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Evidence-based recommendations for treatment with methotrexate in rheumatic disorders.

https://arctichealth.org/en/permalink/ahliterature139626
Source
Dan Med Bull. 2010 Oct;57(10):A4190
Publication Type
Article
Date
Oct-2010
Author
Ole Rintek Madsen
Mikkel Faurschou
Anne Gitte Loft
Inge Juul Sørensen
John Bonde Knudsen
Bo Baslund
Annette Hansen
Michael Sejer Hansen
Mikkel Østergaard
Author Affiliation
Department of Internal Medicine C/Rheumatology, Copenhagen University Hospital Gentofte, 2900 Hellerup, Denmark. rintek@dadlnet.dk
Source
Dan Med Bull. 2010 Oct;57(10):A4190
Date
Oct-2010
Language
English
Publication Type
Article
Keywords
Adult
Antirheumatic Agents - therapeutic use
Delphi Technique
Denmark
Evidence-Based Medicine
Female
Health Status Indicators
Health Surveys
Humans
Internationality
Male
Methotrexate - therapeutic use
Middle Aged
Practice Guidelines as Topic
Questionnaires
Rheumatic Diseases - drug therapy - pathology
Rheumatology - trends
Abstract
The aim of this study was to develop 3E (Evidence, Expertise, Exchange) recommendations (RCs) on the use of methotrexate in rheumatic disorders and to assess the agreement among Danish rheumatologists.
Based on a systematic literature review and Delphi votes, national and multinational (MN) RCs were developed by 751 rheumatologists from 17 countries including Denmark, and the degree of agreement among the participants was assessed. Subsequently, a survey regarding the agreement on the MN RCs was sent to all Danish rheumatologists.
A total of 24 Danish RCs were elaborated by 43 rheumatologists at a national meeting. 71-100% (median 94%) of the participants agreed with each of the RCs. A total of 73 rheumatologists answered the survey on the ten MN RCs. On numerical rating scales with values ranging from zero to ten, the median agreement score for each of these RCs ranged from eight to ten. The RCs were already applied in daily practice by 70-100% (median 91%) of the specialists. Any direct conflict between the national and MN RCs was not evident.
Based on evidence and expert opinion in a MN approach, national and MN RCs on methotrexate therapy were developed and a high level of agreement among Danish rheumatologists was evidenced.
PubMed ID
21040680 View in PubMed
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High incidence of potentially virus-induced malignancies in systemic lupus erythematosus: a long-term followup study in a Danish cohort.

https://arctichealth.org/en/permalink/ahliterature130948
Source
Arthritis Rheum. 2011 Oct;63(10):3032-7
Publication Type
Article
Date
Oct-2011
Author
Lene Dreyer
Mikkel Faurschou
Mette Mogensen
Søren Jacobsen
Author Affiliation
Department of Rheumatology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. lene.dreyer@dadlnet.dk
Source
Arthritis Rheum. 2011 Oct;63(10):3032-7
Date
Oct-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Child
Denmark - epidemiology
Female
Follow-Up Studies
Humans
Incidence
Lupus Erythematosus, Systemic - complications - epidemiology
Male
Middle Aged
Neoplasms - epidemiology - etiology
Papillomavirus Infections - complications - epidemiology
Registries
Risk
Abstract
Patients with systemic lupus erythematosus (SLE) seem to experience an increased prevalence of oncogenic virus infections. The aim of the present study was to investigate whether SLE patients have an increased risk of virus-associated malignancies, defined as malignancies potentially caused by virus infection.
A hospital-based cohort of 576 SLE patients was linked to the Danish Cancer Registry. The cohort was followed up for malignancies from the date of SLE diagnosis, and standardized incidence ratios (SIRs) were calculated for various forms of cancer.
The median duration of followup was 13.2 years. Compared to the general population, the patients experienced an increased overall risk of cancer (SIR 1.6 [95% confidence interval (95% CI)] 1.2-2.0). We observed an increased risk of virus-associated cancers combined (SIR 2.9 [95% CI 2.0-4.1]). Among human papillomavirus (HPV)-associated malignant and premalignant conditions, high risk was found for anal cancer (SIR 26.9 [95% CI 8.7-83.4]), vaginal/vulvar cancer (SIR 9.1 [95% CI 2.3-36.5]), epithelial dysplasia/carcinoma in situ of the uterine cervix (SIR 1.8 [95% CI 1.2-2.7]), and nonmelanoma skin cancer (SIR 2.0 [95% CI 1.2-3.6]). Increased SIRs were also found for other potentially virus-induced cancer types (liver cancer SIR 9.9 [95% CI 2.5-39.8], bladder cancer SIR 3.6 [95% CI 1.4-9.7], and non-Hodgkin's lymphoma SIR 5.0 [95% CI 1.9-13.3]).
The patients in this SLE cohort experienced an increased risk of HPV-associated tumors and other potentially virus-induced cancers during long-term followup. Our findings call for clinical alertness to oncogenic virus infections in SLE patients.
PubMed ID
21953088 View in PubMed
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High risk of ischemic heart disease in patients with lupus nephritis.

https://arctichealth.org/en/permalink/ahliterature131694
Source
J Rheumatol. 2011 Nov;38(11):2400-5
Publication Type
Article
Date
Nov-2011
Author
Mikkel Faurschou
Lene Mellemkjaer
Henrik Starklint
Anne-Lise Kamper
Ulrik Tarp
Anne Voss
Søren Jacobsen
Author Affiliation
Department of Rheumatology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. mikkelf@dadlnet.dk
Source
J Rheumatol. 2011 Nov;38(11):2400-5
Date
Nov-2011
Language
English
Publication Type
Article
Keywords
Adult
Angina Pectoris - epidemiology
Biopsy
Cohort Studies
Denmark
Female
Follow-Up Studies
Humans
Kidney - pathology
Lupus Nephritis - complications - pathology
Male
Myocardial Infarction - epidemiology
Myocardial Ischemia - epidemiology
Retrospective Studies
Risk factors
Abstract
To investigate the occurrence of ischemic heart disease (IHD) in a cohort of 104 Danish patients with biopsy-proven lupus nephritis (LN).
Information on all hospitalizations in Denmark for IHD between 1977 and 2006 was obtained from the Danish National Hospital Register. Occurrence of IHD after date of first renal biopsy in the LN cohort was compared to the occurrence of IHD in the general population by calculation of standardized ratios of observed to expected events (O:E ratios) for different manifestations of IHD registered during inpatient and outpatient hospital visits.
The median duration of followup was 14.7 (range 0.1-30.0) years. Thirty-one first-time hospitalizations for IHD occurred in the cohort, yielding an overall O:E ratio for IHD of 6.8 (95% CI 4.6-9.7). Increased risks were found for angina pectoris (O:E ratio 6.0, 95% CI 3.0-11), myocardial infarction (O:E ratio 7.9, 95% CI 3.8-15), and other IHD-related diagnoses combined (O:E ratio 6.9, 95% CI 3.3-13). A high IHD risk was observed for patients aged
PubMed ID
21885497 View in PubMed
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Incidence of Systemic Lupus Erythematosus and Lupus Nephritis in Denmark: A Nationwide Cohort Study.

https://arctichealth.org/en/permalink/ahliterature287567
Source
J Rheumatol. 2016 Jul;43(7):1335-9
Publication Type
Article
Date
Jul-2016
Author
Marie-Louise F Hermansen
Jesper Lindhardsen
Christian Torp-Pedersen
Mikkel Faurschou
Søren Jacobsen
Source
J Rheumatol. 2016 Jul;43(7):1335-9
Date
Jul-2016
Language
English
Publication Type
Article
Keywords
Adult
Aged
Cohort Studies
Denmark - epidemiology
Female
Humans
Incidence
Lupus Erythematosus, Systemic - epidemiology
Lupus Nephritis - epidemiology
Male
Middle Aged
Prevalence
Abstract
To determine the incidence of systemic lupus erythematosus (SLE) and SLE with concomitant or subsequent lupus nephritis (LN) in Denmark during 1995-2011, using data from the Danish National Patient Registry (NPR).
To assess the incidence of SLE, we identified all persons aged = 18 years in the NPR with at least 1 International Classification of Diseases, 10th ed (ICD-10) code of SLE and at least 365 days of followup under this diagnosis. Identification of LN cases was based on fulfillment of these criteria and = 1 registration under an ICD-10 code of nephritis concomitantly with or after first SLE registration.
The overall annual incidence rate per 100,000 for SLE was 2.35 (95% CI 2.24-2.49); 0.69 (95% CI 0.60-0.78) for men and 3.96 (95% CI 3.75-4.17) for women. For LN, the mean annual incidence rate per 100,000 was estimated to be 0.45 (95% CI 0.38-0.53); 0.20 (95% CI 0.13-0.28) for men and 0.69 (95% CI 0.57-0.83) for women. The differences in SLE incidence rates between sexes decreased by age, and the incidence did not differ between men and women after the age of 60 years for LN. The estimated incidences showed no trends by calendar time. Estimated overall point prevalence (December 31, 2011) per 100,000 was 45.2 (95% CI 43.3-47.4) and 6.4 (95% CI 5.7-7.2) for SLE and LN, respectively.
Our Danish population-based data showed a stable incidence of SLE and LN. As expected, we found higher incidence rates among women than among men, particularly in younger persons.
PubMed ID
27134247 View in PubMed
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Mortality in patients with giant cell arteritis.

https://arctichealth.org/en/permalink/ahliterature261232
Source
Rheumatology (Oxford). 2015 Jan;54(1):139-43
Publication Type
Article
Date
Jan-2015
Author
Bo Baslund
Marie Helleberg
Mikkel Faurschou
Niels Obel
Source
Rheumatology (Oxford). 2015 Jan;54(1):139-43
Date
Jan-2015
Language
English
Publication Type
Article
Keywords
Aged
Cohort Studies
Denmark - epidemiology
Female
Giant Cell Arteritis - epidemiology - mortality
Humans
Male
Registries
Regression Analysis
Retrospective Studies
Risk factors
Survival Rate
Abstract
The aim of this study was to examine whether GCA is associated with increased mortality.
We conducted a nationwide population-based cohort study including all individuals who between 1993 and 2011 were registered in the Danish National Hospital Register and the Danish Pathology Register with a biopsy-proven diagnosis of GCA (n = 1787). Through the Danish Civil Registration System we identified a comparison cohort of 33 953 persons from the background population, individually matched on age and sex. Data on causes of death were obtained from the Danish Registry of Causes of Death. We used Poisson regression to determine mortality rate ratios as estimates of relative risk of death and specific causes of death.
Compared with the general population, the relative risk (RR) of death in patients diagnosed with GCA was 1.17 (95% CI 1.01, 1.36) and 1.22 (95% CI 1.05, 1.41) 0-2 years and >10 years after diagnosis, respectively, whereas we observed no increased mortality during the follow-up period of 2-10 years [RR 0.96 (95% CI 0.88, 1.05)]. The increased mortality during the first 2 years of follow-up was mainly due to diseases of the circulatory system, including aortic aneurisms.
GCA is associated with slightly increased early and late mortality.
PubMed ID
25122725 View in PubMed
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Plasma ficolin levels and risk of nephritis in Danish patients with systemic lupus erythematosus.

https://arctichealth.org/en/permalink/ahliterature281679
Source
Clin Rheumatol. 2017 Feb;36(2):335-341
Publication Type
Article
Date
Feb-2017
Author
Nima Tanha
Katrine Pilely
Mikkel Faurschou
Peter Garred
Søren Jacobsen
Source
Clin Rheumatol. 2017 Feb;36(2):335-341
Date
Feb-2017
Language
English
Publication Type
Article
Keywords
Adult
Aged
Biopsy
Denmark
Female
Follow-Up Studies
Glycoproteins - blood
Humans
Immunity, Innate
Kidney Failure, Chronic - blood - complications
Lectins - blood
Lupus Erythematosus, Systemic - blood - complications - epidemiology
Male
Middle Aged
Nephritis - blood - complications - epidemiology
Risk
Treatment Outcome
Young Adult
Abstract
Given the scavenging properties of ficolins, we hypothesized that variation in the plasma concentrations of the three ficolins may be associated with development of lupus nephritis (LN), type of LN, end-stage renal disease (ESRD), and/or mortality among patients with systemic lupus erythematosus (SLE). SLE patients attending a Danish tertiary rheumatology referral center were included. Plasma concentrations of ficolin-1, ficolin-2, and ficolin-3 were determined and dichotomized by the median into high and low. LN was defined by clinical criteria; type of LN by renal biopsy; ESRD follow-up time was defined as time from onset of LN to the development of ESRD or censoring at the end of follow-up. The study included 112 SLE patients with median disease duration of 8 years of which 53 (47%) had LN at the time of inclusion. During a median follow-up of 10 years, five patients developed ESRD. Sixteen patients died. Odds ratios (ORs) of LN were 1.2 (95% CI: 0.6-2.7), 4.1 (95% CI: 1.7-9.7), and 0.9 (95% CI: 0.4-2.0) for patients with low ficolin-1, ficolin-2, and ficolin-3 plasma levels, respectively. The distribution of histological classes differed between patients with high and low plasma levels of ficolin-1 (p = 0.009). Patients with high ficolin-1 plasma levels had an increased risk of ESRD. There was no association between the levels of the analyzed plasma ficolins and mortality. Low plasma ficolin-2 levels were associated with an increased risk of having LN. High plasma levels of ficolin-1 were associated with the histological subtype of LN and development of ESRD.
PubMed ID
27981461 View in PubMed
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A population-based study of Takayasu´s arteritis in eastern Denmark.

https://arctichealth.org/en/permalink/ahliterature136359
Source
Clin Exp Rheumatol. 2011 Jan-Feb;29(1 Suppl 64):S40-2
Publication Type
Article
Author
Lene Dreyer
Mikkel Faurschou
Bo Baslund
Author Affiliation
Department of Rheumatology, Rigshospitalet, Copenhagen, Denmark. lene.dreyer@dadlnet.dk
Source
Clin Exp Rheumatol. 2011 Jan-Feb;29(1 Suppl 64):S40-2
Language
English
Publication Type
Article
Keywords
Adrenal Cortex Hormones - therapeutic use
Adult
Age of Onset
Aged
Asian Continental Ancestry Group - statistics & numerical data
Denmark - epidemiology
European Continental Ancestry Group - statistics & numerical data
Female
Humans
Immunosuppressive Agents - therapeutic use
Incidence
Male
Middle Aged
Prognosis
Registries
Takayasu Arteritis - diagnosis - drug therapy - epidemiology - ethnology - mortality
Time Factors
Young Adult
Abstract
To evaluate the annual incidence of Takayasu's arteritis (TA) in eastern Denmark and to describe the clinical course of Danish TA patients.
All patients living in the eastern part of Denmark and registered with a first-time hospital discharge diagnosis of TA between 1990 and 2009 were identified. The TA diagnoses of the identified patients were confirmed by medical records review.
A total of 19 TA patients (3 males and 16 females) were included in the study. Two patients were of Asian origin, while 17 were Caucasians. The median patient age at the time of the TA diagnosis was 36 years (range: 19-66 years), and the median time interval between the onset of symptoms attributable to TA and the diagnosis of the disease was 11 months (range: 1-50 months). The estimated mean annual incidence of TA was 0.4 (95% CI: 0.25-0.62) per million. No deaths occurred during a median follow-up period of 11.5 years (range: 0.5-19.5 years). Eleven patients (58%) experienced one or more serious vascular events due to TA. Among these, eight patients developed their vascular complications before the vasculitis diagnosis was established.
In the current cohort, serious vascular events affected a large proportion of patients before the TA diagnosis was made or during follow-up. The incidence of TA in Denmark seems to be comparable to the incidence in other regions of Europe.
PubMed ID
21385546 View in PubMed
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Prolonged risk of specific malignancies following cyclophosphamide therapy among patients with granulomatosis with polyangiitis.

https://arctichealth.org/en/permalink/ahliterature266924
Source
Rheumatology (Oxford). 2015 Aug;54(8):1345-50
Publication Type
Article
Date
Aug-2015
Author
Mikkel Faurschou
Lene Mellemkjaer
Anne Voss
Kresten Krarup Keller
Ib Tonder Hansen
Bo Baslund
Source
Rheumatology (Oxford). 2015 Aug;54(8):1345-50
Date
Aug-2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Antirheumatic Agents - adverse effects - therapeutic use
Cohort Studies
Cyclophosphamide - adverse effects - therapeutic use
Denmark
Dose-Response Relationship, Drug
Female
Follow-Up Studies
Granulomatosis with Polyangiitis - drug therapy
Humans
Incidence
Male
Middle Aged
Registries
Retrospective Studies
Risk factors
Skin Neoplasms - epidemiology
Treatment Outcome
Urinary Bladder Neoplasms - epidemiology
Young Adult
Abstract
The long-term cancer risk for patients treated for granulomatosis with polyangiitis (GPA) is not well characterized. We assessed the risk of early and late-occurring cancers among 293 patients diagnosed with GPA from 1973 to 1999 and followed throughout 2010.
Cancer incidence in the cohort was determined by linkage with the Danish Cancer Registry and compared with that in the general population by calculation of standardized incidence ratios (SIRs).
The median duration of follow-up was 9.7 years (range 0-36). Seventy-three cancers occurred, of which 30 were non-melanoma skin cancers (NMSCs) and 11 were bladder carcinomas. A high occurrence of NMSC was observed from the second year of follow-up onwards, with a SIR of 7.0 (95% CI 2.3, 16) for cases diagnosed =20 years after GPA. The incidence of bladder cancer increased after 5-9, 10-14 and 15-19 years of follow-up, with SIR estimates for these latency periods of 5.3 (95% CI 1.1, 15), 14.4 (95% CI 5.3, 31) and 10.5 (95% CI 1.2, 38), respectively. The incidence of myeloid leukaemia was significantly increased during years 5-9 [SIR 23.9 (95% CI 2.7, 86)]. Increased incidence of NMSC, bladder cancer and myeloid leukaemia was observed among patients exposed to cumulative CYC doses >36 g, while the only malignancy type observed in excess among those treated with lower CYC doses was NMSC. The cancer risk among CYC-naive patients was not significantly increased.
GPA patients experience a greater than expected number of specific malignancies following conventional therapies. Our analyses demonstrate a substantially increased risk of very late-occurring NMSC and bladder cancer in this patient group.
Notes
Comment In: Rheumatology (Oxford). 2015 Aug;54(8):1339-4126018438
PubMed ID
25234661 View in PubMed
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The risk of cardiovascular morbidity and cardiovascular mortality in systemic lupus erythematosus and lupus nephritis: a Danish nationwide population-based cohort study.

https://arctichealth.org/en/permalink/ahliterature285242
Source
Rheumatology (Oxford). 2017 May 01;56(5):709-715
Publication Type
Article
Date
May-01-2017
Author
Marie-Louise Hermansen
Jesper Lindhardsen
Christian Torp-Pedersen
Mikkel Faurschou
Søren Jacobsen
Source
Rheumatology (Oxford). 2017 May 01;56(5):709-715
Date
May-01-2017
Language
English
Publication Type
Article
Keywords
Adult
Cardiovascular Diseases - etiology - mortality
Case-Control Studies
Denmark - epidemiology
Female
Humans
Lupus Erythematosus, Systemic - complications - mortality
Lupus Nephritis - complications - mortality
Male
Middle Aged
Myocardial Infarction - etiology - mortality
Risk factors
Stroke - etiology - mortality
Abstract
. To assess the role of LN as a risk factor for myocardial infarction (MI), stroke and cardiovascular mortality (CVM) in patients with SLE.
. The study was conducted using individual-level data from multiple nationwide registers. We identified a cohort of patients diagnosed with SLE and further determined if they had a diagnosis of LN during 1995-2011. Each SLE patient was matched with five population controls. Hazard ratios (HRs) were calculated to measure the risk of MI, stroke and CVM in SLE patients relative to population controls and in SLE patients with relative to without LN.
. We identified 1644 SLE patients with incident SLE; 233 of these patients had a diagnosis of incident LN during follow-up. The number of events in the SLE cohort was: 42 (MI), 74 (stroke) and 56 (CVM). For MI, the HR was 2.2 (95% CI: 1.4, 3.4) in SLE without LN and 18.3 (95% CI: 5.1, 65) in SLE with LN. The HR for LN was 8.5 (95% CI: 2.2, 33; P = 0.002). For stroke, HRs were 2.1 (95% CI: 1.5, 2.9) and 4.1 (95% CI: 1.9, 8.7) in SLE without and with LN, respectively, and we found no significant association with LN (P = 0.115). For CVM, the respective HRs were 1.6 (95% CI: 1.1, 2.4) and 7.8 (95% CI: 3.0, 20). The corresponding HR for LN was 4.9 (95% CI: 1.8, 13.7; P = 0.002).
. The risk of MI and CVM, but not of stroke, is significantly higher in SLE patients with LN than SLE patients without LN.
PubMed ID
28053276 View in PubMed
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Treatment of orbital inflammation with rituximab in Wegener's granulomatosis.

https://arctichealth.org/en/permalink/ahliterature127660
Source
Clin Exp Rheumatol. 2012 Jan-Feb;30(1 Suppl 70):S7-10
Publication Type
Article
Author
Bo Baslund
Anne Katrine Wiencke
Niels Rasmussen
Mikkel Faurschou
Peter Bjerre Toft
Author Affiliation
Department of Rheumatology, Rigshospitalet, Copenahgen, Denmark. bbaslund@gmail.com
Source
Clin Exp Rheumatol. 2012 Jan-Feb;30(1 Suppl 70):S7-10
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antibodies, Monoclonal, Murine-Derived - therapeutic use
Denmark
Female
Humans
Immunologic Factors - therapeutic use
Inflammation - diagnosis - drug therapy - immunology - physiopathology
Male
Middle Aged
Orbital Diseases - diagnosis - drug therapy - immunology - physiopathology
Physical Examination
Recovery of Function
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Visual Acuity - drug effects
Wegener Granulomatosis - diagnosis - drug therapy - immunology - physiopathology
Young Adult
Abstract
To study the efficacy of rituximab therapy for the treatment of orbital inflammation in patients with Wegener's granulomatosis (WG).
Ten WG patients with orbital inflammation were included in this case-series. None had symptoms suggestive of extra-orbital disease activity. Immunosuppressive medication (mycophenolate and prednisolone) was administered to 3 patients at the time of rituximab therapy. Three patients had previously been treated with anti-tumour-necrosis-factor-alpha antibodies, and one of these patients had also received cyclophosphamide as treatment for orbital inflammation. All patients were treated with 1000 mg of rituximab administered twice with an interval of 14 days between the infusions. Six months after therapy, a physical examination and a control computerised tomography (CT) scan was performed.
All patients had orbital inflammation demonstrated by CT-scan before treatment (3 had bilateral and 7 unilateral orbital involvement). Orbital symptoms at study baseline included pain, pressure sensation behind the eyes, epiphora, diplopia, and affection of the visual acuity. Nine out of ten patients experienced subjective improvement. Four patients (seven eyes) with visual impairment responded to therapy, and the improvement in visual acuity was sustained throughout follow-up (median duration of follow-up: 17 months; range: 6-18 months). At the time of the control CT-scan, size-reduction of the orbital mass was observed in two patients, while the size of the orbital mass was unchanged in eight patients.
Rituximab therapy has positive effects on symptoms, visual acuity and/or granuloma size in some WG patients with orbital inflammation. Treatment with rituximab should be considered in WG patients with this serious manifestation of the disease.
PubMed ID
22272561 View in PubMed
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10 records – page 1 of 1.