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Myelofibrosis with Transient Pancytopenia and CD-68 Marker Positivity: A Case to Review 骨髓纤维化伴短暂性全血细胞减少和CD-68标记物阳性:一例回顾
Pub Date : 2019-01-01 DOI: 10.26502/aimr.0012
M. Asghar, S. Aslam, Durre Naman, Maryam Zafar, Narmin Khan, Haris Alvi, U. Rasheed, Abubakar Tauseef
Myelofibrosis is characterized by a group of clonal neoplastic proliferation under the influence of cytokines such as fibroblast growth factor (particularly by megakaryocytes) which leads to the replacement of normal hematopoietic bone marrow with connective tissue via collagen fibrosis. It most commonly affects patients in the fifth and sixth decade of their life. Constitutional symptoms such as fatigue along with massive splenomegaly, easy fatigability, and easy bruising are reported most commonly in such patients. Here we present a case of a 76-year-old male who was diagnosed with myelofibrosis having transient pancytopenia and CD-68 marker positive.
骨髓纤维化的特点是在成纤维细胞生长因子(特别是巨核细胞)等细胞因子的影响下发生一组克隆性肿瘤增生,通过胶原纤维化导致正常造血骨髓被结缔组织取代。它最常影响患者在他们生命的第五和第六个十年。体质症状如疲劳伴脾肿大、易疲劳、易瘀伤等在这类患者中最常见。在这里,我们提出一个76岁的男性谁被诊断为骨髓纤维化有短暂的全血细胞减少和CD-68标记阳性。
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引用次数: 0
Geriatric Patients: Data on Dental Problems at this Age 老年患者:这个年龄段牙齿问题的数据
Pub Date : 2019-01-01 DOI: 10.26502/aimr.0014
A. Heta, Merilda Tarja, Sonila Kapaj, Eduard Kapaj, E. Milo, Ilma Robo
Introduction: As the age increases, the frequency of hearing loss, visual impairment, cataract and glaucoma is increased. Most of the geriatric patients suffer from at least one chronic disease. The aim of the study is the evaluation of the presence of dental problems in geriatric age and comparison of the frequency of lesion manifestations of pre-geriatric age. Material and methods: In a sample of 73 ad-hoc presented patients, at the University Clinic, Albanian University, for dental treatments, data on the oral status of geriatric patients were collected over a period of 2 weeks, 7-21 May 2019. The conditions for inclusion in the study were the age of the patient, 50 years and over. The mean age of geriatric age is 65 years, but the age of the study was decided to compare the elements of dental problems before the geriatric age, such as a pre-geriatric specimen or geriatric pathologies. Patients were evaluated for age, degree of education, number of teeth in the oral cavity, number of replaceable teeth, number of teeth with caries in the tooth crown, number of denture teeth in the tooth root, number of teeth with gingival recession 3 or more mm. etc. Results: Regardless of the age distribution, almost 55% of the oral cavities are full of natural tooth, the fixed prosthesis is at the highest level at age 50-65 years. Independently of the gender, the average age of the patients involved  is  almost the same 67 years. Crown caries expresses the highest level of 14% at oral cavity at 66-90 years of age, caries of root amounted to 14% of oral cavity at 50-65 years of age. Xerostomia appears at 13% in the age 50-65 years, and 20% in the age of 66-90. Gingival recession and loss of attachment express the highest values at male patients, with a value over 3mm. Conclusions: At geriatric patients, the aim should be to reduce the number of bacteria in the mouth and the mechanical cleaning of the teeth. At pre-geriatric age, it is more common the appearance of caries of the crown than in the geriatric age, where the most common is the caries of the roots of teeth. This fact is supported by the addition and agitation of xerostomia in the oral cavity, which increases with age. The pre-geriatric age still has naturally occurring oral cavity that can be used for fixed prosthetics. At the age of geriatric patients, the total prosthetic replacement takes the highest weight.
随着年龄的增长,听力损失、视力损害、白内障和青光眼的发生频率增加。大多数老年患者至少患有一种慢性疾病。该研究的目的是评估老年期牙齿问题的存在,并比较老年前年龄病变表现的频率。材料和方法:在阿尔巴尼亚大学大学诊所接受牙科治疗的73名临时就诊患者的样本中,收集了2019年5月7日至21日两周内老年患者口腔状况的数据。纳入研究的条件是患者的年龄,50岁及以上。老年年龄的平均年龄为65岁,但研究的年龄是为了比较老年年龄之前牙齿问题的因素,如老年前标本或老年病理。对患者进行年龄、文化程度、口腔内牙数、可替换牙数、牙冠龋齿数、牙根假牙数、牙龈萎缩3 mm及以上的牙数等评估。结果:无论年龄分布如何,近55%的口腔内满牙为天然牙,固定假体在50 ~ 65岁年龄段达到最高水平。不考虑性别,患者的平均年龄几乎都是67岁。冠状龋在66 ~ 90岁时占口腔的14%,50 ~ 65岁时占口腔的14%。口干症在50-65岁的人群中占13%,在66-90岁的人群中占20%。男性患者牙龈萎缩和附着丧失的值最高,超过3mm。结论:对于老年患者,应以减少口腔细菌数量和机械清洁牙齿为目标。在老年前期,冠的龋齿比老年时期更常见,最常见的是牙根的龋齿。随着年龄的增长,口腔口干症的增加和加剧支持了这一事实。老年前的人仍然有自然形成的口腔,可以用于固定的假肢。在老年患者中,全假体置换术所占的重量最大。
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引用次数: 1
Risk Factors for Mortality in Patients with TB/HIV Co-Infection at the General Provincial Reference Hospital of Kinshasa, Democratic Republic of the Congo 刚果民主共和国金沙萨省综合参考医院结核病/艾滋病毒合并感染患者死亡的危险因素
Pub Date : 2019-01-01 DOI: 10.26502/aimr.006
Palambwa Ansot Anzats Ruphine, N. K. Oscar,, G. Bongo, Nsobani Lukelo Désiré, Amuli Jiwe Jean-Pierre
Background: The HIV (human immunodeficiency virus) pandemic has been accompanied by an increase in the incidence of many opportunistic infections like tuberculosis (TB). Despite curative and preventive efforts and free treatment for TB -HIV co-infection, the Democratic Republic of Congo remains the fourth country in Africa where the prevalence of this co-infection remains very high. The aim of this study was to identify the factors that explain mortality in patients with TB/HIV co-infection at the Kinshasa Provincial General Reference Hospital in order to reduce the incidence of complications related to this century's pandemic.Methods: The survey was conducted at the General Provincial Reference Hoisptal of Kinshasa (GPRHK), Kinshasa, DR Congo. This cross-sectional study was conducted between January and November 2018, whereby medical files for patients suffering from TB/HIV co-infection were analyzed. The sample size was determined on the basis of the Fischer formula. Thus, one hundred and forty-four (144) files were selected and consulted. Data were collected based on a pre-established, standardized and anonymous questionnaire. This questionnaire was tested on a sample of 40 files subsequently validated. Descriptive analyses were used to describe the sample profile. The correlational analysis using the Chi-square association test (X2), the confidence interval of the Odds-ratio was performed between different variables. All data were analyzed using SPSS software version 22.0. The p value < 0.05 was considered statistically significant.Results: Multiple regression analysis indicates that the main determinants of mortality in patients with TB/HIV co-infection are as follows: the main predictors of mortality from TB/HIV co-infection were, in order of importance, patients diagnosed with HIV (0.448; p0.05), patients treated with anti-tubercular drugs (0.231; p0.05). The clinical form of tuberculosis ( -0.032; p0.05) and the age of people living with HIV (0.038; p0.05) are not significantly associated with TB-HIV co-infection.Conclusion: The diagnosis of HIV infection in TB patients in the absence of anti-tuberculin prophylaxis, followed by the clinical form of tuberculosis coupled with poor compliance and significant immunosuppression are the major risk factors for mortality.
背景:HIV(人类免疫缺陷病毒)大流行伴随着许多机会性感染的发病率增加,如结核病(TB)。尽管进行了治疗和预防工作,并免费治疗结核病-艾滋病毒合并感染,但刚果民主共和国仍然是非洲第四个这种合并感染流行率仍然很高的国家。本研究的目的是确定金沙萨省综合参考医院结核病/艾滋病毒合并感染患者死亡率的因素,以减少本世纪大流行相关并发症的发生率。方法:在刚果民主共和国金沙萨省综合参考医院(GPRHK)进行调查。这项横断面研究是在2018年1月至11月期间进行的,分析了结核病/艾滋病合并感染患者的医疗档案。样本量是根据Fischer公式确定的。因此,我们选择了144份文件并进行了查阅。数据是根据事先制定的标准化匿名问卷收集的。该问卷在随后验证的40个文件样本上进行了测试。描述性分析用于描述样本剖面。相关分析采用卡方关联检验(X2),不同变量间进行比值比置信区间。所有数据均采用SPSS 22.0软件进行分析。p值< 0.05认为有统计学意义。结果:多元回归分析表明,TB/HIV合并感染患者死亡率的主要影响因素如下:TB/HIV合并感染患者死亡率的主要预测因素依次为:诊断为HIV的患者(0.448;P0.05),抗结核药物治疗组(0.231;p0.05)。肺结核临床形态(-0.032;p0.05)、HIV感染者的年龄(0.038;p0.05)与TB-HIV合并感染无显著相关。结论:结核病患者在未进行抗结核素预防的情况下诊断为HIV感染,其次是结核病临床形式加上依从性差和免疫抑制明显是导致死亡的主要危险因素。
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引用次数: 2
Prevalence of Vitamin D Deficiency in Pregnant Diabetic Patients in Western Libya 利比亚西部妊娠糖尿病患者维生素D缺乏症的患病率
Pub Date : 2019-01-01 DOI: 10.26502/aimr.005
Ghrew Murad, Ellafi Hanan, M. Abdulghani, Bashein Abdulla, Sultan Mohammed, S. Khaled
Despite the relative abundance of sunny weather, surprisingly, there is increasing evidence that vitamin D deficiency is extremely prevalent in females of reproductive age in Middle East countries. There is also increasing interest in the non-classical roles of vitamin in health and disease including its relation to incidence of gestational diabetes, its impact on glycaemic control in diabetes mellitus, and its association with some complications of pregnancy like preeclampsia. The objective of this study was to estimate the prevalence of Vitamin D deficiency in pregnant diabetic patients in west Libya and analyse potential links to socioeconomic and cultural factors. This is a cross sectional observational study. Random plasma was collected form expected mothers attending the Antenatal Diabetes Clinic at Tripoli’s Main Maternity Hospital. Demographics and socioeconomic and cultural factors were recorded at the same time. Samples were analysed for vitamin D level and biochemical screening panel. Vitamin D level was obtained from 160 patients (mean age 35 years). Over all 95 % of the study population had vitamin D levels below normal (defined as vitamin D level of 30 ng/ml, only 1.3%, 2 patients). All patients were taking daily vitamin D Supplements at a dose of 400 IU as per hospital policy. Vitamin D deficiency is extremely prevalent in pregnant diabetic patients in Libya. There is no clear association with socioeconomic risk factors like employment, type of accommodation or geographic distribution. However, most of the study population had life style characterized by minimal exposure to direct sun light. Routine supplementation of Vitamin D in doses of 400 IU/day does not appear to ameliorate the severity of vitamin D deficiency in this group.
尽管阳光充足,令人惊讶的是,越来越多的证据表明,维生素D缺乏症在中东国家育龄妇女中极为普遍。人们对维生素在健康和疾病中的非经典作用也越来越感兴趣,包括它与妊娠糖尿病发病率的关系,它对糖尿病患者血糖控制的影响,以及它与一些妊娠并发症如先兆子痫的关系。本研究的目的是估计利比亚西部怀孕糖尿病患者维生素D缺乏症的患病率,并分析其与社会经济和文化因素的潜在联系。这是一项横断面观察性研究。在的黎波里主要妇产医院产前糖尿病诊所随机收集孕妇血浆。同时记录了人口、社会经济和文化因素。对样品进行维生素D水平分析和生化筛选。从160例患者(平均年龄35岁)中获得维生素D水平。总体而言,95%的研究人群维生素D水平低于正常水平(定义为维生素D水平为30 ng/ml,仅1.3%,2例患者)。根据医院规定,所有患者每天服用400国际单位的维生素D补充剂。维生素D缺乏症在利比亚怀孕的糖尿病患者中极为普遍。与就业、住宿类型或地理分布等社会经济风险因素没有明确的联系。然而,大多数研究人群的生活方式以最少的阳光直射为特征。常规补充400 IU/天的维生素D似乎不能改善该组维生素D缺乏的严重程度。
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引用次数: 0
Global DNA Methylation in Children with Complicated Urinary Tract Infection 复杂尿路感染儿童的整体DNA甲基化
Pub Date : 2019-01-01 DOI: 10.26502/aimr.0017
K. Sekar, S. Krishnamurthy, J. Mandal, M. Rajappa
Background and Objectives: The Study suggests that pathogen interceded DNA methylation changes influence the gene expression pattern contributing to disease progression. To study the association between pathogen-induced global DNA methylation variation in children with complicated Urinary tract infection and healthy children. Methods: The study was conducted in the Department of Pediatrics of a referral hospital. For this study, 50 children as cases with complicated UTI and 50 healthy children as controls were enrolled. Whole blood genomic DNA was isolated from the cases as well as controls. Using 5-mC (methylcytosine) DNA ELISA method, the percentage of genomic DNA methylation in these children was established.  Results: Global DNA methylation level was found highly significant between cases and controls and the percentage of DNA methylation level was (Cases: 25.81 ± 6.9; Controls: 15.354 ± 3.17; P<0.001). Receiver operating curve analysis showed that the area under curve 0.92 for the total study population. Interpretation and conclusions: The results of this study show that genomic DNA methylation varies significantly among cases and controls. This study points towards the role of DNA methylation in the pathogenesis of complicated urinary tract infection.
背景和目的:本研究表明,病原体介导的DNA甲基化改变影响了促进疾病进展的基因表达模式。目的:探讨复杂尿路感染患儿病原体诱导的DNA甲基化变异与健康儿童的关系。方法:本研究在一家转诊医院的儿科进行。在这项研究中,50名儿童作为复杂UTI病例,50名健康儿童作为对照。从病例和对照组中分离出全血基因组DNA。采用5-mC(甲基胞嘧啶)DNA酶联免疫吸附测定法,测定患儿基因组DNA甲基化率。结果:病例与对照组整体DNA甲基化水平差异显著,DNA甲基化百分比为(病例:25.81±6.9;对照组:15.354±3.17;P < 0.001)。受试者工作曲线分析显示,总体研究人群曲线下面积为0.92。解释和结论:本研究结果表明,基因组DNA甲基化在病例和对照组之间存在显著差异。本研究指出了DNA甲基化在复杂尿路感染发病机制中的作用。
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引用次数: 0
SFRP2 Promoter Methylation Analysis in Tumor Tissue, Stool, and Plasma DNA of Patients with Colorectal Cancer 结直肠癌患者肿瘤组织、粪便和血浆DNA中SFRP2启动子甲基化分析
Pub Date : 2019-01-01 DOI: 10.26502/aimr.009
Yong-Suk Kim, Song-Hak Kim, Myong-Nam Kim, Un-Rim Sim
Noninvasive method for early detection of human cancers is promising way to provide more quality health service to the population. The serum and stool of colorectal cancer patients often harbor increased free DNA levels, which can potentially be used for cancer detection. Because SFRP2 (secreted frizzled related protein 2) is considered a Wnt inhibitor whose CpGs were frequently hypermethylated in several human cancers, we investigated the frequency of aberrant SFRP2 promoter methylation in primary tumors and serum or stool samples of colorectal cancer patients by MS-PCR. We detected methylation of SFRP2 in 111 of 117 (94.9%) paraffin-embedded colorectal cancer tissues. Fifty-nine of the 68 (86.8%) available serum samples from these cases carried detectable amounts of the methylated SFRP2 promoter. Sixty-one of 68 (89.7%) available stool samples from the same cases carried positive methylation in the promoter region of SFRP2 gene. In contrast, no methylated SFRP2 promoter DNA was detected in serum and stool samples from 60 healthy controls. Only 2 cases of 68 healthy controls showed methylated SFRP2 promoter DNA in their colorectal tissue. But high frequency of methylated SFRP2 gene promoter has no correlation with the clinic-pathologic features. We concluded that SFRP2 methylation analysis appeared to be a noninvasive tumor marker in serum and/or stool DNA
非侵入性癌症早期检测是一种有希望为人们提供更高质量医疗服务的方法。结直肠癌患者的血清和粪便中通常含有较高的游离DNA水平,这可能用于癌症检测。由于SFRP2(分泌卷曲相关蛋白2)被认为是一种Wnt抑制剂,其CpGs在几种人类癌症中经常高甲基化,因此我们通过MS-PCR研究了原发性肿瘤和结直肠癌患者血清或粪便样本中SFRP2启动子甲基化异常的频率。我们在117个结直肠癌石蜡包埋组织中的111个(94.9%)中检测到SFRP2甲基化。来自这些病例的68个可用血清样本中有59个(86.8%)携带可检测量的甲基化SFRP2启动子。来自同一病例的68份粪便样本中有61份(89.7%)携带SFRP2基因启动子区甲基化阳性。相比之下,60名健康对照者的血清和粪便样本中未检测到甲基化的SFRP2启动子DNA。68例健康对照中只有2例在结直肠组织中显示SFRP2启动子DNA甲基化。但SFRP2基因启动子甲基化频率高与临床病理特征无关。我们得出结论,SFRP2甲基化分析似乎是血清和/或粪便DNA中的非侵入性肿瘤标志物
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引用次数: 2
A Case of Subdural Haemorrhage Following a Trivial Fall - A Case Report 轻微跌倒致硬膜下出血1例
Pub Date : 2019-01-01 DOI: 10.26502/aimr.008
Navin Kumar Devaraj
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引用次数: 0
Clinical Review on the Obstinate Childhood Nocturnal Enuresis Treated with Manual Cure 手法治疗顽固性儿童夜间遗尿症的临床观察
Pub Date : 2019-01-01 DOI: 10.26502/aimr.0011
C. Jang, U. Chon, Chol-Song Ri
Childhood nocturnal enuresis is concerned to be related mainly to the dysfunction of the autonomic nervous system with parasympathetic nerve accentuation, feeble-mindedness, the organic disorder of the central nervous system, the organic abnormality of the urethra, diabetes, diabetes insipidus, parasites, tonsillar hypertrophy, dysmature, dyscontrol of urination and the decrease of ADH secretion. We gave a new outlook that childhood nocturnal enuresis may as well be developed when some functions concerned with voluntary constriction of the external urethral sphincter, constriction and relaxation of cystic smooth muscles are out of control of pelvic and public nerve from S2-4 nerves along sacral segment by subluxation of sacroiliac joint resulting in the depression or dysfunction of sacral segment. In below-mentioned cases who suffered from the obstinate childhood nocturnal enuresis that did not respond at all to modern and Koryo medicines, acupuncture, moxibustion, etc., we introduced the remedy of sacroiliac joint subluxation correction and they were all recovered. This is a new suggestion that childhood nocturnal enuresis might he cause by subluxation of sacroiliac joint and it can be cured with correction remedy.
儿童夜间遗尿主要与自主神经系统功能障碍伴副交感神经突出、精神衰弱、中枢神经系统器质性紊乱、尿道器质性异常、糖尿病、尿囊症、寄生虫、扁桃体肥大、发育不良、排尿障碍、ADH分泌减少有关。我们对儿童期夜间遗尿症的发生提出了新的观点,认为儿童期夜间遗尿症的发生可能是由于骶髂关节半脱位引起的骶段骶2-4神经沿骨盆和公共神经的一些与尿道外括约肌随意收缩、囊性平滑肌收缩和松弛有关的功能失控而导致骶段凹陷或功能障碍。以下顽固性儿童期夜间遗尿,经现代、高丽药物、针灸、艾灸等治疗无效的病例,我们引入骶髂关节半脱位矫正的治疗方法,均痊愈。提示儿童夜间遗尿可能由骶髂关节半脱位引起,可采用矫治方法治疗。
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引用次数: 0
Unscarred Uterine Rupture (UUR) - Not A Rarity In Developing Countries 无疤痕子宫破裂(UUR) -在发展中国家并不罕见
Pub Date : 2019-01-01 DOI: 10.26502/aimr.004
Fizzah Arif
Uterine rupture during pregnancy is a life threatening obstetric complication. It is defined as a nonsurgical disruption in the wall of the uterus along with visceral peritoneum. It is far more common in developing countries due to the numerous direct and indirect factors like lack of family planning, poor maternal health, poor management of labor, home deliveries by untrained professionals and others. It commonly manifests as acute abdomen and hemodynamic instability due to hemoperitoneum. Letter To The Editor Dear Editor, Worldwide incidence of uterine rupture during pregnancy is 1 per 1,416 pregnancies (0.07%). Single most important factor leading to this consequence is a scarred uterus due to previous uterine surgery. Rupture of an unscarred uterus occurs rarely in developed countries its rate is 1 per 8,434 pregnancies (0.012%) whereas the incidence is eight times higher in developing countries that is 1 in 920 (0.11%) [1]. It has been found that uterine rupture can occur in previously normal uterus in early pregnancies and beforehand preparations in such cases prevent from the lethal complications of this dreadful event. Uterine Rupture is a potentially fatal sequalae of late pregnancy and labor in a uterus with scarring. Rupture of unscarred uterus most commonly involves the lower segment of uterus which is the weakest part [2]. In Pakistan, incidence of uterine rupture is reported in 1 out of 64 deliveries [3]. Only 0.012% of normal uteri are at risk of rupture and chances of rupture increases with the number of previous scars. It is 0.5% after one caesarean section and 2% after two or more than two scars [1]. 29.5 % of the diagnosed Pakistani women had unscarred uteri previously [4]. Arch Intern Med Res 2019;2(1): 001-003 DOI: 10.26502/aimr.004 Archives of Internal Medicine Research 2 Factors associated with unscarred uterine rupture (UUR) in developing countries are high parity [5,2], abnormal placenta implantation, uterine anomalies, malpresentations, injudicious use of uterotonics [2] breech extraction, uterine instrumentation, myomectomy and macrosomia [1]. Other factors are low socioeconomic status, unbooked patients, prolonged and mismanaged labor and delay in receiving care during obstructed labor [5]. Clinical presentation of uterine rupture varies at different gestational ages and on the site of rupture. Signs and symptoms include abdominal pain, hemorrhage (revealed or concealed), fetal bradycardia, recession of fetal presenting part, gut prolapse in vagina, presence of placenta at vulva [3], hypotension and hypovolemic shock. Maternal consequences arising from this event include hemorrhage, anemia, bladder injury, need for hysterectomy, hypovolemic shock and death whereas fetal hypoxia, acidosis, admission to NICU and fetal death can occur [1]. In a study conducted to determine the risk factors of uterine rupture in developing countries, it has been reported that the frequency of uterine rupture is twice among the females who
巴基斯坦大学附属医院子宫破裂病例分析。[J] .医学科学31(2015):920-924。5. 王晓明,王晓明。子宫破裂的危险因素分析。妇产科1(2011):102。本文是一篇在知识共享署名(CC-BY)许可4.0的条款和条件下发布的开放获取文章。无疤痕子宫破裂(UUR)在发展中国家并不罕见。内科学研究2(2019):001-003。
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引用次数: 0
The Unusual Case of Child Tantrum - A Case Report 儿童不寻常的发脾气个案报告
Pub Date : 2019-01-01 DOI: 10.26502/aimr.007
N. Devaraj
This is an amazing case report about an eight years old child that displayed child tantrum more synonym of the younger age group. This case also entails how the author managed to uncover the true reasons for his tantrum that left his guardian truly amazed at the ability of physicians to solve a seemingly difficult behavioural problem.
这是一个惊人的病例报告,关于一个八岁的孩子,他表现出了孩子发脾气,这是更年轻的年龄组的同义词。这个案例还涉及作者如何设法揭示他发脾气的真正原因,让他的监护人对医生解决一个看似困难的行为问题的能力感到惊讶。
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引用次数: 0
期刊
Archives of Internal Medicine Research
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