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Independent correlation between ischemia modified albumin and parathormone in hemodialysis patients 血液透析患者缺血修饰白蛋白与甲状旁激素的独立相关性
Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-12 DOI: 10.4081/itjm.2022.1560
Kenan Güçlü, Kağan Tur, Serdar Şahin, Aydın Güçlü
Introduction. Hemodialysis patients are the group which oxidative stress is found more exacerbated. Ischemia modified albumin (IMA) is a new and sensitive marker for ischemia and oxidative stress. At current study we evaluated relation between IMA and biochemical parameters in hemodialysis patients. Materials and Methods. Thirty-four patients on maintenance hemodialysis were included. Pre-hemodialysis and post-hemodialysis blood samples were taken. Serum IMA and biochemistry parameters were measured. Results. There was a positive correlation between alkaline phosphatase (ALP) and IMA (r=0,268, p<0,05), CRP and IMA (r=0,452, p=0,007), parathormone and IMA (r=0,436, p=0,010), There was a negative correlation between albumin and IMA (r=-0,338, p=0,05). Multiple regression analysis was run to predict IMA levels from parathormone, CRP and creatinine the model statistically significantly predicted relation p<0,05, R=0,506, out of four two variables added statistically significant to the prediction, PTH (p=0,006), CRP (p=0,029). In multiregression analysis, IMA was found to be associated with PTH and CRP independent of creatinine value. Conclusions. We showed for the first time that PTH is associated with IMA in hemodialysis patients, independent of the level of renal function.
介绍。血液透析患者是氧化应激加重的人群。缺血修饰白蛋白(IMA)是一种新的、敏感的缺血和氧化应激标志物。在目前的研究中,我们评估了血液透析患者的IMA与生化参数的关系。材料与方法。纳入34例维持性血液透析患者。分别采集血液透析前和血液透析后的血样。测定血清IMA及生化指标。结果。碱性磷酸酶(ALP)与IMA (r=0,268, p= 0.05)、CRP与IMA (r=0,452, p=0,007)、甲状旁腺激素与IMA (r=0,436, p=0,010)呈正相关,白蛋白与IMA呈负相关(r=-0,338, p=0,05)。通过多元回归分析预测甲状旁腺激素、CRP和肌酐水平,模型预测相关性有统计学意义(p < 0.05, R=0,506),其中PTH (p=0,006)、CRP (p=0,029)四个变量对IMA水平的预测有统计学意义。在多元回归分析中,IMA与PTH和CRP相关,独立于肌酐值。结论。我们首次发现PTH与血液透析患者的IMA相关,与肾功能水平无关。
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引用次数: 0
Independent correlation between ischemia modified albumin and parathormone in hemodialysis patients 血液透析患者缺血修饰白蛋白与甲状旁激素的独立相关性
IF 0.4 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-12 DOI: 10.4081/itjm.2023.1560
K. Güçlü, Kağan Tur, S. Şahin, Aydın Güçlü
Introduction. Hemodialysis patients are the group which oxidative stress is found more exacerbated. Ischemia modified albumin (IMA) is a new and sensitive marker for ischemia and oxidative stress. At current study we evaluated relation between IMA and biochemical parameters in hemodialysis patients.Materials and Methods. Thirty-four patients on maintenance hemodialysis were included. Pre-hemodialysis and post-hemodialysis blood samples were taken. Serum IMA and biochemistry parameters were measured.Results. There was a positive correlation between alkaline phosphatase (ALP) and IMA (r=0,268, p<0,05), CRP and IMA (r=0,452, p=0,007), parathormone and IMA (r=0,436, p=0,010), There was a negative correlation between albumin and IMA (r=-0,338, p=0,05). Multiple regression analysis was run to predict IMA levels from parathormone, CRP and creatinine the model statistically significantly predicted relation p<0,05, R=0,506, out of four two variables added statistically significant to the prediction, PTH (p=0,006), CRP (p=0,029). In multiregression analysis, IMA was found to be associated with PTH and CRP independent of creatinine value.Conclusions. We showed for the first time that PTH is associated with IMA in hemodialysis patients, independent of the level of renal function.
介绍。血液透析患者是氧化应激加重的人群。缺血修饰白蛋白(IMA)是一种新的、敏感的缺血和氧化应激标志物。在目前的研究中,我们评估了血液透析患者的IMA与生化参数的关系。材料与方法。纳入34例维持性血液透析患者。分别采集血液透析前和血液透析后的血样。测定血清IMA及生化指标。碱性磷酸酶(ALP)与IMA (r=0,268, p< 0.05)、CRP与IMA (r=0,452, p=0,007)、甲状旁腺激素与IMA (r=0,436, p=0,010)呈正相关,白蛋白与IMA呈负相关(r=-0,338, p=0,05)。运用多元回归分析预测IMA水平,从甲状旁腺激素、CRP和肌酐模型中预测相关性有统计学意义p< 0.05, R=0,506,其中PTH (p=0,006)、CRP (p=0,029) 4个变量中添加有统计学意义的预测。在多元回归分析中发现IMA与PTH和CRP相关,与肌酐值无关。我们首次发现PTH与血液透析患者的IMA相关,与肾功能水平无关。
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引用次数: 0
Delayed diagnosis of plasma cell disorder-related Fanconi syndrome in young adults presenting as osteomalacia: report of two cases with normokalemia and normal haematological parameters at the time of presentation. 表现为骨软化症的年轻人血浆细胞紊乱相关Fanconi综合征的延迟诊断:两例表现时血钾正常且血液学参数正常的病例报告。
IF 0.4 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-12 DOI: 10.4081/itjm.2022.1559
J. Franklin, Praveen V. Pavithran, N. Sidharthan, Seethalkshmy Nv, N. Abraham, V. U. Menon, V. Nair, H. Kumar
Adult-onset hypophosphatemic osteomalacia is rare and diagnosis is frequently delayed. Fanconi syndrome (FS) due to monoclonal gammopathy is a well-recognized, but rare cause of hypophosphatemia. The relatively young age of patients and normal routine hematological parameters often results in late recognition of this treatable disease entity. Low phosphorus, elevated alkaline phosphatase, mildly impaired renal function and hypokalemia are often the only abnormalities on routine evaluation. We summarize the clinico-pathological features of two cases who initially presented with fractures and proximal myopathy and were subsequently found to have FS secondary to light chain proximal tubulopathy. Atypical features like absence of hypokalemia at presentation  and elevated Fibroblast Growth Factor 23(FGF 23), a marker of oncogenic osteomalacia were noted. Marked clinical improvement and recovery of renal parameters were evident with phosphate supplements and  chemotherapy for the plasma cell disorder. FS due to monoclonal gammopathy  may present with atypical features  and diagnosis may be  challenging
成人发病的低磷性骨软化症是罕见的,诊断经常被推迟。由单克隆γ病引起的范可尼综合征(FS)是一种公认但罕见的低磷血症病因。相对年轻的患者和正常的常规血液学参数往往导致较晚的认识这种可治疗的疾病实体。低磷,碱性磷酸酶升高,轻度肾功能受损和低钾血症通常是常规评估的唯一异常。我们总结了两个病例的临床病理特征,他们最初表现为骨折和近端肌病,随后发现FS继发于轻链近端小管病。非典型特征,如没有低钾血症,成纤维细胞生长因子23(FGF 23)升高,这是癌性骨软化的标志。对浆细胞疾病进行磷酸盐补充和化疗后,肾脏参数有明显的临床改善和恢复。单克隆伽玛病引起的FS可能具有不典型特征,诊断可能具有挑战性
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引用次数: 0
Delayed diagnosis of plasma cell disorder-related Fanconi syndrome in young adults presenting as osteomalacia: report of two cases with normokalemia and normal haematological parameters at the time of presentation 以骨软化症为表现的年轻成人浆细胞疾病相关范可尼综合征的延迟诊断:报告两例在表现时血液学参数正常且血液学参数正常的病例
Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-12 DOI: 10.4081/itjm.2023.1559
Joel Franklin, Praveen V. Pavithran, Neeraj Sidharthan, Seethalkshmy NV, Nithya Abraham, V. Usha Menon, Vasantha Nair, Harish Kumar
Adult-onset hypophosphatemic osteomalacia is rare and diagnosis is frequently delayed. Fanconi syndrome (FS) due to monoclonal gammopathy is a well-recognized, but rare cause of hypophosphatemia. The relatively young age of patients and normal routine hematological parameters often results in late recognition of this treatable disease entity. Low phosphorus, elevated alkaline phosphatase, mildly impaired renal function and hypokalemia are often the only abnormalities on routine evaluation. We summarize the clinico-pathological features of two cases who initially presented with fractures and proximal myopathy and were subsequently found to have FS secondary to light chain proximal tubulopathy. Atypical features like absence of hypokalemia at presentation and elevated Fibroblast Growth Factor 23(FGF 23), a marker of oncogenic osteomalacia were noted. Marked clinical improvement and recovery of renal parameters were evident with phosphate supplements and chemotherapy for the plasma cell disorder. FS due to monoclonal gammopathy may present with atypical features and diagnosis may be challenging
成人发病的低磷性骨软化症是罕见的,诊断经常被推迟。由单克隆γ病引起的范可尼综合征(FS)是一种公认但罕见的低磷血症病因。相对年轻的患者和正常的常规血液学参数往往导致较晚的认识这种可治疗的疾病实体。低磷,碱性磷酸酶升高,轻度肾功能受损和低钾血症通常是常规评估的唯一异常。我们总结了两个病例的临床病理特征,他们最初表现为骨折和近端肌病,随后发现FS继发于轻链近端小管病。非典型特征,如没有低钾血症,成纤维细胞生长因子23(FGF 23)升高,这是癌性骨软化的标志。对浆细胞疾病进行磷酸盐补充和化疗后,肾脏参数有明显的临床改善和恢复。单克隆伽玛病引起的FS可能具有不典型特征,诊断可能具有挑战性
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引用次数: 0
Atypical presentation of West Nile encephalitis 西尼罗河脑炎的非典型表现
IF 0.4 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-12 DOI: 10.4081/itjm.2022.1535
G. Cioni, A. Fedeli, G. Bellandi, Rossella Squillante, M. Zuccotti, G. Buffini
West Nile virus (WNV) causes both sporadic infection and outbreaks that may be associated with severe neurologic involvement. The infection is transmitted to humans mainly by mosquito bites, and the virus is preserved in a cycle in which birds are the main host. The typical involvement of the central nervous system is completely indistinguishable from meningitis and encephalitis related to other pathogens. In this report we described the atypical presentation of a WNV meningoencephalitis in a 81-y.o. female patient, showing psychiatric manifestations at the onset. Anamnestic information was essential to progress to the correct diagnosis. Targeted search for the causative agent of meningoencephalitis was perfected after learning that the patient lived in an area adjacent to a nature reserve.
西尼罗河病毒(WNV)引起散发性感染和可能与严重神经系统受累有关的暴发。感染主要通过蚊子叮咬传播给人类,病毒以鸟类为主要宿主的周期保存。中枢神经系统的典型受累与脑膜炎和与其他病原体相关的脑炎完全无法区分。在本报告中,我们描述了一名81-y.o.女性患者的WNV脑膜脑炎的非典型表现,发病时表现为精神症状。记忆信息对于正确诊断至关重要。在得知患者居住在自然保护区附近后,完善了对脑膜脑炎病原体的靶向搜索。
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引用次数: 0
Pattern and sweep visual evoked potential in the objective determination of visual acuity 模式和扫描视觉诱发电位在视觉敏锐度客观测定中的应用
Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-12 DOI: 10.4081/itjm.2022.1556
Mualla Hamurcu
Purpose: To investigate the effects of pattern visual evoked potential (pVEP) and sweep visual evoked potential (sVEP) on the accurate visual acuity (VA) measurement in adults. Methods: Medical files of 282 eyes of 141 patients who underwent VA measurement in our electrophysiology laboratory and did not undergo simulation were retrospectively analyzed. The VA was measured using the Snellen chart. Only those with a VA of higher than 1/10 on the Snellen chart were included in the study. The VA was assessed and reported by the pVEP (VA-pVEP) and sVEP test (VA-sVEP). The correlation analysis was performed using the Pearson correlation analysis. Results: Of 141 patients, 92 were males and 49 were females with a mean age of 37.7±18.4 years. There was a strong positive correlation between the VA measured by the Snellen chart and the VA measured by pVEP (VA-pVEP) (r=0.858, p<0.001). There was a weak positive correlation (r=0.267, p<0.001) between the VA measured by the Snellen chart and the VA measured by the sVEP (VA-sVEP). A weak positive correlation was found for the VA-pVEP and VA-sVEP (r=0.313, p<0.001). Conclusions: For the measurement of the degree of the VA, it seems reasonable to use pVEP initially, while sVEP should be used in cases with short attention span and those who are noncooperative and in infants.
目的:探讨模式视觉诱发电位(pVEP)和扫描视觉诱发电位(sVEP)对成人准确视力(VA)测量的影响。& # x0D;方法:回顾性分析在电生理实验室进行眼内视压测量的141例患者282只眼的医学资料。使用Snellen图测量VA。只有在Snellen图表上VA高于1/10的人才被纳入研究。采用pVEP (VA-pVEP)和sVEP试验(VA-sVEP)对VA进行评估和报告。相关分析采用Pearson相关分析。 结果:141例患者中,男性92例,女性49例,平均年龄37.7±18.4岁。Snellen图测量的VA与pVEP测量的VA (VA-pVEP)有很强的正相关(r=0.858, p<0.001)。Snellen图测量的VA与sVEP测量的VA (VA-sVEP)之间存在弱正相关(r=0.267, p<0.001)。VA-pVEP与VA-sVEP呈弱正相关(r=0.313, p<0.001)。结论:对于VA程度的测量,最初使用pVEP是合理的,而对于注意力持续时间短、不合作的病例和婴儿应使用sVEP。
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引用次数: 0
Interplay between lymphocyte subpopulation, inflammatory cytokines and their correlation with oxidative stress parameters in COVID-19 COVID-19患者淋巴细胞亚群、炎症因子及其与氧化应激参数的相互作用
IF 0.4 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-12 DOI: 10.4081/itjm.2022.1543
M. Petrusevska, D. Zendelovska, E. Atanasovska, K. Spasovska, K. Grozdanovski, S. Stojanovska, Irina Panovska Stavridis, A. Eftimov
Our objective was to investigate the inflammatory and oxidative stress markers in patients with moderate and severe form of COVID-19. In addition, we show the correlation between changes in lymphocyte subsets and markers of oxidative stress as a tool for patient classification. IL-6 and VEGF were analysed by utilizing a High Sensitivity Evidence Investigator™ Biochip Array technology. The total antioxidant capacity (PAT) and the free radical concentrations (d-ROM) were measured in serum utilizing analytical photometric system FRAS5. Peripheral blood was used to determine CD45 + mononuclear, B, T, and NK cells using a multi-parameter flow cytometric immunophenotypic test. Statistically significant differences in IL-6 and VEGF levels were observed between the two patient groups. Decreased values of the absolute number of lymphocytes and their CD4 + and CD8 + positive T cells, NK cells, and CD8 were obtained. In the moderate group, good correlations were found between IL-6 and VEGF and NK cells (r = 0.6973, p <0.05; for IL6 and r = 0.6498, p <0, for VEGF. 05). Cytokines were correlated with CD45+ (r = 0.5610, p <0.05; for IL-6 and r = 0.5462, p <0.05 for VEGF). The oxidative stress index can be used as a cheaper alternative and as a triage tool between severe and moderate illnesses, after showing good correlation with more expensive patient classification analysis.
我们的目的是研究中重度COVID-19患者的炎症和氧化应激标志物。此外,我们展示了淋巴细胞亚群变化和氧化应激标志物之间的相关性,作为患者分类的工具。利用高灵敏度证据调查员™生物芯片阵列技术分析IL-6和VEGF。采用分析光度系统FRAS5测定血清总抗氧化能力(PAT)和自由基浓度(rom)。外周血采用多参数流式细胞术免疫表型检测CD45 +单核细胞、B细胞、T细胞和NK细胞。两组患者IL-6、VEGF水平差异有统计学意义。淋巴细胞及其CD4 +和CD8 +阳性T细胞、NK细胞和CD8的绝对数量下降。中度组IL-6与VEGF、NK细胞相关性较好(r = 0.6973, p <0.05;对于il - 6, r = 0.6498, p <0。05)。细胞因子与CD45+相关(r = 0.5610, p <0.05;IL-6, r = 0.5462, VEGF, p <0.05)。氧化应激指数可以作为一种更便宜的替代方法,在与更昂贵的患者分类分析显示出良好的相关性后,可以作为重度和中度疾病之间的分诊工具。
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引用次数: 0
Organizational actions to tackle distrust: Building Trust Italy. 解决不信任的组织行动:建立信任意大利。
IF 0.4 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-12 DOI: 10.4081/itjm.2022.1554
D. Colimberti, R. Frediani
According to the italian Code of Medical Deontology, mutual trust and mutual respect for values and rights are the care relationship foundation. To establish reciprocal trust and respect, the communication between care providers and patients must be skilled and appropriate, and the time devoted to communication must be considered time of care. But in Italy, in the last decades costs containment policy in the organizations of the National Health Service critically shortened the time available for care. Today, doctors and other healthcare professionals literally do not have the time to establish appropriate care relationships, and this causes a widespread and increasing distrust of patients and their families in the care system. During Covid-19 pandemic also vaccine hesitancy, defined by experts as a delay in acceptance or refusal of vaccination despite availability of vaccination services, was mainly due to a lack of confidence in care system and in scientific research. Slow Medicine ETS, an italian proactive movement of healthcare professional and citizen, following the example of the initiative “Building Trust” recently activated by the ABIM Foundation in the USA, launched a national initiative aimed to promote and plan concrete actions to restore and consolidate people’s trust in health professionals and organizations, in researchers, in scientific and rational approach to knowledge and in its use for the improvement of health and quality of life. Slow Medicine ETS, still successfully leading and supporting the “Choosing Wisely Italy” project, will be engaged in assembling the national network of the new project “Building Trust Italy”.
根据意大利医学道德规范,相互信任和相互尊重价值观和权利是护理关系的基础。为了建立相互信任和尊重,护理提供者和患者之间的沟通必须熟练和适当,用于沟通的时间必须被视为护理时间。但在意大利,在过去几十年中,国家卫生服务组织的成本控制政策大大缩短了可供护理的时间。如今,医生和其他医疗保健专业人员实际上没有时间建立适当的护理关系,这导致了对护理系统中患者及其家人的广泛和日益增长的不信任。在新冠肺炎大流行期间,疫苗犹豫也主要是由于对护理系统和科学研究缺乏信心,专家将其定义为尽管有疫苗接种服务,但仍延迟接受或拒绝接种。慢医学ETS是意大利一个积极主动的医疗专业人员和公民运动,以美国ABIM基金会最近发起的“建立信任”倡议为榜样,发起了一项全国性倡议,旨在促进和计划具体行动,恢复和巩固人们对卫生专业人员和组织、研究人员、,以科学合理的方式获取知识,并将其用于改善健康和生活质量。Slow Medicine ETS仍在成功领导和支持“明智选择意大利”项目,将参与组建新项目“建立信任意大利”的全国网络。
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引用次数: 0
Le cure palliative nel malato internistico: focus sulle malattie croniche in fase avanzata 内科患者的姑息治疗:关注晚期慢性病
IF 0.4 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-12-16 DOI: 10.4081/itjm.q.2022.5
M. Carbone, Fabio Gilioli, R. Antonione
Prefazione - Il ruolo del palliativista in medicina internaGino GobberIl ruolo del medico internista nelle cure palliativeDario ManfellottoLe cure palliative nel malato non-oncologicoItalo PencoLa cura del malato fragile alla fine della vitaAndrea FontanellaLa scuola di specializzazione in Medicina e Cure PalliativeGino Gobber; Dario ManfellottoIntroduzioneFabio GilioliStrumenti per identificare la complessità dei bisogni clinici-assistenziali dei malati e delle loro famiglieFilippo Canzani; Claudio SantiniGestione dei sintomi in fase avanzata: dispnea, delirium, rantolo, nausea e vomito, occlusione intestinaleMatteo MoroniGestione dei sintomi in fase avanzata e nel fine vita: doloreGiuseppe CivardiApproccio assistenziale ai sintomi in fase avanzata e nel fine vitaGabriella Bordin; Michela GuardaDe-prescrizione, rimodulazione e sospensione diagnostiche e terapeutiche in fase avanzata di malattiaCarlo Lorenzo Muzzulini; Michele Berardi; Alessandro ValleAntibioticoterapia nelle cure palliativeMatteo Moroni; Filippo CostanzoEmotrasfusioni in cure palliativeFilomena Panzone; Raffaella AntonioneTerapia anticoagulante in cure palliativeMauro Silingardi; Raffaella AntonioneVentilazione non invasiva in cure palliativeFederico Lari; Raffaella AntonioneScelte terapeutiche in medicina interna: come non perdersi nella complessità del fine vitaMiriam Cappelli; Mauro CarboneRaccomandazioni conclusive
前言-姑息医生在内科的作用Gino Gobber内科医生在姑息治疗中的作用Dario Manfelloto非肿瘤疾病的优先护理Talo Penco生命末期脆弱患者的护理Andrea Fontanella医学与姑息治疗专业学院Gino Gobb;Dario ManfellotoIntroduzioneFasio Gilioli用于识别患者及其家人临床护理需求复杂性的工具Filippo Canzani;Claudio Santini晚期症状管理:呼吸困难、谵妄、rantolo、恶心呕吐、肠梗阻Matteo Moroni晚期和生命末期症状管理:疼痛Giuseppe CivardiCare治疗晚期和生命晚期症状的方法Gabriella Bordin;Michela GuardaDe在疾病晚期的处方、重塑和诊断和治疗悬浮液Carlo Lorenzo Muzzulini;米歇尔·贝拉尔迪;Alessandro Valle姑息治疗中的抗生素Matteo Moroni;Filippo Costanzo缓和治疗中的输血Filomena Panzone;Raffaella Antonion姑息治疗中的抗凝治疗;Raffaella Antonion姑息治疗中的无创通气Federico Lari;Raffaella Antonion内科治疗选择:如何不迷失在生命终结的复杂性中Miriam Cappelli;Mauro Carbon包括建议
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引用次数: 0
La riscoperta della Medicina Narrativa come metodologia di intervento clinico-assistenziale: focus su dolore cronico e fine vita nel contesto pandemico 叙事医学作为一种临床护理干预方法的重新发现:关注疫情背景下的慢性疼痛和生命终结
IF 0.4 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-12-05 DOI: 10.4081/itjm.q.2022.4
A. Fontanella, Stefania Polvani
Il velo oltre le cucine. Lo spazio della Medicina Narrativa nel patrimonio dell'internistaM. MeschiMedicina Narrativa: una pratica comunicativa quotidiana dell’internistaM. MarinelliIl piano diagnostico terapeutico assistenziale (PDTA) per il dolore cronico nella Regione LazioG. Campagna, M. Di Carlo, M. Di Napoli, A. TotoA COVID-19 patient population in a palliative care and hospice ward: outcome of the careM. Saccò, E. Porta, A. Tedeschi, D. CattaneoR-Esistere: linguaggi e storie al tempo della pandemiaM. Cerati, M. Testa, S. PolvaniIl setting clinico-assistenziale del fine vitaG. Campagna, M. Di Napoli, A. TotoMedicina Narrativa nella cura integrale del fine vita e nella terapia del doloreP. Trenta, F. BraccoMedici narratoriA. Fontanella
厨房那边的面纱。小说医学在国际遗产中的地位。小说医学:国际新闻社的日常交流实践。针对LazioG地区慢性疼痛的诊断治疗护理计划(PDTA)。乡村,M. Di Carlo, M. Di Napoli, A. TotoA covi -19E. Porta, A.德语,D. cattaneor -存活法:大流行时期的语言和故事。Cerati, M. Testa, S. PolvaniIl临终关怀诊所。《乡村》,那不勒斯M., A.小说医学就像你说的那样。Fontanella
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引用次数: 0
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Italian Journal of Medicine
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