scholarly journals The effect of A-PRP-therapy on reparative regeneration of bone tissue with acute bone fractures of the limbs

2019 ◽  
pp. 32-38
Author(s):  
A. N. Blazhenko ◽  
I. A. Rodin ◽  
O. N. Ponkina ◽  
M. L. Mukhanov ◽  
A. S. Samoilova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Bone Fractures ◽  
Platelet Rich Plasma ◽  
Control Group ◽  
Study Group ◽  
Reparative Osteogenesis ◽  
Results Of Treatment ◽  
Regeneration Of Bone Tissue ◽  
Fracture Consolidation ◽  
Regeneration Of Bone

Material and methods The study consisted of two parts – in the first part we studied the effect of A-PRP-therapy on the model of a comminuted fracture created in the operating room, an experimental study conducted on 40 Mature rabbits of the Flander breed, all animals were divided according to the principle of analogues into 2 groups (20 animals): in the study group – on the 5th day after osteotomy, platelet-rich plasma was injected into the fracture area, in the comparison group – the fusion occurred without the influence of any drugs. The second part presents the results of clinical testing of A-PRP-therapy, analyzed the results of treatment of 16 women with low-energy fractures of the distal radius metaepiphysis. The study group consisted of 6 patients whose surgical treatment was supplemented by A-PRP-therapy on 7, 14 days after surgery. The control group consisted of 10 patients who underwent surgical treatment without A-PRPtherapy.Results: The use of platelet-rich plasma to stimulate reparative osteogenesis in accute fractures reduces the time of fracture consolidation by 9.5±1.1%.Conclusion Platelet-rich plasma (PRP) to stimulate reparative osteogenesis is an inexpensive, easy to perform and effective procedure. The possibilities of application of this technology in traumatology and orthopedics require further research in order to create protocols for the Use of a-PRP-therapy to stimulate the maturation of bone calluses. Results The use of platelet-rich plasma to stimulate reparative osteogenesis in accute fractures reduces the time of fracture consolidation by 9.5±1.1%.Conclusion Platelet-rich plasma (PRP) to stimulate reparative osteogenesis is an inexpensive, easy to perform and effective alternative to the methods considered. The possibilities of application of this technology in traumatology and orthopedics require further research in order to create protocols for the use of PRPtherapy to stimulate the maturation of bone calluses. 

scholarly journals Reparative Bone Regeneration at Use of Local Antibacterial Carriers in Purulent Osteomyelitis (Experimental Study)

2014 ◽  
Vol 21 (3) ◽  
pp. 62-67
Author(s):  
S. A Erofeev ◽  
L. B Reznik ◽  
G. F Dzyuba ◽  
D. I Odarchenko
Keyword(s):  
Animal Experiment ◽  
Radical Resection ◽  
Reparative Regeneration ◽  
Control Group ◽  
Study Group ◽  
Salvage Resection ◽  
Regeneration Of Bone Tissue ◽  
Morphologic Data ◽  
Regeneration Of Bone ◽  
Tissue Defects

Efficacy of reinforcing local antibacterial carriers use upon the degree and terms of reparative regeneration of bone tissue defects resulted from osteomyelitis process was assessed in animal experiment (36 rabbits). In study group ( n =18) surgical treatment consisted of osteomyelitis focus salvage resection and installation of reinforcing local antibacterial carrier based on polymethyl methacrylate. In control group ( n =18) radical resection of the osteomyelitis focus with adjacent soft tissue structures was performed. In study group growth of microorganisms was not detected already on 28 th postoperative day while in control group the complete depression of pathogenic microflora was achieved only by day 50. Roentgenologic and morphologic data showed marked reparative regeneration in the zone of defect with formation of functionally mature callus under the effect of antibacterial carrier at terms up to 16 weeks.

scholarly journals Capabilities of gravitational surgery for improvement of treatment results in patients with diabetic foot syndrome

2018 ◽  
Vol 99 (3) ◽  
pp. 385-391
Author(s):  
M B Akhmedov ◽  
N S Abushov ◽  
E Dz Zakirdzaev ◽  
Dz V Kosaev ◽  
N I Babaev ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Lipoic Acid ◽  
Diabetic Foot ◽  
Perioperative Period ◽  
Diabetic Foot Syndrome ◽  
Control Group ◽  
Study Group ◽  
Treatment Results ◽  
Narcotic Analgesics ◽  
Results Of Treatment

Aim. Improvement of complex treatment results in patients with diabetic foot syndrome by introducing methods of gravitational surgery and α-lipoic acid. Methods. The results of treatment were analyzed for 558 patients with diabetic foot syndrome treated in Scientific Centre of Surgery named after M.A. Topchubashov (Baku, Azerbaijan) from 1988 to 2015. The age varied from 28 to 83 years. The patients included 416 men and 142 women. The control group included 90 patients who at the perioperative period underwent basic therapy including antibiotics, anticoagulants, antiaggregants, dextrans, angioprotectors, spasmolytics, corticosteroids, narcotic and non-narcotic analgesics. The study group included 468 patients, along with traditional therapy receiving efferent methods (plasmapheresis, ultraviolet blood irradiation, ozone therapy) and α-lipoic acid. 282 patients of the study group received outpatient treatment and 186 - complex inpatient surgical treatment. A comparative evaluation of the results was performed separately in three groups: angiopathy, neuropathy, angioneuropathy. The results were evaluated by clinical and instrumental examinations before and after treatment (6, 12, 60 months and more). Results. In the study group a satisfactory result of treatment was registered in 85.5% of patients, in the control group - in 62.2%, unsatisfactory in 14.5 and 37.8% of patients, respectively (p=0.046). Conclusion. The use of efferent methods and α-lipoic acid provided prompt elimination of numerous pathogenetic disorders observed in diabetes mellitus, decrease of amputation frequency and improvement of complex surgical treatment results in patients with diabetic foot syndrome.

scholarly journals Differentiated approach to radical surgical treatment of elderly patients with tumor diseases of the pancreatoduodenal zone

2021 ◽  
Vol 13 (2) ◽  
pp. 49-56
Author(s):  
Badri V. Sigua ◽  
Vyacheslav P. Zemlyanoy ◽  
Alexey V. Gulyaev ◽  
Malkhaz Yu. Tsikoridze ◽  
Evgeny A. Zakharov
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Comparison Group ◽  
Main Group ◽  
Control Group ◽  
Study Group ◽  
Tumor Diseases ◽  
Results Of Treatment ◽  
Repeated Surgery ◽  
Pancreatic Fistulas

BACKGROUND: In recent years, there has been a widespread increase in the incidence of tumors of the pancreatoduodenal zone, especially noticeable in the older age group. A decrease in the incidence of postoperative complications and mortality after pancreatoduodenal resection made it possible to expand the indications for surgical treatment of elderly and senile patients. AIM: Improvement of the immediate results of pancreatoduodenal resection in the treatment of elderly and senile patients suffering from tumor diseases of the pancreatoduodenal zone. MATERIALS AND METHODS: Pancreatoduodenal resection was performed in 61 elderly and senile patients with tumors of the pancreatoduodenal zone. The main group consisted of 32 patients, whose treatment was carried out in accordance with the developed algorithm for choosing a method for forming a pancreatodigestive anastomosis based on a scale for assessing the risk of developing pancreatic fistulas. The comparison group consisted of 29 patients in whom the method of forming a pancreatodigestive anastomosis was carried out in accordance with the preferences of the operator without taking into account the risk of developing a pancreatic fistula. RESULTS: In the main group, compared with the control group, pylorus-saving interventions were performed significantly more often 27 (84.4%) and 14 (48.3%) (p 0.01). There was also a decrease in the frequency of performing pancreaticojejunostomy 16 (50%) and 22 (75.9%) (p 0.05), due to the use of reservoir terminolateral pancreatojejunostomy 8 (25%) and 0, respectively (p 0.01). Postoperative complications were observed in 14 (43.8%) of the study group and in 21 (72.4%) patients of the comparison group (p 0.05). There was also a decrease in the incidence of postoperative pancreatic fistulas from 8 (27.6%) to 2 (6.2%) (p 0.05) in the study group. Repeated surgery was required in 5 (15.6%) patients of the main group and 11 (37.9%) in the comparison group (p 0.05). The lethal outcome was recorded in 3 (9.4%) patients of the main group and in 7 (24.1%) in the comparison group (p 0.05). CONCLUSIONS: The results of performing pancreatoduodenal resection in the treatment of elderly and senile patients can be comparable with the results of treatment of the general population. The use of the developed algorithm made it possible to reliably reduce the incidence of complications from 72.4 to 43.8% (p 0.05), postoperative pancreatic fistulas from 27.6 to 6.2% (p 0.05), as well as the frequency of repeated interventions. from 37.9 to 15.6 % (p 0.05). In addition, a downward trend in mortality was achieved from 24.1% to 9.4%.

scholarly journals Evolution of diagnosis and surgical treatment of intra-abdominal infiltrates, abscesses of primary and postoperative origin in patients

2021 ◽  
pp. 15-29
Author(s):  
V.V. Skyba ◽  
◽  
V.F. Rybalchenko ◽  
A.V. Ivanko ◽  
R.М. Borys ◽  
...  
Keyword(s):  
Duodenal Ulcer ◽  
Gastric Ulcer ◽  
Surgical Treatment ◽  
Abdominal Cavity ◽  
Postoperative Mortality ◽  
Multiple Organ ◽  
Long Term Results ◽  
Control Group ◽  
Study Group ◽  
Perforated Gastric Ulcer

Purpose – to improve the results of surgical treatment of patients with intra-abdominal infiltrates and abscesses through the introduction of the latest imaging methods and surgical technologies. Materials and methods. In the clinic of the Department of Surgical Diseases No 1, on the basis of the Surgery Center of the Kyiv City Clinical Hospital No. 1 from 2006 to 2019 218 patients with primary and secondary intra-abdominal infiltrates, abscesses and fluid formations were treated. The patients’ age ranged from 16 to 85 years. There were 107 (49.08%) male patients, 111 (50.92%) female patients. Depending on the time of hospitalization (by years), the patients were divided into two groups: the control group (CG) (2006–2012) 117 (53.67%) patients and the study group (SG) (2013–2019) 101 (46.33%) patients. The SG used the latest imaging technologies and improved methods of surgical treatment. Results. The patients were divided into two groups: primary in 191 (87.61%) and secondary postoperative infiltrates and abscesses in 27 (12.39%). The causes of primary infiltrates and abscesses were: complicated forms of appendicitis in 74 (33.94%), perforated stomach and duodenal ulcer in 48 (22.02%), complicated forms of cholecystitis in 69 (31.65%). Postoperative infiltrates and abscesses were observed in 27 (12.39%) patients who underwent urgent surgery: adgeolysis of adhesive ileus in 14 (6.42%) and complicated hernias of various localization in 13 (5.97%). Postoperative complications were diagnosed in 43 (19.72%) patients, of whom 34 (15.59%) from the surgical wound and 29 (15.18%) of the abdominal cavity, who required relaparotomy or laparoscopy, with destructive appendicitis in 10 (13.51%), perforated gastric ulcer and 12 duodenal ulcer in 6 (12.5%), destructive cholecystitis in 9 (13.04%), adhesive intestinal obstruction in 13 (19.12%) and with strangulated and complicated hernias in 14 (17.28%) of the examined patients. During relaparotomy, incompetence of the intestinal wall and intestinal sutures was established in 11 out of 32 patients, an ileostomy was imposed in 7, and cecostomy in 1 patient. Actually, in the control group, 8 (6.84%) patients died on the background of ongoing peritonitis, thrombosis of mesenteric vessels and multiple organ failure and concomitant ailments and in the study group 4 (3.96%) patients died. Conclusions. Surgical treatment is individualized depending on the disease, so with destructive appendicitis from 74 (38.74%) laparotomic in 42 (21.99%), laparoscopic in 32 (16.75%), and in 12 (6.28%) with conversion; perforated gastric ulcer and duodenal ulcer in 48 (25.13%) open laparotomy; with cholecystitis of 69 (36.13%) patients, 48 (25.13%) had laparotomy and 21 (11.00%) had laparoscopic examination. The use of the latest imaging and treatment technologies: Doppler ultrasonography, hydrojet scalpel and laparoscopy in 64 (33.51%), allowed to have better near and long-term results and to reduce postoperative mortality from 6.84% to 3.96%, with an average of 5.5%. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. The authors declare no conflicts of interests. Key words: destructive appendicitis, cholecystitis, perforated gastric ulcer and 12-duodenal ulcer, adhesive leakage, strangulated hernias, diagnosis and treatment.

scholarly journals Can flexible intramedullary nails provide proper fixation of long bone fractures in patients weighing over 100 pounds?

2019 ◽  
Vol 26 (1) ◽  
pp. 9-13
Author(s):  
David B. Frumberg ◽  
Devan J. Van Lanen-Wanek ◽  
Julio J. Jauregui ◽  
Vidushan Nadarajah ◽  
Emmanuel M. Illical
Keyword(s):  
Bone Fractures ◽  
Major Complication ◽  
Tibial Fractures ◽  
Control Group ◽  
Study Group ◽  
Intramedullary Nails ◽  
Biomechanical Models ◽  
Paediatric Patients ◽  
Select Group ◽  
Flexible Intramedullary Nails

Purpose: Length stable diaphyseal femur and tibial shaft fractures in paediatric patients may be fixed with flexible intramedullary nails (FINs) in selected paediatric patients. Previous studies based on biomechanical models have suggested that the forces of gait may overcome the stability of this construct in patients weighing more than 45 kg. Surgeons occasionally use FINs for fixation in patients outside this limit. The purpose of this study was to evaluate whether FINs could be used in paediatric patients weighing over 45 kg without increasing the rate of complications. Methods: A retrospective cohort review was performed for 12 patients weighing over 45 kg with femoral or tibial fractures treated with FINs, matched 1:2 for gender and bone type with 24 patients weighing less than 45 kg; also with femoral or tibial fractures treated with FINs over the same period. Results: There was no significant differences in rate of major complication or increases in angulation between the study and control group. The study group had major complication (8.3%) of hypertrophic nonunion in the tibia, and the control group had one major complication (4.2%) of increased anterior bowing in the femur. The odds ratio of developing a major complication in the study group was 2:1 which was not significant (p = 0.06). Conclusions: FINs can be considered as a treatment option for fixation of femoral and tibial fractures in a select group of paediatric patients weighing more than 45 kg. Clinical and functional outcomes measurements in larger sample sizes are needed before making any definitive conclusions.

scholarly journals Laboratory Tests in Assessing the Risk of Heterotopic Ossification

Medicina ◽  
2020 ◽  
pp. 1-10
Author(s):  
M. V. Stogov ◽  
◽  
Y. P. Soldatov ◽  
G. M. Chibirov ◽  
E. A. Kireeva ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Heterotopic Ossification ◽  
Laboratory Tests ◽  
Bone Fractures ◽  
Length Of Hospital Stay ◽  
Main Group ◽  
Control Group ◽  
Cut Point ◽  
Elbow Fractures ◽  
Degree Of Risk

Heterotopic ossification (HO) is a common complication after injuries and orthopedic interventions. The aim of the study is to assess the feasibility of using laboratory tests to predict and determine the degree of risk of developing heterotopic ossification in patients after surgical treatment of bone fractures. Materials and methods. The results of surgical treatment of the effects of a humeral fracture in 25 patients were analyzed. In retrospect, all patients were divided into two groups: the main group included patients (n=9), who after surgery of the elbow fractures developed complications in the form of HO elbow para-articular tissues. The control group (n=16) consisted of patients who in the year after elbow fractures surgery developed no complications in the form of HO. Blood tests were performed in all patients prior to treatment, 7 days after surgery and at discharge from the hospital. The two groups of comparison (main and control) were comparable in age, time elapsed from the injury, the type of surgery performed, and length of hospital stay. Results. As a result of the study three potential predictors of HO were distinguished by laboratory tests in patients of the main group at the time of discharge: 1) high values of lactate (cut point with 100% sensitivity of the test – 2.32 mmol/l); 2) high values of hemoglobin (cut point with 100% sensitivity of the test – 130 g/l); 3) decreased activity of bone isoenzyme of acid phosphatase (cut point with 100% sensitivity of the test – 4.4 U/l). The odds ratio for a positive result of all three tests for predicting heterotopic ossification is 15.0. Conclusion. The identified laboratory tests allow to predict and determine the degree of risk of heterotopic ossification in patients after treatment of the effects of bone fractures.

scholarly journals Surgical treatment of acetabular fractures

TRAUMA ◽  
2021 ◽  
Vol 22 (4) ◽  
pp. 46-51
Author(s):  
I.I. Trufanov
Keyword(s):  
Surgical Treatment ◽  
Road Traffic ◽  
Platelet Rich Plasma ◽  
Clinical Effectiveness ◽  
Postoperative Management ◽  
Main Group ◽  
The Body ◽  
Social Adaptation ◽  
Acetabular Fractures ◽  
Control Group

Background. Acetabular fractures are severe intra-articular injuries that require anatomical reposition and early function, but they are often complicated by degenerative changes in both the acetabulum and the femoral head, leading to the development of post-traumatic coxarthrosis. The purpose was to study the clinical effectiveness of surgical treatment and postoperative management of patients using autologous platelet-rich plasma in patients with fractures of the acetabulum. Materials and methods. Twenty-eight patients with acetabular fractures of various degrees were operated at the City Emergency Hospital of Zaporizhzhia and the Municipal Clinical Hospital No 9 from 2017 to 2019. Gender composition: 22 men (78.57 %), 6 women (21.43 %), average age 46.64 ± 2.21 years, with a 95% confidence interval 42.31–50.96. Nineteen victims (67.86 %) had road traffic injuries, 7 (25 %) domestic injuries, and 2 (7.14 %) had industrial injuries. Results. In the main group of patients treated with platelet-rich plasma, radiologically visible adhesion of the injured area after 8 weeks occurred in 10 people (83.4 %). In one person (8.3 %), the adhesion occurred after 12, and in another (8.3 %) — 16 weeks after surgery. In the control group, adhesions at 8th week were registered in 14 patients (60.87 %), in 8 (34.78 %) — at 16th week. Given the general recovery of the body in the main group, the activation and social adaptation of patients occurred 2–3 weeks earlier. The assessment was performed radiologically and by the criteria of functional recovery.

scholarly journals THE RESULTS OF SURGICAL TREATMENT IN PATIENTS WITH DIFFUSE POSTOPERATIVE PERITONITIS COMPLICATED WITH SEVERE ABDOMINAL SEPSIS

2015 ◽  
Vol 1 (1) ◽  
pp. 28-32
Author(s):  
F. V. Galimzyanov ◽  
T. M. Bogomyagkova ◽  
M. I. Prudkov ◽  
M. A. Lazareva
Keyword(s):  
Surgical Treatment ◽  
Abdominal Cavity ◽  
Treatment Algorithm ◽  
Abdominal Sepsis ◽  
Postoperative Peritonitis ◽  
Control Group ◽  
Complex Treatment ◽  
Results Of Treatment ◽  
Clinical Indications ◽  
Surgical Methods

Aim of investigation: improvement the results of treatment in patients with diffuse postoperative peritonitis complicated with severe abdominal sepsis. Materials and methods. The present investigation is performed in 132 patients. According to the way of treatment the patients were divided into 2 groups: the first (control) group included 56 patients with diffuse postoperative peritonitis, severe abdominal sepsis who got complex treatment, sanations and abdominal cavity drainage according to “clinical indications”. The second (main) group included 76 patients with diffuse postoperative peritonitis, severe abdominal sepsis who got complex treatment and a surgical treatment algorithm which we have worked out. The patients were in severe condition with marked multiple organ failure, with equal risk of lethality in both groups. Surgical methods included laparotomy, relaparotomy, sanations, abdominal cavity drainage, mini-laparotomy. Results: application of the elaborated algorithm for surgical treatment of patients with diffuse postoperative peritonitis and severe abdominal sepsis made it possible to improve the results of treatment. Intensive ward stay was 1.4 times less accordingly, 10.0 ± 1.4 days and 14.0 ± 1.9 days (p < 0.1). Hospital stay was 3.3 days less accordingly, 29.0 ± 0.9 days and 32.3 ± 1.2 days (p < 0.05). Lethality was 2.5 times less as compared with abdominal cavity sanations according to “clinical indications”, accordingly 21.1 and 51.8 % (p < 0.01).

scholarly journals Surgical treatment of multi-valve heart disease of infective endocarditis

2021 ◽  
pp. 40-49
Author(s):  
Khamidulla ABDUMADJIDOV ◽  
Hijran BURANOV ◽  
Iskender BAYBEKOV ◽  
Bois SAIDKHANOV ◽  
Abdulla ALIMDJANOV
Keyword(s):  
Heart Disease ◽  
Surgical Treatment ◽  
Infective Endocarditis ◽  
Preventive Measures ◽  
Clinical Results ◽  
Control Group ◽  
Study Group ◽  
X Rays ◽  
Infected Area ◽  
Valve Heart Disease

Peculiarities of diagnosis and results of surgical treatment of multi-valve heart disease in infective endocarditis. Analyze data and clinical results operated 156 patients with infective endocarditis, of which 85 were men (56.5%), and women -71 (45.5%). Age Our patients ranged from 12 to 68 (mean 32.76 ± 1.6) years. Diagnosis was based on the classiϐication and criteria Durack D.T. The patients were divided into 2 groups: group 1, 89 (57.4%) patients who underwent a complex developed by the authors of antibiotic therapy, treatment and preventive measures. 2-group 67 (42.6%) patients who underwent the traditional surgical treatment scheme. The diagnosis used: electrocardiography (ECG), X-rays from Skopje, transthoracic echocardiography (TTEHOKG) - all patients, transesophageal echocardiography (TEHOKG) - at 40.5%; coronaroventriculography (CVG) and angiocardiography (ACG) - at 12.65%; blood culture study in 38.6% of patients, with light gistrology electron microscopy (LEM) - in 47.5% of patients.Intraoperative treatment - preventive measures (TPM) were as follows; mechanical and chemical sanitation of the infected area of the heart; valve implantation antibakteriyalnymi properties; hyperthermic perfusion; anti microbial therapy, including anti-fungal agents. Application of the above measures could reduce mortality in the study group and 5.1% in the control group - 9.3%. In dynamics, declined to 3.9% in the last Godi mortality in the study group.

scholarly journals Algorithm for the prevention of pulmonary complications after thoracic surgeries

2021 ◽  
Vol 25 (3) ◽  
pp. 462-465
Author(s):  
O. Yu. Usenko ◽  
A. V. Sydiuk ◽  
O. E. Sydiuk ◽  
A. S. Klimas ◽  
G. Yu. Savenko ◽  
...  
Keyword(s):  
Thoracic Surgery ◽  
Pulmonary Complications ◽  
Control Group ◽  
Study Group ◽  
Thoracic Cavity ◽  
Term Survival ◽  
Statistical Software ◽  
Results Of Treatment ◽  
Retrospective Comparison ◽  
The Difference

Annotation. The biggest problem after operations on the thoracic cavity is the number of pulmonary complications (according to various authors 26-38% of cases). Despite the development of numerous methods for the prevention and treatment of these complications, they remain one of the leading causes of hospital mortality and may be an independent risk factor for worse long-term survival. Therefore, the aim of the work was to improve the results of treatment of patients after operations on the thoracic cavity by developing an algorithm for anesthesia for perioperative prevention of pulmonary complications. Participated in the study 192 patients with diseases of the thoracic cavity (esophagus, lungs, mediastinum), operated on in the thoracoabdominal department of the National Institute of Surgery and Transplantology named after O.O. Shalimov. Retrospective comparison group - 96 patients after thoracic surgery, which used conventional methods of perioperative management. The study group consisted of 96 patients after thoracic surgery, who used a perioperative anesthesia algorithm for the prevention of pulmonary complications. Statistical software EZR v. Was used for statistical calculations. 1.54 (graphical user interface for statistical software R version 4.0.3, R Foundation for Statistical Computing, Vienna, Austria). When conducting a multifactor analysis, it was found that the proposed method of prevention of pulmonary complications can reduce (p=0.001) the risk of development, HS=0.27 (95% CI 0.13-0.58) compared with the control group (with standardization by sex, weight, ASA of the patient). Pulmonary complications developed in 33 (34.4%) patients of the control group and in 13 (13.5%) patients of the study group, the difference was statistically significant, p=0.001. Thus, the application of the proposed technique reduces (p = 0.001) the risk of complications, BP=0.39 (95% CI 0.22 - 0.70) compared to traditional methods.

Sign in / Sign up

Export Citation Format

Share Document