Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 364
Filtrar
1.
Toxins (Basel) ; 11(6)2019 06 21.
Artigo em Inglês | MEDLINE | ID: mdl-31234268

RESUMO

Fescue toxicosis is a multifaceted syndrome that elicits many negative effects on livestock consuming ergot alkaloids produced by endophyte-infected tall fescue. The economic losses associated with fescue toxicosis are primarily due to reproductive failure including altered cyclicity, suppressed hormone secretion, reduced pregnancy rates, agalactia, and reduced offspring birth weights. For decades, a multitude of research has investigated the physiological and cellular mechanisms of these reproductive failures associated with fescue toxicosis. This review will summarize the various effects of ergot alkaloids on female reproduction in grazing livestock species.


Assuntos
Alcaloides de Claviceps/toxicidade , Gado , Intoxicação por Plantas/complicações , Reprodução/efeitos dos fármacos , Animais , Encéfalo/efeitos dos fármacos , Encéfalo/fisiologia , Feminino , Festuca , Lactação , Ovário/efeitos dos fármacos , Ovário/fisiologia , Intoxicação por Plantas/veterinária , Gravidez , Útero/efeitos dos fármacos , Útero/fisiologia
2.
J Pediatr Ophthalmol Strabismus ; 55: e33-e35, 2018 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-30388279

RESUMO

Anisocoria is a significant finding in several ocular and potentially life-threatening neurological disorders. The angel's trumpet (Datura suaveolens), widely used as a garden plant, is a natural alkaloid with anticholinergic effects containing high levels of scopolamine. The authors present a pediatric case of acute anisocoria secondary to contact with the angel's trumpet plant. This case report emphasizes the importance of considering herbal mydriatics in patients with acute, isolated, unilateral mydriasis. It is also important to raise public awareness about the potential risks of the angel's trumpet plant, particularly in areas close to schools and playgrounds. [J Pediatr Ophthalmol Strabismus. 2018;55:e33-e35.].


Assuntos
Anisocoria/etiologia , Datura stramonium/envenenamento , Midríase/etiologia , Intoxicação por Plantas/complicações , Plantas Tóxicas/envenenamento , Doença Aguda , Anisocoria/fisiopatologia , Criança , Feminino , Humanos , Midríase/fisiopatologia , Doenças Raras
3.
PLoS One ; 13(9): e0204656, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30256853

RESUMO

Upper digestive tract (UDT) cancer is rare in cattle, however in Southern Brazil, the UDT squamous cell carcinomas (SCCs) are relatively common and have been associated with bracken fern consumption and the presence of papillomas. Although a theory of pathogenesis considers bovine papillomavirus type 4 (BPV-4) as a cofactor in the development of these SCCs, some aspects of the etiopathogenesis of this disease need to be more investigated. In fact, detection of BPV-4 in UDT papillomas is scarce in other regions of the world and has not been performed in Brazil. Therefore, this study had two aims: 1) to analyze the epidemiological, clinical and pathological aspects of 100 natural cases of SCCs in the UDT of cattle grazing on bracken fern (Pteridium arachnoideum) highly contaminated areas, investigating the associations between these parameters; and 2) to investigate the presence of papillomavirus DNA by polymerase chain reaction (PCR) in the UDT papillomas (n = 47) from 30 cattle that also had UDT SCCs. There were statistically significant associations between clinical signs and tumor localization in the UDT; between histological grade of differentiation and tumor localization; and a trend towards significant association between histological grade of differentiation and presence of metastases. The average age of cattle with oropharyngeal SCCs was 7.39 years, with statistically significant difference comparing to cattle with esophageal SCCs (8.6 years). No statistical association was observed among other clinical-pathological parameters (growth pattern and primary site of the tumor) analyzed. No BPV DNA was detected in papillomas by PCR. Therefore, these results suggest the possibility that papillomas of the UDT are not necessarily associated with BPV infection.


Assuntos
Carcinoma de Células Escamosas/veterinária , Doenças dos Bovinos/etiologia , Neoplasias do Sistema Digestório/veterinária , Intoxicação por Plantas/veterinária , Pteridium/envenenamento , Animais , Papillomavirus Bovino 4/genética , Papillomavirus Bovino 4/isolamento & purificação , Brasil , Carcinoma de Células Escamosas/etiologia , Carcinoma de Células Escamosas/patologia , Bovinos , Doenças dos Bovinos/patologia , Neoplasias do Sistema Digestório/etiologia , Neoplasias do Sistema Digestório/patologia , Neoplasias Esofágicas/etiologia , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas/veterinária , Carcinoma de Células Escamosas do Esôfago/etiologia , Carcinoma de Células Escamosas do Esôfago/patologia , Carcinoma de Células Escamosas do Esôfago/veterinária , Feminino , Masculino , Neoplasias Orofaríngeas/etiologia , Neoplasias Orofaríngeas/patologia , Neoplasias Orofaríngeas/veterinária , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/veterinária , Intoxicação por Plantas/complicações , Intoxicação por Plantas/patologia
4.
Wilderness Environ Med ; 29(3): 411-416, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29980430

RESUMO

We report the case of a patient who presented with respiratory failure, recurrent ventricular fibrillation, ventricular arrhythmias, and hypotension after an intentional ingestion of aconite flowers. Significant ingestion of this plant can produce life-threatening cardio- and neurotoxicity that may require evacuation from the wilderness to a medical facility capable of advanced treatment and intensive care monitoring.


Assuntos
Aconitum/efeitos adversos , Arritmias Cardíacas/etiologia , Intoxicação por Plantas/complicações , Arritmias Cardíacas/sangue , Arritmias Cardíacas/terapia , Ingestão de Alimentos , Flores/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Intoxicação por Plantas/sangue , Intoxicação por Plantas/terapia , Resultado do Tratamento
6.
Pediatr Int ; 59(5): 600-603, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-27973698

RESUMO

BACKGROUND: Wisteria floribunda is a vine commonly found in Korea, Japan, and the USA. The objective of this observational study was to assess the toxicity of W. floribunda seeds in young children. METHODS: Of 28 children in a kindergarten who participated in a field trip, seven ingested W. floribunda seeds: six half of the seed and one a whole seed. These seven children were admitted to the Gachon University Gil Medical Center in Incheon, Korea. RESULTS: All of the children had vomiting within 4 h of ingesting the W. floribunda seed; the child who ingested a whole seed began to vomit 2 h after ingestion. By 5 h after ingestion, they all complained of abdominal pain and one child was lethargic. Leukocytosis was observed in all of the children. Abdominal pain and vomiting subsided in all of the children within 2 days after admission. The average duration of hospitalization was 3.1 days. CONCLUSIONS: W. floribunda seed ingestion induced gastrointestinal and neurologic symptoms in these young children. Given that the onset of vomiting was earlier in the child who ingested a whole seed than in the children who had ingested only a half, the amount of ingested seeds may be associated with the severity of the symptoms. Ingestion of half a raw W. floribunda seed can cause gastrointestinal symptoms in young children and even result in hospitalization.


Assuntos
Dor Abdominal/etiologia , Letargia/etiologia , Intoxicação por Plantas/diagnóstico , Sementes/envenenamento , Vômito/etiologia , Wisteria/envenenamento , Criança , Pré-Escolar , Feminino , Hospitalização , Humanos , Masculino , Intoxicação por Plantas/complicações , República da Coreia
8.
BMJ Case Rep ; 20162016 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-27908913

RESUMO

A previously well woman aged 63 years presents to the emergency department with vomiting, palpitations and 3 presyncopal episodes. She had no previous medical or cardiac history, with the patient stating that she tried a herbal remedy of boiled comfrey leaves for insomnia 18 hours before arrival to the department. Her ECG showed multiple abnormalities, including bradycardia, second-degree atrioventricular node block, Mobitz Type 2, a shortened QT interval, downsloping ST depression and presence of U waves. After viewing the images of comfrey and foxglove, it highlighted the possibility of mistaken ingestion of Digitalis, containing the organic forms of cardiac glycosides, such as digoxin and digitoxin. Raised serum digoxin levels confirmed this. The patient was haemodynamically stable, and given digoxin-binding antibodies. After 5 days of cardiac monitoring, her ECG returned to normal rhythm, and she was discharged home.


Assuntos
Acidentes , Anticorpos Heterófilos/uso terapêutico , Bloqueio Atrioventricular/induzido quimicamente , Confrei , Digitalis/envenenamento , Digoxina/envenenamento , Intoxicação por Plantas/diagnóstico , Distúrbios do Início e da Manutenção do Sono/tratamento farmacológico , Anticorpos Heterófilos/imunologia , Bradicardia/etiologia , Digitalis/imunologia , Digoxina/imunologia , Eletrocardiografia , Feminino , Humanos , Pessoa de Meia-Idade , Folhas de Planta/envenenamento , Intoxicação por Plantas/complicações , Intoxicação por Plantas/tratamento farmacológico , Plantas Medicinais , Resultado do Tratamento , Vômito/etiologia
9.
Pediatr. aten. prim ; 18(71): e125-e128, jul.-sept. 2016. ilus
Artigo em Espanhol | IBECS | ID: ibc-156615

RESUMO

El aceite de árbol de té es una sustancia que se obtiene mediante la destilación de las hojas y ramas frescas del árbol Melaleuca alternifolia. En los últimos años se ha popularizado su uso sobre todo como agente antiinfeccioso tópico en una gran variedad de enfermedades. Se trata de una sustancia natural que tiene un potencial efecto tóxico demostrado sobre todo si se ingiere. Presentamos dos casos de pacientes atendidos en nuestro Servicio de Urgencias tras administración e ingestión accidental de aceite esencial de árbol de té, en ambos casos los padres confundieron el envase con el de la vitamina D. La atención de estos pacientes nos llevó a realizar una búsqueda bibliográfica de casos publicados de intoxicación por ingesta de aceite de árbol de té y a poner de manifiesto la ausencia de advertencias de seguridad en los envases de aceite de árbol de té que actualmente se comercializan en nuestro país (AU)


Tea tree oil is an essential oil obtained by steam distillation of the leaves and terminal branches of Melaleuca alternifolia. In recent years, it has become popular as an antimicrobial agent against a large number of diseases. It is a natural substance that has a potential toxic effect especially if ingested. We report two cases of infants who came to our Emergency Department because they were accidentally given tea tree oil. In both cases parents mistook the tea tree oil bottle with the D vitamin bottle. The care of these patients led us to perform a literature search of published cases of tea tree oil poisoning and highlight the absence of safety warnings on tea tree oil packages currently marketed in our country (AU)


Assuntos
Humanos , Masculino , Lactente , Óleo de Melaleuca/administração & dosagem , Óleo de Melaleuca/toxicidade , Óleo de Melaleuca/uso terapêutico , Emergências/epidemiologia , Intoxicação por Plantas/complicações , Intoxicação por Plantas/terapia , Envenenamento/complicações , Envenenamento/terapia
11.
J Am Vet Med Assoc ; 248(6): 669-72, 2016 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-26953921

RESUMO

CASE DESCRIPTION: Unexplained clinical signs of weight loss and emaciation were reported in a herd of Thoroughbred horses grazing spring pastures on a central Kentucky farm, even though supplemental grain and hay were provided. CLINICAL FINDINGS: A buttercup plant, Ranunculus bulbosus L, was abundantly present in all pastures and paddocks on the farm. All horses, especially lactating mares and their foals, had mild to severe weight loss as assessed by body condition. Seven mares on the farm had been confirmed pregnant between 30 and 45 days of gestation, but were later found to have aborted. Two 2-year-old fillies developed severe diarrhea, incoordination, recumbency, and paralysis and were euthanized. Necropsy of these horses revealed ulcers and erosions in the stomach and large intestine. The findings were considered consistent with buttercup toxicosis. TREATMENT AND OUTCOME: The horses were moved from the buttercup-infested pastures to a farm free of the weed. All horses made an uneventful recovery, and clinical signs resolved after the horses were transferred to buttercup-free pastures. Mares that had aborted conceived successfully in the next breeding season. CLINICAL RELEVANCE: The buttercup plant is toxic for all classes of livestock. The clinical signs associated with buttercup toxicosis may mimic other disease syndromes affecting the gastrointestinal tract of herbivores. On-farm epidemiological investigations are an essential part of the diagnosis of this condition. Consumption of buttercups has previously been associated with abortions in cattle, but to the author's knowledge, this has not previously been described in horses.


Assuntos
Aborto Animal/etiologia , Doenças dos Cavalos/etiologia , Intoxicação por Plantas/veterinária , Ranunculus/envenenamento , Animais , Emaciação/etiologia , Emaciação/veterinária , Feminino , Cavalos , Intoxicação por Plantas/complicações , Gravidez , Perda de Peso
12.
Turk Kardiyol Dern Ars ; 43(7): 648-50, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26536992

RESUMO

Nerium oleander is a popular ornamental plant grown in many tropical and subtropical countries and in the Mediterranean region. It is dangerous because it has been shown to contain several types of cardiac glycosides, and hence can cause cardiac arrhythmias resembling digoxin in their toxicologic manifestations. We report a patient presenting to our hospital with Mobitz type II atrioventricular block after drinking herbal tea prepared from oleander leaves. Three hours after admission, a 200-mg empiric dose of digoxin-specific Fab antibody fragments was administered intravenously over 30 minutes. A 12-lead electrocardiogram (ECG) revealed sinus rhythm at the end of infusion. After 72 hours, the patient was discharged without any symptoms.


Assuntos
Bloqueio Atrioventricular/diagnóstico , Nerium/envenenamento , Intoxicação por Plantas/complicações , Dor Abdominal/etiologia , Adolescente , Bloqueio Atrioventricular/tratamento farmacológico , Bloqueio Atrioventricular/etiologia , Diagnóstico Diferencial , Eletrocardiografia , Feminino , Humanos , Náusea/etiologia , Folhas de Planta
13.
Aust Vet J ; 93(6): 208-13, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26010927

RESUMO

CASE REPORT: This report documents an outbreak of acute renal failure in a flock of 9-month-old White Suffolk-cross ewe lambs. The mortality rate was moderate but the morbidity was high. The lambs had grazed a wheat stubble paddock in which there were several weed species, including Amaranthus spp. CLINICAL SIGNIFICANCE: Renal failure in livestock has been reported internationally following the ingestion of Amaranthus spp. and although it has previously been suspected in Australia no cases have been documented. It is important for Australian veterinarians and farmers to realise the toxic potential of this group of plants.


Assuntos
Lesão Renal Aguda/veterinária , Amaranthus/envenenamento , Intoxicação por Plantas/complicações , Doenças dos Ovinos/etiologia , Lesão Renal Aguda/etiologia , Lesão Renal Aguda/patologia , Animais , Surtos de Doenças/veterinária , Rim/patologia , New South Wales/epidemiologia , Intoxicação por Plantas/etiologia , Intoxicação por Plantas/patologia , Ovinos , Doenças dos Ovinos/epidemiologia , Doenças dos Ovinos/patologia
14.
Am J Case Rep ; 16: 146-8, 2015 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-25754813

RESUMO

BACKGROUND: When discussing known poisons and their clinical consequences, few physicians are aware of the deadly poison abrin. The common symptoms of abrin toxicity include nausea, vomiting, abdominal pain, and diarrhea with or without bloody stool. However, with an estimated fatal human dose of less than 1 microgram/kg, death due to complications such as liver failure, renal failure, and cerebral edema are possible. CASE REPORT: An 18-month-old male presented to the emergency department with an abrupt onset of fever, vomiting, diarrhea, and dehydration. The parents had assumed the child was suffering from a severe gastroenteritis until they noticed 3 consecutive diapers containing colorful seeds that were identified by poison control as belonging to the Abrus precatorius plant. The child's gastrointestinal symptoms were consistent with reported cases of abrin poisoning, but the patient also had an isolated and significantly elevated alkaline phosphatase, with testing unable to reveal the responsible pathological process. CONCLUSIONS: To reduce morbidity and possible mortality, parents and pediatricians alike should be conscious of the danger the Abrus precatorius seed poses to the pediatric population. Children are at a greater risk of ingesting these seeds due to their colorful appearance, and the consequences could be fatal. Through this case report we hope to raise public awareness regarding this toxin. This includes the management of known cases, as well as the possibility of encountering an isolated elevated alkaline phosphatase level as a laboratory finding if ingestion occurs.


Assuntos
Abrina/envenenamento , Abrus/envenenamento , Intoxicação por Plantas/diagnóstico , Sementes/envenenamento , Diarreia/induzido quimicamente , Humanos , Lactente , Masculino , Intoxicação por Plantas/complicações , Intoxicação por Plantas/terapia , Vômito/induzido quimicamente
16.
Toxicon ; 73: 88-95, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23831837

RESUMO

Rayless goldenrod (Isocoma pluriflora) sporadically poisons horses and other livestock in the southwestern United States. Similar to livestock poisoning by white snakeroot (Ageratina altissima) in the midwestern United States, previous research suggests that benzofuran ketones (BFK: tremetone, dehydrotremetone, 6-hydroxytremetone, and 3-oxyangeloyl-tremetone) are responsible for the toxicity of rayless goldenrod. However, experimental reproduction of rayless goldenrod-induced disease and detailed descriptions of poisoning in horses with known concentrations of tremetone and other BFK has not been documented. In this study four horses were fed increasing amounts of rayless goldenrod to obtain doses of approximately 0, 10, 30, and 60 mg BFK/kg BW for 14 days. After seven days of dosing the horse dosed with 60 mg BFK/kg BW horse developed depression, reluctance to eat, dehydration, trembling, and muscle fatigue. Biochemical alterations including increases in the serum enzyme activities of CK, AST, ALT, and LDH, and increased cardiac troponin I concentration, were also identified. Physiologically the clinically poisoned horse had decreased endurance seen as reluctance to perform on the treadmill with increased resting heart rate and a prolonged recovery of heart rate following treadmill exercise. The condition of the horse continued to decline and it was euthanized and necropsied on day 10. At necropsy the myocardium was pale and soft and many of the appendicular and large apical muscles were pale and moist. Histologically, the myocardium had extensive myocardial degeneration and necrosis with extensive fibrosis and multifocal mineralization. Several of the large appendicular muscles in this horse also had small foci of skeletal muscle degeneration and necrosis. Less severe myocardial changes were also identified in the horse dosed with 30 mg BFK/kg BW after 14 days of dosing. No clinical, biochemical or histologic changes were identified in the control horse and the horse dosed with 10 mg BFK/kg BW. These results suggest that doses of 60 mg BFK/kg BW for seven days produce extensive myocardial lesions in horses. The horse dosed with 30 mg BFK/kg BW developed less severe, but similar myocardial lesions over a longer duration, this suggests that poisoning may be cumulative and lower doses of longer duration are also toxic. Horses seem to be uniquely sensitive to rayless goldenrod-induced myocardial disease, therefore cardiac troponin I may be a useful marker of rayless goldenrod poisoning in horses. More work is needed to determine which BFK produce myocardial toxicity and better determine the effects of dose and duration on poisoning in horses.


Assuntos
Asteraceae/química , Benzofuranos/toxicidade , Cardiomiopatias/etiologia , Intoxicação por Plantas/complicações , Alanina Transaminase/sangue , Animais , Aspartato Aminotransferases/sangue , Benzofuranos/análise , Benzofuranos/sangue , Relação Dose-Resposta a Droga , Eletrocardiografia , Frequência Cardíaca/efeitos dos fármacos , Técnicas Histológicas , Cavalos , Cetonas/sangue , Sudoeste dos Estados Unidos , Troponina I
17.
Can Vet J ; 54(1): 61-4, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23814303

RESUMO

Two adult llamas (Lama glama) previously exposed to oak trees (Quercus spp.) were presented with a history of depression and anorexia. Clinicopathological abnormalities included severe gastroenteritis, acute renal failure, and increased liver enzymes. This is believed to be the first report of oak toxicosis in South American camelids.


Assuntos
Lesão Renal Aguda/veterinária , Camelídeos Americanos , Intoxicação por Plantas/veterinária , Quercus/envenenamento , Lesão Renal Aguda/diagnóstico , Lesão Renal Aguda/etiologia , Animais , Evolução Fatal , Masculino , Intoxicação por Plantas/complicações , Intoxicação por Plantas/diagnóstico
18.
Ugeskr Laeger ; 175(24): 1701-2, 2013 Jun 10.
Artigo em Dinamarquês | MEDLINE | ID: mdl-23763926

RESUMO

Plant poisonings are rare in Denmark, but can have fatal consequences. We present a case in which a woman went into cardiac arrest after having ingested leaves from the foxglove plant. Sinus rhythm was not restored until Digibind was administered. Literature in this field is sparse, but we conclude that the following advice can be given: 1) assessment of the degree of poisoning should be based on clinical features and changes of the electrocardiogram; 2) activated charcoal should be given; 3) in case of malignant arrhythmia or cardiac arrest, the use of Digibind should be considered.


Assuntos
Digitalis/envenenamento , Parada Cardíaca , Fragmentos Fab das Imunoglobulinas/uso terapêutico , Fatores Imunológicos/uso terapêutico , Intoxicação por Plantas/tratamento farmacológico , Eletrocardiografia , Feminino , Parada Cardíaca/induzido quimicamente , Parada Cardíaca/tratamento farmacológico , Humanos , Pessoa de Meia-Idade , Intoxicação por Plantas/complicações , Tentativa de Suicídio , Resultado do Tratamento
19.
Ugeskr Laeger ; 175(24): 1707-8, 2013 Jun 10.
Artigo em Dinamarquês | MEDLINE | ID: mdl-23763930

RESUMO

Fatal exposure to poisonous plants in northern Europe is a rare condition. In this case report we describe an intended poisoning with Aconitum napellus (monkshood), which contains the toxin aconitine. The lethal dose in adults is 3-6 mg. The toxin affects excitable cells such as neurons and myocytes causing degrees of unconsciousness, hypotension and cardiac arrhythmias. There is no antidote and treatment is symptomatic. We describe a patient who had eaten monkshood. She was treated with infusion of lidocaine and survived. After 24 hours of treatment and monitoring she was discharged from the intensive care unit.


Assuntos
Aconitum/envenenamento , Intoxicação por Plantas/tratamento farmacológico , Aconitina/envenenamento , Antiarrítmicos/uso terapêutico , Estado Terminal/terapia , Feminino , Humanos , Lidocaína/uso terapêutico , Pessoa de Meia-Idade , Intoxicação por Plantas/complicações , Tentativa de Suicídio , Resultado do Tratamento
20.
Muscle Nerve ; 48(5): 823-7, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23733387

RESUMO

INTRODUCTION: A 28-year-old man presented with acute flaccid paralysis and respiratory failure that persisted for 2 weeks after suicidal ingestion of unknown substances. METHODS: Extensive clinical, nerve, laboratory, and neuroimaging testing excluded alternative causes of this neuromuscular syndrome. Prompted by clues provided by family members, liquid chromatography time-of-flight mass spectrometry was used to investigate for the presence of poison hemlock. RESULTS: Testing of the residue in a jar used for the ingestion of a poisonous concoction confirmed the presence of the nicotinic alkaloid coniine. Analysis of patient serum suggested the presence of conhydrine. Concentrations of amitriptyline and diazepam were also found to be supratherapeutic, but only through the first few days of hospitalization. CONCLUSIONS: Herein we describe a case of reversible coma, flaccid quadriparesis, and neuromuscular respiratory failure caused by intentional ingestion of poison hemlock.


Assuntos
Coma/induzido quimicamente , Conium/envenenamento , Intoxicação por Plantas/complicações , Quadriplegia/induzido quimicamente , Insuficiência Respiratória/induzido quimicamente , Tentativa de Suicídio , Adulto , Conium/química , Ingestão de Alimentos/fisiologia , Humanos , Masculino , Intoxicação por Plantas/sangue
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA