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  1. Article: Overt diabetes imposes a comparable burden on outcomes as pregestational diabetes: a cohort study.

    Oppermann, Maria Lúcia / Campos, Maria Amélia / Hirakata, Vânia Naomi / Reichelt, Angela Jacob

    Diabetology & metabolic syndrome

    2022  Volume 14, Issue 1, Page(s) 177

    Abstract: Background: Women with diabetes first diagnosed during pregnancy (overt diabetes) may be at the same risk level of adverse outcomes as those with known pregestational diabetes. We compared pregnancy outcomes between these groups.: Methods: We ... ...

    Abstract Background: Women with diabetes first diagnosed during pregnancy (overt diabetes) may be at the same risk level of adverse outcomes as those with known pregestational diabetes. We compared pregnancy outcomes between these groups.
    Methods: We evaluated pregnant women with type 2 diabetes, pregestational or overt diabetes, attending high risk antenatal care in two public hospitals in Southern Brazil, from May 20, 2005 to June 30, 2021. Outcomes were retrieved from electronic medical records. Risk of adverse outcomes, expressed as relative risk (RR) and 95% confidence interval (CI), were calculated using Poisson regression with robust estimates.
    Results: Of 618 women, 33% were labelled as having overt diabetes and 67%, pregestational diabetes. Baseline maternal characteristics were similar: there was a slight, non-clinically relevant, difference in maternal age (33 ± 5.7 years in women with pregestational diabetes vs. 32 ± 6.0 years in women with overt diabetes, p = 0.004); and women with overt diabetes reported smoking almost twice compared to those with pregestational diabetes (12.3% vs. 6.5%, p = 0.024). There were no relevant differences between the groups regarding pregnancy outcomes, although there was a trend of higher neonatal intensive care admission in the group of women with pregestational diabetes (45.2% vs. 36.1%, p = 0.051).
    Conclusions: Overt diabetes was diagnosed in one third of this cohort of pregnant women with hyperglycemia. Their pregnancy outcomes were similar to those of women with pregestational diabetes and were mostly related to maternal demographic characteristics and metabolic control. A call to action should be made to identify women of childbearing age at risk for pre-pregnancy diabetes; to detect hyperglycemia before conception; and to implement timely preconception care to all women with diabetes.
    Language English
    Publishing date 2022-11-23
    Publishing country England
    Document type Journal Article
    ZDB-ID 2518786-7
    ISSN 1758-5996
    ISSN 1758-5996
    DOI 10.1186/s13098-022-00939-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Cross-cultural and clinical validation of the MDHAQ/RAPID3 questionnaire in electronic format for a Brazilian population of patients with rheumatoid arthritis.

    Lineburger, Ilka Benedet / Brenol, Claiton Viegas / Goularte, Alice Silveira / Pinheiro, Edila Penna / Hirakata, Vânia Naomi

    Advances in rheumatology (London, England)

    2022  Volume 62, Issue 1, Page(s) 46

    Abstract: Background: Patients with rheumatologic diseases are monitored fundamentally through metric tools or index calculated from clinical data and patient exams, which allow us to assess the severity of the disease and guide the therapeutic decision. In ... ...

    Abstract Background: Patients with rheumatologic diseases are monitored fundamentally through metric tools or index calculated from clinical data and patient exams, which allow us to assess the severity of the disease and guide the therapeutic decision. In rheumatoid arthritis (RA), for treatment to be optimized and considered effective, periodic assessment with composite disease activity index and a 'treat-to-target' approach is required. The Routine Assessment of Patient Index Data 3 (RAPID3) in the Multidimensional Health Assessment Questionnaire (MDHAQ) includes only three measures based on the central patient self-reported dataset and can be used in a 'treat-to-target' approach analogous to the Clinical Disease Activity Index (CDAI) and the Disease Activity Score 28-joints (DAS28). This tool, however, has not undergone cross-cultural or clinical validation in Brazil. In this research, we performed the MDHAQ cross-cultural and clinical validation for the Brazilian population of RA patients.
    Methods: The Portuguese version of the MDHAQ was created identically in an electronic questionnaire and underwent a cross-cultural validation process with 38 participants. Test-retest was performed in 29 patients. Further, a clinical validation with 129 Rheumatoid Arthritis patients was performed. Electronic MDHAQ was answered through an online platform. We also collected socioeconomic data as well as other clinical (CDAI, SDAI, DAS28) and functional (HAQ) scores during the face-to-face assessment of patients.
    Results: MDHAQ/RAPID3 maintained semantic, idiomatic, as well as conceptual and experience equivalence for the Brazilian population, with 92% acceptance of participants. It showed test-retest reliability, adequate internal consistency (Cronbach's α 0.85) and correlation of the scores obtained with adequate association with the DAS28 gold standard. RAPID3 also had high sensitivity (98%), adequate specificity (48%), high negative predictive value (92%) and negative post-test probability of 8%, attributes expected for a test tool for population screening.
    Conclusion: The use of MDHAQ/RAPID3 associated with traditional clinical measures can adequately allow for remote follow-up based on the 'treat-to-target' approach with performance comparable to the gold standard DAS28, being a viable tool in the sample of Brazilian patients with RA in the current context of telehealth.
    MeSH term(s) Humans ; Brazil ; Reproducibility of Results ; Cross-Cultural Comparison ; Arthritis, Rheumatoid/diagnosis ; Electronics
    Language English
    Publishing date 2022-11-22
    Publishing country England
    Document type Journal Article
    ISSN 2523-3106
    ISSN (online) 2523-3106
    DOI 10.1186/s42358-022-00278-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Quality management of the periodic medical examination at a university hospital, from the workers' perspective.

    Toniasso, Sheila de Castro Cardoso / Brum, Maria Carlota Borba / Hirakata, Vania Naomi / Schlatter, Rosane Paixão

    Revista brasileira de medicina do trabalho : publicacao oficial da Associacao Nacional de Medicina do Trabalho-ANAMT

    2022  Volume 20, Issue 2, Page(s) 222–230

    Abstract: Introduction: Implementation of quality assessment methodologies at healthcare services enables the results achieved to be monitored in terms of established objectives and standards of care delivery.: Objectives: To assess the quality of the ... ...

    Abstract Introduction: Implementation of quality assessment methodologies at healthcare services enables the results achieved to be monitored in terms of established objectives and standards of care delivery.
    Objectives: To assess the quality of the processes involved in provision of periodic medical examinations at a University Hospital, from the workers' perspective.
    Methods: This is a cross-sectional study using questionnaires to conduct quality assessment of the periodic medical examination processes, including Net Promoter Score satisfaction questions. Statistical analysis of the results was performed using SPSS version 18. Data on categorical variables are expressed as absolute frequencies and data on continuous variables as means and standard deviations. Chi-square tests and analysis of variance were used to identify associations. A significance level of 0.05 was adopted to determine the statistical relevance of findings.
    Results: A total of 381 respondents with a mean age of 45.25 years were included, 66% of whom were female. There was a statistically significant (p < 0.001) association between duration of consultations and the number of items assessed in the periodic medical examination. In general, the findings from application of the Net Promoter Score for self-scheduling (45%) and service at reception (42%) indicate a need for process improvement, whereas clinical care (50%) rated as a quality process.
    Conclusions: This study identified a set of information that can be used to describe, analyze, and improve the care delivered by the institution's occupational health service and to identify opportunities for improvement of periodic medical examination processes.
    Language English
    Publishing date 2022-06-30
    Publishing country Brazil
    Document type Journal Article
    ZDB-ID 2735204-3
    ISSN 1679-4435
    ISSN 1679-4435
    DOI 10.47626/1679-4435-2022-646
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Effectiveness and Efficacy of Therapeutic Interventions Performed by Nurses for Anxiety Disorders: A Systematic Review.

    Amaral, Roslaine Ifran / Weston, Fernanda Cirne Lima / Hirakata, Vânia Naomi / Paz, Adriana Aparecida / Wesner, Ana Cristina

    Journal of the American Psychiatric Nurses Association

    2022  Volume 28, Issue 4, Page(s) 283–294

    Abstract: BACKGROUND: ...

    Abstract BACKGROUND:
    MeSH term(s) Humans ; Anxiety/therapy ; Anxiety Disorders/therapy ; Quality of Life ; Nurse's Role
    Language English
    Publishing date 2022-01-03
    Publishing country United States
    Document type Journal Article ; Systematic Review
    ZDB-ID 2252638-9
    ISSN 1532-5725 ; 1078-3903
    ISSN (online) 1532-5725
    ISSN 1078-3903
    DOI 10.1177/10783903211068105
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Comparison of Incidence and Prognosis of Myocardial Injury in Patients with COVID-19-Related Respiratory Failure and Other Pulmonary Infections: A Contemporary Cohort Study.

    Vivan, Manoela Astolfi / Hirakata, Vania Naomi / Arteche, Maria Antônia Torres / de Araujo, Débora Marques / Fuchs, Sandra C / Fuchs, Flávio D

    Journal of clinical medicine

    2023  Volume 12, Issue 19

    Abstract: Myocardial injury (MI) is frequent in critically ill patients with COVID-19, but its pathogenesis remains unclear. We hypothesized that MI is not solely due to viral infection by SARS-CoV-2 but rather due to the common pathophysiological mechanisms ... ...

    Abstract Myocardial injury (MI) is frequent in critically ill patients with COVID-19, but its pathogenesis remains unclear. We hypothesized that MI is not solely due to viral infection by SARS-CoV-2 but rather due to the common pathophysiological mechanisms associated with severe pulmonary infections and respiratory failure. This contemporary cohort study was designed to compare the incidence of MI in patients with acute respiratory failure caused by COVID-19 to patients with other pulmonary infections. In addition, we aimed to investigate whether MI was a distinct risk factor for in-hospital mortality in patients with COVID-19 compared to those with non-COVID-19 infections. This study included 1444 patients with COVID-19 (55.5% men; age 58 (46;68) years) and 182 patients with other pulmonary infections (46.9% men; age 62 (44;73) years). The incidence of MI at ICU admission was lower in COVID-19 patients (36.4%) compared to non-COVID-19 patients (56%), and this difference persisted after adjusting for age, sex, coronary artery disease, heart failure, SOFA score, lactate, and C-reactive protein (RR 0.84 (95% CI, 0.71-0.99)). MI at ICU admission was associated with a 59% increase in mortality (RR 1.59 (1.36-1.86);
    Language English
    Publishing date 2023-10-08
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm12196403
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Ketoconazole as second-line treatment for Cushing's disease after transsphenoidal surgery: systematic review and meta-analysis.

    Viecceli, Camila / Mattos, Ana Carolina Viana / Hirakata, Vânia Naomi / Garcia, Sheila Piccoli / Rodrigues, Ticiana da Costa / Czepielewski, Mauro Antônio

    Frontiers in endocrinology

    2023  Volume 14, Page(s) 1145775

    Abstract: Introduction: The first-line treatment for Cushing's disease is transsphenoidal surgery for pituitary tumor resection. Ketoconazole has been used as a second-line drug despite limited data on its safety and efficacy for this purpose. The objective of ... ...

    Abstract Introduction: The first-line treatment for Cushing's disease is transsphenoidal surgery for pituitary tumor resection. Ketoconazole has been used as a second-line drug despite limited data on its safety and efficacy for this purpose. The objective of this meta-analysis was to analyze hypercortisolism control in patients who used ketoconazole as a second-line treatment after transsphenoidal surgery, in addition to other clinical and laboratory criteria that could be related to therapeutic response.
    Methods: We searched for articles that evaluated ketoconazole use in Cushing's disease after transsphenoidal surgery. The search strategies were applied to MEDLINE, EMBASE, and SciELO. Independent reviewers assessed study eligibility and quality and extracted data on hypercortisolism control and related variables such as therapeutic dose, time, and urinary cortisol levels.
    Results: After applying the exclusion criteria, 10 articles (one prospective and nine retrospective studies, totaling 270 patients) were included for complete data analysis. We found no publication bias regarding reported biochemical control or no biochemical control (p = 0.06 and p = 0.42 respectively). Of 270 patients, biochemical control of hypercortisolism occurred in 151 (63%, 95% CI 50-74%) and no biochemical control occurred in 61 (20%, 95% CI 10-35%). According to the meta-regression, neither the final dose, treatment duration, nor initial serum cortisol levels were associated with biochemical control of hypercortisolism.
    Conclusion: Ketoconazole can be considered a safe and efficacious option for Cushing's disease treatment after pituitary surgery.
    Systematic review registration: https://www.crd.york.ac.uk/prospero/#searchadvanced, (CRD42022308041).
    MeSH term(s) Humans ; Ketoconazole/therapeutic use ; Pituitary ACTH Hypersecretion/drug therapy ; Pituitary ACTH Hypersecretion/surgery ; Cushing Syndrome ; Hydrocortisone ; Prospective Studies ; Retrospective Studies
    Chemical Substances Ketoconazole (R9400W927I) ; Hydrocortisone (WI4X0X7BPJ)
    Language English
    Publishing date 2023-05-08
    Publishing country Switzerland
    Document type Meta-Analysis ; Systematic Review ; Research Support, Non-U.S. Gov't
    ZDB-ID 2592084-4
    ISSN 1664-2392
    ISSN 1664-2392
    DOI 10.3389/fendo.2023.1145775
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Peripherally Inserted Central Catheter Versus Centrally Inserted Central Catheter for In-Hospital Infusion Therapy: A Cost-Effectiveness Analysis.

    de Souza Fantin, Simone / Scherer Dos Santos, Marina / Ferro, Eduarda Bordini / Hirakata, Vania Naomi / Ferreira de Azeredo da Silva, André / Rabelo-Silva, Eneida Rejane

    Value in health regional issues

    2024  Volume 41, Page(s) 123–130

    Abstract: Objectives: To evaluate the comparative effectiveness and cost-effectiveness of peripherally inserted central catheters (PICCs) compared with centrally inserted central catheters (CICCs).: Methods: Prospective cohort study was followed by an economic ...

    Abstract Objectives: To evaluate the comparative effectiveness and cost-effectiveness of peripherally inserted central catheters (PICCs) compared with centrally inserted central catheters (CICCs).
    Methods: Prospective cohort study was followed by an economic analysis over a 30-day time horizon. Propensity score matching was used to select hospitalized adults with similar indications for PICC or CICC. The composite outcome was device removal or replacement because of complications before the end of treatment. The economic evaluation was based on a decision tree model for cost-effectiveness analysis, with calculation of the incremental cost-effectiveness ratio (ICER) per catheter removal avoided. All costs are presented in Brazilian reais (BRL) (1 BRL = 0.1870 US dollar).
    Results: A total of 217 patients were followed in each group; 172 (79.3%) of those receiving a PICC and 135 (62.2%) of those receiving a CICC had no device-related complication, respectively. When comparing the events leading to device removal, the risk of composite endpoint was significantly higher in the CICC group (hazard ratio 0.20; 95% CI 0.11-0.35). The cost of PICC placement was BRL 1290.98 versus BRL 467.16 for a CICC. In the base case, the ICER for placing a PICC instead of a CICC was BRL 3349.91 per removal or replacement avoided. On univariate sensitivity analyses, the model proved to be robust within an ICER range of 2500.00 to 4800.00 BRL.
    Conclusions: PICC placement was associated with a lower risk of complications than CICC placement. Although the cost of a PICC is higher, its use avoided complications and need for catheter replacement before the end of treatment.
    MeSH term(s) Humans ; Cost-Benefit Analysis/methods ; Male ; Female ; Catheterization, Peripheral/economics ; Catheterization, Peripheral/methods ; Catheterization, Peripheral/instrumentation ; Prospective Studies ; Middle Aged ; Brazil ; Catheterization, Central Venous/economics ; Catheterization, Central Venous/methods ; Catheterization, Central Venous/instrumentation ; Catheterization, Central Venous/adverse effects ; Aged ; Adult ; Propensity Score ; Cost-Effectiveness Analysis
    Language English
    Publishing date 2024-02-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2679127-4
    ISSN 2212-1102 ; 2212-1099
    ISSN (online) 2212-1102
    ISSN 2212-1099
    DOI 10.1016/j.vhri.2023.12.006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Ultrasound-Guided Peripheral Venipuncture Decreases the Procedure's Pain and Positively Impacts Patient's Experience: The PRECISE Randomized Clinical Trial.

    Junges, Marina / Hansel, Leandro Augusto / Santos, Marina Scherer / Hirakata, Vânia Naomi / Nascimento Ceratti, Rodrigo do / Czerwinski, Gabriela Petró Valli / Saffi, Marco Aurélio Lumertz / Ferro, Eduarda Bordini / Jacobsen, Daniele Volkmer / Rabelo-Silva, Eneida Rejane

    Journal of infusion nursing : the official publication of the Infusion Nurses Society

    2024  Volume 47, Issue 3, Page(s) 190–199

    Abstract: This study aimed to compare patients' experience of pain during ultrasound (US)-guided peripheral venipuncture versus conventional peripheral venipuncture. This randomized clinical trial was conducted at a public university hospital in 2021. Adult ... ...

    Abstract This study aimed to compare patients' experience of pain during ultrasound (US)-guided peripheral venipuncture versus conventional peripheral venipuncture. This randomized clinical trial was conducted at a public university hospital in 2021. Adult patients with indication for intravenous therapy compatible with peripheral intravenous catheters (PIVCs) were included: intervention group (IG), US peripheral venipuncture executed by specialist nurses; control group (CG), conventional peripheral venipuncture executed by clinical practice nurses. The primary outcome was patient experience of pain during the procedure and patient experience related to the PIVC placement method. Sixty-four patients were included, 32 for each group. The pain experienced was none-to-mild in the IG for 25 patients (78.1%) and moderate-to-severe in the CG for 21 patients (65.7%; P < .001). The overall pain rating was 2 (1-3) in the IG and 4 (3-6) in the CG (P < .001). The recommendation of the procedure in IG (net promoter score [NPS] + 90.6%) versus CG (NPS + 18.8%) was considered excellent and good, respectively (P < .001). Patients had less pain and significantly recommended the US-guided procedure. Patient experience with US-guided PIVC, performed by a specialist nurse, was superior to that of conventional peripheral venipuncture.
    MeSH term(s) Humans ; Female ; Male ; Phlebotomy/adverse effects ; Middle Aged ; Ultrasonography, Interventional ; Catheterization, Peripheral/adverse effects ; Adult ; Pain Measurement ; Pain/prevention & control ; Pain Management/methods ; Aged
    Language English
    Publishing date 2024-05-10
    Publishing country United States
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 2192558-6
    ISSN 1539-0667 ; 1533-1458
    ISSN (online) 1539-0667
    ISSN 1533-1458
    DOI 10.1097/NAN.0000000000000542
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  9. Article ; Online: The influence of the municipal human development index and maternal education on infant mortality: an investigation in a retrospective cohort study in the extreme south of Brazil.

    Anele, Carolina Ribeiro / Hirakata, Vânia Naomi / Goldani, Marcelo Zubaran / da Silva, Clécio Homrich

    BMC public health

    2021  Volume 21, Issue 1, Page(s) 194

    Abstract: Background: Infant mortality is considered an important and sensitive health indicator in several countries, especially in underdeveloped and developing countries. Most of the factors influencing infant mortality are interrelated and are the result of ... ...

    Abstract Background: Infant mortality is considered an important and sensitive health indicator in several countries, especially in underdeveloped and developing countries. Most of the factors influencing infant mortality are interrelated and are the result of social issues. Therefore, this study performed an investigation of the influence of the MHDI and maternal education on infant mortality in a capital in the extreme south of Brazil.
    Methods: It is a retrospective cohort study with data on births and deaths in the first year of life for the period of 2000-2017. The association between the independent variables and the outcome was done by bivariate analysis through simple Poisson regression. The variables that can potentially be considered confounding factors were used in a multiple Poisson regression for robust variances - adjusted model.
    Results: The study included 317,545 children, of whom 3107 died. The medium MHDI showed associated with infant death in the first year of life. Maternal education, individually and jointly analyzed with the MHDI, showed association with the outcome of infant death in the first year of life, particularly for children of mothers with lower maternal education (p < 0.001). In relation to other related factors, maternal age; number of Prenatal Care Consultations; gestational age, weight, gender and Apgar Index (5th minute) of the newborn showed association with IM (p < 0.001).
    Conclusions: The HDI is considered a good predictor of infant mortality by some authors and the analyzes of the present study also confirm an association of the medium MHDI and its low MHDIE component with infant mortality. In addition, it was maternal education with less than 8 years of study that that demonstrated a higher risk of death, revealing itself to be a social determinant with a relevant impact on infant mortality. Thus, it is possible to conclude that maternal education is available information, and it is superior to the MHDI to assess the infant mortality outcome.
    MeSH term(s) Brazil/epidemiology ; Child ; Educational Status ; Female ; Humans ; Infant ; Infant Mortality ; Infant, Newborn ; Maternal Age ; Pregnancy ; Retrospective Studies ; Risk Factors
    Language English
    Publishing date 2021-01-22
    Publishing country England
    Document type Journal Article
    ISSN 1471-2458
    ISSN (online) 1471-2458
    DOI 10.1186/s12889-021-10226-9
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  10. Article ; Online: Venous ulcer healing treated with conventional therapy and adjuvant laser: is there a difference?

    Osmarin, Viviane Maria / Bavaresco, Taline / Hirakata, Vania Naomi / Lucena, Amália de Fátima / Echer, Isabel Cristina

    Revista brasileira de enfermagem

    2021  Volume 74, Issue 3, Page(s) e20201117

    Abstract: Objectives: to evaluate the effects of venous ulcer healing in patients after six months of conventional treatment and adjuvant low-power laser therapy.: Methods: prospective cohort study nested in a randomized clinical trial with 38 patients, ... ...

    Abstract Objectives: to evaluate the effects of venous ulcer healing in patients after six months of conventional treatment and adjuvant low-power laser therapy.
    Methods: prospective cohort study nested in a randomized clinical trial with 38 patients, allocated into an intervention group (conventional treatment and adjuvant laser therapy) and a control group (conventional treatment). Patients were followed up as outpatients, sociodemographic and clinical variables were collected, and indicators of the outcomes Wound healing: secondary intention (1103) and Tissue integrity: skin and mucous membranes(1101) of the Nursing Outcomes Classification. Generalized estimating equations, Kaplan-Meier tests, and robust Poisson regression were used in the analysis.
    Results: the clinical indicators Decreased wound size and Scar formation showed a statistically significant difference in the intervention group, higher number of healed wounds, lower rate, longer time to relapse.
    Conclusions: laser therapy adjuvant to conventional treatment returned better results in healing and lower recurrence rates after six months of intervention.
    MeSH term(s) Chronic Disease ; Humans ; Lasers ; Prospective Studies ; Varicose Ulcer/therapy ; Wound Healing
    Language Portuguese
    Publishing date 2021-07-14
    Publishing country Brazil
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 731983-6
    ISSN 1984-0446 ; 0034-7167
    ISSN (online) 1984-0446
    ISSN 0034-7167
    DOI 10.1590/0034-7167-2020-1117
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