Efeitos da eletroestimulação transcutânea do nervo tibial e região parassacral em mulheres com urgência miccional: estudo randomizado e controlado
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Repositório Institucional da UFSCAR |
Texto Completo: | https://repositorio.ufscar.br/handle/ufscar/13898 |
Resumo: | Introduction: Urgency is a strong urge to urinate, which is difficult to postpone and control. Urgency urinary incontinence is the involuntary loss of urine associated with urgency and the overactive bladder is characterized by urgency with or without urinary loss. These are common clinical conditions in women. One of the physiotherapeutic resources that can be used to treat urgency is electrostimulation, such as electrostimulation of the tibial nerve and parasacral electrostimulation. Objective: To investigate the effect of treatment with transcutaneous electrostimulation of the Tibial Nerve or transcutaneous parasacral electrostimulation on urgency. Methods: 99 women, over the age of 18, with a score ≥8 on the Overactive Bladder –Validated 8 - Question Awareness Tool [OAB-V8]), participated in the study, randomized (1:1:1) using a simple draw in 3 groups: 33 in the placebo group, 33 in the tibial group and 33 in the parasacral group. In the tibial and parasacral groups, a frequency of 10Hz was applied and the pulse duration was 200μs. In the placebo group (electrostimulation in the scapular region), a frequency of 100Hz was applied and pulse duration was 100μs. The intensity varied according to the sensitivity of the participant for all groups. Outcome measures: The outcomes were assessed by the International Consultation on Incontinence Questionnaire - Overactive Bladder (ICIQ-OAB), which assesses overactive bladder and investigates irritative urinary symptoms such as daytime frequency, nocturia, urgency and urgent urinary incontinence; Overactive Bladder –Validated 8 - Question Awareness Tool (OAB-V8), which investigates overactive bladder and measures the degree of discomfort, based on the self-perception of the participant; King Health Questionnaire (KHQ), which investigates quality of life in relation to urinary incontinence; and 24-hour Voiding Diary (VD-24h), which investigates voiding habits. The evaluations occurred in four moments: pre-treatment, after the 6th session, after the 12th session (post-treatment) and follow-up (30 days after the end of the treatment). Statistical analysis: Two-way ANOVA for repeated measures was applied to verify the effect of groups, evaluations, and interactions, in the total scores of the ICIQ-OAB, OAB-V8, in the KHQ domains and in the VD-24h variables. In the case of normality of the residues of the ANOVA model, the parametric approach with post-hoc was used by the Bonferroni test. Otherwise, the post-hoc non-parametric approach was used by the Anova-Type Statistic test with Bonferroni correction. The normality of the residues was assessed by the Shapiro-Wilk test. A significance level of 5% was considered. Results: The parassacral and tibial groups, in the post-treatment, presented fewer episodes of urgency than the placebo group (evaluated by the VD-24h). In the follow-up, the parassacral group presented a superior result than the placebo group in the ICIQ-OAB. In the post-treatment, the parassacral group obtained significantly greater results than the placebo group in the domains of incontinence impact and task limitations of the KHQ. Conclusion: In the present study, the number of urgency episodes evaluated by the VD-24h after treatment, showed that the parassacral and tibial groups had better results than the placebo group. Parasacral electrostimulation was more effective in reducing urgency compared to placebo, which is observed by the significant decrease in the total ICIQ-OAB score, at follow-up. |
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Padilha, Juliana FalcãoDriusso, Patriciahttp://lattes.cnpq.br/8898319491890063Vera, Mariana Arias Avilahttp://lattes.cnpq.br/5905617922199364http://lattes.cnpq.br/84939336749924204769fbbb-5f6c-4fde-b221-a71f250c90f62021-03-01T11:34:52Z2021-03-01T11:34:52Z2021-02-10PADILHA, Juliana Falcão. Efeitos da eletroestimulação transcutânea do nervo tibial e região parassacral em mulheres com urgência miccional: estudo randomizado e controlado. 2021. Tese (Doutorado em Fisioterapia) – Universidade Federal de São Carlos, São Carlos, 2021. Disponível em: https://repositorio.ufscar.br/handle/ufscar/13898.https://repositorio.ufscar.br/handle/ufscar/13898Introduction: Urgency is a strong urge to urinate, which is difficult to postpone and control. Urgency urinary incontinence is the involuntary loss of urine associated with urgency and the overactive bladder is characterized by urgency with or without urinary loss. These are common clinical conditions in women. One of the physiotherapeutic resources that can be used to treat urgency is electrostimulation, such as electrostimulation of the tibial nerve and parasacral electrostimulation. Objective: To investigate the effect of treatment with transcutaneous electrostimulation of the Tibial Nerve or transcutaneous parasacral electrostimulation on urgency. Methods: 99 women, over the age of 18, with a score ≥8 on the Overactive Bladder –Validated 8 - Question Awareness Tool [OAB-V8]), participated in the study, randomized (1:1:1) using a simple draw in 3 groups: 33 in the placebo group, 33 in the tibial group and 33 in the parasacral group. In the tibial and parasacral groups, a frequency of 10Hz was applied and the pulse duration was 200μs. In the placebo group (electrostimulation in the scapular region), a frequency of 100Hz was applied and pulse duration was 100μs. The intensity varied according to the sensitivity of the participant for all groups. Outcome measures: The outcomes were assessed by the International Consultation on Incontinence Questionnaire - Overactive Bladder (ICIQ-OAB), which assesses overactive bladder and investigates irritative urinary symptoms such as daytime frequency, nocturia, urgency and urgent urinary incontinence; Overactive Bladder –Validated 8 - Question Awareness Tool (OAB-V8), which investigates overactive bladder and measures the degree of discomfort, based on the self-perception of the participant; King Health Questionnaire (KHQ), which investigates quality of life in relation to urinary incontinence; and 24-hour Voiding Diary (VD-24h), which investigates voiding habits. The evaluations occurred in four moments: pre-treatment, after the 6th session, after the 12th session (post-treatment) and follow-up (30 days after the end of the treatment). Statistical analysis: Two-way ANOVA for repeated measures was applied to verify the effect of groups, evaluations, and interactions, in the total scores of the ICIQ-OAB, OAB-V8, in the KHQ domains and in the VD-24h variables. In the case of normality of the residues of the ANOVA model, the parametric approach with post-hoc was used by the Bonferroni test. Otherwise, the post-hoc non-parametric approach was used by the Anova-Type Statistic test with Bonferroni correction. The normality of the residues was assessed by the Shapiro-Wilk test. A significance level of 5% was considered. Results: The parassacral and tibial groups, in the post-treatment, presented fewer episodes of urgency than the placebo group (evaluated by the VD-24h). In the follow-up, the parassacral group presented a superior result than the placebo group in the ICIQ-OAB. In the post-treatment, the parassacral group obtained significantly greater results than the placebo group in the domains of incontinence impact and task limitations of the KHQ. Conclusion: In the present study, the number of urgency episodes evaluated by the VD-24h after treatment, showed that the parassacral and tibial groups had better results than the placebo group. Parasacral electrostimulation was more effective in reducing urgency compared to placebo, which is observed by the significant decrease in the total ICIQ-OAB score, at follow-up.Introdução: A urgência miccional é uma vontade muito forte de urinar difícil de adiar e controlar. A incontinência urinária de urgência é a perda involuntária de urina associada a urgência miccional e a Síndrome da Bexiga Hiperativa é caracterizada pela urgência miccional com ou sem perda urinária. São condições clínicas frequentes em mulheres. Um dos recursos fisioterapêuticos que pode ser utilizado no tratamento da urgência miccional é a Eletroestimulação, como a Eletroestimulação do Nervo Tibial e Eletroestimulação Parassacral. Objetivo: Investigar o efeito do tratamento com a eletroestimulação transcutânea do Nervo Tibial ou eletroestimulação transcutânea Parassacral sobre a urgência miccional. Métodos: Participaram do estudo 99 mulheres, com idade superior à 18 anos com escore ≥8 no Overactive Bladder –Validated 8 – Question Awareness Tool [OAB-V8]), randomizadas (1:1:1) por meio de sorteio simples em 3 grupos, sendo 33 no grupo placebo; 33 grupo tibial; 33 grupo parassacral. O protocolo para a eletroestimulação transcutânea utilizou-se, corrente bifásica pulsada assimétrica de tensão constante, 12 sessões, duas vezes por semana, por 20 minutos. Nos grupos Tibial e Parassacral aplicou-se frequência de 10Hz, duração do pulso 200μs e no grupo Placebo (eletroestimulação na região da escápula) frequência de 100Hz e duração de pulso 100μs. A intensidade variou conforme a sensibilidade da participante, para todos os grupos. Medidas de resultado: Os desfechos foram avaliados pelo International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ-OAB) (avalia a síndrome da bexiga hiperativa e investiga os sintomas miccionais irritativos: frequência diurna, noctúria, urgência e incontinência urinária de urgência), Overactive Bladder –Validated 8 – Question Awareness Tool (OAB-V8) (investiga a síndrome da bexiga hiperativa e mede o grau de desconforto, a partir da autopercepção da participante), King Health Questionnaire (KHQ) (investiga a qualidade de vida em relação a incontinência urinária) e Diário Miccional de 24h (DM-24h) (investiga hábitos miccionais). As avaliações ocorreram em quatro momentos: Pré-tratamento, após a 6ª, após a 12ª sessão (pós-tratamento) e follow-up (30 dias do término do tratamento). Análise estatística: A ANOVA two-way para medidas repetidas foi aplicada para verificar o efeito de grupos, das avaliações e das interações, nos escores totais do ICIQ-OAB, do OAB-V8, nos domínios do KHQ e nas variáveis do DM-24h. No caso de normalidade dos resíduos do modelo da ANOVA, foi utilizada a abordagem paramétrica com post-hoc pelo teste de Bonferroni. Caso contrário, foi utilizada a abordagem não paramétrica com post-hoc pelo teste Anova-Type Statistic com correção de Bonferroni. A normalidade dos resíduos foi avaliada pelo teste de Shapiro-Wilk. Foi considerado um nível de significância de 5%. Resultados: Os grupos Parassacral e Tibial, no pós-tratamento, apresentaram menos episódios de UM do que o grupo Placebo (avaliado pelo DM-24h). O grupo Parassacral, no follow-up, apresentou melhor resultado que o grupo Placebo no ICIQ-OAB. O grupo Parassacral obteve resultados significativamente melhores do que o grupo Placebo nos domínios Impacto da Incontinência e Limitações de tarefas do KHQ, no pós-tratamento. Conclusão: No presente estudo o número de episódios de UM avaliado pelo DM-24h apontou que os grupos Parassacral e Tibial tiveram melhores resultados do que o grupo Placebo, no pós-tratamento. A eletroestimulação Parassacral foi mais efetiva na redução da UM em comparação ao Placebo, observado pela maior diminuição no escore total do ICIQ-OAB, no follow-up.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)CAPES: código de financiamento - 001porUniversidade Federal de São CarlosCâmpus São CarlosPrograma de Pós-Graduação em Fisioterapia - PPGFtUFSCarAttribution-NonCommercial-NoDerivs 3.0 Brazilhttp://creativecommons.org/licenses/by-nc-nd/3.0/br/info:eu-repo/semantics/openAccessUrgência miccionalIncontinência urinária de urgênciaNervo tibialParassacralSíndrome da bexiga hiperativaEletroestimulação transcutâneaMulherUrgencyUrgency urinary incontinenceOveractive bladderTibial nerveParasacralTranscutaneous electrostimulationWomanCIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONALEfeitos da eletroestimulação transcutânea do nervo tibial e região parassacral em mulheres com urgência miccional: estudo randomizado e controladoEffects of transcutaneous electrical stimulation of the tibial nerve and parasacral region in women with urgency: a randomized controlled study.info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesis600600315f7999-bd83-4042-976d-798fcc179685reponame:Repositório Institucional da UFSCARinstname:Universidade Federal de São Carlos (UFSCAR)instacron:UFSCARORIGINALTese_Juliana Falcão Padilha_VERSÃO FINAL.pdfTese_Juliana Falcão Padilha_VERSÃO FINAL.pdfVersão final da Teseapplication/pdf3679637https://repositorio.ufscar.br/bitstream/ufscar/13898/3/Tese_Juliana%20Falc%c3%a3o%20Padilha_VERS%c3%83O%20FINAL.pdf1fa599c7ea2ee2490840220bace3e721MD53Carta-comprovante-da-versão-final-de-teses-e-dissertações (1).pdfCarta-comprovante-da-versão-final-de-teses-e-dissertações (1).pdfCarta comprovante assinada pelo orientadorapplication/pdf73025https://repositorio.ufscar.br/bitstream/ufscar/13898/4/Carta-comprovante-da-vers%c3%a3o-final-de-teses-e-disserta%c3%a7%c3%b5es%20%281%29.pdf8edc155dbc19b55c9d145fc0aec538dcMD54CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8811https://repositorio.ufscar.br/bitstream/ufscar/13898/5/license_rdfe39d27027a6cc9cb039ad269a5db8e34MD55TEXTTese_Juliana Falcão Padilha_VERSÃO FINAL.pdf.txtTese_Juliana Falcão Padilha_VERSÃO FINAL.pdf.txtExtracted texttext/plain138864https://repositorio.ufscar.br/bitstream/ufscar/13898/6/Tese_Juliana%20Falc%c3%a3o%20Padilha_VERS%c3%83O%20FINAL.pdf.txt63ef470fd542a1ac36f77c7eeea29bcdMD56Carta-comprovante-da-versão-final-de-teses-e-dissertações (1).pdf.txtCarta-comprovante-da-versão-final-de-teses-e-dissertações (1).pdf.txtExtracted texttext/plain1407https://repositorio.ufscar.br/bitstream/ufscar/13898/8/Carta-comprovante-da-vers%c3%a3o-final-de-teses-e-disserta%c3%a7%c3%b5es%20%281%29.pdf.txt7f9f2fd811241e92f9d85fb6c2407319MD58THUMBNAILTese_Juliana Falcão Padilha_VERSÃO FINAL.pdf.jpgTese_Juliana Falcão Padilha_VERSÃO FINAL.pdf.jpgIM Thumbnailimage/jpeg6232https://repositorio.ufscar.br/bitstream/ufscar/13898/7/Tese_Juliana%20Falc%c3%a3o%20Padilha_VERS%c3%83O%20FINAL.pdf.jpg22658e41c9ba6ef7887261ee42100142MD57Carta-comprovante-da-versão-final-de-teses-e-dissertações (1).pdf.jpgCarta-comprovante-da-versão-final-de-teses-e-dissertações (1).pdf.jpgIM Thumbnailimage/jpeg14723https://repositorio.ufscar.br/bitstream/ufscar/13898/9/Carta-comprovante-da-vers%c3%a3o-final-de-teses-e-disserta%c3%a7%c3%b5es%20%281%29.pdf.jpg36b38add6b1732aff017881252403828MD59ufscar/138982023-09-18 18:32:07.019oai:repositorio.ufscar.br:ufscar/13898Repositório InstitucionalPUBhttps://repositorio.ufscar.br/oai/requestopendoar:43222023-09-18T18:32:07Repositório Institucional da UFSCAR - Universidade Federal de São Carlos (UFSCAR)false |
dc.title.por.fl_str_mv |
Efeitos da eletroestimulação transcutânea do nervo tibial e região parassacral em mulheres com urgência miccional: estudo randomizado e controlado |
dc.title.alternative.eng.fl_str_mv |
Effects of transcutaneous electrical stimulation of the tibial nerve and parasacral region in women with urgency: a randomized controlled study. |
title |
Efeitos da eletroestimulação transcutânea do nervo tibial e região parassacral em mulheres com urgência miccional: estudo randomizado e controlado |
spellingShingle |
Efeitos da eletroestimulação transcutânea do nervo tibial e região parassacral em mulheres com urgência miccional: estudo randomizado e controlado Padilha, Juliana Falcão Urgência miccional Incontinência urinária de urgência Nervo tibial Parassacral Síndrome da bexiga hiperativa Eletroestimulação transcutânea Mulher Urgency Urgency urinary incontinence Overactive bladder Tibial nerve Parasacral Transcutaneous electrostimulation Woman CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL |
title_short |
Efeitos da eletroestimulação transcutânea do nervo tibial e região parassacral em mulheres com urgência miccional: estudo randomizado e controlado |
title_full |
Efeitos da eletroestimulação transcutânea do nervo tibial e região parassacral em mulheres com urgência miccional: estudo randomizado e controlado |
title_fullStr |
Efeitos da eletroestimulação transcutânea do nervo tibial e região parassacral em mulheres com urgência miccional: estudo randomizado e controlado |
title_full_unstemmed |
Efeitos da eletroestimulação transcutânea do nervo tibial e região parassacral em mulheres com urgência miccional: estudo randomizado e controlado |
title_sort |
Efeitos da eletroestimulação transcutânea do nervo tibial e região parassacral em mulheres com urgência miccional: estudo randomizado e controlado |
author |
Padilha, Juliana Falcão |
author_facet |
Padilha, Juliana Falcão |
author_role |
author |
dc.contributor.authorlattes.por.fl_str_mv |
http://lattes.cnpq.br/8493933674992420 |
dc.contributor.author.fl_str_mv |
Padilha, Juliana Falcão |
dc.contributor.advisor1.fl_str_mv |
Driusso, Patricia |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/8898319491890063 |
dc.contributor.advisor-co1.fl_str_mv |
Vera, Mariana Arias Avila |
dc.contributor.advisor-co1Lattes.fl_str_mv |
http://lattes.cnpq.br/5905617922199364 |
dc.contributor.authorID.fl_str_mv |
4769fbbb-5f6c-4fde-b221-a71f250c90f6 |
contributor_str_mv |
Driusso, Patricia Vera, Mariana Arias Avila |
dc.subject.por.fl_str_mv |
Urgência miccional Incontinência urinária de urgência Nervo tibial Parassacral Síndrome da bexiga hiperativa Eletroestimulação transcutânea Mulher |
topic |
Urgência miccional Incontinência urinária de urgência Nervo tibial Parassacral Síndrome da bexiga hiperativa Eletroestimulação transcutânea Mulher Urgency Urgency urinary incontinence Overactive bladder Tibial nerve Parasacral Transcutaneous electrostimulation Woman CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL |
dc.subject.eng.fl_str_mv |
Urgency Urgency urinary incontinence Overactive bladder Tibial nerve Parasacral Transcutaneous electrostimulation Woman |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL |
description |
Introduction: Urgency is a strong urge to urinate, which is difficult to postpone and control. Urgency urinary incontinence is the involuntary loss of urine associated with urgency and the overactive bladder is characterized by urgency with or without urinary loss. These are common clinical conditions in women. One of the physiotherapeutic resources that can be used to treat urgency is electrostimulation, such as electrostimulation of the tibial nerve and parasacral electrostimulation. Objective: To investigate the effect of treatment with transcutaneous electrostimulation of the Tibial Nerve or transcutaneous parasacral electrostimulation on urgency. Methods: 99 women, over the age of 18, with a score ≥8 on the Overactive Bladder –Validated 8 - Question Awareness Tool [OAB-V8]), participated in the study, randomized (1:1:1) using a simple draw in 3 groups: 33 in the placebo group, 33 in the tibial group and 33 in the parasacral group. In the tibial and parasacral groups, a frequency of 10Hz was applied and the pulse duration was 200μs. In the placebo group (electrostimulation in the scapular region), a frequency of 100Hz was applied and pulse duration was 100μs. The intensity varied according to the sensitivity of the participant for all groups. Outcome measures: The outcomes were assessed by the International Consultation on Incontinence Questionnaire - Overactive Bladder (ICIQ-OAB), which assesses overactive bladder and investigates irritative urinary symptoms such as daytime frequency, nocturia, urgency and urgent urinary incontinence; Overactive Bladder –Validated 8 - Question Awareness Tool (OAB-V8), which investigates overactive bladder and measures the degree of discomfort, based on the self-perception of the participant; King Health Questionnaire (KHQ), which investigates quality of life in relation to urinary incontinence; and 24-hour Voiding Diary (VD-24h), which investigates voiding habits. The evaluations occurred in four moments: pre-treatment, after the 6th session, after the 12th session (post-treatment) and follow-up (30 days after the end of the treatment). Statistical analysis: Two-way ANOVA for repeated measures was applied to verify the effect of groups, evaluations, and interactions, in the total scores of the ICIQ-OAB, OAB-V8, in the KHQ domains and in the VD-24h variables. In the case of normality of the residues of the ANOVA model, the parametric approach with post-hoc was used by the Bonferroni test. Otherwise, the post-hoc non-parametric approach was used by the Anova-Type Statistic test with Bonferroni correction. The normality of the residues was assessed by the Shapiro-Wilk test. A significance level of 5% was considered. Results: The parassacral and tibial groups, in the post-treatment, presented fewer episodes of urgency than the placebo group (evaluated by the VD-24h). In the follow-up, the parassacral group presented a superior result than the placebo group in the ICIQ-OAB. In the post-treatment, the parassacral group obtained significantly greater results than the placebo group in the domains of incontinence impact and task limitations of the KHQ. Conclusion: In the present study, the number of urgency episodes evaluated by the VD-24h after treatment, showed that the parassacral and tibial groups had better results than the placebo group. Parasacral electrostimulation was more effective in reducing urgency compared to placebo, which is observed by the significant decrease in the total ICIQ-OAB score, at follow-up. |
publishDate |
2021 |
dc.date.accessioned.fl_str_mv |
2021-03-01T11:34:52Z |
dc.date.available.fl_str_mv |
2021-03-01T11:34:52Z |
dc.date.issued.fl_str_mv |
2021-02-10 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
format |
doctoralThesis |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
PADILHA, Juliana Falcão. Efeitos da eletroestimulação transcutânea do nervo tibial e região parassacral em mulheres com urgência miccional: estudo randomizado e controlado. 2021. Tese (Doutorado em Fisioterapia) – Universidade Federal de São Carlos, São Carlos, 2021. Disponível em: https://repositorio.ufscar.br/handle/ufscar/13898. |
dc.identifier.uri.fl_str_mv |
https://repositorio.ufscar.br/handle/ufscar/13898 |
identifier_str_mv |
PADILHA, Juliana Falcão. Efeitos da eletroestimulação transcutânea do nervo tibial e região parassacral em mulheres com urgência miccional: estudo randomizado e controlado. 2021. Tese (Doutorado em Fisioterapia) – Universidade Federal de São Carlos, São Carlos, 2021. Disponível em: https://repositorio.ufscar.br/handle/ufscar/13898. |
url |
https://repositorio.ufscar.br/handle/ufscar/13898 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.confidence.fl_str_mv |
600 600 |
dc.relation.authority.fl_str_mv |
315f7999-bd83-4042-976d-798fcc179685 |
dc.rights.driver.fl_str_mv |
Attribution-NonCommercial-NoDerivs 3.0 Brazil http://creativecommons.org/licenses/by-nc-nd/3.0/br/ info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Attribution-NonCommercial-NoDerivs 3.0 Brazil http://creativecommons.org/licenses/by-nc-nd/3.0/br/ |
eu_rights_str_mv |
openAccess |
dc.publisher.none.fl_str_mv |
Universidade Federal de São Carlos Câmpus São Carlos |
dc.publisher.program.fl_str_mv |
Programa de Pós-Graduação em Fisioterapia - PPGFt |
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UFSCar |
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Universidade Federal de São Carlos Câmpus São Carlos |
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UFSCAR |
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UFSCAR |
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