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Pohjanen VM, Koivurova OP, Niemelä SE, Karttunen RA, Karttunen TJ. Role of Helicobacter pylori and interleukin 6 -174 gene polymorphism in dyslipidemia: a case-control study. BMJ Open 2016; 6:e009987. [PMID: 26781506 PMCID: PMC4735314 DOI: 10.1136/bmjopen-2015-009987] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To assess the role of Helicobacter pylori infection and interleukin 6 polymorphism -174 (rs1800795) in dyslipidemia. DESIGN Case-control study comparing serum lipids between H. pylori positive and negative patients and controlling for IL-6 -174 polymorphism, age, sex and smoking. SETTING 3 hospitals performing outpatient endoscopies in the city of Oulu, Finland. PARTICIPANTS 199 adult patients with dyspepsia symptoms fulfilling Rome criteria originating from ethnically Finnish population. Patients with an immunosuppressive disorder or malignant disease, treated H. pylori infection, immunosuppressive or anticoagulant medication, previous gastric surgery or ongoing antibiotic treatment were excluded. PRIMARY OUTCOME MEASURES Association of H. pylori infection and serum lipid concentrations in the whole group or in genotype-based subgroups. The associations between peptic ulcer, gastric mucosal inflammation and serum lipid concentrations were assessed as secondary outcomes. RESULTS The median high-density lipoprotein (HDL) serum concentration was significantly lower in the H. pylori positive group (0.81 mmol/L) than in the negative group (0.95 mmol/L; p<0.001). In the genotype subgroup analyses, a similar association between H. pylori infection and HDL serum levels was seen within the IL-6 -174 CC genotype group (HDL 0.72 vs 1.06 mmol/L, respectively; p<0.001), but no significant associations were seen in the GC or GG genotype groups. Additionally, patients with peptic ulcer demonstrated lower HDL levels (0.75 mmol/L) than H. pylori positive patients without ulcer (0.86 mmol/L; p=0.010). CONCLUSIONS H. pylori infection associated significantly with low serum levels of HDL in the IL-6 -174 CC genotype patients but not in the other genotypes. This suggests that the association between H. pylori infection and serum HDL could be transmitted through IL-6. We suggest that the role of IL-6 genotype should also be studied in relation to other associations between gastrointestinal microbiome and cardiovascular risk factors.
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Affiliation(s)
- Vesa-Matti Pohjanen
- Department of Pathology, Cancer and Translational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | | | - Seppo E Niemelä
- Department of Internal Medicine, Oulu University Hospital, Oulu, Finland
| | - Riitta A Karttunen
- Department of Medical Microbiology and Immunology, University of Oulu, Oulu, Finland
| | - Tuomo J Karttunen
- Department of Pathology, Cancer and Translational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
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Pohjanen VM, Koivurova OP, Huhta H, Helminen O, Mäkinen JM, Karhukorpi JM, Joensuu T, Koistinen PO, Valtonen JM, Niemelä SE, Karttunen RA, Karttunen TJ. Toll-Like Receptor 4 Wild Type Homozygozity of Polymorphisms +896 and +1196 Is Associated with High Gastrin Serum Levels and Peptic Ulcer Risk. PLoS One 2015; 10:e0131553. [PMID: 26161647 PMCID: PMC4498789 DOI: 10.1371/journal.pone.0131553] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 06/03/2015] [Indexed: 01/14/2023] Open
Abstract
Toll-like receptor 4 is a part of the innate immune system and recognizes Helicobacter pylori lipopolysaccharide. The goal of this study was to analyze the role of Toll-like receptor 4 polymorphisms +896 (rs4986790) and +1196 (rs4986791) in the pathogenesis of Helicobacter pylori related gastroduodenal diseases in relation to gastric secretion and inflammation. Toll-like receptor 4 polymorphisms, serum gastrin-17 and pepsinogen I and II concentrations were determined, and gastroscopies with histopathological analyses were performed to 216 dyspeptic patients. As genotype controls, 179 controls and 61 gastric cancer patients were studied. In our study, the Toll-like receptor 4 +896 and +1196 polymorphisms were in total linkage disequilibrium. The homozygous wild types displayed higher gastrin-17 serum concentrations than the mutants (p = 0.001) and this effect was independent of Helicobacter pylori. The homozygous wild types also displayed an increased risk for peptic ulcers (OR: 4.390). Toll-like receptor 4 genotypes did not show any association with Helicobacter pylori positivity or the features of gastric inflammation. Toll-like receptor 4 expression was seen in gastrin and somatostatin expressing cells of antral mucosa by immunohistochemistry. Our results suggest a role for Toll-like receptor 4 in gastric acid regulation and that the Toll-like receptor 4 +896 and +1196 wild type homozygozity increases peptic ulcer risk via gastrin secretion.
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Affiliation(s)
- Vesa-Matti Pohjanen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | | | - Heikki Huhta
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Olli Helminen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Johanna M. Mäkinen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Jari M. Karhukorpi
- Department of Medical Microbiology and Immunology, Institute of Diagnostics, University of Oulu, Oulu, Finland
- Eastern Finland Laboratory Centre Joint Authority Enterprise (ISLAB), Joensuu, Finland
| | - Tapio Joensuu
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Internal Medicine, Pietarsaari City Hospital, Pietarsaari, Finland
| | | | | | - Seppo E. Niemelä
- Department of Internal Medicine, Oulu University Hospital, Oulu, Finland
| | - Riitta A. Karttunen
- Department of Medical Microbiology and Immunology, Institute of Diagnostics, University of Oulu, Oulu, Finland
| | - Tuomo J. Karttunen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- * E-mail:
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Relationship Between Drug Resistance and cagA Gene in Helicobacter pylori. Jundishapur J Microbiol 2013. [DOI: 10.5812/jjm.8480] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Amjad N, Osman HA, Razak NA, Kassian J, Din J, Abdullah NB. Clinical significance of Helicobacter pylori cagA and iceA genotype status. World J Gastroenterol 2010; 16:4443-7. [PMID: 20845512 PMCID: PMC2941068 DOI: 10.3748/wjg.v16.i35.4443] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To study the presence of Helicobacter pylori (H. pylori) virulence factors and clinical outcome in H. pylori infected patients.
METHODS: A prospective analysis of ninety nine H. pylori-positive patients who underwent endoscopy in our Endoscopy suite were included in this study. DNA was isolated from antral biopsy samples and the presence of cagA, iceA, and iceA2 genotypes were determined by polymerase chain reaction and a reverse hybridization technique. Screening for H. pylori infection was performed in all patients using the rapid urease test (CLO-Test).
RESULTS: From a total of 326 patients who underwent endoscopy for upper gastrointestinal symptoms, 99 patients were determined to be H. pylori-positive. Peptic ulceration was seen in 33 patients (33%). The main virulence strain observed in this cohort was the cagA gene isolated in 43 patients. cagA was associated with peptic ulcer pathology in 39.5% (17/43) and in 28% (16/56) of non-ulcer patients. IceA1 was present in 29 patients (29%) and iceA2 in 15 patients (15%). Ulcer pathology was seen in 39% (11/29) of patients with iceA1, while 31% (22/70) had normal findings. The corresponding values for iceA2 were 33% (5/15) and 33% (28/84), respectively.
CONCLUSION: Virulence factors were not common in our cohort. The incidence of factors cagA, iceA1 and iceA2 were very low although variations were noted in different ethnic groups.
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Prevalence and clinical relevance of cagA, vacA, and iceA genotypes of Helicobacter pylori isolated from Slovenian children. J Pediatr Gastroenterol Nutr 2009; 49:289-96. [PMID: 19525870 DOI: 10.1097/mpg.0b013e31818f09f2] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Although infection with Helicobacter pylori in children mostly induces asymptomatic chronic gastritis, the clinical outcome of H pylori infection is generally unpredictable. To identify the risk subgroup of infected children who can progress toward serious gastrointestinal disease, we assessed the prevalence of H pylori virulence genes cagA, vacA, and iceA in children from southeastern Europe and correlated their presence with the severity of histological changes in the stomach. MATERIALS AND METHODS A total of 165 children (age range 4-18 years, mean 13 years) with H pylori infection were studied for a 6-year period. Virulence genes were determined by polymerase chain reaction from biopsy samples. RESULTS The cagA gene was present in 61.2% of patients. The predominant vacA genotype was s1m1 (42%), followed by s1m2 (28%), and s2m2 (24%). IceA genotypes iceA1 and iceA2 were detected in 62% and 31% of the samples, respectively. Multiple genotypes were found in 11.5% of isolates. The H pylori density score, the degree of chronic and acute inflammation, correlated with a cagA-positive status (P < 0.01, P < 0.01, P = 0.01, respectively). Higher bacterial infiltration (P < 0.01) and degree of chronic inflammation (P = 0.03) were detected in vacA s1-positive samples. CONCLUSION CagA, vacA s1m1, and iceA1 genotypes are the predominant genotypes of H pylori isolated from the southeastern European pediatric population. CagA and vacA s1 are important virulence determinants of H pylori in children, but were not found associated with an increased incidence of precancerous gastric lesions.
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Zhang X, Yan Z, Qu K, Xu JR, Han Y, Qiao W, Chen YJ. Association of cagA and iceA genotypes with Helicobacter pylori related diseases in Xi'an area. Shijie Huaren Xiaohua Zazhi 2009; 17:1632-1637. [DOI: 10.11569/wcjd.v17.i16.1632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To study the impact of cagA, iceA genes and their synergy on the outcome of H pylori infection so as to explore the dominant genotypes of H pylori that induce certain diseases in Xi'an area.
METHODS: One hundred and one H pylori-positive specimens from the patients after gastroscopy were preliminarily selected using the rapid urease test (RUT) and 91 eligible cases were chosen from them using the method of polymerase chain reaction (PCR) to amplify ureC. The subtypes of cagA, iceA genes were detected by PCR and agarose gel electrophoresis. Relationship between different combinations of genotypes and disease was analyzed using χ2 test and Fisher exact test.
RESULTS: The cagA-positive rate was 79.1%, and the overall detection rate of iceA was 75.82%, in which the detection rate oficeA1 was 50.5% and that of iceA2 was 38.5%. The positive rate of cagA+/iceA1+ was higher than that of other groups. Each gene alone or genes in different combinations didn't show any statistical significance in clinical outcomes. The relevance existed in iceA and cagA. 229 bp, 334 bp, 439 bp, 549 bp and 229 bp+334 bp fragments of the genes were found in iceA2.
CONCLUSION: cagA+/iceA1+ is the dominant genotype of H pylori in Xi'an area. Neither a single gene nor the combination of cagA, iceA1, iceA2 are helpful in predicting the clinical outcome of H pylori infection. We may find synergy with the iceA and cagA. iceA2 shows greater variability in Xi'an area.
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Abstract
BACKGROUND Several putative virulence factors for Helicobacter pylori have been identified including cagA, vacA, and iceA. The aims of the present study were to study the distribution of cagA, vacA, and iceA genotypes in children with H. pylori gastritis and to examine the association of genotypes with severity of gastritis. METHODS H. pylori DNA was extracted from antral biopsy specimens from 33 children with H. pylori gastritis. Specific polymerase chain reaction assays were used for three genes: cagA, vacA, and iceA. The features of gastritis were graded in accordance with the updated Sydney System. RESULTS Of the 33 children, 31 (94%) were cagA positive. Twenty-four (72%) had s1c genotype and nine (27%) had s1a. The m1 genotype was seen in 27 (82%) and m2 was found in five (15%). The iceA1 genotype was detected in 25 (76%). Scores of neutrophil activity, chronic inflammation, and H. pylori density were independent of cagA, vacA and iceA status. CONCLUSION The cagA-positive vacA s1c/m1 iceA1 genotype was predominant in Korean children with recurrent abdominal pain and H. pylori gastritis. The cagA, vacA and iceA genotype were not associated with the severity of gastritis.
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Affiliation(s)
- Jae Sung Ko
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
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Lopes AIC, Palha A, Monteiro L, Olcastro M, Pelerito A, Fernandes A. Helicobacter pylori genotypes in children from a population at high gastric cancer risk: no association with gastroduodenal histopathology. Am J Gastroenterol 2006; 101:2113-22. [PMID: 16848806 DOI: 10.1111/j.1572-0241.2006.00732.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Both bacterial and host determinants underlying differences in histopathology and clinical outcome in H. pylori pediatric infection, as compared to adults, are still poorly documented. Pediatric studies may provide important insights on H. pylori infection immunopathogenesis, particularly in high gastric cancer risk populations. The present study concerns H. pylori genotypic diversity of isolates in children from a population with high gastric cancer risk, and its association with demographic and clinical variables, including gastroduodenal endoscopic and histopathological features. METHODS A total of 119 subjects (mean age 10.3 yr, 1.5-18.0 yr) with H. pylori infection were studied. H. pylori vacA, cagA, and iceA genotypes were determined (PCR) in antral-obtained primary cultures; histopathological evaluation was performed in corpus, antrum, and duodenum biopsy specimens. RESULTS cagA-, vacA s2m2, and iceA2 were the most prevalent genotypes. No association was observed between H. pylori genotypes and subject demographic and clinical variables, with the exception of a significant association between vacA s2 genotype and lower corpus inflammation score (p< 0.03). CONCLUSIONS In this pediatric cohort, H. pylori genotype profiles were distinct from those reported in adult subjects in the same area, with a lower prevalence of the putative more virulent genotypes. Moreover, they were not associated with clinical expression of gastroduodenal disease, suggesting the potential role of host and/or environmental factors for the development of clinical disease at a later age.
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Affiliation(s)
- Ana Isabel Costa Lopes
- Gastroenterology Unit, Paediatric Department, University Hospital Santa Maria, Lisboa, Portugal
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Lee JH, Choe YH, Jeon BH, Oh YJ, Kim JJ, Rhee JC, Kim PS, Choi MS. Genotypes of the Helicobacter pylori vacA signal sequence differ with age in Korea. Helicobacter 2004; 9:54-8. [PMID: 15156904 DOI: 10.1111/j.1083-4389.2004.00198.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
BACKGROUND Studies on Helicobacter pylori genotypes have focused on adults in developed countries, and data on the genotypes of Helicobacter pylori recovered from the children are rare. MATERIALS AND METHODS One hundred and twenty-eight biopsy samples from patients with H. pylori infection were studied. The patients' ages ranged from 9 to 83 years. PCR analysis for vacA genotypes was performed using DNA extracted from biopsy specimens. RESULTS Genotyping of the s-region showed s1a in 33 (25.8%) samples and s1c in 82 (64.1%) samples. When the specimens were grouped by age, the distribution of s-region genotype was found to be significantly different between groups (p = .002). The prevalence of s1a was 45.2% in patients < 20 years old, but 14.9% in patients > or = 50 years old. On the other hand, the prevalence of s1c or recombinant s1a-s1c was higher in those > or = 50 years old. The distribution of the m-region did not differ significantly with age (p = .110). CONCLUSIONS Strain populations infecting Korean adults and children differ.
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Affiliation(s)
- Jun Haeng Lee
- Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
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Abstract
Helicobacter pylori causes chronic gastritis worldwide and it is the most important single factor in peptic ulcer disease. Up to half of H. pylori infected individuals develop atrophic gastritis over years and decades. H. pylori infection has also been classified as a class I carcinogen in human gastric cancer. Most infections are obtained in childhood, in Finland mainly before the age of 7 years but the exact transmission routes are not known. The infection shows an age-dependent pattern, the infection being rare among children but gradually becoming more prevalent among older age groups. As new infections are few in adults and the infection only rarely disappears without effective anti-microbial therapy, the occurrence of the infection in the old actually reflects the prevalence of the infection in their childhood. In developed countries, such as Finland, a rapid decline of H. pylori prevalence rate has been demonstrated. In order to speed up this natural decline of the infection, a unique population based 'screen and treat' project was started in Vammala, a semiurban south-western community in Finland. In this survey, young inhabitants were offered diagnosis and treatment for H. pylori.
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Affiliation(s)
- Hilpi Rautelin
- Department of Bacteriology and Immunology, Haartman Institute, University of Helsinki, Helsinki University Central Hospital Laboratory Diagnostics, Helsinki, Finland.
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Podzorski RP, Podzorski DS, Wuerth A, Tolia V. Analysis of the vacA, cagA, cagE, iceA, and babA2 genes in Helicobacter pylori from sixty-one pediatric patients from the Midwestern United States. Diagn Microbiol Infect Dis 2003; 46:83-8. [PMID: 12812722 DOI: 10.1016/s0732-8893(03)00034-8] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This study was designed to characterize H. pylori from pediatric gastric biopsy specimens in terms of several genes (vacA, cagA, cagE, iceA1, iceA2, and babA2) proposed to be involved in the pathogenesis of this organism. Many of these genes have been studied in adult H. pylori isolates, however, these genes have not been well characterized in H. pylori from children. Using PCR we observed that 44% of the H. pylori in our biopsies shared two common genotypes (vacA s1b m1, cagA, cagE, iceA2 +/- babA2). While 26% of the H. pylori had unique genotypes. The cag pathogenicity island associated genes, cagA and cagE, were found together in 64% or our H. pylori, while 84% were iceA2 positive. The presence of the babA2 gene has been proposed to be associated with a higher risk of H. pylori related diseases, however, we found that only 36% of our H. pylori contained this gene.
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Affiliation(s)
- Raymond P Podzorski
- DMC University Laboratories, Wayne State University School of Medicine, 540 E. Canfield, Detroit, MI 48210, USA.
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Oleastro M, Gerhard M, Lopes AI, Ramalho P, Cabral J, Sousa Guerreiro A, Monteiro L. Helicobacter pylori virulence genotypes in Portuguese children and adults with gastroduodenal pathology. Eur J Clin Microbiol Infect Dis 2003; 22:85-91. [PMID: 12627281 DOI: 10.1007/s10096-002-0865-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The aim of this study was to evaluate the prevalence of virulence genotypes, namely cagA, vacA and babA2, of Helicobacter pylori strains isolated from Portuguese adults and children presenting gastroduodenal pathology. One hundred thirty-six strains were studied, 82 isolated from adult patients (50 with nonulcerative gastritis and 32 with active peptic ulcer) and 58 isolated from children (54 with nonulcerative gastritis and 4 with duodenal ulcer). Genotyping of cagA, vacA and babA2 was assessed by polymerase chain reaction. Overall, Helicobacter pylori strains carrying more virulent genotypes were much more prevalent in adults than in children, particularly the type I ( vacAs1- and cagA-positive) and the triple-positive ( vacAs1-, cagA- and babA2-positive) strains ( P<0.001). A subpopulation of adults and children with nonulcerative gastritis was also studied, and differences in the prevalence of virulent genotypes were observed, either for individual genotypes ( P=0.017 for cagA, P=0.010 for vacAs1) or in combinations, i.e. the type I genotype ( P=0.005) and the triple-positive strains ( P=0.031). There was no difference between the two populations in the distribution of babA2 and m1/m2 genotypes. Considering the cohort effect in the epidemiology of Helicobacter pylori infection, these results suggest that different strains might circulate during different periods of time, or that, after infection in childhood, individual strains will undergo changes during the course of infection.
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Affiliation(s)
- M Oleastro
- Laboratório de Bacteriologia, Instituto Nacional Saúde Dr Ricardo Jorge, Av Padre Cruz, 1649-016, Lisboa, Portugal.
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