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1.
J Nat Prod ; 87(4): 1217-1221, 2024 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-38630559

RESUMO

Two unusual naphthoquinones, named here as pleonotoquinones A (1) and B (2), were isolated along with two known anthraquinones (3 and 4) via chromatographic separations of an ethyl acetate extract of the roots of Pleonotoma jasminifolia. Compounds 1 and 2 are the first examples of quinones bearing a 2-methyloxepine moiety. The compounds were isolated with the aid of mass spectrometry and molecular networking, and their structures were resolved using 1D and 2D NMR and HRESIMS data. The isolated compounds were evaluated for their antiproliferative activity against human cancer cell lines, and compounds 1 and 2 displayed cytotoxicity against human colon cancer HCT116 cells (IC50 = 2.6 µM for compound 1 and IC50 = 4.3 µM for compound 2) and human liver cancer HepG2 cells (IC50 = 1.9 µM for compound 1 and IC50 = 6.4 µM for compound 2).


Assuntos
Antineoplásicos Fitogênicos , Ensaios de Seleção de Medicamentos Antitumorais , Naftoquinonas , Raízes de Plantas , Humanos , Naftoquinonas/farmacologia , Naftoquinonas/química , Naftoquinonas/isolamento & purificação , Antineoplásicos Fitogênicos/farmacologia , Antineoplásicos Fitogênicos/química , Antineoplásicos Fitogênicos/isolamento & purificação , Estrutura Molecular , Raízes de Plantas/química , Células Hep G2 , Células HCT116 , Boraginaceae/química
3.
J Esthet Restor Dent ; 2024 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-38581272

RESUMO

OBJECTIVE: To evaluate the effect of fluoride consistency and composition to protect enamel and dentin against the dental erosion. MATERIALS AND METHODS: Bovine enamel and dentin specimens were treated with artificial saliva, neutral fluoride gel (NFG), acidulated phosphate fluoride gel (AFG), neutral fluoride foam (NFF), and acidulated phosphate fluoride foam. The samples were subjected to cycling. Micro energy-dispersive X-ray fluorescence spectrometry, surface roughness (Ra), contact angle (CA), and scanning electron microscopy (SEM) were performed. Composition, CA and Ra data were analyzed by ANOVA and multiple comparison test (p < 0.05). RESULTS: The dentin protected had a significantly higher mineral content than in the control. Eroded unprotected enamel had higher Ra values than normal surfaces. Fluoride treatments increased the Ra in dentin samples. AFG increased the CA in enamel. Fluoride foams increased CA in dentin with reduced mineral loss. SEM analysis found a deposited layer on enamel treated with AFG and remnants of deposits on dentin treated with NFG and NFF. CONCLUSION: Regardless of the form of application, fluoride provided protection against erosion, however with different levels. CLINICAL SIGNIFICANCE: Applying the adequate fluoride form is relevant since the formulations have different effects on both enamel and dentin.

4.
J Esthet Restor Dent ; 2024 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-38563466

RESUMO

OBJECTIVE: This systematic review aimed to analyze the clinical (survival rate, failure risk, or fracture) and laboratory performance (fracture mode or failure) of rehabilitations of endodontically treated teeth, with and without posts. MATERIALS AND METHODS: A systematic search was conducted in the Pubmed, Scopus, Web of Science, Embase, Cochrane Library, and OpenGrey databases up to March 2023, according to PRISMA guidelines. In vitro and clinical studies that compared the clinical and laboratory performance of endodontically treated teeth with and without intraradicular posts were included. Studies selection, data extraction, and risk of bias analysis were performed. RESULTS: Thirty-one in vitro and 7 clinical studies were included. For in vitro studies, fiberglass post (n = 24) was the most mentioned. The follow-up time of the clinical studies ranged from 1 to 17 years, with the fiber-reinforced composite post (n = 3) being the most evaluated, and only failure risk proved to be more favorable for using intraradicular posts. CONCLUSION: Rehabilitations of endodontically treated teeth with and without intraradicular retainers showed no difference in fracture resistance and failure mode, evaluated by in vitro studies. Clinical studies showed no difference in survival rate, but failure risk proved to be more favorable for the use of posts. CLINICAL SIGNIFICANCE: This analysis revealed significant variability between results, however, most laboratory and clinical studies revealed no difference with using the post. Furthermore, it is important to emphasize the need to evaluate the coronary remnant and the general characteristics of the tooth in each situation.

5.
Cytogenet Genome Res ; 2024 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-38631304

RESUMO

Introduction Eukaryotic genomes consist of both single and repetitive sequences, including Satellite DNAs (satDNA), which are non-coding sequences arranged in tandem arrays. These sequences play a crucial role in genomic functions and innovations, influencing processes such as nuclear material maintenance, heterochromatin formation, and sex chromosome differentiation. In this genomic era, advancements in next-generation sequencing and bioinformatic tools have facilitated the comprehensive cataloging of repetitive elements in genomes, particularly in non-model species. This study focuses on the satellitome of Ancistrus sp., a diverse fish species within the Loricariidae family. The genus Ancistrus displays significant karyotypic evolution, with deviations from the ancestral diploid number. Methods Using bioinformatic approaches, we identified 40 satellite DNA families in Ancistrus sp., constituting 5.19% of the genome. The abundance and divergence landscape analysis revealed diverse profiles, indicating recent amplification and homogenization of these satDNA sequences. Results The most abundant satellite, AnSat1-142, constitutes 2.1% of the genome, while the least abundant, AnSat40-52, represents 0.0034%. The monomer repeat length ranges from 16 to 142 base pairs, with an average length of 61 bp. These findings contribute to understanding the genomic dynamics and evolution of satDNAs in Ancistrus sp. Conclusion The study underscores the variability in satDNAs among fish species and provides valuable insights into the chromosomal organization and evolution of repetitive elements in non-model organisms.

6.
Clinics (Sao Paulo) ; 79: 100346, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38574572

RESUMO

BACKGROUND AND OBJECTIVE: Lower limb varicose veins are a prevalent disease associated with several available treatment options, including conventional surgery and polidocanol foam sclerotherapy. However, few studies have analyzed therapeutic modality outcomes based on Patient-Reported Outcome Measures (PROMs). This large sample-size study was designed to evaluate the outcomes of polidocanol foam sclerotherapy compared to conventional surgery based on an analysis of PROMs. METHODS: This was a prospective, observational, and qualitative study of 205 patients who underwent varicose vein treatment with either polidocanol foam sclerotherapy (57 patients, 90 legs) or conventional surgery (148 patients, 236 legs). Patients were preoperatively assessed and re-evaluated 30 days after the procedure using the Venous Disease Severity Score (VCSS) and specific venous disease quality-of-life questionnaires (VEINES-QoL/Sym). RESULTS: Both treatments significantly improved VCSS and VEINES results 30 days after the procedure (p < 0.05). However, surgery promoted greater improvements in VCSS (on average 4.02-points improvement, p < 0.001), VEINES-QoL (average 8-points improvement, p < 0.001), and VEINES-Sym (average 11.66 points improvement, p < 0.001) than did sclerotherapy. Postoperative pain and aesthetic concerns about the legs were the domains of the questionnaires in which the results varied the most between the treatment modalities, with worse results for sclerotherapy. CONCLUSION: Both polidocanol foam sclerotherapy and conventional surgery positively impact patients' quality of life after 30 days, but the improvement is more significant for patients who undergo conventional surgery.


Assuntos
Qualidade de Vida , Varizes , Humanos , Polidocanol , Polietilenoglicóis , Estudos Prospectivos , Veia Safena , Soluções Esclerosantes/uso terapêutico , Soluções Esclerosantes/efeitos adversos , Escleroterapia/efeitos adversos , Resultado do Tratamento , Varizes/cirurgia , Varizes/terapia
7.
Chromosoma ; 2024 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-38546866

RESUMO

Among the repetitive elements, satellite DNA (SatDNA) emerges as extensive arrays of highly similar tandemly repeated units, spanning megabases in length. Given that the satDNA PboSat01-176, previously characterized in P. boiei, prompted our interest for having a high abundance in P. boiei and potential for centromeric satellite, here, we employed various approaches, including low coverage genome sequencing, followed by computational analysis and chromosomal localization techniques in four Proceratophrys species and, investigating the genomic presence and sharing, as well as its potential for chromosomal centromere marker in Proceratophrys frog species. Our findings demonstrate that PboSat01-176 exhibits high abundance across all four Proceratophrys species, displaying distinct characteristics that establish it as the predominant repetitive DNA element in these species. The satellite DNA is prominently clustered in the peri/centromeric region of the chromosomes, particularly in the heterochromatic regions. The widespread presence of PboSat01-176 in closely related Proceratophrys species reinforces the validity of the library hypothesis for repetitive sequences. Thus, this study highlighted the utility of the satDNA family PboSat01-176 as a reliable centromeric marker in Proceratophrys species, with potential to be applied in other species of anuran amphibians. The observed sharing and maintenance of this sequence within the genus suggest possibilities for future research, particularly through expanded sampling to elucidate parameters that underlie the library hypothesis and the evolutionary dynamics of satDNA sequences.

8.
Biochem Biophys Res Commun ; 706: 149748, 2024 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-38460450

RESUMO

Angiogenesis is a process that is controlled by a delicate combination of proangiogenic and antiangiogenic molecules and can be disrupted in various illnesses, including cancer. Non-cancerous diseases can also have an abnormal or insufficient vascular growth, inflammation and hypoxia, which exacerbate angiogenesis. These conditions include atherosclerosis, psoriasis, endometriosis, asthma, obesity and AIDS. Based on that, the present work assessed the in vitro and ex vivo antiangiogenic properties stemming from BthMP, a P-I metalloproteinase from Bothrops moojeni snake venom, via the VEGF pathway. BthMP at a concentration of 5 and 40 µg/mL showed no toxicity to endothelial cells (HUVEC) in the MTT assay and was not able to induce necrosis and colony proliferation. Interestingly, BthMP inhibited adhesion, migration and invasion of HUVECs in Matrigel and arrested in vitro angiogenesis by reducing the average number of nodules in toxin-treated cells by 9.6 and 17.32 at 5 and 40 µg/mL, respectively, and the number of tubules by 15.9 at 5 µg/mL and 21.6 at 40 µg/mL in a VEGF-dependent way, an essential proangiogenic property. Furthermore, BthMP inhibited the occurrence of the angiogenic process in an ex vivo aortic ring test by decreasing new vessel formation by 52% at 5 µg/mL and by 66% at 40 µg/mL and by increasing the expression of an antiangiogenic gene, SFLT-1, and decreasing the expression of the proangiogenic genes VEGFA and ANGPT-1. Finally, this toxin reduces the production of nitric oxide, a marker that promotes angiogenesis and VEGF modulation, and decreases the protein expression of VEGFA in the supernatant of the HUVEC culture by about 30 %. These results suggest that BthMP has a promising antiangiogenic property and proves to be a biotechnological mechanism for understanding the antiangiogenic responses induced by snake venom metalloproteinases, which could be applied to a variety of diseases that exhibit an imbalance of angiogenesis mechanisms.


Assuntos
Bothrops , Células Endoteliais , 60573 , Animais , Feminino , Humanos , Células Endoteliais/metabolismo , Fator A de Crescimento do Endotélio Vascular/metabolismo , Bothrops/metabolismo , Metaloproteases/metabolismo , Venenos de Serpentes , Células Endoteliais da Veia Umbilical Humana/metabolismo , Inibidores da Angiogênese/farmacologia
10.
Journal of Electronics and Electrical Engineering ; 3(1): 148-165, mar.2024. ilus, graf
Artigo em Inglês | CONASS, Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1537914

RESUMO

Ventricular Assist Devices (VADs) play a crucial role in both bridging to transplantation and serving as destination therapy for congestive heart failure (CHF) management. This study aims to address the limitations of existing control strategies for VADs, specifically their inability to adapt automatically to hemodynamic changes. It proposes a novel embedded cyber-physical system (CPS) based on real-time data processing, reconfigurable architecture, and communication protocols aligned with Health 4.0 concepts to enhance physiological control over VADs (PC-VAD). The research employs a multi-objective PC-VAD approach within a hybrid cardiovascular simulator. An embedded CPS is introduced to overcome challenges related to differences in controller characteristics between computers and embedded systems. The study assesses the performance of the embedded CPS by comparing it with a computer-based control system. The embedded CPS demonstrates outcomes comparable to the computer-based control system, maintaining mean arterial pressure and cardiac output at physiological levels. Even in the face of variations in ejection fraction, the embedded CPS dynamically adjusts the pump's rotational speed based on simulated clinical conditions. Notably, there is no aortic reflux to the ventricle through the VAD during testing. These findings affirm the satisfactory control performance of the embedded CPS in regulating VADs. The study concludes that the embedded CPS effectively addresses the limitations of current VAD control strategies, exhibiting control performance comparable to computer-based systems. However, further experimentation and in vivo studies are necessary to validate and ensure its applicability in real-world scenarios.


Assuntos
Coração Auxiliar , Insuficiência Cardíaca
11.
Cancer Discov ; 2024 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-38533987

RESUMO

Cancer homeostasis depends on a balance between activated oncogenic pathways driving tumorigenesis and engagement of stress-response programs that counteract the inherent toxicity of such aberrant signaling. While inhibition of oncogenic signaling pathways has been explored extensively, there is increasing evidence that overactivation of the same pathways can also disrupt cancer homeostasis and cause lethality. We show here that inhibition of Protein Phosphatase 2A (PP2A) hyperactivates multiple oncogenic pathways and engages stress responses in colon cancer cells. Genetic and compound screens identify combined inhibition of PP2A and WEE1 as synergistic in multiple cancer models by collapsing DNA replication and triggering premature mitosis followed by cell death. This combination also suppressed the growth of patient-derived tumors in vivo. Remarkably, acquired resistance to this drug combination suppressed the ability of colon cancer cells to form tumors in vivo. Our data suggest that paradoxical activation of oncogenic signaling can result in tumor suppressive resistance.

13.
Heliyon ; 10(5): e26819, 2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38439847

RESUMO

Nitrogen is one of the essential nutrients for the production of agricultural crops, participating in a complex interaction among soil, plant and the atmosphere. Therefore, its monitoring is important both economically and environmentally. The aim of this work was to estimate the leaf nitrogen contents in sugarcane from hyperspectral reflectance data during different vegetative stages of the plant. The assessments were performed from an experiment designed in completely randomized blocks, with increasing nitrogen doses (0, 60, 120 and 180 kg ha-1). The acquisition of the spectral data occurred at different stages of crop development (67, 99, 144, 164, 200, 228, 255 and 313 days after cutting; DAC). In the laboratory, the hyperspectral responses of the leaves and the Leaf Nitrogen Contents (LNC) were obtained. The hyperspectral data and the LNC values were used to generate spectral models employing the technique of Partial Least Squares Regression (PLSR) Analysis, also with the calculation of the spectral bands of greatest relevance, by the Variable Importance in Projection (VIP). In general, the increase in LNC promoted a smaller reflectance in all wavelengths in the visible (400-680 nm). Acceptable models were obtained (R2 > 0.70 and RMSE <1.41 g kg-1), the most robust of which were those generated from spectra in the visible (400-680 nm) and red-edge (680-750 nm), with values of R2 > 0.81 and RMSE <1.24 g kg-1. An independent validation, leave-one-date-out cross validation (LOOCV), was performed using data from other collections, which confirmed the robustness and the possibility of LNC prediction in new data sets, derived, for instance, from samplings subsequent to the period of study.

14.
Int J Biol Macromol ; 264(Pt 1): 130446, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38423428

RESUMO

Potentially toxic metal ions, such as hexavalent chromium (Cr6+), present in water concern the population's health due to their persistence, bioaccumulation potential, and high toxicity. Highly porous materials based on polysaccharides are promising technologies for metal removal due to their high surface area, biodegradability, and low toxicity. This study evaluated the effect of concentrations of microcellulose (0.5, 1, and 1.5 %) and glutaraldehyde (1, 2, and 3 %) in the adsorption capacity and mechanical properties of chitosan foams. The developed foams exhibited a three-dimensional structure with interconnected pores. Compared to foams without microcellulose, adding 1.5 % microcellulose increased up to 180 % in maximum stress supported by the foams and up to 135 % in Young's modulus. However, Cr6+ sorption capacity decreased with increasing microcellulose and crosslinking agent content due to the occupation of amino groups. Still, the foams exhibited a highly favorable sorption behavior, and the Sips isotherm model provided the best fit to the experimental data. The maximum sorption capacity reached approximately 1.4 mmol·g-1 at pH 4.0 and 25 °C. The foam structural integrity, enhanced mechanical properties, and efficient sorption capacity make them viable alternatives for environmentally friendly and cost-effective treatment of water contaminated with Cr6+ ions.


Assuntos
Quitosana , Cromo , Poluentes Químicos da Água , Poluentes Químicos da Água/química , Quitosana/química , Concentração de Íons de Hidrogênio , Cinética , Água
15.
Front Plant Sci ; 15: 1337750, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38348273

RESUMO

In plants, serpins are a superfamily of serine and cysteine protease inhibitors involved in stress and defense mechanisms, with potential for controlling agricultural pests, making them important biotechnological tools. The objective of this study was to characterize a serpin from Theobroma cacao, called TcSERPIN, to identify its endogenous targets and determine its function and biotechnological potential. TcSERPIN has 390 amino acid residues and shows conservation of the main active site, RCL. Cis-elements related to light, stress, hormones, anaerobic induction, cell cycle regulation and defense have been identified in the gene's regulatory region. TcSERPIN transcripts are accumulated in different tissues of Theobroma cacao. Furthermore, in plants infected with Moniliophtora perniciosa and Phytophthora palmivora, the expression of TcSERPIN was positively regulated. The protein spectrum, rTcSERPIN, reveals a typical ß-sheet pattern and is thermostable at pH 8, but loses its structure with temperature increases above 66°C at pH 7. At the molar ratios of 0.65 and 0.49, rTcSERPIN inhibited 55 and 28% of the activity of papain from Carica papaya and trypsin from Sus scrofa, respectively. The protease trap containing immobilized rTcSERPIN captured endogenous defense proteins from cocoa extracts that are related to metabolic pathways, stress and defense. The evaluation of the biotechnological potential against geohelminth larvae showed that rTcSERPIN and rTcCYS4 (Theobroma cacao cystatin 4) reduced the movement of larvae after 24 hours. The results of this work show that TcSERPIN has ideal biochemical characteristics for biotechnological applications, as well as potential for studies of resistance to phytopathogens of agricultural crops.

16.
Artigo em Inglês | MEDLINE | ID: mdl-38395382

RESUMO

OBJECTIVE: Understanding the causes of amputation is crucial for defining health policies that seek to avoid such an outcome, but only a few studies have investigated the epidemiology of patients submitted to amputations in developing countries. The objective of this study was to analyse all lower limb amputations performed in the public health system in Brazil over a 13 year period, evaluating trends in the number of cases, patient demographics, associated aetiologies, hospital length of stay, and in hospital mortality rate. METHODS: This was a retrospective, population based analysis of all lower limb amputations performed in the Brazilian public health system between 1 January 2008 and 31 December 2020. Using a public database, all types of amputations were selected, defining the number of procedures, their main aetiologies, anatomical level of limb loss, demographic data, regional distribution, and other variables of interest. RESULTS: A total of 633 455 amputations were performed between 2008 and 2020, mostly (55.6%) minor amputations, predominantly in males (67%). There was an upward trend in the number of amputations, determined mainly by the increase in major amputations (50.4% increase in the period). Elderly individuals have the highest rates of amputation. Diabetes mellitus (DM) is becoming the main primary diagnosis associated with amputations over the years. The highest in hospital mortality rate occurred after major amputations and was associated with peripheral arterial disease (PAD). CONCLUSION: Amputation rates in Brazil show an upward trend. DM is becoming the most frequent associated primary diagnosis, although PAD is the diagnosis most associated with major amputations and in hospital death.

18.
Nat Prod Res ; : 1-7, 2024 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-38343284

RESUMO

Mosquitoes of the Aedes genus are responsible for transmitting many vector-borne viral diseases worldwide. Hundreds of thousands of people die annually from vector-borne diseases, including West Nile fever, dengue, tick-borne diseases, yellow fever, chikungunya, Rift Valley fever, and Zika. Billions of people are at the risk of infection on all continents, which is a cause of international concern. Therefore, new vector-control methods are essential for mitigating these illnesses. The bioactive hydrocarbons isolated from Xylopia langsdorfiana St. Hilaire & Tulasne are trachylobanes, a rare class of diterpenes found in the n-hexane fraction of the stem and leaf ethanolic extracts. These were tested against Ae. aegypti fourth-instar larvae over 48 h of exposure, with LC50 values ranging from 19.84 to 72.9 µg/mL, comparable to that of the positive control. The findings highlight the potential of Xylopia langsdorfiana St. Hilaire & Tulasne metabolites for controlling the main vectors of arthropod-borne viruses.

19.
J Vis Exp ; (204)2024 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-38407332

RESUMO

This research delves into the consequences of consistent pinprick stimulation on preterm offspring to ascertain its long-term implications for pain sensitivity. The primary objective of this protocol was to investigate the impact of neonatal pinprick stimuli on the pain threshold in the later stages of life using a preterm rat model. By establishing this model, we aim to advance the research on understanding and managing early postnatal pain associated with prematurity. The findings of this study indicate that while the baseline thresholds to mechanical stimuli remained unaffected, there was a notable increase in mechanical hypersensitivity following complete Freund's adjuvant (CFA) injection in adult rats. Interestingly, compared with male rats, female rats demonstrated heightened inflammatory hypersensitivity. Notably, maternal behavior, the weight of the litters, and the growth trajectory of the offspring remained unchanged by the stimulation. The manifestation of altered nociceptive responses in adulthood after neonatal painful stimuli could be indicative of changes in sensory processing and the functioning of glucocorticoid receptors. However, further research is needed to understand the underlying mechanisms involved and to develop interventions for the consequences of prematurity and neonatal pain in adults.


Assuntos
Hipersensibilidade , Dor , Feminino , Masculino , Animais , Ratos , Dor/etiologia , Limiar da Dor , Sensação , Manejo da Dor , Adjuvante de Freund
20.
Cancer Treat Res Commun ; 38: 100790, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38241969

RESUMO

PURPOSE: Hodgkin's lymphoma is currently treated with a chemotherapy protocol consisting of doxorubicin, bleomycin, vinblastine, and dacarbazine. Due to Brazil facing a bleomycin shortage in 2017, and this drug's high toxicity, this retrospective study evaluates the effect that the absence of bleomycin had on treatment response and overall survival of Hodgkin's lymphoma patients. METHODS: The medical records of 126 HL patients treated between 2007 and 2021 were reviewed and their data collected, followed by grouping into ABVD and AVD groups according to bleomycin use. Data concerning the patient's characteristics, cancer type, and treatment plan were analyzed with proportion tests, Kaplan-Meier curves. univariate Cox regression, and χ2 tests. RESULTS: No discernible differences were found in this study between the overall survival and recurrence rate of patients treated with bleomycin compared to those without. Additionally, there was an increased risk of death in each subsequent cycle of chemotherapy of the complete ABVD protocol, demonstrating a risk of toxicity. Among the variables analyzed, hypertension and the presence of B symptoms were also associated with an increased risk of death, while the use of radiotherapy significantly improved survival. CONCLUSION: The results of this study suggest that bleomycin did not impact the outcome of Hodgkin's lymphoma treatment. Moreover, the increased risk of death associated with its toxicity during each cycle of treatment raises concerns about its role as an essential component of the gold standard for Hodgkin's lymphoma treatment. Therefore, further research and consideration are needed to reassess the use of bleomycin in Hodgkin's lymphoma treatment protocols.


Assuntos
Doença de Hodgkin , Humanos , Doença de Hodgkin/patologia , Bleomicina/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Estudos Retrospectivos , Doxorrubicina/efeitos adversos , Vimblastina/efeitos adversos , Dacarbazina/efeitos adversos
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