One of the many extra-hepatic manifestations of hepatitis B virus (HBV) infections is vasculitis. While the classic HBV-associated vasculitis is polyarteritis nodosa, other vasculitides have been reported. The authors present an atypical case of acute HBV-associated vasculitis in a 57-year-old male with tobacco use disorder, characterised by extremity ischaemia, gangrene, splenic infarction, and positive proteinase-3 antibodies without sinopulmonary, gastrointestinal, or renal disease. The aggressiveness of the patient’s disease necessitated pulse-dose corticosteroids, cyclophosphamide, and two courses of plasmapheresis, and ultimately required multiple amputations of fingers and toes.
{"title":"An Atypical Case of Hepatitis B-Associated Vasculitis","authors":"Zhihong Ren, Georges El Hasbani, Christopher S. Jenkins, Mohamad R. Chehab, Jyotsna Gummadi","doi":"10.33590/emj/10300609","DOIUrl":"https://doi.org/10.33590/emj/10300609","url":null,"abstract":"One of the many extra-hepatic manifestations of hepatitis B virus (HBV) infections is vasculitis. While the classic HBV-associated vasculitis is polyarteritis nodosa, other vasculitides have been reported. The authors present an atypical case of acute HBV-associated vasculitis in a 57-year-old male with tobacco use disorder, characterised by extremity ischaemia, gangrene, splenic infarction, and positive proteinase-3 antibodies without sinopulmonary, gastrointestinal, or renal disease. The aggressiveness of the patient’s disease necessitated pulse-dose corticosteroids, cyclophosphamide, and two courses of plasmapheresis, and ultimately required multiple amputations of fingers and toes.","PeriodicalId":72984,"journal":{"name":"European Medical Journal (Chelmsford, England)","volume":"151 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136182818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Obesity is a lifestyle disease that is a proven predisposing factor for many illnesses and is often associated with a poor prognosis. Here, the author tries to associate the relationship between the incidence of obesity in patients with cancer and the prognosis of the same. The present medical literature suggests an ambiguous and conflicting relationship. This study presents an extensive literature review of the mechanisms that may govern the survival outcomes of patients with cancer presenting with obesity. Medical literature databases, namely PubMed, Google Scholar, and BioMed Central databases, were searched. Out of 335 relevant results, 75 met the inclusion criteria. The results were varying in nature, with some papers showing poor prognosis due to the association of obesity with metabolic and endocrine abnormalities, which promote tumour growth, while others suggest that excess adiposity may promote a greater expression of programmed cell death protein-1 in effector CD8+ T lymphocytes, promoting a better response to immune checkpoint blockade therapies. Some even argue against the existence of the so-called ‘obesity paradox’, considering it a by-product of statistical misinterpretation and biases. In conclusion, the phenomenon is definitely intriguing but needs further investigation and research regarding other processes that may all in all affect cancer prognosis.
{"title":"Ambiguous Effects of Obesity on Cancer Prognosis and Treatment Response: A Narrative Review","authors":"Swastik Pandita","doi":"10.33590/emj/10302656","DOIUrl":"https://doi.org/10.33590/emj/10302656","url":null,"abstract":"Obesity is a lifestyle disease that is a proven predisposing factor for many illnesses and is often associated with a poor prognosis. Here, the author tries to associate the relationship between the incidence of obesity in patients with cancer and the prognosis of the same. The present medical literature suggests an ambiguous and conflicting relationship. This study presents an extensive literature review of the mechanisms that may govern the survival outcomes of patients with cancer presenting with obesity. Medical literature databases, namely PubMed, Google Scholar, and BioMed Central databases, were searched. Out of 335 relevant results, 75 met the inclusion criteria. The results were varying in nature, with some papers showing poor prognosis due to the association of obesity with metabolic and endocrine abnormalities, which promote tumour growth, while others suggest that excess adiposity may promote a greater expression of programmed cell death protein-1 in effector CD8+ T lymphocytes, promoting a better response to immune checkpoint blockade therapies. Some even argue against the existence of the so-called ‘obesity paradox’, considering it a by-product of statistical misinterpretation and biases. In conclusion, the phenomenon is definitely intriguing but needs further investigation and research regarding other processes that may all in all affect cancer prognosis.","PeriodicalId":72984,"journal":{"name":"European Medical Journal (Chelmsford, England)","volume":"74 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135969416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
With a pre-specified aim of improving the standard of care of those living with intermittent catheter use, a roundtable discussion led by a panel of esteemed international experts convened in early 2023. The discussion provided valuable insights and recommendations regarding understanding the challenges associated with intermittent catheter use and catheter-associated complications (CAC). Key issues centred on the myriad of complications associated with intermittent catheterisation (IC), including urinary tract infections (UTI), discomfort, urethral trauma, haematuria, and their impact on patient-reported outcomes. The heterogeneity of patient groups included in IC research evidence, and discrepancies in current guidelines emerged as key concerns. The panel acknowledged the lack of consensus and clarity surrounding definitions and classification of several complications related to IC and the heterogenous range of reported outcome measures, highlighting the critical need for establishing unified definitions of IC-associated complications (ICAC), and better-defined patient groups in future research, in order to avoid these issues, and produce more definitive research conclusions. To promote clarity and consistency in terminology and clinical practice, the roundtable discussion proposed an overarching consensus definition for catheter-related complications of IC and associated endpoints, referring to these as “events that disrupt catheterisation.” The panel also considered the potential of education and innovative catheter technology as an effective means to address these common issues. Recognising the importance of education, the experts highlighted the need for new definitions and descriptions to improve clarity and consistency in clinical practice, and more research involving the array of complications associated with intermittent catheter use. Furthermore, the discussion shed light on advancements in catheter technology, exploring the potential contributions of emerging innovations, such as next-generation catheter technology like FeelClean™ Technology (Convatec, Paddington, London, UK), in minimising complications and enhancing patient outcomes.
{"title":"Insights From an Expert Roundtable Discussion: Navigating Intermittent Catheterisation-Associated Complications","authors":"Hannah Moir","doi":"10.33590/emj/10306793","DOIUrl":"https://doi.org/10.33590/emj/10306793","url":null,"abstract":"With a pre-specified aim of improving the standard of care of those living with intermittent catheter use, a roundtable discussion led by a panel of esteemed international experts convened in early 2023. The discussion provided valuable insights and recommendations regarding understanding the challenges associated with intermittent catheter use and catheter-associated complications (CAC). Key issues centred on the myriad of complications associated with intermittent catheterisation (IC), including urinary tract infections (UTI), discomfort, urethral trauma, haematuria, and their impact on patient-reported outcomes. The heterogeneity of patient groups included in IC research evidence, and discrepancies in current guidelines emerged as key concerns. The panel acknowledged the lack of consensus and clarity surrounding definitions and classification of several complications related to IC and the heterogenous range of reported outcome measures, highlighting the critical need for establishing unified definitions of IC-associated complications (ICAC), and better-defined patient groups in future research, in order to avoid these issues, and produce more definitive research conclusions. To promote clarity and consistency in terminology and clinical practice, the roundtable discussion proposed an overarching consensus definition for catheter-related complications of IC and associated endpoints, referring to these as “events that disrupt catheterisation.” The panel also considered the potential of education and innovative catheter technology as an effective means to address these common issues. Recognising the importance of education, the experts highlighted the need for new definitions and descriptions to improve clarity and consistency in clinical practice, and more research involving the array of complications associated with intermittent catheter use. Furthermore, the discussion shed light on advancements in catheter technology, exploring the potential contributions of emerging innovations, such as next-generation catheter technology like FeelClean™ Technology (Convatec, Paddington, London, UK), in minimising complications and enhancing patient outcomes.","PeriodicalId":72984,"journal":{"name":"European Medical Journal (Chelmsford, England)","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134913522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Medical education is lagging behind advances in planetary health knowledge due to the considerable barriers to introducing new topics into medical curricula. This potentially leaves doctors of the future ill-equipped to deal with the health challenges associated with environmental degradation. The recently conceived ‘infusion’ approach by the Icahn School of Medicine at Mount Sinai, New York, USA, represents a promising method for integrating planetary health topics into medical education. Adopting this approach, the International Medical Education Collaboration on Climate and Sustainability (IMECCS) was founded, with the goal of empowering healthcare students and faculty members worldwide to integrate planetary health education into their curricula. IMECCS consists of medical students and faculty members at universities in the USA, UK, and Honduras with experience in introducing planetary health topics into medical curricula. Based on discussions of challenges and successes, the group created an online open-access resource bank designed to enable a medical student or faculty member, without prior experience, to implement a planetary health curriculum and infuse these topics into existing teaching sessions at their institution.
{"title":"Collaborating to Overcome the Barriers to Implementing Planetary Health Education for Medical Students: The International Medical Education Collaboration on Climate and Sustainability (IMECCS)","authors":"James H.J. Bevan, Kevin Ardon Casco, Nicolas Contento, Aditi Gadre, William Hancock-Cerutti, Chloé Jammes, Valentina Sedlacek, Perry Sheffield","doi":"10.33590/emj/10305307","DOIUrl":"https://doi.org/10.33590/emj/10305307","url":null,"abstract":"Medical education is lagging behind advances in planetary health knowledge due to the considerable barriers to introducing new topics into medical curricula. This potentially leaves doctors of the future ill-equipped to deal with the health challenges associated with environmental degradation. The recently conceived ‘infusion’ approach by the Icahn School of Medicine at Mount Sinai, New York, USA, represents a promising method for integrating planetary health topics into medical education. Adopting this approach, the International Medical Education Collaboration on Climate and Sustainability (IMECCS) was founded, with the goal of empowering healthcare students and faculty members worldwide to integrate planetary health education into their curricula. IMECCS consists of medical students and faculty members at universities in the USA, UK, and Honduras with experience in introducing planetary health topics into medical curricula. Based on discussions of challenges and successes, the group created an online open-access resource bank designed to enable a medical student or faculty member, without prior experience, to implement a planetary health curriculum and infuse these topics into existing teaching sessions at their institution.","PeriodicalId":72984,"journal":{"name":"European Medical Journal (Chelmsford, England)","volume":"145 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134913537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: It is essential to address psychological health, particularly post-traumatic stress disorder (PTSD), among patients who have recovered from COVID-19. The negative impacts on the psychological health of an individual have negative impacts on health-related quality of life. The authors aimed to assess PTSD in patients recovered from COVID-19, and COVID-19-related comorbidities. Methodology: The present study was conducted as an observational cross-sectional study on patients diagnosed with COVID-19 who were discharged from Gandhi Medical College and Hamidia Hospital, both in Bhopal, India, and returning to follow-up at the medicine/psychiatry outpatient department within 6 months after discharge, during the study period of 20 months. Detailed history regarding sociodemographic variables, previous medical history, comorbidities associated with COVID-19 (e.g., mucormycosis, etc.) were noted. PTSD was assessed using the PTSD Symptom Scale (PSS). Results: A total of 120 cases, who recovered from COVID-19 infection and sought care at the authors’ centre, were included in this study, with mean age of 37.520±12.756 years. Mean PTSD score was 3.350±1.528, and PTSD was noted in 85% cases. Of these, 83.3% cases had mild, and 1.7% cases had moderate PTSD. The authors observed no significant association of sociodemographic variables with PTSD on univariate as well as multivariate analysis (p>0.05). Conclusions: Though the wave of COVID-19 pandemic has subsided, the long-term morbidities, particularly due to the impact on psychological health, are still persistent. PTSD is a common consequence following recovery from COVID-19 infection. Thus, mental health services must be provided to patients recovered from COVID-19 infection, mainly targeted at prevention of PTSD.
{"title":"Assessment of Post-Traumatic Stress Disorder in Patients Who Recovered from COVID-19","authors":"Sachin Patidar, Manjula Gupta, Ruchi Soni, Simmi Dube, Sarthak Verma","doi":"10.33590/emj/10300241","DOIUrl":"https://doi.org/10.33590/emj/10300241","url":null,"abstract":"Background: It is essential to address psychological health, particularly post-traumatic stress disorder (PTSD), among patients who have recovered from COVID-19. The negative impacts on the psychological health of an individual have negative impacts on health-related quality of life. The authors aimed to assess PTSD in patients recovered from COVID-19, and COVID-19-related comorbidities. Methodology: The present study was conducted as an observational cross-sectional study on patients diagnosed with COVID-19 who were discharged from Gandhi Medical College and Hamidia Hospital, both in Bhopal, India, and returning to follow-up at the medicine/psychiatry outpatient department within 6 months after discharge, during the study period of 20 months. Detailed history regarding sociodemographic variables, previous medical history, comorbidities associated with COVID-19 (e.g., mucormycosis, etc.) were noted. PTSD was assessed using the PTSD Symptom Scale (PSS). Results: A total of 120 cases, who recovered from COVID-19 infection and sought care at the authors’ centre, were included in this study, with mean age of 37.520±12.756 years. Mean PTSD score was 3.350±1.528, and PTSD was noted in 85% cases. Of these, 83.3% cases had mild, and 1.7% cases had moderate PTSD. The authors observed no significant association of sociodemographic variables with PTSD on univariate as well as multivariate analysis (p>0.05). Conclusions: Though the wave of COVID-19 pandemic has subsided, the long-term morbidities, particularly due to the impact on psychological health, are still persistent. PTSD is a common consequence following recovery from COVID-19 infection. Thus, mental health services must be provided to patients recovered from COVID-19 infection, mainly targeted at prevention of PTSD.","PeriodicalId":72984,"journal":{"name":"European Medical Journal (Chelmsford, England)","volume":"-1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134913368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This continuing medical education-accredited symposium, held at the 2023 International Society for Thrombosis and Haemostasis (ISTH) congress in Montréal, Canada, focused on current unmet needs in anticoagulation, especially in the atrial fibrillation (AF) population, and reflected on the promise of the emerging class of Factor XI inhibitors for stroke prevention (SPAF) in susceptible patients. The faculty agreed that, although direct oral anticoagulants (DOAC) have represented a major advance compared with vitamin K antagonists, their utilisation remains suboptimal, often due to the prevailing fear of bleeding in many types of patients. Older age alone can be a reason for withholding anticoagulation, due to the risk and implications of bleeding. Frailty and comorbidities, such as chronic kidney disease (CKD), which can adversely affect the bioavailability of DOACs, are also deterrents to optimal anticoagulant use. Clinicians may try to avoid or mitigate bleeding by inappropriately prescribing low doses of DOACs, an off-label practice that has been found to fail to protect patients from thrombotic risk, without attenuating the risk of bleeding. In addition, the potential for drug-drug interactions and poor adherence also limit the optimal use of DOACs in real-world clinical practice. A recent patient survey focusing on the topic of ‘minor bleeding’, often referred to by clinicians as ‘nuisance bleeding’, and typically not well captured in clinical trials, revealed the far-reaching impact of ongoing problems with bleeding on quality of life, and the possibility that these experiences may deter patients from adherence to their prescribed anticoagulant regimen. Factor XI represents a promising new target for anticoagulation, which may minimise the risk of bleeding by pharmacologically ‘uncoupling’ the clotting pathway, leading to pathological thrombosis from the cascade largely responsible for physiological haemostasis. Phase II research with investigational Factor XI inhibitors has established their antithrombotic and safety potential, and some of these agents may also avoid other practical drawbacks of DOACs. Phase III evaluation of Factor XI inhibition is ongoing in a number of clinical settings.
{"title":"Improving the Effectiveness of Anticoagulant Therapy: The Promise of Factor XI Inhibition","authors":"Karen Lipworth","doi":"10.33590/emj/10308910","DOIUrl":"https://doi.org/10.33590/emj/10308910","url":null,"abstract":"This continuing medical education-accredited symposium, held at the 2023 International Society for Thrombosis and Haemostasis (ISTH) congress in Montréal, Canada, focused on current unmet needs in anticoagulation, especially in the atrial fibrillation (AF) population, and reflected on the promise of the emerging class of Factor XI inhibitors for stroke prevention (SPAF) in susceptible patients. The faculty agreed that, although direct oral anticoagulants (DOAC) have represented a major advance compared with vitamin K antagonists, their utilisation remains suboptimal, often due to the prevailing fear of bleeding in many types of patients. Older age alone can be a reason for withholding anticoagulation, due to the risk and implications of bleeding. Frailty and comorbidities, such as chronic kidney disease (CKD), which can adversely affect the bioavailability of DOACs, are also deterrents to optimal anticoagulant use. Clinicians may try to avoid or mitigate bleeding by inappropriately prescribing low doses of DOACs, an off-label practice that has been found to fail to protect patients from thrombotic risk, without attenuating the risk of bleeding. In addition, the potential for drug-drug interactions and poor adherence also limit the optimal use of DOACs in real-world clinical practice. A recent patient survey focusing on the topic of ‘minor bleeding’, often referred to by clinicians as ‘nuisance bleeding’, and typically not well captured in clinical trials, revealed the far-reaching impact of ongoing problems with bleeding on quality of life, and the possibility that these experiences may deter patients from adherence to their prescribed anticoagulant regimen. Factor XI represents a promising new target for anticoagulation, which may minimise the risk of bleeding by pharmacologically ‘uncoupling’ the clotting pathway, leading to pathological thrombosis from the cascade largely responsible for physiological haemostasis. Phase II research with investigational Factor XI inhibitors has established their antithrombotic and safety potential, and some of these agents may also avoid other practical drawbacks of DOACs. Phase III evaluation of Factor XI inhibition is ongoing in a number of clinical settings.","PeriodicalId":72984,"journal":{"name":"European Medical Journal (Chelmsford, England)","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134913528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The deficiency of arylsulfatase A due to the mutations in the ARSA gene is the cause of a rare inherited lysosomal storage disease, resulting in the accumulation of sulfatides in the central nervous system (CNS) and peripheral nervous system (PNS). This, in turn, leads to progressive demyelination, neuro-inflammation, and neurodegeneration, and the accumulation in visceral organs. Affected young children gradually lose the ability to walk, stand, talk, and swallow; they lose their independence and show a steady physical and cognitive regression resulting, ultimately, in their premature death at a younger age. This condition not only devastates young patients, but it also deeply affects their families and carers, both psychologically and economically. In this interview, Simon Jones, Consultant in Paediatric Inherited Metabolic Disease at St Mary’s Hospital, Manchester, Honorary Manchester Academic Health Science Centre (MAHSC), and Professor in Paediatrics and Senior Lecturer at the University of Manchester, UK; Dipak Ram, Royal College of Paediatrics and Child Health (RCPCH) and British Paediatric Neurology Association (BPNA) National Training Advisor for Paediatric Neurology, and Consultant Paediatric Neurologist at the Royal Manchester Children’s Hospital, UK; and Ally Shaw, primary caregiver of the patients mentioned in this article, explore how the disease impacts the normal development of predominantly young patients; consider its subtle evolution; and witness the stressful diagnostic odyssey families are experiencing, often leading to the wrong diagnosis, which is compounded by the lack of a national newborn screening. Jones and Ram speak directly about the diagnosis and management of these patients. This article also includes the experience of a mother of two affected children, one of whom was diagnosed thanks to their affected older sister, who gave the younger child the chance of receiving a timely treatment. In this disease, time is of the essence; often, patients are sadly diagnosed too late, and are destined to palliative care and premature death. It is hoped that this interview and testimony will help raise awareness on this disease, and give a chance to future patients and their families.
{"title":"The Unspeakable Disease: A Tale of Two Siblings","authors":"Jones Jones, Dipak Ram, Ally Shaw","doi":"10.33590/emj/10304055","DOIUrl":"https://doi.org/10.33590/emj/10304055","url":null,"abstract":"The deficiency of arylsulfatase A due to the mutations in the ARSA gene is the cause of a rare inherited lysosomal storage disease, resulting in the accumulation of sulfatides in the central nervous system (CNS) and peripheral nervous system (PNS). This, in turn, leads to progressive demyelination, neuro-inflammation, and neurodegeneration, and the accumulation in visceral organs. Affected young children gradually lose the ability to walk, stand, talk, and swallow; they lose their independence and show a steady physical and cognitive regression resulting, ultimately, in their premature death at a younger age. This condition not only devastates young patients, but it also deeply affects their families and carers, both psychologically and economically. In this interview, Simon Jones, Consultant in Paediatric Inherited Metabolic Disease at St Mary’s Hospital, Manchester, Honorary Manchester Academic Health Science Centre (MAHSC), and Professor in Paediatrics and Senior Lecturer at the University of Manchester, UK; Dipak Ram, Royal College of Paediatrics and Child Health (RCPCH) and British Paediatric Neurology Association (BPNA) National Training Advisor for Paediatric Neurology, and Consultant Paediatric Neurologist at the Royal Manchester Children’s Hospital, UK; and Ally Shaw, primary caregiver of the patients mentioned in this article, explore how the disease impacts the normal development of predominantly young patients; consider its subtle evolution; and witness the stressful diagnostic odyssey families are experiencing, often leading to the wrong diagnosis, which is compounded by the lack of a national newborn screening. Jones and Ram speak directly about the diagnosis and management of these patients. This article also includes the experience of a mother of two affected children, one of whom was diagnosed thanks to their affected older sister, who gave the younger child the chance of receiving a timely treatment. In this disease, time is of the essence; often, patients are sadly diagnosed too late, and are destined to palliative care and premature death. It is hoped that this interview and testimony will help raise awareness on this disease, and give a chance to future patients and their families.","PeriodicalId":72984,"journal":{"name":"European Medical Journal (Chelmsford, England)","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134913526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Immune Benefits of HMO Supplementation in Infants with CMPA","authors":"None Nestlé Institute of Health Sciences","doi":"10.33590/emj/10304719","DOIUrl":"https://doi.org/10.33590/emj/10304719","url":null,"abstract":"","PeriodicalId":72984,"journal":{"name":"European Medical Journal (Chelmsford, England)","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134913534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：