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Therapeutic Potential of Silymarin in Mitigating Paclitaxel-Induced Hepatotoxicity and Nephrotoxicity: Insights into Oxidative Stress, Inflammation, and Apoptosis in Rats. 水飞蓟素在减轻紫杉醇诱导的肝毒性和肾毒性方面的治疗潜力:洞察大鼠体内的氧化应激、炎症和细胞凋亡
IF 1.9 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-05-03 DOI: 10.4274/balkanmedj.galenos.2024.2024-1-60
Seda Yakut, Tuğçe Atcalı, Cüneyt Çaglayan, Aykut Ulucan, Fatih Mehmet Kandemir, Adem Kara, Turgut Anuk

Background: Paclitaxel (PAX) is a widely used chemotherapy drug for various cancer types but often induces significant toxicity in multiple organ systems. Silymarin (SIL), a natural flavonoid, has shown therapeutic potential due to its multiple benefits.

Aims: To evaluate the therapeutic efficacy of SIL in mitigating liver and kidney damage induced by PAX in rats, focusing on oxidative stress, inflammation, and apoptosis pathways.

Study design: Experimental animal model.

Methods: The study included 28 male Wistar rats aged 12-14 weeks weighing 270-300 g. The rats were divided into four groups: control, SIL, PAX, and PAX + SIL, with seven in each group. The rats received intraperitoneal (i.p.) injections at a dose of 2 mg per kilogram of body weight of PAX for 5 successive days, followed by oral gavage with 200 mg/kg body mass of SIL for 10 uninterrupted days. We examined the effect of SIL on specific serum biochemical parameters using an autoanalyzer and rat-specific kits. The spectrophotometric methods was used to investigate oxidative stress indicators in kidney and liver tissues. Aquaporin-2 (AQP-2), B-cell lymphoma-2 (Bcl-2), cysteine aspartate-specific protease-3 (caspase-3), interleukin-6 (IL-6), nuclear factor kappa B (NF-κB), and streptavidin-biotin staining were used to assess immunoreactivity in PAX-induced liver and kidney injury models.

Results: SIL treatment significantly reduced serum levels of alanine aminotransferase, aspartate aminotransferase, creatinine, urea, and C-reactive protein, indicating its effectiveness in treating PAX-induced liver and kidney injury. SIL treatment significantly reduced oxidative stress by increasing essential antioxidant parameters, such as superoxide dismutase, catalase, glutathione peroxidase, and glutathione. It also reduced malondialdehyde levels in liver and kidney tissues of SIL-PAX groups (p < 0.05). SIL administration reduced NF-κB, caspase-3, and IL-6 expression while increasing Bcl-2 and AQP2 levels in liver and kidney tissues of rats treated with SIL and PAX (p < 0.05).

Conclusion: Our findings indicate the potential of SIL to alleviate PAX-induced liver and kidney damage in rats by reducing oxidative stress, inflammation, and apoptotic processes.

背景:紫杉醇(PAX)是一种广泛用于治疗各种癌症的化疗药物,但通常会对多个器官系统产生严重毒性。水飞蓟素(SIL)是一种天然类黄酮,因其多种益处而显示出治疗潜力。目的:评估水飞蓟素在减轻 PAX 诱导的大鼠肝脏和肾脏损伤方面的疗效,重点关注氧化应激、炎症和细胞凋亡途径:研究设计:实验动物模型:大鼠分为四组:对照组、SIL 组、PAX 组和 PAX + SIL 组,每组七只。大鼠腹腔注射 PAX,剂量为每公斤体重 2 毫克,连续注射 5 天,然后口服 SIL,剂量为每公斤体重 200 毫克,连续口服 10 天。我们使用自动分析仪和大鼠专用试剂盒检测了 SIL 对特定血清生化指标的影响。分光光度法用于研究肾脏和肝脏组织中的氧化应激指标。使用Aquaporin-2 (AQP-2)、B细胞淋巴瘤-2 (Bcl-2)、半胱氨酸天冬氨酸特异性蛋白酶-3 (caspase-3)、白细胞介素-6 (IL-6)、核因子卡巴B (NF-κB)和链霉亲和素-生物素染色来评估PAX诱导的肝脏和肾脏损伤模型的免疫反应性:结果:SIL 能明显降低血清中丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、肌酐、尿素和 C 反应蛋白的水平,这表明它能有效治疗 PAX 引起的肝肾损伤。SIL 能提高超氧化物歧化酶、过氧化氢酶、谷胱甘肽过氧化物酶和谷胱甘肽等基本抗氧化指标,从而明显降低氧化应激。它还降低了 SIL-PAX 组肝脏和肾脏组织中的丙二醛水平(p < 0.05)。服用 SIL 可降低 NF-κB、caspase-3 和 IL-6 的表达,同时提高 SIL 和 PAX 组大鼠肝脏和肾脏组织中 Bcl-2 和 AQP2 的水平(p < 0.05):我们的研究结果表明,SIL 有可能通过减少氧化应激、炎症和细胞凋亡过程来减轻 PAX 诱导的大鼠肝脏和肾脏损伤。
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引用次数: 0
Binding Activity Classification of Anti-SARS-CoV-2 Molecules using Deep Learning Across Multiple Assays 利用深度学习对多种检测方法中的抗 SARS-CoV-2 分子进行结合活性分类。
IF 1.9 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-05-03 Epub Date: 2024-03-11 DOI: 10.4274/balkanmedj.galenos.2024.2024-1-73
Bilge Eren Yamasan, Selçuk Korkmaz
<p><strong>Background: </strong>The coronavirus disease-2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), has urgently necessitated effective therapeutic solutions, with a focus on rapidly identifying and classifying potential small-molecule drugs. Given traditional methods’ labor-intensive and time-consuming nature, deep learning has emerged as an essential tool for efficiently processing and extracting insights from complex biological data.</p><p><strong>Aims: </strong>To utilize deep learning techniques, particularly deep neural networks (DNN) enhanced with the synthetic minority oversampling technique (SMOTE), to enhance the classification of binding activities in anti-SARS-CoV-2 molecules across various bioassays.</p><p><strong>Methods: </strong>We used 11 bioassay datasets covering various SARS-CoV-2 interactions and inhibitory mechanisms. These assays ranged from spike-ACE2 protein-protein interaction to ACE2 enzymatic activity and 3CL enzymatic activity. To address the prevalent class imbalance in these datasets, the SMOTE technique was employed to generate new samples for the minority class. In our model-building approach, we divided the dataset into 80% training and 20% test sets, reserving 10% of the training set for validation. Our approach involved employing a DNN that integrates ReLU and sigmoid activation functions, incorporates batch normalization, and uses Adam optimization. The hyperparameters and architecture of the DNN were optimized through various tests on layers, minibatch sizes, epoch sizes, and learning rates. A 40% dropout rate was incorporated to mitigate overfitting. For model evaluation, we computed performance metrics, such as balanced accuracy (BACC), precision, recall, F1 score, Matthews’ correlation coefficient (MCC), and area under the curve (AUC).</p><p><strong>Results: </strong>The performance of the DNN across 11 bioassay test sets revealed varying outcomes, significantly influenced by the ratios of active-to-inactive compounds. Assays, such as AlphaLISA and CoV-PPE, demonstrated robust performance across various metrics, including BACC, precision, recall, and AUC, when configured with more balanced ratios (1:3 and 1:1, respectively). This suggests the effective identification of active compounds in both cases. In contrast, assays with higher imbalance ratios, such as 3CL (1:38) and cytopathic effect (1:15), demonstrated higher recall but lower precision, highlighting challenges in accurately identifying active compounds among numerous inactive compounds. However, even in these challenging settings, the model achieved favorable BACC and recall scores. Overall, the DNN model generally performed well, as indicated by the BACC, MCC, and AUC values, especially when considering the degree of dataset imbalance in each assay.</p><p><strong>Conclusion: </strong>This study demonstrates the significant impact of deep learning, particularly DNN models enhanced with SMOTE, i
背景:由严重急性呼吸系统综合征-冠状病毒-2(SARS-CoV-2)引起的冠状病毒病-2019(COVID-19)大流行迫切需要有效的治疗解决方案,重点是快速识别和分类潜在的小分子药物。目的:本研究旨在利用深度学习技术,特别是利用合成少数超采样技术(SMOTE)增强的深度神经网络(DNN),来提高抗SARS-CoV-2分子在各种生物测定中结合活性的分类能力:我们使用了 11 个生物测定数据集,涵盖了各种 SARS-CoV-2 相互作用和抑制机制。这些测定包括尖峰-ACE2 蛋白-蛋白相互作用、ACE2 酶活性和 3CL 酶活性。为了解决这些数据集中普遍存在的类不平衡问题,我们采用了 SMOTE 技术为少数类生成新样本。在建立模型的方法中,我们将数据集分为 80% 的训练集和 20% 的测试集,并保留 10% 的训练集用于验证。我们采用的 DNN 方法整合了 ReLU 和 sigmoid 激活函数、批量归一化和亚当优化。通过对层数、最小批量大小、历时大小和学习率进行各种测试,对 DNN 的超参数和架构进行了优化。我们还加入了 40% 的辍学率,以减少过度拟合。为了对模型进行评估,我们计算了性能指标,如平衡准确率(BACC)、精确度、召回率、F1 分数、马修斯相关系数(MCC)和曲线下面积(AUC):结果:DNN 在 11 个生物测定测试集中的表现显示出不同的结果,其中活性与非活性化合物的比例对其影响很大。AlphaLISA 和 CoV-PPE 等检测方法在配置更均衡的比例(分别为 1:3 和 1:1)时,在 BACC、精确度、召回率和 AUC 等各种指标上都表现出强劲的性能。这表明在这两种情况下都能有效识别活性化合物。相比之下,3CL(1:38)和细胞病理效应(1:15)等不平衡比率较高的检测方法的召回率较高,但精确度较低,这凸显了在众多非活性化合物中准确识别活性化合物所面临的挑战。不过,即使在这些具有挑战性的环境中,该模型也取得了良好的 BACC 和召回分数。总体而言,正如 BACC、MCC 和 AUC 值所显示的那样,DNN 模型总体表现良好,尤其是考虑到每个检测中数据集的不平衡程度时:本研究表明,深度学习,特别是使用 SMOTE 增强的 DNN 模型,在改进 COVID-19 药物发现的生物测定数据集中活性化合物的鉴定方面具有重大影响,其表现优于传统的机器学习模型。此外,本研究还凸显了先进计算技术在解决高通量筛选数据不平衡方面的功效。
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引用次数: 0
Three-Dimensional Echocardiography: A Promising Tool for the Diagnosis of Quadricuspid Pulmonary Valve and Pulmonary Artery Aneurysm 三维超声心动图:诊断四尖瓣肺动脉瓣和肺动脉瘤的有效工具
IF 1.9 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-05-03 Epub Date: 2024-01-22 DOI: 10.4274/balkanmedj.galenos.2024.2023-12-79
Vladyslav Kavalerchyk, Utku Aslan, Tuğba Kemaloğlu Öz
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引用次数: 0
Navigating the Complex Terrain of Cardiovascular Care in Azerbaijan: Challenges and Uncharted Opportunities. 驾驭阿塞拜疆复杂的心血管护理环境:挑战与未知的机遇。
IF 1.9 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-05-03 DOI: 10.4274/balkanmedj.galenos.2024.2024-3-112
Ulvi Mirzoyev
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引用次数: 0
Bronchiectasis in Türkiye: Data from a Multicenter Registry (Turkish Adult Bronchiectasis Database). 土耳其支气管扩张症:来自多中心登记处(土耳其成人支气管扩张症数据库)的数据。
IF 1.9 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-05-03 DOI: 10.4274/balkanmedj.galenos.2024.2023-12-57
Ebru Çakır Edis, Aykut Çilli, Deniz Kızılırmak, Ayşın Şakar Coşkun, Nurcan Güler, Sedat Çiçek, Can Sevinç, Meltem Çoban Ağca, İnci Gülmez, Benan Çağlayan, Mehmet Kabak, Elif Yelda Özgün Niksarlıoğlu, Nurdan Köktürk, Abdullah Sayıner
<p><strong>Background: </strong>Bronchiectasis is a chronic lung disease characterized by permanent bronchial wall dilatation. Although it has been known as an orphan disease, it has recently gained attention because of registry-based studies and drug research.</p><p><strong>Aims: </strong>We aimed to use a multicenter database to analyze and compare data regarding the etiology, associated comorbidities, microbiological characteristics, and preventive strategies of bronchiectasis in Türkiye to those of other countries.</p><p><strong>Study design: </strong>A multicenter prospective cohort study.</p><p><strong>Methods: </strong>The multicenter, prospective cohort study was conducted between March 2019 and January 2022 using the Turkish Adult Bronchiectasis Database, in which 25 centers in Türkiye participated. Patients aged > 18 years who presented with respiratory symptoms such as cough, sputum, and dyspnea and were diagnosed with non-cystic fibrosis bronchiectasis using computed tomography were included in the study. Demographic information, etiologies, comorbidities, pulmonary functions, and microbiological, radiological, and clinical data were collected from the patients.</p><p><strong>Results: </strong>Of the 1,035 study participants, 518 (50%) were females. The mean age of the patients was 56.1 ± 16.1 years. The underlying etiology was detected in 565 (54.6%) patients. While postinfectious origin was the most common cause of bronchiectasis (39.5%), tuberculosis was identified in 11.3% of the patients. An additional comorbidity was detected in 688 (66.5%) patients. The most common comorbidity was cardiovascular disease, and chronic obstructive pulmonary disease (COPD) and bronchiectasis was identified in 19.5% of the patients. The most commonly detected microbiological agent was <i>Pseudomonas aeruginosa</i> (29.4%). Inhaled corticosteroids (ICS) were used in 70.1% of the patients, and the frequency of exacerbations in the last year was significantly higher in patients using ICS than in nonusers (p < 0.0001). Age [odds ratio (OR): 1.028; 95% confidence interval (CI): 1.005-1.051], cachexia (OR: 4.774; 95% CI: 2,054-11,097), high modified medical research council dyspnea scale score (OR: 1,952; 95% CI: 1,459-2,611), presence of chronic renal failure (OR: 4,172; 95% CI: 1,249-13,938) and use of inhaled steroids (OR: 2,587; 95% CI: 1,098-6,098) were significant risk factors for mortality. Mortality rates were higher in patients with COPD than in those with no COPD (21.7-9.1%, p = 0.016). Patients with bronchiectasis and COPD exhibited more frequent exacerbations, exacerbation-related hospitalizations, and hospitalization in the intensive care unit in the previous year than patients without COPD.</p><p><strong>Conclusion: </strong>This is the first multicenter study of bronchiectasis in Türkiye. The study results will provide important data that can guide the development of health policies in Türkiye on issues such as infection control, vaccinatio
背景:支气管扩张症是一种以支气管壁永久性扩张为特征的慢性肺部疾病。尽管支气管扩张症一直被称为 "孤儿病",但最近因登记研究和药物研究而受到关注。研究设计:一项多中心前瞻性队列研究:多中心前瞻性队列研究:这项多中心前瞻性队列研究是在 2019 年 3 月至 2022 年 1 月期间利用土耳其成人支气管扩张症数据库进行的,土耳其有 25 个中心参与了这项研究。研究纳入了年龄大于 18 岁、出现咳嗽、咳痰和呼吸困难等呼吸道症状并通过计算机断层扫描确诊为非囊性纤维化支气管扩张症的患者。研究人员收集了患者的人口统计学信息、病因、合并症、肺功能以及微生物学、放射学和临床数据:在 1,035 名研究参与者中,518 人(50%)为女性。患者的平均年龄为(56.1 ± 16.1)岁。565名患者(54.6%)查出了潜在病因。感染后病因是支气管扩张最常见的病因(39.5%),11.3%的患者患有肺结核。在 688 名(66.5%)患者中还发现了其他合并症。最常见的合并症是心血管疾病,19.5%的患者患有慢性阻塞性肺病(COPD)和支气管扩张症。最常检测到的微生物病原体是铜绿假单胞菌(29.4%)。70.1%的患者使用吸入性皮质类固醇(ICS),使用 ICS 的患者去年病情加重的频率明显高于未使用 ICS 的患者(P < 0.0001)。年龄[几率比(OR):1.028;95% 置信区间(CI):1.005-1.051]、恶病质(OR:4.774;95% CI:2,054-11,097)、改良医学研究委员会呼吸困难量表评分高(OR:1,952;95% CI:1,459-2,611)、存在慢性肾功能衰竭(OR:4,172;95% CI:1,249-13,938)和使用吸入类固醇(OR:2,587;95% CI:1,098-6,098)是导致死亡的重要风险因素。慢性阻塞性肺病患者的死亡率高于非慢性阻塞性肺病患者(21.7%-9.1%,P = 0.016)。与无慢性阻塞性肺病的患者相比,患有支气管扩张症和慢性阻塞性肺病的患者前一年病情加重、与病情加重相关的住院治疗和重症监护室住院治疗的频率更高:这是土耳其首次对支气管扩张症进行多中心研究。研究结果将提供重要数据,为土耳其在感染控制、疫苗接种以及不必要使用抗生素和类固醇等问题上制定卫生政策提供指导。
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引用次数: 0
In Response to “Emphysematous Urinary Tract Infections in Diabetics” 回应 "糖尿病患者气肿性尿路感染"。
IF 1.9 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-05-03 Epub Date: 2024-03-27 DOI: 10.4274/balkanmedj.galenos.2024.2024-1-81.response
Wei Yang, Chendong He
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引用次数: 0
Hybrid Stenting Procedure for Aortic Coarctation in a Very Low Birth Weight Newborn 混合支架置入治疗极低出生体重新生儿主动脉缩窄。
IF 1.9 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-05-03 Epub Date: 2023-11-27 DOI: 10.4274/balkanmedj.galenos.2023.2023-9-57
Aras Tulunoğlu, Fatma Sevinç Şengül, Sertaç Haydin, Alper Güzeltaş
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引用次数: 0
Emerging Technologies in Healthcare and Laboratory Medicine: Trends and Need for a Roadmap to Sustainable Implementation 医疗保健和实验室医学中的新兴技术:趋势和可持续实施路线图的必要性。
IF 1.9 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-03-01 Epub Date: 2024-01-18 DOI: 10.4274/balkanmedj.galenos.2024.2024-1-16
Damien Gruson, Tuğba Kemaloğlu Öz
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引用次数: 0
High Incidence of CPLANE1-Related Joubert Syndrome in the Products of Conceptions from Early Pregnancy Losses 早期妊娠失败的受孕产物中与 CPLANE1 相关的 Joubert 综合征发病率很高。
IF 1.9 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-03-01 Epub Date: 2024-02-14 DOI: 10.4274/balkanmedj.galenos.2024.2023-10-72
Gjorgji Bozhinovski, Marija Terzikj, Katerina Kubelka-Sabit, Dijana Plaseska-Karanfilska

Background: The fetal monogenic causes of early pregnancy losses (EPLs) are mainly unknown, with only a few articles on the subject published. In our previous study of EPLs using whole-exome sequencing analysis, we confirmed a genetic diagnosis of CPLANE1-related Joubert syndrome (JS) in three EPLs from two couples and identified a relatively common CPLANE1 allele among our population (NM_001384732.1:c.1819delT;c.7817T>A, further after referred as “complex allele”). Pathogenic variants in the CPLANE1 (C5orf42) gene are reported to cause JS type 17, a primary ciliopathy with various system defects.

Aims: To examine the hypothesis that the CPLANE1 “complex allele,” whether homozygous or compound heterozygous, is a common cause of EPLs in our population.

Study design: Cohort study/case-control study.ontrol study.

Methods: In this study, we used polymerase chain reaction-based methods to screen for CPLANE1 “complex allele” presence among 246 euploid EPLs (< 12 gestational weeks) from families in North Macedonia. We also investigated the impact of this allele in 650 women with EPLs versus 646 women with no history of pregnancy loss and at least one livebirth, matched by ethnic origin.

Results: We found a high incidence of JS in the total study group of EPLs (2.03%), with a considerably higher incidence among Albanian families (6.25%). Although not statistically significant, women with EPLs had a higher allele frequency of the CPLANE1 “complex allele” (AF = 1.38%) than the controls (AF = 0.85%; p = 0.2). Albanian women had significantly higher frequency of the “complex allele” than the Macedonians (AF = 1.65% and 0.39%, respectively; p = 0.003).

Conclusion: To the best of our knowledge, this is the highest reported incidence of fetal monogenic disease that might cause EPLs. Targeted screening for the CPLANE1 “complex allele” would be warranted in Albanian ethnic couples because it would detect one JS in every 16 euploid EPLs. Our findings have a larger impact on the pathogenesis of pregnancy loss and contribute to a better understanding of the pathogenicity of the variants in the CPLANE1 gene.

背景:早期妊娠损失(EPLs)的胎儿单基因病因主要不明,仅发表过几篇相关文章。在我们之前利用全外显子组测序分析对早孕损失进行的研究中,我们在两对夫妇的三例早孕损失中确诊了与 CPLANE1 相关的朱伯综合征(JS),并在我们的人群中发现了一个相对常见的 CPLANE1 等位基因(NM_001384732.1:c.1819delT;c.7817T>A,之后称为 "复杂等位基因")。据报道,CPLANE1(C5orf42)基因中的致病变异可导致JS 17型,这是一种伴有各种系统缺陷的原发性纤毛症。研究目的:探讨CPLANE1 "复杂等位基因"(无论是同源杂合子还是复合杂合子)是我国人群中EPL常见病因的假设:研究设计:队列研究/病例对照研究:本研究采用聚合酶链反应方法在 246 例单倍体 EPL 中筛查 CPLANE1 "复等位基因 "的存在:我们发现,在所有 EPL 研究组中,JS 的发病率较高(2.03%),阿尔巴尼亚家庭的发病率更高(6.25%)。尽管没有统计学意义,但 EPLs 妇女的 CPLANE1 "复杂等位基因 "等位基因频率(AF = 1.38%)高于对照组(AF = 0.85%;P = 0.2)。阿尔巴尼亚妇女的 "复杂等位基因 "频率明显高于马其顿妇女(AF = 1.65% 和 0.39%,p = 0.003):据我们所知,这是报道的可能导致 EPL 的胎儿单基因病的最高发病率。有必要在阿尔巴尼亚族夫妇中进行 CPLANE1 "复杂等位基因 "的定向筛查,因为这将在每 16 个超常 EPL 中发现一个 JS。我们的研究结果对妊娠丢失的发病机理有较大影响,有助于更好地了解 CPLANE1 基因变异的致病性。
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引用次数: 0
Glial Fibrillary Acidic Protein: Diagnostic and Prognostic Role in Psychomotor Development Dynamics in Patients with Congenital Heart Defects after Cardiovascular Surgery 胶质纤维酸性蛋白:心血管手术后先天性心脏缺陷患者心理运动发育动态的诊断和预后作用。
IF 1.9 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-03-01 Epub Date: 2024-01-04 DOI: 10.4274/balkanmedj.galenos.2023.2023-11-10
Lacramioara Eliza Chiperi, Adina Hutanu
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引用次数: 0
期刊
Balkan Medical Journal
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