scholarly journals Use of different options of anti-inflammatory therapy in patients with severe COVID-19

2021 ◽  
pp. 22-27
Author(s):  
Vita Skoryk
Keyword(s):  
Anticoagulant Activity ◽  
Pulse Therapy ◽  
Wilcoxon Test ◽  
Favourable Result ◽  
Markers Of Inflammation ◽  
Appropriate Treatment ◽  
Group 3 ◽  
Anti Inflammatory ◽  
Group 2 ◽  
Group 1

The aim of the study. To compare the effectiveness of methylprednisolone, dexamethasone and tocilizumab in patients with severe coronavirus disease. Identify the most appropriate treatment option. Materials and methods. Patients of group 1 (n=20) received for anti-inflammatory purposes tocilizumab at a dose of 600–800 mg. Patients in group 2 (n=82) received pulse therapy with methylprednisolone. Patients in group 3 (n=20) received dexamethasone 6 mg / day. Data are presented as M [25–75]. Statistical analysis of the results was performed using the program "Statistica 10". Significance of differences in indicators was assessed using the nonparametric Wilcoxon test. The results were considered reliable at values of p <0.05. Results. The severe course of coronavirus disease with the development of cytokine storm and respiratory distress syndrome is characterized by an increase in markers of inflammation: in group 1 the median CRP was 89.2 g / l, in group 2 – 64.2 g / l, and in 3 – 76.2 g / l, and did not differ significantly between groups (p> 0.05). The level of IL-6 in group 1 was 61.8 pg / ml, in group 2 – 64.6 pg / ml, and in group 3 – 46.5 pg / ml without significant differences between groups (p> 0.05). The level of ferritin in all groups exceeded normal values. Conclusions The most favourable result was obtained when using methylprednisolone: it was possible to reduce the mortality rate to 59.8 %. The relative risk of developing VTE was significantly higher in groups 1 and 3 (RR12 6.8 [2.7–16.8] p12 <0.0001, RR23 0.15 [0.06–0.35] p23 <0.0001), which gives grounds to confirm the presence of anticoagulant activity in methylprednisolone

scholarly journals The Systematic Effect of Mesenchymal Stem Cell Therapy in Critical COVID-19 Patients: A Prospective Double Controlled Trial

2021 ◽  
Vol 30 ◽  
pp. 096368972110249
Author(s):  
G Adas ◽  
Z Cukurova ◽  
K Kart Yasar ◽  
R Yilmaz ◽  
N Isiksacan ◽  
...  
Keyword(s):  
Growth Factors ◽  
Critically Ill ◽  
Inflammatory Cytokines ◽  
Clinical Manifestations ◽  
Systematic Effect ◽  
Cytokine Storm ◽  
Group 3 ◽  
Anti Inflammatory ◽  
Group 2 ◽  
Group 1

The aim of this clinical trial was to control the cytokine storm by administering mesenchymal stem cells (MSCs) to critically-ill COVID-19 patients, to evaluate the healing effect, and to systematically investigate how the treatment works. Patients with moderate and critical COVID-19 clinical manifestations were separated as Group 1 (moderate cases, n = 10, treated conventionally), Group 2 (critical cases, n = 10, treated conventionally), and Group 3 (critical cases, n = 10, treated conventionally plus MSCs transplantation therapy of three consecutive doses on treatment days 0, 3, and 6, (as 3 × 106 cells/kg, intravenously). The treatment mechanism of action was investigated with evaluation markers of the cytokine storm, via biochemical parameters, levels of proinflammatory and anti-inflammatory cytokines, analyses of tissue regeneration via the levels of growth factors, apoptosis markers, chemokines, matrix metalloproteinases, and granzyme-B, and by the assessment of the immunomodulatory effects via total oxidant/antioxidant status markers and the levels of lymphocyte subsets. In the assessment of the overall mortality rates of all the cases, six patients in Group-2 and three patients in Group-3 died, and there was no loss in Group-1. Proinflammatory cytokines IFNγ, IL-6, IL-17A, IL-2, IL-12, anti-inflammatory cytokines IL-10, IL-13, IL-1ra, and growth factors TGF-β, VEGF, KGF, and NGF levels were found to be significant in Group-3. When Group-2 and Group-3 were compared, serum ferritin, fibrinogen and CRP levels in Group-3 had significantly decreased. CD45 +, CD3 +, CD4 +, CD8 +, CD19 +, HLA-DR +, and CD16 + / CD56 + levels were evaluated. In the statistical comparison of the groups, significance was only determined in respect of neutrophils. The results demonstrated the positive systematic and cellular effects of MSCs application on critically ill COVID-19 patients in a versatile way. This effect plays an important role in curing and reducing mortality in critically ill patients.

scholarly journals AB1022 PANNICULITIS IN RHEUMATOLOGICAL PRACTICE: THE RESULTS OF LONG-TERM FOLLOW-UP

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1803.1-1804
Author(s):  
O. Egorova ◽  
B. Belov
Keyword(s):  
Bacterial Infections ◽  
Inflammatory Diseases ◽  
Subcutaneous Fat ◽  
Weight Lifting ◽  
Group 4 ◽  
Group 3 ◽  
Anti Inflammatory ◽  
Group 2 ◽  
Group 1

Background:Panniculitis is a group of heterogeneous inflammatory diseases that occur with damage to the subcutaneous fat (SCF), musculoskeletal system, and often internal organsObjectives:to evaluate the course and outcome in patients with panniculitisMethods:the course of the disease was monitored in 193 patients treated at the V.A. Nasonova Research Institute of Rheumatology for 3-5 years (142 women, 51 men) aged 19 to 77 with the referral diagnosis of erythema nodosum (EN) and undifferentiated panniculitis and with the disease duration of 1 week to 13 years. In addition to general clinical study, serum concentrations of α-1 antitrypsin, amylase, lipase, ferritin, creatinephosphokinase were determined, computed tomography of the chest organs, immunological, ultrasound scanning of the skin and SCF of the node area, tuberculosis tests and pathomorphological study of skin biopsy from the node area were performed.Results:: as a result of laboratory and instrumental examination, the following diagnoses were made: EN associated with infection (72 people – group 1), lipodermatosclerosis (LDS) (40 –group 2), idiopathic lobular panniculitis (ILP) (32 – group 3), Löfgren’s syndrome (SL) (49 –group 4). During the follow-up period, 6 deaths occurred (3.1%): in a patient with LDS due to acute heart failure and in 5 patients with ILP due to the activity of the disease which led to the development of cardiopulmonary pathology and disseminated intravascular coagulation (DIC) syndrome. In group 1, during the observation period, UE recurred in 18 people (25%), the probable causes were: hypothermia (6), exacerbation of chronic tonsillitis (6), acute respiratory viral infections (ARVI) (4), stress (1), a rapid decrease in the dose of glucocorticoids (GC) (1), the cause is unknown (2). In group 2, recurrence occurred in 19 patients (47.5%) due to the lack of anti-inflammatory therapy (plaquenil) (10), trauma (4), stress (3), and weight lifting (2). There was no recurrence in 7 patients in this group, however, nodes would not disappear completely, which is obviously due to the absence of plaquenil. In group 3, recurrence was registered in 24 cases (75%) and it was associated with insufficient effect of the ongoing anti-inflammatory therapy (9), a decrease in blood glucose to minimal doses (6), hypothermia (6) and the absence/cancellation of anti-inflammatory therapy (3). In group 4, recurrence of nodes was registered in 14 cases (28.5%), possible causes: cancellation of GC (9) and cooling/ARVI(5).Conclusion:in the observed group of patients with panniculitis mortality was 3.1%. The main causes of recurrence in EN were viral-bacterial infections, and in case of ILP, LDS and SL it was insufficient effect/absence of anti-inflammatory therapy.Disclosure of Interests:None declared

Use of Nasal Valve Stent with Anterior Rhinomanometry to Quantitate Nasal Valve Obstruction

1990 ◽  
Vol 99 (3) ◽  
pp. 175-178 ◽  
Author(s):  
Barbara J. Guillette ◽  
Curtis J. Perry
Keyword(s):  
Normal Control ◽  
Wilcoxon Test ◽  
Nasal Valve ◽  
Significance Level ◽  
Control Subjects ◽  
Group 3 ◽  
Group 2 ◽  
Valve Area ◽  
Group 1

Some patients have increased resistance in the nasal valve area that is static and does not collapse. Anterior rhinomanometry is unable to document nasal valve disorders in these instances. A simple stent was devised to open the nasal valve area during anterior mask rhinomanometry. Three groups of subjects were studied with and without the stent. These groups were 1) patients with anatomic findings of nasal valve obstruction, 2) normal control subjects, and 3) normal control subjects with artificially created midseptal nasal obstructions. At peak inspiration the median decrease in resistance with the stent in place when compared to nonstented values was 0.91 Pa·cm-3·s-1 for group 1, 0.27 Pa·cm-3·s-1 for group 2, and 0.25 Pa·cm-3·s-1 for group 3. Comparisons using the nonparametric Wilcoxon test had a significance level of p < .001. An easily fashioned, well-tolerated nasal valve stent can be readily incorporated in anterior mask rhinomanometry technique. With use of the stent, nasal valve obstruction can be accurately diagnosed and quantitated.

INFLUENCE OF THE DURABLE APPLICATION OF PROTONIC PUMP INHIBITORS ON CYTOKINE CONCENTRATION IN RAT BLOOD SERUM

2021 ◽  
Vol 74 (7) ◽  
pp. 1575-1580
Author(s):  
Serhii V. Pylypenko ◽  
Andrii A. Koval ◽  
Makarchuk V. Viktoria ◽  
Kostiantyn F. Chub
Keyword(s):  
Blood Serum ◽  
Inflammatory Cytokines ◽  
Male Rats ◽  
Control Group ◽  
Hcl Secretion ◽  
Group 3 ◽  
Anti Inflammatory ◽  
Group 2 ◽  
Student’S T ◽  
Group 1

The aim: Of the work was to determine the content of pro- and anti-inflammatory cytokines in the blood serum of the control group rats and after 28 days of inhibiting HCl secretion in the stomach by proton pump blockers “Omeprazole” and “Pantoprazole”. Materials and methods: The studies were performed on 30 white non-linear male rats weighing 160-180 g, divided into three groups with 10 animals in each. The control (group 1) were injected intraperitoneally with water for injections within 28 days once a day. Group 2 was administered omeprazole. Group 3 was administered pantoprazole. The concentration of cytokines in the blood serum of rats was determined by the enzyme immunoassay method. For statistic data processing, Student’s t-criterion for independent samples was applied. Results: After prolonged administration of omeprazole and pantoprazole, the blood serum concentrations of IFNγ, TNFα, IL-1 in rats increased by 58.5% and 3.41%, 73.3% and 48.4%, 80.2% and 40.8%, respectively, and IL-12B 40p decreased by 36.6% when using omeprazole and was almost indistinguishable from the control values when pantoprazole was administered. With administration of omeprazole, IL-4 concentration decreased by 39.8% and that of pantoprazole increased by 3.86% compared to the control. Administration of omeprazole and pantoprazole did not affect IL-6 concentration. Conclusion: Inhibition of hydrochloric acid secretion in the stomach of rats for 28 days using omeprazole and pantoprazole led to an imbalance between pro- and anti-inflammatory cytokines. The adverse effect of pantoprazole was less pronounced than that of omeprazole.

scholarly journals The Association ofHelicobacter pyloriInfection and Nonsteroidal Anti-Inflammatory Drugs in Peptic Ulcer Disease

2006 ◽  
Vol 20 (4) ◽  
pp. 277-280 ◽  
Author(s):  
Juan Carlos Zapata-Colindres ◽  
Sergio Zepeda-Gómez ◽  
Aldo Montaño-Loza ◽  
Edgar Vázquez-Ballesteros ◽  
José de Jesús Villalobos ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Bleeding Peptic Ulcer ◽  
The Other ◽  
Ulcer Disease ◽  
Group 3 ◽  
Anti Inflammatory ◽  
Group 2 ◽  
H Pylori ◽  
Group 1

BACKGROUND AND AIM: Peptic ulcer disease (PUD) affects 10% of the world population.Helicobacter pyloriinfection and the use of a nonsteroidal anti-inflammatory drug (NSAID) are the principal factors associated with PUD. The aim of the present study was to evaluate a cohort of patients with PUD and determine the association betweenH pyloriinfection and NSAID use.PATIENTS AND METHODS: The medical charts of patients with endoscopic diagnosis of PUD were retrospectively reviewed from September 2002 to August 2003. Patients were divided into three groups according to ulcer etiology:H pyloriinfection (group 1); NSAID use (group 2); and combinedH pyloriinfection and NSAID use (group 3).RESULTS: One hundred two patients were evaluated: 36 men (35.3%) and 66 women (64.7%). Forty patients hadH pyloriinfection, 43 had used NSAIDs and 15 had combinedH pyloriinfection and NSAID use; four patients with ulcers secondary to malignancy were excluded. The frequency of women was significantly higher in group 2 (P=0.01). The mean age of patients in group 1 was significantly lower than in the other two groups (P=0.003). PUD developed earlier in group 3 than in group 2 (5.0±4.7 months versus 1.4±2.1 months, respectively, P=0.018). Thirty-two patients (32.7%) had bleeding peptic ulcer. Group 2 had a higher risk of bleeding peptic ulcer than the other two groups (P=0.001).CONCLUSIONS: The development of PUD was observed earlier in the combinedH pyloriand NSAID group than in patients with only NSAID use. This suggests a synergic effect between the two risks factors in the development of PUD.

scholarly journals Effect of a Topical Nonsteroidal Anti-Inflammatory Drug (0.1% Pranoprofen) on VEGF and COX-2 Expression in Primary Pterygium

2021 ◽  
Vol 12 ◽  
Author(s):  
Bangtao Yao ◽  
Fei Wang ◽  
Xiaogui Zhao ◽  
Bei Wang ◽  
Xiaoli Yue ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Vascular Endothelial ◽  
Systemic Diseases ◽  
Inflammatory Drug ◽  
Group 3 ◽  
Cox 2 ◽  
Anti Inflammatory ◽  
Group 2 ◽  
Group 1 ◽  
Primary Pterygium

Purpose: To evaluate the effect of a topical nonsteroidal anti-inflammatory drug (0.1% pranoprofen) on the expression of VEGF and Cox-2 in primary pterygium.Methods: This was a prospective, randomized study. Between January 2019 and April 2020, 120 patients diagnosed with primary pterygium were enrolled and randomly divided into three groups before operation: 1) 40 patients in group 1 received topical pranoprofen 0.1% four times daily for 4 weeks, 2) 40 patients in group 2 received topical fluorometholone 0.1% four times daily for 4 weeks, and 3) patients in group 3 did not receive treatment. For each group, the age, sex, eye type, best-corrected visual acuity (BCVA), intraocular pressure (IOP), duration of onset, combined systemic diseases, and the results regarding vascular endothelial growth factor (VEGF) and cyclo-oxygen-ase-2 (COX-2) in postoperative pterygial tissues were evaluated in detail.Results: There were no significant differences regarding age, sex, eye type, combined systemic diseases, duration of onset, IOP, and BCVA within the three groups (p &gt; 0.05). The reduction of VEGF and CoX-2 expression of pterygial vascular endothelial cells in group 1 were statistically significant compared to group 2 and group 3 (p &lt; 0.05). There were significant correlations between COX-2 and VEGF expression of pterygial tissues within the three groups (p &lt; 0.05).Conclusion: The present findings suggested that the topical pranoprofen 0.1% could reduce the expression of VEGF and COX-2 in primary pterygium. We confirmed that treatment with pranoprofen offers advantages in early intervention and has therapeutic potential in reducing the postoperative recurrence of primary pterygium patients.Clinical Trial registration: The study was registered with the Chinese Clinical Trial Registry. (http://www.chictr.org.cn/index.aspx, Registration Number: ChiCTR2100047726).

scholarly journals Clinical and parasitological evaluation of pour-on fluazuron and ivermectin for treating canine demodicosis

2014 ◽  
Vol 34 (11) ◽  
pp. 1094-1100
Author(s):  
Clarissa P. Souza ◽  
Regina H.R. Ramadinha ◽  
Fabio B. Scott
Keyword(s):  
Histopathological Examination ◽  
Treatment Protocol ◽  
Wilcoxon Test ◽  
Histological Evaluation ◽  
Significant Difference ◽  
Before And After ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

The objective of the study was to evaluate the efficacy of pour-on formulations of fluazuron and ivermectin in different therapeutic protocols for treatment of demodicosis by means of quantifying mites with skin scraping, histological and clinical evaluation in dogs. Eighteen dogs with skin scrapings positive for Demodex canis were evaluated, divided into three groups. All the animals were treated every 14 days, completing 6 treatments for each animal (days 0, 14, 28, 42, 56 and 70). In group 1, pour-on 2.5% fluazuron was used at the dose of 20mg/kg; in the group 2 pour-on 2.5% fluazuron at a dose of 20 mg/kg in association with pour-on 0.5% ivermectin at the dose of 0.6mg/kg; and in group 3, pour-on 0.5% ivermectin alone was used, at the dose of 0.6mg/kg. The treatment was evaluated and monitored through skin scrapings and clinical follow-up of the lesions every 14 days for 84 days, and through histopathological examination at the end of each treatment protocol. The success rate was defined as the percentage of dogs in each group that had negative skin scrapings after the treatment: this was 16.67% for group 1, and 50% for groups 2 and 3. The reduction in mite counts reached effectiveness of 67.66%, 88.99% and 84.29% for groups 1, 2 and 3 respectively. The Wilcoxon test showed that there was a significant difference between the number of mites before and after treatment in groups 2 and 3. The histopathological examination revealed that only group 1 showed no significant difference in the intensity of infestation between days 0 and 84. Clinically, there was no significant difference between the evaluation before and after treatment in the three groups. pour-on 2.5% fluazuron and pour-on 0.5% ivermectin were not effective for treating canine demodicosis, either in association or as single therapy, when applied every 14 days for a period of 70 days. Quantification of mites using skin scrapings and histological evaluation proved to be ineffective, either one as sole therapeutic evaluation parameters, for canine demodicosis.

scholarly journals A clinical study on alopecia areata

2018 ◽  
Vol 4 (1) ◽  
pp. 66
Author(s):  
Kishan Ninama ◽  
Rashmi Mahajan ◽  
F. E. Bilimoria ◽  
Ashvin Vaghani
Keyword(s):  
Triamcinolone Acetonide ◽  
Alopecia Areata ◽  
Platelet Rich Plasma ◽  
Pulse Therapy ◽  
Treatment Modalities ◽  
Systemic Corticosteroids ◽  
First Choice ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

<p class="abstract"><strong>Background:</strong> Alopecia areata (AA) is a common auto-immune condition, causing hair loss. This disease has limited treatment modalities. Through this study, comparison between established modalities of treatment such as oral mini pulse therapy, intralesional corticosteroids and platelet-rich plasma (PRP) as a newer modality has been done. The objective of the study was to evaluate the efficacy and safety of various treatment modalities in alopecia areata.</p><p class="abstract"><strong>Methods:</strong> 45 patients with alopecia areata presenting to the OPD of Dermatology, Dhiraj hospital, Pipariya were included in this study. It was conducted as a randomized prospective study for a period of 16 weeks. After taking informed consent, patients were randomly distributed into three treatment groups. Group 1 patients were treated with Tab. Betamethasone 0.1 mg/kg every Saturday and Sunday, Group 2 was treated with Inj. Triamcinolone acetonide 10 mg/ml for scalp and 2.5 mg/ml for eye brows and face was injected into deep dermis; Group 3 was treated with Dermaroller followed by application of activated platelet rich plasma (PRP). SALT score was calculated at first visit and 16 weeks. Regrowth was calculated using Mac Donald and Null Horis grading Scale at 16 weeks.<strong></strong></p><p class="abstract"><strong>Results:</strong> The SALT score reduced from 13.27 to 7.52 in Group 1, 13.93 to 8.16 in Group 2 and 42.32 to 21.12 in Group 3. Mean grade of regrowth of hairs observed was 3.47, 3.80, 2.93 in Group 1, 2, 3 respectively. The results were analysed using paired t test.</p><strong>Conclusions:</strong>Intralesional corticosteroids viz. triamcinolone acetonide still remains the first choice of therapy for AA in adults with limited involvement. Systemic corticosteroids give lower response than intralesional steroids. Platelet Rich Plasma (PRP) showed promising results, especially in children and in extensive involvement. Compared to other treatment modalities Inj. PRP is safe and with less side effects.<p> </p>

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.

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