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A 52-week prospective, cohort study of the effects of losartan with or without hydrochlorothiazide (HCTZ) in hypertensive patients with metabolic syndrome.

https://arctichealth.org/en/permalink/ahliterature145472
Source
J Hum Hypertens. 2010 Nov;24(11):739-48
Publication Type
Article
Date
Nov-2010
Author
N. Racine
P. Hamet
J S Sampalis
N. Longo
N. Bastien
Author Affiliation
Department of Medicine, Montreal Heart Institute, Montréal, Québec, Canada.
Source
J Hum Hypertens. 2010 Nov;24(11):739-48
Date
Nov-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Angiotensin II Type 1 Receptor Blockers - adverse effects - therapeutic use
Antihypertensive Agents - adverse effects - therapeutic use
Biological Markers - blood
Blood Glucose - drug effects - metabolism
Blood Pressure - drug effects
Calcium Channel Blockers - therapeutic use
Canada
Chi-Square Distribution
Diabetes Mellitus - blood - chemically induced
Diuretics - adverse effects - therapeutic use
Drug Therapy, Combination
Female
Hemoglobin A, Glycosylated - metabolism
Humans
Hydrochlorothiazide - adverse effects - therapeutic use
Hypertension - blood - complications - drug therapy - physiopathology
Linear Models
Losartan - adverse effects - therapeutic use
Male
Metabolic Syndrome X - blood - complications - physiopathology
Middle Aged
Prospective Studies
Risk assessment
Risk factors
Time Factors
Treatment Outcome
Abstract
The impact of an ARB, with or without hydrochlorothiazide (HCTZ), on glycaemic factors and the risk for developing diabetes in hypertensive patients with the metabolic syndrome have not been fully assessed. This was a 52-week multicentre, prospective, phase-IV, open-label, cohort study of losartan or losartan/HCTZ in hypertensive patients with metabolic syndrome. All subjects were treated initially with losartan 50?mg?day(-1). Those not achieving target blood pressure (BP
PubMed ID
20147971 View in PubMed
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Acarbose for the treatment of type II diabetes: the results of a Canadian multi-centre trial.

https://arctichealth.org/en/permalink/ahliterature214600
Source
Diabetes Res Clin Pract. 1995 Aug;28 Suppl:S167-72
Publication Type
Article
Date
Aug-1995
Author
R G Josse
Author Affiliation
Division of Endocrinology and Metabolism, St. Michael's Hospital, University of Toronto, Ontario, Canada.
Source
Diabetes Res Clin Pract. 1995 Aug;28 Suppl:S167-72
Date
Aug-1995
Language
English
Publication Type
Article
Keywords
Acarbose
Blood Glucose - drug effects - metabolism
Canada
Diabetes Mellitus, Type 2 - drug therapy
Diabetic diet
Female
Hemoglobin A, Glycosylated - analysis
Humans
Hypoglycemic agents - therapeutic use
Insulin - therapeutic use
Male
Metformin - therapeutic use
Middle Aged
Placebos
Sulfonylurea Compounds - therapeutic use
Time Factors
Trisaccharides - therapeutic use
Abstract
The treatment of Type II diabetes (NIDDM) includes an appropriate diet and prudent exercise program. If these measures are insufficient to control the blood sugar, oral agents (sulphonylureas or biguanides) or insulin are added to the therapeutic regimen. Although the diet prescription has undergone some changes and refinements, this approach has been the traditional treatment for NIDDM for nearly 40 years. Recently a new class of oral agents, the alpha-glucosidase inhibitors, has become available. These drugs are competitive inhibitors of the alpha-glucosidase enzymes in the brush border of the bowel wall. They act to slow and delay the rate of carbohydrate absorption, thereby decreasing postprandial hyperglycemia. A recent study was designed to evaluate the long-term efficacy of acarbose, an alpha-glucosidase inhibitor, in improving the glycemic control of patients with NIDDM who were sub-optimally controlled on either diet alone, or diet plus sulphonylurea, metformin or insulin. A total of 354 patients with NIDDM were studied, 77 on diet alone, 83 on metformin, 103 and sulphonylurea and 91 on insulin. Subjects in each treatment stratum were randomized, double-blind to either acarbose or placebo, for 1 year. At baseline and every 3 months thereafter, fasting and postprandial glucose and C-peptide, HbA1c and fasting lipids were measured. Compared to placebo, acarbose treatment resulted in a decrease in mean postprandial glucose in all four strata (19 +/- 0.8 to 15.3 +/- 0.7 mmol/l: P
Notes
Erratum In: Diabetes Res Clin Pract 1995 Sep;29(3):215
PubMed ID
8529510 View in PubMed
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Adherence to national diabetes guidelines through monitoring quality indicators--A comparison of three types of care for the elderly with special emphasis on HbA1c.

https://arctichealth.org/en/permalink/ahliterature271560
Source
Prim Care Diabetes. 2015 Aug;9(4):253-60
Publication Type
Article
Date
Aug-2015
Author
Ann-Sofie Nilsson Neumark
Lars Brudin
Thomas Neumark
Source
Prim Care Diabetes. 2015 Aug;9(4):253-60
Date
Aug-2015
Language
English
Publication Type
Article
Keywords
Aged, 80 and over
Biomarkers - blood
Blood Glucose - drug effects - metabolism
Cross-Sectional Studies
Diabetes Mellitus, Type 1 - blood - diagnosis - drug therapy - epidemiology
Diabetes Mellitus, Type 2 - blood - diagnosis - drug therapy - epidemiology
Female
Guideline Adherence - standards
Health Services for the Aged - standards
Hemoglobin A, Glycosylated - metabolism
Home Care Services
Homes for the Aged
Humans
Hypoglycemic Agents - adverse effects - therapeutic use
Independent living
Male
Nursing Homes
Practice Guidelines as Topic - standards
Practice Patterns, Physicians' - standards
Prevalence
Process Assessment (Health Care) - standards
Quality Indicators, Health Care - standards
Sweden - epidemiology
Treatment Outcome
Abstract
To compare adherence to Swedish guidelines for diabetes care between elderly people living at home with or without home health care, and residents of nursing homes.
Medical records of 277 elderly people aged 80 and older, with known diabetes in a Swedish municipality, were monitored using quality indicators to evaluate processes and outcomes.
Monitoring, in accordance to diabetes guidelines, of HbA1c, lipids, blood pressure and foot examinations was lower among residents of nursing homes (p
PubMed ID
25865853 View in PubMed
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Adiposity and glycemic control in children exposed to perfluorinated compounds.

https://arctichealth.org/en/permalink/ahliterature104801
Source
J Clin Endocrinol Metab. 2014 Apr;99(4):E608-14
Publication Type
Article
Date
Apr-2014
Author
Clara Amalie G Timmermann
Laura I Rossing
Anders Grøntved
Mathias Ried-Larsen
Christine Dalgård
Lars B Andersen
Philippe Grandjean
Flemming Nielsen
Kira D Svendsen
Thomas Scheike
Tina K Jensen
Author Affiliation
Department of Environmental Medicine, Institute of Public Health (C.A.G.T., L.I.R., C.D., P.G., F.N., T.K.J.), and Institute of Sports Science and Clinical Biomechanics (A.G., M.R.-L., L.B.A.), University of Southern Denmark, 5000 Odense C, Denmark; and Department of Biostatistics (K.D.S., T.S.), University of Copenhagen, 1353 Copenhagen, Denmark.
Source
J Clin Endocrinol Metab. 2014 Apr;99(4):E608-14
Date
Apr-2014
Language
English
Publication Type
Article
Keywords
Adiposity - drug effects - physiology
Alkanesulfonic Acids - blood
Blood Glucose - drug effects - metabolism
Body mass index
Caprylates - blood
Child
Denmark - epidemiology
Environmental Exposure - analysis - statistics & numerical data
Environmental Pollutants - blood - toxicity
Female
Fluorocarbons - blood - toxicity
Humans
Insulin Resistance
Male
Obesity - blood - epidemiology
Skinfold thickness
Abstract
Our objective was to explore whether childhood exposure to perfluorinated and polyfluorinated compounds (PFCs), widely used stain- and grease-repellent chemicals, is associated with adiposity and markers of glycemic control.
Body mass index, skinfold thickness, waist circumference, leptin, adiponectin, insulin, glucose, and triglyceride concentrations were assessed in 8- to 10-year-old children in 1997 in a subset of the European Youth Heart Study, Danish component. Plasma PFC concentrations were available from 499 children. Linear regression models were performed to determine the association between PFC exposure and indicators of adiposity and markers of glycemic control.
There was no association between PFC exposures and adiposity or markers of glycemic control in normal-weight children. Among overweight children, an increase of 10 ng perfluorooctane sulfonic acid/mL plasma was associated with 16.2% (95% confidence interval [CI], 5.2%-28.3%) higher insulin concentration, 12.0% (95% CI, 2.4%-22.4%) higher ß-cell activity, 17.6% (95% CI, 5.8%-30.8%) higher insulin resistance, and 8.6% (95% CI, 1.2%-16.5%) higher triglyceride concentrations, and an increase of 10 ng perfluorooctanoic acid/mL plasma was associated with 71.6% (95% CI, 2.4%-187.5%) higher insulin concentration, 67.5% (95% CI, 5.5%-166.0%) higher ß-cell function, 73.9% (95% CI, 0.2%-202.0%) higher insulin resistance, and 76.2% (95% CI, 22.8%-153.0%) higher triglyceride concentrations.
Increased PFC exposure in overweight 8- to 10-year-old children was associated with higher insulin and triglyceride concentrations. Chance findings may explain some of our results, and due to the cross-sectional design, reverse causation cannot be excluded. The findings therefore need to be confirmed in longitudinal studies.
PubMed ID
24606078 View in PubMed
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All-cause mortality and pharmacological treatment intensity following a high risk screening program for diabetes. A 6.6 year follow-up of the ADDITION study, Denmark.

https://arctichealth.org/en/permalink/ahliterature124294
Source
Prim Care Diabetes. 2012 Oct;6(3):193-200
Publication Type
Article
Date
Oct-2012
Author
Torsten Lauritzen
Annelli Sandbaek
Anders Helles Carlsen
Knut Borch-Johnsen
Author Affiliation
School of Public Health, Department of General Practice, University of Aarhus, Denmark. tl@alm.au.dk
Source
Prim Care Diabetes. 2012 Oct;6(3):193-200
Date
Oct-2012
Language
English
Publication Type
Article
Keywords
Adult
Antihypertensive Agents - therapeutic use
Biological Markers - blood
Blood Glucose - drug effects - metabolism
Chi-Square Distribution
Comorbidity
Denmark
Diabetes Mellitus - blood - diagnosis - drug therapy - mortality
Dyslipidemias - diagnosis - drug therapy - mortality
Female
Hemoglobin A, Glycosylated - metabolism
Humans
Hypertension - diagnosis - drug therapy - mortality
Hypoglycemic agents - therapeutic use
Hypolipidemic Agents - therapeutic use
Kaplan-Meier Estimate
Male
Mass Screening - methods
Middle Aged
Predictive value of tests
Proportional Hazards Models
Questionnaires
Risk assessment
Risk factors
Time Factors
Treatment Outcome
Abstract
To study all-cause mortality and pharmacological treatment intensity in relation to baseline glucose metabolism and HbA1c following high risk screening for diabetes in primary care.
Persons aged 40-69 years (N=163,185) received mailed diabetes risk questionnaires. 20,916 persons without diabetes but with high risk of diabetes were stratified by glucose metabolism (normal glucose tolerance (NGT), dysglycemia (IFG or IGT) or diabetes) and by HbA1c at screening (
Notes
Comment In: Prim Care Diabetes. 2012 Dec;6(4):341-222917774
PubMed ID
22595031 View in PubMed
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Associations between patient characteristics, social relations, diabetes management, quality of life, glycaemic control and emotional burden in type 1 diabetes.

https://arctichealth.org/en/permalink/ahliterature277692
Source
Prim Care Diabetes. 2016 Feb;10(1):41-50
Publication Type
Article
Date
Feb-2016
Author
Lene E Joensen
Thomas P Almdal
Ingrid Willaing
Source
Prim Care Diabetes. 2016 Feb;10(1):41-50
Date
Feb-2016
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Age Factors
Biomarkers - blood
Blood Glucose - drug effects - metabolism
Cost of Illness
Cross-Sectional Studies
Denmark - epidemiology
Diabetes Mellitus, Type 1 - blood - diagnosis - drug therapy - epidemiology - psychology
Electronic Health Records
Emotions
Female
Hemoglobin A, Glycosylated - metabolism
Humans
Hypoglycemic agents - therapeutic use
Male
Patient Participation
Quality of Life
Risk factors
Self Care
Sex Factors
Social Behavior
Social Support
Surveys and Questionnaires
Treatment Outcome
Abstract
The objective was to investigate associations between emotional burden and a number of individual variables: patient characteristics, social relations, diabetes management in everyday life, generic quality of life and glycaemic control, including determining to what extend these variables explain the differences in emotional burden in a large Danish population of people with type 1 diabetes.
We analysed a cross-sectional survey of 2419 Danish adults with type-1 diabetes mellitus and data from an electronic patient record. Data were analysed using hierarchical regression of factors of interest with emotional burden of diabetes as the dependent variable.
High emotional burden of diabetes was associated with being female, younger age, other chronic illness, low diabetes-specific support, low generic quality of life, low diabetes empowerment and high Hba1c. Low diabetes empowerment, low generic quality of life and low diabetes-specific support were associated with the largest difference in emotional burden level.
A variety of psychosocial and behavioural factors such as low social support, low generic quality of life and difficulties in managing diabetes are associated with high emotional burden in type-1 diabetes. These findings may call for an expansion of the effort to decrease the emotional burden of diabetes for those who are heavily burdened. Future research should explore the causality of the explored associations as well as potential subgroup differences in order to guide the development of appropriate interventions.
PubMed ID
26163949 View in PubMed
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Asymmetrical dimethylarginine (ADMA) and risk of acute coronary events. Does statin treatment influence plasma ADMA levels?

https://arctichealth.org/en/permalink/ahliterature182467
Source
Atheroscler Suppl. 2003 Dec;4(4):19-22
Publication Type
Article
Date
Dec-2003
Author
Veli-Pekka Valkonen
Juha Laakso
Hannu Päivä
Terho Lehtimäki
Timo A Lakka
Marja Isomustajärvi
Inkeri Ruokonen
Jukka T Salonen
Reijo Laaksonen
Author Affiliation
Research Institute of Public Health, University of Kuopio, Kuopio, Finland
Source
Atheroscler Suppl. 2003 Dec;4(4):19-22
Date
Dec-2003
Language
English
Publication Type
Article
Keywords
Acute Disease
Adult
Aged
Arginine - analogs & derivatives - blood - drug effects
Biological Markers - blood
Blood Glucose - drug effects - metabolism
Case-Control Studies
Cholesterol, HDL - blood - drug effects
Cholesterol, LDL - blood - drug effects
Coronary Disease - blood - drug therapy - epidemiology
Double-Blind Method
Endothelium, Vascular - metabolism - physiopathology
Enzyme Inhibitors - blood
Female
Finland - epidemiology
Heptanoic Acids - therapeutic use
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Hypolipidemic Agents - therapeutic use
Male
Middle Aged
Prospective Studies
Pyrroles - therapeutic use
Risk factors
Simvastatin - therapeutic use
Statistics as Topic
Triglycerides - blood
Abstract
The purpose of this study was to evaluate the hypothesis that high serum levels of ADMA, an indicator of endothelial dysfunction, are associated with an elevated risk of acute coronary events in middle-aged men. To test the hypothesis that lipid lowering medication with statins lowers circulating ADMA levels, we also investigated the effect of simvastatin and atorvastatin treatment on plasma ADMA concentration. In a prospective nested case-control study in 150 middle-aged non-smoking men from Eastern Finland, those who were in the highest quartile for serum ADMA (>0.62 micromol/l) had a 3.9-fold (95% CI: 1.25-12.3, P=0.02) increase in risk of acute coronary events compared with other quartiles. In an 8-week randomised double-blind placebo-controlled trial, plasma ADMA concentrations remained unchanged in simvastatin 80 mg/day (n=16), atorvastatin 40 mg/day (n=16) and placebo (n=16) groups over the study period. Our findings indicate that high serum levels of ADMA, a potential marker for endothelial dysfunction, may increase the risk of acute coronary syndromes. However, aggressive treatment with either simvastatin or atorvastatin did not reduce plasma ADMA levels.
PubMed ID
14664898 View in PubMed
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Be Careful What You Ask For: Effects of Benefit Descriptions on Diabetes Patients' Benefit-Risk Tradeoff Preferences.

https://arctichealth.org/en/permalink/ahliterature282029
Source
Value Health. 2017 Apr;20(4):670-678
Publication Type
Article
Date
Apr-2017
Author
Lill-Brith von Arx
F Reed Johnson
Morten Raun Mørkbak
Trine Kjær
Source
Value Health. 2017 Apr;20(4):670-678
Date
Apr-2017
Language
English
Publication Type
Article
Keywords
Aged
Biomarkers - blood
Blood Glucose - drug effects - metabolism
Choice Behavior
Denmark
Diabetes Mellitus, Type 2 - blood - diagnosis - drug therapy - psychology
Female
Health Knowledge, Attitudes, Practice
Hemoglobin A, Glycosylated - metabolism
Humans
Hypoglycemia - chemically induced
Hypoglycemic Agents - adverse effects - therapeutic use
Insulin - adverse effects - therapeutic use
Likelihood Functions
Logistic Models
Male
Middle Aged
Patient Preference
Risk assessment
Risk factors
Surveys and Questionnaires
Time Factors
Treatment Outcome
Abstract
As more studies report on patient preferences for diabetes treatment, identifying diabetes outcomes other than glycated hemoglobin (HbA1c) to describe effectiveness is warranted to understand patient-relevant, benefit-risk tradeoffs.
The aim of the study was to evaluate how preferences differ when effectiveness (glycemic control) is presented as long-term sequela (LTS) risk mitigation rather than an asymptomatic technical marker (HbA1c).
People with type 2 diabetes and using insulin (n = 3160) were randomly assigned to four self-administered, discrete-choice experiments that differed by their presentation of effectiveness. Epidemiologic reviews were conducted to ensure a close approximation of LTS risk relative to HbA1c levels. The relative importance of treatment benefit-risk characteristics and maximum acceptable risk tradeoffs was estimated using an error-component logit model. Log-likelihood ratio tests were used to compare parameter vectors.
In total, 1031 people responded to the survey. Significantly more severe hypoglycemic events were accepted for a health improvement in terms of LTS mitigation versus HbA1c improvement (0.7 events per year; 95% confidence interval [CI]: 0.4-1.0 vs. 0.2 events per year 95% CI: -0.02 to 0.5) and avoidance of treatment-related heart attack risk (1.4 severe hypoglycemic events per year; 95% CI: 0.8-1.9 vs. 1 event per year; 95% CI: 0.6-1.3). This finding is supported by a log-likelihood test that rejected at the 0.05 level that respondent preference structures are similar across the different experimental arms of the discrete-choice experiment.
We found evidence that benefit descriptions influence elicited preferences for the benefit-risk characteristics of injectable diabetes treatment. These findings argue for using carefully defined effectiveness measures to accurately take account of the patient perspective in benefit-risk assessments.
PubMed ID
28408010 View in PubMed
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Changes in insulin sensitivity and insulin release in relation to glycemia and glucose tolerance in 6,414 Finnish men.

https://arctichealth.org/en/permalink/ahliterature152581
Source
Diabetes. 2009 May;58(5):1212-21
Publication Type
Article
Date
May-2009
Author
Alena Stancáková
Martin Javorský
Teemu Kuulasmaa
Steven M Haffner
Johanna Kuusisto
Markku Laakso
Author Affiliation
Department of Medicine, University of Kuopio and Kuopio University Hospital, Kuopio, Finland.
Source
Diabetes. 2009 May;58(5):1212-21
Date
May-2009
Language
English
Publication Type
Article
Keywords
Area Under Curve
Blood Glucose - drug effects - metabolism
Cross-Sectional Studies
Finland - epidemiology
Glucose Intolerance - blood - epidemiology
Glucose Tolerance Test
Humans
Insulin - pharmacology - secretion
Insulin-Secreting Cells - physiology - secretion
Male
Metabolic Syndrome X - blood - epidemiology
Middle Aged
Reference Values
Abstract
We evaluated insulin sensitivity and insulin secretion across the entire range of fasting (FPG) and 2-h plasma glucose (PG), and we investigated the differences in insulin sensitivity and insulin release in different glucose tolerance categories.
A total of 6,414 Finnish men (aged 57 +/- 7 years, BMI 27.0 +/- 3.9 kg/m2) from our ongoing population-based METSIM (Metabolic Syndrome in Men) study were included. Of these subjects, 2,168 had normal glucose tolerance, 2,859 isolated impaired fasting glucose (IFG), 217 isolated impaired glucose tolerance (IGT), 701 a combination of IFG and IGT, and 469 newly diagnosed type 2 diabetes.
The Matsuda index of insulin sensitivity decreased substantially within the normal range of FPG (-17%) and 2-h PG (-37%) and was approximately -65 and -53% in the diabetic range of FPG and 2-h PG, respectively, compared with the reference range (FPG and 2-h PG
Notes
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PubMed ID
19223598 View in PubMed
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Clinical inertia in response to inadequate glycemic control: do specialists differ from primary care physicians?

https://arctichealth.org/en/permalink/ahliterature176024
Source
Diabetes Care. 2005 Mar;28(3):600-6
Publication Type
Article
Date
Mar-2005
Author
Baiju R Shah
Janet E Hux
Andreas Laupacis
Bernard Zinman
Carl van Walraven
Author Affiliation
Institute for Clinical Evaluative Sciences, G106-2075 Bayview Ave., Toronto, ON, Canada M4N 3M5. baiju.shah@ices.on.ca
Source
Diabetes Care. 2005 Mar;28(3):600-6
Date
Mar-2005
Language
English
Publication Type
Article
Keywords
Aged
Blood Glucose - drug effects - metabolism
Cohort Studies
Diabetes Mellitus - blood - drug therapy - mortality
Family Practice
Female
Hemoglobin A, Glycosylated - metabolism
Humans
Hypoglycemic agents - therapeutic use
Male
Medical Records
Medicine
Ontario
Patient Selection
Specialization
Survival Analysis
Treatment Failure
Abstract
Diabetic patients with inadequate glycemic control ought to have their management intensified. Failure to do so can be termed "clinical inertia." Because data suggest that specialist care results in better control than primary care, we evaluated whether specialists demonstrated less clinical inertia than primary care physicians.
Using administrative data, we studied all non-insulin-requiring diabetic patients in eastern Ontario aged 65 or older who had A1c results >8% between September 1999 and August 2000. Drug intensification was measured by comparing glucose-lowering drug regimens in 4-month blocks before and after the elevated A1c test and was defined as 1) the addition of a new oral drug, 2) a dose increase of an existing oral drug, or 3) the initiation of insulin. Propensity score-based matching was used to control for confounding between groups.
There were 591 patients with specialist care and 1,911 with exclusively primary care. In the matched cohorts, 45.1% of patients with specialist care versus 37.4% with primary care had drug intensification (P = 0.009). Most of this difference was attributed to specialists' more frequent initiation of insulin in response to elevated A1c.
Fewer than one-half of patients with high A1c levels had intensification of their medications, regardless of specialty of their physician. Specialists were more aggressive with insulin initiation than primary care physicians, which may contribute to the lower A1c levels seen with specialist care. Interventions assisting patients and physicians to recognize and overcome clinical inertia should improve diabetes care in the population.
PubMed ID
15735195 View in PubMed
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52 records – page 1 of 6.