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1.
Vet Dermatol ; 34(3): 209-221, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35661451

RESUMO

BACKGROUND: Hereditary equine regional dermal asthenia (HERDA) is a genetic disease that alters collagen biosynthesis. Affected horses exhibit fragile, hyperextensible skin, especially over the dorsal region. Although ultraviolet (UV) radiation seems to contribute to the regional distribution of lesions and worsening of clinical signs, the molecular mechanisms involved are largely unknown. OBJECTIVES: To evaluate the effect of solar radiation on matrix metalloproteinase MMP1, MMP8 and MMP13 gene expression in the dorsal and ventral skin of HERDA-affected and HERDA-unaffected horses [wild-type (WT) horses]. ANIMALS: Six HERDA-affected and six unaffected Quarter horses (WT) were paired according to age, sex and coat colour. MATERIALS AND METHODS: Horses were submitted to 30 day sunlight restriction, followed by 15 day sunlight exposure. Dorsal and ventral skin biopsies were obtained at six sampling times over 45 days. The expression of MMP1, MMP8 and MMP13 genes was measured by quantitative PCR. RESULTS: Although solar radiation modulated MMP1, MMP8 and MMP13 expression, the effects were more pronounced on MMP1. Sun exposure for three days significantly upregulated MMP1 in the dorsal region when compared to the ventral skin in both unaffected and HERDA-affected horses. CONCLUSIONS AND CLINICAL RELEVANCE: This study shows that solar irradiation leads to upregulation of skin collagenase genes particularly MMP1 in the dorsal, sun-exposed skin of horses. Furthermore, this was more marked in HERDA-affected horses. The increased activity of collagenases on the disorganised collagen present in HERDA affected horses would explain why UV radiation leads to deterioration of clinical signs in affected individuals.


Assuntos
Metaloproteinase 1 da Matriz , Metaloproteinase 8 da Matriz , Animais , Cavalos/genética , Metaloproteinase 8 da Matriz/genética , Metaloproteinase 13 da Matriz/genética , Metaloproteinase 1 da Matriz/genética , Astenia/genética , Astenia/patologia , Astenia/veterinária , Colagenases/genética , Expressão Gênica
2.
Pflugers Arch ; 473(5): 753-774, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-32979108

RESUMO

Astroglia represent a class of heterogeneous, in form and function, cells known as astrocytes, which provide for homoeostasis and defence of the central nervous system (CNS). Ageing is associated with morphological and functional remodelling of astrocytes with a prevalence of morphological atrophy and loss of function. In particular, ageing is associated with (i) decrease in astroglial synaptic coverage, (ii) deficits in glutamate and potassium clearance, (iii) reduced astroglial synthesis of synaptogenic factors such as cholesterol, (iv) decrease in aquaporin 4 channels in astroglial endfeet with subsequent decline in the glymphatic clearance, (v) decrease in astroglial metabolic support through the lactate shuttle, (vi) dwindling adult neurogenesis resulting from diminished proliferative capacity of radial stem astrocytes, (vii) decline in the astroglial-vascular coupling and deficient blood-brain barrier and (viii) decrease in astroglial ability to mount reactive astrogliosis. Decrease in reactive capabilities of astroglia are associated with rise of age-dependent neurodegenerative diseases. Astroglial morphology and function can be influenced and improved by lifestyle interventions such as intellectual engagement, social interactions, physical exercise, caloric restriction and healthy diet. These modifications of lifestyle are paramount for cognitive longevity.


Assuntos
Envelhecimento/patologia , Astenia/patologia , Astrócitos/metabolismo , Encéfalo/fisiologia , Animais , Astrócitos/patologia , Encéfalo/crescimento & desenvolvimento , Encéfalo/patologia , Senescência Celular , Humanos
4.
Adv Neurobiol ; 15: 427-449, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28674992

RESUMO

The most notable finding in neurodegenerative diseases is the progressive death of neurones cells. Yet, neuroglial changes can precede and facilitate neuronal loss. This is perhaps expected because astroglial cells maintain the brain homoeostasis, and are responsible for defence and regeneration, so that their malfunction manifested as degeneration or asthenia together with reactivity contribute to pathophysiology. Neuroglia may represent a novel target for therapeutic intervention, be that prevention, slowing progression of or possibly curing neurodegenerative diseases.


Assuntos
Doença de Alzheimer/patologia , Astenia/patologia , Encéfalo/patologia , Neuroglia/patologia , Paralisia/patologia , Doença de Alzheimer/fisiopatologia , Esclerose Amiotrófica Lateral/patologia , Esclerose Amiotrófica Lateral/fisiopatologia , Animais , Astenia/fisiopatologia , Astrócitos/patologia , Encéfalo/fisiopatologia , Modelos Animais de Doenças , Progressão da Doença , Humanos , Doença de Huntington/patologia , Doença de Huntington/fisiopatologia , Camundongos Transgênicos , Microglia/patologia , Doenças Neurodegenerativas/patologia , Doenças Neurodegenerativas/fisiopatologia , Neurônios/patologia , Oligodendroglia/patologia , Paralisia/fisiopatologia
5.
Arch. esp. urol. (Ed. impr.) ; 69(10): 715-718, dic. 2016. ilus
Artigo em Espanhol | IBECS | ID: ibc-158586

RESUMO

OBJETIVO: Resaltar la importancia del manejo y seguimiento estrecho de pacientes con esclerosis tuberosa que asocian angiomiolipomas renales. MÉTODOS: Presentación de un caso clínico. RESULTADOS: Se trata de un paciente varón de 55 años de edad diagnosticado de esclerosis tuberosa en la infancia con posterior hallazgo de masas renales bilaterales y de gran tamaño en estudio de imagen, con compromiso importante de la función renal. El paciente no tuvo un seguimiento adecuado ni recibió tratamiento alguno. Al momento se encuentra en estadio terminal de su enfermedad renal. CONCLUSIÓN: Los pacientes que asocian angiomiolipomas renales y esclerosis tuberosa, presentan características particulares con mayor riesgo de complicaciones por lo que requieren un seguimiento estricto y un manejo específico


OBJECTIVE: To assess the importance of management and close follow-up of patients with tuberous sclerosis that associate renal angiomyolipomas. METHODS: To report a case. RESULTS: A 55 years old men with tuberous sclerosis diagnosed in childhood and later finding of bilateral giant renal masses in imaging studies, with significant compromise of renal function. The patient did not have a proper follow up and did not receive any treatment. At the moment he has end stage kidney disease. CONCLUSION: Patients that associate renal angiomyolipoma and tuberous sclerosis, have specific characteristics with a higher risk of complications requiring strict follow-up and specific treatment


Assuntos
Humanos , Masculino , Adulto , Angiomiolipoma/metabolismo , Angiomiolipoma/patologia , Esclerose Tuberosa/diagnóstico , Astenia/patologia , Prurido/diagnóstico , Everolimo/administração & dosagem , Angiomiolipoma/complicações , Angiomiolipoma/diagnóstico , Esclerose Tuberosa/complicações , Astenia/metabolismo , Prurido/complicações , Everolimo/provisão & distribuição
7.
Vet Ophthalmol ; 18(5): 385-92, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25338739

RESUMO

OBJECTIVES: The aim of this study was to compare ocular dimensions, corneal curvature, and corneal thickness between horses affected with hereditary equine regional dermal asthenia (HERDA) and unaffected horses. ANIMALS: Five HERDA-affected quarter horses and five healthy control quarter horses were used. METHODS: Schirmer's tear test, tonometry, and corneal diameter measurements were performed in both eyes of all horses prior to ophthalmologic examinations. Ultrasonic pachymetry was performed to measure the central, temporal, nasal, dorsal, and ventral corneal thicknesses in all horses. B-mode ultrasound scanning was performed on both eyes of each horse to determine the dimensions of the ocular structures and to calculate the corneal curvature. RESULTS: Each corneal region examined in this study was thinner in the affected group compared with the healthy control group. However, significant differences in corneal thickness were only observed for the central and dorsal regions. HERDA-affected horses exhibited significant increases in corneal curvature and corneal diameter compared with unaffected animals. The ophthalmologic examinations revealed mild corneal opacity in one eye of one affected horse and in both eyes of three affected horses. No significant between-group differences were observed for Schirmer's tear test, intraocular pressure, or ocular dimensions. CONCLUSIONS: Hereditary equine regional dermal asthenia-affected horses exhibit decreased corneal thickness in several regions of the cornea, increased corneal curvature, increased corneal diameter, and mild corneal opacity. Additional research is required to determine whether the increased corneal curvature significantly impacts the visual accuracy of horses with HERDA.


Assuntos
Astenia/veterinária , Córnea/patologia , Oftalmopatias/veterinária , Olho/patologia , Doenças dos Cavalos/patologia , Animais , Astenia/genética , Astenia/patologia , Estudos de Casos e Controles , Córnea/anatomia & histologia , Paquimetria Corneana/veterinária , Olho/anatomia & histologia , Olho/diagnóstico por imagem , Oftalmopatias/diagnóstico por imagem , Oftalmopatias/genética , Oftalmopatias/patologia , Feminino , Doenças dos Cavalos/diagnóstico por imagem , Doenças dos Cavalos/genética , Cavalos/anatomia & histologia , Masculino , Tonometria Ocular/veterinária , Ultrassonografia
8.
Vet Dermatol ; 25(6): 547-54, e95-6, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24964390

RESUMO

BACKGROUND: Hereditary equine regional dermal asthenia (HERDA) is an autosomal recessive disorder affecting quarter horses (QHs); affected horses exhibit characteristic skin abnormalities related to abnormal collagen biosynthesis. HYPOTHESIS/OBJECTIVES: To characterize the thickness and morphological abnormalities of the skin of HERDA-affected horses and to determine the interobserver agreement and the diagnostic accuracy of histopathological examination of skin biopsies from horses with HERDA. ANIMALS: Six affected QHs, confirmed by DNA testing, from a research herd and five unaffected QHs from a stud farm. METHODS: The skin thickness in 25 distinct body regions was measured on both sides in all affected and unaffected horses. Histopathological and ultrastructural evaluation of skin biopsies was performed. RESULTS: The average skin thickness in all of the evaluated regions was thinner in the affected horses. A statistically significant difference between skin thickness of the affected and unaffected animals was observed only when the average magnitude of difference was ≥38.7% (P = 0.038). The interobserver agreement for the histopathological evaluation was fair to substantial. The histopathological sensitivity for the diagnosis of HERDA was dependent on the evaluator and ranged from 73 to 88%, whereas the specificity was affected by the region sampled and ranged from 35 to 75%. CONCLUSIONS AND CLINICAL IMPORTANCE: Despite the regional pattern of the cutaneous signs, skin with decreased thickness was not regionally distributed in the HERDA-affected horses. Histopathological evaluation is informative but not conclusive for establishing the diagnosis. Samples of skin from the neck, croup or back are useful for diagnosis of HERDA. However, the final diagnosis must be confirmed using molecular testing.


Assuntos
Astenia/veterinária , Doenças dos Cavalos/patologia , Dermatopatias Genéticas/veterinária , Pele/patologia , Animais , Astenia/genética , Astenia/patologia , Biópsia , Estudos de Casos e Controles , Ciclofilinas/genética , Feminino , Marcadores Genéticos , Doenças dos Cavalos/genética , Cavalos , Masculino , Mutação de Sentido Incorreto , Variações Dependentes do Observador , Sensibilidade e Especificidade , Pele/ultraestrutura , Dermatopatias Genéticas/genética , Dermatopatias Genéticas/patologia
9.
Vet Clin North Am Equine Pract ; 29(3): 689-702, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24267684

RESUMO

Hereditary equine regional dermal asthenia is a form of Ehlers-Danlos syndrome, and has an autosomal recessive mode of inheritance. Affected horses are typically born normal and develop lesions within the first 2 years of life. The most common symptoms of the disease include stretchy, loose skin that feels doughy or mushy. More severely affected horses experience spontaneous skin sloughing and extensive lacerations, hematomas, and seromas from minor trauma. Affected horses have a higher than expected incidence of corneal ulcers. DNA testing can normal, establish carrier and affected status. Palliative therapy is available, but no curative treatment exists.


Assuntos
Astenia/veterinária , Doenças dos Cavalos/genética , Doenças dos Cavalos/patologia , Dermatopatias Genéticas/veterinária , Animais , Astenia/genética , Astenia/patologia , Astenia/terapia , Doenças dos Cavalos/terapia , Cavalos , Dermatopatias Genéticas/genética , Dermatopatias Genéticas/patologia , Dermatopatias Genéticas/terapia
10.
Zhongguo Zhong Yao Za Zhi ; 38(7): 1067-70, 2013 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-23847959

RESUMO

OBJECTIVE: To observe the effect of Dingguier umbilical paste on rats with functional dyspepsia and mice with splenic asthenia, and investigate the related mechanism. METHOD: Functional dyspepsia models of rats were made by irregular food intake plus diluted hydrochloric acid. Successional treatments were offered for 14 days. The rats weights, contents of serum NO, AChE and MC were measured. The rats with splenic asthenia were made by rhubarb feed, and observed the affection of gastric emptying. RESULT: Compared with those in the model control group, the weight of rats in all dosages Dingguier umbilical paste groups increased obviously (P < 0.05), pepsin activity of rats in the dosage (1.34 g x kg(-1)) Dingguier umbilical paste groups was significantly higher and the contents of NO and quantities of MC in the dosage (2.67 g x kg(-1)) Dingguier umbilical paste groups decreased clearly (P < 0.05), and the contents of serum AChE in all dosages Dingguier umbilical paste groups rose apparently. The weight of mice with splenic asthenia increased obviously, accelerated gastric emptying, and improved the symptom. CONCLUSION: Dingguier umbilical paste has significant improvement of indigestion. The related mechanism may be to reduce the content of serum NO and the quantity of MC and enhance the content of serum AChE.


Assuntos
Astenia/tratamento farmacológico , Medicamentos de Ervas Chinesas/administração & dosagem , Dispepsia/tratamento farmacológico , Baço/efeitos dos fármacos , Animais , Astenia/patologia , Astenia/fisiopatologia , Peso Corporal/efeitos dos fármacos , Dispepsia/fisiopatologia , Ingestão de Alimentos/efeitos dos fármacos , Feminino , Esvaziamento Gástrico/efeitos dos fármacos , Humanos , Masculino , Camundongos , Ratos , Ratos Wistar , Baço/patologia , Umbigo
11.
Acta Trop ; 127(3): 212-5, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23692887

RESUMO

Giardiasis is a disease with worldwide distribution, although its prevalence differs from country to country. In order to investigate the clinical pattern of giardiasis in in-patient children, a case-control study was carried out. In-patient children who had Giardia lamblia infection were compared with non Giardia-infected children, focusing only on 4 clinical manifestations: diarrhoea, abdominal pain, asthenia and vomiting. In multivariable analysis, abdominal pain (odds ratio [OR] 4.71, 95% confidence intervals [CI] 2.66-8.32) and asthenia (OR 3.30, 95% CI 1.16-9.37) had positive and independent associations with Giardia infection. The present study supports the potential role of G. lamblia in abdominal pain in children who attend- and are admitted- to a hospital in Havana City, and highlights the importance to keep abdominal pain and asthenia in mind in hospital admitted children in the event of an association with an evocative epidemiological context.


Assuntos
Dor Abdominal/patologia , Astenia/patologia , Giardíase/patologia , Adolescente , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Giardíase/diagnóstico , Humanos , Lactente , Recém-Nascido , Masculino , Análise Multivariada , Razão de Chances , Prevalência
12.
Rev. esp. patol ; 46(1): 40-44, ene.-mar. 2013. ilus
Artigo em Espanhol | IBECS | ID: ibc-109150

RESUMO

El interés del caso reportado surge a raíz de la obtención de un valor de lipasa superior a 7.000 U/l en una paciente con una paniculitis en miembros inferiores de 10 meses de evolución. Se estableció el diagnóstico de paniculitis pancreática, y adenocarcinoma gástrico con metástasis hepáticas, con la peculiaridad de no encontrar afectación clínica ni radiológica del páncreas. Las paniculitis pancreáticas de origen tumoral no pancreático constituyen una rareza, y son un hecho excepcional en la literatura médica consultada. Este es el primer caso de paniculitis pancreática como signo inicial de un cáncer gástrico, con metástasis hepáticas y con mayor supervivencia reportado en la literatura, lo cual hace que su revisión clínica e histológica sea de extraordinario interés(AU)


A patient presenting with a ten month history of progressive lower limb panniculitis was found to have more than 7,000 lipase U/L. Pancreatic panniculitis and gastric adenocarcinoma with liver metastases was diagnosed, despite no clinical or radiological findings of pancreatic disease. Pancreatic panniculitis arising from a non pancreatic primary is extremely rare. To our knowledge, this is the first time pancreatic panniculitis has been reported as the presenting sign of gastric carcinoma with hepatic metastases. It is also the longest survival to be reported to date(AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Paniculite/diagnóstico , Paniculite/patologia , Adenocarcinoma/diagnóstico , Adenocarcinoma/patologia , Metástase Neoplásica/diagnóstico , Metástase Neoplásica/patologia , Lipase , Gastroscopia/instrumentação , Gastroscopia/métodos , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/patologia , Astenia/complicações , Astenia/patologia , Radiografia Torácica/métodos , Biópsia
13.
Toxicol Pathol ; 39(4): 700-5, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21628719

RESUMO

The Göttingen minipig is one of the nonrodent species recommended by various regulatory authorities for safety assessment of drugs in preclinical studies. In such studies, knowledge of background pathology is critical in order to evaluate the potential renal toxicity. In the present study, the authors report 4 cases of glomerulonephritis out of 154 microbiologically defined Göttingen minipigs microscopically evaluated in preclinical studies. One animal required early sacrifice because of general poor health, and an additional animal died spontaneously. Histopathological evaluation revealed renal lesions in all 4 animals, exhibiting membranous or membranoproliferative glomerulonephritis at different stages, accompanied by secondary tubulo-interstitial damage. The renal changes observed were considered spontaneous in origin and of unknown etiology. Development of this condition in this strain should be considered in future studies.


Assuntos
Glomerulonefrite/veterinária , Doenças dos Suínos/patologia , Fosfatase Alcalina/sangue , Animais , Astenia/patologia , Proliferação de Células , Feminino , Glomerulonefrite/patologia , Hematúria/patologia , Rim/patologia , Contagem de Leucócitos , Masculino , Modelos Animais , Suínos , Porco Miniatura , Testes de Toxicidade/métodos , Xenobióticos/toxicidade
15.
Schweiz Arch Tierheilkd ; 152(4): 188-92, 2010 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-20361398

RESUMO

Hereditary equine dermal asthenia (HERDA) is an autosomal recessive skin disease that affects predominantly Quarter Horses and related breeds. Typical symptoms are easy bruising and hyperextensible skin on the back. The prognosis is guarded, as affected horses cannot be ridden normally and are often euthanised. In the Quarter Horse, HERDA is associated with a mutation in cyclophilin B (PPIB), an enzyme involved in triple helix formation of collagen. Here we describe the case of a Swiss Warmblood filly with symptoms of HERDA without PPIB-mutation and in which we also could exclude Ehlers-Danlos syndrome Type IV, VI, VIIA, VIIB and VIIC (dermatosparaxis type) as etiological diseases.


Assuntos
Astenia/veterinária , Ciclofilinas/genética , Doenças dos Cavalos/genética , Dermatopatias/veterinária , Animais , Astenia/genética , Astenia/patologia , Colágeno/metabolismo , Síndrome de Ehlers-Danlos/genética , Feminino , Doenças dos Cavalos/patologia , Cavalos , Humanos , Mutação , Dermatopatias/genética , Dermatopatias/patologia
16.
Vet Dermatol ; 20(2): 139-43, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19192263

RESUMO

Cutaneous asthenia is a hereditary connective tissue disease, primarily of dogs and cats, resembling Ehlers-Danlos syndrome in man. Collagen dysplasia results in skin hyperextensibility, skin and vessel fragility, and poor wound healing. The purpose of this study was to describe the histological findings in a dog with a collagenopathy consistent with cutaneous asthenia. An 8-month-old crossbreed female dog presented with lacerations and numerous atrophic and irregular scars. The skin was hyperextensible and easily torn by the slightest trauma. Ultrastructurally, the dermis was comprised of elaunin and oxytalan microfibrils. These are immature fibres in which the fibrillar component is increased but elastin is reduced. Collagen fibres were profoundly disorganized. The fibrils had a highly irregular outline and a corroded appearance when viewed in cross-section, and were spiralled and fragmented in a longitudinal view. Dermal fibroblasts displayed a conspicuous thickening of the nuclear lamina. Nuclear lamins form a fibrous nucleoskeletal network of intermediate-sized filaments underlying the inner nuclear membrane. Mutations in lamins or lamin-associated proteins cause a myriad of genetic diseases collectively called laminopathies. Disruption of the nuclear lamina seems to affect chromatin organization and transcriptional regulation of gene expression. A common link among all laminopathies may be a failure of stem cells to regenerate mesenchymal tissue. This could contribute to the connective tissue dysplasia seen in cutaneous asthenia.


Assuntos
Astenia/veterinária , Doenças do Cão/patologia , Microfibrilas/metabolismo , Lâmina Nuclear/patologia , Dermatopatias/veterinária , Animais , Astenia/patologia , Cães , Feminino , Pele/patologia , Dermatopatias/patologia
20.
Med Parazitol (Mosk) ; (4): 49-51, 2006.
Artigo em Russo | MEDLINE | ID: mdl-17290912

RESUMO

The purpose of the investigation was to study the specific features and the course of Helicobacter pylori-associated duodenal ulcer (DU) concurrent with chronic opisthorchiasis (CO) A hundred and twenty-seven patients with H. pylori-associated DU were examined. Of them 78 patients were found to have H. pylori-associated DU concurrent with CO. In mixed pathology, asthenovegetative disorders were observed in most patients, one third had eosinophilia. With an over 10-year history of CO, acid production and pepsin secretion substantially decreased in both phases of gastric secretion. Mucosal atrophic changes were found mainly in the antral portion of the stomach, which frequency correlated with the duration of Opisthorchis invasion. The incidence of atrophic duodenitis tripled. All the patients received eradication therapy by the classical first-line treatment regimen including omeprazole and the antibiotics clarithromycin and amoxicillin. In the mixed pathology group, the time of ulcerative defect scarring increased by an average of 5 days. Fifty-eight with pathology continuously receiving the antisecretoty agent underwent dehelminthization with the anthelminthic bilthricide in 33 patients and with the plant anthelminthic dry aspen bark extract in 25. Evaluation of the efficiency of eradication therapy indicated that the best results of H. pylori eradication had been achieved in the patients dehelminthized with bilthricide. Assessment of long-term results showed that after multimodality therapy (eradication followed by bilthricide dehelminthization), there were no relapses for 2 years and there was a drop in the number of patients resorting to on-request therapy in patients with H. pylori-associated DU concurrent with CO.


Assuntos
Úlcera Duodenal/etiologia , Úlcera Duodenal/fisiopatologia , Infecções por Helicobacter/complicações , Helicobacter pylori , Opistorquíase/complicações , Adulto , Animais , Anti-Helmínticos/uso terapêutico , Antibacterianos/uso terapêutico , Antiulcerosos/uso terapêutico , Astenia/patologia , Atrofia/patologia , Doença Crônica , Úlcera Duodenal/tratamento farmacológico , Duodeno/patologia , Eosinofilia/patologia , Ácido Gástrico/metabolismo , Mucosa Gástrica/metabolismo , Mucosa Gástrica/fisiopatologia , Infecções por Helicobacter/tratamento farmacológico , Humanos , Mucosa Intestinal/patologia , Pessoa de Meia-Idade , Omeprazol/uso terapêutico , Opistorquíase/tratamento farmacológico , Pepsina A/metabolismo , Praziquantel/uso terapêutico , Recidiva , Estômago/fisiopatologia , Resultado do Tratamento
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