scholarly journals Serodiagnosis as Adjunct Assay for Pertussis Infection in São Paulo, Brazil

2014 ◽  
Vol 21 (5) ◽  
pp. 636-640 ◽  
Author(s):  
Lourdes R. A. Vaz-de-Lima ◽  
Monte D. Martin ◽  
Lucia C. Pawloski ◽  
Daniela Leite ◽  
Karen C. P. Rocha ◽  
...  
Keyword(s):  
Public Health Problem ◽  
Enzyme Linked Immunosorbent Assay ◽  
Rt Pcr ◽  
Important Public Health Problem ◽  
Pertussis Infection ◽  
Specimen Collection ◽  
Adolescents And Adults ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

ABSTRACTPertussis remains an important public health problem in many countries despite extensive immunization. Cultures and real-time PCR (RT-PCR) assays are the recommended pertussis diagnostic tests, but they lack sensitivity at the later stage of the disease. This study introduces the IgG anti-pertussis toxin enzyme-linked immunosorbent assay (PT ELISA) in our routine diagnosis to improve disease burden estimation. Serum samples and nasopharyngeal swabs (n= 503) were collected at the same time from patients presenting with cough illness suspected of being pertussis and tested by the PT ELISA and culture and/or RT-PCR, respectively. Patients were separated into three age groups: group 1, <1 year (n= 260; mean age, 3 months), group 2, 1 to 6 years (n= 81; mean age, 3 years), and group 3, ≥7 years (n= 162; mean age, 26 years). The times (means) from cough onset to specimen collection were 16, 24, and 26 days, respectively. In group 1, 83 (82.2%) of 101 positive cases were positive for pertussis by culture/RT-PCR, while 40 (39.6%) tested positive by PT ELISA. In group 2, 6 (19.4%) of 31 positive cases were culture/RT-PCR positive, and 29 (93.6%) were seropositive. In group 3, 13 (13.8%) of 94 positive cases were positive by culture/RT-PCR and 91 (96.8%) were positive by serology. Culture/RT-PCR detected more cases of pertussis in infants (P< 0.0001), whereas the PT ELISA detected more cases in adolescents and adults (P< 0.0001). The timing between cough onset and specimen collection or recent vaccination may have partially affected our results. Serology is a suitable, cost-effective, and complementary pertussis diagnostic tool, especially among older children, adolescents, and adults during the later disease phase.

Abstract 43: Real Time Polymerase Chain Reaction Assays For Detection Of Respiratory Viruses In Kawasaki Disease Patients

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Young Mi Hong ◽  
Seul Bee Lee ◽  
Han Seul Choi ◽  
Jung Hyun Kwon ◽  
Hae Soon Kim ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Respiratory Symptoms ◽  
Respiratory Viruses ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Coronary Artery Diameter ◽  
Group 3 ◽  
Polymerase Chain ◽  
Group 2 ◽  
Group 1

Purpose: Respiratory symptoms are frequently observed in children with Kawasaki disease (KD) during the acute phase. The association rate of KD with antecedent respiratory illness has been reported to range from 56 to 83%. Clinical and epidemiologic features of KD support an infectious cause, but the etiology remains unknown. We investigated the association of respiratory viruses in children with KD using multiplex reverse transcriptase-polymerase chain reaction (RT-PCR). Methods: 138 KD patients were enrolled from January 2010 to June 2013. Two study groups (Group 1; n=94, KD without respiratory symptoms, Group 2; n=44, KD with respiratory symptoms) were compared with a control group (Group 3; n=5, febrile patients with respiratory symptoms). Laboratory data were obtained from each patient including complete blood count (CBC), erythrocyte sedimentation rate (ESR), platelet count, alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum total protein, albumin, C-reactive protein (CRP), NT-pro brain natriuretic peptide (BNP). Echocardiographic measurements were compared between the three groups. RT-PCR was performed using nasopharyngeal secretion to screen for the presence of 14 viruses (corona virus, parainfluenza virus 1, 2 and 3, influenza A and B, respiratory syncytial virus A and B, rhino virus A, B and C, metapneumo virus, adenovirus, and bocavirus) in groups 2 and 3. Results: The rate of KD with respiratory symptoms was 17.5%. The duration of fever was significantly longer and coronary artery diameter was significantly larger in group 2 than in group 1. Coronary artery diameter, CRP, platelet count, ALT, and NT-pro BNP were significantly higher and albumin lower in group 2 compared with group 3. Detection rate of adenovirus was 55.0% in group 2 and 28.6% in group 3. Conclusion: A positive RT-PCR for respiratory viruses may be helpful to elucidate the specific virus in KD patients with respiratory symptoms. NT-proBNP is a very important diagnostic tool in differentiating KD from other febrile viral respiratory infaction.

scholarly journals Modulation of Airway Inflammation by Immunostimulatory CpG Oligodeoxynucleotides in a Murine Model of Allergic Aspergillosis

2004 ◽  
Vol 72 (10) ◽  
pp. 6087-6094 ◽  
Author(s):  
Banani Banerjee ◽  
Kevin J. Kelly ◽  
Jordan N. Fink ◽  
James D. Henderson ◽  
Naveen K. Bansal ◽  
...  
Keyword(s):  
Peripheral Blood ◽  
Immunoglobulin E ◽  
Airway Remodeling ◽  
Atopic Asthma ◽  
Enzyme Linked Immunosorbent Assay ◽  
Cpg Odn ◽  
Group 3 ◽  
Group 2 ◽  
Total Immunoglobulin ◽  
Group 1

ABSTRACT Allergic aspergillosis is a Th2 T-lymphocyte-mediated pulmonary complication in patients with atopic asthma and cystic fibrosis. Therefore, any therapeutic strategy that selectively inhibits Th2 T-cell activation may be useful in downregulating allergic lung inflammation in asthma. In the present study, we developed a CpG oligodeoxynucleotide (ODN)-based immune intervention of allergic inflammation in a mouse model of allergic aspergillosis. Four different groups of mice were used in a short-term immunization protocol. Three experimental groups of animals (groups 1 to 3) were sensitized with Aspergillus fumigatus antigens. Animals in group 1 were immunized with A. fumigatus antigen alone, while those in group 2 were treated with CpG-ODN 1 day before the first antigen immunization, and the animals in group 3 received the first CpG-ODN administration between the antigen treatments. The animals in group 4 served as controls and were given phosphate-buffered saline. Allergen-specific serum immunoglobulins and total immunoglobulin E in different groups of animals were measured by enzyme-linked immunosorbent assay, while airway remodeling and cytokine production were studied by immunohistochemistry. The results demonstrated that CpG-ODN administration either before (group 2) or between (group 3) antigen treatments resulted in reduced total immunoglobulin E levels and peripheral blood eosinophil numbers compared to A. fumigatus allergen-sensitized group 1 animals. Similarly, treatment with CpG-ODN also downregulated inflammatory cell infiltration, goblet cell hyperplasia, and basement membrane thickening compared to A. fumigatus-sensitized mice. The distinct reduction in peripheral blood eosinophilia and airway remodeling in CpG-ODN-treated mice emphasized its usefulness as an immunomodulating agent for allergic fungal diseases.

scholarly journals Circulating salusin-beta levels in the patients with age-related macular degeneration

2021 ◽  
Vol 5 (1) ◽  
pp. 001-004
Author(s):  
Turgut Burak ◽  
Mercan Kadir ◽  
Demir Nesrin ◽  
Ilhan Nevin ◽  
Çatak Onur
Keyword(s):  
Macular Degeneration ◽  
Study Groups ◽  
Age Related Macular Degeneration ◽  
Enzyme Linked Immunosorbent Assay ◽  
Age Related ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
And Gender ◽  
Group 1

Purpose: To evaluate the levels of salusin-beta (β-SAL) in the serum in patients with age-related macular degeneration (ARMD). Methods: Our study was designed as a controlled comparative clinical study. The β-SAL levels in serums of age and sex-matched 20 healthy volunteers as controls (Group 1), 20 patients with dry-age related macular degeneration (d-ARMD) (Group 2) and 20 patients with wet-age related macular degeneration (w-ARMD) (Group 3) were measured with the enzyme-linked immunosorbent assay (ELISA) method. Results: In our study, it was found that age and gender didn’t show a statistically significant difference among the study groups (p > 0. 05). The mean serum β-SAL levels in Group 1, Group 2 and Group 3 were 1372,17 ± 1126.69 pg/mL; 1423,71 ± 1196.84 pg/mL and 940,57 ± 1092.05 pg/mL, respectively. Although the meanβ-SAL levels in w-ARMD seem numerically lower than both the control and d-ARMD groups, this difference among the study groups was not statistically significant (p > 0.05). Conclusion: Our study suggests that β-SAL levels in the patients with ARMD and healthy controls were not different than each other. Further studies with large numbers may reveal possible relationships between β-SAL and ARMD.

scholarly journals Effect of Non Surgical Periodontal Therapy on Gingival Crevicular Fluid and Serum Visfatin Concentration in Periodontal Health and Disease

2012 ◽  
Vol 32 (6) ◽  
pp. 383-388 ◽  
Author(s):  
N.M. Raghavendra ◽  
A.R. Pradeep ◽  
Rahul Kathariya ◽  
Anuj Sharma ◽  
Nishanth S. Rao ◽  
...  
Keyword(s):  
Chronic Periodontitis ◽  
Gingival Crevicular Fluid ◽  
Inflammatory Marker ◽  
Periodontal Therapy ◽  
Enzyme Linked Immunosorbent Assay ◽  
Serum Samples ◽  
Group 3 ◽  
Group 2 ◽  
Crevicular Fluid ◽  
Group 1

Visfatin is a pleiotropic mediator which acts as growth factor, cytokine, enzyme involved in energy including nicotinamide adenine dinucleotide metabolism and has been recently demonstrated to exert several pro-inflammatory functions. The purpose of this study is to evaluate the Visfatin concentration in gingival crevicular fluid (GCF) and serum in patients with chronic periodontitis, and to evaluate the effect of non-surgical periodontal therapy on the GCF and serum visfatin concentration. 30 subjects (age range: 25 to 52 years) were selected and divided into two groups based on the gingival index, probing depth, periodontal attachment level, and radiologic parameters (bone loss): group 1 (15 subjects with healthy periodontium), group 2 (15 subjects with chronic periodontitis), while, Group 2 patients after 8 weeks of the treatment (scaling and root planning, SRP) constituted group 3. GCF samples (by microcapillary pipettes) and serum samples (by venipuncture) were collected to estimate the levels of Visfatin using enzyme linked immunosorbent assay kit. The mean Visfatin concentration in GCF and serum was observed to be the highest in group 2 and lowest in group 1. While concentration in group 3 was similar to group 1. The concentration of Visfatin in GCF and serum decreased after SRP. The Visfatin concentration in GCF and serum found to be highest in chronic periodontitis group and decreases after treatment. Hence Visfatin values can be considered as an “inflammatory marker” can be explored in future as a potential therapeutic target in the treatment of periodontal disease.

scholarly journals Amniotic-fluid Lactoferrin: A Marker for Subclinical Intraamniotic Infection Prior to 32 Weeks Gestation

1995 ◽  
Vol 3 (5) ◽  
pp. 179-183 ◽  
Author(s):  
Kimberly A. Heller ◽  
Phillip C. Greig ◽  
R. Phillip Heine
Keyword(s):  
Amniotic Fluid ◽  
Enzyme Linked Immunosorbent Assay ◽  
Clinical Tool ◽  
Intraamniotic Infection ◽  
Group 4 ◽  
Activated Neutrophils ◽  
Group 3 ◽  
Group 2 ◽  
Normal Gestation ◽  
Group 1

Objective:Lactoferrin is a glycoprotein released from the secondary granules of activated neutrophils in the setting of infection. The purpose of this study was to determine if amniotic-fluid (AF) lactoferrin levels are elevated in preterm labor (PTL) patients with subclinical intraamniotic infection (IAI).Methods:AF samples were obtained from 186 pregnant patients with the following characteristics: group 1 - term, no labor; group 2 - preterm, no labor; group 3 - PTL with IAI; group 4 - PTL without IAI. Lactoferrin levels were measured with an enzyme-linked immunosorbent assay (ELISA).Results:AF lactoferrin levels were elevated in normal gestation after 31 weeks (P < 0.0001). Lactoferrin levels were also higher in infected PTL patients compared with noninfected PTL patients at gestations ≤31 weeks (P = 0.005). An AF lactoferrin level of >2.5 μg/ml is highly suggestive of infection in PTL patients at <32 weeks, with an overall sensitivity of 82% and a specificity of 83%, when infection is defined as a positive AF culture or positive placental histology.Conclusions:AF lactoferrin levels increase after 31 weeks in normal gestations, but lactoferrin levels >2.5 μg/ml in PTL patients before this gestational age are highly suggestive of IAI. AF lactoferrin levels may be a useful clinical tool for selecting those PTL patients who might benefit from antimicrobial therapy, closer observation, or early delivery.

scholarly journals The state of carotid artery wall in hypertensive patients with gout based on the study of inflammatory markers

2021 ◽  
Vol 23 (5) ◽  
pp. 608-613
Author(s):  
H. P. Kuzmina ◽  
O. M. Lazarenko
Keyword(s):  
Lipid Metabolism ◽  
Carotid Artery ◽  
Serum Ferritin ◽  
Inflammatory Markers ◽  
Enzyme Linked Immunosorbent Assay ◽  
Atherosclerotic Plaques ◽  
Hypertensive Patients ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

The aim. To analyze the frequency of atherosclerotic lesions of the carotid arteries and association with the lipid metabolism and inflammatory markers in hypertensive patients with gout. Materials and methods. 122 patients with hypertension aged 30 to 65 years were examined (mean age (56.0 (47.0; 62.0)), inclu­ding 104 men (85.2 %) and 18 women (14.8 %). Group 1 included 72 hypertensive patients with gout; group 2 – 50 hypertensive patients without gout; group 3 – 20 gout patients without hypertension. Serum levels of high sensitivity C-reactive protein were detected by enzyme-linked immunosorbent assay. Serum ferritin levels were measured using electrochemiluminescent detection. The patients underwent carotid artery ultrasound according to standard methods. Results. The duration of gout exacerbation and the pain intensity evaluated with the visual analog scale (VAS) (P < 0.01) were significantly higher in group 1, than those in group 3 (P < 0.01). Serum ferritin levels were 2.6 (P < 0.01) times higher in group 1 than those in group 2. In patients with gout, the levels of ferritin were significantly 2.1 times higher, than in group 2 (P < 0.01). The levels of hsСRP in patients of group 1 were 3.1 times higher than those in group 2 (P < 0.01). The proportion of patients with intima-media complex (IMC) thickness ≥0.9 mm was higher in group 1 than in groups 2 (χ2 = 4.58, P < 0.05) and 3 (χ2 = 24.96, P < 0.01). In the structure of plaques, isoechoic were significantly more often seen among group 1 patients as compared to group 3 (χ2 = 6.56, P < 0.01), and hyperechoic – as compared to group 2 (χ2 = 4.63, P < 0.05). Hypoechoic plaques were detected in groups 1 and 2 with similar frequency (P > 0.05). This type of plaque was associated with a high risk of cerebrovascular events. In the patients with arterial hypertension and gout, a significant moderate positive correlation was found between the IMC thickness and the serum uric acid level (rs = 0.46, P < 0.01), hsCRP (rs = 0.33, P < 0.01), age (rs = 0.33; P < 0.01), duration of gout (rs = 0.27, P < 0.05) and VAS (rs = 0.39, P < 0.01); the level of hsCRP was correlated with the presence of atherosclerotic plaques (τ = +0.64, P < 0.05). Conclusions. The combination of hypertension with gout in patients was associated with a high incidence of IMC thickness ≥0.9 mm and atherosclerotic plaques, more severe disorders of purine and lipid metabolism, increased inflammatory markers (ferritin and hsCRP), that should be considered not only in the aspect of chronic inflammation, but also as a part of the disease.

scholarly journals CovidNudge: diagnostic accuracy of a novel lab-free point-of-care diagnostic for SARS-CoV-2

2020 ◽  
Author(s):  
Malick M Gibani ◽  
Christofer Toumazou ◽  
Mohammadreza Sohbati ◽  
Rashmita Sahoo ◽  
Maria Karvela ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Point Of Care ◽  
N Gene ◽  
Hospital Inpatient ◽  
Standard Laboratory ◽  
Rt Pcr ◽  
Viral Transport Medium ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background Access to rapid diagnosis is key to the control and management of SARS-CoV-2. Reverse Transcriptase- Polymerase Chain Reaction (RT-PCR) testing usually requires a centralised laboratory and significant infrastructure. We describe the development and diagnostic accuracy assessment of a novel, rapid point-of-care RT-PCR test, the DnaNudge platform CovidNudge test, which requires no laboratory handling or sample pre-processing. Methods Nasopharyngeal swabs are inserted directly into a cartridge which contains all reagents and components required for RT-PCR reactions, including multiple technical replicates of seven SARS-CoV-2 gene targets (rdrp1, rdrp2, e-gene, n-gene, n1, n2 and n3) and human ribonuclease P (RNaseP) as a positive control. Between April and May 2020, swab samples were tested in parallel using the CovidNudge direct-to-cartridge platform and standard laboratory RT-PCR using swabs in viral transport medium. Samples were collected from three groups: self-referred healthcare workers with suspected COVID-19 (Group 1, n=280/386; 73%); patients attending the emergency department with suspected COVID-19 (Group 2, n=15/386; 4%) and hospital inpatient admissions with or without suspected COVID-19 (Group 3, n=91/386; 23%). Results Of 386 paired samples tested across all groups, 67 tested positive on the CovidNudge platform and 71 with standard laboratory RT-PCR. The sensitivity of the test varied by group (Group 1 93% [84-98%], Group 2 100% [48-100%] and Group 3 100% [29-100%], giving an average sensitivity of 94.4% (95% confidence interval 86-98%) and an overall specificity of 100% (95%CI 99-100%; Group 1 100% [98-100%]; Group 2 100% [69-100%] and Group 3 100% [96-100%]). Point of care testing performance was comparable during a period of high (25%) and low (3%) background prevalence. Amplification of the viral nucleocapsid (n1, n2, n3) targets were most sensitive for detection of SARS-CoV2, with the assay able to detect 1x104 viral particles in a single swab. Conclusions The CovidNudge platform offers a sensitive, specific and rapid point of care test for the presence of SARS-CoV-2 without laboratory handling or sample pre-processing. The implementation of such a device could be used to enable rapid decisions for clinical care and testing programs.

Levels of Melatonin in Continuous Spikes and Waves During Sleep

2019 ◽  
Vol 34 (6) ◽  
pp. 309-312 ◽  
Author(s):  
Senem Ayça ◽  
Halil Ural Aksoy ◽  
İsmail Taştan ◽  
Muzaffer Polat
Keyword(s):  
Circadian Rhythm ◽  
Immunosorbent Assay ◽  
Enzyme Linked Immunosorbent Assay ◽  
Rapid Decline ◽  
Blood Samples ◽  
Group 3 ◽  
Group 2 ◽  
Continuous Spikes And Waves ◽  
Group 1

Levels of melatonin have been reported before in children with epilepsy, but such has not been reported to date in those with continuous spikes and waves during sleep. The aim of the present study was to assess serum melatonin levels and melatonin circadian rhythm in patients with continuous spikes and waves during sleep and epilepsy. Serum melatonin was measured in 39 children stratified into 3 groups. Group 1 included 15 patients with continuous spikes and waves during sleep, group 2 included 12 epilepsy patients, and group 3 included 12 controls, respectively. Blood samples were taken from all participants at 1:00 am and 9:00 am and melatonin levels were measured using a quantitative enzyme-linked immunosorbent assay test. The 9:00 am melatonin levels of group 1 were significantly decreased and pair groups were compared. The Pa value (representing a comparison between groups 1 and 2) was .002, the Pb value (representing a comparison between groups 1 and 3) was .001, and the Pc value (representing a comparison between groups 2 and 3) was .86. These findings suggest that the 9:00 am melatonin levels were significantly decreased in the comparison of groups 2 and 3. Further detailed research is necessary to determine the factors leading to the rapid decline of morning melatonin levels of children with continuous spikes and waves during sleep.

In-vivo evaluation of the effect of cyanoacrylate on prosthetic vascular graft infection – does cyanoacrylate increase the severity of infection?

VASA ◽  
2020 ◽  
Vol 49 (4) ◽  
pp. 281-284
Author(s):  
Atıf Yolgosteren ◽  
Gencehan Kumtepe ◽  
Melda Payaslioglu ◽  
Cuneyt Ozakin
Keyword(s):  
Vascular Graft ◽  
Graft Infection ◽  
Vascular Graft Infection ◽  
Group 4 ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Prosthetic Vascular Graft Infection ◽  
Group 1

Summary. Background: Prosthetic vascular graft infection (PVGI) is a complication with high mortality. Cyanoacrylate (CA) is an adhesive which has been used in a number of surgical procedures. In this in-vivo study, we aimed to evaluate the relationship between PVGI and CA. Materials and methods: Thirty-two rats were equally divided into four groups. Pouch was formed on back of rats until deep fascia. In group 1, vascular graft with polyethyleneterephthalate (PET) was placed into pouch. In group 2, MRSA strain with a density of 1 ml 0.5 MacFarland was injected into pouch. In group 3, 1 cm 2 vascular graft with PET piece was placed into pouch and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. In group 4, 1 cm 2 vascular graft with PET piece impregnated with N-butyl cyanoacrylate-based adhesive was placed and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. All rats were scarified in 96th hour, culture samples were taken where intervention was performed and were evaluated microbiologically. Bacteria reproducing in each group were numerically evaluated based on colony-forming unit (CFU/ml) and compared by taking their average. Results: MRSA reproduction of 0 CFU/ml in group 1, of 1410 CFU/ml in group 2, of 180 200 CFU/ml in group 3 and of 625 300 CFU/ml in group 4 was present. A statistically significant difference was present between group 1 and group 4 (p < 0.01), between group 2 and group 4 (p < 0.01), between group 3 and group 4 (p < 0.05). In terms of reproduction, no statistically significant difference was found in group 1, group 2, group 3 in themselves. Conclusions: We observed that the rate of infection increased in the cyanoacyrylate group where cyanoacrylate was used. We think that surgeon should be more careful in using CA in vascular surgery.

Abnormal Haemostasis and Blood Viscosity in Malignant Hypertension

1984 ◽  
Vol 52 (03) ◽  
pp. 253-255 ◽  
Author(s):  
C Isles ◽  
G D O Lowe ◽  
B M Rankin ◽  
C D Forbes ◽  
N Lucie ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Viscosity ◽  
Renal Damage ◽  
Antithrombin Iii ◽  
Plasma Viscosity ◽  
Malignant Hypertension ◽  
Fibrin Deposition ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

SummaryWe have previously shown abnormalities of haemostasis suggestive of intravascular coagulation in patients with malignant hypertension, a condition associated with retinopathy and renal fibrin deposition. To determine whether such abnormalities are specific to malignant hypertension, we have measured several haemostatic and haemorheological variables in 18 patients with malignant hypertension (Group 1), 18 matched healthy controls (Group 2), and 18 patients with non-malignant hypertension (Group 3) matched for renal pathology, blood pressure and serum creatinine with Group 1. Both Groups 1 and 3 had increased mean levels of fibrinogen, factor VIIIc, beta-thrombo- globulin, plasma viscosity and blood viscosity (corrected for haematocrit); and decreased mean levels of haematocrit, antithrombin III and platelet count. Mean levels of fast antiplasmin and alpha2-macroglobulin were elevated in Group 1 but not in Group 3. We conclude that most blood abnormalities are not specific to malignant hypertension; are also present in patients with non-malignant hypertension who have similar levels of blood pressure and renal damage; and might result from renal damage as well as promoting further renal damage by enhancing fibrin deposition. However increased levels of fibrinolytic inhibitors in malignant hypertension merit further investigation in relation to removal of renal fibrin.

Sign in / Sign up

Export Citation Format

Share Document