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1.
Sensors (Basel) ; 23(1)2023 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-36617153

RESUMO

The human-robot collaboration (HRC) solutions presented so far have the disadvantage that the interaction between humans and robots is based on the human's state or on specific gestures purposely performed by the human, thus increasing the time required to perform a task and slowing down the pace of human labor, making such solutions uninteresting. In this study, a different concept of the HRC system is introduced, consisting of an HRC framework for managing assembly processes that are executed simultaneously or individually by humans and robots. This HRC framework based on deep learning models uses only one type of data, RGB camera data, to make predictions about the collaborative workspace and human action, and consequently manage the assembly process. To validate the HRC framework, an industrial HRC demonstrator was built to assemble a mechanical component. Four different HRC frameworks were created based on the convolutional neural network (CNN) model structures: Faster R-CNN ResNet-50 and ResNet-101, YOLOv2 and YOLOv3. The HRC framework with YOLOv3 structure showed the best performance, showing a mean average performance of 72.26% and allowed the HRC industrial demonstrator to successfully complete all assembly tasks within a desired time window. The HRC framework has proven effective for industrial assembly applications.


Assuntos
Aprendizado Profundo , Robótica , Humanos , Redes Neurais de Computação , Gestos
2.
J Dev Orig Health Dis ; 12(3): 456-464, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-32662387

RESUMO

In animal models, exposure to excess testosterone during gestation induces polycystic ovary syndrome (PCOS)-like reproductive and metabolic traits in female offspring, suggesting that the hyperandrogenemic intrauterine environment may have a role in the etiology of PCOS. Additionally, few studies have also addressed metabolic and reproductive outcomes in male offspring. In the present study, the intravenous glucose tolerance test (IGTT) was used to assess the insulin-glucose homeostasis at various ages during sexual development in male sheep born to testosterone-treated ewes. To further analyze the programming effect of testosterone on insulin-glucose homeostasis, indexes of insulin sensitivity were assessed in orchidectomized post-pubertal males born to testosterone-treated ewes (Torq-males) and orchidectomized post-puberal controls (Corq-males) before and 48 h after a testosterone injection. There was no difference in insulin sensitivity indexes between males born to testosterone-treated ewes (T-males) and control males born to control ewes (C-males) at 5, 10, 20 and 30 weeks of age, representing the infantile, early and late pre-pubertal, and early post-pubertal stage of sexual development, respectively. In orchidectomized males, basal levels of insulin and glucose were not different between both groups before and after the testosterone injection; however, Torq-males released more insulin before and after T challenge during the first 20 min of the test. Despite this, plasma glucose concentrations were not different in both groups during IVGTT, resulting in an insulin sensitivity index composite similar between groups. We concluded that the effect of prenatal exposure to excess testosterone may reprogram the pancreatic ß-cells insulin release in ovine males, with effects more evident in castrated males versus intact males.


Assuntos
Desenvolvimento Fetal , Resistência à Insulina , Exposição Materna , Efeitos Tardios da Exposição Pré-Natal , Testosterona , Animais , Feminino , Masculino , Orquiectomia , Gravidez , Maturidade Sexual , Ovinos
3.
Sci Rep ; 10(1): 404, 2020 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-31941959

RESUMO

Hyperandrogenemia and metabolic disturbances during postnatal life are strongly linked both to polycystic ovary syndrome and other conditions that arise from prenatal exposure to androgen excess. In an animal model of this condition, we reported that insulin sensitivity (IS) was lower in young female sheep born to testosterone-treated mothers versus sheep born to non-exposed mothers (control). This lower insulin sensitivity remains throughout reproductive life. However, it is unknown whether abnormal postnatal levels of testosterone (T) further decrease IS derived from prenatal exposure to testosterone. Therefore, we assessed the effects of an acute testosterone administration (40 mg) on IS and insulin secretion during an intravenous glucose tolerance test performed at 40 weeks of age (adulthood) in previously ovariectomized sheep at 26 weeks of age (prepuberty), that were either prenatally exposed to testosterone (T-females, n = 6) or not (C-females, n = 6). The incremental area under the curve of insulin was greater in C-females both with or without the acute testosterone treatment (P < 0.05). The ISI-Composite was lower after an acute testosterone treatment, only in T-females. We conclude that prenatal exposure to testosterone disrupts pancreatic insulin secretion in response to glucose and that in this setting further hyperandrogenemia may predispose to lower insulin sensitivity.


Assuntos
Desenvolvimento Embrionário/efeitos dos fármacos , Resistência à Insulina , Secreção de Insulina/efeitos dos fármacos , Efeitos Tardios da Exposição Pré-Natal/patologia , Testosterona/efeitos adversos , Animais , Feminino , Gravidez , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Efeitos Tardios da Exposição Pré-Natal/metabolismo , Ovinos
4.
PLoS One ; 9(5): e97617, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24849624

RESUMO

The aim of this study was to compare a real-time PCR assay, with a conventional culture/PCR method, to detect S. aureus, mecA and Panton-Valentine Leukocidin (PVL) genes in animals and retail meat, using a two-step selective enrichment protocol. A total of 234 samples were examined (77 animal nasal swabs, 112 retail raw meat, and 45 deli meat). The multiplex real-time PCR targeted the genes: nuc (identification of S. aureus), mecA (associated with methicillin resistance) and PVL (virulence factor), and the primary and secondary enrichment samples were assessed. The conventional culture/PCR method included the two-step selective enrichment, selective plating, biochemical testing, and multiplex PCR for confirmation. The conventional culture/PCR method recovered 95/234 positive S. aureus samples. Application of real-time PCR on samples following primary and secondary enrichment detected S. aureus in 111/234 and 120/234 samples respectively. For detection of S. aureus, the kappa statistic was 0.68-0.88 (from substantial to almost perfect agreement) and 0.29-0.77 (from fair to substantial agreement) for primary and secondary enrichments, using real-time PCR. For detection of mecA gene, the kappa statistic was 0-0.49 (from no agreement beyond that expected by chance to moderate agreement) for primary and secondary enrichment samples. Two pork samples were mecA gene positive by all methods. The real-time PCR assay detected the mecA gene in samples that were negative for S. aureus, but positive for Staphylococcus spp. The PVL gene was not detected in any sample by the conventional culture/PCR method or the real-time PCR assay. Among S. aureus isolated by conventional culture/PCR method, the sequence type ST398, and multi-drug resistant strains were found in animals and raw meat samples. The real-time PCR assay may be recommended as a rapid method for detection of S. aureus and the mecA gene, with further confirmation of methicillin-resistant S. aureus (MRSA) using the standard culture method.


Assuntos
Proteínas de Bactérias/genética , Toxinas Bacterianas/genética , Exotoxinas/genética , Leucocidinas/genética , Carne/análise , Reação em Cadeia da Polimerase em Tempo Real , Staphylococcus aureus/genética , Staphylococcus aureus/isolamento & purificação , Animais , Bovinos , Farmacorresistência Bacteriana/genética , Tipagem de Sequências Multilocus , Proteínas de Ligação às Penicilinas , Staphylococcus aureus/efeitos dos fármacos
5.
Reproduction ; 145(6): 567-76, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23579187

RESUMO

Prenatal exposure to excess testosterone induces reproductive disturbances in both female and male sheep. In females, it alters the hypothalamus-pituitary-ovarian axis. In males, prenatal testosterone excess reduces sperm count and motility. Focusing on males, this study tested whether pituitary LH responsiveness to GNRH is increased in prenatal testosterone-exposed males and whether testicular function is compromised in the testosterone-exposed males. Control males (n=6) and males born to ewes exposed to twice weekly injections of 30  mg testosterone propionate from days 30 to 90 and of 40  mg testosterone propionate from days 90 to 120 of gestation (n=6) were studied at 20 and 30 weeks of age. Pituitary and testicular responsiveness was tested by administering a GNRH analog (leuprolide acetate). To complement the analyses, the mRNA expression of LH receptor (LHR) and that of steroidogenic enzymes were determined in testicular tissue. Basal LH and testosterone concentrations were higher in the testosterone-exposed-males. While LH response to the GNRH analog was higher in the testosterone-exposed males than in the control males, testosterone responses did not differ between the treatment groups. The testosterone:LH ratio was higher in the control males than in the testosterone-exposed males of 30 weeks of age, suggestive of reduced Leydig cell sensitivity to LH in the testosterone-exposed males. The expression of LHR mRNA was lower in the testosterone-exposed males, but the mRNA expression of steroidogenic enzymes did not differ between the groups. These findings indicate that prenatal testosterone excess has opposing effects at the pituitary and testicular levels, namely increased pituitary sensitivity to GNRH at the level of pituitary and decreased sensitivity of the testes to LH.


Assuntos
Hiperplasia Suprarrenal Congênita/metabolismo , Modelos Animais de Doenças , Hormônio Liberador de Gonadotropina/metabolismo , Hormônio Luteinizante/metabolismo , Hipófise/metabolismo , Testículo/metabolismo , Testosterona/metabolismo , Hiperplasia Suprarrenal Congênita/sangue , Hiperplasia Suprarrenal Congênita/etiologia , Animais , Animais Endogâmicos , Feminino , Regulação da Expressão Gênica no Desenvolvimento/efeitos dos fármacos , Hormônio Liberador de Gonadotropina/agonistas , Hormônio Liberador de Gonadotropina/análogos & derivados , Leuprolida/farmacologia , Hormônio Luteinizante/sangue , Masculino , Hipófise/efeitos dos fármacos , Síndrome do Ovário Policístico/fisiopatologia , Gravidez , Complicações na Gravidez/fisiopatologia , Distribuição Aleatória , Receptores do LH/genética , Receptores do LH/metabolismo , Maturidade Sexual , Carneiro Doméstico , Esteroides/biossíntese , Testículo/efeitos dos fármacos , Testosterona/sangue , Propionato de Testosterona
6.
PLoS One ; 8(2): e57710, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23469055

RESUMO

Disruption of the maternal environment during pregnancy is a key contributor to offspring diseases that develop in adult life. To explore the impact of chronodisruption during pregnancy in primates, we exposed pregnant capuchin monkeys to constant light (eliminating the maternal melatonin rhythm) from the last third of gestation to term. Maternal temperature and activity circadian rhythms were assessed as well as the newborn temperature rhythm. Additionally we studied the effect of daily maternal melatonin replacement during pregnancy on these rhythms. Ten pregnant capuchin monkeys were exposed to constant light from 60% of gestation to term. Five received a daily oral dose of melatonin (250 µg kg/body weight) at 1800 h (LL+Mel) and the other five a placebo (LL). Six additional pregnant females were maintained in a 14∶10 light:dark cycles and their newborns were used as controls (LD). Rhythms were recorded 96 h before delivery in the mother and at 4-6 days of age in the newborn. Exposure to constant light had no effect on the maternal body temperature rhythm however it delayed the acrophase of the activity rhythm. Neither rhythm was affected by melatonin replacement. In contrast, maternal exposure to constant light affected the newborn body temperature rhythm. This rhythm was entrained in control newborns whereas LL newborns showed a random distribution of the acrophases over 24-h. In addition, mean temperature was decreased (34.0±0.6 vs 36.1±0.2°C, in LL and control, respectively P<0.05). Maternal melatonin replacement during pregnancy re-synchronized the acrophases and restored mean temperature to the values in control newborns. Our findings demonstrate that prenatal melatonin is a Zeitgeber for the newborn temperature rhythm and supports normal body temperature maintenance. Altogether these prenatal melatonin effects highlight the physiological importance of the maternal melatonin rhythm during pregnancy for the newborn primate.


Assuntos
Ritmo Circadiano/efeitos da radiação , Luz , Mães , Temperatura , Animais , Animais Recém-Nascidos , Comportamento Animal/efeitos dos fármacos , Comportamento Animal/fisiologia , Comportamento Animal/efeitos da radiação , Cebus , Ritmo Circadiano/efeitos dos fármacos , Feminino , Masculino , Exposição Materna/efeitos adversos , Melatonina/farmacologia , Gravidez , Terceiro Trimestre da Gravidez/efeitos dos fármacos , Terceiro Trimestre da Gravidez/fisiologia , Terceiro Trimestre da Gravidez/efeitos da radiação , Fatores de Tempo
7.
Endocrine ; 43(3): 705-13, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23076741

RESUMO

The reprograming effects of prenatal testosterone (T) treatment on postnatal reproductive parameters have been studied extensively in females of several species but similar studies in males are limited. We recently found that prenatal T treatment increases Sertoli cell number and reduced spermatogenesis in adult rams. If such disruptions are manifested early in life and involve changes in testicular paracrine environment remain to be explored. This study addresses the impact of prenatal T excess on testicular parameters in infant males, including Sertoli cell number and expression of critical genes [FSH receptor (FSHR), androgen receptor (AR), transforming growth factor beta 1 (TGFB1), 3 (TGFB3), transforming growth factor beta type 1 receptor, (TGFBR1), and anti-Müllerian hormone (AMH)] modulating testicular function. At 4 week of age, male lambs born to dams treated with 30 mg of T propionate twice weekly from day 30 to 90, followed by 40 mg of T propionate from day 90 to 120 of pregnancy (T-males), had a higher number of Sertoli cells/testis (P = 0.035) than control males (C-males) born to dams treated with the vehicle. While no differences were observed in the expression of FSHR and TGFB3, testicular TGFBR1 expression was found to be lower in T-males (P = 0.03) compared to C-males. Expression level of AMH, TGFB1, and AR also tended to be lower in T-males. These findings provide evidence that impact of fetal exposure to T excess is evident early in postnatal life, mainly characterized by an increase in Sertoli cell number. This could explain the testicular dysfunction observed in adult rams.


Assuntos
Efeitos Tardios da Exposição Pré-Natal , Células de Sertoli/efeitos dos fármacos , Testículo/efeitos dos fármacos , Testosterona/farmacologia , Animais , Contagem de Células , Feminino , Desenvolvimento Fetal/efeitos dos fármacos , Hormônio Foliculoestimulante/sangue , Hormônio Luteinizante/sangue , Masculino , Gravidez , Receptores Androgênicos/genética , Receptores Androgênicos/metabolismo , Receptores do FSH/genética , Receptores do FSH/metabolismo , Células de Sertoli/citologia , Células de Sertoli/metabolismo , Ovinos , Espermatogênese/efeitos dos fármacos , Testículo/citologia , Testículo/crescimento & desenvolvimento , Testosterona/sangue , Fator de Crescimento Transformador beta3/genética , Fator de Crescimento Transformador beta3/metabolismo
8.
Am J Physiol Endocrinol Metab ; 299(6): E998-E1005, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20858754

RESUMO

Exposure to excess testosterone (T) during fetal life has a profound impact on the metabolic and reproductive functions in the female's postnatal life. However, less is known about the effects of excess testosterone in males. The aim of the present study was to evaluate the impact (consequences) of an excess of T during fetal development on mature male testis. The testicular evaluation was by histological analysis and by determination of mRNA expression of the FSH receptor (FSH-R), transforming growth factor-ß type I receptor (TßR-I), and two members of the TGF-ß superfamily, transforming growth factor-ß3 (TGFß3) and anti-Müllerian hormone (AMH) in males born to mothers receiving an excess of T during pregnancy. At 42 wk of age, postpubertal males born to mothers treated with 30 mg of T propionate twice weekly from day 30 to 90, followed by 40 mg of T propionate from day 90 to 120 of pregnancy (T males), showed higher concentrations of FSH in response to a GnRH analog, a higher number of Sertoli cells/seminiferous tubule cross-section, and a lower number of germ cells/tubules (P < 0.05) than control males (C males) born to mothers treated with the vehicle. The mRNA expression of FSH-R and of TßR-I was higher in T males compared with C males (P < 0.05). Moreover, in T males, AMH expression level correlated negatively with the expression level of TGFß3. In C males, this latter correlation was not observed. These results suggest that prenatal exposure to an excess of T can negatively modify some histological and molecular characteristics of the mature testis.


Assuntos
Células Germinativas/metabolismo , Efeitos Tardios da Exposição Pré-Natal , Receptores do FSH/metabolismo , Células de Sertoli/metabolismo , Testículo/metabolismo , Testosterona/metabolismo , Análise de Variância , Animais , Contagem de Células , Feminino , Hormônio Foliculoestimulante/sangue , Células Germinativas/citologia , Células Germinativas/efeitos dos fármacos , Leuprolida/farmacologia , Masculino , Troca Materno-Fetal , Gravidez , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Radioimunoensaio , Receptores do FSH/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Células de Sertoli/citologia , Células de Sertoli/efeitos dos fármacos , Ovinos , Testículo/efeitos dos fármacos , Testosterona/farmacologia
9.
Endocrinology ; 149(12): 6444-8, 2008 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-18669598

RESUMO

The reproductive system is extremely susceptible to insults from exposure to exogenous steroids during development. Excess prenatal testosterone exposure programs neuroendocrine, ovarian, and metabolic deficits in the female, features seen in women with polycystic ovary disease. The objective of this study was to determine whether prenatal testosterone excess also disrupts the male reproductive system, using sheep as a model system. The extent of reproductive disruption was tested by assessing sperm quantity and quality as well as Leydig cell responsiveness to human chorionic gonadotropin. Males born to mothers treated with 30 mg testosterone propionate twice weekly from d 30 to 90 and with 40 mg testosterone propionate from d 90 to 120 of pregnancy (T-males) showed a significant reduction (P < 0.05) in body weight, scrotal circumference, and sperm count compared with control males. Mean straight line velocity of sperms was also lower in T-males (P < 0.05). Circulating testosterone levels in response to the human chorionic gonadotropin did not differ between groups. These findings demonstrate that exposure to excess testosterone during fetal development has a negative impact on reproductive health of the male offspring, raising concerns relative to unintended human exposure to steroidal mimics in the environment.


Assuntos
Efeitos Tardios da Exposição Pré-Natal/fisiopatologia , Contagem de Espermatozoides , Motilidade dos Espermatozoides/efeitos dos fármacos , Testosterona/toxicidade , Animais , Peso Corporal/efeitos dos fármacos , Gonadotropina Coriônica/farmacologia , Feminino , Humanos , Células Intersticiais do Testículo/citologia , Células Intersticiais do Testículo/efeitos dos fármacos , Masculino , Gravidez , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Maturidade Sexual/efeitos dos fármacos , Maturidade Sexual/fisiologia , Ovinos , Propionato de Testosterona/toxicidade
10.
Biol Res ; 38(2-3): 235-44, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-16238102

RESUMO

Similar to women with Polycystic Ovary Syndrome (PCOS), female sheep treated prenatally with testosterone (T-females) are hypergonadotropic, exhibit neuroendocrine defects, multifollicular ovarian morphology, hyperinsulinemia and cycle defects. Hypergonadotropism and multifollicular morphology may in part be due to developmentally regulated increase in pituitary responsiveness to GnRH and may culminate in increased ovarian estradiol production. In this study, we utilized a GnRH agonist, leuprolide, to determine the developmental impact of prenatal testosterone exposure on pituitary-gonadal function and to establish if prenatal exposure produces changes in the reproductive axis similar to those described for women with PCOS. Eight control and eight T-females were injected intravenously with 0.1 microg of leuprolide acetate per kilogram of body weight at 5, 10 and 20 weeks of age. Blood samples were collected by means of an indwelling jugular vein catheter at 0, 3, 6, 9, 12, 18, 24, 30, 36, 42 and 48 hours after leuprolide. Area under the curve (AUC) of LH response to leuprolide increased progressively between the three ages studied (P<0.05). AUC of LH in T-females was higher than in control females of the same age at 5 and 10 weeks of age (P < 0.05), but similar at 20 weeks of age. AUC of estradiol response was lower at 10 but higher at 20 weeks of age in T-females compared to controls of the same age (P < 0.05). Our findings suggest that prenatal T treatment alters the pituitary and ovarian responsiveness in a manner comparable to that observed in women with PCOS.


Assuntos
Fármacos para a Fertilidade Feminina/farmacologia , Hormônio Liberador de Gonadotropina/agonistas , Leuprolida/farmacologia , Ovário/efeitos dos fármacos , Hipófise/efeitos dos fármacos , Animais , Estradiol/sangue , Feminino , Hormônio Luteinizante/sangue , Ovário/metabolismo , Hipófise/metabolismo , Progesterona/sangue , Progestinas/administração & dosagem , Prostaglandinas/administração & dosagem , Ovinos , Testosterona , Fatores de Tempo , Virilismo/induzido quimicamente
11.
Biol Res ; 37(1): 11-28, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15174302

RESUMO

The circadian time-keeping system ensures predictive adaptation of individuals to the reproducible 24-h day/night alternations of our planet by generating the 24-h (circadian) rhythms found in hormone release and cardiovascular, biophysical and behavioral functions, and others. In mammals, the master clock resides in the suprachiasmatic nucleus (SCN) of the hypothalamus. The molecular events determining the functional oscillation of the SCN neurons with a period of 24-h involve recurrent expression of several clock proteins that interact in complex transcription/translation feedback loops. In mammals, a glutamatergic monosynaptic pathway originating from the retina regulaltes the clock gene expression pattern in the SCN neurons, synchronizing them to the light:dark cycle. The emerging concept is that neural/humoral output signals from the SCN impinge upon peripheral clocks located in other areas of the brain, heart, lung, gastrointestinal tract, liver, kidney, fibroblasts, and most of the cell phenotypes, resulting in overt circadian rhythms in integrated physiological functions. Here we review the impact of day/night alternation on integrated physiology; the molecular mechanisms and input/output signaling pathways involved in SCN circadian function; the current concept of peripheral clocks; and the potential role of melatonin as a circadian neuroendocrine transducer.


Assuntos
Ritmo Circadiano/fisiologia , Expressão Gênica/fisiologia , Melatonina/fisiologia , Núcleo Supraquiasmático/fisiologia , Animais , Relógios Biológicos/fisiologia , Ritmo Circadiano/genética
12.
Biol. Res ; 37(1): 11-28, 2004. ilus, graf
Artigo em Inglês | LILACS | ID: lil-365976

RESUMO

The circadian time-keeping system ensures predictive adaptation of individuals to the reproducible 24-h day/night alternations of our planet by generating the 24-h (circadian) rhythms found in hormone release and cardiovascular, biophysical and behavioral functions, and others. In mammals, the master clock resides in the suprachiasmatic nucleus (SCN) of the hypothalamus. The molecular events determining the functional oscillation of the SCN neurons with a period of 24-h involve recurrent expression of several clock proteins that interact in complex transcription/translation feedback loops. In mammals, a glutamatergic monosynaptic pathway originating from the retina regulaltes the clock gene expression pattern in the SCN neurons, synchronizing them to the light:dark cycle. The emerging concept is that neural/humoral output signals from the SCN impinge upon peripheral clocks located in other areas of the brain, heart, lung, gastrointestinal tract, liver, kidney, fibroblasts, and most of the cell phenotypes, resulting in overt circadian rhythms in integrated physiological functions. Here we review the impact of day/night alternation on integrated physiology; the molecular mechanisms and input/output signaling pathways involved in SCN circadian function; the current concept of peripheral clocks; and the potential role of melatonin as a circadian neuroendocrine transducer.


Assuntos
Animais , Ritmo Circadiano , Expressão Gênica , Melatonina , Núcleo Supraquiasmático , Ritmo Circadiano
15.
s.l; s.n; 1939. 7 p.
Não convencional em Espanhol | Sec. Est. Saúde SP, HANSEN, Hanseníase, SESSP-ILSLACERVO, Sec. Est. Saúde SP | ID: biblio-1234424

Assuntos
Hanseníase
16.
Buenos Aires; s.n; 1937. 26 p. tab, map.
Não convencional em Espanhol | Sec. Est. Saúde SP, HANSEN, Hanseníase, SESSP-ILSLACERVO, Sec. Est. Saúde SP | ID: biblio-1239393
18.
19.
Rosario; s.n; 1935. 19 p. map.
Não convencional em Espanhol | Sec. Est. Saúde SP, HANSEN, Hanseníase, SESSP-ILSLACERVO, Sec. Est. Saúde SP | ID: biblio-1239430
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