Traumatismos bucomaxilofaciais em um hospital público do Brasil Central: estudo retrospectivo
Autor(a) principal: | |
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Data de Publicação: | 2013 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Repositório Institucional da UFG |
dARK ID: | ark:/38995/00130000030h0 |
Texto Completo: | http://repositorio.bc.ufg.br/tede/handle/tde/3040 |
Resumo: | Aim: To evaluate epidemiological aspects of maxillofacial-oral injuries in hospitalized patients. Material and Methods: The sample was composed by 405 patients treated at the Department of Oral and Maxillofacial Surgery of the Emergency Hospital of Aparecida de Goiânia, Brazil, between 2011 and 2013. The following informations were collected from the patients’ medical records: gender, age, cause of injury, seasonal distribution, patient’s location and type of injury. The statistical treatment analyzed data from frequency distribution and chi-squared test. The level of significance was set at 5% for all analyses. Results: Higher occurrence of maxillofacial-oral injuries was observed in males (n=294; 72.59%), with 21-30 years old (n=106; 26.17%) and from the city of Aparecida de Goiânia. The main etiologic factors involved were vehicle traffic accidents (n=124; 30.62%), falls (n=92; 22.72%) and violence (n=87; 21.48%). The seasonal distribution showed that most cases occurred in autumn (n=154; 38.02%), followed by summer (n=138; 34.07%). The most common injuries were facial fractures (n = 324; 80.0%), the nasal bone, the most affected (n = 161; 39.75%) anatomical region. Statistically significant associations between etiological factor, gender and age (p <0.005) were observed. Conclusions: There were a high number of maxillofacial-oral injuries in males, aged less than 30 years old and due vehicle traffic accidents. |
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Estrela, Carloshttp://lattes.cnpq.br/3611967334176683Alencar, Ana Helena G. deEstrela, CarlosAlencar, Ana Helena G. dePécora, Jesus DjalmaSousa, Hugo Alexandre deDecurcio, Daniel de Almeidahttp://lattes.cnpq.br/3886437917190457Scartezini, Guilherme Romano2014-09-08T21:27:40Z2014-09-082013-12-10SCARTEZINI, Guilherme Romano. Traumatismos bucomaxilofaciais em um hospital público do Brasil Central: estudo retrospectivo. 2013. 64 f. Tese (Doutorado em Ciências da Saúde) - Universidade Federal de Goiás - Goiânia, Goiânia, 2013.http://repositorio.bc.ufg.br/tede/handle/tde/3040ark:/38995/00130000030h0Aim: To evaluate epidemiological aspects of maxillofacial-oral injuries in hospitalized patients. Material and Methods: The sample was composed by 405 patients treated at the Department of Oral and Maxillofacial Surgery of the Emergency Hospital of Aparecida de Goiânia, Brazil, between 2011 and 2013. The following informations were collected from the patients’ medical records: gender, age, cause of injury, seasonal distribution, patient’s location and type of injury. The statistical treatment analyzed data from frequency distribution and chi-squared test. The level of significance was set at 5% for all analyses. Results: Higher occurrence of maxillofacial-oral injuries was observed in males (n=294; 72.59%), with 21-30 years old (n=106; 26.17%) and from the city of Aparecida de Goiânia. The main etiologic factors involved were vehicle traffic accidents (n=124; 30.62%), falls (n=92; 22.72%) and violence (n=87; 21.48%). The seasonal distribution showed that most cases occurred in autumn (n=154; 38.02%), followed by summer (n=138; 34.07%). The most common injuries were facial fractures (n = 324; 80.0%), the nasal bone, the most affected (n = 161; 39.75%) anatomical region. Statistically significant associations between etiological factor, gender and age (p <0.005) were observed. Conclusions: There were a high number of maxillofacial-oral injuries in males, aged less than 30 years old and due vehicle traffic accidents.Objetivo: avaliar os aspectos epidemiológicos dos traumatismos bucomaxilofaciais em prontuários de pacientes atendidos em um hospital público do Brasil Central. Material e método: a amostra do estudo foi proveniente da revisão de prontuários de 405 pacientes atendidos no serviço de cirurgia e traumatologia bucomaxilofacial (CTBMF) do Hospital de Urgências de Aparecida de Goiânia (HUAPA) - GO, Brasil, entre os anos de 2011 e 2013. Os seguintes dados foram coletados dos registros hospitalares de cada paciente: gênero, idade, fator etiológico, data do atendimento, procedência e região anatômica atingida. O tratamento estatístico analisou os dados frente à distribuição de frequência e qui-quadrado. O nível de significância foi de p<0,05. Resultados: observou-se elevada frequência de traumatismos bucomaxilofaciais em indivíduos do gênero masculino (n=294; 72,59%). A faixa etária mais acometida foi entre 21-30 anos (n=106; 26,17%), provenientes da cidade de Aparecida de Goiânia. Os principais fatores etiológicos foram os acidentes de trânsito motorizados (n=124; 30,62%), quedas (n=92; 22,72%) e violência (n=87; 21,48%). A distribuição sazonal evidenciou elevado número de traumatismos no outono (n=154; 38,02%) e no verão (n=138; 34,07%). O traumatismo mais comum foi a fratura facial (n=324; 80,0%), sendo o nariz, a região anatômica mais atingida (n=161; 39,75%). Foram observadas associações significantes entre fator etiológico, gênero e faixa etária (p<0,005). Conclusão: os dados obtidos se assemelham aos encontrados na literatura, no que diz respeito à prevalência do gênero masculino, da faixa etária e dos acidentes de trânsito como principal agente etiológico.Submitted by Erika Demachki (erikademachki@gmail.com) on 2014-09-08T21:27:40Z No. of bitstreams: 2 Scartezini, Guilherme Romano - 2013.pdf: 1148660 bytes, checksum: 90b275997068b644fac95cddab8e6264 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5)Made available in DSpace on 2014-09-08T21:27:40Z (GMT). No. of bitstreams: 2 Scartezini, Guilherme Romano - 2013.pdf: 1148660 bytes, checksum: 90b275997068b644fac95cddab8e6264 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2013-12-10application/pdfhttp://repositorio.bc.ufg.br/tede/retrieve/7368/Scartezini%2c%20Guilherme%20Romano%20-%202013.pdf.jpgporUniversidade Federal de GoiásPrograma de Pós-graduação em Ciências da Saúde (FM)UFGBrasilFaculdade de Medicina - FM (RG)Brasileiro BF, Passeri LA. Epidemiological analysis of maxillofacial fractures in Brazil: a 5-year prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 102: 28-34. Jin Z, Jiang X, Shang L. Analysis of 627 hospitalized maxillofacial-oral injuries in Xi’an, China. Dent Traumatol 2013. Gassner R, Tuli T, Hächl O, Rudisch A, Ulmer H. Craniomaxillofacial trauma: a 10 year review of 9543 cases with 21067 injuries. J Craniomaxillofac Surg 2003; 31:51-61. Kotecha S, Scannell J, Monaghan A, Williams RW. A four year retrospective study of 1062 patients presenting with maxillofacial emergencies at a specialist paediatric hospital. Br J Oral Maxillofac Surg 2008; 293-6. Scariot R, Oliveira IA, Passeri LA, Rebellato NLB, Müller PR. Maxillofacial injuries in a group of Brazilian subjects under 18 years of age. J Appl Oral Sci 2009; 17:195-8. Cavalcanti AL, Bezerra PKM, Oliveira DM, Granville-Garcia AF. Maxillofacial injuries and dental trauma in patients aged 19-80 years, Recife, Brazil. Rev Esp Cir Oral Maxilofac 2010; 32:11-6. Chrcanovic BR, Abreu MHNG, Freire-Maia B, Souza LN. 1,454 mandibular fractures: A 3-year study in a hospital in Belo Horizonte, Brazil. J Craniomaxillofac Surg 2012; 40:116-23. Lee KH, Snape L, Steenberg LJ, Worthington J. Comparison between interpersonal violence and motor vehicle accidents in the etiology of maxillofacial fractures. ANZ J Surg 2007: 77:695- Kostakis G, Stathopoulos P, Dais P, Gkinis G, Igoumenakis D, Mezitis M, Rallis G. An epidemiologic analysis of 1142 maxillofacial fractures and concomitant injuries. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114:S69-73. Motamedi MHK. An assessment of maxillofacial fractures: a 5-year study of 237 patients. J Oral Maxillofac Surg 2003; 61:61-4. Chrcanovic BR, Freire-Maia B, Souza LN, Araújo VO, Abreu MH. Facial fractures: a 1-year retrospective study in a hospital in Belo Horizonte. Braz Oral Res 2004; 18:322-8. Subhashraj K, Nandakumar N, Ravindran C. Review of maxillofacial injuries in Chennai, India: a study of 2748 cases. Br J Oral Maxillofac Surg 2007; 45:637-9. van den Bergh B, Karagozoglu KH, Heymans MW, Forouzanfar T. Aetiology and incidence of maxcillofacial trauma in Amsterdam: a retrospective analysis of 579 patients. J Craniomaxillofac Surg 2012; 40:e165-9. Hogg NJ, Stewart TC, Armstrong JE, Girotti MJ. Epidemiology of maxillofacial injuries at trauma hospital in Ontario, Canada between 1992 and 1997. J Trauma 2000; 49: 425:32. Iida S, Kogo M, Sugiura T, Mima T, Matsuya T. Retrospective analysis of 1502 patients with facial fractures. Int J Oral Maxillofac Surg 2001; 30:286-90. Ribeiro MFP, Marcenes W, Croucher R, Sheiham A. The prevalence and causes of maxillofacial fractures in patients attending accident and emergency departments in Recife-Brazil. Int Dent J 2004; 54:47-51. Maliska MCS, Júnior SML, Gil JN. Analysis of 185 maxillofacial fractures in the state of Santa Catarina, Brazil. Braz Oral Res 2009; 23:268-74. Chrcanovic BR, Abreu MHNG, Freire-Maia B, Souza LN. Facial fractures in children and adolescents: a retrospective study of 3 years in a hospital in Belo Horizonte, Brazil. Dent Traumatol 2010; 26:262-70. Leles JLR, Santos ÊJ, Jorge FD, Silva ET, Leles CR. Risk factors for maxillofacial injuries in a Brazilian emergency hospital sample. J Appl Oral Sci 2010; 18:23-9. Pereira CM, Filho MS, Carneiro DS, Arcanjo RC, Andrade LA, Araújo MGB. Epidemiology of maxillofacial injuries at a regional hospital in Goiânia, Brazil, between 2008 and 2010. RSBO 2011; 8:381-5. IBGE [Brazilian Institute of Geography and Statistics]. Demographic Census; 2013. World Health Organization. Standardization of reporting of dental disease and condition. Technical Report Series 1962; n.242, 23p. Roccia F, Bianchi F, Zavattero E, Tanteri G, Ramieri. Characteristics of maxillofacial trauma in females: a retrospective analysis of 367 patients. J Craniomaxillofac Surg 2010; 38:314-9. Lin S, Levin L, Goldman S, Peled M. Dento-alveolar and maxillofacial injuries – a retrospective study from a level 1 trauma center in Israel. Dent Traumatol 2007; 23:155-7. Al Ahmed HEA, Jaber MA, Fanas SHA, Karas M. The pattern of maxillofacial fractures in Sharjah, United Arab Emirates: A review of 230 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004; 98:166-70. Yokoyama T, Motozawa Y, Sasaki T, Hitosugi M. A retrospective analysis of oral and maxillofacial injuries in motor vehicle accidents. J Oral Maxillofac Surg 2006; 64:1731-35. Anderson PJ. Fractures of the facial skeleton in children. Injury 1995; 26:47-50. Arosarena OA, Fritsch TA, Hsueh Y, Aynehchi B, Haug R. Maxillofacial injuries and violence against women. Arch Facial Plast Surg 2009; 11:48-52. Oji C. Jaw fractures in Enugu, Nigeria, 1985-95. Br J Oral Maxillofac Surg 1999; 37: 106-9. Almeida-Filho N, Rouquayrol MZ. Introdução à epidemiologia. 3 ed. Rio de Janeiro: Medsi, 2002. Freire MCM, Pattusi MP. Tipos de estudo. In: Estrela C. Metodologia Científica. 2 ed. São Paulo: Artes Médicas, 2005. p.185-209. Antunes JLF, Peres MA. Fundamentos de odontologia, epidemiologia da saúde bucal. Rio de Janeiro: Guanabara Koogan, 2006. Hulley SB, Cummings SR. 1988. Designing Clinical Research. 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dc.title.por.fl_str_mv |
Traumatismos bucomaxilofaciais em um hospital público do Brasil Central: estudo retrospectivo |
dc.title.alternative.eng.fl_str_mv |
Maxillofacial trauma in a public hospital in Central Brazil: a retrospective study |
title |
Traumatismos bucomaxilofaciais em um hospital público do Brasil Central: estudo retrospectivo |
spellingShingle |
Traumatismos bucomaxilofaciais em um hospital público do Brasil Central: estudo retrospectivo Scartezini, Guilherme Romano Traumatismo bucomaxilofacial Trauma Fratura de nariz Epidemiologia Prevenção Maxillofacial-oral injury Trauma Nasal fracture Epidemiology Prevention CIENCIAS DA SAUDE |
title_short |
Traumatismos bucomaxilofaciais em um hospital público do Brasil Central: estudo retrospectivo |
title_full |
Traumatismos bucomaxilofaciais em um hospital público do Brasil Central: estudo retrospectivo |
title_fullStr |
Traumatismos bucomaxilofaciais em um hospital público do Brasil Central: estudo retrospectivo |
title_full_unstemmed |
Traumatismos bucomaxilofaciais em um hospital público do Brasil Central: estudo retrospectivo |
title_sort |
Traumatismos bucomaxilofaciais em um hospital público do Brasil Central: estudo retrospectivo |
author |
Scartezini, Guilherme Romano |
author_facet |
Scartezini, Guilherme Romano |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Estrela, Carlos |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/3611967334176683 |
dc.contributor.advisor-co1.fl_str_mv |
Alencar, Ana Helena G. de |
dc.contributor.referee1.fl_str_mv |
Estrela, Carlos |
dc.contributor.referee2.fl_str_mv |
Alencar, Ana Helena G. de |
dc.contributor.referee3.fl_str_mv |
Pécora, Jesus Djalma |
dc.contributor.referee4.fl_str_mv |
Sousa, Hugo Alexandre de |
dc.contributor.referee5.fl_str_mv |
Decurcio, Daniel de Almeida |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/3886437917190457 |
dc.contributor.author.fl_str_mv |
Scartezini, Guilherme Romano |
contributor_str_mv |
Estrela, Carlos Alencar, Ana Helena G. de Estrela, Carlos Alencar, Ana Helena G. de Pécora, Jesus Djalma Sousa, Hugo Alexandre de Decurcio, Daniel de Almeida |
dc.subject.por.fl_str_mv |
Traumatismo bucomaxilofacial Trauma Fratura de nariz Epidemiologia Prevenção |
topic |
Traumatismo bucomaxilofacial Trauma Fratura de nariz Epidemiologia Prevenção Maxillofacial-oral injury Trauma Nasal fracture Epidemiology Prevention CIENCIAS DA SAUDE |
dc.subject.eng.fl_str_mv |
Maxillofacial-oral injury Trauma Nasal fracture Epidemiology Prevention |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE |
description |
Aim: To evaluate epidemiological aspects of maxillofacial-oral injuries in hospitalized patients. Material and Methods: The sample was composed by 405 patients treated at the Department of Oral and Maxillofacial Surgery of the Emergency Hospital of Aparecida de Goiânia, Brazil, between 2011 and 2013. The following informations were collected from the patients’ medical records: gender, age, cause of injury, seasonal distribution, patient’s location and type of injury. The statistical treatment analyzed data from frequency distribution and chi-squared test. The level of significance was set at 5% for all analyses. Results: Higher occurrence of maxillofacial-oral injuries was observed in males (n=294; 72.59%), with 21-30 years old (n=106; 26.17%) and from the city of Aparecida de Goiânia. The main etiologic factors involved were vehicle traffic accidents (n=124; 30.62%), falls (n=92; 22.72%) and violence (n=87; 21.48%). The seasonal distribution showed that most cases occurred in autumn (n=154; 38.02%), followed by summer (n=138; 34.07%). The most common injuries were facial fractures (n = 324; 80.0%), the nasal bone, the most affected (n = 161; 39.75%) anatomical region. Statistically significant associations between etiological factor, gender and age (p <0.005) were observed. Conclusions: There were a high number of maxillofacial-oral injuries in males, aged less than 30 years old and due vehicle traffic accidents. |
publishDate |
2013 |
dc.date.issued.fl_str_mv |
2013-12-10 |
dc.date.accessioned.fl_str_mv |
2014-09-08T21:27:40Z |
dc.date.available.fl_str_mv |
2014-09-08 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
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SCARTEZINI, Guilherme Romano. Traumatismos bucomaxilofaciais em um hospital público do Brasil Central: estudo retrospectivo. 2013. 64 f. Tese (Doutorado em Ciências da Saúde) - Universidade Federal de Goiás - Goiânia, Goiânia, 2013. |
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http://repositorio.bc.ufg.br/tede/handle/tde/3040 |
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SCARTEZINI, Guilherme Romano. Traumatismos bucomaxilofaciais em um hospital público do Brasil Central: estudo retrospectivo. 2013. 64 f. Tese (Doutorado em Ciências da Saúde) - Universidade Federal de Goiás - Goiânia, Goiânia, 2013. ark:/38995/00130000030h0 |
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http://repositorio.bc.ufg.br/tede/handle/tde/3040 |
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por |
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Brasileiro BF, Passeri LA. Epidemiological analysis of maxillofacial fractures in Brazil: a 5-year prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 102: 28-34. Jin Z, Jiang X, Shang L. Analysis of 627 hospitalized maxillofacial-oral injuries in Xi’an, China. Dent Traumatol 2013. Gassner R, Tuli T, Hächl O, Rudisch A, Ulmer H. Craniomaxillofacial trauma: a 10 year review of 9543 cases with 21067 injuries. J Craniomaxillofac Surg 2003; 31:51-61. Kotecha S, Scannell J, Monaghan A, Williams RW. A four year retrospective study of 1062 patients presenting with maxillofacial emergencies at a specialist paediatric hospital. Br J Oral Maxillofac Surg 2008; 293-6. Scariot R, Oliveira IA, Passeri LA, Rebellato NLB, Müller PR. Maxillofacial injuries in a group of Brazilian subjects under 18 years of age. J Appl Oral Sci 2009; 17:195-8. Cavalcanti AL, Bezerra PKM, Oliveira DM, Granville-Garcia AF. Maxillofacial injuries and dental trauma in patients aged 19-80 years, Recife, Brazil. Rev Esp Cir Oral Maxilofac 2010; 32:11-6. Chrcanovic BR, Abreu MHNG, Freire-Maia B, Souza LN. 1,454 mandibular fractures: A 3-year study in a hospital in Belo Horizonte, Brazil. J Craniomaxillofac Surg 2012; 40:116-23. Lee KH, Snape L, Steenberg LJ, Worthington J. Comparison between interpersonal violence and motor vehicle accidents in the etiology of maxillofacial fractures. ANZ J Surg 2007: 77:695- Kostakis G, Stathopoulos P, Dais P, Gkinis G, Igoumenakis D, Mezitis M, Rallis G. An epidemiologic analysis of 1142 maxillofacial fractures and concomitant injuries. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114:S69-73. Motamedi MHK. An assessment of maxillofacial fractures: a 5-year study of 237 patients. J Oral Maxillofac Surg 2003; 61:61-4. Chrcanovic BR, Freire-Maia B, Souza LN, Araújo VO, Abreu MH. Facial fractures: a 1-year retrospective study in a hospital in Belo Horizonte. Braz Oral Res 2004; 18:322-8. Subhashraj K, Nandakumar N, Ravindran C. Review of maxillofacial injuries in Chennai, India: a study of 2748 cases. Br J Oral Maxillofac Surg 2007; 45:637-9. van den Bergh B, Karagozoglu KH, Heymans MW, Forouzanfar T. Aetiology and incidence of maxcillofacial trauma in Amsterdam: a retrospective analysis of 579 patients. J Craniomaxillofac Surg 2012; 40:e165-9. Hogg NJ, Stewart TC, Armstrong JE, Girotti MJ. Epidemiology of maxillofacial injuries at trauma hospital in Ontario, Canada between 1992 and 1997. J Trauma 2000; 49: 425:32. Iida S, Kogo M, Sugiura T, Mima T, Matsuya T. Retrospective analysis of 1502 patients with facial fractures. Int J Oral Maxillofac Surg 2001; 30:286-90. Ribeiro MFP, Marcenes W, Croucher R, Sheiham A. The prevalence and causes of maxillofacial fractures in patients attending accident and emergency departments in Recife-Brazil. Int Dent J 2004; 54:47-51. Maliska MCS, Júnior SML, Gil JN. Analysis of 185 maxillofacial fractures in the state of Santa Catarina, Brazil. Braz Oral Res 2009; 23:268-74. Chrcanovic BR, Abreu MHNG, Freire-Maia B, Souza LN. Facial fractures in children and adolescents: a retrospective study of 3 years in a hospital in Belo Horizonte, Brazil. Dent Traumatol 2010; 26:262-70. Leles JLR, Santos ÊJ, Jorge FD, Silva ET, Leles CR. Risk factors for maxillofacial injuries in a Brazilian emergency hospital sample. J Appl Oral Sci 2010; 18:23-9. Pereira CM, Filho MS, Carneiro DS, Arcanjo RC, Andrade LA, Araújo MGB. Epidemiology of maxillofacial injuries at a regional hospital in Goiânia, Brazil, between 2008 and 2010. RSBO 2011; 8:381-5. IBGE [Brazilian Institute of Geography and Statistics]. Demographic Census; 2013. World Health Organization. Standardization of reporting of dental disease and condition. Technical Report Series 1962; n.242, 23p. Roccia F, Bianchi F, Zavattero E, Tanteri G, Ramieri. Characteristics of maxillofacial trauma in females: a retrospective analysis of 367 patients. J Craniomaxillofac Surg 2010; 38:314-9. Lin S, Levin L, Goldman S, Peled M. Dento-alveolar and maxillofacial injuries – a retrospective study from a level 1 trauma center in Israel. Dent Traumatol 2007; 23:155-7. Al Ahmed HEA, Jaber MA, Fanas SHA, Karas M. The pattern of maxillofacial fractures in Sharjah, United Arab Emirates: A review of 230 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004; 98:166-70. Yokoyama T, Motozawa Y, Sasaki T, Hitosugi M. A retrospective analysis of oral and maxillofacial injuries in motor vehicle accidents. J Oral Maxillofac Surg 2006; 64:1731-35. Anderson PJ. Fractures of the facial skeleton in children. Injury 1995; 26:47-50. Arosarena OA, Fritsch TA, Hsueh Y, Aynehchi B, Haug R. Maxillofacial injuries and violence against women. Arch Facial Plast Surg 2009; 11:48-52. Oji C. Jaw fractures in Enugu, Nigeria, 1985-95. Br J Oral Maxillofac Surg 1999; 37: 106-9. Almeida-Filho N, Rouquayrol MZ. Introdução à epidemiologia. 3 ed. Rio de Janeiro: Medsi, 2002. Freire MCM, Pattusi MP. Tipos de estudo. In: Estrela C. Metodologia Científica. 2 ed. São Paulo: Artes Médicas, 2005. p.185-209. Antunes JLF, Peres MA. Fundamentos de odontologia, epidemiologia da saúde bucal. Rio de Janeiro: Guanabara Koogan, 2006. Hulley SB, Cummings SR. 1988. Designing Clinical Research. Baltimore (MD, Williams & Wilkins). |
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