Molecular detection of bacteria in dentinal carious lesions and in biofilm of children with different stages of early childhood caries
Autor(a) principal: | |
---|---|
Data de Publicação: | 2014 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da UFC |
Texto Completo: | http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=14164 |
Resumo: | Early childhood caries (ECC) is considered a serious public health issue among children all over the world. However, many aspects should be explored about the oral microbiota related to the ECC progression and how the bacterial community modifies according to the dentine lesion activity. This thesis, composed by two chapters, aimed to investigate and quantify with quantitative polymerase chain reaction (qPCR) the following bacteria Actinomyces naeslundii, Bifidobacterium spp., Lactobacillus acidophilus, Streptococcus gordonii, Streptococcus mutans, as well as members of the groups Lactobacillus casei and Mitis on biofilm from pre-school children with different stages of early childhood caries progression (Chapter 1) and on active and inactive dentine carious lesions (Chapter 2), and also to verify the association of these microorganisms on the process of health or disease. The sample consisted on preschool children aged between 2 and 5 years from nurseries and public preeschools in Fortaleza-CE. The children were examined for caries diagnosis with ICDAS II index (International Caries Detection Assessment System), and the Nyvad criteria, in order to evaluate prevalence and caries activity. The supragingival biofilm collection was taken from 75 children, who were divided in three groups according to the ICDAS II: CF (caries free) (n=20), ECL (presence of enamel caries lesion) (n=17) and DCL (presence of dentine caries lesion) (n=38). Samples of carious dentine were collected under rubber dam isolation of 56 lesions of dentine affected by caries, being 17 inactive and 39 active. The DNA of all the collected samples was extracted and purified, then tested for the presence of the formerly mentioned bacterial species/groups through qPCR. The quantity of bacteria was compared through the Kruskal-Wallis and Mann-Whitney tests. Besides, the association between the presence of bacteria and ECC was analyzed through the Chi-square test, with a 5% significance level and the multiple logistic regression was applied. Bacteria from the group L. casei and L. acidophilus presented low detection on biofilm of all evaluated groups. The presence of S. mutans and Bifidobacterium spp. showed a strong association with dental caries progression on the biofilm from children with dentine lesions with odds ratio of 21,5 and 5,9; respectively. On active dentine lesions, concentrations of Bifidobacterium spp. and species from the Lactobacillus casei group were significantly higher when compared to the inactive lesions (p<0.05). The levels of Actinomyces naeslundii, Streptococcus gordonni and species from Mitis group were not significantly different among biofilm groups as well as comparing dentine lesions. In conclusion, the microbial profile from biofilm samples presented differences on the proportion of acidogenic and aciduric bacteria with dental caries progression. The presence of Bifidobacterium spp. and S. mutans presented a strong association with the development of the more advanced stages of ECC. Regarding the activity of dentine lesions, higher detection levels of the group L. casei and Bifidobacterium spp. showed an important role of these bacteria in the dentine caries activity. |
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info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisMolecular detection of bacteria in dentinal carious lesions and in biofilm of children with different stages of early childhood cariesIdentificaÃÃo molecular de bactÃrias em lesÃes cariosas dentinÃrias e em biofilme de crianÃas com diferentes estÃgios da cÃrie precoce da infÃncia2014-11-25Lidiany Karla Azevedo Rodrigues48424927320http://buscatextual.cnpq.br/buscatextual/visualizacv.jsp?id=K4778609U1Maria Izabel Florindo Guedes47501723753http://lattes.cnpq.br/5282771143306034Nadia Accioly Pinto Nogueira19127057372http://lattes.cnpq.br/9261322165669741Francisco Cesar Barroso Barbosa22976443204http://lattes.cnpq.br/3251670003132829 Paula Borges Jacques44055862334http://lattes.cnpq.br/9089358539004793 81752016300http://lattes.cnpq.br/0258475042187470Beatriz GonÃalves NevesUniversidade Federal do CearÃPrograma de PÃs-GraduaÃÃo em OdontologiaUFCBRActinomyces Bacteria Bifidobacterium Child Dental caries Dental plaque Dentine Lactobacillus Primary teeth Real-time polymerase chain reaction StreptococcusODONTOLOGIAEarly childhood caries (ECC) is considered a serious public health issue among children all over the world. However, many aspects should be explored about the oral microbiota related to the ECC progression and how the bacterial community modifies according to the dentine lesion activity. This thesis, composed by two chapters, aimed to investigate and quantify with quantitative polymerase chain reaction (qPCR) the following bacteria Actinomyces naeslundii, Bifidobacterium spp., Lactobacillus acidophilus, Streptococcus gordonii, Streptococcus mutans, as well as members of the groups Lactobacillus casei and Mitis on biofilm from pre-school children with different stages of early childhood caries progression (Chapter 1) and on active and inactive dentine carious lesions (Chapter 2), and also to verify the association of these microorganisms on the process of health or disease. The sample consisted on preschool children aged between 2 and 5 years from nurseries and public preeschools in Fortaleza-CE. The children were examined for caries diagnosis with ICDAS II index (International Caries Detection Assessment System), and the Nyvad criteria, in order to evaluate prevalence and caries activity. The supragingival biofilm collection was taken from 75 children, who were divided in three groups according to the ICDAS II: CF (caries free) (n=20), ECL (presence of enamel caries lesion) (n=17) and DCL (presence of dentine caries lesion) (n=38). Samples of carious dentine were collected under rubber dam isolation of 56 lesions of dentine affected by caries, being 17 inactive and 39 active. The DNA of all the collected samples was extracted and purified, then tested for the presence of the formerly mentioned bacterial species/groups through qPCR. The quantity of bacteria was compared through the Kruskal-Wallis and Mann-Whitney tests. Besides, the association between the presence of bacteria and ECC was analyzed through the Chi-square test, with a 5% significance level and the multiple logistic regression was applied. Bacteria from the group L. casei and L. acidophilus presented low detection on biofilm of all evaluated groups. The presence of S. mutans and Bifidobacterium spp. showed a strong association with dental caries progression on the biofilm from children with dentine lesions with odds ratio of 21,5 and 5,9; respectively. On active dentine lesions, concentrations of Bifidobacterium spp. and species from the Lactobacillus casei group were significantly higher when compared to the inactive lesions (p<0.05). The levels of Actinomyces naeslundii, Streptococcus gordonni and species from Mitis group were not significantly different among biofilm groups as well as comparing dentine lesions. In conclusion, the microbial profile from biofilm samples presented differences on the proportion of acidogenic and aciduric bacteria with dental caries progression. The presence of Bifidobacterium spp. and S. mutans presented a strong association with the development of the more advanced stages of ECC. Regarding the activity of dentine lesions, higher detection levels of the group L. casei and Bifidobacterium spp. showed an important role of these bacteria in the dentine caries activity. A cÃrie precoce da infÃncia (CPI) Ã considerada um grave problema de saÃde pÃblica em crianÃas prÃ-escolares em todo mundo. No entanto, muitos aspectos ainda devem ser explorados acerca da microbiota oral relacionada com a progressÃo da CPI e como a comunidade bacteriana se modifica de acordo com a atividade da lesÃo dentinÃria. Esta tese, constituÃda de dois capÃtulos, teve como objetivo identificar e quantificar atravÃs da tÃcnica de reaÃÃo em cadeia da polimerase quantitativa (qPCR) as bactÃrias Actinomyces naeslundii, Bifidobacterium spp., Lactobacillus acidophilus, Streptococcus gordonii, Streptococcus mutans, bem como espÃcies dos grupos Lactobacillus casei e Mitis em biofilme de crianÃas prÃ-escolares com diferentes estÃgios de progressÃo da cÃrie precoce da infÃncia (CapÃtulo 1) e em lesÃes cariosas dentinÃrias ativas e inativas (CapÃtulo 2) e ainda verificar a associaÃÃo destes microrganismos ao processo de saÃde ou de doenÃa. A amostra consistiu em prÃ-escolares com idade entre 2 e 5 anos de idade que frequentavam creches e escolas pÃblicas de Fortaleza-CE. As crianÃas foram examinadas com o uso de Ãndices visuais ICDAS II (International Caries Detection Assessment System) e Nyvad, a fim de avaliar a prevalÃncia e atividade de cÃrie. A coleta de biofilme supragengival foi realizada em 75 crianÃas, as quais foram agrupadas de acordo com Ãndice ICDAS II em trÃs grupos: CF (livres de cÃrie) (n=20), ECL (presenÃa de lesÃes de cÃrie em esmalte) (n=17) e DCL (presenÃa de lesÃes de cÃrie em dentina) (n=38). Amostras de dentina cariada foram coletadas sob isolamento absoluto de 56 lesÃes cariosas dentinÃrias, sendo 17 inativas e 39 ativas. O DNA de todas as amostras coletadas foi extraÃdo e purificado e, em seguida, testado para a presenÃa das espÃcies/grupos bacterianos acima citados atravÃs de qPCR. A quantidade das bactÃrias foi comparada pelos testes Kruskal-Wallis e Mann-Whitney. AlÃm disso, a associaÃÃo da presenÃa de bactÃrias e CPI foi analisada atravÃs do teste Qui-quadrado, com nÃvel de significÃncia de 5% e aplicado a regressÃo logÃstica mÃltipla. BactÃrias L. acidophilus e do grupo L. casei apresentaram baixa detecÃÃo no biofilme de todos os grupos avaliados. A presenÃa de S. mutans e Bifidobacterium spp. mostrou forte associaÃÃo com a progressÃo da doenÃa no biofilme de crianÃas com lesÃes dentinÃrias com âodds ratioâ de 21,5 e 5,9, respectivamente. Em lesÃes dentinÃrias ativas, concentraÃÃes de Bifidobacterium spp. e bactÃrias do grupo L. casei foram significativamente maiores quando comparadas Ãs lesÃes inativas (p<0.05). Os nÃveis de A. naeslundii, bactÃrias do grupo Mitis e S. gordonni nÃo apresentaram diferenÃa significativa entre os grupos de biofilme, assim como nas lesÃes dentinÃrias. Conclui-se que as amostras de biofilme apresentaram alteraÃÃo na proporÃÃo de bactÃrias acidogÃnicas e acidÃricas com a progressÃo da doenÃa cÃrie. A presenÃa de Bifidobacterium spp. e S. mutans apresentou forte associaÃÃo com os estÃgios mais avanÃados da CPI. Em relaÃÃo Ãs lesÃes dentinÃrias, o aumento da concentraÃÃo de bactÃrias Bifidobacterium spp. e do grupo L. casei evidenciou um papel importante destas bactÃrias na atividade de lesÃes dentinÃrias. Conselho Nacional de Desenvolvimento CientÃfico e TecnolÃgicohttp://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=14164application/pdfinfo:eu-repo/semantics/openAccessporreponame:Biblioteca Digital de Teses e Dissertações da UFCinstname:Universidade Federal do Cearáinstacron:UFC2019-01-21T11:27:21Zmail@mail.com - |
dc.title.en.fl_str_mv |
Molecular detection of bacteria in dentinal carious lesions and in biofilm of children with different stages of early childhood caries |
dc.title.alternative.pt.fl_str_mv |
IdentificaÃÃo molecular de bactÃrias em lesÃes cariosas dentinÃrias e em biofilme de crianÃas com diferentes estÃgios da cÃrie precoce da infÃncia |
title |
Molecular detection of bacteria in dentinal carious lesions and in biofilm of children with different stages of early childhood caries |
spellingShingle |
Molecular detection of bacteria in dentinal carious lesions and in biofilm of children with different stages of early childhood caries Beatriz GonÃalves Neves Actinomyces Bacteria Bifidobacterium Child Dental caries Dental plaque Dentine Lactobacillus Primary teeth Real-time polymerase chain reaction Streptococcus ODONTOLOGIA |
title_short |
Molecular detection of bacteria in dentinal carious lesions and in biofilm of children with different stages of early childhood caries |
title_full |
Molecular detection of bacteria in dentinal carious lesions and in biofilm of children with different stages of early childhood caries |
title_fullStr |
Molecular detection of bacteria in dentinal carious lesions and in biofilm of children with different stages of early childhood caries |
title_full_unstemmed |
Molecular detection of bacteria in dentinal carious lesions and in biofilm of children with different stages of early childhood caries |
title_sort |
Molecular detection of bacteria in dentinal carious lesions and in biofilm of children with different stages of early childhood caries |
author |
Beatriz GonÃalves Neves |
author_facet |
Beatriz GonÃalves Neves |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Lidiany Karla Azevedo Rodrigues |
dc.contributor.advisor1ID.fl_str_mv |
48424927320 |
dc.contributor.advisor1Lattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.jsp?id=K4778609U1 |
dc.contributor.referee1.fl_str_mv |
Maria Izabel Florindo Guedes |
dc.contributor.referee1ID.fl_str_mv |
47501723753 |
dc.contributor.referee1Lattes.fl_str_mv |
http://lattes.cnpq.br/5282771143306034 |
dc.contributor.referee2.fl_str_mv |
Nadia Accioly Pinto Nogueira |
dc.contributor.referee2ID.fl_str_mv |
19127057372 |
dc.contributor.referee2Lattes.fl_str_mv |
http://lattes.cnpq.br/9261322165669741 |
dc.contributor.referee3.fl_str_mv |
Francisco Cesar Barroso Barbosa |
dc.contributor.referee3ID.fl_str_mv |
22976443204 |
dc.contributor.referee3Lattes.fl_str_mv |
http://lattes.cnpq.br/3251670003132829 |
dc.contributor.referee4.fl_str_mv |
Paula Borges Jacques |
dc.contributor.referee4ID.fl_str_mv |
44055862334 |
dc.contributor.referee4Lattes.fl_str_mv |
http://lattes.cnpq.br/9089358539004793 |
dc.contributor.authorID.fl_str_mv |
81752016300 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/0258475042187470 |
dc.contributor.author.fl_str_mv |
Beatriz GonÃalves Neves |
contributor_str_mv |
Lidiany Karla Azevedo Rodrigues Maria Izabel Florindo Guedes Nadia Accioly Pinto Nogueira Francisco Cesar Barroso Barbosa Paula Borges Jacques |
dc.subject.eng.fl_str_mv |
Actinomyces Bacteria Bifidobacterium Child Dental caries Dental plaque Dentine Lactobacillus Primary teeth Real-time polymerase chain reaction Streptococcus |
topic |
Actinomyces Bacteria Bifidobacterium Child Dental caries Dental plaque Dentine Lactobacillus Primary teeth Real-time polymerase chain reaction Streptococcus ODONTOLOGIA |
dc.subject.cnpq.fl_str_mv |
ODONTOLOGIA |
dc.description.sponsorship.fl_txt_mv |
Conselho Nacional de Desenvolvimento CientÃfico e TecnolÃgico |
dc.description.abstract.por.fl_txt_mv |
Early childhood caries (ECC) is considered a serious public health issue among children all over the world. However, many aspects should be explored about the oral microbiota related to the ECC progression and how the bacterial community modifies according to the dentine lesion activity. This thesis, composed by two chapters, aimed to investigate and quantify with quantitative polymerase chain reaction (qPCR) the following bacteria Actinomyces naeslundii, Bifidobacterium spp., Lactobacillus acidophilus, Streptococcus gordonii, Streptococcus mutans, as well as members of the groups Lactobacillus casei and Mitis on biofilm from pre-school children with different stages of early childhood caries progression (Chapter 1) and on active and inactive dentine carious lesions (Chapter 2), and also to verify the association of these microorganisms on the process of health or disease. The sample consisted on preschool children aged between 2 and 5 years from nurseries and public preeschools in Fortaleza-CE. The children were examined for caries diagnosis with ICDAS II index (International Caries Detection Assessment System), and the Nyvad criteria, in order to evaluate prevalence and caries activity. The supragingival biofilm collection was taken from 75 children, who were divided in three groups according to the ICDAS II: CF (caries free) (n=20), ECL (presence of enamel caries lesion) (n=17) and DCL (presence of dentine caries lesion) (n=38). Samples of carious dentine were collected under rubber dam isolation of 56 lesions of dentine affected by caries, being 17 inactive and 39 active. The DNA of all the collected samples was extracted and purified, then tested for the presence of the formerly mentioned bacterial species/groups through qPCR. The quantity of bacteria was compared through the Kruskal-Wallis and Mann-Whitney tests. Besides, the association between the presence of bacteria and ECC was analyzed through the Chi-square test, with a 5% significance level and the multiple logistic regression was applied. Bacteria from the group L. casei and L. acidophilus presented low detection on biofilm of all evaluated groups. The presence of S. mutans and Bifidobacterium spp. showed a strong association with dental caries progression on the biofilm from children with dentine lesions with odds ratio of 21,5 and 5,9; respectively. On active dentine lesions, concentrations of Bifidobacterium spp. and species from the Lactobacillus casei group were significantly higher when compared to the inactive lesions (p<0.05). The levels of Actinomyces naeslundii, Streptococcus gordonni and species from Mitis group were not significantly different among biofilm groups as well as comparing dentine lesions. In conclusion, the microbial profile from biofilm samples presented differences on the proportion of acidogenic and aciduric bacteria with dental caries progression. The presence of Bifidobacterium spp. and S. mutans presented a strong association with the development of the more advanced stages of ECC. Regarding the activity of dentine lesions, higher detection levels of the group L. casei and Bifidobacterium spp. showed an important role of these bacteria in the dentine caries activity. A cÃrie precoce da infÃncia (CPI) Ã considerada um grave problema de saÃde pÃblica em crianÃas prÃ-escolares em todo mundo. No entanto, muitos aspectos ainda devem ser explorados acerca da microbiota oral relacionada com a progressÃo da CPI e como a comunidade bacteriana se modifica de acordo com a atividade da lesÃo dentinÃria. Esta tese, constituÃda de dois capÃtulos, teve como objetivo identificar e quantificar atravÃs da tÃcnica de reaÃÃo em cadeia da polimerase quantitativa (qPCR) as bactÃrias Actinomyces naeslundii, Bifidobacterium spp., Lactobacillus acidophilus, Streptococcus gordonii, Streptococcus mutans, bem como espÃcies dos grupos Lactobacillus casei e Mitis em biofilme de crianÃas prÃ-escolares com diferentes estÃgios de progressÃo da cÃrie precoce da infÃncia (CapÃtulo 1) e em lesÃes cariosas dentinÃrias ativas e inativas (CapÃtulo 2) e ainda verificar a associaÃÃo destes microrganismos ao processo de saÃde ou de doenÃa. A amostra consistiu em prÃ-escolares com idade entre 2 e 5 anos de idade que frequentavam creches e escolas pÃblicas de Fortaleza-CE. As crianÃas foram examinadas com o uso de Ãndices visuais ICDAS II (International Caries Detection Assessment System) e Nyvad, a fim de avaliar a prevalÃncia e atividade de cÃrie. A coleta de biofilme supragengival foi realizada em 75 crianÃas, as quais foram agrupadas de acordo com Ãndice ICDAS II em trÃs grupos: CF (livres de cÃrie) (n=20), ECL (presenÃa de lesÃes de cÃrie em esmalte) (n=17) e DCL (presenÃa de lesÃes de cÃrie em dentina) (n=38). Amostras de dentina cariada foram coletadas sob isolamento absoluto de 56 lesÃes cariosas dentinÃrias, sendo 17 inativas e 39 ativas. O DNA de todas as amostras coletadas foi extraÃdo e purificado e, em seguida, testado para a presenÃa das espÃcies/grupos bacterianos acima citados atravÃs de qPCR. A quantidade das bactÃrias foi comparada pelos testes Kruskal-Wallis e Mann-Whitney. AlÃm disso, a associaÃÃo da presenÃa de bactÃrias e CPI foi analisada atravÃs do teste Qui-quadrado, com nÃvel de significÃncia de 5% e aplicado a regressÃo logÃstica mÃltipla. BactÃrias L. acidophilus e do grupo L. casei apresentaram baixa detecÃÃo no biofilme de todos os grupos avaliados. A presenÃa de S. mutans e Bifidobacterium spp. mostrou forte associaÃÃo com a progressÃo da doenÃa no biofilme de crianÃas com lesÃes dentinÃrias com âodds ratioâ de 21,5 e 5,9, respectivamente. Em lesÃes dentinÃrias ativas, concentraÃÃes de Bifidobacterium spp. e bactÃrias do grupo L. casei foram significativamente maiores quando comparadas Ãs lesÃes inativas (p<0.05). Os nÃveis de A. naeslundii, bactÃrias do grupo Mitis e S. gordonni nÃo apresentaram diferenÃa significativa entre os grupos de biofilme, assim como nas lesÃes dentinÃrias. Conclui-se que as amostras de biofilme apresentaram alteraÃÃo na proporÃÃo de bactÃrias acidogÃnicas e acidÃricas com a progressÃo da doenÃa cÃrie. A presenÃa de Bifidobacterium spp. e S. mutans apresentou forte associaÃÃo com os estÃgios mais avanÃados da CPI. Em relaÃÃo Ãs lesÃes dentinÃrias, o aumento da concentraÃÃo de bactÃrias Bifidobacterium spp. e do grupo L. casei evidenciou um papel importante destas bactÃrias na atividade de lesÃes dentinÃrias. |
description |
Early childhood caries (ECC) is considered a serious public health issue among children all over the world. However, many aspects should be explored about the oral microbiota related to the ECC progression and how the bacterial community modifies according to the dentine lesion activity. This thesis, composed by two chapters, aimed to investigate and quantify with quantitative polymerase chain reaction (qPCR) the following bacteria Actinomyces naeslundii, Bifidobacterium spp., Lactobacillus acidophilus, Streptococcus gordonii, Streptococcus mutans, as well as members of the groups Lactobacillus casei and Mitis on biofilm from pre-school children with different stages of early childhood caries progression (Chapter 1) and on active and inactive dentine carious lesions (Chapter 2), and also to verify the association of these microorganisms on the process of health or disease. The sample consisted on preschool children aged between 2 and 5 years from nurseries and public preeschools in Fortaleza-CE. The children were examined for caries diagnosis with ICDAS II index (International Caries Detection Assessment System), and the Nyvad criteria, in order to evaluate prevalence and caries activity. The supragingival biofilm collection was taken from 75 children, who were divided in three groups according to the ICDAS II: CF (caries free) (n=20), ECL (presence of enamel caries lesion) (n=17) and DCL (presence of dentine caries lesion) (n=38). Samples of carious dentine were collected under rubber dam isolation of 56 lesions of dentine affected by caries, being 17 inactive and 39 active. The DNA of all the collected samples was extracted and purified, then tested for the presence of the formerly mentioned bacterial species/groups through qPCR. The quantity of bacteria was compared through the Kruskal-Wallis and Mann-Whitney tests. Besides, the association between the presence of bacteria and ECC was analyzed through the Chi-square test, with a 5% significance level and the multiple logistic regression was applied. Bacteria from the group L. casei and L. acidophilus presented low detection on biofilm of all evaluated groups. The presence of S. mutans and Bifidobacterium spp. showed a strong association with dental caries progression on the biofilm from children with dentine lesions with odds ratio of 21,5 and 5,9; respectively. On active dentine lesions, concentrations of Bifidobacterium spp. and species from the Lactobacillus casei group were significantly higher when compared to the inactive lesions (p<0.05). The levels of Actinomyces naeslundii, Streptococcus gordonni and species from Mitis group were not significantly different among biofilm groups as well as comparing dentine lesions. In conclusion, the microbial profile from biofilm samples presented differences on the proportion of acidogenic and aciduric bacteria with dental caries progression. The presence of Bifidobacterium spp. and S. mutans presented a strong association with the development of the more advanced stages of ECC. Regarding the activity of dentine lesions, higher detection levels of the group L. casei and Bifidobacterium spp. showed an important role of these bacteria in the dentine caries activity. |
publishDate |
2014 |
dc.date.issued.fl_str_mv |
2014-11-25 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
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publishedVersion |
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doctoralThesis |
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http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=14164 |
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http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=14164 |
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por |
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Universidade Federal do Cearà |
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Programa de PÃs-GraduaÃÃo em Odontologia |
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UFC |
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BR |
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Universidade Federal do Cearà |
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