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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Introdu&#231;&#227;o</span><p id="par0005" class="elsevierStylePara elsevierViewall">O p&#234;nfigo engloba um grupo de doen&#231;as bolhosas autoimunes resultantes da produ&#231;&#227;o de autoanticorpos contra as desmogle&#237;nas &#40;Dsg&#41;&#46; Autoanticorpos IgG contra Dsg1 afetam a pele no p&#234;nfigo foli&#225;ceo &#40;PF&#41;&#44; e autoanticorpos IgG contra Dsg3 e Dsg1 afetam as mucosas e a pele no p&#234;nfigo vulgar &#40;PV&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">1</span></a> O PF &#233; end&#234;mico no Brasil&#44; onde &#233; conhecido como &#8220;fogo selvagem&#8221;&#46; Mais recentemente&#44; o diagn&#243;stico de PV superou o de PF em algumas regi&#245;es brasileiras&#46;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">2&#44;3</span></a> Embora os alelos HLA classe I e II diferenciem as formas cl&#237;nicas de PF e de PV&#44; sua etiopatogenia n&#227;o &#233; totalmente compreendida&#46;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">4&#8211;6</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Fatores ex&#243;genos t&#234;m sido associados &#224; patog&#234;nese do p&#234;nfigo&#44; incluindo medicamentos e elementos nutricionais ricos em tiol&#44; metais pesados&#44; infec&#231;&#227;o pelo v&#237;rus herpes e picada de inseto&#46;<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">7&#8211;14</span></a> Al&#233;m disso&#44; em estudos de caso&#8208;controle com base em entrevistas&#44; a exposi&#231;&#227;o a pesticidas&#44; principalmente aos organofosforados &#40;OP&#41;&#44; tem sido relacionada ao PV na &#193;sia&#44; Europa e Am&#233;rica do Norte&#44;<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">15&#8211;19</span></a> e tamb&#233;m ao &#8220;fogo selvagem&#8221; no Brasil&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">20</span></a> PV foi descrito ap&#243;s dermatite de contato com dicloro&#8208;difenil&#8208;tricloroetano e diazinon&#46;<a class="elsevierStyleCrossRefs" href="#bib0310"><span class="elsevierStyleSup">21&#44;22</span></a> Utilizando pele humana normal como substrato e amostras de soro de PV&#44; o clorpirif&#243;s induziu p&#234;nfigo em um experimento <span class="elsevierStyleItalic">in vitro</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">23</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">N&#227;o h&#225; relato de abordagem mais abrangente em rela&#231;&#227;o &#224; quantifica&#231;&#227;o de n&#237;veis de pesticidas em uma popula&#231;&#227;o brasileira mais ampla de p&#234;nfigo para melhor compreens&#227;o da sua conex&#227;o ambiental com o p&#234;nfigo&#46; Este estudo teve como objetivo avaliar a exposi&#231;&#227;o a pesticidas por meio de &#40;i&#41; entrevista com base em question&#225;rio e &#40;ii&#41; medidas quantifica&#231;&#227;o dos n&#237;veis de pesticidas OP e organoclorados &#40;OC&#41; em amostras de cabelo do couro cabeludo de pacientes com PV e PF e controles residentes na regi&#227;o nordeste do estado de S&#227;o Paulo&#44; uma &#225;rea do Sudeste brasileiro onde ambas as formas cl&#237;nicas de p&#234;nfigo s&#227;o prevalentes&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">3</span></a></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Materiais e m&#233;todos</span><p id="par0020" class="elsevierStylePara elsevierViewall">Neste estudo transversal de caso&#8208;controle&#44; tr&#234;s grupos foram comparados&#58; pacientes com PV &#40;doravante denominados PV&#41;&#44; pacientes com PF &#40;doravante denominados PF&#41; e controles&#46; Este estudo foi aprovado pelo Comit&#234; de &#201;tica em Pesquisa local do Hospital Universit&#225;rio da Faculdade de Medicina de Ribeir&#227;o Preto da Universidade de S&#227;o Paulo &#40;n&#176; 2248&#47;2010&#41;&#44; e todos os participantes assinaram o termo de consentimento livre e esclarecido&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Grupos de pacientes e controles</span><p id="par0025" class="elsevierStylePara elsevierViewall">Setenta e cinco pacientes com p&#234;nfigo atendidos no Ambulat&#243;rio de Dermatologia do Hospital das Cl&#237;nicas da Faculdade de Medicina de Ribeir&#227;o Preto da Universidade de S&#227;o Paulo &#40;SP&#44; Brasil&#41; foram inclu&#237;dos no estudo&#46; Entre eles&#44; 32 tinham PV &#40;mediana de idade<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>50 anos&#44; 75&#37; do sexo feminino&#41; e 43 tinham PF &#40;mediana de idade<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>46 anos&#44; 58&#44;1&#37; do sexo feminino&#41;&#44; respectivamente &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46; O diagn&#243;stico de PV e PF foi estabelecido com base em caracter&#237;sticas cl&#237;nicas&#44; histopatol&#243;gicas e de imunofluoresc&#234;ncia &#40;direta&#44; indireta ou ambas&#41; e determina&#231;&#227;o de autoanticorpos contra Dsg1 e Dsg3 por ELISA &#40;MBL&#44; Jap&#227;o&#41;&#46; Os controles consistiram em 67 parentes e vizinhos saud&#225;veis dos pacientes com p&#234;nfigo &#40;mediana de idade<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>46 anos&#44; 70&#44;1&#37; do sexo feminino&#59; <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46; PV&#44; PF e controles residiam na regi&#227;o nordeste do estado de S&#227;o Paulo&#44; localizado no Sudeste do Brasil&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Question&#225;rios</span><p id="par0030" class="elsevierStylePara elsevierViewall">Os question&#225;rios&#44; elaborados pelos autores&#44; foram aplicados a 28 pacientes com PV e 39 com PF e a 48 controles&#46; As respostas a cada item dos question&#225;rios foram incompletas nos tr&#234;s grupos&#46; Assim&#44; 28 pacientes com PV e 40 controles responderam a &#8220;&#193;rea de resid&#234;ncia&#8221;&#59; e 27 pacientes com PV e 48 controles responderam &#224;s quest&#245;es sobre &#8220;Exposi&#231;&#227;o a pesticidas&#8221; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46; Os indiv&#237;duos foram entrevistados por ocasi&#227;o da sua visita ao Ambulat&#243;rio de Dermatologia do Hospital das Cl&#237;nicas da Faculdade de Medicina de Ribeir&#227;o Preto da Universidade de S&#227;o Paulo&#46; Duas informa&#231;&#245;es principais foram analisadas&#58; &#225;rea de resid&#234;ncia &#40;rural ou urbana&#41; por ocasi&#227;o do aparecimento do p&#234;nfigo e exposi&#231;&#227;o a pesticidas relacionada a atividades profissionais ou outras causas&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Coleta de amostras de cabelo</span><p id="par0035" class="elsevierStylePara elsevierViewall">Com o aux&#237;lio de uma tesoura est&#233;ril&#44; foram cortados cerca de 500<span class="elsevierStyleHsp" style=""></span>mg da raiz do cabelo do couro cabeludo na regi&#227;o occipital e armazenados em envelopes de papel individuais em temperatura ambiente at&#233; a an&#225;lise&#46; As amostras foram testadas para pesticidas OP e OC&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">M&#233;todos anal&#237;ticos de pesticidas OP e OC e valores aceit&#225;veis</span><p id="par0040" class="elsevierStylePara elsevierViewall">Os agrot&#243;xicos pertencentes &#224;s classes OP e OC foram analisados por cromatografia em fase gasosa acoplada &#224; espectrometria de massa &#40;GC&#47;MS&#41;&#46; O procedimento de extra&#231;&#227;o para an&#225;lise de amostras de cabelo para presen&#231;a de OP e OC foi o mesmo descrito por Tsatsakis et al&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">24</span></a> e adaptado &#224;s condi&#231;&#245;es instrumentais do Laborat&#243;rio de Toxicologia Forense do Departamento de Qu&#237;mica da Faculdade de Filosofia&#44; Ci&#234;ncias e Letras de Ribeir&#227;o Preto da Universidade de S&#227;o Paulo&#46; Os experimentos foram realizados em um cromat&#243;grafo a g&#225;s 7890A acoplado a um espectr&#244;metro de massa 5975C Inert &#40;Agilent Technologies&#44; EUA&#41; equipado com uma coluna cromatogr&#225;fica DB&#8208;5MSUI &#40;30 m<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>0&#44;25<span class="elsevierStyleHsp" style=""></span>mm&#47;d&#46;i&#46;&#44; 0&#44;25<span class="elsevierStyleHsp" style=""></span>&#956;m de espessura de filme&#59; Agilent Technologies&#44; EUA&#41;&#46; Os analitos foram elu&#237;dos com programa&#231;&#227;o linear de temperatura do forno&#44; como descrito a seguir&#58; 60<span class="elsevierStyleHsp" style=""></span>&#176;C por 2&#44;0<span class="elsevierStyleHsp" style=""></span>min&#44; aumento para 315<span class="elsevierStyleHsp" style=""></span>&#176;C a 30<span class="elsevierStyleHsp" style=""></span>&#176;C&#47;min&#44; e 315<span class="elsevierStyleHsp" style=""></span>&#176;C por 2<span class="elsevierStyleHsp" style=""></span>min &#40;tempo total de 12&#44;5<span class="elsevierStyleHsp" style=""></span>min&#41;&#46; As temperaturas da porta de inje&#231;&#227;o e da linha de transfer&#234;ncia foram ajustadas para 280<span class="elsevierStyleHsp" style=""></span>&#176;C&#46; H&#233;lio ultrapuro foi usado como g&#225;s carreador a uma vaz&#227;o de 1&#44;0<span class="elsevierStyleHsp" style=""></span>mL&#47;min&#44; e as amostras foram injetadas no modo <span class="elsevierStyleItalic">splitless</span> &#40;utilizando <span class="elsevierStyleItalic">liner split</span> ultrainerte desativado com l&#227; de vidro para melhorar a cromatografia&#41;&#46; O espectr&#244;metro de massa foi ajustado para o modo SIM&#46; Os dados foram adquiridos e o instrumento foi controlado com o <span class="elsevierStyleItalic">software</span> Agilent Technologies ChemStation&#44; vers&#227;o E02021431&#44; fornecido pelo fabricante&#46; A <a class="elsevierStyleCrossRef" href="#sec0090">tabela suplementar 1</a> fornece os valores de limite de detec&#231;&#227;o &#40;LOD&#41; e limite de quantifica&#231;&#227;o &#40;LOQ&#41; dos pesticidas&#46; Os valores de ingest&#227;o di&#225;ria aceit&#225;vel &#40;IDA&#41; para OP detectados neste estudo s&#227;o os seguintes&#58; clorpirif&#243;s &#40;10 pg&#47;mg&#41;&#44; diazinon &#40;2 pg&#47;mg&#41; e malation &#40;300 pg&#47;mg&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">25</span></a> O uso de diclorv&#243;s&#44; metil&#8208;paration e paration foi banido&#46; O uso dos pesticidas OC aldrin&#44; BHC&#44; DDT e endrin tamb&#233;m foi banido&#44; ent&#227;o nenhum valor de IDA est&#225; dispon&#237;vel para eles&#46; As amostras que testaram positivo&#44; mas abaixo do limite de detec&#231;&#227;o &#40;&#60; LOQ&#41; foram inclu&#237;das no presente estudo&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">An&#225;lise estat&#237;stica</span><p id="par0045" class="elsevierStylePara elsevierViewall">Os testes de Kruskal&#8208;Wallis e Mann&#8208;Whitney foram utilizados para analisar idade e dura&#231;&#227;o da doen&#231;a&#44; respectivamente&#46; O teste de Fischer foi utilizado para analisar as frequ&#234;ncias das vari&#225;veis&#46; Adotou&#8208;se p &#8804; 0&#44;05 e empregou&#8208;se a compara&#231;&#227;o bicaudal&#46; A an&#225;lise estat&#237;stica foi realizada utilizando&#8208;se o <span class="elsevierStyleItalic">software</span> SPSS&#44; 26&#46;0 &#40;IBM&#44; EUA&#41;&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Resultados</span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Dados demogr&#225;ficos e cl&#237;nicos</span><p id="par0050" class="elsevierStylePara elsevierViewall">Os grupos de 32 PV&#44; 43 PF e 67 controles n&#227;o diferiram quanto &#224; idade ou sexo&#46; Dados sobre a idade de 14 controles n&#227;o estavam dispon&#237;veis&#46; A dura&#231;&#227;o da doen&#231;a foi maior no grupo PF do que no PV &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;005&#59; <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Dados de entrevistas com base em question&#225;rio</span><p id="par0055" class="elsevierStylePara elsevierViewall">N&#227;o houve diferen&#231;a estat&#237;stica comparando &#225;rea de resid&#234;ncia urbana ou rural entre PV&#44; PF e controles &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;2853&#41;&#46; Dois &#40;7&#44;1&#37;&#41; dos 28 PV e 7 &#40;18&#37;&#41; dos 39 PF&#44; mas nenhum dos 48 controles&#44; informaram residir na zona rural&#46; As informa&#231;&#245;es positivas ou negativas sobre a exposi&#231;&#227;o a pesticidas foram semelhantes entre os grupos &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;186&#59; <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Quantifica&#231;&#227;o dos n&#237;veis de OP e OC em amostras de cabelo</span><p id="par0060" class="elsevierStylePara elsevierViewall">Pesticidas OP e OC foram quantificados em amostras de cabelo de 32 PV&#44; 43 PF e 67 controles &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46; Vinte e um &#40;14&#44;8&#37;&#41; dos 142 indiv&#237;duos testaram positivo para OP&#44; OC ou ambos&#46; O grupo PF &#40;11 &#91;25&#44;6&#37;&#93;&#41; apresentou mais pacientes contaminados do que o PV &#40;2 &#91;6&#44;3&#37;&#93;&#41;&#44; mas tinha tantos indiv&#237;duos contaminados quanto os controles &#40;8 &#91;11&#44;9&#37;&#93;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;034 e p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0753&#44; respectivamente&#41;&#46; PV e controles tiveram detec&#231;&#227;o de pesticidas semelhante &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;4928&#41;&#46; Tr&#234;s &#40;7&#37;&#41; PF testaram positivo para OP e OC&#46; Nenhum dos 32 PV testou positivo para OP&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Quatro OC e seis OP foram detectados em pacientes e controles &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#41;&#46; Entre os OC&#44; aldrin foi detectado em dois controles &#40;&#60; LOQ e 7&#44;7 pg&#47;mg&#41;&#59; BHC em dois PV e quatro PF &#40;varia&#231;&#227;o &#8804; LOQ a 12&#44;2 pg&#47;mg&#41;&#59; DDT em um PV e dois PF &#40;&#60; LOQ&#41;&#59; e endrin em um controle &#40;9&#44;1 pg&#47;mg&#41;&#46; Entre os OP&#44; o clorpirif&#243;s foi detectado em dois PF e tr&#234;s controles &#40;varia&#231;&#227;o &#8804; LOQ a 12&#44;6 pg&#47;mg&#41;&#59; diazinon em cinco PF e dois controles &#40;varia&#231;&#227;o &#8804; LOQ a 15&#44;6 pg&#47;mg&#41;&#59; diclorv&#243;s em quatro PF e dois controles &#40;varia&#231;&#227;o &#8804; LOQ a 9&#44;1 pg&#47;mg&#41;&#59; malation em dois PF e um controle &#40;varia&#231;&#227;o &#8804; LOQ a 8&#44;3 pg&#47;mg&#41;&#59; metil&#8208;paration em um PF &#40;12&#44;1 pg&#47;mg&#41;&#59; e paration em outro PF &#40;&#60; LOQ&#41;&#46; Alguns PF testaram positivo para tr&#234;s ou quatro OP&#44; com predomin&#226;ncia de diazinon e diclorv&#243;s&#46; Diurom foi detectado em um PF&#46; Sete &#40;70&#37;&#41; dos 10 PF eram do sexo feminino&#44; residiam em &#225;reas rurais no in&#237;cio do p&#234;nfigo e haviam sido expostas a pesticidas durante suas atividades profissionais no campo &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Discuss&#227;o</span><p id="par0070" class="elsevierStylePara elsevierViewall">A patog&#234;nese do p&#234;nfigo &#233; atribu&#237;da ao hist&#243;rico gen&#233;tico e a fatores ambientais&#44; incluindo pesticidas&#46;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">4&#8211;6&#44;15&#8211;20&#44;26</span></a> H&#225; poucos relatos de pesticidas desencadeando autoimunidade&#46; Eles foram descritos como causadores de imunotoxicidade&#44; disfun&#231;&#227;o end&#243;crina&#44; dist&#250;rbios neurodegenerativos e c&#226;ncer&#44; entre outras condi&#231;&#245;es&#46; Em rela&#231;&#227;o &#224;s doen&#231;as autoimunes&#44; os pesticidas t&#234;m sido relacionados principalmente ao l&#250;pus eritematoso sist&#234;mico e &#224; artrite reumatoide&#46;<a class="elsevierStyleCrossRefs" href="#bib0340"><span class="elsevierStyleSup">27&#8211;30</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">Que seja do nosso conhecimento&#44; este &#233; o primeiro relato sobre a quantifica&#231;&#227;o de n&#237;veis de pesticidas em pacientes com PV e PF&#44; em compara&#231;&#227;o com controles&#46; Escolheu&#8208;se quantificar os n&#237;veis de pesticidas em amostras de cabelo porque s&#227;o considerados biomarcadores humanos de exposi&#231;&#227;o aos pesticidas&#46;<a class="elsevierStyleCrossRefs" href="#bib0360"><span class="elsevierStyleSup">31&#8211;33</span></a> O presente estudo confirmou a contamina&#231;&#227;o por OP e&#47;ou OC em amostras de cabelo em PV&#44; PF e controles &#40;6&#44;3&#37;&#44; 25&#44;6&#37; e 11&#44;9&#37;&#44; respectivamente&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0437&#41;&#46; Em compara&#231;&#227;o com PV&#44; PF apresentou maior frequ&#234;ncia de contamina&#231;&#227;o com pesticidas &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;034&#41;&#46; Al&#233;m disso&#44; nove &#40;20&#44;9&#37;&#41; de 43 PF&#44; mas nenhum dos 32 PV testou positivo para OP&#46; Alguns PF testaram positivo para tr&#234;s ou quatro OP&#44; com predomin&#226;ncia de diazinon e diclorv&#243;s&#46; OC foi detectado de modo semelhante em PV&#44; PF e controles&#44; embora seu uso tenha sido banido desde 1985&#46;<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">34</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">O mecanismo imunol&#243;gico proposto para PV utilizando clorpirif&#243;s&#44;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">23</span></a> que &#233; um dos OP detectados em PF e controles neste estudo&#44; n&#227;o explica a patog&#234;nese do PV nesse pesticida&#44; uma vez que o PV n&#227;o apresentou nenhuma contamina&#231;&#227;o por OP&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Como se explica a preval&#234;ncia aumentada de contamina&#231;&#227;o por pesticidas no PF&#63; Historicamente&#44; no Brasil&#44; o PF estava distribu&#237;do em &#225;reas rurais pr&#243;ximas aos rios&#44; e a exposi&#231;&#227;o a pesticidas foi considerada um poss&#237;vel fator de risco para PF no pa&#237;s&#46;<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">20&#44;35</span></a> Entretanto&#44; as entrevistas com base em question&#225;rio n&#227;o revelaram diferen&#231;a estat&#237;stica entre PV&#44; PF e controles em termos de resid&#234;ncia urbana ou rural e exposi&#231;&#227;o a pesticidas&#46; Por outro lado&#44; a maioria do grupo PF com contamina&#231;&#227;o capilar por OC ou OP informou que residia na zona rural no in&#237;cio do p&#234;nfigo e havia sido exposta a pesticidas durante suas atividades profissionais no campo &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#41;&#46; Al&#233;m disso&#44; a doen&#231;a tem dura&#231;&#227;o maior no PF do que no PV&#44; o que pode ter contribu&#237;do para a bioacumula&#231;&#227;o de pesticidas no PF&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">A exposi&#231;&#227;o a pesticidas foi confirmada em doadores de sangue e na popula&#231;&#227;o rural no Brasil&#46;<a class="elsevierStyleCrossRefs" href="#bib0385"><span class="elsevierStyleSup">36&#8211;38</span></a> Al&#233;m disso&#44; o perfil imunol&#243;gico foi determinado em agricultores brasileiros expostos a pesticidas&#46;<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">39&#44;40</span></a> Em nosso estudo&#44; em oito controles que apresentaram contamina&#231;&#227;o com pesticidas &#40;seis OP e dois OC&#59; <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#41;&#44; foram pesquisados autoanticorpos contra Dsg1 e Dsg3 utilizando ELISA &#40;MBL&#44; Jap&#227;o&#41;&#44; com resultados negativos em tr&#234;s &#40;C<span class="elsevierStyleInf">1</span>&#44; C<span class="elsevierStyleInf">7</span> e C<span class="elsevierStyleInf">8</span>&#41;&#46; Os perfis de HLA classe II foram determinados nos oito controles &#40;C<span class="elsevierStyleInf">1</span> a C<span class="elsevierStyleInf">8</span>&#59; dados n&#227;o mostrados&#41;&#46; Em dois dos seis controles contaminados com OP observamos&#58; um controle &#40;C1&#41; contaminado com diazinon e malation apresentou ambos os alelos <span class="elsevierStyleItalic">HLA&#8208;DRB1</span>&#42;01&#58;01 e <span class="elsevierStyleItalic">HLA&#8208;DQB1</span>&#42;05&#58;01 de suscetibilidade para PF&#59; e outro &#40;C5&#41; contaminado com diclorv&#243;s e clorpirif&#243;s apresentou o alelo <span class="elsevierStyleItalic">HLA&#8208;DQB1</span>&#42;03&#58;02 de suscetibilidade para PV&#46; Os outros seis controles n&#227;o apresentaram alelos associados com PV e PF &#40;para alelos HLA associados a PV e PF&#44; ver Brochado et al&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">4</span></a>&#41;&#46; Sabendo que ambas as formas cl&#237;nicas de p&#234;nfigo s&#227;o prevalentes na regi&#227;o nordeste do estado de S&#227;o Paulo<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">35</span></a> testar anticorpos contra Dsg e determinar os alelos HLA em uma ampla popula&#231;&#227;o exposta a pesticidas forneceria informa&#231;&#245;es importantes sobre a rela&#231;&#227;o pesticidas&#8208;p&#234;nfigo&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Os resultados do presente estudo corroboram um relato recente de Chang e Tsai&#44;<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">41</span></a> em revis&#227;o sistem&#225;tica e metan&#225;lise&#46; Eles inclu&#237;ram cinco estudos de caso&#8208;controle<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">15&#8211;17&#44;19&#44;20</span></a> com base em entrevistas sobre a rela&#231;&#227;o entre exposi&#231;&#227;o a pesticidas e PV e PF&#46; Os autoress conclu&#237;ram haver associa&#231;&#227;o entre exposi&#231;&#227;o a pesticidas e p&#234;nfigo&#46;<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">41</span></a> Em nosso estudo&#44; demonstramos a contamina&#231;&#227;o do cabelo por OC e&#47;ou OP nos tr&#234;s grupos estudados&#59; o grupo PF foi o que apresentou a maior contamina&#231;&#227;o por pesticidas&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conclus&#227;o</span><p id="par0100" class="elsevierStylePara elsevierViewall">O presente estudo confirmou a contamina&#231;&#227;o do cabelo com pesticidas OC e&#47;ou OP em PF&#44; PV e controles&#46; Os pacientes com PV n&#227;o testaram positivo para pesticidas OP&#46; Alguns pacientes com PF testaram positivo para tr&#234;s ou quatro OP&#44; com predomin&#226;ncia de diazinon e diclorv&#243;s&#46; Embora PV e PF tenham fornecido informa&#231;&#245;es semelhantes sobre resid&#234;ncia em &#225;reas rurais no in&#237;cio do p&#234;nfigo e estarem expostos a pesticidas&#44; a detec&#231;&#227;o desses foi mais frequente em amostras de cabelo de PF em compara&#231;&#227;o com PV&#46; A rela&#231;&#227;o entre a patog&#234;nese de PF e pesticidas ainda precisa ser elucidada&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Suporte financeiro</span><p id="par0105" class="elsevierStylePara elsevierViewall">Este estudo foi parcialmente financiado pela Funda&#231;&#227;o de Amparo &#224; Pesquisa do Estado de S&#227;o Paulo &#40;FAPESP&#44; n&#176; 2010&#47;51729&#8208;2&#41;&#46; O primeiro autor recebeu bolsa de mestrado da Coordena&#231;&#227;o de Aperfei&#231;oamento de Pessoal de N&#237;vel Superior &#40;CAPES&#41;&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Contribui&#231;&#227;o dos autores</span><p id="par0110" class="elsevierStylePara elsevierViewall">Bruno de Martins&#58; Aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; revis&#227;o cr&#237;tica do manuscrito&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Leonardo La Serra&#58; An&#225;lise estat&#237;stica&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; revis&#227;o cr&#237;tica da literatura&#59; revis&#227;o cr&#237;tica do manuscrito&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Rafael Lanaro&#58; Aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; revis&#227;o cr&#237;tica do manuscrito&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Ana Maria Roselino&#58; Aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; concep&#231;&#227;o e planejamento do estudo&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; revis&#227;o cr&#237;tica do manuscrito&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflito de interesses</span><p id="par0130" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Fundamentos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Pesticidas&#44; principalmente os organofosforados &#40;OP&#41;&#44; t&#234;m sido relacionados ao aumento do risco de p&#234;nfigo vulgar &#40;PV&#41; e p&#234;nfigo foli&#225;ceo &#40;PF&#41;&#44; por&#233;m seus n&#237;veis n&#227;o foram determinados em pacientes com p&#234;nfigo&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Avaliar a exposi&#231;&#227;o e a quantifica&#231;&#227;o dos pesticidas&#44; comparando PV&#44; PF e grupos controle no Sudeste do Brasil&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Informa&#231;&#245;es sobre resid&#234;ncia urbana ou rural e exposi&#231;&#227;o a pesticidas no in&#237;cio do p&#234;nfigo foram avaliadas por meio de entrevista por question&#225;rio&#46; Amostras de cabelos do couro cabeludo de casos de PV&#44; PF e controles foram testadas para pesticidas OP e organoclorados &#40;OC&#41; por cromatografia em fase gasosa acoplada &#224; espectrometria de massa&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A minoria dos casos de PV &#40;2 &#91;7&#44;1&#37;&#93; de 28&#41; e PF &#40;7 &#91;18&#37;&#93; de 39&#41;&#44; mas nenhum dos 48 controles&#44; informou viver em &#225;reas rurais no in&#237;cio do p&#234;nfigo &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;2853&#41;&#46; PV &#40;33&#44;3&#37;&#41;&#44; PF &#40;38&#44;5&#37;&#41; e controles &#40;20&#37;&#41; relataram exposi&#231;&#227;o a pesticidas &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;186&#41;&#46; Vinte e um &#40;14&#44;8&#37;&#41; de 142 indiv&#237;duos testaram positivo para OP e&#47;ou OC&#58; PV &#40;2 &#91;6&#44;3&#37;&#93; de 32&#41; e PF &#40;11 &#91;25&#44;6&#37;&#93; de 43&#41; apresentaram contamina&#231;&#227;o por pesticidas semelhante aos controles &#40;8 &#91;11&#44;9&#37;&#93; de 67&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;4928&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0753&#44; respectivamente&#41;&#44; mas PF apresentou maior contamina&#231;&#227;o do que PV &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;034&#41;&#46; PV n&#227;o mostrou nenhuma positividade para OP&#46; Tr&#234;s &#40;7&#37;&#41; casos de PF testaram positivo para OP e OC&#46; Alguns PF testaram positivo para tr&#234;s ou quatro OP&#44; com predomin&#226;ncia de diazinon e diclorv&#243;s&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Limita&#231;&#227;o do estudo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Falta de dados para alguns controles&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclus&#227;o</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Embora a frequ&#234;ncia de pacientes com PV e PF expostos a pesticidas tenha sido semelhante&#44; os pesticidas foram mais frequentemente detectados em amostras de cabelo de PF em compara&#231;&#227;o com PV&#46; A rela&#231;&#227;o entre causa e efeito precisa ser determinada&#46;</p></span>"
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;41&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;29&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;2218</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Feminino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 &#40;75&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25 &#40;58&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47 &#40;70&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">n<span class="elsevierStyleHsp" style=""></span>&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">31</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">n<span class="elsevierStyleHsp" style=""></span>&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">43</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Dura&#231;&#227;o da doen&#231;a &#40;anos&#41; mediana &#40;p25&#8211;p75&#41;</span></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;2&#8211;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;5&#8211;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">0&#44;005</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Entrevista por question&#225;rio</span><a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">n<span class="elsevierStyleHsp" style=""></span>&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">28 &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">n<span class="elsevierStyleHsp" style=""></span>&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">39 &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">n<span class="elsevierStyleHsp" style=""></span>&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">48 &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleSup">a&#44;b</span>0&#44;2853</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#193;rea de resid&#234;ncia</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Rural&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;7&#44;1&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;18&#44;0&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Urbana&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 &#40;92&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32 &#40;82&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">n<span class="elsevierStyleHsp" style=""></span>&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">27 &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">n<span class="elsevierStyleHsp" style=""></span>&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">39 &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">n<span class="elsevierStyleHsp" style=""></span>&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">40 &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;1860</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Exposi&#231;&#227;o a pesticidas</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sim&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;33&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;38&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;20&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#227;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;66&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 &#40;61&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32 &#40;80&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Detec&#231;&#227;o de pesticidas no cabelo</span></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">n<span class="elsevierStyleHsp" style=""></span>&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">32 &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">n<span class="elsevierStyleHsp" style=""></span>&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">43 &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">n<span class="elsevierStyleHsp" style=""></span>&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">67 &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Organofosforados</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sim&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;20&#44;9&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;9&#44;0&#41;<span class="elsevierStyleSup">c</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleSup">b&#44;c</span>0&#44;0914</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#227;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34 &#40;79&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61 &#40;91&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Organoclorados</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sim&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;6&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;11&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">2 &#40;3&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
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                  \t\t\t\t">0&#44;1707</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#227;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">30 &#40;93&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">38 &#40;88&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">65 &#40;97&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Total</td><td class="td" title="\n
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                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sim</td><td class="td" title="\n
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                  \t\t\t\t  " rowspan="2" align="left" valign="\n
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                  \t\t\t\t">2 &#40;6&#44;3&#41;<span class="elsevierStyleSup">a</span></td><td class="td" title="\n
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                  \t\t\t\t  " rowspan="2" align="left" valign="\n
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                  \t\t\t\t">11 &#40;25&#44;6&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#167;</span></a><span class="elsevierStyleSup">b</span></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleSup">abc</span><span class="elsevierStyleItalic">0&#44;043</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleSup">ab</span><span class="elsevierStyleItalic">0&#44;034</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " rowspan="2" align="left" valign="\n
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                  \t\t\t\t">N&#227;o</td><td class="td" title="\n
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                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 &#40;93&#44;7&#41;</td><td class="td" title="\n
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                  \t\t\t\t  " rowspan="2" align="left" valign="\n
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                  \t\t\t\t">32 &#40;74&#44;4&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
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                  \t\t\t\t">59 &#40;88&#44;1&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleSup">bc</span>0&#44;0753&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleSup">ac</span>0&#44;4928&nbsp;\t\t\t\t\t\t\n
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Tr&#234;s pacientes com PF apresentaram detec&#231;&#227;o de pesticidas organofosforados e organoclorados&#46;</p>"
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          "pt" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Dados demogr&#225;ficos e cl&#237;nicos&#44; &#225;rea de resid&#234;ncia e exposi&#231;&#227;o a pesticidas no in&#237;cio da doen&#231;a&#44; registrados em question&#225;rios&#44; e detec&#231;&#227;o de pesticidas organofosforados e organoclorados em amostras de cabelo de pacientes com p&#234;nfigo vulgar &#40;PV&#41; e p&#234;nfigo foli&#225;ceo &#40;PF&#41; e controles</p>"
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          "leyenda" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">BHC&#44; hexaclorobenzeno&#59; DDT&#44; dicloro&#8208;difenil&#8208;tricloroetano&#59; LOQ&#44; limite de quantifica&#231;&#227;o&#59; ND&#44; n&#227;o dispon&#237;vel&#46;</p>"
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                  <table border="0" frame="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Sexo&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col">In&#237;cio da doen&#231;a at&#233; a coleta de amostras de cabelo &#40;anos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col">Idade&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col">Profiss&#227;o&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col">Question&#225;rios&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="11" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Classes de pesticidas &#40;pg&#47;mL&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a></th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Zona de resid&#234;ncia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Pesticidas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="4" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Organoclorados</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="6" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Organofosforados</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Outro&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Exposi&#231;&#227;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Aldrin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">BHC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">DDT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Endrin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Clorpirif&#243;s&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Diazinon&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Diclorv&#243;s&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Malation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Metil paration&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Paration&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PV<span class="elsevierStyleInf">1</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
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Artigo original
Quantificação de pesticidas em amostras de cabelo de pacientes com pênfigo foliáceo e pênfigo vulgar no Sudeste do Brasil
Leonardo La Serraa, Adriana Martinelli Salathiela, Rafael Lanarob,c, Bruno de Martinisd, Ana Maria Roselinoa,
Corresponding author
amfrosel@fmrp.usp.br

Autor para correspondência.
a Departamento de Clínica Médica, Divisão de Dermatologia, Hospital Universitário, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, SP, Brasil
b Centro de Controle de Intoxicações, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
c Faculdade de Ciências Farmacêuticas, Universidade Estadual de Campinas, Campinas, SP, Brasil
d Departamento de Química, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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            "entidad" => "Faculdade de Ci&#234;ncias Farmac&#234;uticas&#44; Universidade Estadual de Campinas&#44; Campinas&#44; SP&#44; Brasil"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Departamento de Qu&#237;mica&#44; Faculdade de Filosofia&#44; Ci&#234;ncias e Letras de Ribeir&#227;o Preto&#44; Universidade de S&#227;o Paulo&#44; Ribeir&#227;o Preto&#44; SP&#44; Brasil"
            "etiqueta" => "d"
            "identificador" => "aff0020"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Autor para correspond&#234;ncia&#46;"
          ]
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Introdu&#231;&#227;o</span><p id="par0005" class="elsevierStylePara elsevierViewall">O p&#234;nfigo engloba um grupo de doen&#231;as bolhosas autoimunes resultantes da produ&#231;&#227;o de autoanticorpos contra as desmogle&#237;nas &#40;Dsg&#41;&#46; Autoanticorpos IgG contra Dsg1 afetam a pele no p&#234;nfigo foli&#225;ceo &#40;PF&#41;&#44; e autoanticorpos IgG contra Dsg3 e Dsg1 afetam as mucosas e a pele no p&#234;nfigo vulgar &#40;PV&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">1</span></a> O PF &#233; end&#234;mico no Brasil&#44; onde &#233; conhecido como &#8220;fogo selvagem&#8221;&#46; Mais recentemente&#44; o diagn&#243;stico de PV superou o de PF em algumas regi&#245;es brasileiras&#46;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">2&#44;3</span></a> Embora os alelos HLA classe I e II diferenciem as formas cl&#237;nicas de PF e de PV&#44; sua etiopatogenia n&#227;o &#233; totalmente compreendida&#46;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">4&#8211;6</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Fatores ex&#243;genos t&#234;m sido associados &#224; patog&#234;nese do p&#234;nfigo&#44; incluindo medicamentos e elementos nutricionais ricos em tiol&#44; metais pesados&#44; infec&#231;&#227;o pelo v&#237;rus herpes e picada de inseto&#46;<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">7&#8211;14</span></a> Al&#233;m disso&#44; em estudos de caso&#8208;controle com base em entrevistas&#44; a exposi&#231;&#227;o a pesticidas&#44; principalmente aos organofosforados &#40;OP&#41;&#44; tem sido relacionada ao PV na &#193;sia&#44; Europa e Am&#233;rica do Norte&#44;<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">15&#8211;19</span></a> e tamb&#233;m ao &#8220;fogo selvagem&#8221; no Brasil&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">20</span></a> PV foi descrito ap&#243;s dermatite de contato com dicloro&#8208;difenil&#8208;tricloroetano e diazinon&#46;<a class="elsevierStyleCrossRefs" href="#bib0310"><span class="elsevierStyleSup">21&#44;22</span></a> Utilizando pele humana normal como substrato e amostras de soro de PV&#44; o clorpirif&#243;s induziu p&#234;nfigo em um experimento <span class="elsevierStyleItalic">in vitro</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">23</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">N&#227;o h&#225; relato de abordagem mais abrangente em rela&#231;&#227;o &#224; quantifica&#231;&#227;o de n&#237;veis de pesticidas em uma popula&#231;&#227;o brasileira mais ampla de p&#234;nfigo para melhor compreens&#227;o da sua conex&#227;o ambiental com o p&#234;nfigo&#46; Este estudo teve como objetivo avaliar a exposi&#231;&#227;o a pesticidas por meio de &#40;i&#41; entrevista com base em question&#225;rio e &#40;ii&#41; medidas quantifica&#231;&#227;o dos n&#237;veis de pesticidas OP e organoclorados &#40;OC&#41; em amostras de cabelo do couro cabeludo de pacientes com PV e PF e controles residentes na regi&#227;o nordeste do estado de S&#227;o Paulo&#44; uma &#225;rea do Sudeste brasileiro onde ambas as formas cl&#237;nicas de p&#234;nfigo s&#227;o prevalentes&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">3</span></a></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Materiais e m&#233;todos</span><p id="par0020" class="elsevierStylePara elsevierViewall">Neste estudo transversal de caso&#8208;controle&#44; tr&#234;s grupos foram comparados&#58; pacientes com PV &#40;doravante denominados PV&#41;&#44; pacientes com PF &#40;doravante denominados PF&#41; e controles&#46; Este estudo foi aprovado pelo Comit&#234; de &#201;tica em Pesquisa local do Hospital Universit&#225;rio da Faculdade de Medicina de Ribeir&#227;o Preto da Universidade de S&#227;o Paulo &#40;n&#176; 2248&#47;2010&#41;&#44; e todos os participantes assinaram o termo de consentimento livre e esclarecido&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Grupos de pacientes e controles</span><p id="par0025" class="elsevierStylePara elsevierViewall">Setenta e cinco pacientes com p&#234;nfigo atendidos no Ambulat&#243;rio de Dermatologia do Hospital das Cl&#237;nicas da Faculdade de Medicina de Ribeir&#227;o Preto da Universidade de S&#227;o Paulo &#40;SP&#44; Brasil&#41; foram inclu&#237;dos no estudo&#46; Entre eles&#44; 32 tinham PV &#40;mediana de idade<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>50 anos&#44; 75&#37; do sexo feminino&#41; e 43 tinham PF &#40;mediana de idade<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>46 anos&#44; 58&#44;1&#37; do sexo feminino&#41;&#44; respectivamente &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46; O diagn&#243;stico de PV e PF foi estabelecido com base em caracter&#237;sticas cl&#237;nicas&#44; histopatol&#243;gicas e de imunofluoresc&#234;ncia &#40;direta&#44; indireta ou ambas&#41; e determina&#231;&#227;o de autoanticorpos contra Dsg1 e Dsg3 por ELISA &#40;MBL&#44; Jap&#227;o&#41;&#46; Os controles consistiram em 67 parentes e vizinhos saud&#225;veis dos pacientes com p&#234;nfigo &#40;mediana de idade<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>46 anos&#44; 70&#44;1&#37; do sexo feminino&#59; <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46; PV&#44; PF e controles residiam na regi&#227;o nordeste do estado de S&#227;o Paulo&#44; localizado no Sudeste do Brasil&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Question&#225;rios</span><p id="par0030" class="elsevierStylePara elsevierViewall">Os question&#225;rios&#44; elaborados pelos autores&#44; foram aplicados a 28 pacientes com PV e 39 com PF e a 48 controles&#46; As respostas a cada item dos question&#225;rios foram incompletas nos tr&#234;s grupos&#46; Assim&#44; 28 pacientes com PV e 40 controles responderam a &#8220;&#193;rea de resid&#234;ncia&#8221;&#59; e 27 pacientes com PV e 48 controles responderam &#224;s quest&#245;es sobre &#8220;Exposi&#231;&#227;o a pesticidas&#8221; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46; Os indiv&#237;duos foram entrevistados por ocasi&#227;o da sua visita ao Ambulat&#243;rio de Dermatologia do Hospital das Cl&#237;nicas da Faculdade de Medicina de Ribeir&#227;o Preto da Universidade de S&#227;o Paulo&#46; Duas informa&#231;&#245;es principais foram analisadas&#58; &#225;rea de resid&#234;ncia &#40;rural ou urbana&#41; por ocasi&#227;o do aparecimento do p&#234;nfigo e exposi&#231;&#227;o a pesticidas relacionada a atividades profissionais ou outras causas&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Coleta de amostras de cabelo</span><p id="par0035" class="elsevierStylePara elsevierViewall">Com o aux&#237;lio de uma tesoura est&#233;ril&#44; foram cortados cerca de 500<span class="elsevierStyleHsp" style=""></span>mg da raiz do cabelo do couro cabeludo na regi&#227;o occipital e armazenados em envelopes de papel individuais em temperatura ambiente at&#233; a an&#225;lise&#46; As amostras foram testadas para pesticidas OP e OC&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">M&#233;todos anal&#237;ticos de pesticidas OP e OC e valores aceit&#225;veis</span><p id="par0040" class="elsevierStylePara elsevierViewall">Os agrot&#243;xicos pertencentes &#224;s classes OP e OC foram analisados por cromatografia em fase gasosa acoplada &#224; espectrometria de massa &#40;GC&#47;MS&#41;&#46; O procedimento de extra&#231;&#227;o para an&#225;lise de amostras de cabelo para presen&#231;a de OP e OC foi o mesmo descrito por Tsatsakis et al&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">24</span></a> e adaptado &#224;s condi&#231;&#245;es instrumentais do Laborat&#243;rio de Toxicologia Forense do Departamento de Qu&#237;mica da Faculdade de Filosofia&#44; Ci&#234;ncias e Letras de Ribeir&#227;o Preto da Universidade de S&#227;o Paulo&#46; Os experimentos foram realizados em um cromat&#243;grafo a g&#225;s 7890A acoplado a um espectr&#244;metro de massa 5975C Inert &#40;Agilent Technologies&#44; EUA&#41; equipado com uma coluna cromatogr&#225;fica DB&#8208;5MSUI &#40;30 m<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>0&#44;25<span class="elsevierStyleHsp" style=""></span>mm&#47;d&#46;i&#46;&#44; 0&#44;25<span class="elsevierStyleHsp" style=""></span>&#956;m de espessura de filme&#59; Agilent Technologies&#44; EUA&#41;&#46; Os analitos foram elu&#237;dos com programa&#231;&#227;o linear de temperatura do forno&#44; como descrito a seguir&#58; 60<span class="elsevierStyleHsp" style=""></span>&#176;C por 2&#44;0<span class="elsevierStyleHsp" style=""></span>min&#44; aumento para 315<span class="elsevierStyleHsp" style=""></span>&#176;C a 30<span class="elsevierStyleHsp" style=""></span>&#176;C&#47;min&#44; e 315<span class="elsevierStyleHsp" style=""></span>&#176;C por 2<span class="elsevierStyleHsp" style=""></span>min &#40;tempo total de 12&#44;5<span class="elsevierStyleHsp" style=""></span>min&#41;&#46; As temperaturas da porta de inje&#231;&#227;o e da linha de transfer&#234;ncia foram ajustadas para 280<span class="elsevierStyleHsp" style=""></span>&#176;C&#46; H&#233;lio ultrapuro foi usado como g&#225;s carreador a uma vaz&#227;o de 1&#44;0<span class="elsevierStyleHsp" style=""></span>mL&#47;min&#44; e as amostras foram injetadas no modo <span class="elsevierStyleItalic">splitless</span> &#40;utilizando <span class="elsevierStyleItalic">liner split</span> ultrainerte desativado com l&#227; de vidro para melhorar a cromatografia&#41;&#46; O espectr&#244;metro de massa foi ajustado para o modo SIM&#46; Os dados foram adquiridos e o instrumento foi controlado com o <span class="elsevierStyleItalic">software</span> Agilent Technologies ChemStation&#44; vers&#227;o E02021431&#44; fornecido pelo fabricante&#46; A <a class="elsevierStyleCrossRef" href="#sec0090">tabela suplementar 1</a> fornece os valores de limite de detec&#231;&#227;o &#40;LOD&#41; e limite de quantifica&#231;&#227;o &#40;LOQ&#41; dos pesticidas&#46; Os valores de ingest&#227;o di&#225;ria aceit&#225;vel &#40;IDA&#41; para OP detectados neste estudo s&#227;o os seguintes&#58; clorpirif&#243;s &#40;10 pg&#47;mg&#41;&#44; diazinon &#40;2 pg&#47;mg&#41; e malation &#40;300 pg&#47;mg&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">25</span></a> O uso de diclorv&#243;s&#44; metil&#8208;paration e paration foi banido&#46; O uso dos pesticidas OC aldrin&#44; BHC&#44; DDT e endrin tamb&#233;m foi banido&#44; ent&#227;o nenhum valor de IDA est&#225; dispon&#237;vel para eles&#46; As amostras que testaram positivo&#44; mas abaixo do limite de detec&#231;&#227;o &#40;&#60; LOQ&#41; foram inclu&#237;das no presente estudo&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">An&#225;lise estat&#237;stica</span><p id="par0045" class="elsevierStylePara elsevierViewall">Os testes de Kruskal&#8208;Wallis e Mann&#8208;Whitney foram utilizados para analisar idade e dura&#231;&#227;o da doen&#231;a&#44; respectivamente&#46; O teste de Fischer foi utilizado para analisar as frequ&#234;ncias das vari&#225;veis&#46; Adotou&#8208;se p &#8804; 0&#44;05 e empregou&#8208;se a compara&#231;&#227;o bicaudal&#46; A an&#225;lise estat&#237;stica foi realizada utilizando&#8208;se o <span class="elsevierStyleItalic">software</span> SPSS&#44; 26&#46;0 &#40;IBM&#44; EUA&#41;&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Resultados</span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Dados demogr&#225;ficos e cl&#237;nicos</span><p id="par0050" class="elsevierStylePara elsevierViewall">Os grupos de 32 PV&#44; 43 PF e 67 controles n&#227;o diferiram quanto &#224; idade ou sexo&#46; Dados sobre a idade de 14 controles n&#227;o estavam dispon&#237;veis&#46; A dura&#231;&#227;o da doen&#231;a foi maior no grupo PF do que no PV &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;005&#59; <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Dados de entrevistas com base em question&#225;rio</span><p id="par0055" class="elsevierStylePara elsevierViewall">N&#227;o houve diferen&#231;a estat&#237;stica comparando &#225;rea de resid&#234;ncia urbana ou rural entre PV&#44; PF e controles &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;2853&#41;&#46; Dois &#40;7&#44;1&#37;&#41; dos 28 PV e 7 &#40;18&#37;&#41; dos 39 PF&#44; mas nenhum dos 48 controles&#44; informaram residir na zona rural&#46; As informa&#231;&#245;es positivas ou negativas sobre a exposi&#231;&#227;o a pesticidas foram semelhantes entre os grupos &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;186&#59; <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Quantifica&#231;&#227;o dos n&#237;veis de OP e OC em amostras de cabelo</span><p id="par0060" class="elsevierStylePara elsevierViewall">Pesticidas OP e OC foram quantificados em amostras de cabelo de 32 PV&#44; 43 PF e 67 controles &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46; Vinte e um &#40;14&#44;8&#37;&#41; dos 142 indiv&#237;duos testaram positivo para OP&#44; OC ou ambos&#46; O grupo PF &#40;11 &#91;25&#44;6&#37;&#93;&#41; apresentou mais pacientes contaminados do que o PV &#40;2 &#91;6&#44;3&#37;&#93;&#41;&#44; mas tinha tantos indiv&#237;duos contaminados quanto os controles &#40;8 &#91;11&#44;9&#37;&#93;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;034 e p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0753&#44; respectivamente&#41;&#46; PV e controles tiveram detec&#231;&#227;o de pesticidas semelhante &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;4928&#41;&#46; Tr&#234;s &#40;7&#37;&#41; PF testaram positivo para OP e OC&#46; Nenhum dos 32 PV testou positivo para OP&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Quatro OC e seis OP foram detectados em pacientes e controles &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#41;&#46; Entre os OC&#44; aldrin foi detectado em dois controles &#40;&#60; LOQ e 7&#44;7 pg&#47;mg&#41;&#59; BHC em dois PV e quatro PF &#40;varia&#231;&#227;o &#8804; LOQ a 12&#44;2 pg&#47;mg&#41;&#59; DDT em um PV e dois PF &#40;&#60; LOQ&#41;&#59; e endrin em um controle &#40;9&#44;1 pg&#47;mg&#41;&#46; Entre os OP&#44; o clorpirif&#243;s foi detectado em dois PF e tr&#234;s controles &#40;varia&#231;&#227;o &#8804; LOQ a 12&#44;6 pg&#47;mg&#41;&#59; diazinon em cinco PF e dois controles &#40;varia&#231;&#227;o &#8804; LOQ a 15&#44;6 pg&#47;mg&#41;&#59; diclorv&#243;s em quatro PF e dois controles &#40;varia&#231;&#227;o &#8804; LOQ a 9&#44;1 pg&#47;mg&#41;&#59; malation em dois PF e um controle &#40;varia&#231;&#227;o &#8804; LOQ a 8&#44;3 pg&#47;mg&#41;&#59; metil&#8208;paration em um PF &#40;12&#44;1 pg&#47;mg&#41;&#59; e paration em outro PF &#40;&#60; LOQ&#41;&#46; Alguns PF testaram positivo para tr&#234;s ou quatro OP&#44; com predomin&#226;ncia de diazinon e diclorv&#243;s&#46; Diurom foi detectado em um PF&#46; Sete &#40;70&#37;&#41; dos 10 PF eram do sexo feminino&#44; residiam em &#225;reas rurais no in&#237;cio do p&#234;nfigo e haviam sido expostas a pesticidas durante suas atividades profissionais no campo &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Discuss&#227;o</span><p id="par0070" class="elsevierStylePara elsevierViewall">A patog&#234;nese do p&#234;nfigo &#233; atribu&#237;da ao hist&#243;rico gen&#233;tico e a fatores ambientais&#44; incluindo pesticidas&#46;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">4&#8211;6&#44;15&#8211;20&#44;26</span></a> H&#225; poucos relatos de pesticidas desencadeando autoimunidade&#46; Eles foram descritos como causadores de imunotoxicidade&#44; disfun&#231;&#227;o end&#243;crina&#44; dist&#250;rbios neurodegenerativos e c&#226;ncer&#44; entre outras condi&#231;&#245;es&#46; Em rela&#231;&#227;o &#224;s doen&#231;as autoimunes&#44; os pesticidas t&#234;m sido relacionados principalmente ao l&#250;pus eritematoso sist&#234;mico e &#224; artrite reumatoide&#46;<a class="elsevierStyleCrossRefs" href="#bib0340"><span class="elsevierStyleSup">27&#8211;30</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">Que seja do nosso conhecimento&#44; este &#233; o primeiro relato sobre a quantifica&#231;&#227;o de n&#237;veis de pesticidas em pacientes com PV e PF&#44; em compara&#231;&#227;o com controles&#46; Escolheu&#8208;se quantificar os n&#237;veis de pesticidas em amostras de cabelo porque s&#227;o considerados biomarcadores humanos de exposi&#231;&#227;o aos pesticidas&#46;<a class="elsevierStyleCrossRefs" href="#bib0360"><span class="elsevierStyleSup">31&#8211;33</span></a> O presente estudo confirmou a contamina&#231;&#227;o por OP e&#47;ou OC em amostras de cabelo em PV&#44; PF e controles &#40;6&#44;3&#37;&#44; 25&#44;6&#37; e 11&#44;9&#37;&#44; respectivamente&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0437&#41;&#46; Em compara&#231;&#227;o com PV&#44; PF apresentou maior frequ&#234;ncia de contamina&#231;&#227;o com pesticidas &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;034&#41;&#46; Al&#233;m disso&#44; nove &#40;20&#44;9&#37;&#41; de 43 PF&#44; mas nenhum dos 32 PV testou positivo para OP&#46; Alguns PF testaram positivo para tr&#234;s ou quatro OP&#44; com predomin&#226;ncia de diazinon e diclorv&#243;s&#46; OC foi detectado de modo semelhante em PV&#44; PF e controles&#44; embora seu uso tenha sido banido desde 1985&#46;<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">34</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">O mecanismo imunol&#243;gico proposto para PV utilizando clorpirif&#243;s&#44;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">23</span></a> que &#233; um dos OP detectados em PF e controles neste estudo&#44; n&#227;o explica a patog&#234;nese do PV nesse pesticida&#44; uma vez que o PV n&#227;o apresentou nenhuma contamina&#231;&#227;o por OP&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Como se explica a preval&#234;ncia aumentada de contamina&#231;&#227;o por pesticidas no PF&#63; Historicamente&#44; no Brasil&#44; o PF estava distribu&#237;do em &#225;reas rurais pr&#243;ximas aos rios&#44; e a exposi&#231;&#227;o a pesticidas foi considerada um poss&#237;vel fator de risco para PF no pa&#237;s&#46;<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">20&#44;35</span></a> Entretanto&#44; as entrevistas com base em question&#225;rio n&#227;o revelaram diferen&#231;a estat&#237;stica entre PV&#44; PF e controles em termos de resid&#234;ncia urbana ou rural e exposi&#231;&#227;o a pesticidas&#46; Por outro lado&#44; a maioria do grupo PF com contamina&#231;&#227;o capilar por OC ou OP informou que residia na zona rural no in&#237;cio do p&#234;nfigo e havia sido exposta a pesticidas durante suas atividades profissionais no campo &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#41;&#46; Al&#233;m disso&#44; a doen&#231;a tem dura&#231;&#227;o maior no PF do que no PV&#44; o que pode ter contribu&#237;do para a bioacumula&#231;&#227;o de pesticidas no PF&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">A exposi&#231;&#227;o a pesticidas foi confirmada em doadores de sangue e na popula&#231;&#227;o rural no Brasil&#46;<a class="elsevierStyleCrossRefs" href="#bib0385"><span class="elsevierStyleSup">36&#8211;38</span></a> Al&#233;m disso&#44; o perfil imunol&#243;gico foi determinado em agricultores brasileiros expostos a pesticidas&#46;<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">39&#44;40</span></a> Em nosso estudo&#44; em oito controles que apresentaram contamina&#231;&#227;o com pesticidas &#40;seis OP e dois OC&#59; <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#41;&#44; foram pesquisados autoanticorpos contra Dsg1 e Dsg3 utilizando ELISA &#40;MBL&#44; Jap&#227;o&#41;&#44; com resultados negativos em tr&#234;s &#40;C<span class="elsevierStyleInf">1</span>&#44; C<span class="elsevierStyleInf">7</span> e C<span class="elsevierStyleInf">8</span>&#41;&#46; Os perfis de HLA classe II foram determinados nos oito controles &#40;C<span class="elsevierStyleInf">1</span> a C<span class="elsevierStyleInf">8</span>&#59; dados n&#227;o mostrados&#41;&#46; Em dois dos seis controles contaminados com OP observamos&#58; um controle &#40;C1&#41; contaminado com diazinon e malation apresentou ambos os alelos <span class="elsevierStyleItalic">HLA&#8208;DRB1</span>&#42;01&#58;01 e <span class="elsevierStyleItalic">HLA&#8208;DQB1</span>&#42;05&#58;01 de suscetibilidade para PF&#59; e outro &#40;C5&#41; contaminado com diclorv&#243;s e clorpirif&#243;s apresentou o alelo <span class="elsevierStyleItalic">HLA&#8208;DQB1</span>&#42;03&#58;02 de suscetibilidade para PV&#46; Os outros seis controles n&#227;o apresentaram alelos associados com PV e PF &#40;para alelos HLA associados a PV e PF&#44; ver Brochado et al&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">4</span></a>&#41;&#46; Sabendo que ambas as formas cl&#237;nicas de p&#234;nfigo s&#227;o prevalentes na regi&#227;o nordeste do estado de S&#227;o Paulo<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">35</span></a> testar anticorpos contra Dsg e determinar os alelos HLA em uma ampla popula&#231;&#227;o exposta a pesticidas forneceria informa&#231;&#245;es importantes sobre a rela&#231;&#227;o pesticidas&#8208;p&#234;nfigo&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Os resultados do presente estudo corroboram um relato recente de Chang e Tsai&#44;<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">41</span></a> em revis&#227;o sistem&#225;tica e metan&#225;lise&#46; Eles inclu&#237;ram cinco estudos de caso&#8208;controle<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">15&#8211;17&#44;19&#44;20</span></a> com base em entrevistas sobre a rela&#231;&#227;o entre exposi&#231;&#227;o a pesticidas e PV e PF&#46; Os autoress conclu&#237;ram haver associa&#231;&#227;o entre exposi&#231;&#227;o a pesticidas e p&#234;nfigo&#46;<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">41</span></a> Em nosso estudo&#44; demonstramos a contamina&#231;&#227;o do cabelo por OC e&#47;ou OP nos tr&#234;s grupos estudados&#59; o grupo PF foi o que apresentou a maior contamina&#231;&#227;o por pesticidas&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conclus&#227;o</span><p id="par0100" class="elsevierStylePara elsevierViewall">O presente estudo confirmou a contamina&#231;&#227;o do cabelo com pesticidas OC e&#47;ou OP em PF&#44; PV e controles&#46; Os pacientes com PV n&#227;o testaram positivo para pesticidas OP&#46; Alguns pacientes com PF testaram positivo para tr&#234;s ou quatro OP&#44; com predomin&#226;ncia de diazinon e diclorv&#243;s&#46; Embora PV e PF tenham fornecido informa&#231;&#245;es semelhantes sobre resid&#234;ncia em &#225;reas rurais no in&#237;cio do p&#234;nfigo e estarem expostos a pesticidas&#44; a detec&#231;&#227;o desses foi mais frequente em amostras de cabelo de PF em compara&#231;&#227;o com PV&#46; A rela&#231;&#227;o entre a patog&#234;nese de PF e pesticidas ainda precisa ser elucidada&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Suporte financeiro</span><p id="par0105" class="elsevierStylePara elsevierViewall">Este estudo foi parcialmente financiado pela Funda&#231;&#227;o de Amparo &#224; Pesquisa do Estado de S&#227;o Paulo &#40;FAPESP&#44; n&#176; 2010&#47;51729&#8208;2&#41;&#46; O primeiro autor recebeu bolsa de mestrado da Coordena&#231;&#227;o de Aperfei&#231;oamento de Pessoal de N&#237;vel Superior &#40;CAPES&#41;&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Contribui&#231;&#227;o dos autores</span><p id="par0110" class="elsevierStylePara elsevierViewall">Bruno de Martins&#58; Aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; revis&#227;o cr&#237;tica do manuscrito&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Leonardo La Serra&#58; An&#225;lise estat&#237;stica&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; revis&#227;o cr&#237;tica da literatura&#59; revis&#227;o cr&#237;tica do manuscrito&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Rafael Lanaro&#58; Aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; revis&#227;o cr&#237;tica do manuscrito&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Ana Maria Roselino&#58; Aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; concep&#231;&#227;o e planejamento do estudo&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; revis&#227;o cr&#237;tica do manuscrito&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflito de interesses</span><p id="par0130" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Fundamentos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Pesticidas&#44; principalmente os organofosforados &#40;OP&#41;&#44; t&#234;m sido relacionados ao aumento do risco de p&#234;nfigo vulgar &#40;PV&#41; e p&#234;nfigo foli&#225;ceo &#40;PF&#41;&#44; por&#233;m seus n&#237;veis n&#227;o foram determinados em pacientes com p&#234;nfigo&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Avaliar a exposi&#231;&#227;o e a quantifica&#231;&#227;o dos pesticidas&#44; comparando PV&#44; PF e grupos controle no Sudeste do Brasil&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Informa&#231;&#245;es sobre resid&#234;ncia urbana ou rural e exposi&#231;&#227;o a pesticidas no in&#237;cio do p&#234;nfigo foram avaliadas por meio de entrevista por question&#225;rio&#46; Amostras de cabelos do couro cabeludo de casos de PV&#44; PF e controles foram testadas para pesticidas OP e organoclorados &#40;OC&#41; por cromatografia em fase gasosa acoplada &#224; espectrometria de massa&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A minoria dos casos de PV &#40;2 &#91;7&#44;1&#37;&#93; de 28&#41; e PF &#40;7 &#91;18&#37;&#93; de 39&#41;&#44; mas nenhum dos 48 controles&#44; informou viver em &#225;reas rurais no in&#237;cio do p&#234;nfigo &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;2853&#41;&#46; PV &#40;33&#44;3&#37;&#41;&#44; PF &#40;38&#44;5&#37;&#41; e controles &#40;20&#37;&#41; relataram exposi&#231;&#227;o a pesticidas &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;186&#41;&#46; Vinte e um &#40;14&#44;8&#37;&#41; de 142 indiv&#237;duos testaram positivo para OP e&#47;ou OC&#58; PV &#40;2 &#91;6&#44;3&#37;&#93; de 32&#41; e PF &#40;11 &#91;25&#44;6&#37;&#93; de 43&#41; apresentaram contamina&#231;&#227;o por pesticidas semelhante aos controles &#40;8 &#91;11&#44;9&#37;&#93; de 67&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;4928&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0753&#44; respectivamente&#41;&#44; mas PF apresentou maior contamina&#231;&#227;o do que PV &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;034&#41;&#46; PV n&#227;o mostrou nenhuma positividade para OP&#46; Tr&#234;s &#40;7&#37;&#41; casos de PF testaram positivo para OP e OC&#46; Alguns PF testaram positivo para tr&#234;s ou quatro OP&#44; com predomin&#226;ncia de diazinon e diclorv&#243;s&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Limita&#231;&#227;o do estudo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Falta de dados para alguns controles&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclus&#227;o</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Embora a frequ&#234;ncia de pacientes com PV e PF expostos a pesticidas tenha sido semelhante&#44; os pesticidas foram mais frequentemente detectados em amostras de cabelo de PF em compara&#231;&#227;o com PV&#46; A rela&#231;&#227;o entre causa e efeito precisa ser determinada&#46;</p></span>"
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                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Idade &#40;anos&#41; mediana &#40;p25&#8211;p75&#41;</span></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50 &#40;36&#8211;62&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46 &#40;31&#8211;58&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46 &#40;38&#8211;59&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;6513&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">n<span class="elsevierStyleHsp" style=""></span>&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">32 &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">n<span class="elsevierStyleHsp" style=""></span>&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">43 &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">n<span class="elsevierStyleHsp" style=""></span>&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">67 &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Sexo</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Masculino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;25&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;41&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;29&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;2218</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Feminino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 &#40;75&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25 &#40;58&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47 &#40;70&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">n<span class="elsevierStyleHsp" style=""></span>&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">31</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">n<span class="elsevierStyleHsp" style=""></span>&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">43</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Dura&#231;&#227;o da doen&#231;a &#40;anos&#41; mediana &#40;p25&#8211;p75&#41;</span></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;2&#8211;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;5&#8211;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">0&#44;005</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Entrevista por question&#225;rio</span><a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">n<span class="elsevierStyleHsp" style=""></span>&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">28 &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">n<span class="elsevierStyleHsp" style=""></span>&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">39 &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">n<span class="elsevierStyleHsp" style=""></span>&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">48 &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleSup">a&#44;b</span>0&#44;2853</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#193;rea de resid&#234;ncia</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Rural&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;7&#44;1&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;18&#44;0&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Urbana&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 &#40;92&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32 &#40;82&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">n<span class="elsevierStyleHsp" style=""></span>&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">27 &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">n<span class="elsevierStyleHsp" style=""></span>&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">39 &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">n<span class="elsevierStyleHsp" style=""></span>&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">40 &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;1860</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Exposi&#231;&#227;o a pesticidas</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sim&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;33&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;38&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;20&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#227;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;66&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 &#40;61&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32 &#40;80&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Detec&#231;&#227;o de pesticidas no cabelo</span></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">n<span class="elsevierStyleHsp" style=""></span>&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">32 &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">N&#227;o&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Sim&nbsp;\t\t\t\t\t\t\n
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          "pt" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Dados demogr&#225;ficos e cl&#237;nicos&#44; &#225;rea de resid&#234;ncia e exposi&#231;&#227;o a pesticidas no in&#237;cio da doen&#231;a&#44; registrados em question&#225;rios&#44; e detec&#231;&#227;o de pesticidas organofosforados e organoclorados em amostras de cabelo de pacientes com p&#234;nfigo vulgar &#40;PV&#41; e p&#234;nfigo foli&#225;ceo &#40;PF&#41; e controles</p>"
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                  \t\t\t\t" scope="col">Sexo&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col">In&#237;cio da doen&#231;a at&#233; a coleta de amostras de cabelo &#40;anos&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Classes de pesticidas &#40;pg&#47;mL&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a></th></tr><tr title="table-row"><th class="td" title="\n
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                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col">Outro&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Exposi&#231;&#227;o&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Aldrin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">BHC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">DDT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Endrin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Clorpirif&#243;s&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Diazinon&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Diclorv&#243;s&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Malation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Metil paration&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Paration&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PV<span class="elsevierStyleInf">1</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Empregada dom&#233;stica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Urbana&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PV<span class="elsevierStyleInf">2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Apicultor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Rural&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sim&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>LOQ&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>LOQ&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PF<span class="elsevierStyleInf">1</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Agricultor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Urbana&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sim&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>LOQ&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">8&#44;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">PF<span class="elsevierStyleInf">2</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">F&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Agricultor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Rural&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sim&nbsp;\t\t\t\t\t\t\n
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Article information
ISSN: 26662752
Original language: Portuguese
DOI:10.1016/j.abdp.2023.05.010
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