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<meta name="DC.Title" content="Spectrum of Spinal Cord, Spinal Root, and Brain MRI Abnormalities in Congenital Zika Syndrome with and without Arthrogryposis" />
<meta name="DC.Identifier" content="10.3174/ajnr.A5125" />
<meta name="DC.Date" content="2017-05-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2017 by American Journal of Neuroradiology. Indicates open access to non-subscribers at www.ajnr.org" />
<meta name="DC.AccessRights" content="open-access" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Arthrogryposis is among the malformations of congenital Zika syndrome. Similar to the brain, there might exist a spectrum of spinal cord abnormalities. The purpose of this study was to explore and describe in detail the MR imaging features found in the spinal cords, nerve roots, and brains of children with congenital Zika syndrome with and without arthrogryposis.

MATERIALS AND METHODS: Twelve infants with congenital Zika syndrome (4 with arthrogryposis and 8 without) who had undergone brain and spinal cord MR imaging were retrospectively selected. Qualitative and quantitative analyses were performed and compared between groups.

RESULTS: At visual inspection, both groups showed reduced thoracic spinal cord thickness: 75% (6/8) of the group without arthrogryposis and 100% (4/4) of the arthrogryposis group. However, the latter had the entire spinal cord reduced and more severely reduced conus medullaris anterior roots (respectively, P = .002 and .007). Quantitative differences were found for conus medullaris base and cervical and lumbar intumescences diameters (respectively, P = .008, .048, .008), with more prominent reduction in arthrogryposis. Periventricular calcifications were more frequent in infants with arthrogryposis ( P = .018).

CONCLUSIONS: Most infants had some degree of spinal cord thickness reduction, predominant in the thoracic segment (without arthrogryposis) or in the entire spinal cord (with arthrogryposis). The conus medullaris anterior roots were reduced in both groups (thinner in arthrogryposis). A prominent anterior median fissure of the spinal cord was absent in infants without arthrogryposis. Brain stem hypoplasia was present in all infants with arthrogryposis, periventricular calcifications, in the majority, and polymicrogyria was absent.

AACD
:   Association for Assistance of Disabled Children
GRE
:   gradient recalled-echo
IgM
:   immunoglobulin M" />
<meta name="DC.Contributor" content="M.F.V.V. Aragao" />
<meta name="DC.Contributor" content="A.M. Brainer-Lima" />
<meta name="DC.Contributor" content="A.C. Holanda" />
<meta name="DC.Contributor" content="V. van der Linden" />
<meta name="DC.Contributor" content="L. Vasco Aragão" />
<meta name="DC.Contributor" content="M.L.M. Silva Júnior" />
<meta name="DC.Contributor" content="C. Sarteschi" />
<meta name="DC.Contributor" content="N.C.L. Petribu" />
<meta name="DC.Contributor" content="M.M. Valença" />
<meta name="article:published_time" content="2017-05-01" />
<meta name="article:section" content="SPINE" />
<meta name="citation_title" content="Spectrum of Spinal Cord, Spinal Root, and Brain MRI Abnormalities in Congenital Zika Syndrome with and without Arthrogryposis" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Arthrogryposis is among the malformations of congenital Zika syndrome. Similar to the brain, there might exist a spectrum of spinal cord abnormalities. The purpose of this study was to explore and describe in detail the MR imaging features found in the spinal cords, nerve roots, and brains of children with congenital Zika syndrome with and without arthrogryposis.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Twelve infants with congenital Zika syndrome (4 with arthrogryposis and 8 without) who had undergone brain and spinal cord MR imaging were retrospectively selected. Qualitative and quantitative analyses were performed and compared between groups.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;At visual inspection, both groups showed reduced thoracic spinal cord thickness: 75% (6/8) of the group without arthrogryposis and 100% (4/4) of the arthrogryposis group. However, the latter had the entire spinal cord reduced and more severely reduced conus medullaris anterior roots (respectively, &lt;i&gt;P&lt;/i&gt; = .002 and .007). Quantitative differences were found for conus medullaris base and cervical and lumbar intumescences diameters (respectively, &lt;i&gt;P&lt;/i&gt; = .008, .048, .008), with more prominent reduction in arthrogryposis. Periventricular calcifications were more frequent in infants with arthrogryposis (&lt;i&gt;P&lt;/i&gt; = .018).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Most infants had some degree of spinal cord thickness reduction, predominant in the thoracic segment (without arthrogryposis) or in the entire spinal cord (with arthrogryposis). The conus medullaris anterior roots were reduced in both groups (thinner in arthrogryposis). A prominent anterior median fissure of the spinal cord was absent in infants without arthrogryposis. Brain stem hypoplasia was present in all infants with arthrogryposis, periventricular calcifications, in the majority, and polymicrogyria was absent.&lt;/p&gt;" />
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<meta name="twitter:title" content="Spectrum of Spinal Cord, Spinal Root, and Brain MRI Abnormalities in Congenital Zika Syndrome with and without Arthrogryposis" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Arthrogryposis is among the malformations of congenital Zika syndrome. Similar to the brain, there might exist a spectrum of spinal cord abnormalities. The purpose of this study was to explore and describe in detail the MR imaging features found in the spinal cords, nerve roots, and brains of children with congenital Zika syndrome with and without arthrogryposis.

MATERIALS AND METHODS: Twelve infants with congenital Zika syndrome (4 with arthrogryposis and 8 without) who had undergone brain and spinal cord MR imaging were retrospectively selected. Qualitative and quantitative analyses were performed and compared between groups.

RESULTS: At visual inspection, both groups showed reduced thoracic spinal cord thickness: 75% (6/8) of the group without arthrogryposis and 100% (4/4) of the arthrogryposis group. However, the latter had the entire spinal cord reduced and more severely reduced conus medullaris anterior roots (respectively, P = .002 and .007). Quantitative differences were found for conus medullaris base and cervical and lumbar intumescences diameters (respectively, P = .008, .048, .008), with more prominent reduction in arthrogryposis. Periventricular calcifications were more frequent in infants with arthrogryposis ( P = .018).

CONCLUSIONS: Most infants had some degree of spinal cord thickness reduction, predominant in the thoracic segment (without arthrogryposis) or in the entire spinal cord (with arthrogryposis). The conus medullaris anterior roots were reduced in both groups (thinner in arthrogryposis). A prominent anterior median fissure of the spinal cord was absent in infants without arthrogryposis. Brain stem hypoplasia was present in all infants with arthrogryposis, periventricular calcifications, in the majority, and polymicrogyria was absent.

AACD
:   Association for Assistance of Disabled Children
GRE
:   gradient recalled-echo
IgM
:   immunoglobulin M" />
<meta name="og-title" property="og:title" content="Spectrum of Spinal Cord, Spinal Root, and Brain MRI Abnormalities in Congenital Zika Syndrome with and without Arthrogryposis" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/38/5/1045" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Arthrogryposis is among the malformations of congenital Zika syndrome. Similar to the brain, there might exist a spectrum of spinal cord abnormalities. The purpose of this study was to explore and describe in detail the MR imaging features found in the spinal cords, nerve roots, and brains of children with congenital Zika syndrome with and without arthrogryposis.

MATERIALS AND METHODS: Twelve infants with congenital Zika syndrome (4 with arthrogryposis and 8 without) who had undergone brain and spinal cord MR imaging were retrospectively selected. Qualitative and quantitative analyses were performed and compared between groups.

RESULTS: At visual inspection, both groups showed reduced thoracic spinal cord thickness: 75% (6/8) of the group without arthrogryposis and 100% (4/4) of the arthrogryposis group. However, the latter had the entire spinal cord reduced and more severely reduced conus medullaris anterior roots (respectively, P = .002 and .007). Quantitative differences were found for conus medullaris base and cervical and lumbar intumescences diameters (respectively, P = .008, .048, .008), with more prominent reduction in arthrogryposis. Periventricular calcifications were more frequent in infants with arthrogryposis ( P = .018).

CONCLUSIONS: Most infants had some degree of spinal cord thickness reduction, predominant in the thoracic segment (without arthrogryposis) or in the entire spinal cord (with arthrogryposis). The conus medullaris anterior roots were reduced in both groups (thinner in arthrogryposis). A prominent anterior median fissure of the spinal cord was absent in infants without arthrogryposis. Brain stem hypoplasia was present in all infants with arthrogryposis, periventricular calcifications, in the majority, and polymicrogyria was absent.

AACD
:   Association for Assistance of Disabled Children
GRE
:   gradient recalled-echo
IgM
:   immunoglobulin M" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node54361--5" data-node-nid="54361" id="top-node-54361--6942344066" data-pisa="ajnr;38/5/1045" data-pisa-master="ajnr;ajnr.A5125" data-apath="/ajnr/38/5/1045.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
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      <h1 class="highwire-cite-title" id="page-title">Spectrum of Spinal Cord, Spinal Root, and Brain MRI Abnormalities in Congenital Zika Syndrome with and without Arthrogryposis</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">M.F.V.V. Aragao</span>, <span class="highwire-citation-author" data-delta="1">A.M. Brainer-Lima</span>, <span class="highwire-citation-author" data-delta="2">A.C. Holanda</span>, <span class="highwire-citation-author" data-delta="3">V. van der Linden</span>, <span class="highwire-citation-author" data-delta="4">L. Vasco Aragão</span>, <span class="highwire-citation-author" data-delta="5">M.L.M. Silva Júnior</span>, <span class="highwire-citation-author" data-delta="6">C. Sarteschi</span>, <span class="highwire-citation-author" data-delta="7">N.C.L. Petribu</span> and <span class="highwire-citation-author" data-delta="8">M.M. Valença</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">May 2017,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">38 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(5) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1045-1053; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A5125 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-54361--6942344066" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">M.F.V.V. Aragao </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Centro Diagnostico Multimagem (M.F.V.V.A.), Recife, Brazil</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Mauricio de Nassau University (M.F.V.V.A., A.M.B.-L.), Recife, Brazil</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.F.V.V.%2BAragao%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Aragao%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.F.V.V.%2BAragao%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-2341-1422" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M.F.V.V. Aragao</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">A.M. Brainer-Lima </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>PROCAPE (A.M.B.-L.), University of Pernambuco, Recife, Brazil</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Mauricio de Nassau University (M.F.V.V.A., A.M.B.-L.), Recife, Brazil</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.M.%2BBrainer-Lima%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Brainer-Lima%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AA.M.%2BBrainer-Lima%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0003-0096-4101" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A.M. Brainer-Lima</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">A.C. Holanda </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Federal University of Pernambuco (A.C.H., M.L.M.S.J., M.M.V.), Recife, Brazil</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.C.%2BHolanda%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Holanda%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AA.C.%2BHolanda%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-4127-2366" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A.C. Holanda</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">V. van der Linden </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>e</span>Association for Assistance of Disabled Children (V.v.d.L.), Recife, Brazil</div><div class='author-affiliation'><span class='nlm-sup'>f</span>Barão de Lucena Hospital (V.v.d.L., N.C.L.P.), Recife, Brazil</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=V.%2Bvan%2Bder%2BLinden%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=van%20der%20Linden%20V&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AV.%2Bvan%2Bder%2BLinden%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0003-1641-9386" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for V. van der Linden</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">L. Vasco Aragão </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>g</span>Prof Fernando Figueira Integral Medicine Institute (L.V.A.), Recife, Brazil</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=L.%2BVasco%2BArag%C3%A3o%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Vasco%20Arag%C3%A3o%20L&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AL.%2BVasco%2BArag%25C3%25A3o%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-7132-8634" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for L. Vasco Aragão</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">M.L.M. Silva Júnior </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Federal University of Pernambuco (A.C.H., M.L.M.S.J., M.M.V.), Recife, Brazil</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.L.M.%2BSilva%2BJ%C3%BAnior%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Silva%20J%C3%BAnior%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.L.M.%2BSilva%2BJ%25C3%25BAnior%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-9002-107X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M.L.M. Silva Júnior</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">C. Sarteschi </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>h</span>Fundação Oswaldo Cruz–Fiocruz/PE (C.S.), Recife, Brazil.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=C.%2BSarteschi%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Sarteschi%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AC.%2BSarteschi%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-8536-0598" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for C. Sarteschi</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">N.C.L. 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Valença </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Federal University of Pernambuco (A.C.H., M.L.M.S.J., M.M.V.), Recife, Brazil</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.M.%2BValen%C3%A7a%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Valen%C3%A7a%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.M.%2BValen%25C3%25A7a%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0003-0678-3782" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M.M. 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          <a href="/content/38/5" class="highwire-cite-linked-title" data-icon-position="" data-hide-link-title="0"><span class="highwire-cite-title">American Journal of Neuroradiology</span></a>      
      
        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 38</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 5 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 May 2017 </div></div>
      
      
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      <div class="highwire-cite-title">Spectrum of Spinal Cord, Spinal Root, and Brain MRI Abnormalities in Congenital Zika Syndrome with and without Arthrogryposis</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">M.F.V.V.</span> <span class="nlm-surname">Aragao</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">A.M.</span> <span class="nlm-surname">Brainer-Lima</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">A.C.</span> <span class="nlm-surname">Holanda</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">V.</span> <span class="nlm-surname">van der Linden</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">L.</span> <span class="nlm-surname">Vasco Aragão</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">M.L.M.</span> <span class="nlm-surname">Silva Júnior</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">C.</span> <span class="nlm-surname">Sarteschi</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">N.C.L.</span> <span class="nlm-surname">Petribu</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">M.M.</span> <span class="nlm-surname">Valença</span></span></span></div>
  
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