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1.
Clin Podiatr Med Surg ; 39(1): 1-14, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34809788

RESUMO

Clubfoot or talipes equinovarus deformity is one of the most common anomalies affecting the lower extremities. This review provides an update on the outcomes of various treatment options used to correct clubfoot. The ultimate goal in the treatment of clubfoot is to obtain a fully functional and pain-free foot and maintain a long-term correction. The Ponseti method is now considered the gold standard of treatment for primary clubfoot. Relapse is common after primary treatment with the Ponseti method, and other interventions are discussed that are used to provide for long-term successful outcomes.


Assuntos
Pé Torto Equinovaro , Moldes Cirúrgicos , Pé Torto Equinovaro/terapia , , Humanos , Lactente , Recidiva , Resultado do Tratamento
2.
Clin Podiatr Med Surg ; 39(1): 113-127, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34809790

RESUMO

Limb length inequality or discrepancy (LLD) occurs when there is a difference in length between 2 limbs or when deviation exists from a normally expected length for a given age. The magnitude of the discrepancy is defined as the difference between the 2 extremities. Aside from congenital etiologies, LLD can also arise from infection, paralysis, tumors/neoplasm, and surgery. Approximately 70% to 90% of the world's population has some elements of LLD with compensation allowing for tolerance and potentially masking the extent to which one limb could be significantly shorter either functionally or structurally. Components of functional LLD could include congenital shortening of soft tissues, joint contractures, axial skeleton malalignment, and abnormal pedal biomechanics (ie, posterior tibial tendonitis or equinovarus). In accordance with literature reports, most individuals can tolerate upwards of a 2 cm discrepancy. Although a constellation of symptoms such as joint pain, arthritis, alterations in oxygen consumption/heart rate, and low back pathology can occur later on in adulthood, the focus in this review will be with early diagnosis and management in the pediatric population.


Assuntos
Artrite , Pé Torto Equinovaro , Adulto , Fenômenos Biomecânicos , Criança , , Humanos , Desigualdade de Membros Inferiores
4.
Artigo em Inglês | MEDLINE | ID: mdl-34769761

RESUMO

BACKGROUND: Several studies have shown the relationship between poor footwear fit and the risk of feet deformities. The available evidence seems to show that the development of hallux valgus deformity in the feet of schoolchildren may be related to the use of shoes that are poorly fitting in length. The objective of this cross-sectional study was to analyze the relationship between poor footwear fit in length and risk of developing hallux valgus. METHODS: Using an instrument that was designed and calibrated for this purpose, maximum foot length was obtained and compared to the inner length of the shoe in 187 schoolchildren. Hallux valgus angle (HVA) was measured on weight-bearing podogram image obtained from the longest foot in 188 schoolchildren. RESULTS: By default, the footwear was poorly fitting in length (too short or close-fitting) in 38.5% of the schoolchildren, with boys having the worst footwear fit; though no significant differences stood out. (p = 0.276). Regarding the HVA, no significant differences were recorded according to age or gender (p = 0.573). A strong correlation was observed between too-short footwear and the increase in HVA in 10-year-old boys (r = 0.817; p = 0.025) and in 9-year-old girls (r = 0.705; p = 0.005). CONCLUSIONS: Inadequate footwear fit in length may be a predisposing extrinsic risk factor for the development of hallux valgus in schoolchildren of both sexes. Results of the present study demonstrate the need to adapt the sizes of footwear to the rapid increase in foot-length that occur at puberty to avoid the risk of developing hallux valgus, especially at the ages of onset pubertal foot growth.


Assuntos
Hallux Valgus , Criança , Estudos Transversais , Feminino , , Hallux Valgus/epidemiologia , Hallux Valgus/etiologia , Humanos , Masculino , Fatores de Risco , Sapatos
5.
Acta Ortop Mex ; 35(2): 211-214, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34731926

RESUMO

Epithelioma cuniculatum is characterized as a slow growing lesion on the sole of the foot. A diagnosis is usually delayed by a low clinical suspicion and misdirection due to its similarity to an infection. This tumor rarely metastasize but a local invasion of adjacent soft tissues is common, requiring ample surgical resection or even amputation in advanced cases. We report a case a 76-year-old patient with a 5-year-old lesion on the sole of the foot, which was originally treated as a wart without improvement while the lesion slowly evolved. The patient was referred to our center with a diagnosis of chronic osteomyelitis. An excisional biopsy revealed an invasive keratinizing squamous carcinoma. In this advanced phase of the disease the only possible treatment was a Syme amputation.


Assuntos
Neoplasias Ósseas , Carcinoma Verrucoso , Doenças do Pé , Idoso , Amputação , Pré-Escolar , , Doenças do Pé/diagnóstico , Doenças do Pé/cirurgia , Humanos
6.
Georgian Med News ; (319): 7-12, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34749314

RESUMO

Hoffmann-Clayton procedures appears to be promising surgical treatment in severe rheumatoid forefoot deformities. It has been reported that 80% to 90% of foot deformities in adults are due to rheumatoid arthritis. Despite of various surgical approaches, early functional and cosmetic results have been the greatest concern among patients. Thus, optimal surgical approach in correction of severe rheumatoid forefoot deformities is of vital importance for better subjective and clinical results. Clinical study was conducted on 56 painful chronic rheumatoid foot who were treated by arthrodesis of 1st metatarsophalangeal (MTP) and lesser metatarsal head resections. They were divided into 2 groups based on surgical approach in lesser metatarsal head resections. 1st group had 25 feet with dorsal approach (Clayton) and 2nd group - 31 feet with plantar approach (Hoffmann). Subjective and clinical outcomes were evaluated in both groups. The mean post-operative AOFAS scores were 67.82 (range: 32 - 82) and mean post-operative Foot Function Index (FFI) was 0.51 (range: 0.23 to 0.63) in both groups. Eighty seven percent (48/56 feet) reported early pain relief, improved cosmetic appearance, and improved footwear comfort in Hoffmann group. The mean hallux valgus angles improved from 37 to 15 degrees and the 1st intermetatarsal angle from 17 to 8 degrees in both groups. Four feet had non-union of the 1st MTP joint arthrodesis and three among them were re-operated. Hoffmann and Clayton procedures are optimal methods for excision arthroplasty of lesser metatarsal heads. However, Hoffmann (plantar approach) serves to be more convenient resulting in early recovery, adequate functional stability, rehabilitation and better cosmetic results.


Assuntos
Deformidades Adquiridas do Pé , Hallux Valgus , Articulação Metatarsofalângica , Adulto , , Deformidades Adquiridas do Pé/diagnóstico por imagem , Deformidades Adquiridas do Pé/etiologia , Deformidades Adquiridas do Pé/cirurgia , Hallux Valgus/diagnóstico por imagem , Hallux Valgus/cirurgia , Humanos , Articulação Metatarsofalângica/diagnóstico por imagem , Articulação Metatarsofalângica/cirurgia , Radiografia , Estudos Retrospectivos , Resultado do Tratamento
7.
Foot Ankle Clin ; 26(4): 639-653, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34752232

RESUMO

Children with cerebral palsy frequently develop foot deformities, most commonly equinus contractures, which can be managed with orthotics up to age 5 to 7 years. Plantar flexor lengthening, typically around this age, should be restricted to the offending muscle only, usually with a fascia release of the gastrocnemius. Equinovarus, mainly a problem in children with unilateral cerebral palsy, often responds to plantar flexor lengthening. If further tendon transfers are needed, they should be done when the child is older to avoid overcorrection. Planovalgus mostly improves spontaneously up to age 5 years. Surgical correction is best done in adolescence.


Assuntos
Paralisia Cerebral , Pé Equino , Deformidades do Pé , Adolescente , Paralisia Cerebral/complicações , Criança , Pré-Escolar , Pé Equino/etiologia , Pé Equino/cirurgia , , Deformidades do Pé/etiologia , Deformidades do Pé/cirurgia , Humanos , Músculo Esquelético
8.
Foot Ankle Clin ; 26(4): 655-683, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34752233

RESUMO

Every child with a neuromotor disorder is at risk for the development or a deterioration of foot deformities. This relates to central and peripheral diseases. Almost any kind of deformity may occur. As the basic problems mostly remain, a multidisciplinary team care program is necessary in addition to surgical management of the feet. Surgery must respect any muscle imbalance as well as joint deformities and instabilities. Postoperative orthotic support supplements most treatments. Long-term follow-ups are strongly advised to detect any recurrences or overcorrections.


Assuntos
Deformidades Adquiridas do Pé , Deformidades do Pé , Artropatias , Doenças do Sistema Nervoso , Criança , , Humanos
9.
Foot Ankle Clin ; 26(4): 747-764, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34752237

RESUMO

Clubfoot overcorrection can develop gradually over years and is characterized in school age by hindfoot valgus position due to excessive rigid peritalar eversion, sometimes accompanied by supramalleolar valgus malalignment. Surgical treatment is recommended in severe cases and consists of bony realignment at the peritalar complex by osteotomy or fusion, correction of the supramalleolar valgus deformity in younger children by hemiepiphyseodesis, or osteotomy in adolescents. In addition, dorsal bunion requires stabilization of the medial tarsometatarsal ray and transfer of the tendons of Mm. tibialis anterior and flexor hallucis longus.


Assuntos
Pé Torto Equinovaro , Adolescente , Criança , Pé Torto Equinovaro/cirurgia , , Humanos , Osteotomia , Tendões
10.
Foot Ankle Clin ; 26(4): 765-805, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34752238

RESUMO

Various surgical techniques are known for the treatment of flexible flatfoot in children after failure of nonsurgical attempts. Data collected in a review of the last 10-year period (2010-2020) show that among the 691 feet undergoing subtalar arthroereisis with endorthesis, average age at surgery was 11.40 years and in the 1856 feet that underwent subtalar arthroereisis with calcaneo-stop 11.69 years, while the complications rate was 9.00% and 6.38%, respectively. These data confirm that subtalar arthroereisis with calcaneo-stop may have an advantage over subtalar arthroereisis with endorthesis as the screw is not placed across the subtalar joint but instead into the calcaneus.


Assuntos
Calcâneo , Pé Chato , Articulação Talocalcânea , Parafusos Ósseos , Calcâneo/cirurgia , Criança , Pé Chato/cirurgia , , Humanos , Articulação Talocalcânea/cirurgia , Resultado do Tratamento
11.
Foot Ankle Clin ; 26(4): 851-871, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34752241

RESUMO

Bone tumors affecting pediatric foot are a rare occurrence. Most lesions are benign, but a thorough diagnostic evaluation must always be performed to rule out malignant tumors. Approach to benign lesions is conservative, from observation follow-up to curettage or mininvasive techniques. In malignant lesions, a wide resection must be performed and same protocols applied as in tumors affecting other skeletal sites. Reconstructive procedures should aim to mechanical stability and long-lasting results; joint motion restoring can be attempted when not negatively affecting stability. Amputation procedures should be considered as a still viable choice because of their good functional result in the foot.


Assuntos
Neoplasias Ósseas , Doenças do Pé , Procedimentos Cirúrgicos Reconstrutivos , Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/cirurgia , Criança , Pé/cirurgia , Doenças do Pé/diagnóstico , Doenças do Pé/cirurgia , Humanos , Estudos Retrospectivos
12.
Foot Ankle Clin ; 26(4): 915-939, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34752244

RESUMO

The pediatric flexible flatfoot is a common foot shape that is most often asymptomatic and may be a physiologic variant of normal. Surgery is only indicated when nonoperative interventions have failed to resolve symptoms. The goal of surgery is to alleviate symptoms by improving hindfoot alignment and restoring the medial arch while preserving joint mobility. This article focuses on the common bony techniques for surgical correction of the pediatric flexible flatfoot that has failed nonoperative management, including calcaneal, midfoot, and supramalleolar osteotomies and distal tibial hemiepiphyseodesis.


Assuntos
Calcâneo , Pé Chato , Deformidades Adquiridas do Pé , Criança , Pé Chato/diagnóstico por imagem , Pé Chato/cirurgia , , Humanos , Osteotomia
13.
J Anim Sci ; 99(11)2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34735572

RESUMO

The objective of this study was to estimate genetic parameters for feet and leg traits, relationships within feet and leg traits, and relationships between feet and leg traits and production traits in Red Angus cattle. Subjective scores for 14 traits including body condition score (BCS), front hoof angle (FHA), front heel depth (FHD), front claw shape (FCS), rear hoof angle (RHA), rear heel depth (RHD), rear claw shape (RCS), size of hoof (SIZE), front side view (FSV), knee orientation (KNEE), front hoof orientation (FHO), rear side view (RSV), rear view (RV), and a composite score (COMP) were collected by trained evaluators on 1,720 Red Angus cattle. All traits except COMP were scored as intermediate optimum traits. Performance data, and EPD were obtained on all animals measured and a three-generation pedigree was obtained from the Red Angus Association of America (RAAA) that contained 13,306 animals. Data were modeled using a linear bivariate animal model with random additive genetic and residual effects, and fixed effects of age and contemporary group (herd-year) implemented in ASREML 4.0. Heritability estimates of BCS, FHA, FHD, FCS, RHA, RHD, RCS, SIZE, FSV, KNEE, FHO, RSV, RV, and COMP were 0.11, 0.20, 0.17, 0.09, 0.19, 0.25, 0.17, 0.36, 0.16, 0.17, 0.17, 0.30, 0.14, and 0.12, respectively. These results demonstrate feet and leg traits are lowly to moderately heritable. Strong, positive genetic correlations were observed between FHA and FHD (0.89), FHA and RHA (0.88), FHD and RHA (0.85), FHA and RHD (0.85), FHD and RHD (0.94), and FHO and KNEE (0.95), indicating these traits were highly related to each other. Strong and negative genetic correlations were observed between KNEE and FSV (-0.59) and FHO and FSV (-0.75). The strongest Pearson correlation between front limb traits (FHA, FHD, FSV, FHO, KNEE, and COMP) and Stayability EPD (STAY) was FSV (r = 0.16) and for rear limb traits (RHA, RHD, RCS, RSV, RV, and COMP) and STAY was RCS (r = -0.12). This suggests cattle with more slope to the angle of the shoulder and cattle with less evidence of hoof curl may stay in the herd longer. Further investigation into the economic viability of feet and leg trait genetic prediction with a larger population of animals is required to help validate these findings.


Assuntos
Doenças dos Bovinos , Doenças do Pé , Casco e Garras , Animais , Bovinos/genética , Doenças dos Bovinos/genética , , Doenças do Pé/veterinária , Fenótipo
14.
J Anim Sci ; 99(11)2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34735573
15.
Br J Hosp Med (Lond) ; 82(9): 1-7, 2021 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-34601938

RESUMO

Metatarsalgia is a common clinical conundrum that requires careful assessment. There are a variety of causes and understanding these can help manage the pain. These causes have different imaging characteristics and require specific imaging. By understanding core imaging principles and how they apply to causes of metatarsalgia, pathology can be more efficiently investigated. This article covers primary, secondary and iatrogenic causes of metatarsalgia with the most appropriate imaging modalities for each and the salient imaging findings. This article reviews the common forefoot pathologies and how they may be optimally radiologically investigated, with an emphasis on the key imaging findings.


Assuntos
Mãos , Metatarsalgia , Diagnóstico por Imagem , Testes Diagnósticos de Rotina , , Humanos , Metatarsalgia/diagnóstico por imagem , Metatarsalgia/etiologia
16.
Beijing Da Xue Xue Bao Yi Xue Ban ; 53(5): 907-914, 2021 Oct 18.
Artigo em Chinês | MEDLINE | ID: mdl-34650293

RESUMO

OBJECTIVE: To analyze the effects of visual restoration after cataract surgery on plantar pressure and biomechanics of foot in elder individuals. METHODS: Thirty-two patients [male/female 5/27, (70.1±5.2) years old] with age-related cataract were recruited between October 2016 and December 2019. The footscan system was employed to record the data of plantar pressure during level walking before and 1-month after the cataract surgery. Parameters of peak pressure (PP), impulse (I), pressure-time integral (PTI) and time to peak pressure (TPP) from the regions of the 1st toe (T1), 2nd to 5th toes (T2-5), 1st to 5th metatarsal heads (M1-M5), midfoot (MF), medial hindfoot (HM) and lateral hindfoot (HL) were analyzed respectively. RESULTS: Post-operatively, the visual function was effectively reconstructed with improved visual acuity in both eyes (Z=-4.878, -4.801; P < 0.001). The PP (t=2.266, P=0.031) and I (t=2.152, P=0.039) values in M2 region on the dominant side (right foot) increased statistically at post-operative phase, while the changes of pressure and temporal para-meters in other regions remained stable. There was laterality in plantar pressure at pre-operative phase, manifested as greater PP values in M1, M2, MF, and HM regions on the dominant sides (t=-2.414, -2.478, -2.144, -5.269; P < 0.05), greater PP values in T1, M3, M5 and HL regions on the non-dominant sides (t=4.830, 3.155, 2.686, 3.683; P < 0.05), greater I values in M1, MF, and HM regions on the dominant sides (t=-2.380, -2.185, -5.320; P < 0.05) and greater I values in T1, M3, M5 and HL regions on the non-dominant sides (t=4.489, 2.247, 2.838, 3.992; P < 0.05). post-operatively, the pressure tended to be compatible between the two sides in regions of M3 and MF, while the magnitude of laterality in regions of M1 (ZPP△= -2.721, P=0.007; ZI△=-2.581, P=0.010), M2 (ZPP△=-2.674, P=0.007; ZI△=-2.375, P=0.018) and M5 (ZPP△=1.991, P=0.046; ZI△=2.150, P=0.032) was further increased. CONCLUSION: Changes in plantar pressure after cataract surgery were characterized as increased pressure in the 2nd metatarsal head area on the dominant side. Visual restoration might intensify the laterality in the medial of forefoot on the dominant side and the lateral of forefoot on the non-dominant side.


Assuntos
, Idoso , Fenômenos Biomecânicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pressão
17.
Sensors (Basel) ; 21(19)2021 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-34640771

RESUMO

Normal pressure hydrocephalus (NPH) is a chronic and progressive disease that affects predominantly elderly subjects. The most prevalent symptoms are gait disorders, generally determined by visual observation or measurements taken in complex laboratory environments. However, controlled testing environments can have a significant influence on the way subjects walk and hinder the identification of natural walking characteristics. The study aimed to investigate the differences in walking patterns between a controlled environment (10 m walking test) and real-world environment (72 h recording) based on measurements taken via a wearable gait assessment device. We tested whether real-world environment measurements can be beneficial for the identification of gait disorders by performing a comparison of patients' gait parameters with an aged-matched control group in both environments. Subsequently, we implemented four machine learning classifiers to inspect the individual strides' profiles. Our results on twenty young subjects, twenty elderly subjects and twelve NPH patients indicate that patients exhibited a considerable difference between the two environments, in particular gait speed (p-value p=0.0073), stride length (p-value p=0.0073), foot clearance (p-value p=0.0117) and swing/stance ratio (p-value p=0.0098). Importantly, measurements taken in real-world environments yield a better discrimination of NPH patients compared to the controlled setting. Finally, the use of stride classifiers provides promise in the identification of strides affected by motion disorders.


Assuntos
Transtornos Neurológicos da Marcha , Hidrocefalia de Pressão Normal , Idoso , , Marcha , Transtornos Neurológicos da Marcha/diagnóstico , Humanos , Caminhada
18.
Sensors (Basel) ; 21(19)2021 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-34640838

RESUMO

Walking has been demonstrated to improve health in people with diabetes and peripheral arterial disease. However, continuous walking can produce repeated stress on the plantar foot and cause a high risk of foot ulcers. In addition, a higher walking intensity (i.e., including different speeds and durations) will increase the risk. Therefore, quantifying the walking intensity is essential for rehabilitation interventions to indicate suitable walking exercise. This study proposed a machine learning model to classify the walking speed and duration using plantar region pressure images. A wearable plantar pressure measurement system was used to measure plantar pressures during walking. An Artificial Neural Network (ANN) was adopted to develop a model for walking intensity classification using different plantar region pressure images, including the first toe (T1), the first metatarsal head (M1), the second metatarsal head (M2), and the heel (HL). The classification consisted of three walking speeds (i.e., slow at 0.8 m/s, moderate at 1.6 m/s, and fast at 2.4 m/s) and two walking durations (i.e., 10 min and 20 min). Of the 12 participants, 10 participants (720 images) were randomly selected to train the classification model, and 2 participants (144 images) were utilized to evaluate the model performance. Experimental evaluation indicated that the ANN model effectively classified different walking speeds and durations based on the plantar region pressure images. Each plantar region pressure image (i.e., T1, M1, M2, and HL) generates different accuracies of the classification model. Higher performance was achieved when classifying walking speeds (0.8 m/s, 1.6 m/s, and 2.4 m/s) and 10 min walking duration in the T1 region, evidenced by an F1-score of 0.94. The dataset T1 could be an essential variable in machine learning to classify the walking intensity at different speeds and durations.


Assuntos
Caminhada , Dispositivos Eletrônicos Vestíveis , , Humanos , Redes Neurais de Computação , Pressão
19.
Sensors (Basel) ; 21(19)2021 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-34640878

RESUMO

Climbing stairs is a fundamental part of daily life, adding additional demands on the postural control system compared to level walking. Although real-world gait analysis studies likely contain stair ambulation sequences, algorithms dedicated to the analysis of such activities are still missing. Therefore, we propose a new gait analysis pipeline for foot-worn inertial sensors, which can segment, parametrize, and classify strides from continuous gait sequences that include level walking, stair ascending, and stair descending. For segmentation, an existing approach based on the hidden Markov model and a feature-based gait event detection were extended, reaching an average segmentation F1 score of 98.5% and gait event timing errors below ±10ms for all conditions. Stride types were classified with an accuracy of 98.2% using spatial features derived from a Kalman filter-based trajectory reconstruction. The evaluation was performed on a dataset of 20 healthy participants walking on three different staircases at different speeds. The entire pipeline was additionally validated end-to-end on an independent dataset of 13 Parkinson's disease patients. The presented work aims to extend real-world gait analysis by including stair ambulation parameters in order to gain new insights into mobility impairments that can be linked to clinically relevant conditions such as a patient's fall risk and disease state or progression.


Assuntos
Análise da Marcha , Caminhada , Algoritmos , , Marcha , Humanos
20.
Sensors (Basel) ; 21(19)2021 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-34640882

RESUMO

The purpose was to compare step-by-step kinematics measured using force plates (criterion), an IMU only and a combined laser IMU system in well-trained sprinters. Fourteen male experienced sprinters performed a 50-m sprint. Step-by-step kinematics were measured by 50 force plates and compared with an IMU-3D motion capture system and a combined laser+IMU system attached to each foot. Results showed that step kinematics (step velocity, length, contact and flight times) were different when measured with the IMU-3D system, compared with force plates, while the laser+IMU system, showed in general the same kinematics as measured with force plates without a systematic bias. Based upon the findings it can be concluded that the laser+IMU system is as accurate in measuring step-by-step kinematics as the force plate system. At the moment, the IMU-3D system is only accurate in measuring stride patterns (temporal parameters); it is not accurate enough to measure step lengths (spatial) and velocities due to the inaccuracies in step length, especially at high velocities. It is suggested that this laser+IMU system is valid and accurate, which can be used easily in training and competition to obtain step-by step kinematics and give direct feedback of this information during training and competition.


Assuntos
, Lasers , Fenômenos Biomecânicos , Estudos de Coortes , Humanos , Masculino
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