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1.
S D Med ; 72(10): 438-441, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31816202

RESUMO

Human papillomavirus (HPV) is a sexually transmitted virus that is the leading cause of cervical cancer world- wide. It is vaccine-preventable. According to the Centers for Disease Control, only 60 percent of girls have started the HPV vaccination series countrywide and only 50 percent of boys have started. South Dakota is below this national average. In an effort to assess - and improve - HPV vaccination rates in our practice a quality improvement effort was undertaken. Two interventions were implemented a month apart: the first was a mailing to the parent(s) of all patients 11-12 years of age during the time period of the intervention; the second was an in-office reminder system for both patients and physicians at the time of an office encounter. After each of the interventions, the immunization rate for one injection was significantly greater than baseline; while slightly higher than baseline, that for those receiving both injections was not statistically different for either intervention.


Assuntos
Infecções por Papillomavirus , Vacinas contra Papillomavirus , Neoplasias do Colo do Útero , Vacinação/estatística & dados numéricos , Adolescente , Criança , Medicina de Família e Comunidade , Feminino , Humanos , Imunização , Masculino , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , South Dakota , Neoplasias do Colo do Útero/prevenção & controle , Neoplasias do Colo do Útero/virologia
2.
Arch Environ Contam Toxicol ; 77(3): 336-343, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31384978

RESUMO

We collected Walleye Sander vitreus (May-October) from Bitter and Twin lakes, South Dakota to assess seasonal- and diet-related variation in tissue mercury (Hg) concentration. The average Hg concentration in Walleye was 43-68% higher in the spring for Bitter (p < 0.008) and Twin Lakes (p < 0.017) compared with summer or autumn months. Bioenergetics analysis of Bitter Lake Walleye showed that consumption of fish prey (primarily Fathead Minnow Pimephales promelas) increased from late summer through winter and was linked to increased Hg accumulation in Walleye the following spring. Mercury concentration varied significantly with Walleye age but was similar for comparably-aged male (0.62 µg/g) and female fish (0.62 µg/g). However, after adjusting for Walleye size (total length, mm), mean Hg concentration was greater in male (0.66 µg/g) compared with female (0.50 µg/g) fish, likely due to slower growth rate of male Walleye. At 425 mm, male Walleye in Bitter Lake were approximately 1 year older than female fish. These findings show that diet, age, and gender-related growth affect Hg concentration in Walleye and are important factors to consider in fish contaminant monitoring programs.


Assuntos
Mercúrio/análise , Percas , Poluentes Químicos da Água/análise , Fatores Etários , Animais , Tamanho Corporal , Dieta , Ecotoxicologia/métodos , Monitoramento Ambiental/métodos , Feminino , Lagos , Masculino , Percas/fisiologia , Comportamento Predatório , Estações do Ano , South Dakota
3.
S D Med ; 72(8): 349-353, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31465639

RESUMO

INTRODUCTION: Safe sleep recommendations for infants have been evolving over the past three decades. It has been shown that physicians' recommendations strongly influence parents' choice of infant sleep position. However, the proportion of physicians and/or nurses giving infant sleep advice to parents is reportedly low. METHODS: A survey was conducted in South Dakota to evaluate pediatricians' and family practitioners' knowledge of safe sleep recommendations for infants. Survey questions assessed their beliefs regarding risk factors for sudden infant death syndrome (SIDS) and their recommendations for safe sleep environments provided to parents/caregivers. RESULTS: Among the respondents, 98 percent felt that it is important to discuss SIDS with every parent and 80 percent of them indicated a need within their profession to have further information on the topic of SIDS. However, 31 percent of physicians with 16 years or more since training and 64.5 percent of those with less than 16 years since training did provide safe sleep advice to parents and caregivers. CONCLUSIONS: Despite the knowledge of SIDS risk factors, gaps were seen in dissemination of information regarding all risk factors to parents. While sleep position, postnatal exposures and breast feeding were more likely to be addressed, other elements of a safe sleep environment such as bedding surface, bed sharing, pacifier use and room ventilation were less likely to be covered. These findings indicate the need for improved health care provider education/communication in South Dakota.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Pediatras/psicologia , Guias de Prática Clínica como Assunto , Morte Súbita do Lactente , Leitos , Humanos , Lactente , Pediatras/normas , Fatores de Risco , Sono , South Dakota , Decúbito Dorsal
4.
S D Med ; 72(8): 354-360, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31465640

RESUMO

INTRODUCTION: The Centers for Disease Control and Prevention updated recommendations for human papillomavirus (HPV) vaccine in 2016. National and statewide statistics indicate that HPV vaccination in the adolescent population is well below the administration rates for other vaccines. Because cancers associated with HPV infection are vaccine preventable, low administration rates are a cause for concern. METHODS: Through a two-year project funded by the South Dakota Department of Health, Sanford Health implemented a quality improvement project to address the low rate of HPV vaccine administration in their clinics in South Dakota. Evidence-based interventions included: implementation of a client reminder and recall system, vaccine education for providers and staff, a provider assessment and feedback system, and re-education on protocol (standing) orders. RESULTS: Implementation of this quality improvement project resulted in the following: 104,571 client reminders distributed, re-education on standing orders for vaccine administration, as well as feedback on missed opportunities for vaccination, and increased awareness for all providers and staff. In patients ages 11-26, HPV vaccine series completion rates increased by 13 percent in the two-year period. Zero-dose HPV vaccination dropped 22 percent in the seven pilot clinics over the two-year grant period, and by 10 percent overall when the additional clinics (n=32) were added in the second year. DISCUSSION: Implementation of the above practices provided a significant increase in awareness of the need to assess and administer HPV vaccine. The methods used are easily adaptable to any clinic system. These practices can increase HPV vaccination rates and ultimately decrease the number of HPV associated cancers.


Assuntos
Infecções por Papillomavirus , Vacinas contra Papillomavirus/administração & dosagem , Vacinação/estatística & dados numéricos , Adolescente , Adulto , Criança , Medicina de Família e Comunidade , Humanos , Infecções por Papillomavirus/prevenção & controle , Melhoria de Qualidade , South Dakota , Adulto Jovem
5.
S D Med ; 72(4): 150-162, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31436928

RESUMO

Within the context of medical reformation outlined by Hoffman in a series of three papers in South Dakota Medicine and the challenge of legislation involving the independent practice of advanced practice nurses, we undertook two surveys of physicians and patients. We wanted to better understand physicians' attitudes toward certain opportunities for reform and how they conformed to the viewpoints of our patients. We found that, at least with respect to nurse practice legislation, physicians' perceptions were at odds with their patients over questions of access and quality. Moreover, we found attitudinal differences among physicians depending upon whether they were independent or affiliated with a health care system and whether they were primary care physicians or specialists. We concluded that physicians do not yet share the common understanding necessary to advocate for a principle of medical practice encompassing the core needs of patients and the spectrum of caregivers.


Assuntos
Reforma dos Serviços de Saúde , Medicina , Médicos de Atenção Primária , Atitude do Pessoal de Saúde , Humanos , South Dakota , Inquéritos e Questionários
6.
S D Med ; 72(4): 164-167, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31436929

RESUMO

BACKGROUND: The Sioux Falls Family Medicine Residency serves a large non-English speaking and low socioeconomic status population. We designed a quality initiative to increase influenza and pneumonia vaccination rates in our elderly patients. METHODS: The main components of the project included improved clinic workflow, physician and staff education, and heightened patient awareness of vaccination importance. For the latter, we employed posters with key points about why patients should receive the vaccines, and personalized handouts with a photo of their provider discussing the importance of receiving these vaccines. The handouts were translated into the four most common non-English languages served by our clinics. RESULTS: Following implementation of the initiative, influenza vaccination rates increased from 35 to 53 percent, PPSV23 vaccination rates increased from 62.5 to 64 percent, and most impressively, PCV13 vaccination rates increased from 40 to 60 percent. CONCLUSION: This quality improvement project demonstrated meaningful change with minimal financial and logistical investment and should be sustainable in the long-term.


Assuntos
Programas de Imunização/organização & administração , Vacinas contra Influenza , Influenza Humana/prevenção & controle , Pneumonia/prevenção & controle , Idoso , Medicina de Família e Comunidade , Humanos , Vacinas contra Influenza/administração & dosagem , South Dakota , Vacinação
7.
S D Med ; 72(6): 254-259, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31461230

RESUMO

The University of South Dakota Physician Assistant Studies Program (USD PA Program) is in its 26th year of operation. The mission remains the same: to provide "a comprehensive primary care education that prepares graduates to deliver high-quality health care to meet the needs of patients in South Dakota and the surrounding region." The inaugural class graduated in 1995 making the class of 2018 our 24th. Graduates now number 462. The purpose of this article is to provide a brief historical background and to describe the evolution of the program and its contribution to the health care workforce of South Dakota and the region.


Assuntos
Educação Médica , Assistentes Médicos , Humanos , Atenção Primária à Saúde , Pesquisa , South Dakota
8.
S D Med ; 72(6): 267-271, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31461232

RESUMO

INTRODUCTION: Due to an increase in the incidence of skin cancer and a shortage of primary care and specialty physicians in rural areas, creative public health strategies must be employed to address disparities in skin cancer education, prevention, and detection. METHODS: Hair salons in eastern South Dakota communities with populations less than 15,000 were visited in-person by medical student facilitators. Hair professionals at these locations completed pre-survey assessments for baseline self-assessed comfort with detecting suspicious skin lesions and with educating patrons on skin cancer prevention strategies. Their likelihood to both alert patrons of suspicious skin lesions and encourage them to have their lesion evaluated by a physician was also assessed. A 20-minute educational PowerPoint presentation was given. Final assessment was evaluated with a post-presentation survey. RESULTS: Self-assessed hair professional comfort with identifying suspicious skin lesions was higher in post-survey results, in addition, the educational presentation increased comfort with sharing skin cancer prevention information with patrons. Hair professionals also reported increased likelihood that they would alert patrons to suspect skin lesions. Also, hair professionals reported increased likelihood that they would encourage patrons to seek medical care for their concerning lesions. CONCLUSIONS: Hair professionals may act as lay skin cancer educators in rural salons. Educational programs for hair professionals can increase their comfort with detecting lesions suspicious for skin cancer, increase their comfort with sharing skin protection information with patrons, and increase their likelihood of both alerting their patrons about suspicious skin lesions and encouraging their patrons to have their suspicious lesions evaluated.


Assuntos
Educação em Saúde/organização & administração , Serviços de Saúde Rural/organização & administração , Neoplasias Cutâneas , Educação em Saúde/métodos , Humanos , Pele , Neoplasias Cutâneas/prevenção & controle , South Dakota , Inquéritos e Questionários
9.
S D Med ; 72(7): 299-302, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31461584

RESUMO

INTRODUCTION: Many organizations recommend childhood vision screenings. Furthermore, 42 out of 50 states in the U.S. have laws requiring these examinations looking for multiple ocular abnormalities that can lead to amblyopia, which has the potential to result in lifelong visual impairment. Currently, South Dakota is not a state with similar aforementioned law. The purpose of this research was to examine vision screening laws and programs across America to potentially provide a framework from which South Dakota could adopt its own law. METHODS: This is a healthcare policy review of childhood vision screenings across the U.S. government websites and departments of education and/or health were contacted for information regarding laws and their processes of vision screenings. The University of South Dakota Sanford School of Medicine (USD SSOM) Pediatric Residency Program was queried on their current practice. The 14 largest school districts in South Dakota were questioned on their policies. Other current regular childhood health screenings in South Dakota were also investigated. RESULTS: Most states utilize the public school systems and school personnel in performing screenings. The USD SSOM Pediatric Residency Program routinely screens children at kindergarten physical exams. The majority of the largest school districts in South Dakota routinely screen their students using a variety of methods. There are a few other routine health screenings covered by insurance and Medicaid in South Dakota. CONCLUSION: South Dakota does not have a law requiring childhood vision screenings. Despite this, many screenings are still performed in schools or in medical offices.


Assuntos
Política de Saúde , Seleção Visual , Criança , Assistência à Saúde , Humanos , South Dakota , Estudantes , Estados Unidos
10.
S D Med ; 72(5): 196-198, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31454471
11.
S D Med ; 72(5): 206-213, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31454473

RESUMO

INTRODUCTION: Individual health is influenced by multiple, potentially correlated factors including healthcare availability, community context, and socioeconomic factors. To measure the health changes at county-levels across North Dakota, South Dakota, and Minnesota, a measure of relative health, health index, was developed incorporating multiple indicators from domains of health conditions, health behaviors, and social determinants. METHODS: We combined data from all 206 counties in the aforementioned three states for the years 2008-2012 from multiple data sources. We performed factor analysis that accounted for a hierarchical structure of the overall health index comprising of 15 indicators. RESULTS: A hierarchical structure is identified in which three intermediate factors are connecting the health index with 15 health indicators. The grouping results of the 206 counties based on health index values demonstrate the existence of a gradient in health conditions in the Northern Plains. CONCLUSIONS: The health status of urban areas was generally better than that of rural areas in the Northern Plains during this study period. The developed index adds stability to the estimates of the population characteristics, especially in rural, sparsely populated counties.


Assuntos
Comportamentos Relacionados com a Saúde , Nível de Saúde , Indicadores Básicos de Saúde , Humanos , Minnesota , North Dakota , South Dakota
12.
Holist Nurs Pract ; 33(4): 197-203, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31192831

RESUMO

This study tests the hypothesis that yoga breathing (pranayama) improves lung function in healthy volunteers during a 6-week protocol. A randomized controlled pilot study demonstrated an improvement in peak expiratory flow rate and forced expiratory volume. The easy-to-learn approach can be translated to the inpatient and outpatient settings.


Assuntos
Exercícios Respiratórios/normas , Respiração , Testes de Função Respiratória/estatística & dados numéricos , Ioga , Adulto , Exercícios Respiratórios/métodos , Feminino , Voluntários Saudáveis/estatística & dados numéricos , Humanos , Pulmão/fisiologia , Masculino , Projetos Piloto , Testes de Função Respiratória/métodos , South Dakota
13.
J Econ Entomol ; 112(5): 2407-2417, 2019 09 23.
Artigo em Inglês | MEDLINE | ID: mdl-31081894

RESUMO

Soybean aphid, Aphis glycines Matsumura (Hemiptera: Aphididae), infestations of soybean, Glycine max (L.) Merr. (Fabales: Fabaceae), and the associated yield loss have led to a large dependence on insecticidal management in soybean throughout the Midwestern United States. However, several populations of pyrethroid-resistant soybean aphids have recently been found in Iowa, Minnesota, North Dakota and South Dakota, which highlights the importance of alternative management approaches. One such alternative method is host-plant resistance, which uses naturally occurring plant defenses in crop cultivars to reduce the potential for yield loss from a pest population. Current soybean aphid-resistant cultivars do not protect against all soybean aphids due to the presence of virulent biotypes. In particular, soybean aphid biotype 4 is virulent to Rag1 and Rag2 resistance genes both individually and in combination. However, we hypothesized that resistance to biotype 4 may exist in previously identified, but uncharacterized resistant soybean plant introductions (PIs). To test this, we evaluated 51 previously identified but uncharacterized soybean aphid-resistant PIs for their resistance to colonies of soybean aphid biotype 4 collected in separate site-years (Lomira, WI 2013; Volga, SD 2015, 2016). Free-choice tests identified 14 PIs with putative resistance to 'Lomira13', two to 'Volga15', and eight to 'Volga16' soybean aphid colonies. Follow-up, no-choice tests corroborated two to three resistant PIs per colony, and PI 437696, which was resistant to each of the three colonies and could aid in breeding efforts and an integrated approach to soybean aphid management.


Assuntos
Afídeos , Animais , Iowa , Meio-Oeste dos Estados Unidos , Minnesota , North Dakota , South Dakota , Soja
14.
J Pediatr Ophthalmol Strabismus ; 56(3): 157-161, 2019 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-31116862

RESUMO

PURPOSE: To evaluate the validity of remote telemedicine screening for retinopathy of prematurity (ROP) in a population of at-risk preterm infants in Iowa and South Dakota. METHODS: The medical records for all preterm infants screened for ROP at neonatal intensive care units (NICUs) in Sioux City, Iowa, and Sioux Falls, South Dakota, from September 1, 2017, to July 31, 2018, were retrospectively reviewed. The RetCam Shuttle (Natus Medical Inc., Pleasanton, CA) was used to capture retinal images, which were posted on a secure server for evaluation by a pediatric ophthalmologist. Infants with suspected ROP approaching the criteria for treatment with anti-vascular endothelial growth factor (VEGF) medications were transferred to the Children's Hospital and Medical Center NICU in Omaha, Nebraska, where a comprehensive examination was performed and treatment was administered when indicated. The remaining infants received an outpatient comprehensive examination by one of two pediatric ophthalmologists within 2 weeks of discharge. RESULTS: A total of 124 telemedicine examinations were performed on 35 infants during the study period. Remote telemedicine screening for referral-warranted ROP using the RetCam Shuttle had a sensitivity of 100%, specificity of 97%, positive predictive value of 66.7%, and negative predictive value of 100%. Of the three infants transferred for referral-warranted ROP, two required treatment with anti-VEGF medications. Good outcomes were noted in all cases, and no patients progressed beyond stage 3 ROP. CONCLUSIONS: Telemedicine screening reliably detected referral-warranted ROP in at-risk premature infants at two remote sites, with no poor outcomes during the 11-month period. These results demonstrate the validity and utility of remote telemedicine screening for ROP. [J Pediatr Ophthalmol Strabismus. 2019;56(3):157-161.].


Assuntos
Triagem Neonatal/métodos , Retinopatia da Prematuridade/diagnóstico , Telemedicina/instrumentação , Desenho de Equipamento , Feminino , Seguimentos , Idade Gestacional , Humanos , Incidência , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Iowa/epidemiologia , Masculino , Oftalmoscopia/métodos , Reprodutibilidade dos Testes , Retinopatia da Prematuridade/epidemiologia , Estudos Retrospectivos , Índice de Gravidade de Doença , South Dakota/epidemiologia
15.
S D Med ; 72(3): 114-118, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31018055

RESUMO

American Indian health care in the state of South Dakota meets the definition of a humanitarian crisis and as such is being called a third-world country within its own borders. This dizzying challenge will require an out-ofthe-box but previously successful Transorganization, to address a problem which will never be solved by separate organizations operating in silos. It will also require visionary leadership to shine a permanent light on this conundrum, inviting all physicians and healthcare systems to join together as a team of teams, until this situation is transformed. The urgency of this matter demands much more than the typical call for leadership. It demands a shout.


Assuntos
Assistência à Saúde/organização & administração , Índios Norte-Americanos , Liderança , Médicos , Humanos , Equipe de Assistência ao Paciente , South Dakota
17.
S D Med ; 72(3): 131-132, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31018060

RESUMO

This article discusses the historical trauma and modern struggles of Oglala Lakota Sioux tribal members on the Pine Ridge Indian Reservation in southwestern South Dakota. In order for healthcare providers to understand why patients from this region have soaring rates of diabetes, teen pregnancies and premature death, it is important to have exposure to their culture and daily life. As part of their medical school curriculum, students at the Sanford School of Medicine take part in cultural immersion trips in order to better understand and relate to the people on the Pine Ridge Reservation. These experiences are led by local Lakota people and allow students to be exposed to the modern healthcare and government facilities, and also take part in traditional ceremonies such as drumming circles and art shows. By the end of the journey, future physicians leave with a better understanding of day-to-day Lakota life and increased empathy and understanding for their Native American counterparts.


Assuntos
Assistência à Saúde Culturalmente Competente , Diabetes Mellitus/etnologia , Diabetes Mellitus/prevenção & controle , Índios Norte-Americanos , Gravidez na Adolescência , Adolescente , Adulto , Assistência à Saúde , Feminino , Humanos , Masculino , Gravidez , Gravidez na Adolescência/etnologia , Gravidez na Adolescência/prevenção & controle , South Dakota
18.
S D Med ; 72(2): 52, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30855729
19.
S D Med ; 72(1): 6-11, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30849221

RESUMO

In 2017, similar to 2016, there was a decrease in total live resident births in South Dakota. Racial minorities comprised 25 percent of these newborns, demonstrating a similar pattern of diversity among births observed nationwide. Unlike 2016, when the state recorded its lowest ever rate of infant mortality (4.8 per 1,000 live births), in 2017 it spiked to 7.8. This increase was primarily observed in the neonatal deaths in both the white and minority population. An increase in births of very low birth weight newborns and deaths due to congenital anomalies partially contributed to this increase. Compared to the nation, a higher percent of the state's infant deaths occur among those with birthweights above 2499 grams. A positive finding apparent in the 2017 mortality data was the decrease in the rate of sudden unexpected infant deaths from what has been observed in recent years. The small number of births in the state requires caution in interpreting findings that show year to year variability. Nonetheless, while the trend in infant mortality in the state is declining, it remains higher than the 2016 rate 5.9 for the nation.


Assuntos
Coeficiente de Natalidade , Mortalidade Infantil , Nascimento Vivo , Coeficiente de Natalidade/etnologia , Coeficiente de Natalidade/tendências , Peso ao Nascer , Causas de Morte , Humanos , Lactente , Mortalidade Infantil/etnologia , Mortalidade Infantil/tendências , Recém-Nascido , Nascimento Vivo/epidemiologia , South Dakota
20.
Molecules ; 24(3)2019 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-30717185

RESUMO

In this research, we propose a novel concept for a non-destructive evaluation of volatiles emitted from ripening grapes using solid-phase microextraction (SPME). This concept is novel to both the traditional vinifera grapes and the cold-hardy cultivars. Our sample models are cold-hardy varieties in the upper Midwest for which many of the basic multiyear grape flavor and wine style data is needed. Non-destructive sampling included a use of polyvinyl fluoride (PVF) chambers temporarily enclosing and concentrating volatiles emitted by a whole cluster of grapes on a vine and a modified 2 mL glass vial for a vacuum-assisted sampling of volatiles from a single grape berry. We used SPME for either sampling in the field or headspace of crushed grapes in the lab and followed with analyses on gas chromatography-mass spectrometry (GC-MS). We have shown that it is feasible to detect volatile organic compounds (VOCs) emitted in-vivo from single grape berries (39 compounds) and whole clusters (44 compounds). Over 110 VOCs were released to headspace from crushed berries. Spatial (vineyard location) and temporal variations in VOC profiles were observed for all four cultivars. However, these changes were not consistent by growing season, by location, within cultivars, or by ripening stage when analyzed by multivariate analyses such as principal component analysis (PCA) and hierarchical cluster analyses (HCA). Research into aroma compounds present in cold-hardy cultivars is essential to the continued growth of the wine industry in cold climates and diversification of agriculture in the upper Midwestern area of the U.S.


Assuntos
Frutas/química , Cromatografia Gasosa-Espectrometria de Massas/métodos , Microextração em Fase Sólida/métodos , Vitis/metabolismo , Compostos Orgânicos Voláteis/isolamento & purificação , Fazendas , Frutas/crescimento & desenvolvimento , Frutas/metabolismo , Humanos , Iowa , Análise Multivariada , Polivinil , Análise de Componente Principal , South Dakota , Vitis/química , Vitis/crescimento & desenvolvimento , Compostos Orgânicos Voláteis/classificação , Vinho/análise
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