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1.
Rev. bras. ciênc. avic ; 24(1): eRBCA-2019-1237, 2022. tab
Artículo en Inglés | VETINDEX | ID: biblio-1368370

RESUMEN

This study aimed to evaluate different n6:n3ratios on performance, serum biochemical variables, and egg quality in 81-week-old laying hens. A total of 224 laying hens, 81-week-old Hysex White, were utilized and distributed in a completely randomized design consisting of seven treatments and eight replications of four birds per cage, totaling 56 cages. The experimental treatments consisted of seven different n6:n3fatty acid ratios: 1.0:1.0, 2.0:1.0, 4.0:1.0, 8.0:1.0, 16.0:1.0, 32.0:1.0, and 64.0:1.0. For diet formulation, sunflower oil, rich in omega-6, and linseed oil, rich in omega-3, were used. Productive performance, egg quality and serum biochemical variables of laying hens were evaluated at the end of the cycle at 26, 27, and 28 days. Analysis of variance (ANOVA) was conducted and orthogonal contrasts were used to obtain the sum of squares of the treatment of the analysis of variance in polynomial regression effects. Egg quality variables did not vary significantly between the diets. Therefore, diet supplementation with polyunsaturated fatty acids at different ratios was possible without altering egg quality. The only exception was Haugh unit, which displayed a quadratic effect indicating that the best value was the n6:n3ratio of 32, according to data significance. It was concluded that an increase in n6:n3ratios decreases laying hens' feed intake. The n6:n3 ratio of 34.64 provides greater eggs' Haugh units, decreasing from that value on. The ratios of n6:n3 did not influence the hens' serum biochemical variables.(AU)


Asunto(s)
Animales , Femenino , Ácidos Grasos Omega-3 , Pollos/metabolismo , Ácidos Grasos Omega-6 , Huevos , Ácidos Grasos Insaturados
2.
Br Poult Sci ; 62(5): 717-725, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33719771

RESUMEN

1. The effect of microencapsulated and uncoated butyric acid as an alternative to antibiotics on performance, intestinal morphology and regeneration of intestinal mucosa was studied in birds experimentally infected with Eimeria spp. 1 to 42 d-old.2. A total of 1,320 male Cobb® broiler chicks were allocated to one of five treatments in a completely randomised design, comprising a negative control, uncoated butyric acid (UA), microencapsulated butyric acid (MA), combined U + M butyric acid and a positive control (antibiotic+anticoccidial) in six replications. At 16 d-old, the birds were inoculated orally with 0.5 ml of a solution containing an Eimeria spp. pool.3. At 21 d of age, the birds receiving butyric acid alone had higher body weight gain (BWG) and feed intake (FI) compared to those supplemented with the blend of acids. For the total rearing period, in all variables, the positive control performed best (P < 0.001).4. At 14 d of age, birds that received diets containing UA had a deeper crypt depth in the jejunum than those fed diets containing microencapsulated acid (P = 0.0194). At 21 d of age, the birds fed the acids had higher villi (P = 0.0058) in the duodenum, compared to the negative control group.5. Supplementation with microencapsulated acid contributed to the intestinal health and recovery of post-challenge birds, but did not result in improvements in performance.


Asunto(s)
Coccidiosis , Eimeria , Enfermedades de las Aves de Corral , Alimentación Animal/análisis , Animales , Ácido Butírico , Pollos , Coccidiosis/tratamiento farmacológico , Coccidiosis/veterinaria , Dieta , Suplementos Dietéticos , Mucosa Intestinal , Masculino , Enfermedades de las Aves de Corral/tratamiento farmacológico , Regeneración
3.
Br Poult Sci ; 62(2): 251-260, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33064014

RESUMEN

1. The effect of A. subrufescens and P. ostreatus mushrooms as an alternative to antibiotics (avilamycin or monensin sodium) on performance, intestinal morphometry, immunity, and biochemical profile of broilers challenged with Eimeria spp. was studied from 1 to 42 d old. A total of 900 male Cobb® broiler chicks were distributed, according to a completely randomised design, into five treatments with six replicates each.2. The treatments consisted of: negative control (NC) - basal diet (BD) with no anticoccidial or antibiotic (non-challenged birds); negative control challenged (NCC) - NC fed to Eimeria spp. challenged birds; BD with 0.2% A. subrufescens inclusion for challenged birds (As), BD with 0.2% P. ostreatus inclusion for challenged birds (Po); and a positive control - BD with anticoccidial and antibiotic inclusion for challenged birds (ATB).3. At 11 d.o., the birds were each inoculated orally with 1 ml solution containing 2 × 105 sporulated oocysts/ml Eimeria acervulina and 2 × 104 sporulated oocysts/ml E. maxima and E. tenella.4. Birds subjected to Eimeria spp. challenge up to 21 d of age had greater crypt depth, indicating that the presence of undesirable microorganisms had an effect on cell proliferation.5. At 21 d old, the birds receiving ATB had higher average weight gain (AWG), feed intake (AFI), and feed conversion ratio (FCR) compared to those fed diets supplemented with mushrooms (As or Po). For the total rearing period (42 days), the birds that received ATB had higher AWG and AFI (P < 0.001) compared to those that received As or Po diets. Feeding avilamycin did not affect (P = 0.0676) FCR compared to the As or Po diet groups.6. From the morphometric and blood analyses there were no differences between broilers fed ATB, Po or As diets in either rearing periods. However, Po and As supplementation lowered blood triglyceride levels. At 21d there was a difference (P < 0.05) for MCV and haemoglobin, in which the mushrooms were similar to the antibiotic. At 42 d, there was a difference (P < 0.05) in haematocrit, erythrocyte, MCV, H: L, protein and albumin variables, in which the use of mushrooms was similar to the positive control, demonstrating that both (mushrooms and antibiotics) promoted a certain improvement in the health of the chickens.7. A. subrufescens and P. ostreatus can be used in broiler diets without compromising intestinal or haematological status, however, these ingredients did not result in improvements in performance.


Asunto(s)
Agaricus , Coccidiosis , Eimeria , Pleurotus , Enfermedades de las Aves de Corral , Alimentación Animal/análisis , Animales , Antibacterianos/farmacología , Pollos , Coccidiosis/tratamiento farmacológico , Coccidiosis/veterinaria , Dieta/veterinaria , Suplementos Dietéticos , Masculino , Enfermedades de las Aves de Corral/tratamiento farmacológico
4.
Sci Rep ; 10(1): 21010, 2020 12 03.
Artículo en Inglés | MEDLINE | ID: mdl-33273516

RESUMEN

Thyroid nodules are common, and their investigation is very important to exclude the possibility of cancer. The increase in blood vessels of malignant tumours may be related to local temperature augmentation detectable on the skin surface. The objective of this paper is to evaluate the feasibility of Infrared Thermography for cancer identification. For this purpose, two studies were performed. One used numerical modelling to simulate regional metabolic temperature propagation to evaluate whether a nodule is perceptible on the skin surface. A second study considered thyroid nodule identification by using convolutional neural networks (CNNs). First, variations in nodular size and fat thickness were investigated, showing that the fat layer has an important role in regional heat transfer. In the second study, the training process achieved accuracy of 96% for in-sample and 95% for validation. In the testing phase, 92% accuracy, 100% precision and 80% recall were achieved. Thus, the presented studies suggest the feasibility of using Infrared Thermography with the CNN Artificial Intelligence technique as additional information in the investigation of thyroid nodules for patients without a very thick subcutaneous fat layer.


Asunto(s)
Termografía/métodos , Nódulo Tiroideo/diagnóstico , Humanos , Rayos Infrarrojos , Modelos Teóricos , Redes Neurales de la Computación , Sensibilidad y Especificidad , Conductividad Térmica , Termografía/normas
5.
Endocrine ; 50(3): 749-55, 2015 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-25982151

RESUMEN

The aims of this study are to determine the prevalence of coronary atherosclerosis in acromegalic patients and to investigate the relationship between the coronary artery calcium score (CS) and acromegaly status and clinical parameters [Framingham risk score (FRS)]. Fifty-six acromegalic patients and paired non-acromegalic volunteers were stratified according to the FRS into low-, intermediate-, and high-risk groups. CS was assessed using multidetector computed tomography. The patients were considered to have controlled or active acromegaly at the time they were submitted to evaluation. Sixty-six percent of acromegalic patients exhibited arterial hypertension, 36 % had diabetes mellitus, and 34 % had hypercholesterolemia. The median FRS and the median risk for cardiovascular event within the next 10 years were similar in the acromegalics and the controls. The median total CS and CS >75th percentile didn't differ significantly between these groups. In patients with controlled acromegaly, a low, intermediate, or high FRS risk was observed in 86, 14, and 0 %, respectively. In patients with active disease, a low, intermediate, or high FRS risk was verified in 94, 3, and 3 %, respectively, and differences between the controlled and active groups were not significant. Seventy-two percent of the patients had total CS = 0, and there were no differences between the controlled and active groups. The risk of coronary artery disease in acromegalic patients, determined according to FRS and CS, is low despite the high prevalence of metabolic abnormalities.


Asunto(s)
Acromegalia/epidemiología , Enfermedad de la Arteria Coronaria/epidemiología , Adulto , Anciano , Brasil/epidemiología , Estudios de Casos y Controles , Estudios Transversales , Femenino , Hormona del Crecimiento/metabolismo , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Medición de Riesgo , Índice de Severidad de la Enfermedad , Adulto Joven
6.
Arq. bras. med. vet. zootec ; Arq. bras. med. vet. zootec. (Online);65(6): 1641-1646, Dec. 2013. ilus
Artículo en Inglés | LILACS | ID: lil-696842

RESUMEN

Traumatic paracostal hernia is classified as an abdominal hernia that protrudes from the abdomen to a non physiologic space over the ribs. Treatment requires surgical reconstruction of the disrupted musculature in the thoracoabdominal region. Laparoscopic paracostal herniorrhaphy was performed in an eight-month-old male Teckel, presented after a car accident injury. A three-portal laparoscopic access was used for definitive diagnosis and hernia correction. After traction of the herniated omentum, a thoracoabdominal communication caused a left side pneumothorax, which was successfully drained with a chest tube placement. The herniorrhaphy was accomplished with intracorporeal sutures by a combination of Ford interlocking and cross mattress patterns. The postoperative period was uneventful. The laparoscopic paracostal herniorrhaphy was satisfactory, allowing both diagnosis and correction of the paracostal defect, showing to be a feasible alternative to the open surgery.


A hérnia traumática paracostal é classificada como uma hérnia abdominal com abaulamento do abdômen formando um espaço não fisiológico sobre as costelas. O tratamento consiste em reconstituir cirurgicamente a musculatura rompida da região toracoabdominal. A herniorrafia paracostal laparoscópica foi realizada em um cão da raça Teckel, macho de oito meses de idade, com histórico de trauma automobilístico. Optou-se pela utilização da abordagem laparoscópica tanto para o diagnóstico definitivo quanto para a correção da mesma. Foi utilizado o acesso com três portais, permitindo a tração do omento herniado, momento este em que o animal apresentou pneumotórax devido a uma comunicação toracoabdominal esquerda. O paciente foi submetido à toracocentese e adaptação de dreno no hemitórax esquerdo. A herniorrafia foi realizada com sutura intracorpórea em padrão contínuo de colchoeiro e festonada de Ford com fio monofilamentar náilon zero. O paciente apresentou rápida recuperação pós-operatória, sem ocorrências de recidivas. Assim, a herniorrafia paracostal laparoscópica mostrou-se satisfatória, possibilitando o diagnóstico definitivo e concomitante correção do defeito abdominal e diafragmático, podendo ser indicada como uma alternativa à cirurgia convencional.


Asunto(s)
Animales , Perros , Hernia Abdominal/patología , Herniorrafia , Laparoscopía/métodos , Perros/clasificación
7.
Arq. bras. med. vet. zootec ; 65(6): 1641-1646, Dec. 2013. ilus
Artículo en Inglés | VETINDEX | ID: vti-10161

RESUMEN

Traumatic paracostal hernia is classified as an abdominal hernia that protrudes from the abdomen to a non physiologic space over the ribs. Treatment requires surgical reconstruction of the disrupted musculature in the thoracoabdominal region. Laparoscopic paracostal herniorrhaphy was performed in an eight-month-old male Teckel, presented after a car accident injury. A three-portal laparoscopic access was used for definitive diagnosis and hernia correction. After traction of the herniated omentum, a thoracoabdominal communication caused a left side pneumothorax, which was successfully drained with a chest tube placement. The herniorrhaphy was accomplished with intracorporeal sutures by a combination of Ford interlocking and cross mattress patterns. The postoperative period was uneventful. The laparoscopic paracostal herniorrhaphy was satisfactory, allowing both diagnosis and correction of the paracostal defect, showing to be a feasible alternative to the open surgery.(AU)


A hérnia traumática paracostal é classificada como uma hérnia abdominal com abaulamento do abdômen formando um espaço não fisiológico sobre as costelas. O tratamento consiste em reconstituir cirurgicamente a musculatura rompida da região toracoabdominal. A herniorrafia paracostal laparoscópica foi realizada em um cão da raça Teckel, macho de oito meses de idade, com histórico de trauma automobilístico. Optou-se pela utilização da abordagem laparoscópica tanto para o diagnóstico definitivo quanto para a correção da mesma. Foi utilizado o acesso com três portais, permitindo a tração do omento herniado, momento este em que o animal apresentou pneumotórax devido a uma comunicação toracoabdominal esquerda. O paciente foi submetido à toracocentese e adaptação de dreno no hemitórax esquerdo. A herniorrafia foi realizada com sutura intracorpórea em padrão contínuo de colchoeiro e festonada de Ford com fio monofilamentar náilon zero. O paciente apresentou rápida recuperação pós-operatória, sem ocorrências de recidivas. Assim, a herniorrafia paracostal laparoscópica mostrou-se satisfatória, possibilitando o diagnóstico definitivo e concomitante correção do defeito abdominal e diafragmático, podendo ser indicada como uma alternativa à cirurgia convencional.(AU)


Asunto(s)
Animales , Perros , Hernia Abdominal/patología , Laparoscopía/métodos , Herniorrafia , Perros/clasificación
8.
Osteoporos Int ; 21(12): 2019-25, 2010 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-20306022

RESUMEN

SUMMARY: Studies on body composition and bone mineral density in acromegaly have conflicting results. Our data point to an increase in lean mass, a decrease in adipose tissue, and that the anabolic effect of GH on bone is partially dependent on modifications in body composition. INTRODUCTION: The effects of growth hormone (GH) and insulin-like growth factor I (IGF-I) excess and gonadal status on bone mineral density (BMD) and body composition (BC) in acromegalic patients are uncertain. METHODS: Bone mineral density and BC were evaluated by dual-energy X-ray absorptiometry (Prodigy-GE) in 75 patients (22 men and 53 women) with acromegaly, mean age 48.9 ± 14.5 years. Acromegaly was considered "controlled" when serum IGF-I was within the specific age-adjusted reference range, and serum GH was lower than 2.5 ng/mL. Comparisons between groups were performed using unpaired t test or Mann-Whitney U test. Categorical variables were analyzed by chi-square (x (2)) test. In order to compare data of different subgroups stratified by disease activity and gonadal status, one-way analysis of variance (ANOVA) and Bonferroni post hoc analysis were performed. To evaluate the correlation between GH and IGF-I and densitometric parameters, Pearson and Spearman rank order correlation were performed, as appropriate. RESULTS: There were no differences in BMD when considering disease activity and gonadal status. Active disease and eugonadism were positively correlated to an increase in lean mass and a decrease in fat mass. After multiple linear regression, there were positive correlations between GH and Z-score at lumbar spine and between lean mass and BMD at proximal femur. CONCLUSION: Our data support that GH-IGF-I excess and eugonadism have great influence on BC modifications and that the anabolic effects of GH-IGF-I on bone are, at least in part, dependent on these alterations in body composition.


Asunto(s)
Acromegalia/fisiopatología , Composición Corporal/fisiología , Densidad Ósea/fisiología , Hormona de Crecimiento Humana/sangre , Factor I del Crecimiento Similar a la Insulina/análisis , Acromegalia/sangre , Acromegalia/complicaciones , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Fémur/fisiopatología , Humanos , Hipogonadismo/sangre , Hipogonadismo/complicaciones , Hipogonadismo/fisiopatología , Vértebras Lumbares/fisiopatología , Masculino , Persona de Mediana Edad , Radio (Anatomía)/fisiopatología , Adulto Joven
9.
Acta Radiol ; 49(1): 75-9, 2008 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-18210315

RESUMEN

Although imaging and clinical criteria are already established for the diagnosis of mucoid degeneration of the anterior cruciate ligament (ACL), many radiologists remain unaware of their existence. Once regarded as a rare occurrence, it has been recently suggested that its incidence is in fact very much higher than previously thought, and that it is probably underdiagnosed or misdiagnosed as partial ruptures of the ACL or as cystic ganglia. In this review, the authors revisit the literature concerning this subject and present their personal experience with it, stressing the paramount importance of magnetic resonance imaging and correlation with clinical data for a correct diagnosis.


Asunto(s)
Ligamento Cruzado Anterior/patología , Artropatías/diagnóstico , Articulación de la Rodilla/patología , Imagen por Resonancia Magnética/métodos , Envejecimiento , Diagnóstico Diferencial , Ganglión/diagnóstico , Humanos , Moco , Rango del Movimiento Articular
10.
Childs Nerv Syst ; 24(1): 99-104, 2008 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-17619885

RESUMEN

INTRODUCTION: Maternal folic acid deficiency is the most important metabolic factor in the etiology of neural tube defects (NTD) and is reduced by ethanol, which is extensively consumed by young women. OBJECTIVE: The objective of the study was to determine whether folic acid supplementation in dietary saccharose is efficient in the prevention NTD induced by ethanol in fetuses of Swiss mice. MATERIALS AND METHODS: Pregnant mice were divided into four groups of six animals each: control (C), ethanol (E), deficient-supplemented (DS), and deficient-supplemented + ethanol (DSE). Groups C and E received commercial mouse chow (containing 3 mg/kg folic acid) throughout the experiment, while groups DS and DSE received a folic acid-free diet with the addition of saccharose supplemented with folic acid (2 mg/kg folic acid) in water. Group E and DSE animals received ethanol (4 g/kg) administered intraperitoneally from the seventh to the ninth gestational day (gd) and were euthanized on the 18th gd, while groups C and DS received saline. RESULTS: Congenital anomalies were observed in groups E and DSE. The fetal weight and length of the animals in group E were lower than in groups C and DS and, in group DSE, were lower than in groups C and DS. The placental diameter of group E was smaller than that of group C, and the placental weight of group C animals was lower than that of groups E, DSE, and DS. CONCLUSION: The study demonstrated that dietary supplementation with folate in saccharose is an accessible means of consumption that could be further diffused but in an increased dose than recommended to reduce the teratogenic effects of ethanol.


Asunto(s)
Anomalías Inducidas por Medicamentos/prevención & control , Etanol/toxicidad , Ácido Fólico/uso terapéutico , Sacarosa/química , Administración Oral , Animales , Depresores del Sistema Nervioso Central/administración & dosificación , Depresores del Sistema Nervioso Central/toxicidad , Suplementos Dietéticos , Etanol/administración & dosificación , Femenino , Retardo del Crecimiento Fetal/inducido químicamente , Retardo del Crecimiento Fetal/prevención & control , Peso Fetal/efectos de los fármacos , Ácido Fólico/administración & dosificación , Ácido Fólico/química , Edad Gestacional , Inyecciones Intraperitoneales , Masculino , Exposición Materna , Ratones , Defectos del Tubo Neural/inducido químicamente , Defectos del Tubo Neural/prevención & control , Embarazo , Resultado del Embarazo , Efectos Tardíos de la Exposición Prenatal/inducido químicamente , Efectos Tardíos de la Exposición Prenatal/prevención & control
11.
J Endocrinol Invest ; 29(11): 1006-11, 2006 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-17259799

RESUMEN

A 72-yr-old acromegalic man, who presented with pain in the left femur, was found to have a metastatic osteosarcoma. Only three cases describing the coexistence of acromegaly and osteosarcoma have been reported by the literature. As the patient didn't have other risk factors for osteosarcoma, the hypothesis that accelerated rate of bone turnover caused by long-term exposure to high GH and IGF-I could act as a predisposing factor in the development of this malignant bone tumor is discussed.


Asunto(s)
Acromegalia/complicaciones , Neoplasias Femorales/etiología , Osteosarcoma/etiología , Anciano , Neoplasias Óseas/secundario , Resultado Fatal , Humanos , Masculino , Osteosarcoma/secundario
12.
Ann Thorac Surg ; 72(4): 1388-9, 2001 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-11603475

RESUMEN

A case of iatrogenic left ventricular pseudoaneurysm in a male patient, with a diagnosis of pericarditis, is presented. The patient developed severe complications after an attempted diagnostic and therapeutic pericardiocentesis. Six months later, after corrective surgery, the pseudoaneurysm recurred. The patient had a second operation and two connections to the left ventricle were found. One year later the patient is well.


Asunto(s)
Aneurisma Falso/cirugía , Aneurisma Cardíaco/cirugía , Ventrículos Cardíacos/cirugía , Pericardiocentesis , Pericarditis/diagnóstico , Adulto , Humanos , Enfermedad Iatrogénica , Masculino , Pericarditis/cirugía , Complicaciones Posoperatorias/cirugía , Recurrencia , Reoperación , Técnicas de Sutura
15.
Mol Cell Biochem ; 124(2): 121-9, 1993 Jul 21.
Artículo en Inglés | MEDLINE | ID: mdl-7694075

RESUMEN

The mitogenic activity of acidic fibroblast growth factor (aFGF) is potentiated by the highly sulfated hexasaccharide [IdoUA,2S-GlcNS,6S]2-[GlcUA-GlcNS,6S] the structural repetitive unit of lung heparin chains. On a mass basis, the effect of both heparin and oligosaccharide are equivalent whereas on a molar basis, heparin, which contains about seven hexasaccharide repeats, is more efficient. On the other hand, a pentasulfated tetrasaccharide or di- and tri-sulfated disaccharides are much less effective in potentiating aFGF activity than the hexasaccharide. If the growth factor is pre-incubated with the hexasaccharide at pH 7.2 and then exposed to pH 3.5 the 306/345 nm fluorescence ratio is similar to that of native aFGF indicating that the oligosaccharide stabilizes a native conformation of the protein. Heparan sulfates extracted from various mammalian tissues were also able to potentiate aFGF mitogenic activity. On a mass basis they were in general less efficient than heparin; however, heparan sulfate prepared from medium conditioned by 3T3 fibroblasts is more efficient than heparin both on a mass and molar basis. A highly sulfated oligosaccharide isolated after digestion of pancreas heparan sulfate with heparitinase I is more active than the intact molecule, reaching a potentiating effect equivalent to that of lung heparin, whereas an N-acetylated oligosaccharide isolated after nitrous acid degradation is inactive. These data suggest that the mitogenic activity of aFGF is primarily potentiated by interacting with highly sulfated regions of heparan sulfates chains.


Asunto(s)
Factor 1 de Crecimiento de Fibroblastos/farmacología , Heparina/química , Heparitina Sulfato/química , Mitosis/efectos de los fármacos , Oligosacáridos/farmacología , Animales , Secuencia de Carbohidratos , Bovinos , Sinergismo Farmacológico , Fibroblastos/efectos de los fármacos , Hígado/química , Pulmón/química , Ratones , Ratones Endogámicos BALB C , Datos de Secuencia Molecular , Oligosacáridos/aislamiento & purificación , Especificidad de Órganos , Páncreas/química , Conejos , Bazo/química
17.
Arq. bras. cardiol ; Arq. bras. cardiol;41(6): 449-450, 1983. ilus, tab
Artículo en Portugués | LILACS | ID: lil-18523

RESUMEN

Os autores apresentam uma comparacao entre massagens cardiacas externas efetuadas com o calcanhar, com o cotovelo e pela maneira classica em um manequim registrador, utilizando 30 voluntarios. As duas alternativas (calcanhar e cotovelo) mostraram-se eficientes quando aplicadas por reanimadores com baixo peso (calcanhar) em ambulancias com teto baixo (cotovelo)


Asunto(s)
Humanos , Adolescente , Adulto , Masaje Cardíaco
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