Comparison Of The Prevalence Of Helicobacter Pylori Infection in Patients With Ulcerative Colitis Versus Normal Egyptian population

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Waleed Abd El Aaty Hamed ◽  
Hend Mubarak Mohammed ◽  
Ahmed Fouad Helmy ◽  
Amr Alaa El-Din Mohamed
Keyword(s):  
Ulcerative Colitis ◽  
Gastrointestinal Symptoms ◽  
Clinical History ◽  
Historical Control ◽  
Control Group ◽  
Study Group ◽  
University Hospitals ◽  
Medicine Department ◽  
H Pylori ◽  
Control Samples

Abstract Background The prevalence of inflammatory bowels diseases (IBD) increases in societies adapting a Western life style. Thus, it appears that there is an inverse relation between the prevalence of IBD and H. Pylori infection. Aim To compare the prevalence of H. Pylori Ag in stool between Ulcerative colitis patients and a normal healthy Egyptian sample. Patients and methods The current study was conducted on 70 patients recruited from the IBD study group clinic in Tropical medicine department of Ain Shams University Hospitals .This study group was compared to historical Control samples of healthy Egyptian subjects who were retrieved from a previously conducted study (saad et al.,2008). The enrolled patients fulfilled the inclusion and exclusion criteria and were divided to two groups o Study group: All patients who were diagnosed with U.C. based on clinical history, laboratory and endoscopic finding according to ECCO 2017 guidelines (Sandro et al., 2017). o Control group: Historical Control samples from healthy Egyptian subjects. Both groups were compared according to basal epidemiologic data and H. pylori Ag in stool positivity, gastrointestinal symptoms, colonscopic and microscopic findings, mainstay treatment lines of U.C., biological therapy and criteria of disease activity . Results Most of the enrolled patients in the current study were aged between 20-39 years with 48.6% aging between 20-29 years old and 38.6% between 30-39 years. While the majority of the cases were females (62.9%), only 11.4% of the included cases were smokers . We found that of the 70 patients in the cases group with ulcerative colitis, only 34 (48.6%) had positive H. pylori versus 555 reported positive samples in control group (91.7%). So there was a high significant statistical difference between the 2 groups Conclusion There is a significant association between H. pylori infection and ulcerative colitis that supports a possible protective benefit of H. pylori infection against the development of U.C. but still further studies are needed

scholarly journals Does additional weekend and holiday physiotherapy benefit geriatric patients with hip fracture? — A case-historical control study

2021 ◽  
pp. 1-10
Author(s):  
Dennis Kim Chung Mo ◽  
Ken Kin Ming Lau ◽  
Donna Mei Yee Fung ◽  
Bosco Hon Ming Ma ◽  
Titanic Fuk On Lau ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Length Of Stay ◽  
Functional Outcomes ◽  
Geriatric Patients ◽  
Historical Control ◽  
Hospital Length Of Stay ◽  
Lower Percentage ◽  
Control Group ◽  
Study Group ◽  
Rehabilitation Hospital

Objective: To evaluate the new service model of additional weekend and holiday physiotherapy (PT) by comparing functional outcomes and hospital length of stay between a group of geriatric patients with hip fracture receiving daily PT training and a group of geriatric patients with hip fracture receiving weekdays PT training. Methods: A retrospective case-historical control chart review was conducted and a total of 355 patients were identified. Between-group comparisons were done on functional outcomes including Modified Functional Ambulation Classification (MFAC), Elderly Mobility Scale (EMS), Modified Barthel Index (MBI) and process outcome in terms of length of stay (LOS) in hospitals. Results: With similar characteristics, patients who received weekend and holiday PT training had a significant higher percentage of MFAC Category III and a significant lower percentage of MFAC Category II ([Formula: see text]) and significant higher MBI scores ([Formula: see text] deviation, median; Study group: [Formula: see text] points, 51 points; Control group: [Formula: see text] points, 43 points; [Formula: see text]) upon admission to rehabilitation hospital. A similar trend in EMS scores (Study group: [Formula: see text] points, 7 points; Control group: [Formula: see text] points, 6 points; [Formula: see text]) and MBI scores (Study group: [Formula: see text] points, 68 points; Control group: [Formula: see text] points, 64 points; [Formula: see text]) were observed upon discharge from the rehabilitation hospital. The average LOS in acute hospitals remained static (Study group: [Formula: see text] days, 7 days; Control group: [Formula: see text] days, 6 days; [Formula: see text]). The average LOS in rehabilitation hospital (Study group: [Formula: see text] days, 20 days; Control group: [Formula: see text] days, 23 days; [Formula: see text]) and total in-patient LOS (Study group: [Formula: see text] days, 26 days; Control group: [Formula: see text] days, 28 days; [Formula: see text]) were significantly reduced. A higher percentage of days having PT training during hospitalization in rehabilitation hospital was shown with the implementation of new service (Study group: 89.1%; Control group: 65.9%, [Formula: see text]). Conclusion: Additional weekend and holiday PT training in post-operative acute and rehabilitation hospitalization benefits geriatric patients with hip fracture in terms of improved training efficiency, where hospital LOS was shortened with more PT sessions, without any significant impacts on functional outcome.

The Prevalence of Pantoprozole Associated Thrombocytopenia in a Community Hospital - A Retrospective Study.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 3980-3980
Author(s):  
Randi Katz ◽  
Jason Bratcher ◽  
Efrat Dotan ◽  
Carrie Wasserman ◽  
Michelene Liebman ◽  
...  
Keyword(s):  
Platelet Count ◽  
Side Effect ◽  
Hospitalized Patients ◽  
Sufficient Evidence ◽  
Control Group ◽  
Study Group ◽  
Significant Side Effect ◽  
Retrospective Case ◽  
Ulcer Disease ◽  
H Pylori

Abstract Proton Pump Inhibitors (PPIs) are widely used in the treatment of peptic ulcer disease, Helicobacter pylori (H pylori) gastritis and gastro-esophageal reflux disease. PPIs are known to be relatively safe medications, with the most common adverse reactions reported as diarrhea, nausea, vomiting, abdominal pain and headache. Thrombocytopenia has not been found to be a significant side effect of PPI use. Furthermore, successful treatment of H pylori associated immune thrombocytopenic purpura (ITP) with PPI therapy has been reported in the literature. In clinical practice, however, PPI use has been thought to be associated with medication-induced thrombocytopenia, although the precise prevalence of this consequence has not been quantified. The purpose of this study is to determine the prevalence of thrombocytopenia in hospitalized patients treated with pantoprazole, a commonly prescribed PPI, compared to non-medicated controls. In this retrospective, case-controlled analysis, we analyzed the platelet counts of 626 patients between 18 and 80 years of age who were admitted to an urban, community-based hospital and were medicated with pantoprazole for at least three days during their hospital stay. Thrombocytopenia was defined as a drop in the platelet count to below 150,000/ml, or a drop of at least 50% from baseline. Patients who had a platelet count below 150,000/ml on admission or were hospitalized for less than 3 days were excluded from the study. A control group of 560 patients with the same inclusion criteria who had not been prescribed pantoprazole was analyzed for comparison. 626 patients were included in the study group and 560 patients in the control group. The median age was 67 years in study group, and 61 years in the control group. The mean platelet count on admission was 260,00/ml in the study group, and 257,000/ml in the control group. Of the subject group, 39 patients (6.2%) met our definition of thrombocytopenia, which was not statistically different from the 35 patients (6.2%) with thrombocytopenia in the control group (p=0.90). Our study compared patients who received PPI therapy with pantoprazole for at least three hospital days to patients without treatment. We found no difference in the rate of thrombocytopenia between hospitalized patients treated with pantoprazole and the non-medicated controls. The rate of thrombocytopenia that we observed is probably an estimate of the overall thrombocytopenia rate in hospitalized patients irrespective of specific medications. While our report did not control for variables such as concurrent medication use, comorbid illnesses, and patient demographics, we are confident that the sample size selected for this study is large enough to provide sufficient evidence that thrombocytopenia is not a significant side effect of pantoprazole therapy.

Evaluation of Transverse Maxillary Expansion after a Segmental Posterior Subapical Maxillary Osteotomy in Cleft Lip and Palate Patients with Severe Collapse of the Lateral Maxillary Segments

2014 ◽  
Vol 51 (6) ◽  
pp. 651-657 ◽  
Author(s):  
S. Carpentier ◽  
J. Van Gastel ◽  
J. Schoenaers ◽  
C. Carels ◽  
V. Vander Poorten ◽  
...  
Keyword(s):  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Adult Patients ◽  
Control Group ◽  
Study Group ◽  
Maxillary Expansion ◽  
University Hospitals ◽  
Rapid Palatal Expansion ◽  
Maxillary Osteotomy

Objective The purpose of this longitudinal retrospective study was to evaluate transverse maxillary expansion after a Schuchardt or segmental posterior subapical maxillary osteotomy (SPSMO) in patients with cleft lip and palate (CLP). A second aim was to compare these data with data for adult patients without CLP who were receiving a surgical assisted rapid palatal expansion (SARPE). Method The study group comprised 19 patients with CLP and a severe transversally collapsed maxilla who were treated with SPSMO followed by hyrax expansion at the University Hospitals Leuven. Dental casts of the 19 patients were analyzed before treatment, at maximum expansion, during orthodontic treatment, at the completion of orthodontic treatment. and 2 years after orthodontic treatment and were measured at the canine, premolar, and molar levels. Adult patients without CLP who were enrolled in a prospective study served as the control group. Results Maxillary expansion within the study group was significantly greater ( P < .05) at all measured levels compared with the maxillary arch before treatment. No significant relapse was measured in the study group 2 years after orthodontic treatment. When comparing the study and control groups, the only statistical difference was that canine expansion was significantly greater in the study group. Conclusion SPSMO followed by maxillary expansion and orthodontic treatment is an appropriate treatment option to correct a severe transversally collapsed maxilla in patients with CLP. The overall treatment effect of SPSMO expansion is comparable with the effects of SARPE, although canine expansion was greater in the SPSMO group.

scholarly journals RECURRENT ABDOMINAL PAIN

2006 ◽  
Vol 13 (04) ◽  
pp. 563-571
Author(s):  
MUHAMMAD TARIQ NADEEM ◽  
MAZHAR ABBAS ◽  
TAQI HASSAN ◽  
Shahid Masood
Keyword(s):  
Helicobacter Pylori ◽  
Abdominal Pain ◽  
Recurrent Abdominal Pain ◽  
Control Group ◽  
P Value ◽  
Study Group ◽  
Endoscopic Findings ◽  
Group A ◽  
H Pylori ◽  
Group B

Objective: To assess the association between the Helicobacter Pylori (H.pylori) infection andrecurrent abdominal pain (RAP) by documenting the frequency of Helicobacter pylori infection in children aged 5 to 15years in our setup. Design: A comparative study. Place and Duration of Study: The study was conducted in pediatricunit Military Hospital Rawalpindi over one year period from 1st Apr 200 to 31st Mar 2002. Subject and Methods: Wedivided the patients into two groups; group A or the study group and the group B or the control group. In group A, atotal of 87 Children aged 5 to 15 years presenting with RAP in which no underlying cause was found on initialassessment underwent upper gastrointestinal tract (GIT) endoscopic examination. In group B (control) we included 68children in whom upper GIT endoscopy was done for any reason other than the RAP. In both the groups thegastroduodenal biopsy samples were sent for culture and histological examination for the diagnosis of H. pyloriinfection. The signs and symptoms of these patients were analyzed in detail. Results: In group A, out of 87 patientswho were endoscoped there were 44 female and 43 male. 54(62%) were found positive and 33(38%) were foundnegative for H.pylori on histopathology and culture examination of biopsy samples. In the control group (B) thefrequency of H.pylori infection was 35% (24 of 68) which was significantly lower than the study group (p-value .001).The frequency of H.pylori increased significantly with advancement in age (p-value .003) and lowering of thesocioeconomic status (p-value.002). The commonest endoscopic finding was antral gastritis (31 of 87; 35.6%). Antralnodularity was observed in 8(26%) out of 36 cases of antral gastritis and in 23(74%) cases there was antral erythemawithout nodularity. The remaining endoscopic findings were pan-gastritis (14 of 87;16%), duodenal ulcer (10 of87;11.5%), duodenitis (4 of 87;4.6%) and gastric ulcer (2 of 87;2.3%). The less frequent findings were gastric andduodenal erosions and esophagitis (about 1% each).Their was no abnormal finding in 22(25.3%) cases. Childrenpredominantly (52%) had the symptoms characteristics of ulcer-like dyspepsia. Recurrent epigastric pain wassignificantly more common in the H.pylori positive than the H. pylori negative children (44 of 87 vs 16 of 33 [p-value.001]). There was no difference for other symptom characteristics when comparing infected with non-infected children.Conclusion: The frequency of H.pylori infection is high in children with recurrent abdominal pain and there is a high degree of association between recurrent abdominal pain, endoscopic findings (chronic gastritis, duodenitis, gastric andduodenal ulcer) and the H. pylori infection.

scholarly journals Relation between exposure to different multimedia programs and presentation of attention deficit hyperactivity disorder

2022 ◽  
Vol 38 (1) ◽  
Author(s):  
Afaf Hamdy Khalil ◽  
Ahmed Mohamed Zayed ◽  
Ayman Amer ◽  
Hemmat Baz
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Arabic Language ◽  
Control Group ◽  
Study Group ◽  
Typically Developing ◽  
University Hospitals ◽  
Typically Developing Children ◽  
Hyperactivity Disorder ◽  
The Relationship

Abstract Background The current study aimed at constructing an Arabic-language questionnaire to investigate the association of the severity of ADHD with children’s degree of exposure to multimedia per day and the age of starting the engagement, and the effect of different multimedia programs on the attention, language, and socio-behavioral aspects in children presented with attention deficit hyperactivity disorder (ADHD). The present study was conducted on 69 children who attended the Phoniatric Unit at Mansoura University Hospitals and were divided into 2 groups: 30 normal typically developing children as a control group and 39 children with ADHD as the study group. The study group was subdivided into 3 subgroups according to ADHD severity; each subgroup consisted of 13 children. Results The time at which the child started to be exposed to multimedia showed no significant differences among ADHD subgroups as all of the cases started before the age of 2 years. Kids with mild ADHD had a significant increase in watching children’s programs, cartoons, rhymes, and commercials than the other two higher grades (moderate and severe) of ADHD. Conclusion The constructed Arabic questionnaire proved to be reliable and a valid tool that examined the relationship between multimedia usage and ADHD.

Diagnostic Utility of Beta 2 Microglobulin in Patients with Irritable Bowel Syndrome and Ulcerative Colitis

2021 ◽  
Vol 30 (2) ◽  
pp. 89-97
Author(s):  
Mohamed Eltabbakh ◽  
Waheed Abd Almonsef ◽  
Shimaa Y. Kamel ◽  
Soha Abuelela ◽  
AL-Shaimaa M. AL-Tabbakh ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Irritable Bowel Syndrome ◽  
Inactive Disease ◽  
Control Group ◽  
University Hospitals ◽  
Roc Curve Analysis ◽  
Inflammatory Conditions ◽  
The Difference ◽  
Irritable Bowel ◽  
Beta 2 Microglobulin

Background: Inflammatory bowel disease (IBD) is a chronically relapsing disease. It includes ulcerative colitis (UC) and crohn's disease (CD). Symptoms of IBD could be conflicting sometimes with irritable bowel syndrome (IBS) of diarrheal type. The ideal marker for IBD/IBS diagnosis has not yet been identified. B2 microglobulin (B2-M) is a low molecular weight protein released by activated T and B lymphocytes. It has been shown to increase in several chronic inflammatory conditions. Objectives: Assessment of the diagnostic role of (B2-M) in IBS cases presented with diarrhea (IBS-D type) and UC cases. Methodology: This case control study was conducted at Gastroenterology Unit in Tropical Medicine Department, Ain- Shams University Hospitals, Cairo, Egypt. Forty patients with UC, and twenty patients with IBS in addition to twenty healthy persons as control were included. Results: There was a higher mean of B2-M values among U.C group (1.93)(mean B2-M in Active UC was 2.26 and 1.61 in inactive disease) compared to the other two groups(1.51 in IBS and 1.43 in control group) and the difference was highly statistically significant(P=0.000).Using ROC curve analysis of different cut off values of (B2-M) for detection of UC cases among IBS cases, we found that at a cut off value of <1.5 , we got sensitivity, specificity, PPV, NPV and accuracy of 75 %, 70 %, 83.3%, 58.3 %, and 0.753% respectively and this was the best cut off value. Conclusion: B2-M level may have a diagnostic and differentiating utility between UC cases and IBS-D type as well as a potential indicator of disease activation in UC patients.

scholarly journals Breast cancer mortality and overdiagnosis after implementation of population-based screening in Denmark

2020 ◽  
Vol 184 (3) ◽  
pp. 891-899
Author(s):  
Elsebeth Lynge ◽  
Anna-Belle Beau ◽  
My von Euler-Chelpin ◽  
George Napolitano ◽  
Sisse Njor ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Incidence ◽  
Cancer Mortality ◽  
Breast Cancer Mortality ◽  
Breast Cancer Incidence ◽  
Historical Control Group ◽  
Historical Control ◽  
Control Group ◽  
Study Group ◽  
Screening Programs

Abstract Introduction Service breast cancer screening is difficult to evaluate because there is no unscreened control group. Due to a natural experiment, where 20% of women were offered screening in two regions up to 17 years before other women, Denmark is in a unique position. We utilized this opportunity to assess outcome of service screening. Materials and methods Screening was offered in Copenhagen from 1991 and Funen from 1993 to women aged 50–69 years. We used difference-in-differences methodology with a study group offered screening; a historical control group; a regional control group; and a regional–historical control group, comparing breast cancer mortality and incidence, including ductal carcinoma in situ, between study and historical control group adjusted for changes in other regions, and calculating ratios of rate ratios (RRR) with 95% confidence intervals (CI). Data came from Central Population Register; mammography screening databases; Cause of Death Register; and Danish Cancer Register. Results For breast cancer mortality, the study group accumulated 1,551,465 person-years and 911 deaths. Long-term breast cancer mortality in Copenhagen was 20% below expected in absence of screening; RRR 0.80 (95% CI 0.71–0.90), and in Funen 22% below; RRR 0.78 (95% CI 0.68–0.89). Combined, cumulative breast cancer incidence in women followed 8+ years post-screening was 2.3% above expected in absence of screening; RRR 1.023 (95% CI 0.97–1.08). Discussion Benefit-to-harm ratio of the two Danish screening programs was 2.6 saved breast cancer deaths per overdiagnosed case. Screening can affect only breast cancers diagnosed in screening age. Due to high breast cancer incidence after age 70, only one-third of breast cancer deaths after age 50 could potentially be affected by screening. Increasing upper age limit could be considered, but might affect benefit-to-harm ratio negatively.

scholarly journals Chronic Inflammation Impairs Male Fertility—A Case-Control Study in Ulcerative Colitis Patients

2021 ◽  
Vol 10 (7) ◽  
pp. 1460
Author(s):  
Artur Wdowiak ◽  
Mariusz Gujski ◽  
Iwona Bojar ◽  
Dorota Raczkiewicz ◽  
Joanna Bartosińska ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Dna Fragmentation ◽  
Male Fertility ◽  
Sperm Quality ◽  
Sperm Count ◽  
Microbial Pathogens ◽  
Semen Parameters ◽  
Control Group ◽  
Study Group ◽  
Healthy Males

Recent evidence indicates that a systemic state of inflammation may exert a negative effect on male fertility. The aim of this study is to evaluate sperm quality parameters in male patients with ulcerative colitis (UC). Between December 2019 and December 2020 semen analyses are performed in 50 patients with UC in clinical remission. The control group consists of 50 healthy volunteers. Total sperm count, sperm count, percentage of morphologically normal spermatozoa, viability, and progressive motility, are significantly lower in the study group than in healthy males (p < 0.001). The DNA fragmentation index (DFI) and oxidation-reduction potential (ORP) are significantly higher in the study group (28.9% and 1.55% on average, respectively) than in healthy males (14.6% and 0.79% on average, respectively). Bacteriospermia is more clearly observed in the study group (p = 0.037), and the most frequent pathogen is Enterococcus faecalis. The DFI and ORP are significantly higher in bacteria carriers, compared to males without microbial pathogens from both the study and control groups (p < 0.001). To conclude, UC patients have worse basic sperm parameters compared to their healthy counterparts. Deterioration of semen parameters, as well as an intensified DNA fragmentation could be a result of oxidative stress intensification.

scholarly journals Ozone Therapy in Patients with the New Coronavirus Infection COVID-19

2020 ◽  
Vol 99 (5) ◽  
pp. 94-100
Author(s):  
E.V. Hammad ◽  
I.G. Nikitin ◽  
K.V. Fedorova
Keyword(s):  
Clinical History ◽  
Solution Concentration ◽  
Physiological Solution ◽  
Control Group ◽  
Study Group ◽  
Imaging Data ◽  
Ozone Therapy ◽  
Physiological Processes ◽  
Coronavirus Infection ◽  
Therapy Protocol

Aim. In our work we seek to develop new approaches for treating patients with COVID-19. The first reports about new coronavirus infection, COVID-19, came out in China in 2019. It was recognized by WHO as a pandemic crisis on March 11, 2020. Currently, there is no standard therapy protocol for COVID-19 and the drugs are used off label. Materials and methods. We have implemented ozone therapy into clinical practice as an adjuvant treatment regimen for patients with SARS-CoV-2 infection. In our study, 19 patients received ozone therapy and 18 patients were members of the control group. All patients had a positive PCR test for SARS-CoV-2 infection and were matched by the following features: sex, age, severity of symptoms, imaging data and clinical history. Patients in the study group received ozone therapy in the form of daily intravenous infusions of ozonized physiological solution (concentration: 2.2-2.4 mg/l). Conclusion. We observed a statistically significant improvement in laboratory, radiological and clinical tests of patients in the study group compared to the control group on the 14th day. Thus, we have demonstrated the benefits of using ozone therapy in patients with the new coronavirus infection COVID-19. Taking into consideration the physiological processes underlying such approach, ozone therapy should be justified for both phases: the beginning and at the peak of the disease.

scholarly journals ORAL MUCOSA LESIONS AND ORAL SYMPTOMS IN INFLAMMATORY BOWEL DISEASE PATIENTS

2015 ◽  
Vol 52 (2) ◽  
pp. 105-110 ◽  
Author(s):  
Nuno LARANJEIRA ◽  
Jorge FONSECA ◽  
Tânia MEIRA ◽  
João FREITAS ◽  
Sara VALIDO ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Oral Mucosa ◽  
Bowel Disease ◽  
Statistical Significance ◽  
Control Group ◽  
Study Group ◽  
Immunosuppressant Therapy ◽  
Oral Symptoms ◽  
Inflammatory Bowel

Background Inflammatory Bowel Disease is known for its extra intestinal manifestations, the oral cavity is no exception. Objectives The aim of this study was to evaluate the association between Inflammatory Bowel Disease and oral mucosa lesions and symptoms, and complementary to evaluate their possible relation with oral hygiene, smoking habits, drug therapy, duration and activity of the disease. Methods Patients were selected from the Gastroenterology Clinic of a Portuguese tertiary referral hospital. This sample consisted of 113 patients previously diagnosed with ulcerative colitis or Crohn’s disease along with a control group of 58 healthy individuals that were accompanying the study group patients to their appointments. Clinical interviews and clinical examinations were performed for data collection. Results The patients in the study group were more affected by oral symptoms (P=0.011), and showed a trend towards a higher incidence of oral mucosal lesions, even though statistical significance was not reached (8.8% versus 3.4% in the control group; P=0.159). Patients in active phase were the most affected. No differences were detected between Crohn’s disease and ulcerative colitis, or concerning smoking habits. The corticosteroid and immunosuppressant therapy seemed to increase the incidence of oral symptoms (P=0.052). The oral mucosa lesions increased and the oral symptoms decreased over the course of the disease, however without statistical significance. Conclusion Oral mucosa’s lesions and oral symptoms were positively associated with Inflammatory Bowel Disease, mainly during disease activity periods and conceivably, associated with corticosteroid and immunosuppressant therapy.

Sign in / Sign up

Export Citation Format

Share Document