People report a change to their sense of smell about three to four months after infection. Key Takeaways. After a few weeks it started to come back and all seemed fine. Heart rate, which had remained up at 86 after my walk, dropped to 64." 2021;11(10):1497-1500. doi:10.1002/alr.22818, Villar PMAC, Chua RU, Robles RP. This information is for informational purposes only and is not meant to be a substitute for professional medical advice, diagnosis or treatment. A loss of smell or taste that begins days after vaccination is much more likely to be due to COVID-19 infection. This content does not have an English version. And there is the issue of COVID rebound after Paxlovid treatment where the infection initially resolves and then reappears a week or so later, he detailed. "We've seen a few individuals with unusual taste after vaccines, commonly a metallic taste that lasts for several days," said Dr. I would run to the garbage, gag, and spit out anything I would eat, 11-year-old Aviva Epstein who ested positive for coronavirus told NBC New York. The taste is "like having nickels in your mouth," a South Carolina patient named John Howard told NBC News. People Are Taking Ivermectin, a Deworming Drug for Animals, to Treat COVIDHere's Why That's a Bad Idea, Paxlovid Was Most Effective in Older Adults During Omicron Surge, Study Shows, Is It COVID, Flu, or RSV? For an optimal experience visit our site on another browser. Heres how to get them, Number of COVID-19 symptoms you have could determine how long youre sick, study says, Remdesivir now the first and only COVID-19 treatment approved for use in US, FDA says, Florida COVID weekly report: Statewide cases and hospitalizations see decline, Cardiovascular deaths rose in first years of COVID, study says. There is no known treatment for Paxlovid mouth, but there are many reasons for caution before initiating Paxlovid therapy, Dr. Cutler continued. Carla M. Delgado is a health and culture writer based in the Philippines. Evaluation of chilblains as manifestation of the COVID-19 pandemic. Recently, some people have reported developing a metallic taste in their mouths after receiving the COVID-19 vaccine. How well do face masks protect against COVID-19? Keep in mind every body is different when healing. Loss of smell and taste in 2013 European patients with mild to moderate COVID-19. Here's what to know about what Paxlovid mouth is, how it happens, and why it shouldn't deter you from the treatment if it's recommended by a healthcare provider. Despite the bad taste, Sue said that she never considered stopping Paxlovid. https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html. Paxlovid is a combination of two drugsnirmatrelvir and ritonavirthat are co-packaged to be used together to treat mild-to-moderate COVID-19. Just a handful reported metallic taste following vaccinations, she said. A study examining the role of the oral cavity in SARS-CoV-2 infection has found evidence the virus infects cells in the mouth, which could explain why some patients with COVID-19 experience taste loss, dry mouth and blistering. All rights reserved. . Anosmia, the partial or full loss of sense of smell, is a common symptom of COVID-19. This data adds to our knowledge about the long-term effects of COVID-19 in different organ systems. Begin Exploring Women's Health Solutions at Mayo Clinic Store. Hoarseness: How Likely Is It to Be a COVID Symptom? COVID-19: Who's at higher risk of serious symptoms? NIH reports that [t]he most common taste disorder is phantom taste perception:a lingering, often unpleasant taste even though there is nothing in your mouth., The sense of taste and smell are very closely related, said Dr. D.J. By Linda Adey. Getting this after covid and even months later. But . Drinking a lot of water turned out to be a good thing for Sue both in dealing with the taste of Paxlovid and rehydrating from diarrheawhich is both a COVID symptom and a side effect of the medication. In addition to the bad taste, Paxlovid also has other side effects, including diarrhea, elevated blood pressure, and muscle aches. COVID-19 can cause taste changes that last longer. Smell disorders like parosmia and anosmia significantly affect patients quality of life, experts say. The taste may last for the duration of Paxlovid treatmentfive daysand has been described as bitter or metallic. Cookies collect information about your preferences and your devices and are used to make the site work as you expect it to, to understand how you interact with the site, and to show advertisements that are targeted to your interests. [Dysgeusia is] not limited to [Paxlovid]. While COVID-19 vaccine-related metallic taste is short-lived and likely does not need treatment, there are recommended treatments for a metallic taste due to other causes. Smell and taste recovery in coronavirus disease 2019 patients: A 60-day objective and prospective study. Theres no way of knowing when a persons sense of smell will return to normal, but smell training may help. You can find out more about our use, change your default settings, and withdraw your consent at any time with effect for the future by visiting Cookies Settings, which can also be found in the footer of the site. Some people recovering from COVID-19 report that foods taste rotten, metallic, or skunk-like, describing a condition called parosmia. . Mayo Clinic; 2021. This side effect is very rare, however. It disappeared after eating dinner. COVID-19: Presentation, management, and follow-up (adult). If your job puts you in the path of metal fumes like zinc oxide, it might mess with your sense of taste. Accessed March 16, 2021. These taste receptors on our taste buds help detect whether food is salty, sweet . "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. Some people recovering from COVID-19 report that foods taste rotten, metallic, or skunk-like, describing a condition called parosmia. a host of people have now claimed that they have an intense metallic taste in their mouth that . Shankaran said that these candies can increase saliva production, which may help control the bad taste. Pfizer announces additional phase 2/3 study results confirming robust efficacy of novel COVID-19 oral antiviral treatment candidate in reducing risk of hospitalization or death. 0:00. Others also chimed in to call the taste of Paxlovid mouth "gross" or to ask for food suggestions that would cover up the "horrible bitter metallic" flavor. According to experts, parosmia may occur if COVID-19 damages olfactory receptors in the nose or affects the parts of the brain necessary for the sense of smell. He has also been a news editor for America Online and has contributed to the Associated Press and The Washington Post. Steak Is Dull and Squash Tastes Spoiled: A Chef Shares His Experience Losing His Tastebuds After COVID-19. Going from no smell to distorted smell can be a step on the road to recovery.. 1:39. It is therefore not a stretch to think that COVID-19, caused by a coronavirus, can result in smell or taste disturbances., In March, the Academy requested that anosmia and dysgeusia be added to the list of symptoms, noting that, [a]nosmia, in particular, has been seen in patients ultimately testing positive for the coronavirus with no other symptoms.. Something with a strong taste can help distract from the taste with the medication, she said. Here are some of the most recent reports of long-hauler symptoms that are perplexing doctors around the world. When you visit the site, Dotdash Meredith and its partners may store or retrieve information on your browser, mostly in the form of cookies. Antiviral substances fight against viruses and inhibit their growth. Alex Turner-Cohen Powered by. When it happens, the metal taste occurs almost immediately after the shot. According to Dr. Mehdizadeh, Paxlovid mouth should be a short-lived annoyance. Covid-19 vaccinations are no exception, and some people have reported feeling flulike symptoms for several days after receiving the shot. But one possible red flag we've been hearing a lot about lately is missing from the catalog: a strange metallic taste in the mouth. Interestingly, parosmia can be a sign of a recovering sense of smell, Schamess said. She is the former managing editor of Drug Topics magazine. "Typically, metal mouth resolves itself once the underlying cause has been treated, but a COVID-19-induced metallic taste in the mouth could stick around for weeks or even months after your . Well talk about what the effect is like, why it happens after some medications and vaccines, and what you should watch for if it happens to you. The best approach to treating a metallic taste is prevention or correction of the underlying disorder. . Candidates for the medication must also have a positive SARS-CoV-2 test and have a high risk of progressing to severe COVID-19, possibly resulting in hospitalization or death. Signs and symptoms (child). At the very . GoodRx works to make its website accessible to all, including those with disabilities. CDC guidelines do not include recommendations for those experiencing distorted taste but do note that [t]his list is not all inclusive. ive seen a big difference within the 4 weeks. However, some people are finding that it can leave a bad taste in their mouths while theyre on it. Affected patients can perceive some of the chemicals that comprise odors, but not others, leading to distorted odor perception. According to John Sellick, an infectious disease specialist at the University of Buffalo, out of tens of thousands of both Pfizer and Moderna vaccine doses that have been administered, only a handful of people reported a metallic taste after the shot. Interim clinical guidance for management of patients with confirmed coronavirus disease (COVID-19). I would also like to sign up for a free GoodRx account, Written by Jennifer Gershman, PharmD, CPh, PACS, Written by Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP. Those that developed it described it as tasting like nickels. "People experiencing this may need to try different foods, drinks, or candies to see what can make it . Buddy Creech, an infectious disease expert and the director of the Vanderbilt Vaccine Research Program at the Vanderbilt University Medical Center in Nashville, Tennessee. They can feel disconnected from others. Signs and symptoms of COVID-19 may appear 2 to 14 days after exposure. Can poor sleep impact your weight loss goals? Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Dr. Cutler stressed the decision to initiate Paxlovid therapy is complex, and a person must consider all the potential benefits, risks, and options before deciding on the best course of action. Here's How COVID-19 Can Affect Your Mouth. Pregnancy. Other treatments, like chewing gum to stimulate saliva, may also be helpful. Soon enough, they both experienced Paxlovid mouth.. Erika Edwards is a health and medical news writer and reporter for NBC News and "TODAY.". Mayo Clinic Minute: How dirty are common surfaces? Drinking a lot of water can help saliva get back to its "optimal composition to clear things out of your mouth," Rawson said. Dr. Johannes recommended using mints and gum to help distract from any unpleasant flavor. . GoodRx provides no warranty for any information. The symptoms can last 10 to 14 days or for months. However, further research on the effectiveness of smell training is needed before making any definitive conclusions, Manes said. The drug has been shown to cut the risk of hospitalization or death in high-risk people by nearly 90% if it's taken within the first few days of infectionsaid Pfizer in 2021but those benefits may come with a bad taste many are dubbing "Paxlovid mouth.". Pfizer. If you think you might be experiencing symptoms of COVID-19, call your health care provider. The bottom line. These individuals describe a condition called parosmia where odors become distorted. Paxlovid, the medication most often prescribed for COVID-19, may leave an unusual and unpleasant taste in a patient's mouth when they're on it. As a result, it can taste bitter when you take it. My sister, Susan DeBenedette of Tucson, Arizona, found this out the hard way. Loss of Taste, Smell in COVID-19 Might Last Up to 5 Months, Smell Training Could Help People Who Lost Their Sense of Smell From COVID-19, Overview and Causes of Olfactory Disorders. When it was still in clinical trials, Paxlovid did cause impaired or altered taste in some of the patients who took it. However, swollen, discolored fingers or toes could also be chilblains, an inflammatory skin condition. Chemotherapy drugs also often cause a metallic taste in the mouth. For those experiencing a distorted sense of taste or smell, the Academy recommends they, alert physicians to the possibility of COVID-19 infection and warrant serious consideration for self-isolation and testing of these individuals. Exceptions apply to those with respiratory diseases like allergic rhinitis, acute rhinosinusitis, or chronic rhinosinusitis. And among 18-to-34 year olds with no underlying health conditions, one in five were still feeling symptoms in the same time frame, according to the CDC. No Im not taking any not even iron medicine Im suppose to be taking because I came severely anemic. Only some of the noses chemical receptors are working, so an individual picks up parts of the chemical signature, which results in a distorted smell, The sensors in the nose are working, but the brain is unable to process the sensory input, like when there is nerve damage in the olfactory pathway. Pardhan S, et al. We know from previous research that coronavirus infections are seen in post-viral anosmia. The academy also wrote that these symptoms, "should alert physicians to the possibility of COVID-19 infection andwarrant serious consideration for self-isolation and testing of these individuals.". One potential side effect of Paxlovid is dysgeusia. Mao L, et al. It has a number of different immune benefits, and it also helps with sense of taste and smell, he explained. A metallic taste in the mouth usually doesn't appear as the only symptom of a COVID infection. Experts say it's a rare but real phenomenon. And like other coronaviruses, such as those that cause the common cold, SARS-CoV-2 has been shown to cause a loss of smell and taste. Shankaran said that the dysgeusia caused by Paxlovid has nothing to do with the loss of the senses of taste and smell that was seen frequently with infection from the first COVID-19 variants that circulated in 2020 and 2021. Especially when drinking coffee or eating anything with artificial sweeteners. It was just annoying.. This is a very rare side effect. I wouldnt say it was sickening. Mayo Clinic Minute: You're washing your hands all wrong. Coronavirus symptoms: Having a metallic taste in your mouth could signal COVID-19 (Image: Getty Images) "Roughly a week prior to admission, the patient began to experience a subtle decrease in . Nick Blackmer is a librarian, fact-checker, and researcher with more than 20 years experience in consumer-oriented health and wellness content. A low zinc level can cause the metallic taste. Unusual COVID-19 symptoms: What are they? Does anyone else have a metallic taste in their mouth after they eat and during? Coronavirus (COVID-19) update: FDA authorizes first oral antiviral for treatment of COVID-19. Among the peculiar and alarming symptoms reported by individuals, who experts call long-haulers, are early signs of Parkinsons disease, scaly skin rashes and unpleasant tastes in their mouths. Verywell Health's content is for informational and educational purposes only. Because a zinc deficiency is a common but often overlooked cause, encourage patients and primary care providers to assess zinc levels. But theres no telling if thats the case. Doctors are hesitant to make clear cause-and-effect relationships because there isnt enough evidence to know if COVID-19, the disease the coronavirus causes, triggers the symptoms. Chilblains develop in response to repeated exposure to cold air. My sister, Susan DeBenedette of Tucson, Arizona, found this out the hard way. Nitin Desai, MD, CEO and chief medical officer of COVID PreCheck, told POPSUGAR that he had "a funny metallic taste" in his mouth after getting his second dose of the Pfizer vaccine. A Dec. 2020 study published in the Neurology Clinical Practice found that 62.4 percent of coronavirus cases had symptoms of dysgeusia, which is a distortion of the sense of taste. . All rights reserved. i am 4 months post covid and i just started having a metallic taste , Ughhhh Im over a year and it just started happening to me :(. "If it were me," said Alan, "I would go with the bad taste and decrease my likelihood of being on a ventilator and lifelong complications.". The most common are fever, cough and tiredness. Taste is closely connected to smell, Dr. Korn says. Shivanjali Shankaran, MD, assistant professor in the Division of Infectious Diseases at Rush Medical College in Chicago, told Verywell that the alteration or impairment of the sense of taste is called dysgeusia. Delirium in older patients with COVID-19 presenting to the emergency department. Annals of Internal Medicine. How Viagra became a new 'tool' for young men, Ankylosing Spondylitis Pain: Fact or Fiction, Cardiovascular health: Insomnia linked to greater risk of heart attack. Raad N, Ghorbani J, Safavi Naeini A, Tajik N, Karimi-Galougahi M. Parosmia in patients with COVID-19 and olfactory dysfunction. COVID-19 Symptoms: Metallic Taste Has Been a Sign of Coronavirus for Some, Copyright 2023 Heavy, Inc. All rights reserved. . Allscripts EPSi. McGill University. COVID-19: Testing. Cinnamon candies like Hot Tamales, Red Hots, Atomic Fireballs, or strong mints like Altoids have been recommended in online forums where people have been looking for ideas to cope with Paxlovid mouth. high blood pressure medications. https://www . "Metallic taste is interesting, because we really don't know the biological basis for it," Nancy Rawson, vice president of the Monell Chemical Senses Center in Philadelphia, said. People with kidney impairment may take one 150-mg tablet of nirmatrelvir and one 100-mg tablet of ritonavir for each dose. Cancer Treatment. The taste lingered for the five days they took the medication and only wore off a few hours after they had taken their last dose. In the meantime, drinking plenty of water, chewing gum, and avoiding metal utensils may help you feel better. The taste in the mouth will fade but give it some time. Verywell Health's content is for informational and educational purposes only. Learn more about antiviral substances, including what products have antiviral, Researchers worldwide are working to develop treatments for COVID-19, the disease that the novel coronavirus causes. Verret in an interview with ABC. Pfizer. Odors are created by chemicals or aromatic compounds that float through the air and stimulate chemical receptors in the nose, Andrew Schamess, MD, internal medicine physician at The Ohio State University Wexner Medical Center, told Verywell. Researchers have known for over 20 years that ritonavir causes a bitter or metallic taste. Right now, experts can't say exactly why this happens or how common it is. High prevalence of concurrent gastrointestinal manifestations in patients with SARS-CoV-2: Early experience from California. It can be caused by infections, seizures, even brain tumors., COVID-19 has been linked with a loss of smell and taste, Manes said. Dehydration. How do COVID-19 antibody tests differ from diagnostic tests? Why things taste and smell different after Covid. Whenever youre taking an antiviral or an antibacterial medication, I would recommend taking a probiotic as well.. In addition to arm soreness and a little malaise, some people are reporting an unusual side effect following their Covid-19 vaccinations: an intense metallic taste that can last for days. Places like Express and Inc. have reported anecdotal instances in which those who had the virus experienced an uncomfortable metallic taste in their mouths. In this Snapshot feature, we look at what we know about symptoms of infection with Omicron, home treatments, and prevention measures. Paxlovid, the antiviral COVID-19 medication is leading to reports of "Paxlovid mouth," or a "bitter, metallic" taste after taking the medication. CNS Disorders. Centers for Disease Control and Prevention. Thank you, {{form.email}}, for signing up. Symptoms of disordered taste are very often attributed to smell disorder because the two senses are so closely linked. When the damage occurs in the parts of the brain that are necessary for smell, it results in absence or distortion of the sense of smell.. Justin Burke is a food writer, recipe developer, and award winning pastry chef and baker. A Centers for Disease Control and Prevention survey between April and June of nearly 300 infected individuals revealed that 35% had not returned to their usual state of health two to three weeks after getting testing. "This is a new medication and we don't know for sure, but it's not suspected that the taste should stay too long," he said. To smell properly, an individual has to be able to perceive the smell through the chemical receptors in their nose. This is true in many patients, although, unfortunately, not all.. As smell receptors in the nose come back online, recovery of individual receptor types is uneven. It's been a long day, your stomach's rumbling and you've just tucked into your favourite Jamaican dish: you wait for that kick, but nothing, no taste whatsoever. There are many medications which have adverse interactions with Paxlovid. We encourage clinicians taking care of patients with COVID-19 to ask about and evaluate any skin symptoms.. Recently, people have reported experiencing an intense metallic taste in their mouth after getting the COVID vaccine.The taste is "like having nickels in your mouth," a South Carolina patient . Two specific cases of COVID toes discolored, swollen and rashy feet lasted longer than 130 days, according to the doctors findings presented at the 29th Congress of the European Academy of Dermatology and Venereology meeting. AskMayoExpert. What to know about antiviral drugs and products. First: "Both of the drugs in Paxlovid are bitter," Jamie Alan, PharmD, PhD, associate professor of pharmacology and toxicology at Michigan State University, told Health. It . This could be why the bad taste of Paxlovid lasts until the next dose. Nothing, he said. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. The bad taste is pretty bad, but the medications are definitely worth it because they have really good long-term effects, said Shankaran. The experience is "like having nickels in your mouth," said John Howard, 45, of Columbia, South Carolina. For others, we dont know exactly what causes the metallic taste, but scientists have found some possibilities. The research also found that saliva is infectious, indicating the mouth may play a part in transmitting the virus deeper into the body or to others. But COVID-19 can cause symptoms you may not expect, including: Skin changes. Mayo Clinic; 2021. A medical professional works at a drive-thru coronavirus testing site at Cambridge Health Alliance Somerville Hospital on April 28, 2020 in Somerville, Massachusetts. His symptoms were mild, a sore throat and a cough. Welders are at high risk of a condition called metal fume fever. When it happens, it begins almost immediately after the shot and lasts up to a couple of days. Last week we published a story about the phenomenon of post-Covid parosmia, a condition where tastes and smells are distorted, and pleasant smells often become disgusting . Erika Edwards and Matteo Moschella. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. His work includes kitchen culture and mental health, queer food, and American dessert history. "It has been reported that some individuals infected with COVID-19 experience the symptom of a metallic taste in their mouth," New York City-based internist Nesochi Okeke-Igbokwe, MD, told Health . It is worth keeping in mind that it goes away soon after completing the 5-day Paxlovid course.. There are some case studies that looked at the efficacy of smell training for olfactory dysfunction, but its difficult to make a concrete deduction since most people normally recover their sense of smell over time. Instead, Shankaran suggests having foods or drinks that coat your mouth, like chocolate milk, chocolate pudding, or peanut butter. Why Does COVID-19 Affect the Sense of Smell? GoodRx is not sponsored by or affiliated with any of the third-party brands identified. IE 11 is not supported. Symptoms of COVID-19. The medication is authorized for emergency use in people ages 12 or older who weigh at least 88 pounds, have tested positive for COVID-19, and are at high risk for severe illness. and commented so maybe it is . Extracorporeal membrane oxygenation (ECMO), Fever treatment: Quick guide to treating a fever, Fight coronavirus (COVID-19) transmission at home. U.S. Food & Drug Administration. Those who are at low risk of complications probably have little to lose by stopping early, because they had little chance of hospitalization or death to begin with, he said. Developing a metallic taste in your mouth after receiving the COVID-19 vaccine is a very rare side effect. . If you are having difficulty accessing this website, please call or email us at (855) 268-2822 or ada@goodrx.com so that we can provide you with the services you require through alternative means. The addition of impaired taste and smell to the list of coronavirus symptoms has prompted questions if a metallic taste is a reliable indicator of the coronavirus. As for the lingering bad taste the drug can leave in the mouth, that may be because the drug is excreted in the salivary glands, said Alanthat's a process that happens with other medications too, including IV saline solutions, and isn't unique to Paxlovid. But the agency does not list an unusual taste as a possible side effect of the vaccine. 2020; doi:10.1053/j.gastro.2020.04.008. Brushing your teeth or using mouthwash wont usually help with the dysgeusia. Many recovered coronavirus patients have reported a loss of taste, but some have been cursed with the opposite: an off-putting taste that no amount of teeth brushing . Loss of smell or taste. "Typically, metal mouth resolves itself once the underlying cause has been treated, but a COVID-19 induced metallic taste in the mouth could stick around for weeks or even months after your . A new study from the Massachusetts General Hospital found that nearly 1,000 coronavirus patients from 39 countries had skin problems long after their infection cleared. The Journal of Laryngology and Otology. Real-time updates and all local stories you want right in the palm of your hand. In addition to arm soreness and a little malaise, some people are reporting an unusual side effect following their Covid-19 vaccinations: an intense metallic taste that can last for days. For most people, each dose consists of two 150-mg tablets of nirmatrelvir and one 100-mg tablet of ritonavir. My grandma has this after a year with covid. Here is the latest advice, You can order another round of free at-home COVID tests. Seasonal allergies can also contribute to impaired smell and taste. Instead, try to suck on strong-tasting hard candies or have something to drink that can help you cope with the taste until you finish your prescribed course of treatment. He estimates between 10% and 30% of those with anosmia . Treatment involves addressing the underlying cause of dysgeusia. The ambulatory COVID-19 convalescents in Tyrol, Austria (AT), and South Tyrol, Italy (IT) participated in the Health after COVID-19 in Tyrol (HACT) online survey between 30 September 2020 and 5 . A 1999 case report detailed such a reaction in a woman after she received an injection of lidocaine, a type of anesthetic. If you develop a strange taste or loss of taste days after the vaccine, that is more likely to be from COVID-19 infection, not a side effect of the vaccine. I have seen patients still affected after a year., Eventually, the rest of the smell receptors recover, and smell perception returns gradually to normal, he added. Why can I taste saline and medications when they're inserted into my IV? After each subsequent dose, my congestion and coughing subsided more. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Fact sheet for healthcare providers: emergency use authorization for Paxlovid. If you have developed a loss of taste, rather than a metallic taste, or a change in taste that starts days after you get the vaccine, that is more likely due to COVID-19 infection. A 2021 study found that almost half of the survey participants who had parosmia and a confirmed case of COVID-19 recovered their sense of smell in about three months. JAMA Dermatology. Is Paxlovid Still Effective Against New COVID Variants? Some people who have experienced Paxlovid mouth say that it goes away when they are eating or drinking. Since an ounce of prevention is worth a pound of cure, the best way to avoid Paxlovid mouth is to avoid COVID through vaccination, masking, and other proven preventive measures. Dr. David Cutler. Patients can either instead develop parosmia, or note parosmia as they are recovering from their loss of smell..
© Grupo Superpão. Todos os Direitos Reservados.
