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1.
Zhonghua Wei Chang Wai Ke Za Zhi ; 23(1): 56-64, 2020 Jan 25.
Artigo em Chinês | MEDLINE | ID: mdl-31958932

RESUMO

Objective: To explore the application of endoscopic tattooing with carbon nanoparticles in the treatment of advanced colorectal cancer (ACRC). Methods: A randomized controlled study was used. Inclusion criteria: (1) age more than 18 years old, and colorectal cancer was found for the first time and confirmed by colonoscopy and biopsy; (2) advanced colorectal cancer (preoperative TNM stage of T3/N1 or above, local unresectable lesion, M1 stage and simultaneously resectable metastatic lesion), and patients agreed to receive neoadjuvant therapy; (3) advanced colorectal cancer (TNM stage of T3/N1 or above) with simultaneous unresectable metastatic lesion, and patients refused operation and consented to chemoradiotherapy. Patients with previous abdominal surgery history, radiotherapy and chemotherapy history, urgent need for surgery or endoscopic stent placement and those with severe allergic constitution were excluded. Based on the above criteria, 120 patients diagnosed with ACRC in No.900 Hospital of the Joint Logistics Team from January 2016 to December 2017 were prospectively enrolled and randomly divided into tattoo group and non-tattoo group by random number table method. Tattoo group were tattooed within 1-7 days before chemoradiotherapy. The labeling location of the lesions: (1) if the colonoscopy could pass smoothly, 4 points were injected into the intestinal wall of the both opposite sides 1 cm cephalad and caudad of the tumor; (2) if the colorectal cavity was severely narrow and the colonoscopy could not pass, only 4 points were injected in 4 quadrants at 1 cm caudad of the tumor. Each injection point was injected with 0.1 ml carbon nanoparticles, and the size of the tumor was measured according to the range of carbon nanoparticles staining. The efficacy was evaluated after 8 weeks of chemoradiotherapy. Patients who were defined to be suitable for operation underwent operation 6 weeks after chemoradiotherapy. The following parameters were compared between two groups: lesion identification time, operation time, blood loss, distance from lesion to distal margin, the rate of first positive margin and the rate of anal sphincter preservation (rectal cancer). Among patients who had been evaluated as having no indication for surgery, those who were effective in chemoradiotherapy continued to receive chemotherapy in the original regimen; if the treatment failed, the chemotherapy regimen was replaced, and the efficacy was finally evaluated after six months [referring to the revised RECIST guidelines (version 1.1)]. Results: Three patients withdrew from this study, and 117 patients were enrolled in this study finally, including 59 cases in tattoo group and 58 cases in the non-tattoo group. There were no significant differences in baseline data between two groups (all P>0.05). All the patients had slight adverse reactions of radiotherapy and chemotherapy before operation, and could tolerate after symptomatic management without interruption of treatment. All the patients in the tattoo group had no discomfort such as fever, abdominal pain, abdominal distention, hematochezia, etc. and the intestinal mucosa could be seen clearly with black staining after being tattooed. A total of 77 patients were evaluated with surgical indications, including 39 cases in the tattoo group (tattoo-operable) and 38 cases in the non-tattoo group (non-tattoo-operatable). There were no significant differences in baseline data between the two groups (all P>0.05). Forty patients without operation indications continued chemoradiotherapy, including 20 cases in tattoo group (tattoo-inoperable) and 20 cases in non-tattoo group (non-tattoo-inoperable), whose differences in baseline data between the two groups were not significant as well (all P>0.05). No obvious edema, necrosis or abscess were found in the tattooed segments and the black spots could be seen quickly and clearly on the serosa of rectum in tattoo-operable patients. As compared to non-tattoo group, tattoo group had significantly shorter lesion identification time [(3.4±1.4) minutes vs. (11.8±3.4) minutes, t=-14.07,P<0.001], shorter operation time [(155.7±44.5) minutes vs. (177.2±30.2) minutes, t=-2.48,P=0.015], less blood loss [(101.3±36.7) ml vs.(120.2±38.2) ml, t=-2.22,P=0.029], shorter distance from lesion to distal margin [(3.7±1.0) cm vs. (4.6±1.7) cm, t=-2.20, P=0.034], while tattoo group had slightly higher rate of anal sphincter preservation [66.7%(16/24) vs. 45.5%(10/22), χ(2)=2.10,P=0.234] and lower rate of first positive resection margin [0 vs. 4.5%(1/22), χ(2)=0.62,P=0.480], but their differences were not significant. There were no significant differences in the degree of tumor differentiation and TNM stage between two groups. Patients without operative indication were evaluated for efficacy of chemoradiotherapy again after half a year. One case of complete response (CR), 8 of partial response (PR), 10 of stable disease (SD) and 1 of progressive disease (PD) were found and the improvement rate was 45.0% (9/20) in tattoo-inoperable patients. No case of CR, 6 of PR, 11 of SD and 3 of PD were found and the improvement rate was 30.0% (6/20) in non-tattoo-inoperable patients. There was no significant difference in the improvement rate between the two groups (P=0.514). Conclusions: Endoscopic tattooing with carbon nanoparticles injection is safe and reliable for colorectal tumor positioning. It can assist rapid detection of lesions during surgery after neoadjuvant treatment, perform accurate resection, significantly shorten the operation time and reduce surgical trauma; can assist colonoscopy accurately to measure the size of the lesions before and after chemoradiotherapy, and increase the means of assessing the efficacy to guide the follow-up treatment plan. This technique is worth clinical promotion and application.


Assuntos
Carbono/administração & dosagem , Neoplasias do Colo/terapia , Nanopartículas/administração & dosagem , Neoplasias Retais/terapia , Tatuagem/métodos , Adolescente , Quimiorradioterapia Adjuvante , Neoplasias do Colo/patologia , Neoplasias do Colo/cirurgia , Colonoscopia , Neoplasias Colorretais/patologia , Neoplasias Colorretais/cirurgia , Neoplasias Colorretais/terapia , Terapia Combinada , Humanos , Neoplasias Retais/patologia , Neoplasias Retais/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
2.
Anal Chim Acta ; 1079: 59-72, 2019 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-31387720

RESUMO

This review summarizes the current regulatory status of tattoos in all their versions in the European Union framework, as well as the analytical approaches developed so far to control the safety of this type of products. Publications from the last two decades (2000-2019) have been reviewed in which body-decorating products have become more and more popular. Tattoo inks, permanent make-up, sticker tattoos, and henna-based products are covered. The report highlights that there is no unique regulation for body art products, conforming a complex legislative framework even within the European community. The labelling of tattoo related products is generally non-existent or incorrect. It is therefore very difficult to know their chemical composition in detail. Pigments are ingredients common to all types of tattoos, so they are the most covered compounds in this review, along with their impurities and degradation products, including aromatic amines, metals or PAH. Other types of undesirable compounds are also included, such as plasticizers or para-phenylenediamine. Although the development of methods of analysis has increased in recent times, there is still margin for improvement in the analytical coverage of this topic. The challenge is, indeed, a systematic analytical approach to control body-decorating products, but ideally within a clear and common harmonised regulatory framework. Finally, tattoo-based sensors for biomonitoring have also been included in this review, since although its purpose is not decorative; its clinical importance is very relevant.


Assuntos
Corantes/análise , Tatuagem/legislação & jurisprudência , Europa (Continente) , Humanos , Tatuagem/métodos
3.
Gastrointest Endosc Clin N Am ; 29(4): 687-703, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31445691

RESUMO

Retrieval of lesions after endoscopic polypectomy enables histopathologic analysis and guides future surgical management and endoscopic surveillance intervals. Various techniques and devices have been described with distinct advantages and disadvantages to accomplish retrieval. Appropriate histopathologic analysis depends on lesion handling and preparation. How lesions are handled further depends on size, endoscopic appearance, and removal technique. Endoscopic marking or tattooing is a well-described process that uses dye mediums to leave longstanding marks in the colon. Techniques, dye mediums, and locations within the colon influence tattoo approach.


Assuntos
Pólipos do Colo/cirurgia , Colonoscopia/métodos , Neoplasias Colorretais/prevenção & controle , Lesões Pré-Cancerosas/cirurgia , Tatuagem/métodos , Idoso , Pólipos do Colo/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Lesões Pré-Cancerosas/diagnóstico por imagem , Lesões Pré-Cancerosas/patologia , Sensibilidade e Especificidade , Manejo de Espécimes
4.
Nanoscale ; 11(30): 14294-14302, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31318368

RESUMO

Room-temperature printing of conductive traces has the potential to facilitate the direct writing of electronic tattoos and other medical devices onto biological tissue, such as human skin. However, in order to achieve sufficient electrical performance, the vast majority of conductive inks require biologically harmful post-processing techniques. In addition, most printed conductive traces will degrade with bending stresses that occur from everyday movement. In this work, water-based inks consisting of high aspect ratio silver nanowires are shown to enable the printing of conductive traces at low temperatures and without harmful post-processing. Moreover, the traces produced from these inks retain high electrical performance, even while undergoing up to 50% bending strain and cyclic bending strain over a thousand bending cycles. This ink has a rapid dry time of less than 2 minutes, which is imperative for applications requiring the direct writing of electronics on sensitive surfaces. Demonstrations of conductive traces printed onto soft, nonplanar materials, including an apple and a human finger, highlight the utility of these new silver nanowire inks. These mechanically robust films are ideally suited for printing directly on biological substrates and may find potential applications in the direct-write printing of electronic tattoos and other biomedical devices.


Assuntos
Nanofios/química , Prata/química , Tatuagem/métodos , Eletrônica , Humanos , Tinta , Tatuagem/instrumentação
5.
South Med J ; 112(4): 222-227, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30943541

RESUMO

OBJECTIVES: Accurate localization of a colonic lesion is crucial to successful resection. Although colonic tattooing is a widely accepted technique to mark lesions for future identification surgery or repeat colonoscopy, no consensus guidelines exist. The objective of this study was to determine whether the current tattooing practice at a tertiary medical center differs from recommendations in the literature and self-reported provider practice. METHODS: The study consisted of an observational retrospective chart review of patients who received colonic tattoos, as well as a provider survey of reported tattooing practices at a tertiary academic medical center. A total of 747 patients older than 18 years of age who underwent colonoscopy with tattoo were included. Forty-four gastroenterologists performing endoscopy were surveyed on tattooing techniques. RESULTS: In the majority of cases, neither the number of tattoos, location of the tattoo nor the distance from the lesion was specified within the report. Following the index procedure, a tattoo was detected in 75% of surgical resections and 73% of endoscopies. At the time of surgery, however, the tattoo and/or the lesion was detected approximately 94% of the time. Twenty-five endoscopists (56.8%) completed the survey. Differences were seen the between the chart review and reported practice. Most providers report placing ≥2 marks (87.2%); however, chart review revealed that only 56.2 % were tattooed with ≥2 marks. CONCLUSIONS: Variation exists between the reported tattooing practice and actual practice. Despite this, most tattoos are identified at the time of surgery or repeat endoscopy. Further research is needed to determine whether a standardized approach to tattooing and reporting could improve localization at repeat endoscopy.


Assuntos
Pólipos do Colo/cirurgia , Colonoscopia/métodos , Neoplasias Colorretais/cirurgia , Documentação/estatística & dados numéricos , Gastroenterologistas , Padrões de Prática Médica/estatística & dados numéricos , Tatuagem/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Pólipos do Colo/diagnóstico , Neoplasias Colorretais/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tatuagem/métodos , Centros de Atenção Terciária , Adulto Jovem
6.
Int J Dermatol ; 58(6): 750-755, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30828798

RESUMO

BACKGROUND: Even though dermatologists often perform drug delivery procedures, it is necessary to assess their safety. OBJECTIVE: Quantify the amount of medication delivered using the MMP drug delivery technique and outline other safety parameters. METHODS: Using a simple and novel technique, we attempted to quantify the amount of medication delivered by weighing human skin samples before and after delivery. RESULTS: In drug delivery done on human skin using a liquid with a density of 1,271,460 µg/ml (the values expressed in this manuscript are in µg), a needling density of 570 perforations/cm2 , and a needling depth of 300 microns, we estimate that 1,175 µg/cm2 were delivered (standard deviation 601 µg/cm2 , standard error 190 µg/cm2 ). LIMITATIONS: This result is only applicable to the protocol proposed in this study for the MMP drug delivery technique. CONCLUSION: The MMP drug delivery technique injects small amounts of medication (1,175 µg/cm2 ) homogeneously into the dermis.


Assuntos
Fármacos Dermatológicos/administração & dosagem , Sistemas de Liberação de Medicamentos/instrumentação , Tatuagem/instrumentação , Sistemas de Liberação de Medicamentos/métodos , Humanos , Injeções Subcutâneas/instrumentação , Injeções Subcutâneas/métodos , Pele , Absorção Cutânea , Tatuagem/métodos
9.
PLoS One ; 14(1): e0209853, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30629615

RESUMO

INTRODUCTION: Tattooing especially gains popularity among both men and women in adulthood from the wide range of socioeconomic groups and is noted as a risk taking behaviour in adults. Especially when tattooing does not perform to the highest standards, it can potentially be the hazardous practice. Myanmar has a paucity of evidence-based information on the estimated prevalence of tattoos and awareness of potential disease transmission from tattooing under insanitary conditions as well as the infection risk. The present research was undertaken to help identify the self-reported prevalence of tattooing among adults (18-35 years) and their knowledge of transmission risk of blood-borne infections and its determinants. METHODS: A community-based cross-sectional study focused on residents aged 18-35 years was carried out in two urban and two rural areas in Mandalay district, Mandalay Region during 2015. Trained interviewers used a pre-tested structured questionnaire for face-to-face interviews with one eligible participant per selected household (n = 401). Bivariate analysis and multivariable analysis using binary logistic regression were done to ascertain the relevant explanatory variables. RESULTS: The overall self-reported prevalence of tattooing was 19.5% (78/401) (95% CI = 16-24). Nearly 80% of participants (318/401) knew at least one blood-borne viral infection that could be transmitted from tattooing. The persons who had high formal education, manual laborers and those who lived with their families were significantly more likely to cite at least one blood-borne viral infection. Their perceived possibility to remove tattoo independently influenced the practice of tattooing (aOR = 1.91, 95% CI = 1.06-3.45; p = 0.03) compared with participants who reported no perceived possibility. Tattooing was more common in male (aOR = 13.07, 95% CI = 6.25-27.33; p<0.001) compared to female which was independently significant. CONCLUSIONS: This study ascertained the tattoo prevalence as two in ten adults of working age especially among male in central part of Myanmar in the context of lack of registration system for tattoo parlours and the issuance of safety guidelines. Findings have suggested the target groups and risk factors to be included in future health promotion programs. Future research directions should focus on perspectives of tattooists to create and sustain the sanitary practices to reduce the chance of transmission of blood-borne viral infections.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde/etnologia , Tatuagem/efeitos adversos , Tatuagem/psicologia , Adolescente , Adulto , Patógenos Transmitidos pelo Sangue , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Mianmar/etnologia , Prevalência , Fatores de Risco , Autorrelato , Inquéritos e Questionários , Tatuagem/métodos , Viroses/etiologia
10.
Mil Med ; 184(1-2): e275-e279, 2019 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-30085282

RESUMO

Since the National Smallpox Vaccination Program began in 2002, over 2.4 million military servicemembers have been inoculated. Use of bifurcated needles to introduce live vaccinia virus by repeated skin trauma is largely the same process that was first developed over 200 years ago, and is similar to that of tattoo administration. Both tattoos and smallpox inoculation can cause local immune dysregulation, with prior research cautioning further complications if they are placed in the same area within a close timeframe. Here we present the case of a soldier with smallpox autoinoculation, who reported receiving a tattoo directly over his inoculation site 4 days after vaccination. Initial scattered flesh-colored papules evolved over several days to classic umbilicated lesions with additional fevers, chills, myalgias, and suspected secondary infection. Thirteen cases of tattoo and smallpox inoculation complications have been reported in the Vaccine Adverse Events Reporting System (VAERS) database in 15 years. Current US Army Public Health Command (USAPHC) guidance mandates no new tattoos for 30 days post-inoculation, although the Military Vaccine Agency notes that this period may be extended to a window of greater than 60 days on a case-by-case basis. This incident illustrates the risks of current smallpox vaccination practice and poor patient adherence to post-vaccination care instructions. Continued use of traditional smallpox vaccination administration necessitates increased education and emphasis on proper inoculation site aftercare.


Assuntos
Militares , Vacina Antivariólica/efeitos adversos , Varíola/imunologia , Tatuagem/efeitos adversos , Sistemas de Notificação de Reações Adversas a Medicamentos , Humanos , Masculino , Tatuagem/métodos , Vaccinia/etiologia , Adulto Jovem
12.
Cornea ; 38(1): 54-61, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30222713

RESUMO

PURPOSE: To report the use of different superficial keratopigmentation (KTP) techniques for restoring or enhancing cosmetic appearance of eyes impaired for several reasons. METHODS: This is a retrospective, consecutive, noncomparative interventional series of cases, in which 136 cosmetically disabled eyes (due to different corneal abnormalities) of 130 patients were included. A total of 222 procedures of superficial manual KTP and superficial automated KTP were performed. The procedures were divided into 2 groups: first and second-stage procedures. The patients' cosmetic appearance and satisfaction were evaluated and graded as excellent, good, or poor. RESULTS: A total of 222 procedures were performed, 57.2% were superficial automated KTP, 22.5% were superficial manual KTP, and 20.3% included the combination of superficial KTP with other KTP techniques. Six procedures were purely cosmetic, 16 therapeutic functional, and 200 therapeutic cosmetic. Superficial KTP, as a second-stage procedure, was performed in 13 eyes that were previously pigmented by intrastromal techniques. Superficial KTP as an initial indication (first-stage procedure) alone or in combination with another KTP technique in the same surgery was performed in 123 eyes, in which 44.7% of them were reoperated once or more. Best-corrected visual acuity changed insignificantly, and the intraocular pressure decreased significantly in all the studied groups. No intraoperative complications were observed, 11.2% of eyes with a follow-up time of more than 3 months developed postoperative complications. Most of the patients (98.5%) were satisfied. CONCLUSIONS: The modern superficial KTP procedure provides the possibility to improve the cosmetic appearance of impaired eyes, as an alternative to evisceration, enucleation, prosthetic contact lenses, or keratoplasty.


Assuntos
Corantes/farmacologia , Córnea/cirurgia , Opacidade da Córnea/cirurgia , Previsões , Satisfação do Paciente , Tatuagem/métodos , Acuidade Visual , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
13.
Int J Dermatol ; 58(1): 103-107, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30444267

RESUMO

BACKGROUND: The most infallible approach to male pattern baldness (MPB) is hair transplantation in the thinning area in parallel to medical treatment to prevent further alopecia progression. For an individual with advanced stage hair loss, a megasession surgery is recommended to meet the high donor hair requirement. Yet a most effective therapeutic regimen for alopecia, hair transplantation inevitably has its advantages and disadvantages for it is done with the expense of donor hair sacrifice, intraoperative and postoperative pain, and unavoidable scars. Also, with poor donor condition, surgery may not even be an option. Nowadays, more patients with such limitations are undergoing shaved style scalp medical tattoo (SMT). OBJECTIVE: To assess the effectiveness of SMT technique for shaved hair style. METHODS AND MATERIALS: A total of 80 patients who were included in the study underwent SMT for shaved hair style between June 2014 and June 2017 and were followed for at least 6 months afterward. Patients and the surgeon completed a survey about donor and recipient site surgical results using a 5-point Likert scale. RESULTS: The average satisfaction scores of patients and surgeon were 4.8 and 4.9, respectively. CONCLUSION: Shaved style SMT can be considered one of the most effective treatment methods for patients with advanced stage hair loss. LEVEL OF EVIDENCE: IV.


Assuntos
Alopecia/terapia , Couro Cabeludo , Tatuagem/métodos , Adulto , Idoso , Remoção de Cabelo/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Inquéritos e Questionários
18.
Aesthetic Plast Surg ; 42(6): 1478-1484, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29948101

RESUMO

INTRODUCTION: Nipple-areolar complex reconstruction is the final step of the reconstructive procedure in breast cancer patients. Nowadays, a combination of a local flap for nipple reconstruction and skin grafting or tattooing for areola reconstruction is deemed a first choice. In this paper, we are combining the techniques of local flap and full-thickness skin graft from the upper inner thigh for simultaneous reconstruction of the nipple and areola. PATIENTS AND METHODS: From January, 2016 to December, 2017, 23 female patients with an absent unilateral nipple-areolar complex due to post-oncological mastectomy and immediate implant-based breast reconstruction were subjects of the study. On an out-patient clinic basis, the percentage of the nipple projection loss was calculated at the intervals of 3 , 6 and 12 months postoperatively. At the final visit, the patient's subjective satisfaction on the reconstructed areola compared to the normal contralateral side was evaluated using a visual analogue scale. RESULTS: Over the course of time, the mean nipple projection loss was 20.16 ± 12.88, 31.78 ± 11.63 and 34.69 ± 12.01% at 3 , 6 and 12 months postoperatively, respectively. Patients' overall satisfaction on the grafted areola was as follows; the largest number of patients (8 patients) had a 'good' satisfaction 12-months postoperatively. Out of 21 patients, those who considered the result to be 'poor' and 'disappointing' each accounted for 1 and 3 patients. CONCLUSION: The combination of nipple-areolar complex reconstruction technique introduced in this study has proven to be a safe and efficacious alternative in patients with implant-based reconstruction requiring small- to medium-sized nipple projection, especially when the skin envelope is too tight for a local flap only. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .


Assuntos
Implantes de Mama , Mamoplastia/métodos , Mastectomia/métodos , Mamilos/cirurgia , Transplante de Pele/métodos , Retalhos Cirúrgicos/transplante , Adulto , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Estudos de Coortes , Estética , Feminino , Seguimentos , Rejeição de Enxerto , Humanos , Pessoa de Meia-Idade , Satisfação do Paciente , Estudos Retrospectivos , Medição de Risco , Tatuagem/métodos , Fatores de Tempo , Resultado do Tratamento
20.
AMA J Ethics ; 20(4): 366-371, 2018 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-29671730

RESUMO

The goal of plastic surgeons performing postmastectomy anatomic reconstruction is to create a breast structure that closely matches the shape and appearance of a patient's native breast. Tattoo artists have helped improve outcomes with nipple-areolar tattooing. Some patients now prefer to have more extensive, nonanatomic designs to help camouflage their scars. Two questions are considered here: What role should plastic surgeons have in supporting or performing nonanatomic reconstruction? And should insurance programs cover nonanatomic breast reconstruction options?


Assuntos
Cicatriz/terapia , Mamoplastia/ética , Retalhos Cirúrgicos/ética , Tatuagem/ética , Adulto , Feminino , Humanos , Mamoplastia/métodos , Satisfação do Paciente , Tatuagem/métodos
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