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Jha R, Liu DD, Gerstl JVE, Renauld S, Kilgallon JL, Blitz SE, Medeiros L, Nawabi NLA, Singh H, Chua MMJ, Tobochnik S, Cosgrove GR, Rolston JD. Comparative effectiveness of stereotactic, subdural, or hybrid intracranial EEG monitoring in epilepsy surgery. J Neurosurg 2024:1-9. [PMID: 38457804 DOI: 10.3171/2024.1.jns232560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/04/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVE Surgical intervention can be curative or palliative for drug-resistant focal epilepsy. However, if the seizure onset zone (SOZ) cannot be adequately localized via noninvasive tests, intracranial EEG (iEEG) recordings are often carried out to develop surgical plans in appropriate candidates. Stereotactic EEG (SEEG), subdural EEG (SDE), and SDE with depth electrodes (hybrid) are major tools used for investigation, but there is no class 1 or 2 evidence comparing the effectiveness of these modalities. METHODS The authors identified an institutional cohort of patients who underwent iEEG monitoring between 2001 and 2022. Demographic data, preoperative clinical features, iEEG intervention, and follow-up data were identified. Primary study endpoints included the following: 1) likelihood of SOZ localization; 2) likelihood of surgical treatment after iEEG; 3) seizure outcomes; and 4) complications. RESULTS A total of 329 patients were identified (176 in the SEEG, 60 in the SDE, and 93 in the hybrid cohort) who were followed for a median of 5.4 (IQR 6.8) years. Baseline characteristics, including demographics, mean age at epilepsy diagnosis, mean age at iEEG investigation, number of preoperative antiseizure medications, and preoperative seizure frequency, were not statistically different across the 3 cohorts. Patients in the SEEG cohort were more likely to have their SOZ localized than were the patients in the SDE group (OR 2.3) and were less likely to undergo subsequent resection (OR 0.3) or to have complications (OR 0.4), although there was no statistical difference with respect to likelihood of undergoing any subsequent neurosurgical treatment, or with respect to favorable seizure outcomes. Patients in the hybrid cohort were more likely to have SOZ localized than were patients in the SDE group (OR 3.1), but were more likely to undergo resection (OR 4.9) or any neurosurgical treatment (OR 2.5) compared to patients in the SEEG group. Patients in the hybrid cohort had better seizure outcomes compared to the SDE (OR 2.3) but not to the SEEG group. CONCLUSIONS Patients in the SEEG group were more likely to have their SOZ localized and patients in the SDE group were more likely to undergo resection, but they did not differ with respect to seizure outcomes.
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Affiliation(s)
| | | | | | - Sophia Renauld
- 1Harvard Medical School, Boston
- 3Harvard MIT MD PhD Program, Harvard Medical School, Boston, Massachusetts
| | | | | | | | | | | | | | - Steven Tobochnik
- 4Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston; and
| | - G Rees Cosgrove
- 1Harvard Medical School, Boston
- Departments of2Neurosurgery and
| | - John D Rolston
- 1Harvard Medical School, Boston
- Departments of2Neurosurgery and
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2
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Tong L, Medeiros L, Moen EL, Dhand A, Linda W. Dissecting patterns and predictors of interhospital transfers for patients with brain metastasis. J Neurosurg 2024; 140:27-37. [PMID: 37486906 PMCID: PMC10787816 DOI: 10.3171/2023.5.jns222922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 05/18/2023] [Indexed: 07/26/2023]
Abstract
OBJECTIVE Interhospital transfers in the acute setting may contribute to high cost, patient inconvenience, and delayed treatment. The authors sought to understand patterns and predictors in the transfer of brain metastasis patients after emergency department (ED) encounter. METHODS The authors analyzed 3037 patients with brain metastasis who presented to the ED in Massachusetts and were included in the Healthcare Cost and Utilization Project State Inpatient Database and State Emergency Department Database in 2018 and 2019. RESULTS The authors found that 6.9% of brain metastasis patients who presented to the ED were transferred to another facility, either directly or indirectly after admission. The sending EDs were more likely to be nonteaching hospitals without neurosurgery and radiation oncology services (p < 0.01). Transferred patients were more likely to present with neurological symptoms compared to those admitted or discharged (p < 0.01). Among those transferred, approximately 30% did not undergo a significant procedure after transfer and approximately 10% were discharged within 3 days, in addition to not undergoing significant interventions. In total, 74% of transferred patients were sent to a facility significantly farther (> 3 miles) than the nearest facility with neurosurgery and radiation oncology services. Further distance transfers were not associated with improvements in 30-day readmission rate (OR [95% CI] 0.64 [0.30-1.34] for 15-30 miles; OR [95% CI] 0.73 [0.37-1.46] for > 30 miles), 90-day readmission rate (OR [95% CI] 0.50 [0.18-1.28] for 15-30 miles; OR [95% CI] 0.53 [0.18-1.51] for > 30 miles), and length of stay (OR [95% CI] 1.21 days [0.94-1.29] for both 15-30 miles and > 30 miles) compared to close-distance transfers. CONCLUSIONS The authors identified a notable proportion of transfers without subsequent significant intervention or appreciable medical management. This may reflect ED physician discomfort with the neurological symptoms of brain metastasis. Many patients were also transferred to hospitals distant from their point of origin and demonstrated no differences in readmission rates and length of stay.
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Affiliation(s)
- Lilin Tong
- Departments of Neurosurgery
- Boston University School of Medicine, Boston, Massachusetts
| | | | - Erika L. Moen
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Amar Dhand
- Departments of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
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Banko L, Patel RV, Nawabi N, Altshuler M, Medeiros L, Cosgrove GR, Bi WL. Strategies to improve surgical technical competency: a systematic review. Acta Neurochir (Wien) 2023; 165:3565-3572. [PMID: 37945995 DOI: 10.1007/s00701-023-05868-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 10/18/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND A cornerstone of surgical residency training is an educational program that produces highly skilled and effective surgeons. Training structures are constantly being revised due to evolving program structures, shifting workforces, and variability in the clinical environment. This has resulted in significant heterogeneity in all surgical resident education, training tools utilized, and measures of training efficacy. METHODS We systematically reviewed educational interventions for technical skills in neurosurgery published across PubMed, Embase, and Web of Science over four decades. We extracted general characteristics of each surgical training tool while categorizing educational interventions by modality and neurosurgical application. RESULTS We identified 626 studies which developed surgical training tools across eight different training modalities: textbooks and literature (11), online resources (53), didactic teaching and one-on-one instruction (7), laboratory courses (50), cadaveric models (63), animal models (47), mixed reality (166), and physical models (229). While publication volume has grown exponentially, a majority of studies were cited with relatively low frequency. Most training programs were published in the development and validation phase with only 2.1% of tools implemented long-term. Each training modality expressed unique strengths and limitations, with limited data reported on the educational impact connected to each training tool. CONCLUSIONS Numerous surgical training tools have been developed and implemented across residency training programs. Though many creative and cutting-edge tools have been devised, evidence supporting educational efficacy and long-term application is lacking. Increased utilization of novel surgical training tools will require validation of metrics used to assess the training outcomes and optimized integration with clinical practice.
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Affiliation(s)
- Lauren Banko
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Ruchit V Patel
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
| | - Noah Nawabi
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
| | - Marcelle Altshuler
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
| | - Lila Medeiros
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
| | - G Rees Cosgrove
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
| | - Wenya Linda Bi
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
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Gupta S, Nawabi NL, Emani S, Medeiros L, Bernstock JD, Duvall J, Ng P, Smith TR, Wen PY, Reardon DA, Arnaout O. An expanded role for surgery in grade 3 1p/19q co-deleted oligodendroglioma. Neurooncol Adv 2023; 5:vdad046. [PMID: 37215951 PMCID: PMC10195195 DOI: 10.1093/noajnl/vdad046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023] Open
Abstract
Background Grade 3 1p/19q co-deleted oligodendroglioma is an uncommon primary CNS tumor with a high rate of progression and recurrence. This study examines the benefit of surgery after progression and identifies predictors of survival. Methods This is a single-institution retrospective cohort study of consecutive adult patients with anaplastic or grade 3 1p/19q co-deleted oligodendroglioma diagnosed between 2001 and 2020. Results Eighty patients with 1p/19q co-deleted grade 3 oligodendroglioma were included. The median age was 47 years (interquartile range 38-56) and 38.8% were women. All patients underwent surgery, including gross total resection (GTR) for 26.3% of patients, subtotal resection (STR) for 70.0% of patients, and biopsy for 3.8% of patients. Forty-three cases (53.8%) progressed at a median of 5.6 years, and the median overall survival (OS) was 14.1 years. Among 43 cases of progression or recurrence, 21 (48.8%) underwent another resection. Patients who underwent a second operation had improved OS (P = .041) and survival after progression/recurrence (P = .012), but similar time to subsequent progression as patients who did not have repeat surgery (P = .50). Predictors of mortality at initial diagnosis included a preoperative Karnofsky Performance Status (KPS) under 80 (hazard ratio [HR] 5.4; 95% CI 1.5-19.2), an STR or biopsy rather than GTR (HR 4.1; 95% CI 1.2-14.2), and a persistent postoperative neurologic deficit (HR 4.0; 95% CI 1.2-14.1). Conclusions Repeat surgery is associated with increased survival, but not time to subsequent progression for progressing or recurrent 1p/19q co-deleted grade 3 oligodendrogliomas recur. Mortality is associated with a preoperative KPS under 80, lack of GTR, and persistent postoperative neurologic deficits after the initial surgery.
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Affiliation(s)
- Saksham Gupta
- Corresponding Author: Saksham Gupta, MD, Department of Neurosurgery, Brigham and Women’s Hospital, 60 Fenwood Road, BTM 4, Boston, MA 02115, USA ()
| | | | - Siva Emani
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Lila Medeiros
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Joshua D Bernstock
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Julia Duvall
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Patrick Ng
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Timothy R Smith
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Patrick Y Wen
- Center for Neuro-Oncology, Dana-Farber Cancer Center, Brigham and Women’s Hospital, Boston, MA, USA
| | - David A Reardon
- Center for Neuro-Oncology, Dana-Farber Cancer Center, Brigham and Women’s Hospital, Boston, MA, USA
| | - Omar Arnaout
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
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Reis MWD, Mancilha EMB, Boturão-Neto E, Silveira JPP, Medeiros L, Franco JRB. SARCOMA RETROAURICULAR: CASO RARO DE RECIDIVA EM LEUCEMIA MIELOIDE AGUDA. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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6
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Camoes-Barbosa A, Mendes I, Medeiros L. Contralateral upper limb weakness following botulinum toxin A injection for poststroke spasticity. Toxicon 2018. [DOI: 10.1016/j.toxicon.2018.11.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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7
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Fheodoroff K, Rekand T, Medeiros L, Koßmehl P, Wissel J, Bensmail D, Scheschonka A, Flatau-Baqué B, Simon O, Dressler D, Simpson D. Incobotulinumtoxina treatment improves quality of life of patients with upper- and lower-limb spasticity. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Morgado J, Sousa AP, Alves P, Medeiros L. Hereditary neuropathy with liability to pressure palsy presenting as a bilateral brachial plexopathy. Neurologia 2016; 32:626-629. [PMID: 26874568 DOI: 10.1016/j.nrl.2015.11.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Revised: 10/26/2015] [Accepted: 11/30/2015] [Indexed: 10/22/2022] Open
Affiliation(s)
- J Morgado
- Servicio de Neurología, Centro Hospitalar Lisboa Central, Lisboa, Portugal.
| | - A P Sousa
- Servicio de Neurología, Centro Hospitalar Lisboa Central, Lisboa, Portugal
| | - P Alves
- Servicio de Radiología, Centro Hospitalar Lisboa Central, Lisboa, Portugal
| | - L Medeiros
- Servicio de Neurofisiología, Centro Hospitalar Lisboa Central, Lisboa, Portugal
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Dabaja B, Pinnix C, Fowler N, Allen P, Reed V, Ballas L, Horace P, Rodriguez M, Nastoupil L, Kwak L, Medeiros L, Arzu I, Ha C. Definitive Radiation Therapy for Stage I and II Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma: Report of a Prospective Study. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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10
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Tao R, Shihadeh F, Pinnix C, Arzu I, Reed V, Oki Y, Westin J, Fayad L, Medeiros L, Rodriguez A, Dabaja B. Does Skeletal Presentation Make a Difference in Outcomes of Diffuse Large B-cell Lymphoma? A Review of the 25-Year Experience With Treating Primary Bone Lymphoma. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Pinnix C, Westin J, Ahmed M, Reed V, Romaguerra J, Oki Y, Rodriguez M, Fayad L, Hagemeister F, Kwak L, Medeiros L, Francesco T, Davis R, Chuang H, Davis R, Dabaja B. The Role of Radiation Therapy in the Treatment of Primary Mediastinal B Cell Lymphoma Treated with Rituximab containing Regimens. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.2673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Bolling C, Leite M, Neto JG, Barreto H, Tadiello F, Medeiros L, Rodrigues F. INJURY PROFILE OF BRAZILIAN ATHLETES IN OLYMPIC GAMES 2012. Br J Sports Med 2014. [DOI: 10.1136/bjsports-2014-093494.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Pedrosa A, Santos A, Ferreira M, Araújo C, Barbosa R, Medeiros L. Is carbon dioxide laser vaporization a valuable tool in the management of oral leukoplakia? A survey at an oncology hospital. Lasers Med Sci 2014; 30:1629-30. [PMID: 24570088 DOI: 10.1007/s10103-014-1551-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 02/11/2014] [Indexed: 10/25/2022]
Affiliation(s)
- A Pedrosa
- Department of Dermatology and Venereology, Centro Hospitalar São João EPE, Alameda Prof. Hernani Monteiro, 4200-319, Porto, Portugal,
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Dabaja B, Voong R, Shihadeh F, Arzu I, Pinnix C, Mazloom A, Medeiros L, Romaguera J, Rodriguez M, Allen P. Radiation Therapy Is a Very Effective Modality in the Treatment of Mantle Cell Lymphoma, >80% Complete Disappearance of Disease Site in Heavily Pretreated Patients. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Meyer J, Medeiros L, Janiga G, Thévenin D. Simulation des Trennungsvorgangs einer instabilen Emulsion mittels numerischer Strömungsmechanik. CHEM-ING-TECH 2013. [DOI: 10.1002/cite.201250649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Dabaja B, Liang F, Shihadeh F, Etzel C, Medeiros L, Fayad L, Oki Y, Hagemeister F, Rodriguez A. Mid-therapy Positron Emission Tomography Scans Significantly Predict Outcome in Patients With Diffuse Large B-cell Lymphoma (DLBCL) Treated With Chemotherapy Alone But Not When Consolidation Radiation is Added. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Medeiros L, Marassi CD, Duarte RS, da Silva MG, Lilenbaum W. Comparison of decontamination methods for primary isolation of Mycobacterium bovis in paucibacillary bovine tissues. Lett Appl Microbiol 2011; 54:182-6. [PMID: 22118726 DOI: 10.1111/j.1472-765x.2011.03185.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIMS To compare three decontamination methods applied to paucibacillary samples for primary isolation of Mycobacterium bovis from suspect lesions. Tuberculosis caused by Myco. bovis is an important infectious disease of cattle in Brazil and also has zoonotic potential. Although a national campaign based on testing and slaughtering cattle has achieved good results, there is a strong need to develop better diagnostic methods to identify cattle with recent infections harbouring few bacilli. METHODS AND RESULTS A dairy herd (274 adult crossbred cows) located in the state of Rio de Janeiro was tested for tuberculosis with both single intradermal tuberculin test and comparative intradermal tuberculin test. Reactive cows (n=27, 9.8%) were slaughtered and suspect lesions were collected (one sample per cow). Samples considered paucibacillary (based on microscopy) were decontaminated with 0.75% hexadecylpyridinium chloride (HPC), 4% sodium hydroxide (Petroff) or 6% sulphuric acid. Using these methods, 10, five and six, respectively, of the 27 samples yielded positive cultures. Overall, Myco.bovis was isolated from 14 of 24 cows. Although the HPC method resulted in isolation of more Myco.bovis strains than either Petroff or sulphuric acid methods (P=0.015), it did not result in the recovery of Myco.bovis from all samples. However, using both HPC and 6% sulphuric acid methods for decontamination was possible to identify 13 of 14 (92·9%) of infected cows. CONCLUSIONS At least two methods should be used concurrently for primary isolation of Myco. bovis from bovine tissues, particularly for paucibacillary samples. SIGNIFICANCE AND IMPACT OF THE STUDY Detection of low numbers of Myco.bovis in tissue is an important goal in optimizing the detection of bovine tuberculosis and should assist in identification of infected cattle, in particular, those with few Myco.bovis bacilli. This was apparently the first study comparing three decontamination methods for the detection of Myco.bovis in paucibacillary samples from naturally infected cattle.
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Affiliation(s)
- L Medeiros
- Universidade Federal Fluminense, Laboratório de Bacteriologia Veterinária, Rua Hernani Mello, Niterói-RJ, Brazil.
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Falavigna M, Kieling C, Wolff F, Medeiros L, Alves L, Cheinquer H, Duncan B. P2-76 Antibiotics for hepatic encephalopathy: systematic review of randomised controlled trials. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976i.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Dabaja BS, Phan J, Medeiros L, Chuang H, Fayad L, Hagemeister F, Shihadeh FD, Allen P, Rodriguez MA. Clinical implications of PET-negative residual disease at the completion of chemotherapy for diffuse large B-cell Lymphoma. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e18516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Marassi C, Medeiros L, McNair J, Lilenbaum W. Use of recombinant proteins MPB70 or MPB83 as capture antigens in ELISAs to confirm bovine tuberculosis infections in Brazil. Acta Trop 2011; 118:101-4. [PMID: 21420374 DOI: 10.1016/j.actatropica.2011.02.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2011] [Revised: 02/23/2011] [Accepted: 02/26/2011] [Indexed: 10/18/2022]
Abstract
The objective was to evaluate the use of two indirect IgG-ELISA tests (with recombinant proteins MPB70 or MPB83, respectively, as capture antigens) as confirmatory tests for diagnosis of bovine tuberculosis in a herd of naturally infected dairy cows. Results for ELISA-MPB70 and ELISA-MPB83 were similar (kappa statistic=0.92) on Days 0 (day of intradermal injection with purified protein derivatives, PPD), 7, and 21. The kappa statistic between ELISA and the Comparative Intradermal Tuberculin Test, as well as ELISA sensitivity and specificity (relative to culture or PCR as standards) were: 0.7, 34.4% and 75% on Day 0; 0.25, 53.8% and 66.6% on Day 7; and 0.01, 1.8% and 77.7% on Day 21, respectively. In conclusion, although ELISAs using MPB70 or MPB83 as antigens were not reliable indicators of infection status, especially on Days 7 and 21, they were of potential value as complementary tools to intradermal PPD testing.
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Barnes M, Schnitzler A, Medeiros L, Aguilar M, Lehnert-Batar A, Minnasch P. Efficacy and safety of NT 201 for upper limb spasticity of various etiologies--a randomized parallel-group study. Acta Neurol Scand 2010; 122:295-302. [PMID: 20456248 DOI: 10.1111/j.1600-0404.2010.01354.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess efficacy and safety of two dilutions of botulinum neurotoxin type A NT 201 (Xeomin®) in patients with upper limb spasticity of diverse etiology. METHODS Changes in functional disability and muscle tone from baseline to week 4 after NT 201 treatment. RESULTS One hundred ninety-two patients with stroke, brain injury, multiple sclerosis, or cerebral palsy were randomized to either 50 or 20 U/ml NT 201 dilutions. The maximum total NT 201 dose was 495 units. Four weeks post-injection, a ≥ 1-point reduction was observed on the Disability Assessment Scale in 57.1%, and on the Ashworth scale in ≥ 62.2% of patients. The 20 U/ml NT 201 dilution was non-inferior to the 50 U/ml NT 201 dilution. Global improvement was rated high by patients (80.2%) and investigators (89.0%). CONCLUSIONS NT 201 improved functional disability and muscle tone and was well tolerated in patients with upper limb spasticity of diverse etiology in both dilutions.
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Affiliation(s)
- M Barnes
- 14 Rake House Farm, North Shields, UK.
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Franco V, Funke V, Nunes E, Setubal D, Medeiros L, Michels M, Bonamin C, Nabhan S, Ribeiro L, Morando J, Bitencourt M, Bonfim C, Vieira A, Loth G, Pasquini R, Neto J. Extracorporeal Photopheresis In Refractory Acute And/Or Chronic Graft Versus Host Disease After Allogeneic Stem Cell Transplantation. Biol Blood Marrow Transplant 2010. [DOI: 10.1016/j.bbmt.2009.12.465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Penna B, Varges R, Medeiros L, Martins G, Martins R, Lilenbaum W. In vitro antimicrobial susceptibility of staphylococci isolated from canine pyoderma in Rio de Janeiro, Brazil. Braz J Microbiol 2009. [DOI: 10.1590/s1517-83822009000300011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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24
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De-Paula VS, Razzera G, Medeiros L, Miyamoto CA, Almeida MS, Kurtenbach E, Almeida FCL, Valente AP. Evolutionary relationship between defensins in the Poaceae family strengthened by the characterization of new sugarcane defensins. Plant Mol Biol 2008; 68:321-335. [PMID: 18618271 DOI: 10.1007/s11103-008-9372-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2008] [Accepted: 06/28/2008] [Indexed: 05/26/2023]
Abstract
Plant defensins are small (45-54 amino acids), highly basic, cysteine-rich peptides structurally related to defensins of other organisms, including insects and mammals. Small putative proteins (MW < 10 kDa) containing eight cysteines were screened based on the sugarcane expressed sequence tag (EST) database. We selected ORFs that exhibited 25-100% similarity in primary sequence with other defensins in the NCBI database and that contained eight cysteines. This similarity is sufficient for folding prediction, but not enough for biological activity inference. Six putative defensins (Sd1-6) were selected, and activity assays showed that recombinant Sd1, Sd3 and Sd5 are active against fungi, but not against bacteria. Structural characterization, based on circular dichroism (CD) and nuclear magnetic resonance (NMR) spectroscopy showed that the structures of these Sds were compatible with alpha/beta proteins, a feature expected for plant defensins. Phylogenetic analysis revealed that sugarcane defensins could clearly be grouped within defensins from Poaceae family and Andropogoneae tribe. Our work demonstrates that defensins show strong conservation in the Poaceae family and may indicate that the same conservation occurs in other families. We suggest that evolutionary relationships within plant families can be used as a procedure to predict and annotate new defensins in genomes and group them in evolutionary classes to help in the investigation of their biological function.
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Affiliation(s)
- V S De-Paula
- Centro Nacional de Ressonância Magnética Nuclear, Instituto de Bioquímica Médica, Universidade Federal do Rio de Janeiro, Av. Brigadeiro Trompowski, s/n, CCS Bloco E sala 10, Rio de Janeiro, RJ, Brazil
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Bonfim C, Koliski A, Bitencourt M, Quiroga M, Setubal D, Funke V, Ruiz J, Medeiros L, Oliveira M, Coutinho E, Zanis Neto J, de Medeiros C, Pasquini R. 215: Hematopoietic Stem Cell Transplantation (HSCT) in Wiskott Aldrich Syndrome (WAS): A Single Center Experience in 25 Patients. Biol Blood Marrow Transplant 2008. [DOI: 10.1016/j.bbmt.2007.12.224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Funke V, Nunes E, Medeiros L, Setubal D, Ruiz J, Oliveira M, Bittencourt M, Bonfim C, Neto J, Medeiros C, Pasquini R. 387: Effect of Acute and Chronic GVHD on Overall Survival in 122 Unrelated Transplants for Malignant Diseases Performed Over Ten Years in a Single Center in Brazil. Biol Blood Marrow Transplant 2008. [DOI: 10.1016/j.bbmt.2007.12.397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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27
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Funke V, Pettengill C, Bonfim C, Ruiz J, Azambuja A, Medeiros L, Setubal D, Bitencourt M, Oliveira M, Coutinho E, Zanis-neto J, de Medeiros C, Pasquini R. 237: Long term results of allogeneic stem cell transplant for CML in pediatric patients. Biol Blood Marrow Transplant 2007. [DOI: 10.1016/j.bbmt.2006.12.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Medeiros L, Zucoloto FS. Nutritional balancing in fruit flies: performance of wild adult females of Anastrepha obliqua (Diptera: Tephritidae) fed on single-food or food-pair treatments. J Insect Physiol 2006; 52:1121-7. [PMID: 17078966 DOI: 10.1016/j.jinsphys.2006.07.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2005] [Revised: 07/18/2006] [Accepted: 07/19/2006] [Indexed: 05/12/2023]
Abstract
The aim of the present study was to investigate the effects of different artificial diets, in which sucrose and brewer's yeast were offered separately (food-pair treatment) or mixed (single-food treatment), on the regulation of nutrient ingestion and the performance of wild adult females of Anastrepha obliqua. The amount of diet consumed by females of A. obliqua increased as the concentration of yeast in the diet increased, revealing a phagostimulant effect of yeast. The amount of sucrose ingested was constant in all groups, showing that these flies regulate the ingestion of sucrose. Longevity and production of eggs/female were similar in both groups. Our results suggest that A. obliqua females regulate the ingestion of nutrients to obtain an adequate performance. Dietary self-selective behavior was more efficient for the females of A. obliqua than feeding on a single-food, because the self-selecting flies ingested less food and had a similar performance as the ones fed on the single-food treatment.
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Affiliation(s)
- L Medeiros
- Department of Biology, FFCLRP, University of São Paulo, Avenida dos Bandeirantes, 3900, 14040 901 Ribeirão Preto, SP, Brazil
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Medeiros L, Chen G, Kendall P, Schroeder M, Hillers V, Bergmann V. CANCER PATIENT BELIEFS, BARRIERS AND MOTIVATORS TO ADOPTING FOOD SAFETY RECOMMENDATIONS: A QUALITATIVE NEEDS ASSESSMENT STUDY. ACTA ACUST UNITED AC 2003. [DOI: 10.1016/s0002-8223(08)70011-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
Traditionally, nutrition educators have used a fairly global approach to teach food safety by teaching a broad range of safe food handling behaviors in the expectation that this will lead to the avoidance of foodborne illness. This approach can be confusing and lead to evaluation data that are difficult to interpret. This article suggests that food safety education and evaluation in the future be organized around five behavioral constructs: practice personal hygiene, cook foods adequately, avoid cross-contamination, keep foods at safe temperatures, and avoid food from unsafe sources. These five constructs are derived from data on actual outbreaks and estimated incidences of foodborne illness. Research is needed to establish reliable and valid evaluation measures for these five behavioral constructs. Evaluation instruments can be tailored to fit specific education programs. If evaluation instruments focus on these five behavior areas, the result will be meaningful evaluation data that can be more easily summarized across food safety education programs for consumers.
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Affiliation(s)
- L Medeiros
- Department of Human Nutrition, The Ohio State University, Columbus, Ohio 43210, USA.
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Abstract
OBJECTIVE We previously surveyed cyclin D1 expression in common acquired nevi, Spitz nevi, and malignant melanomas and reported that benign nevi maintain a zonal pattern of cyclin D1 expression, in contrast with malignant melanomas. Our aim was to extend those observations by examining cyclin D1 expression in dysplastic nevi. METHODS Cyclin D1 overexpression in 23 dysplastic nevi was detected by an immunohistochemical technique. The extent of atypia of the nevi was graded as mild, moderate, or severe, using previously established criteria. RESULTS Cyclin D1 overexpression in dysplastic nevi maintained a zonal pattern, similar to Spitz nevi. Cyclin D1 overexpression was greatest in the region of the epidermal-dermal junction and was significantly less prominent in the papillary and reticular dermis, suggesting that cyclin D1 expression is under cell control and correlates with maturation of nevus cells. Cyclin D1 overexpression also correlated with cytologic atypia, as dysplastic nevi with moderate or severe cytologic atypia contained a greater percentage of cyclin D1-positive cells than did nevi with mild atypia. Six dysplastic nevi with many cyclin D1--positive cells were assessed by fluorescence in situ hybridization studies using cyclin D1--specific and chromosome 11 centromeric probes. In all cases, there was no evidence of 11q13 translocation, amplification, or trisomy of chromosome 11. CONCLUSIONS Cyclin D1 may be involved in the pathogenesis of dysplastic nevi. Cyclin D1 overexpression does not appear to be explained by cyclin D1 locus amplification or translocation in most cases, and it may be a result of other cell abnormalities that up-regulate the protein level of cyclin D1.
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Affiliation(s)
- C Ewanowich
- Department of Laboratory Medicine & Pathology, University of Alberta, Edmonton, Alberta, Canada
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Giovanelli A, da Silva CL, Medeiros L, de Vasconcellos MC. The molluscicidal activity of the latex of Euphorbia splendens var. hislopii on Melanoides tuberculata (Thiaridae), a snail associated with habitats of Biomphalaria glabrata (Planorbidae). Mem Inst Oswaldo Cruz 2001; 96:123-5. [PMID: 11285483 DOI: 10.1590/s0074-02762001000100014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The use of the latex of Euphorbia splendens var. hislopii was considered as an effective control method for Biomphalaria glabrata in Sumidouro, Rio de Janeiro. However, the appearance and expansion of the snail Melanoides tuberculata since August 1997, with the concomitant reduction of the population of B. glabrata suggest that competitive exclusion might be taking place. Depending on the susceptibility of the thiarid to the E. splendens toxin, the natural control that is occurring could be interrupted by the employment of the latex if the planorbid were less susceptible to the toxin. The aim of this study is to investigate the molluscicidal activity of the latex on M. tuberculata. We used 420 M. tuberculata, from Sumidouro. Fourteen different latex concentrations were tested using World Health Organization general methodology. Probit analysis was used for LD90 and LD50 determination. The LD50 was 3.57 mg/l and LD90 was 6.22 mg/l. At the highest concentration (10 mg/l) there was no survival. No significant differences among replicas (chi2 = 8.31; gl = 13; p > 0.05) were found. The LD90 dose for M. tuberculata was 13.8 times greater than that for B. glabrata, so that the molluscicide in the presence of the thiarid may have a synergic effect on reduction of Biomphalaria populations.
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Affiliation(s)
- A Giovanelli
- Departamento de Biologia, Instituto Oswaldo Cruz, Rio de Janeiro, RJ, 21045-900, Brasil
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Abruzzo L, Medeiros L. The Non-Hodgkin' s Lymphomas and Plasma Cell Dyscrasias. Diagn Pathol 2000. [DOI: 10.1201/b13994-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Abruzzo L, Medeiros L, Elenitoba-Johnson K. Hodgkin's Disease. Diagn Pathol 2000. [DOI: 10.1201/b13994-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Monteiro TC, Esperança P, Baptista I, Medeiros L, Candido J. [Transverse myelitis]. ACTA MEDICA PORT 1995; 8:691-4. [PMID: 8669319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The authors report three clinical cases of acute transverse myelitis in young patients with emphasis given to the seriousness of this kind of pathology, the need to exclude a potentially treatable cause and the controversial corticosteroid treatment.
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Affiliation(s)
- T C Monteiro
- Serviço de Medicina, Hospital de S. José, Lisboa
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Medeiros L. [Oral presentation of non-Hodgkin's lymphoma. Literature review apropos of a clinical case]. Stoma (Lisb) 1990; 2:47-8, 51-2, 54. [PMID: 2094966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The author makes a review of Non Hodgkin's Lymphoma and Oral Presentations, and includes a case report of the Oral and Maxilo-Facial Surgery of the Snt. António's Hospital--Porto.
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Figueiredo A, Medeiros L. [Melkersson-Rosenthal syndrome. Apropos of a clinical case]. Stoma (Lisb) 1990; 2:25-6, 29-30. [PMID: 2218902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Cunha E, Barros M, Leal D, Medeiros L, Andrade V. [The Manchester operation in the treatment of genital prolapse]. Rev Ginecol Obstet (Sao Paulo) 1965; 116:308-12. [PMID: 5897930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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