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1.
Br Dent J ; 229(7): 411-416, 2020 10.
Artigo em Inglês | MEDLINE | ID: covidwho-839375

RESUMO

The COVID-19 pandemic resulted in severe limitation and closure of dental practices in many countries. Outside of the acute (peak) phases of the disease, dentistry has begun to be practised again. However, there is emerging evidence that SARS-CoV-2 can be transmitted via airborne routes, carrying implications for dental procedures that produce aerosol. At the time of writing, additional precautions are required when a procedure considered to generate aerosol is undertaken.This paper aims to present evidence-based treatments that remove or reduce the generation of aerosols during the management of carious lesions. It maps aerosol generating procedures (AGPs), where possible, to alternative non-AGPs or low AGPs. This risk reduction approach overcomes the less favourable outcomes associated with temporary solutions or extraction-only approaches. Even if this risk reduction approach for aerosol generation becomes unnecessary in the future, these procedures are not only suitable but desirable for use as part of general dental care post-COVID-19.


Assuntos
Infecções por Coronavirus , Cárie Dentária , Pandemias , Pneumonia Viral , Aerossóis , Betacoronavirus , Cárie Dentária/prevenção & controle , Humanos
2.
Nat Commun ; 11(1): 4834, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33004794

RESUMO

Atmospheric ice nucleating particles (INPs) influence global climate by altering cloud formation, lifetime, and precipitation efficiency. The role of secondary organic aerosol (SOA) material as a source of INPs in the ambient atmosphere has not been well defined. Here, we demonstrate the potential for biogenic SOA to activate as depositional INPs in the upper troposphere by combining field measurements with laboratory experiments. Ambient INPs were measured in a remote mountaintop location at -46 °C and an ice supersaturation of 30% with concentrations ranging from 0.1 to 70 L-1. Concentrations of depositional INPs were positively correlated with the mass fractions and loadings of isoprene-derived secondary organic aerosols. Compositional analysis of ice residuals showed that ambient particles with isoprene-derived SOA material can act as depositional ice nuclei. Laboratory experiments further demonstrated the ability of isoprene-derived SOA to nucleate ice under a range of atmospheric conditions. We further show that ambient concentrations of isoprene-derived SOA can be competitive with other INP sources. This demonstrates that isoprene and potentially other biogenically-derived SOA materials could influence cirrus formation and properties.


Assuntos
Aerossóis/química , Atmosfera/química , Butadienos/análise , Hemiterpenos/análise , Gelo/análise , Clima
3.
PLoS One ; 15(10): e0240421, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33031477

RESUMO

OBJECTIVE: To evaluate the microbial loading in aerosols produced after air-puff by non-contact tonometer (NCT) as well as the effect of alcohol disinfection on the inhibition of microbes and thus to provide suggestions for the prevention and control of COVID-19 in ophthalmic departments of hospitals or clinics during the great pandemics. METHODS: A cross-sectional study was carried out in this study. A NIDEK NCT was used for intraocular pressure (IOP) measurement for patients who visited Department of Ophthalmology in Qilu Hospital of Shandong University during March 18-25 2020. After ultra-violate (UV) light disinfection, the room air was sampled for 5 minutes. Before and after alcohol disinfection, the air samples and nozzle surface samples were respectively collected by plate exposure method and sterile moist cotton swab technique after predetermined times of NCT air-puff. Microbial colony counts were calculated after incubation for 48 hours. Finally, mass spectrometry was performed for the accurate identification of microbial species. RESULTS: Increased microbial colonies were detected from air samples close to NCT nozzle after air-puff compared with air samples at a distance of 1 meter from the nozzle (p = 0.001). Interestingly, none microbes were detected on the surface of NCT nozzle. Importantly, after 75% alcohol disinfection less microbes were detected in the air beside the nozzle (p = 0.003). Microbial species identification showed more than ten strains of microbes, all of which were non-pathogenic. CONCLUSION: Aerosols containing microbes were produced by NCT air-puff in the ophthalmic consultation room, which may be a possible virus transmission route in the department of ophthalmology during the COVID-19 pandemic. Alcohol disinfection for the nozzle and the surrounding air was efficient at decreasing the microbes contained in the aerosols and theoretically this prevention measure could also inhibit the virus. This will give guidance for the prevention of virus transmission and protection of hospital staff and patients.


Assuntos
Microbiologia do Ar , Álcoois/química , Infecções por Coronavirus/prevenção & controle , Desinfetantes/química , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Tonometria Ocular/métodos , Aerossóis/química , Betacoronavirus/fisiologia , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Hospitais , Humanos , Oftalmologia/métodos , Pneumonia Viral/epidemiologia
5.
Br Dent J ; 229(7): 411-416, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33037360

RESUMO

The COVID-19 pandemic resulted in severe limitation and closure of dental practices in many countries. Outside of the acute (peak) phases of the disease, dentistry has begun to be practised again. However, there is emerging evidence that SARS-CoV-2 can be transmitted via airborne routes, carrying implications for dental procedures that produce aerosol. At the time of writing, additional precautions are required when a procedure considered to generate aerosol is undertaken.This paper aims to present evidence-based treatments that remove or reduce the generation of aerosols during the management of carious lesions. It maps aerosol generating procedures (AGPs), where possible, to alternative non-AGPs or low AGPs. This risk reduction approach overcomes the less favourable outcomes associated with temporary solutions or extraction-only approaches. Even if this risk reduction approach for aerosol generation becomes unnecessary in the future, these procedures are not only suitable but desirable for use as part of general dental care post-COVID-19.


Assuntos
Infecções por Coronavirus , Cárie Dentária , Pandemias , Pneumonia Viral , Aerossóis , Betacoronavirus , Cárie Dentária/prevenção & controle , Humanos
7.
Med Hypotheses ; 143: 110244, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33017910

RESUMO

Corona virus disease 2019 (Covid-19), a pandemia emerged recently, caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2). The receptor for corona virus and influenza A is the mucosal cell membrane protein angiotensin converting enzyme 2 (ACE2), which is abundant on the membrane of alveolar cells and enterocytes. Viral spike protein 1 (S1) is the ligand, with an affinity of 14.7 nM to the receptor. The main port of entry for the virus is the upper respiratory tract, and the diagnosis is usually by PCR of the viral RNA with nasal and pharyngeal swab test. Human defensin 5 (HDEF5) is a protein encoded by the DEFA gene, secreted by Paneth cells in the small intestine and by granules of neutrophils. It has an affinity of 39.3 nM to ACE2, much higher than that of the corona S1. HDEF5 may also attach to glycosylated Corona S1 protein, make its efficiency even better. The issues to be investigated are the affinity of HDEF5 to S1 protein, the ability of recombinant HDEF5 function in attaching both ACE2 and S1, and the feasibility to perform aerosol spray of this protein. In addition, safety and efficiency should be studied in phases I, II and II clinical protocols. Thus, an aerosol spray of HDEF5 given through the nose and throat, once to several times a day, may be a very efficient approach to prevent infection with SARA-CoV-2 as well as influenza A.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/virologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/virologia , Glicoproteína da Espícula de Coronavírus/química , alfa-Defensinas/administração & dosagem , Aerossóis , Humanos , Ligantes , Peptidil Dipeptidase A/química , Proteínas Recombinantes/química , alfa-Defensinas/química
8.
J Breath Res ; 14(4): 042003, 2020 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-33021206

RESUMO

Diagnosis of SARS-COV-2 infection (COVID-19) is currently based on detection of the viral RNA in nasopharyngeal swab samples by reverse transcription polymerase chain reaction (RT-PCR). However, sampling via nasopharyngeal swabs frequently provokes sneezing or coughing, which results in increased risk of the viral dissemination and environmental contamination. Furthermore, the sensitivity associated with the PCR tests s limited to 60%-70%, which is mainly attributable to technical deficiency in sampling. Given that the disease is transmitted via exhaled aerosol and droplets, and that the exhaled breath condensate (EBC) is the established modality for sampling exhaled aerosol, detection of the viral RNA in EBC is a promising approach for safe and efficient diagnosis of the disease. Subjects are those patients who are diagnosed with COVID-19 by positive nasopharyngeal swab PCR test and admitted to Saitama Medical Center, Japan. EBC samples will be collected using an R-tube® or R-tubeVent® device. Collected EBC samples will be introduced into a nucleic acid purifier. The purified nucleic acids will undergo amplification through RT-PCR for detection and quantification of SARS-COV-2 RNA. To date we have collected eight samples from seven subjects. Among them, two samples from two subjects tested positive for SARS-COV-2 RNA by the RT-PCR. Reflecting the second wave of COVID-19 prevalence in Japan, new admissions of COVID-19 patients to the Saitama Medical Center are increasing, and we are expecting to collect at least 50 EBC samples from 25 patients before the end of this year.


Assuntos
Testes Respiratórios/instrumentação , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodos , Aerossóis/análise , Betacoronavirus , Técnicas de Laboratório Clínico , Tosse , Expiração , Humanos , Japão , Pandemias , RNA Viral/análise , Projetos de Pesquisa , Manejo de Espécimes , Carga Viral
9.
J Breath Res ; 14(4): 040202, 2020 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-33021207

RESUMO

In contrast to blood and urine samples, breath is invisible and ubiquitous in the environment. Different precautions are now necessary beyond the usual 'Universal Precautions'. In the era of COVID-19, breath (especially the aerosol fraction) can no longer be considered as harmless in the clinic or laboratory. As Journal of Breath Research is a primary resource for breath-related research, we (the editors) are presently developing safety guidance applicable to all breath research , not just for those projects that involve known COVID-19 infected subjects. We are starting this process by implementing requirements on reporting safety precautions in research papers and notes. This editorial announces that authors of all new submissions to JBR henceforth must state clearly the procedures undertaken for assuring laboratory and clinical safety, much like the existing requirements for disclosing Ethics Committee or Institutional Review Board protocols for studies on human subjects. In the following, we additionally make some recommendations based on best practices drawn from our experience and input from the JBR Editorial Board.


Assuntos
Pesquisa Biomédica/tendências , Testes Respiratórios , Controle de Doenças Transmissíveis , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Aerossóis , Betacoronavirus , Pesquisa Biomédica/normas , Humanos , Pandemias , Equipamento de Proteção Individual , Saúde Pública , Risco , Segurança
10.
BMJ Open Respir Res ; 7(1)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33023899

RESUMO

Patients with COVID-19 often need therapeutic interventions that are considered high aerosol-generating procedures. These are either being performed by healthcare providers with potentially inadequate personal protective equipment or the procedures are being delayed until patients clear their viral load. Both scenarios are suboptimal. We present a simple, cost-effective method of creating a portable negative pressure environment using equipment that is found in most hospitals to better protect healthcare providers and to facilitate more timely care for patients with COVID-19.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Exposição Ocupacional/prevenção & controle , Salas Cirúrgicas/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Campos Cirúrgicos , Aerossóis , Humanos , Pressão , Sucção
11.
J Breath Res ; 14(4): 041003, 2020 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-33006317

RESUMO

We hypothesized that most patients with severe pulmonary COVID-19 were exposed to cough aerosols. Among patients that were almost 100% certain which person infected them, only 14 out of 38 overall, and 9 out of 25 hospitalized patients requiring supplemental oxygen, were infected by someone who coughed, which did not support our hypothesis. Talking, especially with a loud voice, could be an alternative source generating SARS-CoV-2 aerosols. Further research is needed to determine how SARS-CoV-2 spreads. Avoiding to talk when you are not wearing your mask and not talking with a loud voice, 'voice etiquette', could be other public health interventions worthwhile exploring.


Assuntos
Aerossóis , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/etiologia , Tosse/complicações , Pneumonia Viral/diagnóstico , Pneumonia Viral/etiologia , Betacoronavirus , Humanos , Pandemias
15.
J Contemp Dent Pract ; 21(6): 599-603, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: covidwho-833765

RESUMO

AIM: The aim of the present study was to take a survey on Italian practitioners concerning the perceived risks of aerosol contamination in COVID-19 times and their attitude toward modifications of treatment protocols to reduce this risk. MATERIALS AND METHODS: Power analysis calculated a minimum sample size of 150 participants at 99% confidence level with a 5% margin of error. To homogenize responses elicited by different preventive measures by various national governments, only Italian dentists were included in the survey: overall 500 responses were collected. RESULTS: Of the 500 analyzed respondents, there were 266 females and 234 males; 379 practitioners were allocated in the more experienced groups, and the remaining 121 in the less experienced group based on less or more than 5 years of practice. The 70% of the dentists consider the dental practice more dangerous for the diffusion of COVID-19 than other social activities. The 5% consider dental practice more dangerous only for the patients. Aerosol contamination was perceived as a risk from the most dentist (70%), but there was agreement on the most dangerous way of cross infection in dental settings. Most of the dentists (55%) believed implementations in their protocols were needed to reduce the risk of COVID-19 infections. No significant differences were found within the groups: both women and men, as well as practitioners with different experience levels (younger or older than 35 years) perceived very similarly the problems related to COVID-19 in dentistry (p > 0.05). CONCLUSION: The survey demonstrated that COVID-19 had a great impact on dental practitioners; it increased not only fear of aerosol contamination during dental treatments but also influenced the fear of close contacts. SIGNIFICANCE: Airborne and waterborne infections are related with dental treatments and considered the preferred ways of diffusion for COVID-19. The risk of aerosol-related infections could interfere with the clinical practice of the dentist, during the COVID-19 pandemic; the limitations that provided changes to everyday behavior could affect the perception of the safety of the operators, staff, and patient and this could also affect economically the dental office.


Assuntos
Infecções por Coronavirus , Odontólogos , Pandemias , Pneumonia Viral , Aerossóis , Betacoronavirus , Feminino , Humanos , Itália , Masculino , Papel Profissional , Inquéritos e Questionários
16.
J Breath Res ; 14(4): 041003, 2020 10 02.
Artigo em Inglês | MEDLINE | ID: covidwho-812734

RESUMO

We hypothesized that most patients with severe pulmonary COVID-19 were exposed to cough aerosols. Among patients that were almost 100% certain which person infected them, only 14 out of 38 overall, and 9 out of 25 hospitalized patients requiring supplemental oxygen, were infected by someone who coughed, which did not support our hypothesis. Talking, especially with a loud voice, could be an alternative source generating SARS-CoV-2 aerosols. Further research is needed to determine how SARS-CoV-2 spreads. Avoiding to talk when you are not wearing your mask and not talking with a loud voice, 'voice etiquette', could be other public health interventions worthwhile exploring.


Assuntos
Aerossóis , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/etiologia , Tosse/complicações , Pneumonia Viral/diagnóstico , Pneumonia Viral/etiologia , Betacoronavirus , Humanos , Pandemias
17.
Environ Monit Assess ; 192(11): 676, 2020 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-33025262

RESUMO

Long-term aerosol optical thickness (AOT) composited data (2002-2017) derived from Moderate Resolution Imaging Spectroradiometer (MODIS) on the Terra and Aqua spacecraft was used to evaluate the temporal and spatial variability of aerosol in Xiamen city by using wavelet analysis, and the relationship between the surface mass concentrations of particulate matter with aerodynamic diameters less than 2.5 µm (PM2.5) and the AOT was analyzed by using linear regression. The results showed that AOT increased gradually from 2002 to 2011, and then decreased. AOT displayed a significant 9-month periodicity in AOT was inferred wavelet analysis. AOT also showed significant annual variability in response to changes in weather and aerosol pollution. We observed highest AOT values in April, with a monthly mean of 1.00 ± 0.18. Lowest values were observed in December, with a mean AOT of 0.52 ± 0.11. Multi-year monthly AOT fluctuations were lowest in January with a low variation coefficient (0.14), and the largest fluctuations appeared in July with a high variation coefficient (0.29). Higher AOT values (~ 1.1) were predominantly located in the southern urban areas of Xiamen and lower AOT values (~ 0.3) were mainly located in northern rural regions. The aerosol pollution was serious in April with the smallest spatial variation coefficient of 0.25, and the highest spatial variation coefficient appeared in July. Highest intraannual variability predominantly occurred in the high-value areas in the center of Xiamen. AOT values remained high in Xiamen Island throughout the year with a multi-year mean of 0.87. There was a moderate correlation between ground-based PM2.5 and MODIS AOT. Therefore, we confirm the suitability of MODIS AOT to accurately estimate PM2.5 concentration and evaluate the temporal and spatial characteristics of air quality in Xiamen.


Assuntos
Monitoramento Ambiental , Material Particulado , Aerossóis/análise , China , Cidades , Material Particulado/análise
18.
J Contemp Dent Pract ; 21(6): 599-603, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-33025925

RESUMO

AIM: The aim of the present study was to take a survey on Italian practitioners concerning the perceived risks of aerosol contamination in COVID-19 times and their attitude toward modifications of treatment protocols to reduce this risk. MATERIALS AND METHODS: Power analysis calculated a minimum sample size of 150 participants at 99% confidence level with a 5% margin of error. To homogenize responses elicited by different preventive measures by various national governments, only Italian dentists were included in the survey: overall 500 responses were collected. RESULTS: Of the 500 analyzed respondents, there were 266 females and 234 males; 379 practitioners were allocated in the more experienced groups, and the remaining 121 in the less experienced group based on less or more than 5 years of practice. The 70% of the dentists consider the dental practice more dangerous for the diffusion of COVID-19 than other social activities. The 5% consider dental practice more dangerous only for the patients. Aerosol contamination was perceived as a risk from the most dentist (70%), but there was agreement on the most dangerous way of cross infection in dental settings. Most of the dentists (55%) believed implementations in their protocols were needed to reduce the risk of COVID-19 infections. No significant differences were found within the groups: both women and men, as well as practitioners with different experience levels (younger or older than 35 years) perceived very similarly the problems related to COVID-19 in dentistry (p > 0.05). CONCLUSION: The survey demonstrated that COVID-19 had a great impact on dental practitioners; it increased not only fear of aerosol contamination during dental treatments but also influenced the fear of close contacts. SIGNIFICANCE: Airborne and waterborne infections are related with dental treatments and considered the preferred ways of diffusion for COVID-19. The risk of aerosol-related infections could interfere with the clinical practice of the dentist, during the COVID-19 pandemic; the limitations that provided changes to everyday behavior could affect the perception of the safety of the operators, staff, and patient and this could also affect economically the dental office.


Assuntos
Infecções por Coronavirus , Odontólogos , Pandemias , Pneumonia Viral , Aerossóis , Betacoronavirus , Feminino , Humanos , Itália , Masculino , Papel Profissional , Inquéritos e Questionários
19.
J Environ Qual ; 49(3): 762-768, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-33016392

RESUMO

Sulfur (S) and sulfate (SO4 2- ) in fine particulate matter (PM2.5 ) are monitored by the Interagency Monitoring of Protected Visual Environments (IMPROVE) network at remote and rural sites across the United States. Within the IMPROVE network, S is determined from X-ray fluorescence (XRF) spectroscopy from a Teflon filter, and SO4 2- is determined via ion chromatography (IC) from a nylon filter. Differences in S and SO4 2- estimates may indicate the presence of organosulfur (OS) species or biases between sampling and analytical methods. To reduce potential biases, an inductively coupled plasma-optical emission spectroscopy (ICP-OES) method was developed to allow for analysis of SO4 2- and S from a single filter extract. Sulfur (ICP-OES) and SO4 2- (IC) estimates from 2016 IMPROVE filters correlated strongly, suggesting that, on average, ICP-OES accurately estimated S. However, observed differences between slopes suggested the presence of water-soluble OS species, especially during summer. Organosulfur species are important indicators of secondary organic aerosols formed through reactions of biogenic and anthropogenic pollutants and can be quantified through laboratory techniques such as reverse-phase liquid chromatography (RPLC) or hydrophilic liquid interaction chromatography (HILIC) coupled to electrospray ionization-high-resolution tandem mass spectrometry (RPLC/ESI-HR-MS/MS and HILIC/ESI-HR-MS/MS, respectively), and field techniques using Aerodyne aerosol mass spectrometry (AMS). However, these methods are costly and introduce relatively large uncertainties when scaled for large networks such as IMPROVE. The method described in this report provides an inexpensive complement to XRF, which measures total S (insoluble and water-soluble S) to estimate water-soluble S and OS concentrations in PM.


Assuntos
Nylons , Espectrometria de Massas em Tandem , Aerossóis , Análise Espectral , Enxofre , Estados Unidos
20.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 47(3): 106-110, jul.-sept. 2020. graf
Artigo em Espanhol | IBECS | ID: ibc-189900

RESUMO

La convivencia con la infección por COVID-19 (coronavirus disease 2019) en todos los entornos hospitalarios y de salud supone un reto actual de adaptación, creación de circuitos, protocolos y nuevos modelos de asistencia. Son todavía bastantes las incógnitas a resolver sobre esta infección en la actualidad, y mucho más desconocido es el impacto que la misma supone si lo trasladamos al terreno quirúrgico. La evidencia respecto al efecto del SARS-CoV-2 y cirugía laparoscópica es escasa y de calidad limitada, pero aun así, la laparoscopia ha sido considerada de elección por las distintas sociedades científicas en pacientes COVID para la mayoría de indicaciones en ginecología, por las conocidas ventajas hacia el paciente respecto a la vía abierta: menor morbilidad y estancia hospitalaria y porque comporta procedimientos quirúrgicos autónomos y contenidos respecto a la liberación de humo y donde, además, el instrumental y la disposición en quirófano permiten un alejamiento del cirujano y del resto de profesionales en el área quirúrgica respecto al paciente. A modo global, las dos recomendaciones fundamentales en quirófano de cirugía laparoscópica en esta época COVID incluyen: el uso de equipo de protección personal adecuado para el personal de quirófano y la adopción de precauciones para reducir la exposición al CO2 y el humo quirúrgico que puede producirse en estos procedimientos


Coexistence with COVID-19 infection (coronavirus disease 2019) in all hospital and health care settings is a current challenge of adaptation, as well as the creation of new protocols and care models. At present, there are still many unknowns about this infection, and much more unknown is the impact into the surgical field. Although evidence regarding the effect of SARS-CoV-2 and laparoscopic surgery is scarce, laparoscopy has been considered the method of choice by different scientific societies for most indications in gynaecology during the COVID-19 pandemic. This is due to the advantages over the open route. There is less morbidity and hospital stay, and in addition, as it involves autonomous and contained surgical procedures with respect to smoke release. Moreover, the instruments and the setting in the operating room mean that there can be safe distance from the surgeon and other staff to the patient. Overall, the main recommendations in laparoscopic surgery during the COVID era include: the use of Personal Protective Equipment for operating room personnel, and the adoption of safety measures to reduce CO2 exposure and surgical smoke reléase


Assuntos
Humanos , Feminino , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Laparoscopia/métodos , Reação em Cadeia da Polimerase , Algoritmos , Aerossóis/administração & dosagem , Aerossóis/normas , RNA Viral/sangue , Fatores de Risco
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