-receptor LuxR responsible for initiating a cascade of reactions leading to bioluminescence. In-silico study suggested the antagonistic binding of gingerol to LuxR by hydrogen bonding and hydrophobic interactions which should, in theory, reduce bioluminescence. This was corroborated experimentally by rigorous image analysis of luminescence using hue, saturation and luminescence (HSL) values. Hence, we conclude gingerol as a potent QS-inhibitor for LuxR that may also inhibit the other members of AHL-receptor family.


Assuntos
Catecóis/farmacologia , Álcoois Graxos/farmacologia , Medições Luminescentes , Percepção de Quorum/efeitos dos fármacos , Proteínas Repressoras/antagonistas & inibidores , Transativadores/antagonistas & inibidores , Vibrio/efeitos dos fármacos , Catecóis/química , Relação Dose-Resposta a Droga , Álcoois Graxos/química , Ligantes , Modelos Moleculares , Estrutura Molecular , Proteínas Repressoras/química , Proteínas Repressoras/metabolismo , Relação Estrutura-Atividade , Transativadores/química , Transativadores/metabolismo , Vibrio/metabolismo
10.
J Hazard Mater ; 388: 122047, 2020 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-31954311

RESUMO

Currently, radioactive waste is disposed primarily by burial in a deep geological repository. Microorganisms thriving in such contaminated environment show tolerance to radionuclides. In the present study the bacterial flora, from soil sample collected from an area around atomic power station exposed to radionuclides and heavy metals, was cultivated and assessed for thorium (Th) tolerance. Of all the isolates, strain AM7 identified as O. intermedium was selected since it could thrive at high levels of Th (1000 mg L-1). AM7 was characterized physico-chemically and its culture medium was optimized using central composite design of response surface methodology for assessing its growth properties in presence of Th. The strain also showed exceptional exopolysaccharide (EPS) production and its yield was further analyzed using one factor study to investigate the influence of each medium component. On supplementing the EPS medium with Th, no significant decrease in yield was observed. FTIR spectroscopy revealed the functional groups of EPS involved in EPS-Th binding. To the best of our knowledge, this is the first report showing exceptional Th-tolerance by any bacteria. Such study will help other researchers to strategize an environment-friendly way of radwaste disposal.


Assuntos
Biopolímeros/metabolismo , Ochrobactrum/efeitos da radiação , Polissacarídeos Bacterianos/metabolismo , Tolerância a Radiação , Poluentes Radioativos do Solo/farmacologia , Compostos de Tório/farmacologia , Consórcios Microbianos , Ochrobactrum/genética , Ochrobactrum/crescimento & desenvolvimento , Ochrobactrum/metabolismo , RNA Ribossômico 16S
11.
World J Microbiol Biotechnol ; 28(3): 891-9, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22805809

RESUMO

A novel Enterobacter cancerogenus MSA2 is a plant growth promoting gamma-proteobacterium that was isolated from the rhizosphere of Jatropha cucas a potentially important biofuel feed stock plant. Based on phenotypic, physiological, biochemical and phylogenetic studies, strain MSA2 could be classified as a member of E. cancerogenus. However, comparisons of characteristics with other known species of the genus Enterobacter suggested that strain MSA2 could be a novel PGPB strain. In vitro studies were carried for the plant growth promoting attribute of this culture. It tested positive for ACC (1-aminocyclopropane-1-carboxylic acid) deaminase production, phytase, phosphate solubilization, IAA (Indole acetic acid) production, siderophore, and ammonia production. The isolate was then used as a inoculant for the vegetative study of Jatropha curcas plant. Enterobacter cancerogenus MSA2 supplemented with 1% carboxymethylcellulose showed overall plant growth promotion effect resulting in enhanced root length (124.14%), fresh root mass (81%), fresh shoot mass (120.02%), dry root mass (124%), dry shoot mass (105.54%), number of leaf (30.72%), chlorophyll content (50.41%), and biomass (87.20%) over control under the days of experimental observation. This study was designed for 120 days and was in triplicate and the data was collected at every 30 days.


Assuntos
Enterobacter/metabolismo , Jatropha/crescimento & desenvolvimento , Jatropha/microbiologia , Técnicas de Tipagem Bacteriana , Biomassa , Clorofila/análise , Análise por Conglomerados , DNA Bacteriano/química , DNA Bacteriano/genética , DNA Ribossômico/química , DNA Ribossômico/genética , Enterobacter/classificação , Enterobacter/genética , Enterobacter/isolamento & purificação , Dados de Sequência Molecular , Filogenia , Folhas de Planta/crescimento & desenvolvimento , Raízes de Plantas/crescimento & desenvolvimento , Brotos de Planta/crescimento & desenvolvimento , RNA Ribossômico 16S/genética , Rizosfera , Análise de Sequência de DNA , Microbiologia do Solo
12.
Braz. j. microbiol ; 43(2): 639-648, Apr.-June 2012. graf, tab
Artigo em Inglês | LILACS | ID: lil-644481

RESUMO

Microbial siderophores confiscate the available ferric ions around the roots and trigger a reaction resulting in plant growth promotion. In our study, a high level of siderophore production was observed from a newly isolated Pseudomonas sp. from the rhizosphere of Chickpea plants. Under an iron depleted condition in Standard Succinic acid medium a 1000 µgmL-1 of siderophore production was achieved. Increasing the concentration of iron showed an inverse relationship between growth and siderophore production. Fourier Transform Infrared Spectroscopy (FTIR) analysis of the purified crystals, its UV spectral analysis and High Pressure Liquid Chromatography (HPLC) revealed the identity of the siderophore as similar to that of pyoverdin with distinctive characters. Electron spray ionization mass spectroscopy (ESIMS) shows presence of abundance of A1 ions (419 m/z) and branching of amino acids from B1-B5. This pyoverdin contains a cyclic tetra peptide but Serine and Arginine are missing. Based on our analysis and deviations from the reported structure of pyoverdin it is suggested that this pseudomonas produces distinctly characterized pyoverdin siderophore.


Assuntos
Ácido Succínico/análise , Ácido Succínico/isolamento & purificação , Aeromonas/isolamento & purificação , Compostos de Ferro/análise , Técnicas In Vitro , Estruturas Vegetais , Sideróforos/análise , Sideróforos/isolamento & purificação , Cromatografia Líquida de Alta Pressão/métodos , Fluorescência , Métodos
13.
Braz J Microbiol ; 43(2): 639-48, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24031875

RESUMO

Microbial siderophores confiscate the available ferric ions around the roots and trigger a reaction resulting in plant growth promotion. In our study, a high level of siderophore production was observed from a newly isolated Pseudomonas sp. from the rhizosphere of Chickpea plants. Under an iron depleted condition in Standard Succinic acid medium a 1000 µgmL(-1) of siderophore production was achieved. Increasing the concentration of iron showed an inverse relationship between growth and siderophore production. Fourier Transform Infrared Spectroscopy (FTIR) analysis of the purified crystals, its UV spectral analysis and High Pressure Liquid Chromatography (HPLC) revealed the identity of the siderophore as similar to that of pyoverdin with distinctive characters. Electron spray ionization mass spectroscopy (ESIMS) shows presence of abundance of A1 ions (419 m/z) and branching of amino acids from B1-B5. This pyoverdin contains a cyclic tetra peptide but Serine and Arginine are missing. Based on our analysis and deviations from the reported structure of pyoverdin it is suggested that this pseudomonas produces distinctly characterized pyoverdin siderophore.

14.
Int J Radiat Oncol Biol Phys ; 81(4): 1005-9, 2011 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-20932675

RESUMO

PURPOSE: Several randomized trials have shown a benefit of dose escalation to 78 to 79 Gy for men treated with external radiation for localized prostate cancer. Single-institution data suggest a benefit with even higher doses. American College of Radiology 03-12 is a Phase II trial testing the safety and efficacy of 82 GyE (Gray equivalent) delivered with conformal proton radiation. METHODS AND MATERIALS: From 2003-2006, 85 men with localized prostate cancer were accrued to American College of Radiology 03-12. Eighty-four were eligible for analysis. They were treated with conformal proton radiation alone to a total dose of 82 GyE. The study was designed to test whether the rate of 18-month Grade 3+ late toxicity was greater than 10%. RESULTS: The median follow-up was 31.6 months. Regarding treatment-related acute toxicity, there were 39 Grade 1 cases (46%), 19 Grade 2 cases (23%) and 2 Grade 3 cases (2%). Regarding genitourinary/gastrointestinal toxicity, there were 42 Grade 1 cases (50%), 12 Grade 2 cases (14%) and 1 Grade 3 case (1%). Regarding late toxicity, there were 28 Grade 1 cases (33%), 22 Grade 2 cases (26%), 6 Grade 3 cases (7%), and 1 Grade 4 case (1%). The late genitourinary/gastrointestinal rates were the same. The estimated rate of Grade 3+ late toxicity at 18 months was 6.08%. CONCLUSIONS: Although not free of late toxicity, 82 GyE at 2 GyE per fraction delivered with conformal proton radiation did not exceed the late morbidity target tested in this trial. There was sufficient morbidity, however, that this may be the maximal dose that can be delivered safely with this technique and fractionation.


Assuntos
Trato Gastrointestinal/efeitos da radiação , Neoplasias da Próstata/radioterapia , Terapia com Prótons , Lesões por Radiação/patologia , Radioterapia Conformacional/efeitos adversos , Sistema Urogenital/efeitos da radiação , Adulto , Idoso , Idoso de 80 Anos ou mais , Seguimentos , Humanos , Masculino , Dose Máxima Tolerável , Pessoa de Meia-Idade , Neoplasias da Próstata/patologia , Prótons/efeitos adversos , Radioterapia (Especialidade) , Dosagem Radioterapêutica , Radioterapia Conformacional/métodos , Estados Unidos
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