Increased levels of Porphyromonas gingivalis are associated with ischemic and hemorrhagic cerebrovascular disease in humans: an in vivo study
Identifieur interne : 003C89 ( Ncbi/Merge ); précédent : 003C88; suivant : 003C90Increased levels of Porphyromonas gingivalis are associated with ischemic and hemorrhagic cerebrovascular disease in humans: an in vivo study
Auteurs : Janaina Salomon Ghizoni [Brésil] ; Luís Antônio De Assis Taveira [Brésil] ; Gustavo Pompermaier Garlet [Brésil] ; Marcos Flávio Ghizoni [Brésil] ; Jefferson Ricardo Pereira [Brésil] ; Thiago José Dionísio [Brésil] ; Daniel Thomas Brozoski [Brésil] ; Carlos Ferreira Santos [Brésil] ; Adriana Campos Passanezi Sant'Ana [Brésil]Source :
- Journal of Applied Oral Science [ 1678-7757 ] ; 2012.
Abstract
This study investigated the role of periodontal disease in the development of stroke or cerebral infarction in patients by evaluating the clinical periodontal conditions and the subgingival levels of periodontopathogens.
Twenty patients with ischemic (I-CVA) or hemorrhagic (H-CVA) cerebrovascular
episodes (test group) and 60 systemically healthy patients (control group) were
evaluated for: probing depth, clinical attachment level, bleeding on probing and
plaque index.
The test group showed a significant increase in each of the following parameters:
pocket depth, clinical attachment loss, bleeding on probing, plaque index and
number of missing teeth when compared to control values (p<0.05, unpaired
t-test). Likewise, the test group had increased numbers of sites that were
contaminated with
Stroke patients had deeper pockets, more severe attachment loss, increased
bleeding on probing, increased plaque indexes, and in their pockets harbored
increased levels of
Url:
DOI: 10.1590/S1678-77572012000100019
PubMed: 22437687
PubMed Central: 3928781
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PMC:3928781Le document en format XML
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are
associated with ischemic and hemorrhagic cerebrovascular disease in humans: an
<italic>in vivo</italic>
study</title>
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<wicri:regionArea> DDS, MSc, PhD student, Discipline of Oral Pathology, Bauru School of Dentistry, University of São Paulo, Bauru, SP</wicri:regionArea>
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<author><name sortKey="Dionisio, Thiago Jose" sort="Dionisio, Thiago Jose" uniqKey="Dionisio T" first="Thiago José" last="Dionísio">Thiago José Dionísio</name>
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<author><name sortKey="Sant Ana, Adriana Campos Passanezi" sort="Sant Ana, Adriana Campos Passanezi" uniqKey="Sant Ana A" first="Adriana Campos Passanezi" last="Sant'Ana">Adriana Campos Passanezi Sant'Ana</name>
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<wicri:regionArea> DDS, MSc, PhD, Associate Professor, Discipline of Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru, SP</wicri:regionArea>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Increased levels of <italic>Porphyromonas gingivalis</italic>
are
associated with ischemic and hemorrhagic cerebrovascular disease in humans: an
<italic>in vivo</italic>
study</title>
<author><name sortKey="Ghizoni, Janaina Salomon" sort="Ghizoni, Janaina Salomon" uniqKey="Ghizoni J" first="Janaina Salomon" last="Ghizoni">Janaina Salomon Ghizoni</name>
<affiliation wicri:level="4"><nlm:aff id="aff01"> DDS, MSc, PhD student, Discipline of Oral Pathology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">Brésil</country>
<wicri:regionArea> DDS, MSc, PhD student, Discipline of Oral Pathology, Bauru School of Dentistry, University of São Paulo, Bauru, SP</wicri:regionArea>
<placeName><region type="state">État de São Paulo</region>
<settlement type="city">São Paulo</settlement>
</placeName>
<orgName type="university">Université de São Paulo</orgName>
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<author><name sortKey="Taveira, Luis Antonio De Assis" sort="Taveira, Luis Antonio De Assis" uniqKey="Taveira L" first="Luís Antônio De Assis" last="Taveira">Luís Antônio De Assis Taveira</name>
<affiliation wicri:level="4"><nlm:aff id="aff02"> DDS, MSc, PhD, Associate Professor, Discipline of Oral Pathology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">Brésil</country>
<wicri:regionArea> DDS, MSc, PhD, Associate Professor, Discipline of Oral Pathology, Bauru School of Dentistry, University of São Paulo, Bauru, SP</wicri:regionArea>
<placeName><region type="state">État de São Paulo</region>
<settlement type="city">São Paulo</settlement>
</placeName>
<orgName type="university">Université de São Paulo</orgName>
</affiliation>
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<author><name sortKey="Garlet, Gustavo Pompermaier" sort="Garlet, Gustavo Pompermaier" uniqKey="Garlet G" first="Gustavo Pompermaier" last="Garlet">Gustavo Pompermaier Garlet</name>
<affiliation wicri:level="4"><nlm:aff id="aff03"> DDS, MSc, PhD, Associate Professor, Discipline of Histology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">Brésil</country>
<wicri:regionArea> DDS, MSc, PhD, Associate Professor, Discipline of Histology, Bauru School of Dentistry, University of São Paulo, Bauru, SP</wicri:regionArea>
<placeName><region type="state">État de São Paulo</region>
<settlement type="city">São Paulo</settlement>
</placeName>
<orgName type="university">Université de São Paulo</orgName>
</affiliation>
</author>
<author><name sortKey="Ghizoni, Marcos Flavio" sort="Ghizoni, Marcos Flavio" uniqKey="Ghizoni M" first="Marcos Flávio" last="Ghizoni">Marcos Flávio Ghizoni</name>
<affiliation wicri:level="2"><nlm:aff id="aff04"> MD, MSc, PhD, Associate Professor, Discipline of Neurosurgery, University of Southern of Santa Catarina - UNISUL, Tubarão, SC, Brazil.</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">Brésil</country>
<wicri:regionArea> MD, MSc, PhD, Associate Professor, Discipline of Neurosurgery, University of Southern of Santa Catarina - UNISUL, Tubarão, SC</wicri:regionArea>
<placeName><region type="state">Santa Catarina</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Pereira, Jefferson Ricardo" sort="Pereira, Jefferson Ricardo" uniqKey="Pereira J" first="Jefferson Ricardo" last="Pereira">Jefferson Ricardo Pereira</name>
<affiliation wicri:level="2"><nlm:aff id="aff05"> DDS, MSc, PhD, Associate Professor, Discipline of Prosthodontics, University of Southern of Santa Catarina - UNISUL, Tubarão, SC, Brazil.</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">Brésil</country>
<wicri:regionArea> DDS, MSc, PhD, Associate Professor, Discipline of Prosthodontics, University of Southern of Santa Catarina - UNISUL, Tubarão, SC</wicri:regionArea>
<placeName><region type="state">Santa Catarina</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Dionisio, Thiago Jose" sort="Dionisio, Thiago Jose" uniqKey="Dionisio T" first="Thiago José" last="Dionísio">Thiago José Dionísio</name>
<affiliation wicri:level="4"><nlm:aff id="aff06"> Laboratory Specialist, MSc, Discipline of Pharmacology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">Brésil</country>
<wicri:regionArea> Laboratory Specialist, MSc, Discipline of Pharmacology, Bauru School of Dentistry, University of São Paulo, Bauru, SP</wicri:regionArea>
<placeName><region type="state">État de São Paulo</region>
<settlement type="city">São Paulo</settlement>
</placeName>
<orgName type="university">Université de São Paulo</orgName>
</affiliation>
</author>
<author><name sortKey="Brozoski, Daniel Thomas" sort="Brozoski, Daniel Thomas" uniqKey="Brozoski D" first="Daniel Thomas" last="Brozoski">Daniel Thomas Brozoski</name>
<affiliation wicri:level="4"><nlm:aff id="aff07"> Postdoctoral Fellow, PhD, Discipline of Pharmacology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">Brésil</country>
<wicri:regionArea> Postdoctoral Fellow, PhD, Discipline of Pharmacology, Bauru School of Dentistry, University of São Paulo, Bauru, SP</wicri:regionArea>
<placeName><region type="state">État de São Paulo</region>
<settlement type="city">São Paulo</settlement>
</placeName>
<orgName type="university">Université de São Paulo</orgName>
</affiliation>
</author>
<author><name sortKey="Santos, Carlos Ferreira" sort="Santos, Carlos Ferreira" uniqKey="Santos C" first="Carlos Ferreira" last="Santos">Carlos Ferreira Santos</name>
<affiliation wicri:level="4"><nlm:aff id="aff08"> DDS, MSc, PhD, Professor, Discipline of Pharmacology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">Brésil</country>
<wicri:regionArea> DDS, MSc, PhD, Professor, Discipline of Pharmacology, Bauru School of Dentistry, University of São Paulo, Bauru, SP</wicri:regionArea>
<placeName><region type="state">État de São Paulo</region>
<settlement type="city">São Paulo</settlement>
</placeName>
<orgName type="university">Université de São Paulo</orgName>
</affiliation>
</author>
<author><name sortKey="Sant Ana, Adriana Campos Passanezi" sort="Sant Ana, Adriana Campos Passanezi" uniqKey="Sant Ana A" first="Adriana Campos Passanezi" last="Sant'Ana">Adriana Campos Passanezi Sant'Ana</name>
<affiliation wicri:level="4"><nlm:aff id="aff09"> DDS, MSc, PhD, Associate Professor, Discipline of Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">Brésil</country>
<wicri:regionArea> DDS, MSc, PhD, Associate Professor, Discipline of Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru, SP</wicri:regionArea>
<placeName><region type="state">État de São Paulo</region>
<settlement type="city">São Paulo</settlement>
</placeName>
<orgName type="university">Université de São Paulo</orgName>
</affiliation>
</author>
</analytic>
<series><title level="j">Journal of Applied Oral Science</title>
<idno type="ISSN">1678-7757</idno>
<idno type="eISSN">1678-7765</idno>
<imprint><date when="2012">2012</date>
</imprint>
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<front><div type="abstract" xml:lang="en"><sec><title>Objective:</title>
<p>This study investigated the role of periodontal disease in the development of
stroke or cerebral infarction in patients by evaluating the clinical periodontal
conditions and the subgingival levels of periodontopathogens.</p>
</sec>
<sec><title>Material and Methods:</title>
<p>Twenty patients with ischemic (I-CVA) or hemorrhagic (H-CVA) cerebrovascular
episodes (test group) and 60 systemically healthy patients (control group) were
evaluated for: probing depth, clinical attachment level, bleeding on probing and
plaque index. <italic>Porphyromonas gingivalis</italic>
and
<italic>Aggregatibacter actinomycetemcomitans</italic>
were both identified and
quantified in subgingival plaque samples by conventional and real-time PCR,
respectively.</p>
</sec>
<sec><title>Results:</title>
<p>The test group showed a significant increase in each of the following parameters:
pocket depth, clinical attachment loss, bleeding on probing, plaque index and
number of missing teeth when compared to control values (p<0.05, unpaired
t-test). Likewise, the test group had increased numbers of sites that were
contaminated with <italic>P. gingivalis</italic>
(60%x10%; p<0.001; chi-squared
test) and displayed greater prevalence of periodontal disease, with an odds ratio
of 48.06 (95% CI: 5.96-387.72; p<0.001). Notably, a positive correlation
between probing depth and the levels of <italic>P. gingivalis</italic>
in ischemic
stroke was found (r=0.60; p=0.03; Spearman's rank correlation coefficient test).
<italic>A. actinomycetemcomitans</italic>
DNA was not detected in any of the
groups by conventional or real-time PCR.</p>
</sec>
<sec><title>Conclusions:</title>
<p>Stroke patients had deeper pockets, more severe attachment loss, increased
bleeding on probing, increased plaque indexes, and in their pockets harbored
increased levels of <italic>P. gingivalis</italic>
. These findings suggest that
periodontal disease is a risk factor for the development of cerebral hemorrhage or
infarction. Early treatment of periodontitis may counteract the development of
cerebrovascular episodes.</p>
</sec>
</div>
</front>
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<author><name sortKey="Suwalski, P" uniqKey="Suwalski P">P Suwalski</name>
</author>
<author><name sortKey="Kowalski, J" uniqKey="Kowalski J">J Kowalski</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Zetola, Vhf" uniqKey="Zetola V">VHF Zétola</name>
</author>
<author><name sortKey="N Vak, Em" uniqKey="N Vak E">EM Nóvak</name>
</author>
<author><name sortKey="Camargo, Chf" uniqKey="Camargo C">CHF Camargo</name>
</author>
<author><name sortKey="Carraro, H" uniqKey="Carraro H">H Carraro</name>
</author>
<author><name sortKey="Coral, P" uniqKey="Coral P">P Coral</name>
</author>
<author><name sortKey="Muzzio, Ja" uniqKey="Muzzio J">JA Muzzio</name>
</author>
</analytic>
</biblStruct>
</listBibl>
</div1>
</back>
</TEI>
<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Appl Oral Sci</journal-id>
<journal-id journal-id-type="iso-abbrev">J Appl Oral Sci</journal-id>
<journal-id journal-id-type="publisher-id">J. Appl. Oral. Sci.</journal-id>
<journal-title-group><journal-title>Journal of Applied Oral Science</journal-title>
</journal-title-group>
<issn pub-type="ppub">1678-7757</issn>
<issn pub-type="epub">1678-7765</issn>
<publisher><publisher-name>Faculdade de Odontologia de Bauru da Universidade de São
Paulo</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">22437687</article-id>
<article-id pub-id-type="pmc">3928781</article-id>
<article-id pub-id-type="doi">10.1590/S1678-77572012000100019</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Original Articles</subject>
</subj-group>
</article-categories>
<title-group><article-title>Increased levels of <italic>Porphyromonas gingivalis</italic>
are
associated with ischemic and hemorrhagic cerebrovascular disease in humans: an
<italic>in vivo</italic>
study</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>GHIZONI</surname>
<given-names>Janaina Salomon</given-names>
</name>
<xref ref-type="aff" rid="aff01">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>TAVEIRA</surname>
<given-names>Luís Antônio de Assis</given-names>
</name>
<xref ref-type="aff" rid="aff02">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>GARLET</surname>
<given-names>Gustavo Pompermaier</given-names>
</name>
<xref ref-type="aff" rid="aff03">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>GHIZONI</surname>
<given-names>Marcos Flávio</given-names>
</name>
<xref ref-type="aff" rid="aff04">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>PEREIRA</surname>
<given-names>Jefferson Ricardo</given-names>
</name>
<xref ref-type="aff" rid="aff05">5</xref>
</contrib>
<contrib contrib-type="author"><name><surname>DIONÍSIO</surname>
<given-names>Thiago José</given-names>
</name>
<xref ref-type="aff" rid="aff06">6</xref>
</contrib>
<contrib contrib-type="author"><name><surname>BROZOSKI</surname>
<given-names>Daniel Thomas</given-names>
</name>
<xref ref-type="aff" rid="aff07">7</xref>
</contrib>
<contrib contrib-type="author"><name><surname>SANTOS</surname>
<given-names>Carlos Ferreira</given-names>
</name>
<xref ref-type="aff" rid="aff08">8</xref>
<xref ref-type="corresp" rid="c01"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>SANT'ANA</surname>
<given-names>Adriana Campos Passanezi</given-names>
</name>
<xref ref-type="aff" rid="aff09">9</xref>
</contrib>
</contrib-group>
<aff id="aff01"><label>1</label>
DDS, MSc, PhD student, Discipline of Oral Pathology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.</aff>
<aff id="aff02"><label>2</label>
DDS, MSc, PhD, Associate Professor, Discipline of Oral Pathology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.</aff>
<aff id="aff03"><label>3</label>
DDS, MSc, PhD, Associate Professor, Discipline of Histology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.</aff>
<aff id="aff04"><label>4</label>
MD, MSc, PhD, Associate Professor, Discipline of Neurosurgery, University of Southern of Santa Catarina - UNISUL, Tubarão, SC, Brazil.</aff>
<aff id="aff05"><label>5</label>
DDS, MSc, PhD, Associate Professor, Discipline of Prosthodontics, University of Southern of Santa Catarina - UNISUL, Tubarão, SC, Brazil.</aff>
<aff id="aff06"><label>6</label>
Laboratory Specialist, MSc, Discipline of Pharmacology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.</aff>
<aff id="aff07"><label>7</label>
Postdoctoral Fellow, PhD, Discipline of Pharmacology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.</aff>
<aff id="aff08"><label>8</label>
DDS, MSc, PhD, Professor, Discipline of Pharmacology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.</aff>
<aff id="aff09"><label>9</label>
DDS, MSc, PhD, Associate Professor, Discipline of Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.</aff>
<author-notes><corresp id="c01"><bold>Corresponding address:</bold>
Prof. Dr. Carlos F. Santos - Faculdade de
Odontologia de Bauru - USP - Departamento de Ciências Biológicas - Disciplina de
Farmacologia - Alameda Dr. Octávio Pinheiro Brisolla, 9-75 - Bauru - São Paulo -
17012-901 - Brazil - Phone: +55 14 32358282 - Fax: +55 14 32234679 - e-mail:
<email>cebola@usp.br</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><season>Jan-Feb</season>
<year>2012</year>
</pub-date>
<volume>20</volume>
<issue>1</issue>
<fpage>104</fpage>
<lpage>112</lpage>
<history><date date-type="received"><day>27</day>
<month>10</month>
<year>2011</year>
</date>
<date date-type="rev-recd"><day>26</day>
<month>11</month>
<year>2011</year>
</date>
<date date-type="accepted"><day>27</day>
<month>11</month>
<year>2011</year>
</date>
</history>
<permissions><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/"><license-p>This is an Open Access article distributed under the terms of the Creative
Commons Attribution Non-Commercial License which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the
original work is properly cited. </license-p>
</license>
</permissions>
<abstract><sec><title>Objective:</title>
<p>This study investigated the role of periodontal disease in the development of
stroke or cerebral infarction in patients by evaluating the clinical periodontal
conditions and the subgingival levels of periodontopathogens.</p>
</sec>
<sec><title>Material and Methods:</title>
<p>Twenty patients with ischemic (I-CVA) or hemorrhagic (H-CVA) cerebrovascular
episodes (test group) and 60 systemically healthy patients (control group) were
evaluated for: probing depth, clinical attachment level, bleeding on probing and
plaque index. <italic>Porphyromonas gingivalis</italic>
and
<italic>Aggregatibacter actinomycetemcomitans</italic>
were both identified and
quantified in subgingival plaque samples by conventional and real-time PCR,
respectively.</p>
</sec>
<sec><title>Results:</title>
<p>The test group showed a significant increase in each of the following parameters:
pocket depth, clinical attachment loss, bleeding on probing, plaque index and
number of missing teeth when compared to control values (p<0.05, unpaired
t-test). Likewise, the test group had increased numbers of sites that were
contaminated with <italic>P. gingivalis</italic>
(60%x10%; p<0.001; chi-squared
test) and displayed greater prevalence of periodontal disease, with an odds ratio
of 48.06 (95% CI: 5.96-387.72; p<0.001). Notably, a positive correlation
between probing depth and the levels of <italic>P. gingivalis</italic>
in ischemic
stroke was found (r=0.60; p=0.03; Spearman's rank correlation coefficient test).
<italic>A. actinomycetemcomitans</italic>
DNA was not detected in any of the
groups by conventional or real-time PCR.</p>
</sec>
<sec><title>Conclusions:</title>
<p>Stroke patients had deeper pockets, more severe attachment loss, increased
bleeding on probing, increased plaque indexes, and in their pockets harbored
increased levels of <italic>P. gingivalis</italic>
. These findings suggest that
periodontal disease is a risk factor for the development of cerebral hemorrhage or
infarction. Early treatment of periodontitis may counteract the development of
cerebrovascular episodes.</p>
</sec>
</abstract>
<kwd-group><kwd>Periodontal diseases</kwd>
<kwd>Stroke</kwd>
<kwd>Infection</kwd>
<kwd>Pathogenesis</kwd>
<kwd>Atherogenesis</kwd>
</kwd-group>
<funding-group><award-group><funding-source>The State of São Paulo Research Foundation</funding-source>
<award-id>2006/02376-4</award-id>
</award-group>
<award-group><funding-source>Coordination of Support for Higher Education</funding-source>
</award-group>
</funding-group>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Brésil</li>
</country>
<region><li>Santa Catarina</li>
<li>État de São Paulo</li>
</region>
<settlement><li>São Paulo</li>
</settlement>
<orgName><li>Université de São Paulo</li>
</orgName>
</list>
<tree><country name="Brésil"><region name="État de São Paulo"><name sortKey="Ghizoni, Janaina Salomon" sort="Ghizoni, Janaina Salomon" uniqKey="Ghizoni J" first="Janaina Salomon" last="Ghizoni">Janaina Salomon Ghizoni</name>
</region>
<name sortKey="Brozoski, Daniel Thomas" sort="Brozoski, Daniel Thomas" uniqKey="Brozoski D" first="Daniel Thomas" last="Brozoski">Daniel Thomas Brozoski</name>
<name sortKey="Dionisio, Thiago Jose" sort="Dionisio, Thiago Jose" uniqKey="Dionisio T" first="Thiago José" last="Dionísio">Thiago José Dionísio</name>
<name sortKey="Garlet, Gustavo Pompermaier" sort="Garlet, Gustavo Pompermaier" uniqKey="Garlet G" first="Gustavo Pompermaier" last="Garlet">Gustavo Pompermaier Garlet</name>
<name sortKey="Ghizoni, Marcos Flavio" sort="Ghizoni, Marcos Flavio" uniqKey="Ghizoni M" first="Marcos Flávio" last="Ghizoni">Marcos Flávio Ghizoni</name>
<name sortKey="Pereira, Jefferson Ricardo" sort="Pereira, Jefferson Ricardo" uniqKey="Pereira J" first="Jefferson Ricardo" last="Pereira">Jefferson Ricardo Pereira</name>
<name sortKey="Sant Ana, Adriana Campos Passanezi" sort="Sant Ana, Adriana Campos Passanezi" uniqKey="Sant Ana A" first="Adriana Campos Passanezi" last="Sant'Ana">Adriana Campos Passanezi Sant'Ana</name>
<name sortKey="Santos, Carlos Ferreira" sort="Santos, Carlos Ferreira" uniqKey="Santos C" first="Carlos Ferreira" last="Santos">Carlos Ferreira Santos</name>
<name sortKey="Taveira, Luis Antonio De Assis" sort="Taveira, Luis Antonio De Assis" uniqKey="Taveira L" first="Luís Antônio De Assis" last="Taveira">Luís Antônio De Assis Taveira</name>
</country>
</tree>
</affiliations>
</record>
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