Gestational trophoblastic syndrome and human immunodeficiency virus (HIV) infection: A retrospective analysis

2003 ◽  
Vol 13 (6) ◽  
pp. 875-878 ◽  
Author(s):  
M. Moodley ◽  
J. Moodley
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Case Reports ◽  
Hiv Positive ◽  
Risk Category ◽  
Immunodeficiency Virus ◽  
The Subject ◽  
The Mean ◽  
Sub Saharan

The appropriate management of gynecological malignancies in association with human immunodeficiency virus (HIV) infection is not established. To date the reported literature on the subject consists mainly of case reports. Due to the increasing prevalence of HIV infection, especially in sub-Saharan countries, the chances of finding both conditions in the same patient has produced management and ethical dilemmas. This retrospective study describes the management of 12 HIV-infected patients and compares their outcome with 29 non HIV-infected patients. The mean age of the non HIV-infected patients was 30 years (range 16–56 years), while the mean age of the HIV-infected patients was 32 years (range 20–47 years). In terms of risk factors, there were 72% of non HIV-infected women in the high-risk category compared to 50% of HIV-infected women (P = 0.468). All patients who received treatment had CD4 counts greater than 200 cells/μl. Two HIV-infected women who did not receive any form of chemotherapy due to low CD4 counts (41 cells/μl and 84 cells/μl) demised of their disease. The majority of women (86% non HIV-infected & 90% HIV-infected) received lfewer than 10 cycles of chemotherapy to attain cure. Most side effects were minor. None of the HIV-infected patients who received chemotherapy demised of their disease. In total, irrespective of risk category, there were 38 patients (93%) who were cured of their disease by chemotherapy including 10 HIV-positive patients. All patients were alive and free of disease at their last follow-up visit. Although the numbers are small, it is proposed that HIV-infected patients with choriocarcinoma and a reasonable degree of CD4 counts (>200cells/μl) should receive standard therapy.

Older Children and Adolescents Living With Perinatally Acquired Human Immunodeficiency Virus Infection

PEDIATRICS ◽  
1995 ◽  
Vol 95 (5) ◽  
pp. 657-663
Author(s):  
Samuel Grubman ◽  
Elaine Gross ◽  
Nancy Lerner-Weiss ◽  
Myriam Hernandez ◽  
George D. McSherry ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Children And Adolescents ◽  
Late Onset ◽  
Medical Center ◽  
Symptomatic Disease ◽  
Immunodeficiency Virus ◽  
Perinatally Acquired ◽  
The Mean

Objective. To describe the clinical, immunologic, and psychosocial characteristics of children living with perinatally-acquired human immunodeficiency virus (HIV) infection beyond the age of 9 years. Methods. This is a descriptive cohort study of 42 surviving perinatally infected children older than 9 years followed at the Children's Hospital Acquired Immunodeficiency Syndrome (AIDS) Program (part of a university-based inner city medical center) as of June 1993. The study is based on medical record data of clinical, immunologic, and psychosocial parameters. Results. The cohort includes 20 boys and 22 girls with a mean age of 136 months. The mean age at diagnosis of HIV infection was 88 months, and 59.5% were asymptomatic at the time of diagnosis. Currently, after a mean follow-up period of 48 months from diagnosis, 23.8% remain asymptomatic, 19.1% have non-AIDS-defining HIV-related symptoms, and 57.1% have AIDS; 85.7% of the cohort did not develop HIV-related symptoms until after 48 months of age (late-onset prolonged survivors). There was an average annual decline of 71.4 CD4+ cells/µL in the cohort from the ages of 7 to 16 years, and 21.4% have a current CD4+ lymphocyte count of greater than 500 cells/µL, 28.6% between 200 and 500 cells/µL, and 50% less than 200 cells/µL; 76% are orphaned as a result of maternal death, with the majority of the cohort (60%) cared for by extended family members. Disclosure of diagnosis has occurred in 57.1%. The vast majority of the cohort (76%) are attending regular school, with the remainder in special education. Conclusions. Although close to one quarter of the children and adolescents ages 9 to 16 years living with perinatally acquired HIV infection described in this cohort remain asymptomatic and have a relatively intact immune system, the remainder are living with significant HIV-related symptoms, many of which are chronic in nature and have an impact on daily living. The children in this cohort had both significant immunologic deterioration and symptomatic disease progression during the mean follow-up period of 48 months from the time of diagnosis with HIV infection.

Abstract WP426: Subarachnoid Hemorrhage in patients infected with Human Immunodeficiency Virus

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Haralabos Zacharatos ◽  
Malik M Adil ◽  
Ameer E Hassan ◽  
Sarwat I Gilani ◽  
Adnan I Qureshi
Keyword(s):  
Human Immunodeficiency Virus ◽  
Subarachnoid Hemorrhage ◽  
Blood Transfusion ◽  
Hospital Mortality ◽  
Hiv Infection ◽  
The United States ◽  
Hiv Positive ◽  
Published Data ◽  
Immunodeficiency Virus ◽  
Hiv Negative

Background: There is limited data regarding the unique attributes of ischemic stroke among patients infected with human immunodeficiency virus (HIV). There is no published data regarding the occurrence and outcomes of subarachnoid hemorrhage (SAH) among HIV infected persons. Methods: The largest all-payer Nationwide Inpatient Sample (NIS 2002-2010) data was used to identify and analyze all patients presenting with the primary diagnosis of SAH in the United States. Among this cohort, we identified the patients who were not HIV positive and those who were HIV positive. Patient demographics, medical co-morbidities, in-hospital complications, in-hospital procedures, and discharge disposition were compared between the two groups. The association between HIV infection and outcomes was evaluated in multivariate analysis after adjusting for potential confounders. Results: Of the 351,491 patients admitted with SAH, 1367 (0.39%) were infected with HIV. HIV infected patients were younger, mean age [±SD] of 45 ±14.2 years versus those who were not 58±19 years, (p<0.0001). The rate of blood transfusion [27,286 (7.8%) versus 245.6 (18%), p=0.0003], mechanical ventilation [51,199 (14.6%) versus 316.1(23.1%), p=0.008], and sepsis [14,644 (4.2%) versus 236.1 (17.3%), p<0.0001] was significantly higher among HIV infected patients. After adjusting for age, gender, hypertension, coagulopathy, atrial fibrillation, renal failure, and dyslipidemia, HIV negative patients had a significantly higher rate of discharge to home (odds ratio [OR] 1.9, 95% CI: 1.4-2.6, p<0.0001) and lower in-patient mortality (OR 0.4, 95% CI: 0.3-0.5, p<0.001). Further adjustment for blood transfusion and sepsis reduced the odds of discharge to home for the HIV negative patients, from 1.9 to 1.7 but did not affect in-hospital mortality. Conclusion: The in-hospital mortality in HIV infected patients with SAH is higher despite these patients being younger than non-HIV infected patients. We believe that this study provides a nationwide perspective which may have some important implications for early recognition and diagnosis of HIV-infection in SAH patients.

scholarly journals Clinical Pharmacokinetics of Nelfinavir and Its Metabolite M8 in Human Immunodeficiency Virus (HIV)-Positive and HIV-Hepatitis C Virus-Coinfected Subjects

2005 ◽  
Vol 49 (2) ◽  
pp. 643-649 ◽  
Author(s):  
Mario Regazzi ◽  
Renato Maserati ◽  
Paola Villani ◽  
Maria Cusato ◽  
Patrizia Zucchi ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Hiv Positive ◽  
Therapeutic Drug ◽  
Hiv Patients ◽  
Standard Dosage ◽  
Clinical Pharmacokinetics ◽  
Immunodeficiency Virus ◽  
The Mean

ABSTRACT In order to evaluate the potential risk of nelfinavir (NFV) accumulation in human immunodeficiency virus (HIV)-hepatitis C virus (HCV)-coinfected patients with liver disease, we investigated the concentrations of NFV and M8, the active metabolite of NFV, in plasma HIV-positive (HIV+) patients coinfected with HCV. A total of 119 HIV+ subjects were included in our study: 67 HIV+ patients, 32 HIV+ and HCV-positive (HCV+) patients without cirrhosis, and 20 HIV+ and HCV+ patients with cirrhosis. Most of the enrolled patients (chronically treated) were taking NFV at the standard dosage of 1,250 mg twice a day. To assay plasma NFV and M8 concentrations, patients underwent serial plasma samplings during the dosing interval at steady state. Plasma NFV and M8 concentrations were measured simultaneously by a high-performance liquid chromatography method with UV detection. The HIV+ and HCV+ patients with and without cirrhosis had significantly lower NFV oral clearances than the HIV+ and HCV-negative individuals (28 and 58% lower, respectively; P < 0.05), which translated into higher areas under the concentration-time curves for cirrhotic and noncirrhotic patients. The NFV absorption rate was significantly lower in cirrhotic patients, resulting in a longer time to the maximum concentration in serum. The mean ratios of the M8 concentration/NFV concentration were significantly lower (P < 0.05) in HIV+ and HCV+ subjects with cirrhosis (0.06 ± 0.074) than in the subjects in the other two groups. The mean ratios for M8 and NFV were not statistically different between HIV+ and HCV-negative patients (0.16 ± 0.13) and HIV+ and HCV+ patients without cirrhosis (0.24 ± 0.17), but the interpatient variability was high. Our results indicate that the pharmacokinetics of NFV and M8 are altered in HIV+ and HCV+ patients, especially those with liver cirrhosis. Therefore, there may be a role for therapeutic drug monitoring in individualizing the NFV dosage in HIV-HCV-coinfected patients.

scholarly journals Levels of Macrophage Inflammatory Protein 1α (MIP-1α) and MIP-1β in Intervillous Blood Plasma Samples from Women with Placental Malaria and Human Immunodeficiency Virus Infection

2003 ◽  
Vol 10 (4) ◽  
pp. 631-636 ◽  
Author(s):  
Sujittra Chaisavaneeyakorn ◽  
Julie M. Moore ◽  
Lisa Mirel ◽  
Caroline Othoro ◽  
Juliana Otieno ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Blood Plasma ◽  
Plasma Levels ◽  
Placental Malaria ◽  
Hiv Positive ◽  
Inflammatory Protein ◽  
Immunodeficiency Virus ◽  
Macrophage Inflammatory Protein ◽  
Hiv Negative

ABSTRACT Macrophage inflammatory protein-1α (MIP-1α) and MIP-1β play an important role in modulating immune responses. To understand their importance in immunity to placental malaria (PM) and in human immunodeficiency virus (HIV)-PM coinfection, we investigated levels of these chemokines in the placental intervillous blood plasma (IVB plasma) and cord blood plasma of HIV-negative PM-negative, HIV-negative PM-positive, HIV-positive PM-negative, and HIV-positive PM-positive women. Compared to HIV-negative PM-negative women, the MIP-1β concentration in IVB plasma was significantly elevated in HIV-negative PM-positive women and HIV-positive PM-positive women, but it was unaltered in HIV-positive PM-negative women. Also, PM-infected women, irrespective of their HIV status, had significantly higher levels of MIP-1β than HIV-positive PM-negative women. The MIP-1α level was not altered in association with either infection. The IVB plasma levels of MIP-1α and MIP-1β positively correlated with the cord blood plasma levels of these chemokines. As with IVB plasma, only cord plasma from PM-infected mothers had significantly elevated levels of MIP-1β compared to PM-negative mothers, irrespective of their HIV infection status. MIP-1β and MIP-1α levels in PM-positive women were positively associated with parasite density and malaria pigment levels. Regardless of HIV serostatus, the IVB MIP-1β level was significantly lower in women with PM-associated anemia. In summary, an elevated level of MIP-1β was associated with PM. HIV infection did not significantly alter these two chemokine levels in IVB plasma.

Influence of HLA-B*5703 and HLA-B*1403 on Susceptibility to Spondyloarthropathies in the Zambian Population

2008 ◽  
Vol 35 (11) ◽  
pp. 2236-2240 ◽  
Author(s):  
ROBERTO DÍAZ-PEÑA ◽  
MIGUEL ANGEL BLANCO-GELAZ ◽  
PANGANANI NJOBVU ◽  
ANTONIO LÓPEZ-VAZQUEZ ◽  
BEATRIZ SUÁREZ-ÁLVAREZ ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Ankylosing Spondylitis ◽  
Reactive Arthritis ◽  
Hiv Positive ◽  
Sample Population ◽  
Type I ◽  
Hla B27 ◽  
New Findings ◽  
Immunodeficiency Virus ◽  
Sub Saharan

ObjectiveTo analyze the distribution of HLA-B alleles and to investigate their contribution in the susceptibility to spondyloarthropathies (SpA) in a sample population from Zambia, in order to determine a relationship between some HLA-B alleles and development of ankylosing spondylitis (AS), reactive arthritis (ReA), or undifferentiated SpA (uSpA).MethodsWe selected 72 patients with SpA and found that 46 had uSpA, 23 ReA, and 3AS.We also selected 92 matched controls; 55 of these had human immunodeficiency virus type I (HIV-I) infection.ResultsWe found a significant increase in the rate of uSpA and ReA with features of Reiter’s syndrome (RS) in HIV-positive individuals who carried the HLA-B*5703 allele (pc < 0.0001 and pc < 0.001, respectively). Among the significant new findings identified were the presence of B*1403 in 2 of the 3 AS patients (pc < 0.05, OR 47), confirming previous data in the Togolese population.ConclusionThe presence of B*5703 and HIV infection may not affect susceptibility to AS and ReA, but they do show an important influence in uSpA and RS. Our findings confirm that HLA-B* 1403 is the only factor to increase the risk of AS in a sub-Saharan African population, whereas HLA-B27 was virtually absent in patients with AS.

scholarly journals Seroprevalence of HIV in blood donors at tertiary care center, M.Y.H. Indore, India

2018 ◽  
Vol 7 (1) ◽  
pp. 183
Author(s):  
Priyanka Solanki ◽  
Ashok Yadav ◽  
Khushboo Likhar
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Blood Donors ◽  
Care Center ◽  
Tertiary Care ◽  
Blood Bank ◽  
Hiv Positive ◽  
Screening Programs ◽  
Immunodeficiency Virus ◽  
Voluntary Donor

Background: Transfusion of blood has become an important mode of transmission of infections such as human immunodeficiency virus and hepatitis B to the recipients. Blood transfusion is a boon in medical era if properly screened. The aim of study was to determine the seroprevalence of HIV donors in blood bank at M.Y.H. Indore.Methods: The study was conducted in the blood bank, M.Y.H. Hospital, Indore. Total 115775 donors attending blood bank were included in the study. All the donor samples were screened for detection of antibodies for human immunodeficiency virus by microwell Enzyme Linked Immunosorption Assay (ELISA) method. The seroprevalence of HIV infection among the donors was determined over a period of five years since January 2013 to December 2017.Results: Total 115775 blood donors were recorded. Out of total 115775 blood donors included in the study, replacement donor were 10766 (9.29%) while voluntary donor were 105009 (90.70%). In the duration of five-year study period, total 80 cases (0.06%) were reactive to HIV. Out of total 115775 blood donors included in the study, maximum cases i.e. 22 (0.08%) cases were found to be positive for HIV infection in year 2017. Out of 10766 replacement donors included in the study, 64 cases (0.59%) were reactive to HIV infection. While out of 105009 voluntary donors, 16 cases (0.01%) were found to be reactive to HIV infection. Voluntary donors are more as compared to the replacement donors. Number of HIV positive patients were found to more in replacement donor as compared to the voluntary donors.Conclusions: The seroprevalence of HIV is low in this study and hence it is concluded that the more the number of voluntary donors, the less the number of HIV positive cases. Voluntary donors can be motivated by proper health education and high quality screening programs.

scholarly journals Aktinomikosis di tonsil lingualis dan supraglotis sebagai manifestasi klinis pertama pada pasien imunokompromais

2017 ◽  
Vol 47 (1) ◽  
pp. 81
Author(s):  
Raden Isma Nurul Aini ◽  
Sinta Sari Ratunanda ◽  
W. Wijana ◽  
Agung Dinasti Permana ◽  
Sally Mahdiani
Keyword(s):  
Risk Factors ◽  
Human Immunodeficiency Virus ◽  
Case Reports ◽  
Upper Esophageal Sphincter ◽  
Hiv Positive ◽  
Lingual Tonsil ◽  
Immunodeficiency Virus ◽  
Swallowing Difficulty ◽  
Esophageal Sphincter

Latar belakang: Aktinomikosis merupakan infeksi bakteri kronis yang jarang ditemukan (1:300.000orang per tahun). Berbagai faktor risiko dapat mengakibatkan infeksi tersebut, sehingga pengobatan perludilakukan berdasarkan etiologi dan faktor risiko.Tujuan: Melaporkan dan menganalisis kasus yangjarang, yaitu aktinomikosis di hipofaring dan laring pada penderita dengan HIV-positive, yang menutupidua-pertiga inlet laring dan sfingter esofagus atas.Kasus: Laki-laki berusia 21 tahun datang dengankeluhan sulit menelan dan rasa mengganjal di tenggorok sejak 2 bulan. Pada pemeriksaan rinolaringoskopididapatkan massa berbenjol pada tonsil lingualis dan supraglotis. Hasil biopsi menunjukkan peradangankronis karena Actinomyces sp. Metode: Pencarian literatur dilakukan melalui Pubmed, Proquest, ClinicalKey, dan Google Scholar, dengan tidak membatasi tahun pencarian jurnal. Berdasarkan kriteria inklusi daneksklusi, didapatkan tiga artikel yang telah dilakukan critical appraisal. Hasil: Tidak ditemukan publikasimengenai kasus aktinomikosis servikofasial pada pasien dengan human immunodeficiency virus (HIV)positif. Tiga artikel yang ditemukan menunjukkan bahwa aktinomikosis dapat timbul pada pasien yangimunokompromais dalam jangka waktu lama. Pada tiga artikel yang dianalisis, manajemen aktinomikosisdapat dilakukan dan memberikan hasil yang baik karena telah diketahui faktor risiko sebelumnya. Namunpada kasus ini, infeksi HIV (+) sebagai faktor risiko baru ditemukan setelah manajemen aktinomikosis,dengan tindakan pembedahan dan medikamentosa sehingga memengaruhi outcome dari manajemen pasientersebut.Kesimpulan: Analisis faktor risiko pada aktinomikosis, seperti keadaan defisiensi imun akibatinfeksi HIV, perlu diinvestigasi secara mendalam sehingga dapat memperbaiki outcome manajemen pasien.Kata kunci: Aktinomikosis, disfagia, faktor risiko, defisiensi imun, human immunodeficiency virus ABSTRACTSBackground: Actinomycosis is a rare chronic bacterial infection that could be found in humans(incidence rate is 1 per 300,000 per year). There are various risk factors which can promote infection,and the treatment should be based on etiology and risk factors. Purpose: To present and analyse a caseof HIV-positive 21-year-old man with cervicofacial actinomycosis in hypopharynx and larynx, closingtwo-third of laryngeal inlet and upper esophageal sphincter. Case: A 21-years old man came with chiefcomplain of swallowing difficulty and blocking sensation in the throat. Rhinolaryngoscopy revealedcauliflower-like masses on lingual tonsil and supraglottic. Biopsy result showed chronic inflammation dueto Actinomyces sp. Method: Search of literatures was conducted on Pubmed, Proquest, Clinical Key, andGoogle Scholar without limiting years of journals. Based on the inclusion and exclusion criteria, threearticles were obtained as full texts and considered useful for the authors to be analysed. Result: Authorsdid not find any case reports and other papers discussing cervicofacial actinomycosis with HIV-positivein national and international journals. Three articles revealed that infection due to Actimomyces sp. wasrelated with long-term immunosuppressed conditions. In these articles, actinomycosis managementsshowed good response since their risk factors were known. However in our case, HIV as a predisposingfactor was discovered postoperatively, and after pharmacological treatment of actinomycosis had beenadministerred, affecting outcome and next management of this patient. Conclusion: In-depth analysisof actinomycosis predisposing factors, HIV infection should be included in order to improve the patientmanagement outcome. Keywords: Actinomycosis, risk factor, immunocompromised, human immunodeficiency virus

scholarly journals Incidence of tuberculosis among HIV-positive adults on antiretroviral therapy at Debre Markos Referral Hospital, Northwest Ethiopia: A retrospective record review

2019 ◽  
Author(s):  
Belisty Temesgen ◽  
Getiye Dejenu Kibret ◽  
Nakachew Mekonnen Alamirew ◽  
Animut Alebel
Keyword(s):  
Human Immunodeficiency Virus ◽  
Opportunistic Infections ◽  
Hemoglobin Level ◽  
Disease Stage ◽  
Hiv Positive ◽  
Retrospective Record Review ◽  
Immunodeficiency Virus ◽  
Hiv Positive Adults ◽  
Record Review

Abstract Background: Tuberculosis is the leading cause of morbidity and mortality among people living with human immunodeficiency virus. Almost one-third of deaths among people living with human immunodeficiency virus are attributed to tuberculosis. Despite this fact, in Ethiopia, particularly in our study area there is a scarcity of information regarding the incidence and predictors of TB among peoples living with HIV. Thus, this study aimed to assess the incidence and predictors of tuberculosis among HIV-positive adults on ART. Methods: A retrospective record review was conducted among 544 HIV-positive adults on ART at Debre Markos Referral Hospital from January 1, 2012 to December 31, 2017. The study participants were selected using a simple random sampling technique. The data extraction format was adapted from ART intake and follow-up forms. Data were entered using Epi-Data version 4.2 and analyzed using STATA Version 13. Tuberculosis free survival time was estimated using the Kaplan-Meier survival curve. Both the bi-variable and multivariable Cox-proportional hazard regression models were used to identify predictors of the time to develop TB. Results: Among 492 HIV-positive adults included in the final analysis, 16.9% developed TB at the time of follow up. The incidence rate of TB was found to be 6.5 (95%CI: 5.2, 8.0) per 100-person years of observation. Advanced WHO clinical disease stage (III and IV) (AHR: 2.1, 95% CI: 1.2, 3.2), being ambulatory and bedridden (AHR: 1.8, 95% CI: 1.1, 3.1), baseline opportunistic infections (AHR: 2.8, 95% CI: 1.7, 4.4), low hemoglobin level (AHR: 3.5, 95% CI: 2.1, 5.8), and not taking IPT (AHR: 3.9, 95% CI: 1.9, 7.6) were found to be the predictors of TB. Conclusion: In this study, a high incidence rate of TB was observed among HIV-positive adults. Advanced WHO clinical disease stage (III and IV), being ambulatory and bedridden, baseline opportunistic infections, low hemoglobin level, and not taking IPT were found to be the predictors of TB. Keywords: HIV, Incidence, Predictors, TB

Reduction in prevalence of invasive cervical cancer in KwaZulu-Natal, South Africa: impact of the human immunodeficiency virus epidemic

2006 ◽  
Vol 16 (3) ◽  
pp. 1036-1040
Author(s):  
M. Moodley
Keyword(s):  
South Africa ◽  
Cervical Cancer ◽  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Invasive Cervical Cancer ◽  
Epidemiologic Data ◽  
Kwazulu Natal ◽  
Immunodeficiency Virus ◽  
Time Periods ◽  
Sub Saharan

The bulk of the human immunodeficiency virus (HIV) pandemic continues to ravage the developing world, especially sub-Saharan countries. The HIV seroprevalence among women with invasive cervical cancer varies in different parts of the world. A comparison of women with cervical cancer was undertaken for epidemiologic data in the province of KwaZulu-Natal, South Africa, which has the highest HIV prevalence. The two time periods of study were 1999 and 2003. The aim was to determine the trends of prevalence of invasive cervical cancer and HIV infection among such women. While the background prevalence of HIV infection among women with invasive cervical cancer in our setting has remained constant over the two time periods (21% and 21.8%), there has been a significant reduction in the number of women presenting with invasive cervical cancer to our center (672 to 271) over the two time periods, with no changes in other variables. On the contrary, the prevalence of HIV infection among antenatal attendees had risen from 32.5% to 38.5% in the 1999 and 2003 periods, respectively. Reasons for this dramatic trend are presented together with other epidemiologic data.

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