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1.
Dent J (Basel) ; 12(6)2024 Jun 11.
Artículo en Inglés | MEDLINE | ID: mdl-38920880

RESUMEN

COVID-19, a respiratory illness with a global impact on millions, has recently been linked to manifestations affecting various bodily systems, including the oral cavity. Studies highlight oral issues, like ulcers, blisters, and white patches, alongside olfactory and gustatory dysfunction, influencing an individual's quality of life. In this context, our study aimed to assess the frequency of oral lesions, olfactory and gustatory disorders, and xerostomia resulting from COVID-19. An observational study was conducted with 414 patients to evaluate the frequency of oral symptoms resulting from COVID-19. Patients were diagnosed with mild symptoms and evaluated through clinical examination of the oral cavity and a questionnaire to assess functional alterations. The findings showed that 139 out of 414 patients presented clinical manifestations, with oral lesions being the most prevalent (19.1%), followed by gustatory disorders (18.1%), xerostomia (14.2%), and olfactory dysfunction (14%). The most prevalent oral lesions were ulcerations (n = 51), candidiasis (n = 8), and erythema or red plaques (n = 7). Unfortunately, 50 (12.1%) patients died during this study. Therefore, oral lesions, olfactory and gustatory dysfunctions, and xerostomia are common symptoms associated with COVID-19.

2.
Gynecol Oncol ; 181: 76-82, 2024 02.
Artículo en Inglés | MEDLINE | ID: mdl-38141534

RESUMEN

OBJECTIVES: This study aimed to describe an operative technique for vaginal hysterectomy (VH) and assess the costs, perioperative, and oncological outcomes for this procedure when used in the treatment of patients with low-risk endometrial cancer (LREC). METHODS: A retrospective analysis of medical records was conducted on patients who underwent VH to treat precursor and invasive endometrial lesions between April 2019 and November 2021 at a single center in São Paulo, Brazil. RESULTS: Thirty-four patients met the inclusion criteria. The mean patient age was 61.9 years, and the mean body mass index (BMI) was 34. Obese patients (BMI ≥ 30) accounted for 77% of the sample. Preoperative functional capacity measures were Eastern Cooperative Oncology Group (ECOG) 0-1 and ECOG-2 for 91% and 9% of the patients, respectively. The mean operative time and length of hospital stay were 109 min and 1.2 days, respectively. Four patients had a conversion of the surgical route to laparotomy. No major intraoperative complications were observed. Patients who underwent surgical conversion had a greater uterine volume (227 versus 107 mL, p = 0.006) and longer operative time (177 versus 96 min, p = 0.001). The total cost associated with VH was, on average, US$ 2058.77 (R$ 10,925.91), representing 47% of the cost associated with non-vaginal routes. Twenty-eight patients received a definitive diagnosis of endometrial carcinoma; of these, three received adjuvant radiotherapy. The mean follow-up period was 34.6 months for the patients diagnosed with cancer. One case of disease recurrence occurred 16.6 months after surgery, with one death at 28.6 months of follow-up. CONCLUSIONS: These findings suggest that VH could be a feasible and cost-effective alternative for selected patients with LREC in low-resource settings.


Asunto(s)
Neoplasias Endometriales , Laparoscopía , Femenino , Humanos , Persona de Mediana Edad , Histerectomía Vaginal/métodos , Estudios Retrospectivos , Histerectomía/métodos , Laparoscopía/métodos , Brasil , Neoplasias Endometriales/patología , Complicaciones Posoperatorias/etiología
3.
Braz Oral Res ; 37: e012, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36790253

RESUMEN

Fanconi anemia is a rare autosomal recessive disease. In this disease, cytokine pathways can induce the bone marrow failure that is observed in individuals with Fanconi anemia. Interleukin IL-17 exhibits a protective effect in organisms because it induces neutrophil recruitment and shows a pathological role in several models of autoimmune diseases, periodontal disease, cancer, allograft rejection, and graft versus host disease. Polymorphisms in the IL17A and IL17RA genes were evaluated from DNA in saliva, comparing individuals with or without Fanconi anemia, using models of genotypic transmission (additive, dominant, and recessive). Polymorphisms in the IL17A and IL17RA genes (rs2241044 [C allele], rs879577 [C allele], rs9606615 [T allele], and rs2241043 [C allele]) were risk factors for developing Fanconi anemia. We also performed an analysis of gene markers with clinical variables in the Fanconi group. Polymorphisms in the IL17A gene (rs3819025 [A allele] and rs2275913 [G allele], respectively) were associated with an age of less than 20 years (p = 0.026; RP 0.65) and the female sex (p = 0.043; RP 0.88). The IL17RA gene was also associated with age and the presence of leukoplakia (a potentially malignant oral disorder). An age of less than 20 years was associated with rs917864 (T allele; p = 0.036; RP 0.67). The presence of leukoplakia was associated with rs17606615 (T allele; p = 0.042; RP 0.47). To our knowledge, this is the first study that associates IL17A and IL17RA gene polymorphisms with Fanconi anemia and examines rs2241044 polymorphisms in scientific literature thus far.


Asunto(s)
Anemia de Fanconi , Adulto , Femenino , Humanos , Adulto Joven , Anemia de Fanconi/genética , Genotipo , Interleucina-17/genética , Interleucina-17/metabolismo , Polimorfismo de Nucleótido Simple , Receptores de Interleucina-17/genética , Factores de Riesgo , Masculino
4.
Braz. oral res. (Online) ; 37: e012, 2023. tab
Artículo en Inglés | LILACS-Express | LILACS, BBO - Odontología | ID: biblio-1420953

RESUMEN

Abstract Fanconi anemia is a rare autosomal recessive disease. In this disease, cytokine pathways can induce the bone marrow failure that is observed in individuals with Fanconi anemia. Interleukin IL-17 exhibits a protective effect in organisms because it induces neutrophil recruitment and shows a pathological role in several models of autoimmune diseases, periodontal disease, cancer, allograft rejection, and graft versus host disease. Polymorphisms in the IL17A and IL17RA genes were evaluated from DNA in saliva, comparing individuals with or without Fanconi anemia, using models of genotypic transmission (additive, dominant, and recessive). Polymorphisms in the IL17A and IL17RA genes (rs2241044 [C allele], rs879577 [C allele], rs9606615 [T allele], and rs2241043 [C allele]) were risk factors for developing Fanconi anemia. We also performed an analysis of gene markers with clinical variables in the Fanconi group. Polymorphisms in the IL17A gene (rs3819025 [A allele] and rs2275913 [G allele], respectively) were associated with an age of less than 20 years (p = 0.026; RP 0.65) and the female sex (p = 0.043; RP 0.88). The IL17RA gene was also associated with age and the presence of leukoplakia (a potentially malignant oral disorder). An age of less than 20 years was associated with rs917864 (T allele; p = 0.036; RP 0.67). The presence of leukoplakia was associated with rs17606615 (T allele; p = 0.042; RP 0.47). To our knowledge, this is the first study that associates IL17A and IL17RA gene polymorphisms with Fanconi anemia and examines rs2241044 polymorphisms in scientific literature thus far.

5.
Acta Vet. Brasilica ; 12(2): 40-44, jun. 2018. tab
Artículo en Inglés | VETINDEX | ID: biblio-1453134

RESUMEN

Toxoplasma gondii and Cystoisopora spp. are coccidian protozoa and compulsory intracellular parasites. These parasites present an enteric cycle phase, wild and domestic felines are definitive hosts capable of eliminating non-sporulated oocysts by faeces. Furthermore, they share the same transmission path, through the ingestion of infectious oocysts or the ingestion of cysts present on tissues. Most cat infections occur subclinically. Commonly, clinical and severe disease develops more often in kittens and immunocompromised animals. The present paper reports a case of coinfection of T. gondii and Cystoisospora spp in a feline of approximately 20 days old, weighing 260 grams, assisted at the Veterinary Hospital - UEM. The patient presented acute signs of limited mobility, remaining only in sternal position, cervical ventroflexion, dyspnea, lethargy and anorexia. T. gondii was identified through Polymerase Chain Reaction (PCR) test using a blood sample, whereas the co-analysis by flotation in saturated saline solution (Willis technique) was able to verify the presence of oocysts of Cystoisospora spp. After negative result from PCR test using stool sample, the presence of Cystoisospora spp. was confirmed, differentiating it from oocysts of T. gondii. The treatment based on sulfamethoxazole and trimethoprim was able to control the infection and decrease disease symptoms, proving to be effective and showing significant clinical improvement within 3 days after starting the treatment.


Asunto(s)
Animales , Gatos , Coinfección/tratamiento farmacológico , Coinfección/veterinaria , Isosporiasis/diagnóstico , Isosporiasis/veterinaria , Toxoplasmosis Animal/diagnóstico , Animales Recién Nacidos/parasitología
6.
Acta Vet. bras. ; 12(2): 40-44, jun. 2018. tab
Artículo en Inglés | VETINDEX | ID: vti-735051

RESUMEN

Toxoplasma gondii and Cystoisopora spp. are coccidian protozoa and compulsory intracellular parasites. These parasites present an enteric cycle phase, wild and domestic felines are definitive hosts capable of eliminating non-sporulated oocysts by faeces. Furthermore, they share the same transmission path, through the ingestion of infectious oocysts or the ingestion of cysts present on tissues. Most cat infections occur subclinically. Commonly, clinical and severe disease develops more often in kittens and immunocompromised animals. The present paper reports a case of coinfection of T. gondii and Cystoisospora spp in a feline of approximately 20 days old, weighing 260 grams, assisted at the Veterinary Hospital - UEM. The patient presented acute signs of limited mobility, remaining only in sternal position, cervical ventroflexion, dyspnea, lethargy and anorexia. T. gondii was identified through Polymerase Chain Reaction (PCR) test using a blood sample, whereas the co-analysis by flotation in saturated saline solution (Willis technique) was able to verify the presence of oocysts of Cystoisospora spp. After negative result from PCR test using stool sample, the presence of Cystoisospora spp. was confirmed, differentiating it from oocysts of T. gondii. The treatment based on sulfamethoxazole and trimethoprim was able to control the infection and decrease disease symptoms, proving to be effective and showing significant clinical improvement within 3 days after starting the treatment.(AU)


Asunto(s)
Animales , Gatos , Toxoplasmosis Animal/diagnóstico , Isosporiasis/diagnóstico , Isosporiasis/veterinaria , Coinfección/tratamiento farmacológico , Coinfección/veterinaria , Animales Recién Nacidos/parasitología
7.
Fertil Steril ; 94(6): 2050-3, 2010 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-20079896

RESUMEN

OBJECTIVE: To evaluate zona pellucida birefringence (ZPB) in immature and mature oocytes collected after controlled ovarian stimulation and to assess the influence of ZPB on oocyte development. DESIGN: Prospective study. SETTING(S): Private assisted reproduction centre. PATIENT(S): Thirty patients undergoing intracytoplasmic sperm injection. INTERVENTION(S): The ZPB of mature and immature oocytes was evaluated using a polarization imaging software module, and the oocytes were classified as high birefringence (HB) or low birefringence. MAIN OUTCOME MEASURE(S): The ZPB of in vivo and in vitro matured oocytes and its influence on spontaneous nuclear maturation in vitro, fertilization, and embryo quality. RESULT(S): The percentage of HB oocytes was higher in immature than in mature oocytes (40.1 vs. 23.6%). Among immature oocytes, an increased percentage of HB in prophase-I stage oocytes compared to metaphase I stage oocytes was also observed (50.7 vs. 25.0%). However, the percentage of HB oocytes did not change when comparing oocytes before and after in vitro maturation for both prophase I and metaphase I oocytes. No influence of ZPB was observed on the spontaneous in vitro maturation potential. Exclusively for metaphase II retrieved oocytes, a positive influence of ZPB on fertilization (odds ratio [OR], 1.78; 95% confidence interval [CI], 1.27-2.49) and embryo quality (OR, 2.28; 95% CI, 1.04-4.99) was noted. CONCLUSION(S): ZPB may be a useful tool to predict embryo quality for metaphase-II oocytes. Moreover, the completion of nuclear changes in the production of metaphase-II oocytes in vitro may not reflect their molecular maturity.


Asunto(s)
Oocitos/fisiología , Oogénesis/fisiología , Zona Pelúcida/fisiología , Birrefringencia , Diferenciación Celular/fisiología , Células Cultivadas , Transferencia de Embrión , Femenino , Fertilización/fisiología , Humanos , Oocitos/química , Oocitos/ultraestructura , Inducción de la Ovulación , Embarazo , Inyecciones de Esperma Intracitoplasmáticas , Zona Pelúcida/química
8.
Chiropt. neotrop. ; 16(1, supl.): 86-89, 2010.
Artículo en Portugués | VETINDEX | ID: vti-13278

RESUMEN

Os quirópteros apresentam uma elevada diversidade, constituindo em muitas áreas tropicais e subtropicais a maior parte da fauna de mamíferos (Taddei 1983). Por ser um dos mamíferos mais abundantes na região Neotropical (Humphrey e Bonaccorso 1983), os morcegos contribuem para a riqueza faunística, além de atuarem diretamente na dinâmica dos ecossistemas realizando a polinização e dispersão de sementes de algumas espécies vegetais e controlando as populações de boa parte dos insetos noturnos e crepusculares. Segundo Fenton et al. (1992), os morcegos apresentam um grande potencial como indicadores dos níveis de degradação do hábitat em muitas partes do globo, seja através da estrutura de suas comunidades e guildas alimentares, seja pela presença de espécies consideradas indicadoras de hábitat bem preservado.[...]

9.
Chiropt. Neotrop. (Impr.) ; 16(1, supl.): 86-89, 2010.
Artículo en Portugués | LILACS-Express | VETINDEX | ID: biblio-1471876

RESUMEN

Os quirópteros apresentam uma elevada diversidade, constituindo em muitas áreas tropicais e subtropicais a maior parte da fauna de mamíferos (Taddei 1983). Por ser um dos mamíferos mais abundantes na região Neotropical (Humphrey e Bonaccorso 1983), os morcegos contribuem para a riqueza faunística, além de atuarem diretamente na dinâmica dos ecossistemas realizando a polinização e dispersão de sementes de algumas espécies vegetais e controlando as populações de boa parte dos insetos noturnos e crepusculares. Segundo Fenton et al. (1992), os morcegos apresentam um grande potencial como indicadores dos níveis de degradação do hábitat em muitas partes do globo, seja através da estrutura de suas comunidades e guildas alimentares, seja pela presença de espécies consideradas indicadoras de hábitat bem preservado.[...]

10.
Int Braz J Urol ; 35(2): 190-7; discussion 197-8, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-19409123

RESUMEN

PURPOSE: Report the characteristics of cryopreserved semen from a cohort of male cancer patients, attitudes towards cryopreservation and outcomes of semen samples based on a 12-year cryopreservation program. MATERIAL AND METHODS: Data from 98 male cancer patients whose sperm samples were banked were evaluated. Demographic parameters, semen characteristics, destination of sperm banked samples and questionnaires answered by the patients regarding cryopreservation time were evaluated. RESULTS: The cancer diagnoses were testicle (56.1%), prostate (15.3%), Hodgkin's lymphomas (9.2%), non-Hodgkin's lymphomas (7.1%), leukemia (3.1%) and other malignancies (9.2%). The patients with testicular cancer presented lower sperm concentration (p < 0.001); however, there were no differences with the percentage of normozoospermic patients among cancer type groups (p = 0.185). A shorter time between cancer diagnosis and sperm banking was observed for testicular and prostate cancer patients (p < 0.001). Most of the patients (89.5%) favored sperm banking as a fertility preservation method. CONCLUSIONS: Although less than 20% of banked sperm samples were disposed of, the majority of patients related sperm banking with safe for fertility preservation. Our results show that all male cancer patients of reproductive age facing cancer treatment could be offered sperm banking.


Asunto(s)
Criopreservación/estadística & datos numéricos , Infertilidad Masculina/prevención & control , Neoplasias , Preservación de Semen/estadística & datos numéricos , Bancos de Esperma , Adolescente , Adulto , Anciano , Actitud Frente a la Salud , Métodos Epidemiológicos , Humanos , Infertilidad Masculina/inducido químicamente , Masculino , Persona de Mediana Edad , Neoplasias/terapia , Neoplasias de la Próstata/diagnóstico , Neoplasias de la Próstata/terapia , Radioterapia/efectos adversos , Análisis de Semen , Bancos de Esperma/estadística & datos numéricos , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/terapia , Adulto Joven
11.
Int. braz. j. urol ; 35(2): 190-198, Mar.-Apr. 2009. tab
Artículo en Inglés | LILACS | ID: lil-516966

RESUMEN

PURPOSE: Report the characteristics of cryopreserved semen from a cohort of male cancer patients, attitudes towards cryopreservation and outcomes of semen samples based on a 12-year cryopreservation program. MATERIAL AND METHODS: Data from 98 male cancer patients whose sperm samples were banked were evaluated. Demographic parameters, semen characteristics, destination of sperm banked samples and questionnaires answered by the patients regarding cryopreservation time were evaluated. RESULTS: The cancer diagnoses were testicle (56.1 percent), prostate (15.3 percent), Hodgkin’s lymphomas (9.2 percent), non-Hodgkin’s lymphomas (7.1 percent), leukemia (3.1 percent) and other malignancies (9.2 percent). The patients with testicular cancer presented lower sperm concentration (p < 0.001); however, there were no differences with the percentage of normozoospermic patients among cancer type groups (p = 0.185). A shorter time between cancer diagnosis and sperm banking was observed for testicular and prostate cancer patients (p < 0.001). Most of the patients (89.5 percent) favored sperm banking as a fertility preservation method. CONCLUSIONS: Although less than 20 percent of banked sperm samples were disposed of, the majority of patients related sperm banking with safe for fertility preservation. Our results show that all male cancer patients of reproductive age facing cancer treatment could be offered sperm banking.


Asunto(s)
Adolescente , Adulto , Anciano , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Criopreservación/estadística & datos numéricos , Infertilidad Masculina/prevención & control , Neoplasias , Bancos de Esperma , Preservación de Semen/estadística & datos numéricos , Actitud Frente a la Salud , Métodos Epidemiológicos , Infertilidad Masculina/inducido químicamente , Neoplasias/terapia , Neoplasias de la Próstata/diagnóstico , Neoplasias de la Próstata/terapia , Radioterapia/efectos adversos , Análisis de Semen , Bancos de Esperma , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/terapia , Adulto Joven
12.
Rev. bras. ginecol. obstet ; Rev. bras. ginecol. obstet;30(4): 171-176, abr. 2008. tab
Artículo en Portugués | LILACS | ID: lil-485974

RESUMEN

OBJETIVO: o objetivo deste estudo foi avaliar os parâmetros laboratoriais e clínicos de pacientes submetidos à reprodução humana assistida, associando técnicas de processamento seminal para eliminação de partículas virais da amostra de sêmen em casais nos quais o homem é infectado pelo vírus da imunodeficiência humana adquirida (HIV). MÉTODOS: foram avaliados 11 ciclos de injeção intracitoplasmática de espermatozóide (ICSI) realizados em casais nos quais os homens eram infectados pelo HIV (Grupo HIV), e 35 ciclos de ICSI nos quais se utilizaram espermatozóides doados (Grupo Controle). As amostras de sêmen dos doadores foram submetidas à análise seminal completa, processamento seminal (lavagem) e criopreservação. Os homens do Grupo HIV receberam antibioticoterapia prévia e realizou-se análise seminal, lavagem e gradiente descontínuo de densidade antes da criopreservação. As amostras foram avaliadas para carga viral e a ICSI foi realizada quando não houve detecção do HIV. RESULTADOS: quanto aos resultados da análise seminal, os grupos se mostraram comparáveis em relação à concentração e motilidade progressiva dos espermatozóides. Entretanto, a porcentagem de espermatozóides morfologicamente normais foi maior no Grupo Controle (14,3 por cento) comparado ao HIV (5,8 por cento; p=0,002). Na avaliação dos parâmetros embrionários, as taxas de fertilização normal (Controle: 74,7 por cento e HIV: 71,7; p=0,838) e de bons embriões (Controle: 42,4 por cento e HIV: 65,1 por cento; p=0,312) foram semelhantes. Por outro lado, o Grupo Controle apresentou melhores resultados clínicos que o HIV (gestação continuada: 52,9 e 12,5 por cento; p=0,054; implantação: 42,6 e 10,4 por cento; p=0,059, respectivamente), apesar de as diferenças não serem estatisticamente significantes. Após o nascimento, não houve soroconversão das mães e das crianças nascidas. CONCLUSÕES: a associação de técnicas de processamento seminal para eliminação do HIV de amostras...


PURPOSE: the propose of this study was to analyze the clinical and laboratorial parameters of patients submitted to human assisted reproduction techniques with association of sperm processing techniques, in order to remove virus particles from semen samples of couples in which men was infected by human immunodeficiency virus (HIV). METHODS: it was assessed 11 intracytoplasmatic sperm injection (ICSI) cycles from couples whose men were HIV seropositive (HIV Group), and 35 cycles in which semen donors' samples were used in ICSI procedures (Control Group). Semen samples from Control Group were submitted to routine semen analysis, sperm wash and cryopreservation. The man from HIV Group received previous antibiotic therapy; the semen samples were analyzed routinely and prepared by sperm wash and density gradient method before cryopreservation. Those samples were evaluated to viral load and ICSI was performed when no HIV was detected. RESULTS: regards to semen analysis the groups were similar to sperm concentration and progressive motility. Nevertheless, the percentage of sperm with normal morphology were higher on Control Group (14.3 percent) than HIV (5.8 percent; p=0.002). On embryo parameters assessment, the normal fertilization (CT: 74.7 percent and HIV: 71.7; p=0.838, respectively) and good embryos rate (CT: 42.4 percent and HIV: 65.1 percent; p=0.312, respectively) were comparable. On the other hand, the Control Group presented better clinic results than HIV Group (ongoing pregnancy rate: 52.9 percent versus 12.5 percent; p=0.054, and implantation rate: 42.6 versus 10.4 percent; p=0.059, respectively), however the differences were not statistically significant. After delivery, no seroconversion was observed on mother and child. CONCLUSIONS: the association of sperm processing techniques in order to remove HIV from semen samples does not influence in laboratorial parameters of assisted reproduction techniques cycles. On the other hand, ...


Asunto(s)
Humanos , Femenino , Embarazo , Implantación del Embrión , VIH , Índice de Embarazo , Semen , Inyecciones de Esperma Intracitoplasmáticas
13.
Rev Bras Ginecol Obstet ; 30(4): 171-6, 2008 Apr.
Artículo en Portugués | MEDLINE | ID: mdl-19142488

RESUMEN

PURPOSE: the propose of this study was to analyze the clinical and laboratorial parameters of patients submitted to human assisted reproduction techniques with association of sperm processing techniques, in order to remove virus particles from semen samples of couples in which men was infected by human immunodeficiency virus (HIV). METHODS: assessed were 11 intracytoplasmatic sperm injection (ICSI) cycles from couples whose men were HIV seropositive (HIV Group), and 35 cycles in which semen donors' samples were used in ICSI procedures (Control Group). Semen samples from Control Group were submitted to routine semen analysis, sperm wash and cryopreservation. The man from HIV Group received previous antibiotic therapy; the semen samples were analyzed routinely and prepared by sperm wash and density gradient method before cryopreservation. Those samples were evaluated to viral load and ICSI was performed when no HIV was detected. RESULTS: with regards to semen analysis, the groups were similar to sperm concentration and progressive motility. Nevertheless, the percentage of sperm with normal morphology were higher on Control Group (14.3%) than HIV (5.8%; p=0.002). On embryo parameters assessment, the normal fertilization (CT: 74.7% and HIV: 71.7; p=0.838, respectively) and good embryos rate (CT: 42.4% and HIV: 65.1%; p=0.312, respectively) were comparable. On the other hand, the Control Group presented better clinic results than HIV Group (ongoing pregnancy rate: 52.9% versus 12.5%; p=0.054, and implantation rate: 42.6 versus 10.4%; p=0.059, respectively), however the differences were not statistically significant. After delivery, no seroconversion was observed on mother and child. CONCLUSIONS: the association of sperm processing techniques in order to remove HIV from semen samples does not influence in laboratorial parameters of assisted reproduction techniques cycles. On the other hand, it has been demonstrated excellent results getting safety gametes to serodiscordant couples.


Asunto(s)
Seronegatividad para VIH , Seropositividad para VIH , Semen , Inyecciones de Esperma Intracitoplasmáticas/métodos , Adulto , Femenino , Humanos , Masculino , Estudios Retrospectivos
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