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1.
Artigo em Inglês | LILACS-Express | LILACS, VETINDEX | ID: biblio-1467154

RESUMO

Abstract The objective of the present work was to assess the qualitative and quantitative characteristics of semen from the surubim do Iguaçu (Steindachneridion melanodermatum). Induced spermiation was achieved in eleven males with mean weight of 1.76 ± 0.48 kg and average age of two years and semen was collected by stripping. The average volume was 1.34 ± 0.73 mL. The duration of sperm motility was 154.4 ± 72.6 and 149.0 ± 77.5 seconds after activation with hatchery water and distilled water, respectively. The sperm concentration estimated by hemocytometer was 5.423 ± 2.155 x 1010 spermatozoa/mL. The results indicate that S. melanodermatum semen is easily obtained during the spawning season and the seminal characteristics are adequate insemination and subsequent in vitro fertilization.


Resumo O objetivo do presente trabalho foi avaliar características qualitativas e quantitativas do sêmen de surubim do Iguaçu (Steindachneridion melanodermatum). Para as análises, utilizaram-se onze machos com peso médio de 1,76±0,48 kg e idade média de dois anos, submetidos ao tratamento de hipofisação. O volume médio de sêmen coletado foi de 1,34 ± 0,73 mL. O tempo médio de motilidade dos espermatozoides após a coleta foi de 154,4 ± 72,6 e 149,0 ± 77,5 segundos para ativação com água do tanque e água destilada, respectivamente. Para a concentração espermática, a média foi de 5,423 ± 2,155 x1010 espermatozoides/mL. Os resultados indicam que o sêmen de S. melanodermatum é facilmente obtido no período reprodutivo analisado, e que as características seminais avaliadas são adequadas para reprodução induzida.

2.
J Gen Intern Med ; 16(10): 656-62, 2001 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-11679032

RESUMO

OBJECTIVE: Health-related quality of life (HRQOL) impairment may be a central component of chronic prostatitis for men afflicted with this condition. Our objective was to examine HRQOL, and factors associated with HRQOL, using both general and condition-specific instruments. DESIGN: Chronic Prostatitis Cohort (CPC) study. SETTING: Six clinical research centers across the United States and Canada. PARTICIPANTS: Two hundred seventy-eight men with chronic prostatitis. MEASUREMENTS AND MAIN RESULTS: The Short Form 12 (SF-12) Mental Component Summary (MCS) and Physical Component Summary (PCS), and the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) were measures used. CPC subjects' MCS scores (44.0 +/- 9.8) were lower than those observed in the most severe subgroups of patients with congestive heart failure and diabetes mellitus, and PCS scores (46.4+/-9.5) were worse than those among the general U.S. male population. Decreasing scores were seen in both domains with worsening symptom severity (P < .01). History of psychiatric disease and younger age were strongly associated with worse MCS scores, whereas history of rheumatologic disease was associated with worse PCS scores. Predictors of more severe NIH-CPSI scores included lower educational level and lower income; history of rheumatic disease was associated with higher scores. CONCLUSIONS: Men with chronic prostatitis experience impairment in the mental and physical domains of general HRQOL, as well as condition-specific HRQOL. To optimize the care of men with this condition, clinicians should consider administering HRQOL instruments to their patients to better understand the impact of the condition on patients' lives.


Assuntos
Prostatite , Qualidade de Vida , Adulto , Doença Crônica , Indicadores Básicos de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
3.
Am J Med ; 111(4): 255-60, 2001 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-11566454

RESUMO

PURPOSE: Because the effects of androgen replacement on lipoprotein levels are uncertain, we sought to determine the effect of transdermal testosterone treatment on serum lipid and apolipoprotein levels in elderly men. SUBJECTS AND METHODS: One hundred and eight healthy men more than 65 years of age who had serum testosterone concentrations >1 SD below the mean for young men were randomly assigned to receive either testosterone (54 men; 6 mg/day) or placebo (54 men) transdermally in a double-blind fashion for 36 months. Serum concentrations of lipids and apolipoproteins were measured, and cardiovascular events recorded. RESULTS: Serum total cholesterol concentrations decreased in both the testosterone-treated men and placebo-treated men, but the 3-year mean (+/- SD) decreases in the two groups (testosterone treated, -17 +/- 29 mg/dL; placebo treated, -12 +/- 38 mg/dL) were not significantly different from each other (P = 0.4). Similarly, serum low-density lipoprotein (LDL) cholesterol levels decreased in both treatment groups, but the decreases in the two groups (testosterone treated, -16 +/- 24 mg/dL; placebo treated, -16 +/- 33 mg/dL) were similar (P = 1.0). Levels of high-density lipoprotein (HDL) cholesterol, triglycerides, and apolipoproteins A-I and B did not change. Lipoprotein(a) levels increased in both groups by similar amounts (testosterone treated, 3 +/- 9 mg/dL; placebo treated, 4 +/- 6 mg/dL; P = 1.0). The number of cardiovascular events was small and did not differ significantly between the testosterone-treated men (9 events) and the placebo-treated men (5 events) during the 3-year study (relative risk = 1.8; 95% confidence interval: 0.7 to 5.0). CONCLUSIONS: As compared with placebo, transdermal testosterone treatment of healthy elderly men for 3 years did not affect any of the lipid or apolipoprotein parameters that we measured. The effect of testosterone treatment on cardiovascular events was unclear, because the number of events was small.


Assuntos
Apolipoproteínas/sangue , Lipídeos/sangue , Testosterona/uso terapêutico , Administração Cutânea , Idoso , Densidade Óssea/efeitos dos fármacos , Método Duplo-Cego , Ensaio de Imunoadsorção Enzimática , Humanos , Masculino , Músculos/efeitos dos fármacos , Estatísticas não Paramétricas , Testosterona/sangue , Fatores de Tempo
4.
Arch Dermatol ; 137(6): 778-83, 2001 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-11405770

RESUMO

OBJECTIVE: To measure the incidence of cancer in patients with psoriasis, stratified by the severity of their disease. DESIGN: A cohort study. SETTING: Administrative claims records obtained from Medicaid programs in 3 US states. PARTICIPANTS: All individuals in the claims database who qualified for 1 of the 5 following groups: severe psoriasis as defined by treatment with systemic medication, less severe psoriasis, severe eczema, history of organ transplantation, and hypertension. MAIN OUTCOME MEASURE: A diagnosis of cancer. RESULTS: Individuals with severe psoriasis were more likely to develop a malignancy than those with hypertension (risk ratio, 1.78; 95% confidence interval [CI], 1.32-2.40). The risk of malignancy in the severe psoriasis group approaches that in patients with organ transplants (risk ratio, 2.12; 95% CI, 1.80-2.50). Most of these cancers were nonmelanoma skin cancers and lymphoproliferative malignancies. Those with less severe psoriasis were only slightly more likely to develop a new malignancy than those with hypertension (risk ratio, 1.13; 95% CI, 1.03-1.25). CONCLUSIONS: Patients with psoriasis are at an increased risk of developing a malignancy compared with patients with hypertension. The increased risk is greatest for those with severe disease (ie, patients with psoriasis treated with systemic agents) and minimal (if an increased risk at all) for those with less severe disease compared with those in the hypertension group. The increased risk is mainly for lymphoproliferative cancers and nonmelanoma skin cancers.


Assuntos
Psoríase/complicações , Neoplasias Cutâneas/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Incidência , Masculino , Medicaid/estatística & dados numéricos , Prontuários Médicos , Mid-Atlantic Region/epidemiologia , Pessoa de Meia-Idade , Psoríase/patologia , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Neoplasias Cutâneas/etiologia
5.
Diabetes Care ; 24(3): 483-8, 2001 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-11289472

RESUMO

OBJECTIVE: The goal of this study was to specifically estimate the effectiveness of platelet releasate, a widely available treatment administered by a proprietary group of wound care centers (WCCs) for the treatment of diabetic neuropathic foot ulceration. RESEARCH DESIGN AND METHODS: Treatment effectiveness was estimated in a retrospective cohort study controlling for treatment selection bias using logistic regression-derived propensity scores. RESULTS: Platelet releasate was more effective than standard care. The relative risk for a wound to heal after treatment with platelet releasate compared with standard care at a WCC varied from 1.14 (95% CI 1.03-1.27) to 1.59 (1.49-1.70). The effect was greatest in those with the most severe wounds, i.e., large wounds that affect deeper anatomical structures. CONCLUSIONS: Within the limitations of the ability of propensity score analysis to control for selection bias, platelet releasate is more effective than standard therapy. This effect is more pronounced in more severe wounds. Unfortunately, severe wounds have not been evaluated in randomized clinical trials of new interventions. We encourage the inclusion of these patients in future trials.


Assuntos
Plaquetas/fisiologia , Pé Diabético/tratamento farmacológico , Neuropatias Diabéticas/tratamento farmacológico , Substâncias de Crescimento/uso terapêutico , Fator de Crescimento Derivado de Plaquetas/uso terapêutico , Cicatrização/efeitos dos fármacos , Idoso , Plaquetas/metabolismo , Estudos de Coortes , Bases de Dados Factuais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
6.
Psychiatry Res ; 106(2): 113-22, 2001 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-11306250

RESUMO

This study measured changes in regional cerebral blood flow (rCBF) during the complex cognitive task of meditation using single photon emission computed tomography. Eight experienced Tibetan Buddhist meditators were injected at baseline with 7 mCi HMPAO and scanned 20 min later for 45 min. The subjects then meditated for 1 h at which time they were injected with 25 mCi HMPAO and scanned 20 min later for 30 min. Values were obtained for regions of interest in major brain structures and normalized to whole brain activity. The percentage change between meditation and baseline was compared. Correlations between structures were also determined. Significantly increased rCBF (P<0.05) was observed in the cingulate gyrus, inferior and orbital frontal cortex, dorsolateral prefrontal cortex (DLPFC), and thalamus. The change in rCBF in the left DLPFC correlated negatively (P<0.05) with that in the left superior parietal lobe. Increased frontal rCBF may reflect focused concentration and thalamic increases overall increased cortical activity during meditation. The correlation between the DLPFC and the superior parietal lobe may reflect an altered sense of space experienced during meditation. These results suggest a complex rCBF pattern during the task of meditation.


Assuntos
Encéfalo/irrigação sanguínea , Encéfalo/diagnóstico por imagem , Cognição/fisiologia , Meditação , Tomografia Computadorizada de Emissão de Fóton Único , Adulto , Budismo , Circulação Cerebrovascular/fisiologia , Lobo Frontal/irrigação sanguínea , Lobo Frontal/diagnóstico por imagem , Lateralidade Funcional/fisiologia , Giro do Cíngulo/irrigação sanguínea , Giro do Cíngulo/diagnóstico por imagem , Humanos , Pessoa de Meia-Idade , Oximas , Lobo Parietal/irrigação sanguínea , Lobo Parietal/diagnóstico por imagem , Córtex Pré-Frontal/irrigação sanguínea , Córtex Pré-Frontal/diagnóstico por imagem , Compostos Radiofarmacêuticos , Percepção Espacial/fisiologia , Tálamo/irrigação sanguínea , Tálamo/diagnóstico por imagem
7.
Arch Dermatol ; 136(12): 1531-5, 2000 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-11115166

RESUMO

OBJECTIVE: To estimate the effect of various risk factors on the probability that neuropathic diabetic foot ulcers will heal within 20 weeks of care. DESIGN AND SETTING: A pooled or meta-analysis of individual patient data from the standard care arms of 5 randomized clinical trials was conducted. We analyzed 586 subjects with diabetes mellitus who had a neuropathic diabetic foot ulcer. All patients received good wound care, debridement, and "off-loading" of the wound. MAIN OUTCOME MEASURE: Multivariable logistic regression was used to calculate the magnitude of the association of each risk factor with patients having healed wounds. RESULTS: Logistic regression odds ratios (ORs; 95% confidence intervals [95% CIs]) revealed that those patients with a diabetic neuropathic foot ulcer that healed within 20 weeks using standard care were more likely to have a smaller wound (OR = 0.67; 95% CI, 0.55-0.81), a wound that existed for a shorter period (OR = 0.73; 95% CI, 0.61-0.87), and be nonwhite (OR = 0.64; 95% CI, 0.43-0.96) compared with patients whose wounds did not heal within 20 weeks. The patient's age (OR = 0.99; 95% CI, 0.89-1.01), serum level of glycosylated hemoglobin at the start of the study (OR = 1.03; 95% CI, 0.97-1.10), and sex (OR = 1. 02; 95% CI, 0.69-1.50) were unassociated with the probability of wound healing. Substantial heterogeneity was not found among the studies. CONCLUSIONS: A standard care regimen for diabetic neuropathic foot ulcers is most likely to be effective for patients who have wounds that are small and of brief duration. This information should help dermatologists decide initially whether to use standard care, to try a new treatment, or to refer the patient to a specialty center.


Assuntos
Pé Diabético/patologia , Pé Diabético/terapia , Cicatrização , Adulto , Idoso , Idoso de 80 Anos ou mais , Ensaios Clínicos como Assunto , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Fatores de Risco , Fatores de Tempo
8.
J Clin Endocrinol Metab ; 85(8): 2670-7, 2000 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-10946864

RESUMO

Treatment of hypogonadal men with testosterone has been shown to ameliorate the effects of testosterone deficiency on bone, muscle, erythropoiesis, and the prostate. Most previous studies, however, have employed somewhat pharmacological doses of testosterone esters, which could result in exaggerated effects, and/or have been of relatively short duration or employed previously treated men, which could result in dampened effects. The goal of this study was to determine the magnitude and time course of the effects of physiological testosterone replacement for 3 yr on bone density, muscle mass and strength, erythropoiesis, prostate volume, energy, sexual function, and lipids in previously untreated hypogonadal men. We selected 18 men who were hypogonadal (mean serum testosterone +/- SD, 78 +/- 77 ng/dL; 2.7 +/- 2.7 nmol/L) due to organic disease and had never previously been treated for hypogonadism. We treated them with testosterone transdermally for 3 yr. Sixteen men completed 12 months of the protocol, and 14 men completed 36 months. The mean serum testosterone concentration reached the normal range by 3 months of treatment and remained there for the duration of treatment. Bone mineral density of the lumbar spine (L2-L4) increased by 7.7 +/- 7.6% (P < 0.001), and that of the femoral trochanter increased by 4.0 +/- 5.4% (P = 0.02); both reached maximum values by 24 months. Fat-free mass increased 3.1 kg (P = 0.004), and fat-free mass of the arms and legs individually increased, principally within the first 6 months. The decrease in fat mass was not statistically significant. Strength of knee flexion and extension did not change. Hematocrit increased dramatically, from mildly anemic (38.0 +/- 3.0%) to midnormal (43.1 +/- 4.0%; P = 0.002) within 3 months, and remained at that level for the duration of treatment. Prostate volume also increased dramatically, from subnormal (12.0 +/- 6.0 mL) before treatment to normal (22.4 +/- 8.4 mL; P = 0.004), principally during the first 6 months. Self-reported sense of energy (49 +/- 19% to 66 +/- 24%; P = 0.01) and sexual function (24 +/- 20% to 66 +/- 24%; P < 0.001) also increased, principally within the first 3 months. Lipids did not change. We conclude from this study that replacing testosterone in hypogonadal men increases bone mineral density of the spine and hip, fat-free mass, prostate volume, erythropoiesis, energy, and sexual function. The full effect of testosterone on bone mineral density took 24 months, but the full effects on the other tissues took only 3-6 months. These results provide the basis for monitoring the magnitude and the time course of the effects of testosterone replacement in hypogonadal men.


Assuntos
Terapia de Reposição Hormonal , Hipogonadismo/tratamento farmacológico , Testosterona/uso terapêutico , Administração Cutânea , Adulto , Densidade Óssea/efeitos dos fármacos , Eritropoese/efeitos dos fármacos , Humanos , Hipogonadismo/fisiopatologia , Hipogonadismo/psicologia , Lipídeos/sangue , Masculino , Próstata/anatomia & histologia , Antígeno Prostático Específico/sangue , Escroto , Comportamento Sexual , Testosterona/administração & dosagem , Testosterona/sangue , Fatores de Tempo
9.
LDI Issue Brief ; 5(4): 1-4, 2000 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-12523342

RESUMO

The national statistics are familiar by now: each year, more than 2 million women are raped and/or physically assaulted; more than one-third of them are injured during their most recent assault. Annually, more than 500,000 women seek medical services as a result of violence-related injuries, often from hospital emergency departments. But national statistics cannot fully capture the extent of violence experienced by women in inner-city areas, nor do they point to modifiable risk factors at a community level. This Issue Brief highlights a new study that investigates the circumstances and correlates of violent injuries among women in one urban, low-income community.


Assuntos
População Urbana , Violência , Serviços de Saúde da Mulher , Serviços Médicos de Emergência , Feminino , Política de Saúde , Humanos , Masculino , Philadelphia/epidemiologia , Fatores de Risco , Fatores Socioeconômicos , Maus-Tratos Conjugais/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias , Estados Unidos , População Urbana/estatística & dados numéricos , Violência/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia , Ferimentos e Lesões/etiologia
10.
N Engl J Med ; 341(25): 1899-905, 1999 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-10601510

RESUMO

BACKGROUND: Although the rate of death from injuries due to violent acts is much higher among black women than among white women in the United States, little is known about the nature and correlates of violent injuries among black women living in urban areas. METHODS: In this case-control study conducted at three emergency departments in one inner-city community (in west Philadelphia), we studied 405 adolescent girls and women who had been intentionally injured and 520 adolescent girls and women (control subjects) who had health problems not related to violent injury. Data were collected by conducting standardized interviews with use of questionnaires and by screening urine for illicit drugs. Individual logistic-regression models were constructed to identify factors associated with violent injuries inflicted by partners and those inflicted by persons other than the partners of the victims. RESULTS: The male partners of the injured women were much more likely than the male partners of control subjects to use cocaine (odds ratio, 4.4; 95 percent confidence interval, 2.3 to 8.4) and to have been arrested in the past (odds ratio, 3.1; 95 percent confidence interval, 1.8 to 5.2). Fifty-three percent of violent injuries to the women had been perpetrated by persons other than their partners. Women's use of illicit drugs and alcohol abuse were factors associated with both violence on the part of partners and violence on the part of other persons. Neighborhood characteristics, including low median income, a high rate of change of residence, and poor education, were independently associated with the risk of violent injuries among women. CONCLUSIONS: Women in this urban, low-income community face violence from both partners and other persons. Substance abuse, particularly cocaine use, is a significant correlate of violent injuries. Standard Census data may help identify neighborhoods where women are at high risk for such violence and that would benefit from community-level interventions.


Assuntos
Violência Doméstica/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia , Adolescente , Adulto , Estudos de Casos e Controles , Transtornos Relacionados ao Uso de Cocaína/epidemiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Philadelphia/epidemiologia , Fatores de Risco , Fatores Socioeconômicos , Maus-Tratos Conjugais/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Ferimentos e Lesões/etiologia
11.
J Clin Endocrinol Metab ; 84(8): 2647-53, 1999 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-10443654

RESUMO

As men age, serum testosterone concentrations decrease, the percentage of body mass that is fat increases, the percentage of lean body mass decreases, and muscle strength decreases. Because these changes are similar to those that occur in hypogonadal men, we hypothesized that increasing the serum testosterone concentration of men over 65 yr of age to that in young men would decrease their fat mass, increase their lean mass, and increase their muscle strength. We randomized 108 men over 65 yr of age to wear either a testosterone patch or a placebo patch in a double blind study for 36 months. We measured body composition by dual energy x-ray absorptiometry and muscle strength by dynamometer before and during treatment. Ninety-six men completed the entire 36-month protocol. Fat mass decreased (-3.0+/-0.5 kg) in the testosterone-treated men during the 36 months of treatment, which was significantly different (P = 0.001) from the decrease (-0.7+/-0.5 kg) in the placebo-treated men. Lean mass increased (1.9+/-0.3 kg) in the testosterone-treated men, which was significantly different (P < 0.001) from that (0.2+/-0.2 kg) in the placebo-treated men. The decrease in fat mass in the testosterone-treated men was principally in the arms (-0.7+/-0.1 kg; P < 0.001 compared to the placebo group) and legs (-1.1+/-0.2 kg; P < 0.001), and the increase in lean mass was principally in the trunk (1.9+/-0.3 kg; P < 0.001). The change in strength of knee extension and flexion at 60 degrees and 180 degrees angular velocity during treatment, however, was not significantly different between the two groups. We conclude that increasing the serum testosterone concentrations of normal men over 65 yr of age to the midnormal range for young men decreased fat mass, principally in the arms and legs, and increased lean mass, principally in the trunk, but did not increase the strength of knee extension and flexion, as measured by dynamometer.


Assuntos
Composição Corporal/efeitos dos fármacos , Músculos/efeitos dos fármacos , Testosterona/farmacologia , Idoso , Método Duplo-Cego , Humanos , Masculino , Testosterona/sangue
12.
J Clin Endocrinol Metab ; 84(6): 1966-72, 1999 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-10372695

RESUMO

As men age, their serum testosterone concentrations decrease, as do their bone densities. Because bone density is also low in hypogonadal men, we hypothesized that increasing the serum testosterone concentrations of men over 65 yr to those found in young men would increase their bone densities. We randomized 108 men over 65 yr of age to wear either a testosterone patch or a placebo patch double blindly for 36 months. We measured bone mineral density by dual energy x-ray absorptiometry before and during treatment. Ninety-six men completed the entire 36-month protocol. The mean serum testosterone concentration in the men treated with testosterone increased from 367 +/- 79 ng/dL (+/-SD; 12.7 +/- 2.7 nmol/L) before treatment to 625 +/- 249 ng/dL (21.7 +/- 8.6 nmol/L; P < 0.001) at 6 months of treatment and remained at that level for the duration of the study. The mean bone mineral density of the lumbar spine increased (P < 0.001) in both the placebo-treated (2.5 +/- 0.6%) and testosterone-treated (4.2 +/- 0.8%) groups, but the mean changes did not differ between the groups. Linear regression analysis, however, demonstrated that the lower the pretreatment serum testosterone concentration, the greater the effect of testosterone treatment on lumbar spine bone density from 0-36 months (P = 0.02). This analysis showed a minimal effect (0.9 +/- 1.0%) of testosterone treatment on bone mineral density for a pretreatment serum testosterone concentration of 400 ng/dL (13.9 nmol/L), but an increase of 5.9 +/- 2.2% for a pretreatment testosterone concentration of 200 ng/dL (6.9 nmol/L). Increasing the serum testosterone concentrations of normal men over 65 yr of age to the midnormal range for young men did not increase lumbar spine bone density overall, but did increase it in those men with low pretreatment serum testosterone concentrations.


Assuntos
Densidade Óssea/efeitos dos fármacos , Testosterona/uso terapêutico , Administração Cutânea , Idoso , Osso e Ossos/metabolismo , Método Duplo-Cego , Hematócrito , Hemoglobinas/metabolismo , Humanos , Masculino , Doenças Prostáticas/induzido quimicamente , Mecânica Respiratória/efeitos dos fármacos , Sono/efeitos dos fármacos , Testosterona/administração & dosagem , Testosterona/efeitos adversos
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