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The Antibiotic Resistance Profile of Pseudomonas Aeruginosa in a Tertiary Medical Center from Malaysia 马来西亚某三级医疗中心铜绿假单胞菌耐药性分析
Pub Date : 2022-02-03 DOI: 10.3329/jom.v23i1.57938
Mohd Ali Faiz, C. H. Ding, A. Wahab, M. N. Tzar, A. Sulong, K. Wong, P. F. Wong
Background: Pseudomonas aeruginosa is a notorious gram-negative bacterium that has become a globalpublic health concern owing to the emergence of multi- and pandrug-resistant strains. This study sought todetermine the antibiotic susceptibility profile of P. aeruginosa in a tertiary medical center from Malaysia.Materials and Methods: Each isolate’s identity was confirmed using the VITEK 2 GN kit, and subjectedto antibiotic susceptibility testing using the VITEK 2 AST-N374 card (for testing against piperacillintazobactam,ceftazidime, cefepime, imipenem, meropenem, amikacin, gentamicin and ciprofloxacin) andEtest strips (for testing against doripenem and polymyxin B). Isolates which were not susceptible to >1carbapenem were tested for carbapenemase production using the modified carbapenem inactivationMethod (mCIM).Results: Out of 102 isolates studied, 64 (62.7%) were fully susceptible to all the antibiotics tested.Twenty-six (25.5%) were resistant to >1 antibiotic from >2 antibiotic classes, and 21 (20.6%) wereresistant to >1 antibiotic from >3 classes. Susceptibility was highest with polymyxin B (100%) and lowestwith piperacillin-tazobactam (64.7%). Carbapenem susceptibility was between 78.4% to 81.4%. Out of 22isolates which were not susceptible to >1 carbapenem, 18 (81.8%) were not susceptible to all threecarbapenems.Conclusion: More than half of our P. aeruginosa isolates were fully susceptible to all the anti-pseudomonalantibiotics tested. Multidrug-resistant strains accounted for between 20% to 25% of all our P. aeruginosaisolates. Through mCIM testing, carbapenemase production did not appear to be the dominant resistancemechanism.J MEDICINE 2022; 23: 54-60
背景:铜绿假单胞菌是一种臭名昭著的革兰氏阴性细菌,由于出现了多重和普遍耐药菌株,已成为全球公共卫生关注的问题。本研究旨在确定马来西亚三级医疗中心铜绿假单胞菌的抗生素敏感性。材料与方法:使用VITEK 2 GN试剂盒确认每个分离株的鉴定,并使用VITEK 2 AST-N374卡(用于检测哌拉西林他唑巴坦、头孢他啶、头孢吡肟、亚胺培南、美罗培南、阿米卡星、庆大霉素和环丙沙星)和耐药试纸(用于检测多利培南和多粘菌素B)进行抗生素敏感性试验。使用改进的碳青霉烯类失活法(mCIM)检测对bbb1碳青霉烯类不敏感的分离株的碳青霉烯酶产率。结果:102株分离菌中64株(62.7%)对所有抗生素均完全敏感。对>2类>1耐药26例(25.5%),对>3类>1耐药21例(20.6%)。多粘菌素B的敏感性最高(100%),哌拉西林-他唑巴坦最低(64.7%)。碳青霉烯敏感性在78.4% ~ 81.4%之间。22株对bbb1碳青霉烯类不敏感的菌株中,18株(81.8%)对3种碳青霉烯类均不敏感。结论:半数以上铜绿假单胞菌对所有抗假单胞菌抗生素均完全敏感。耐多药菌株占我们所有铜绿假单胞菌分离株的20%至25%。通过mCIM测试,碳青霉烯酶的产生似乎不是主要的耐药机制。[J]中华医学杂志2022;23: 54-60
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引用次数: 0
Clinical Consequences and Economic Burden Associated with Febrile Neutropenia in Hospitalized Cancer Patients: A Prospective Study 住院癌症患者发热性中性粒细胞减少症的临床后果和经济负担:一项前瞻性研究
Pub Date : 2022-02-03 DOI: 10.3329/jom.v23i1.57937
Tamanna Bahar, Shaila Rahman, Zulfia Zinat Chowdhury, T. Kabir, Fahmida Akther, Salina Haque, A. Islam, M. Ali, Md. Mahbubur Rahman
Objective: Febrile neutropenia (FN) is viewed as the most decimating oncological crisis particularly inchemotherapy-incited patients. The primary objective of the study was to identify the total directexpenditure of patients during febrile neutropenia with clinical consequences and the secondary aim wasto find out the factors associated with higher cost.Materials and Method: This was a single-centered hospital-based study in the largest and only specializedcancer care centre in Bangladesh in the government sector. This prospective study was done in theinpatients’ department of the National Institute of Cancer Research and Hospital from April 2020 toJanuary 2021. The primary outcome was the out-of-pocket patient payments (adjusted by governmentsubsidy) per FN episode. Univariate analysis and multiple linear regression were conducted to identifythe factors associated with higher costs.Results and Discussions: A total of 101 patients were enrolled in the study. The mean (SD) age was33.49 (±15.79) years. Of the 101 participants, 63.4% were male. Among the patients, 13.9% died during theepisode and 86.1% recovered. Having co-morbidities and COVID-19 were associated with an increasedrisk of death. The mean cost was US$ 999.44 (±499.05) and the mean length of hospital stay was 21.98(±9.3) days. The longer hospital stay was significantly associated with higher costs.Conclusion: This study will help to ascertain the hospital cost and clinical outcome of FN whichultimately can help in policymaking strategy.J MEDICINE 2022; 23: 48-53
目的:发热性中性粒细胞减少症(FN)被认为是最致命的肿瘤危机,特别是在化疗患者中。本研究的主要目的是确定发热性中性粒细胞减少症患者的总直接支出与临床后果,次要目的是找出与高成本相关的因素。材料和方法:这是一项单中心医院研究,在孟加拉国政府部门最大也是唯一的专业癌症护理中心进行。这项前瞻性研究于2020年4月至2021年1月在国家癌症研究所和医院的住院病人部进行。主要结果是每次FN发作的患者自付费用(经政府补贴调整)。通过单因素分析和多元线性回归分析,确定了与高成本相关的因素。结果和讨论:共有101例患者入组研究。平均(SD)年龄为33.49(±15.79)岁。在101名参与者中,63.4%是男性。13.9%的患者在发作期间死亡,86.1%的患者康复。合并疾病和COVID-19与死亡风险增加有关。平均费用为999.44美元(±499.05),平均住院时间为21.98(±9.3)天。住院时间越长,费用越高。结论:本研究有助于确定FN的医院成本和临床效果,最终为政策制定提供依据。[J]中华医学杂志2022;23: 48-53
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引用次数: 0
Clinico-pathological Profile and Immediate Hospital Outcome of Acute Pancreatitis 急性胰腺炎的临床病理特征和即时医院转归
Pub Date : 2022-02-03 DOI: 10.3329/jom.v23i1.57933
MS Alam, M. Rahman, A. Kabir, Md. Uzzwal Mallik, Saima Azad
Background: Acute pancreatitis (AP) is a significant cause of acute abdominal pain, morbidity andhospitalization. Knowing the details of the clinico-pathological presentation and outcome of the diseasemay aid the better understanding of the disease.Objective: The study was designed to assess the clinico-pathological profile and to estimate immediatehospital outcome of acute pancreatitis patients admitted into a tertiary care hospital.Materials and Methods: This hospital based cross-sectional type of observational study was conductedat Dhaka Medical College Hospital (DMCH), for one-year period (June 2018-May 2019).Total 106established cases of acute pancreatitis were included in this study. Data was analyzed by the SPSS 22Windows version and graph & chart were expressed by using SPSS 22 and MS Excel. The Result waspresented with tables and charts.Results: Among 106 patients, mean age of the patients was 42.5 ±11.3 SD (years), with male predominance(male: female-1.2:1). All of the patients complained abdominal pain (100%) while anorexia (48.1%), 43.4%had vomiting and 31.1% had fever. Regarding clinical signs, abdominal distension (45.3%), paralytic ileus(34.9%) and dehydration (43.4%) were found to be the major clinical signs. The common location of painwas in epigastric region (73.6%) with radiation to back in 20.8% patients. Pain was severe agonizing innature in 76.4% cases. Of all, gall stone disease (17.0%) was the most prevalent cause. According toAPACHE-II score, 74.5% patients had mild pancreatitis (APACHE-II <8) while according to Glasgowcriteria, 66.0% had mild disease (Glasgow score <3). Mean APACHE-II score was 7.07±2.50 and Glasgowscore was 2.90±2.33. Mean hospital stays were 8.9±3.6 days and NPO (nothing per oral) 4.9±1.9 days.Among the patients, 77.4% patients were alive and mortality rate was 22.6%.Conclusion: Although, a larger portion of the patients had no identifiable cause but gall stone was themost common etiology. Pain commonly located in epigastric region with radiation to back. Of all thecases, more than sixty percent of the patients had mild pancreatitis estimated by APACHE II score andGlasgow score. Mean hospital stays were about 9 days and nothing per oral was about 5 days. Overallmortality rate was 22.6%.J MEDICINE 2022; 23: 24-29
背景:急性胰腺炎(AP)是引起急性腹痛、发病和住院的重要原因。了解疾病的临床病理表现和结果的细节可能有助于更好地了解疾病。目的:本研究旨在评估三级护理医院收治的急性胰腺炎患者的临床病理特征,并评估其即时住院结果。材料和方法:这项基于医院的横断面观察性研究在达卡医学院医院(DMCH)进行,为期一年(2018年6月至2019年5月)。本研究共纳入106例确诊的急性胰腺炎病例。数据采用SPSS 22Windows软件进行分析,图表采用SPSS 22软件和MS Excel进行表达。结果用表格和图表表示。结果:106例患者的平均年龄为42.5±11.3 SD(年),以男性为主(男性:女性-1.2:1),所有患者均主诉腹痛(100%),厌食(48.1%),呕吐43.4%,发烧31.1%。在临床症状方面,腹胀(45.3%)、麻痹性肠梗阻(34.9%)和脱水(43.4%)是主要的临床症状。最常见的疼痛部位是上腹部(73.6%),20.8%的患者是背部放射。76.4%的患者的疼痛表现为严重的内脏疼痛。胆囊结石是最常见的病因(17.0%)。根据APACHE-II评分,74.5%的患者患有轻度胰腺炎(APACHE-II<8),而根据Glasgow标准,66.0%的患者患有轻微疾病(Glasgow评分<3)。平均APACHE-II评分为7.07±2.50,Glasgow评分为2.90±2.33。平均住院时间为8.9±3.6天,NPO(每次口服无)为4.9±1.9天。在这些患者中,77.4%的患者是活着的,死亡率为22.6%。结论:虽然大部分患者没有明确的病因,但胆结石是最常见的病因。疼痛通常位于上腹部,背部有辐射。根据APACHE II评分和Glasgow评分,超过60%的患者患有轻度胰腺炎。平均住院时间约为9天,每次口服约为5天。总体死亡率为22.6%。《医学杂志》2022;23:24-29
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引用次数: 0
Evidence Based Management of COVID-19 - Bangladesh Perspective 基于证据的COVID-19管理——孟加拉国视角
Pub Date : 2022-02-03 DOI: 10.3329/jom.v23i1.57929
M. Kabir
Abstract not availableJ MEDICINE 2022; 23: 1-2
[j]中华医学杂志2022;23: 1 - 2
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引用次数: 0
Comparison of Central Venous Catheter Related Deep Venous Thrombosis According to Insertion Site in an Intensive Care Unit of Bangladesh 孟加拉国重症监护室中心静脉导管插入部位与深静脉血栓形成的比较
Pub Date : 2022-02-03 DOI: 10.3329/jom.v23i1.57932
D. Saha, S. Nazneen, A. Ahsan, Madhurima Saha, K. Fatema, F. Ahmed, R. Sultana
Background: Central venous catheter (CVC) is usually inserted into subclavian, internal jugular, orfemoral vein in critically ill patients. CVCs are associated with intravascular (infectious, thrombotic) andmechanical complications. CVC related deep venous thrombosis (DVT) is a common intravascularcomplication.Objectives: To see the variation in occurrence of CVC related deep venous thrombosis according todifferent insertion site.Method: It was a prospective observational study conducted in dept. of Critical Care Medicine, BIRDEMGeneral Hospital; during a period of May, 2016 to July, 2019. Purposive sampling was conducted in patientsfulfilling the selection criteria. The CVCs were percutaneously inserted using the Seldinger techniquewith standard operating procedure. After CVC insertion, patients were followed up daily to see any signof deep venous thrombosis. After catheter removal [due to any cause including suspected catheterrelated blood stream infection (CRBSI), DVT, mechanical cause], all the study patients were investigated byduplex ultrasonography (USG) within 2 days for detection of venous thrombosis. The outcome wascatheter related deep venous thrombosis (DVT).Results: A total 349 patients, of which 167 (47.9%) patients had CVC in subclavian, 88 (25.2%) in internaljugular and 94 (26.9%) in femoral vein. Total 12 patients were suspected to have catheter related DVT, but11(3.2%) patients were confirmed as DVT by duplex USG. DVT occurred significantly higher in femoralcatheter site (8.5%) than subclavian (1.8%) and internal jugular site (0%).Conclusion: The occurrence of catheter related DVT was higher in femoral site than other two sites.J MEDICINE 2022; 23: 20-23
背景:中心静脉导管(CVC)常用于危重患者的锁骨下静脉、颈内静脉或股静脉。cvc与血管内(感染性、血栓性)和机械并发症有关。CVC相关性深静脉血栓形成(DVT)是一种常见的血管内并发症。目的:观察CVC相关深静脉血栓的发生与不同植入部位的关系。方法:采用前瞻性观察研究方法,在柏德华总医院重症医学科进行;在2016年5月至2019年7月期间。对符合选择标准的患者进行有目的的抽样。采用Seldinger技术,按照标准操作程序经皮插入cvc。CVC植入后,每天随访患者是否有深静脉血栓形成的迹象。所有患者在拔管后(任何原因包括疑似导管相关血流感染(CRBSI)、DVT、机械原因),均在2天内行双工超声(USG)检查静脉血栓形成情况。结果为导管相关性深静脉血栓形成(DVT)。结果:349例患者中锁骨下CVC 167例(47.9%),颈内CVC 88例(25.2%),股静脉CVC 94例(26.9%)。12例患者疑似导管相关性DVT,但11例(3.2%)患者经双工超声心动图确诊为DVT。股导管部位DVT发生率(8.5%)明显高于锁骨下部位(1.8%)和颈内部位(0%)。结论:股动脉导管相关性DVT的发生率高于其他两个部位。[J]中华医学杂志2022;23: 20
{"title":"Comparison of Central Venous Catheter Related Deep Venous Thrombosis According to Insertion Site in an Intensive Care Unit of Bangladesh","authors":"D. Saha, S. Nazneen, A. Ahsan, Madhurima Saha, K. Fatema, F. Ahmed, R. Sultana","doi":"10.3329/jom.v23i1.57932","DOIUrl":"https://doi.org/10.3329/jom.v23i1.57932","url":null,"abstract":"Background: Central venous catheter (CVC) is usually inserted into subclavian, internal jugular, orfemoral vein in critically ill patients. CVCs are associated with intravascular (infectious, thrombotic) andmechanical complications. CVC related deep venous thrombosis (DVT) is a common intravascularcomplication.Objectives: To see the variation in occurrence of CVC related deep venous thrombosis according todifferent insertion site.\u0000Method: It was a prospective observational study conducted in dept. of Critical Care Medicine, BIRDEMGeneral Hospital; during a period of May, 2016 to July, 2019. Purposive sampling was conducted in patientsfulfilling the selection criteria. The CVCs were percutaneously inserted using the Seldinger techniquewith standard operating procedure. After CVC insertion, patients were followed up daily to see any signof deep venous thrombosis. After catheter removal [due to any cause including suspected catheterrelated blood stream infection (CRBSI), DVT, mechanical cause], all the study patients were investigated byduplex ultrasonography (USG) within 2 days for detection of venous thrombosis. The outcome wascatheter related deep venous thrombosis (DVT).\u0000Results: A total 349 patients, of which 167 (47.9%) patients had CVC in subclavian, 88 (25.2%) in internaljugular and 94 (26.9%) in femoral vein. Total 12 patients were suspected to have catheter related DVT, but11(3.2%) patients were confirmed as DVT by duplex USG. DVT occurred significantly higher in femoralcatheter site (8.5%) than subclavian (1.8%) and internal jugular site (0%).\u0000Conclusion: The occurrence of catheter related DVT was higher in femoral site than other two sites.\u0000J MEDICINE 2022; 23: 20-23","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45883902","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}
引用次数: 0
The Pharmacogenomics Aspects of Drugs Used in COVID-19 Treatment 新冠肺炎治疗药物的药物基因组学方面
Pub Date : 2022-02-03 DOI: 10.3329/jom.v23i1.57939
G. Khan, Yomna Elsayed, M. Said
The increase in mortality and morbidity related to the novel COVID-19 virus led researchers to work ondeveloping new therapies to destroy the virus. Numerous clinical trials have started to find drugs that willeffectively treat the signs and symptoms of the virus. This review aims to summarize the pharmacogenomicaspects of drugs such as hydroxychloroquine, chloroquine, azithromycin, remdesivir, favipiravir, ribavirin,lopinavir/ritonavir, darunavir/cobicistat, interferon beta-1b, tocilizumab, ruxolitinib, baricitinib, andcorticosteroids used in the treatment of this virus. The data will be collected from various websites such asPubMed, Lancet, WHO website, PharmGKB website, IDSA Guidelines on the treatment & management ofCOVID-19 Patients, the U.S. Food and Drug Administration (FDA) product labeling, and pharmacogenomicstables. Incomplete data exists related to the efficacy and safety of these drugs and healthcare providers arestruggling to make the right treatment choices. Drug-gene variants may alter the pharmacokinetics andsafety of some drugs and thus produce adverse drug reactions. Therefore, pharmacogenomics may helpdoctors decide the correct course of treatment by knowing the genetic makeup of an individual. This caneventually help to eliminate adverse drug reactions and reduce the mortality rate.J MEDICINE 2022; 23: 61-76
与新型COVID-19病毒相关的死亡率和发病率的增加促使研究人员致力于开发新的疗法来摧毁这种病毒。许多临床试验已经开始寻找能够有效治疗这种病毒体征和症状的药物。本文综述了羟氯喹、氯喹、阿奇霉素、瑞德西韦、法匹拉韦、利巴韦林、洛匹那韦/利托那韦、达若那韦/可比司他、干扰素β -1b、托珠单抗、鲁索利替尼、巴西替尼和皮质类固醇等治疗该病毒的药物基因组学方面的研究进展。数据将从pubmed、Lancet、WHO网站、PharmGKB网站、IDSA covid -19患者治疗和管理指南、美国食品和药物管理局(FDA)产品标签和药物基因组学数据库等多个网站收集。与这些药物的有效性和安全性相关的数据不完整,医疗保健提供者正在努力做出正确的治疗选择。药物基因变异可能改变某些药物的药代动力学和安全性,从而产生药物不良反应。因此,药物基因组学可以通过了解个体的基因组成来帮助医生决定正确的治疗方案。这最终有助于消除药物不良反应,降低死亡率。[J]中华医学杂志2022;23日:61 - 76
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引用次数: 0
Recent Updates on microRNA as Potential Biomarkers for Diagnosis of Gestational Diabetes mellitus microRNA作为妊娠期糖尿病诊断潜在生物标志物的最新进展
Pub Date : 2021-12-27 DOI: 10.20944/preprints202112.0426.v1
Kazi Mahmuda Akter, B. Umar, S. Rahman
Background/Aims: Screening for gestational diabetes mellitus (GDM) are currently done at 24 - 28 weeks of conception, missing out on the most vulnerable period of organogenesis and thus preventing clinicians from starting treatments until the late second or third trimester. MicroRNAs (miR) are small non-coding RNA molecules that could aid in detecting or predicting GDM through establishing a novel non-invasive prenatal testing (NIPT) tool. The objective of this study was to summarize the most recent updates on plasma microRNAs as GDM diagnostic biomarkers. Methods: Between April and June 2021, a PubMed literature search was undertaken to review recent articles on human plasma miR associated with GDM. Animal studies and papers that are written in languages other than English were excluded. Only plasma miRNAs were used to avoid coagulation biases. Results: A total of 31 miRNAs were found significantly upregulated in the plasma samples of patients with GDM. It was found mainly during the 2nd or 3rd trimester except for miR-223 and miR-23a that were upregulated at 9 – 11 weeks of gestation. Conclusion: Though extensive prospective cohort studies are required, miR-223 and miR-23a should be considered the most promising to develop a successful NIPT tool because they were found to be upregulated earliest, during the first trimester.
背景/目的:妊娠期糖尿病(GDM)的筛查目前在怀孕24-28周时进行,错过了器官发生的最脆弱时期,从而使临床医生无法在妊娠中期或晚期开始治疗。微小RNA(miR)是一种小的非编码RNA分子,可以通过建立一种新的无创产前检测(NIPT)工具来帮助检测或预测GDM。本研究的目的是总结血浆微小RNA作为GDM诊断生物标志物的最新进展。方法:在2021年4月至6月期间,PubMed进行了文献检索,以回顾最近关于与GDM相关的人血浆miR的文章。动物研究和用英语以外的语言撰写的论文被排除在外。仅使用血浆miRNA来避免凝血偏差。结果:共发现31个miRNA在GDM患者的血浆样本中显著上调。除miR-223和miR-23a在妊娠9-11周上调外,主要在妊娠中期或晚期发现。结论:尽管需要进行广泛的前瞻性队列研究,但miR-223和miR-23a应被认为是开发成功的NIPT工具最有希望的,因为它们被发现最早在妊娠早期上调。
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引用次数: 1
Analysis of the dental health level within the framework of a social project for medical examination and maintenance of orphanages in the Republic of Kazakhstan 哈萨克斯坦共和国孤儿院医疗检查和维护社会项目框架内的牙齿健康水平分析
Pub Date : 2021-12-13 DOI: 10.31082/1728-452X-2020-215-216-5-6-38-52
M. Iskakova, Urnisa Kuvatbaeva, Madina Aukhadiyeva
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引用次数: 0
Anxiety disorders in clinical practice - a modern view on the problem of therapy 临床实践中的焦虑障碍——对治疗问题的现代看法
Pub Date : 2021-12-13 DOI: 10.31082/1728-452X-2020-215-216-5-6-63-70
L. Kuanova, Corporate Fund
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引用次数: 0
Modern approaches to the diagnosis and treatment of mixed anxiety-depressive disorders in primary health care 在初级卫生保健中诊断和治疗混合性焦虑抑郁障碍的现代方法
Pub Date : 2021-12-13 DOI: 10.31082/1728-452X-2020-215-216-5-6-53-62
N. Raspopova, Maria Dzhamantayeva, Yerbol Nurkatov, Laila Uteniyazova, Gulnaziya Idenova, Yulia Kotsaba, G. Kozhakhmetova
{"title":"Modern approaches to the diagnosis and treatment of mixed anxiety-depressive disorders in primary health care","authors":"N. Raspopova, Maria Dzhamantayeva, Yerbol Nurkatov, Laila Uteniyazova, Gulnaziya Idenova, Yulia Kotsaba, G. Kozhakhmetova","doi":"10.31082/1728-452X-2020-215-216-5-6-53-62","DOIUrl":"https://doi.org/10.31082/1728-452X-2020-215-216-5-6-53-62","url":null,"abstract":"","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":"1 1","pages":"53-62"},"PeriodicalIF":0.0,"publicationDate":"2021-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48813314","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}
引用次数: 0
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