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1.
J Agric Food Chem ; 71(24): 9429-9440, 2023 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-37294890

RESUMO

Hyperuricemia (HUA) is a widespread metabolic disease marked by an elevated level of uric acid, and is a risk factor for premature death. The protective effect of corn silk flavonoids (CSF) against HUA and its potential mechanisms were explored. Five important apoptosis and inflammation-related signaling pathways were identified by network pharmacological analysis. The CSF exhibited significant uric acid (UA)-lowering activity in vitro by decreasing xanthine oxidase (XOD) and increasing hypoxanthine-guanine phosphoribosyl transferase levels. In a potassium oxonate-induced HUA in vivo, CSF treatment effectively inhibited XOD activity and promoted UA excretion. Furthermore, it decreased the levels of TNF-α and IL-6 and restored pathological damage. In summary, CSF is a functional food component to improve HUA by reducing inflammation and apoptosis through the down-regulating PI3K/AKT/NF-κB pathway.


Assuntos
Hiperuricemia , Humanos , Hiperuricemia/metabolismo , Flavonoides/farmacologia , NF-kappa B/genética , Proteínas Proto-Oncogênicas c-akt/genética , Proteínas Proto-Oncogênicas c-akt/metabolismo , Fosfatidilinositol 3-Quinases/genética , Fosfatidilinositol 3-Quinases/metabolismo , Zea mays/metabolismo , Ácido Úrico/metabolismo , Inflamação/tratamento farmacológico , Xantina Oxidase , Seda/efeitos adversos
2.
Cornea ; 40(10): 1357-1359, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34481413

RESUMO

PURPOSE: To present a rare presentation of pyogenic granuloma arising almost 4 decades after a scleral buckle for retinal detachment. METHOD: We describe the clinical presentation, diagnostic workup, and management of a suspicious conjunctival lesion in an immunocompromised patient. We report the histopathological findings and the postoperative outcome. RESULTS: A 58-year-old man with human immunodeficiency virus presented for evaluation of a possible malignant conjunctival lesion in the left eye. The patient reported that the lesion had appeared 1.5 months before presentation with significant growth over the past month. The patient denied any trauma to the eye other than an ocular history of retinal detachment repair with scleral buckle 37 years earlier. Clinical examination revealed a pink, fleshy, mobile, and lobulated conjunctival lesion measuring 7 mm by 10 mm, emanating from the superior-nasal bulbar quadrant. A high-resolution optical coherence tomography revealed highly cellular infiltrate and hyperreflective mass with significant posterior shadowing. Further exploration of the lesion revealed a white, stringy, cauliflower-like material on the underside of the lesion. Surgical excision and pathology subsequently confirmed a diagnosis of pyogenic granuloma with remnants of silk suture. CONCLUSIONS: A diagnosis of pyogenic granuloma secondary to retained silk sutures should be considered in patients with a history of intraocular surgery irrespective of other risk factors and length of time since procedure.


Assuntos
Granuloma Piogênico/etiologia , Descolamento Retiniano/cirurgia , Recurvamento da Esclera/efeitos adversos , Seda/efeitos adversos , Suturas/efeitos adversos , Antibióticos Antineoplásicos/administração & dosagem , Crioterapia , Granuloma Piogênico/diagnóstico , Granuloma Piogênico/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Mitomicina/administração & dosagem , Fatores de Tempo
3.
Int J Toxicol ; 39(3_suppl): 127S-144S, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33203267

RESUMO

The Expert Panel for Cosmetic Ingredient Safety (Panel) reviewed the safety of Hydrolyzed Silk and 9 other silk protein ingredients, which function primarily as skin and hair conditioning agents and bulking agents in cosmetic products. The Panel reviewed relevant data relating to the safety of these ingredients and concluded that 8 ingredients are safe in the present practices of use and concentration in cosmetics, as described in this safety assessment, but that the available data are insufficient for determining the safety of 2 silk protein ingredients in cosmetic products, MEA-Hydrolyzed Silk and Silkworm Cocoon Extract.


Assuntos
Cosméticos , Seda , Animais , Produtos Biológicos/efeitos adversos , Produtos Biológicos/química , Produtos Biológicos/toxicidade , Qualidade de Produtos para o Consumidor , Cosméticos/efeitos adversos , Cosméticos/química , Cosméticos/toxicidade , Feminino , Cobaias , Humanos , Masculino , Camundongos , Ratos , Seda/efeitos adversos , Seda/química , Seda/toxicidade , Testes de Toxicidade
4.
Urologiia ; (6): 113-114, 2019 12 31.
Artigo em Russo | MEDLINE | ID: mdl-32003179

RESUMO

Suture granuloma is very rare complication of surgical procedures developing from the non-absorbable sutures. The development of suture granuloma is a chronic process and includes multinucleated giant cell formation. It has two step process including the initial reaction of tissue inflicted the passage of the needle and specific inflammatory reaction of the suture material. There is no pathognomonic imaging modality fort he diagnosis of suture granuloma. Surgery is used to for the diagnosis and eradication of the inflammation. A 59 year old man presented with 3*2 cm sized palpable, firm painless nodular mass in the right scrotum. The patient was treated with high orchiectomy before 3 weeks. The mass was excised and reported as silk suture granuloma.


Assuntos
Granuloma , Orquiectomia , Seda , Granuloma/etiologia , Humanos , Inflamação , Masculino , Pessoa de Meia-Idade , Orquiectomia/efeitos adversos , Seda/efeitos adversos , Suturas
5.
J Neurosurg Spine ; 29(5): 599-607, 2018 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-30141762

RESUMO

The authors investigated the effects of a silk solution against laminectomy-induced dural adhesion formation and inflammation in a rat model. They found that it significantly reduced postlaminectomy dural adhesion formation and inflammation. Dural adhesion formation, thought to be an inevitable consequence of laminectomy, is one of the most common complications following spinal surgery, and the authors' results indicate that the silk solution might be a potential novel therapeutic agent for dural adhesion formation.


Assuntos
Inflamação/complicações , Laminectomia/efeitos adversos , Seda/efeitos adversos , Animais , Modelos Animais de Doenças , Interleucina-1beta/metabolismo , Óxido Nítrico/metabolismo , Ratos
7.
Microsc Res Tech ; 80(3): 291-297, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26999258

RESUMO

The aim of this study was to compare the tissue reactions to silk fibroin scaffolds in the abdominal wall, vagina, and pelvic vesico-uterine of rats. Silk fibroin scaffolds were implanted subcutaneously in the abdominal, pelvic vesico-uterine space, and under the vaginal mucosa of 16 rats. The animals were euthanized at 2, 4, 8, and 12 weeks postoperatively. Hematoxylin and eosin staining was performed to evaluate cellular infiltration, the percentage of macrophages and granulocytes inside and around the scaffolds. The amounts of M1/M2 macrophages at the interface of scaffolds and host tissue were evaluated through an immunofluorescence assay. The degree of acute inflammation was similar among the three groups, and lasted no more than 4 weeks. A faster ingrowth of fibroblasts was found in the abdominally implanted silk fibroin scaffolds, while vaginal implanted scaffolds committed a slower tissue ingrowth rate and much more macrophages infiltration than the pelvic and abdominal group. However, a significantly higher amount of M2 cells were seen in the three groups. In general, silk fibroin has nice biocompatibility in the abdominal, vagina, and pelvic tissue, eliciting healthy tissue formation, and might be a potential choice for female pelvic reconstruction. Microsc. Res. Tech. 80:291-297, 2017. © 2016 Wiley Periodicals, Inc.


Assuntos
Parede Abdominal/fisiologia , Materiais Biocompatíveis/síntese química , Fibroínas/administração & dosagem , Pelve/fisiologia , Seda/administração & dosagem , Vagina/fisiologia , Animais , Materiais Biocompatíveis/administração & dosagem , Materiais Biocompatíveis/efeitos adversos , Feminino , Fibroínas/efeitos adversos , Fibroínas/química , Granulócitos/imunologia , Inflamação/imunologia , Macrófagos/citologia , Macrófagos/imunologia , Porosidade , Ratos , Ratos Sprague-Dawley , Seda/efeitos adversos , Seda/química , Engenharia Tecidual/métodos , Tecidos Suporte/efeitos adversos , Tecidos Suporte/química
9.
Int J Occup Med Environ Health ; 28(5): 915-9, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26224503

RESUMO

N-hexane neuropathy is an occupational disease caused by exposure to n-hexane, which is used as a solvent in silk screen printing. Here, we describe a 35-year-old man, a silk screen printer by profession, who presented with dizziness, distal swelling of both lower limbs for 10 months and tingling and burning sensation in both feet for 9.5 months along with cold allodynia. The patient had normal results of a motor and sensory system examination, apart from an impaired temperature sense. Nerve conduction tests showed a conduction block in bilateral common peroneal nerves and absence of conduction in bilateral sural nerves. These symptoms resolved when further exposure to n-hexane was ceased but cold allodynia remained. Thus, cold allodynia and impaired temperature sense can be a manifestation of n-hexane neuropathy. Hence, abnormalities on nerve conduction studies can be detected in n-hexane neuropathy patients, even before clinical examination detects any such abnormalities. In the case of the patients presenting with sensory motor neuropathy, history of occupational exposure to n-hexane becomes important, as the sooner the disease is detected, the better the chances of recovery.


Assuntos
Temperatura Baixa/efeitos adversos , Hexanos/efeitos adversos , Hiperalgesia/diagnóstico , Doenças Profissionais/diagnóstico , Seda/efeitos adversos , Nervo Sural/fisiopatologia , Vertigem/diagnóstico , Adulto , Eletromiografia , Hexanos/análise , Humanos , Hiperalgesia/etiologia , Hiperalgesia/fisiopatologia , Masculino , Condução Nervosa/efeitos dos fármacos , Doenças Profissionais/fisiopatologia , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/análise , Seda/análise , Nervo Sural/efeitos dos fármacos , Vertigem/etiologia , Vertigem/fisiopatologia
12.
J Biomed Mater Res A ; 103(2): 534-44, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24753349

RESUMO

Cartilage tissue engineering has emerged as an attractive therapeutic option for repairing damaged cartilage tissue in the arthritic joint. High levels of proinflammatory cytokines present at arthritic joints can cause cartilage destruction and instability of the engineered cartilage tissue, and thus it is critical to engineer strong and stable cartilage that is resistant to the inflammatory environment. In this study, we demonstrate that scaffolding materials with different pore sizes and fabrication methods influence the microenvironment of chondrocytes and the response of these cells to proinflammatory cytokines, interleukin-1beta, and tumor necrosis factor alpha. Silk scaffolds prepared using the organic solvent hexafluoroisopropanol as compared to an aqueous-based method, as well as those with larger pore sizes, supported the deposition of higher cartilage matrix levels and lower expression of cartilage matrix degradation-related genes, as well as lower expression of endogenous proinflammatory cytokines IL-1ß in articular chondrocytes. These biochemical properties could be related to the physical properties of the scaffolds such as the water uptake and the tendency to leach or adsorb proinflammatory cytokines. Thus, scaffold structure may influence the behavior of chondrocytes by influencing the microenvironment under inflammatory conditions, and should be considered as an important component for bioengineering stable cartilage tissues.


Assuntos
Microambiente Celular , Condrócitos/metabolismo , Interleucina-1beta/biossíntese , Seda/efeitos adversos , Tecidos Suporte/efeitos adversos , Animais , Cartilagem/metabolismo , Cartilagem/patologia , Bovinos , Células Cultivadas , Condrócitos/patologia , Inflamação/induzido quimicamente , Inflamação/metabolismo , Inflamação/patologia , Seda/química , Tecidos Suporte/química
14.
J Laparoendosc Adv Surg Tech A ; 24(6): 428-31, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24784781

RESUMO

PURPOSE: We evaluated the effect of different suture materials in a laparoscopic preperitoneal ligation of the patent processus vaginalis in a rabbit survival model. MATERIALS AND METHODS: New Zealand White rabbits underwent laparoscopic assisted preperitoneal ligation of the patent processus vaginalis. The processus vaginalis was closed with silk (n=10), polyglactin 910 (Vicryl(®); Ethicon, a Johnson & Johnson Company, Somerville, NJ) (n=10), or polypropylene (Prolene(®); Ethicon) (n=10). At necropsy, the suture was removed, and repair integrity was evaluated. RESULTS: All rabbits survived to necropsy without complications. No suture material was identified during necropsy of the Vicryl group. Eight (80%) of the Vicryl closures failed, with six (60%) failing at initial inspection. Following removal of suture material, nine (90%) of the Prolene closures failed, and only one (10%) of the silk closures failed (P=.009). CONCLUSIONS: The silk suture resulted in an improved closure rate. Ligation with silk suture probably incited an increased inflammatory response that likely created a scar while persisting long enough for the scar to become established. In contrast, the Vicryl sutures probably failed because the sutures dissolved before a scar was able to fully develop. Finally, the Prolene closures were suture dependent as evidenced by failure when the suture was removed. Nonabsorbable braided suture may improve closure of pediatric indirect inguinal hernias during laparoscopic-assisted preperitoneal ligation.


Assuntos
Hérnia Inguinal/cirurgia , Laparoscopia/métodos , Poliglactina 910/efeitos adversos , Polipropilenos/efeitos adversos , Seda/efeitos adversos , Suturas/efeitos adversos , Animais , Cicatriz , Masculino , Peritônio/cirurgia , Coelhos , Hidrocele Testicular/cirurgia
15.
Ann Surg ; 259(4): 781-92, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23873006

RESUMO

OBJECTIVE: The aim of this study was to investigate biomechanical and immunogenic properties of spider silk meshes implanted as fascia replacement in a rat in vivo model. BACKGROUND: Meshes for hernia repair require optimal characteristics with regard to strength, elasticity, and cytocompatibility. Spider silk as a biomaterial with outstanding mechanical properties is potentially suitable for this application. METHODS: Commercially available meshes used for hernia repair (Surgisis and Ultrapro) were compared with handwoven meshes manufactured from native dragline silk of Nephila spp. All meshes were tied onto the paravertebral fascia, whereas sham-operated rats were sutured without mesh implantation. After 4 or 14 days, 4 weeks, and 4 or 8 months, tissue samples were analyzed concerning inflammation and biointegration both by histological and biochemical methods and by biomechanical stability tests. RESULTS: Histological sections revealed rapid cell migration into the spider silk meshes with increased numbers of giant cells compared with controls with initial decomposition of silk fibers after 4 weeks. Four months postoperatively, spider silk was completely degraded with the formation of a stable scar verified by constant tensile strength values. Surgisis elicited excessive stability loss from day 4 to day 14 (P < 0.001), with distinct inflammatory reaction demonstrated by lymphocyte and neutrophil invasion. Ultrapro also showed decreasing strength and poor elongation behavior, whereas spider silk samples had the highest relative elongation (P < 0.05). CONCLUSIONS: Hand-manufactured spider silk meshes with good biocompatibility and beneficial mechanical properties seem superior to standard biological and synthetic meshes, implying an innovative alternative to currently used meshes for hernia repair.


Assuntos
Materiais Biocompatíveis , Fasciotomia , Herniorrafia/instrumentação , Seda , Aranhas , Telas Cirúrgicas , Animais , Materiais Biocompatíveis/efeitos adversos , Materiais Biocompatíveis/química , Fenômenos Biomecânicos , Cicatriz/etiologia , Cicatriz/patologia , Fáscia/patologia , Feminino , Reação a Corpo Estranho/etiologia , Reação a Corpo Estranho/patologia , Masculino , Teste de Materiais , Complicações Pós-Operatórias/patologia , Distribuição Aleatória , Ratos , Seda/efeitos adversos , Seda/química , Telas Cirúrgicas/efeitos adversos , Resistência à Tração
16.
Pediatr Allergy Immunol ; 24(6): 603-13, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23980847

RESUMO

Atopic dermatitis (AD) is a relapsing inflammatory skin disease with a considerable social and economic burden. Functional textiles may have antimicrobial and antipruritic properties and have been used as complementary treatment in AD. We aimed to assess their effectiveness and safety in this setting. We carried out a systematic review of three large biomedical databases. GRADE approach was used to rate the levels of evidence and grade of recommendation. Meta-analyses of comparable studies were carried out. Thirteen studies (eight randomized controlled trials and five observational studies) met the eligibility criteria. Interventions were limited to silk (six studies), silver-coated cotton (five studies), borage oil, and ethylene vinyl alcohol (EVOH) fiber (one study each). Silver textiles were associated with improvement in SCORAD (2 of 4), fewer symptoms, a lower need for rescue medication (1 of 2), no difference in quality of life, decreased Staphyloccosus aureus colonization (2 of 3), and improvement of trans-epidermal water loss (1 of 2), with no safety concerns. Silk textile use was associated with improvement in SCORAD and symptoms (2 of 4), with no differences in quality of life or need for rescue medication. With borage oil use only skin erythema showed improvement, and with EVOH fiber, an improvement in eczema severity was reported. Recommendation for the use of functional textiles in AD treatment is weak, supported by low quality of evidence regarding effectiveness in AD symptoms and severity, with no evidence of hazardous consequences with their use. More studies with better methodology and longer follow-up are needed.


Assuntos
Terapias Complementares , Dermatite Atópica/terapia , Infecções Cutâneas Estafilocócicas/terapia , Staphylococcus aureus/imunologia , Têxteis/estatística & dados numéricos , Fibra de Algodão , Dermatite Atópica/complicações , Progressão da Doença , Humanos , Óleos de Plantas/administração & dosagem , Óleos de Plantas/efeitos adversos , Polivinil/administração & dosagem , Polivinil/efeitos adversos , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Seda/administração & dosagem , Seda/efeitos adversos , Prata/administração & dosagem , Prata/efeitos adversos , Infecções Cutâneas Estafilocócicas/complicações , Resultado do Tratamento , Ácido gama-Linolênico/administração & dosagem , Ácido gama-Linolênico/efeitos adversos
17.
Med Oral Patol Oral Cir Bucal ; 18(4): e701-5, 2013 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-23722129

RESUMO

OBJECTIVES: To elucidate the predisposing factors and clinical characteristics related to the occurrence of stitch abscess after surgery in patients with oral squamous cell carcinoma (SCC). PATIENTS AND METHODS: The subjects were 232 patients who underwent excision and/or reconstruction and/or neck dissection for oral SCC using silk sutures for high ligation of the blood vessels. Detection rates and characteristics of patients with stitch abscess were retrospectively evaluated by comparing patients with and without stitch abscesses after surgery diagnosed by ultrasonography and findings of various modalities in 232 patients. Several echogenic dots with subtle acoustic shadows in a hypoechoic mass were identified as the characteristic findings of stitch abscess on US. The patient groups with and without stitch abscess were compared with respect to various factors to identify those that predispose to the occurrence of stitch abscess. The factors analyzed included patients' sex and age, chemotherapy treatment, radiotherapy treatment, the presence of a history of allergy, and blood test results. RESULTS: A significant correlation was found between the occurrence of stitch abscess and age, liver function abnormalities on blood tests, and the presence of a history of allergy. Multiple stitch abscesses clearly tended to occur more often than single ones in patients with stitch abscess. CONCLUSIONS: The occurrence of stitch abscesses was related to age, liver dysfunction, and/or the presence of allergies. When diagnosing stitch abscess, the occurrence of multiple stitch abscesses is important.


Assuntos
Abscesso/epidemiologia , Abscesso/etiologia , Carcinoma de Células Escamosas/cirurgia , Neoplasias Bucais/cirurgia , Seda/efeitos adversos , Suturas/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
18.
Skin Res Technol ; 19(1): e409-16, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22694170

RESUMO

BACKGROUND: An increasing number of people is reported to have sensitive skin. Consequently, the development of textile materials with comfortable wearing properties has become a major interest. One method to create a pleasant sensation of textile materials on the skin is to coat them with silk proteins. This technologically complex procedure requires both optimization and control. METHODS: The present study was aimed to characterize the subjective perception of different textiles and to objectively assess their influence on skin morphology with non-invasive optical techniques like optical coherence tomography (OCT), laser scanning microscopy (LSM) and optical surface profilometry (OP). Furthermore, optical methods were used to characterize surface properties of different textile fabrics. RESULTS: In the present study it could be shown that optical non-invasive methods, as applied in cosmetology and dermatology are suited to characterize the structural properties of fabrics and the effects that textile materials have on the skin. Here, both unfinished textile materials and fabrics finished with silk protein coating were investigated by OCT, LSM and OP. In addition, volunteers were interviewed about their subjective sensation when these fabrics were in contact with their skin. CONCLUSION: The study showed that optical methods could be applied to compare textile materials in vitro, which permit the wearing comfort to be predicted and in vivo perception on the skin.


Assuntos
Dermatite de Contato/etiologia , Dermatite de Contato/prevenção & controle , Seda/efeitos adversos , Têxteis/efeitos adversos , Adulto , Vestuário/efeitos adversos , Dermatite de Contato/patologia , Feminino , Humanos , Masculino , Microscopia Confocal , Pessoa de Meia-Idade , Nylons/efeitos adversos , Poliésteres/efeitos adversos , Testes Cutâneos , Propriedades de Superfície , Inquéritos e Questionários , Tomografia de Coerência Óptica , Adulto Jovem
19.
Interv Neuroradiol ; 18(4): 413-25, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23217636

RESUMO

Flow-diverting stents (Silk and PED) have radically changed the approach to intracranial aneurysm treatment from the use of endosaccular materials to use of an extraaneurysmal endoluminal device. However, much debate surrounds the most appropriate indications for the use of FD stents and the problems raised by several possible complications.We analysed our technical difficulties and the early (less than ten days after treatment) and late complications encountered in 30 aneurysms treated comprising 13 giant lesions, 12 large, five with maximum diameters <10 mm and one blister-like aneurysm. In our experience the primary indications for the use of FD stents can be the symptomatic intracavernous giant aneurysms. Although the extracavernous carotid siphon aneurysms have major risk of bleeding, FD stents are indicated clearly explaining the risks to the patient in case of severe mass effect. There is a very complex assessment for aneurysms of the vertebrobasilar circulation.


Assuntos
Procedimentos Endovasculares/efeitos adversos , Aneurisma Intracraniano/terapia , Seda/efeitos adversos , Stents/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Angiografia Cerebral , Procedimentos Endovasculares/instrumentação , Feminino , Humanos , Aneurisma Intracraniano/diagnóstico , Aneurisma Intracraniano/epidemiologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Tomografia Computadorizada por Raios X , Resultado do Tratamento
20.
Br J Neurosurg ; 25(5): 652-4, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21848441

RESUMO

Our patient presented with a mass lesion mimicking a meningioma. The mass was resected, but pathological examination confirmed a foreign body granuloma, which was caused by silk fibres used as tenting sutures 8 years previously. Herein, we describe the case and review the neurosurgical literature on intracranial foreign body granulomas.


Assuntos
Neoplasias Encefálicas/diagnóstico por imagem , Granuloma de Corpo Estranho/diagnóstico por imagem , Complicações Pós-Operatórias , Seda/efeitos adversos , Suturas/efeitos adversos , Neoplasias Encefálicas/etiologia , Neoplasias Encefálicas/patologia , Craniotomia , Diagnóstico Diferencial , Feminino , Granuloma de Corpo Estranho/etiologia , Granuloma de Corpo Estranho/patologia , Humanos , Meningioma/diagnóstico por imagem , Pessoa de Meia-Idade , Radiografia , Técnicas de Sutura
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