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A 10-year follow-up of postmenopausal women on long-term continuous combined hormone replacement therapy: Update of safety and quality-of-life findings.

https://arctichealth.org/en/permalink/ahliterature80782
Source
J Br Menopause Soc. 2006 Sep;12(3):115-25
Publication Type
Article
Date
Sep-2006
Author
Heikkinen Jorma
Vaheri Raija
Timonen Ulla
Author Affiliation
The Deaconness Institute of Oulu, Isokatu, Oulu, Finland.
Source
J Br Menopause Soc. 2006 Sep;12(3):115-25
Date
Sep-2006
Language
English
Publication Type
Article
Keywords
Breast Neoplasms - chemically induced - epidemiology
Cerebrovascular Accident - chemically induced - epidemiology
Dose-Response Relationship, Drug
Endometrial Neoplasms - chemically induced - epidemiology
Estradiol - administration & dosage - adverse effects - analogs & derivatives
Estrogens, Conjugated (USP) - administration & dosage - adverse effects
Female
Finland
Follow-Up Studies
Hormone Replacement Therapy - adverse effects - psychology
Humans
Medroxyprogesterone 17-Acetate - administration & dosage - adverse effects
Middle Aged
Postmenopause - drug effects - physiology
Quality of Life
Treatment Outcome
Abstract
OBJECTIVE: To assess the safety and health-related quality of life (HRQOL) of continuous combined hormone replacement therapy (ccHRT) with estradiol valerate/medroxyprogesterone acetate (E(2)V/MPA) over nine years and at follow-up one year after discontinuation. Study design: A total of 419 women were randomized to one of four treatments: once-daily 1 mg E2V/2.5 mg MPA (1 + 2.5 group); 1 mg E2V/5 mg MPA daily (1 + 5 group); 2 mg E2V/2.5 mg MPA daily (2 + 2.5 group); 2 mg E2V/5 mg MPA daily (2 + 5 group) (Indivina, Orion Pharma). For the last six months, all received the 1 + 2.5 dosage. The 2 + 2.5 dosage was discontinued at the end of year 7. A total of 198 women continued after year 7. RESULTS: Annualized percentage rates for cardiovascular events [corrected] and endometrial cancers [corrected] were below national rates for Finland and those reported for the Women's Health Initiative. There were no serious events with the 1 + 2.5 dosage or after ccHRT discontinuation. Climacteric symptoms remained significantly below baseline values after dosage reduction; some symptoms recurred after discontinuation of ccHRT. HRQOL ratings improved with ccHRT, irrespective of dosage, including depressed mood, anxiety, health perception and sexual interest. Scores on a scale assessing daily functioning and enjoyment (Q-LES-Q) improved from year 7 to year 9. They deteriorated during follow-up in women not continuing ccHRT. CONCLUSIONS: Lower dosages of HRT were as effective as higher doses in improving climacteric symptoms and HRQOL ratings and had fewer safety concerns. Following discontinuation of ccHRT, patient satisfaction was variable, with 15% electing to continue or restart HRT and 7% resuming at follow-up. This supports the need for an individualized approach to therapy recommendations.
Notes
Erratum In: J Br Menopause Soc. 2006 Dec;12(4):174
PubMed ID
16953985 View in PubMed
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Androgen therapy: testing before prescribing and monitoring during therapy.

https://arctichealth.org/en/permalink/ahliterature160341
Source
Can Fam Physician. 2007 Nov;53(11):1936-42
Publication Type
Article
Date
Nov-2007
Author
Alan Katz
Anne Katz
Charles Burchill
Author Affiliation
408-727 McDermot Ave, Winnipeg, MB. Alan_Katz@cpe.umanitoba.ca
Source
Can Fam Physician. 2007 Nov;53(11):1936-42
Date
Nov-2007
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Blood Chemical Analysis
Cohort Studies
Drug Utilization
Family Practice
Follow-Up Studies
Hormone Replacement Therapy - adverse effects - methods
Humans
Male
Manitoba
Middle Aged
Monitoring, Physiologic
Prostate - drug effects - metabolism
Prostate-Specific Antigen - blood
Prostatic Neoplasms - blood - physiopathology
Retrospective Studies
Risk factors
Testosterone - administration & dosage - metabolism
Abstract
To explore the extent to which biochemical testing is used to diagnose androgen deficiency before initiating treatment and to learn whether recommendations for clinical monitoring of men taking androgen therapy are being followed.
Population-based retrospective cohort study.
Winnipeg, Man.
A total of 902 men who filled at least 2 prescriptions for androgen therapy.
Whether men had had baseline prostate-specific antigen (PSA) and testosterone testing before initiation of therapy and whether men had been monitored during the first year of treatment.
Of the 902 men who filled first-time prescriptions during the study period, only 475 (52.7%) had ever had PSA or testosterone tests. Before starting therapy, 315 men (34.9%) had had PSA tests, and 152 men (16.9%) had had testosterone tests. Less than 1% of the entire sample had had 3 or more tests during the year following initiation of therapy.
Indications for androgen therapy in this population appear to be based on clinical symptoms rather than on demonstrated biochemical androgen deficiency. Recommendations for clinical monitoring of men taking androgen therapy are not followed consistently.
Notes
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PubMed ID
18000271 View in PubMed
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Are smoking-associated cancers prevented or postponed in women using hormone replacement therapy?

https://arctichealth.org/en/permalink/ahliterature18213
Source
Obstet Gynecol. 2003 Sep;102(3):565-70
Publication Type
Article
Date
Sep-2003
Author
H. Olsson
A. Bladström
C. Ingvar
Author Affiliation
Department of Oncology, University Hospital, Lund, Sweden. hakan.olsson@onk.lu.se
Source
Obstet Gynecol. 2003 Sep;102(3):565-70
Date
Sep-2003
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Aged
Cohort Studies
Comparative Study
Confidence Intervals
Female
Hormone Replacement Therapy - adverse effects - methods
Humans
Incidence
Menopause
Middle Aged
Neoplasms - epidemiology - etiology - prevention & control
Probability
Prognosis
Proportional Hazards Models
Registries
Research Support, Non-U.S. Gov't
Risk assessment
Smoking - adverse effects
Survival Analysis
Sweden - epidemiology
Abstract
OBECTIVE: To investigate the relationship between hormone replacement therapy (HRT), smoking, and cancer incidence. METHODS: Baseline interviews were conducted from 1990 to 1992 in a population-based cohort of 29,508 Swedish women aged 25-65 years with no history of cancer. Cancer incidence in the cohort was assessed through December 31, 1999, with the Swedish Cancer Registry, the Population Census Registry, and the Cause of Death Registry. RESULTS: When follow-up ended, the cohort included 226,611 person-years. A total of 1145 malignancies were diagnosed (observed), and 1166.6 were expected (standardized incidence ratio 0.98; 95% confidence interval [CI] 0.93, 1.04). Women who had experienced a natural menopause and had ever used HRT had no increased incidence of cancer overall (standardized incidence ratio 1.03; 95% CI 0.88, 1.19). Long-term HRT users who smoked had a decreased incidence of smoking-related cancers, such as the oral cavity, pharynx, hypopharynx, larynx, esophagus, lung, cervix, and bladder (standardized incidence ratio 0.24; 95% CI 0.08, 0.76). The effect was seen regardless of the type of HRT (progestin versus non-progestin-containing preparations) used and number of cigarettes smoked. The protective role of HRT for colon cancer was evident among both smokers and nonsmokers. An increased incidence of endometrial cancer was seen only for nonsmokers who used HRT. CONCLUSION: Our data indicate that HRT use protects women against smoking-associated cancers. This effect occurs regardless of the type of HRT and the amount of smoking.
PubMed ID
12962944 View in PubMed
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Attitudes towards the menopause and hormone therapy over the turn of the century.

https://arctichealth.org/en/permalink/ahliterature81722
Source
Maturitas. 2007 Jan 20;56(1):12-20
Publication Type
Article
Date
Jan-20-2007
Author
Lindh-Astrand Lotta
Brynhildsen Jan
Hoffmann Mikael
Liffner Susanne
Hammar Mats
Author Affiliation
Division of Obstetrics and Gynecology, Department of Molecular and Clinical Medicine, Faculty of Health Sciences, University Hospital, S-581 85 Linköping, Sweden. Lotta.Lind-Astrand@lio.se
Source
Maturitas. 2007 Jan 20;56(1):12-20
Date
Jan-20-2007
Language
English
Publication Type
Article
Keywords
Attitude to Health
Female
Follow-Up Studies
Health Surveys
History, 20th Century
History, 21st Century
Hormone Replacement Therapy - adverse effects - history - psychology
Humans
Middle Aged
Perimenopause - psychology
Sweden
Abstract
OBJECTIVE: To assess attitudes and beliefs about the menopausal transition in a population of peri- and postmenopausal women, and if these attitudes differed before and after publication of studies on risks and benefits with hormone therapy (HT). MATERIALS AND METHODS: In 1999 and 2003 all women aged 53 and 54 years in the community of Linköping, Sweden, were sent a questionnaire about use of HT, menopausal status and attitudes regarding menopause and HT. RESULTS: Most women regarded menopause as a natural process characterized by both hormonal deficiency and aging and these views did not differ between 1999 and 2003. A majority of women thought that significant climacteric symptoms were a good reason to use HT, but not that women without symptoms should use HT. The fraction of women who supported HT use was, however, significantly lower in 2003 than in 1999. Most women agreed that menopause leads to increased freedom and that it is a relief not to have to think about contraception and pregnancies. CONCLUSIONS: Most Swedish women had a mainly biological view on menopause but nevertheless they thought that only women with climacteric symptoms should use HT. Women's attitudes towards HT have changed after recent reports on risks from long-term use of HT whereas the attitudes towards the menopausal transition were stable. Other factors than attitudes towards menopause affect women's actual use of HT. Probably women's and health care provider's apprehension of the risk-benefit balance of HT use is one such factor.
PubMed ID
16797891 View in PubMed
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Bone mineral density, bone markers, and fractures in adult males with congenital adrenal hyperplasia.

https://arctichealth.org/en/permalink/ahliterature118415
Source
Eur J Endocrinol. 2013 Mar;168(3):331-41
Publication Type
Article
Date
Mar-2013
Author
Henrik Falhammar
Helena Filipsson Nyström
Anna Wedell
Kerstin Brismar
Marja Thorén
Author Affiliation
Department of Endocrinology, Metabolism and Diabetes, D02:04, Karolinska University Hospital, SE-171 76 Stockholm, Sweden. henrik.falhammar@ki.se
Source
Eur J Endocrinol. 2013 Mar;168(3):331-41
Date
Mar-2013
Language
English
Publication Type
Article
Keywords
Adrenal Hyperplasia, Congenital - drug therapy - genetics - metabolism - physiopathology
Adult
Aged
Biological Markers - blood
Bone Density
Bone and Bones - metabolism
Cohort Studies
Fractures, Bone - epidemiology - etiology
Genetic Association Studies
Glucocorticoids - adverse effects - therapeutic use
Hormone Replacement Therapy - adverse effects
Humans
Insulin-Like Growth Factor I - analysis
Male
Middle Aged
Mutation
Osteocalcin - blood
Osteoporosis - epidemiology - etiology - physiopathology
Prevalence
Steroid 21-Hydroxylase - genetics - metabolism
Sweden - epidemiology
Young Adult
Abstract
The aim of this study was to determine bone mineral density (BMD), markers of bone metabolism, fractures, and steroids reflecting hormonal control in adult males with congenital adrenal hyperplasia (CAH). SUBJECTS, METHODS, AND DESIGN: We compared CAH males with 21-hydroxylase deficiency (n=30), 19-67 years old, with age- and sex-matched controls (n=32). Subgroups of CYP21A2 genotypes, age, glucocorticoid preparation, poor control vs overtreatment, and early vs late (>36 months) diagnosis were studied. BMD measured by dual energy X-ray absorptiometry and markers of bone metabolism and androgens/17-hydroxyprogesterone levels were investigated.
All, including older (>30 years), CAH patients had lower BMD in all measured sites compared with control subjects. The null group demonstrated lower BMD in more locations than the other groups. Osteoporosis/osteopenia was present in 81% of CAH patients compared with 32% in controls (=30 years). Fracture frequency was similar, osteocalcin was lower, and fewer patients than controls had vitamin D insufficiency. IGF1 was elevated in the milder genotypes. In patients, total body BMD was positively correlated to weight, BMI, total lean body mass, and triglycerides, and negatively to prolactin. Patients on prednisolone had lower BMD and osteocalcin levels than those on hydrocortisone/cortisone acetate. Patients with poor control had higher femoral neck BMD. There were no differences in BMD between patients with an early vs late diagnosis.
CAH males have low BMD and bone formation markers. BMD should be monitored, adequate prophylaxis and treatment established, and glucocorticoid doses optimized to minimize the risk of future fractures.
PubMed ID
23211577 View in PubMed
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[Breast cancer--a lifestyle disease?]

https://arctichealth.org/en/permalink/ahliterature9057
Source
Ugeskr Laeger. 2005 Dec 5;167(49):4636-41
Publication Type
Article
Date
Dec-5-2005
Author
Niels T Kroman
Øjvind Lidegaard
Marianne Ewertz Kvistgaard
Author Affiliation
Amtssygehuset i Herlev, Brystkirurgisk Afdeling F, Herlev. kroman@dadlnet.dk
Source
Ugeskr Laeger. 2005 Dec 5;167(49):4636-41
Date
Dec-5-2005
Language
Danish
Publication Type
Article
Keywords
Adolescent
Adult
Alcohol Drinking - adverse effects
Breast Neoplasms - etiology - genetics - prevention & control
Contraceptives, Oral, Hormonal - adverse effects
English Abstract
Female
Genetic Predisposition to Disease
Gravidity
Hormone Replacement Therapy - adverse effects
Humans
Life Style
Menarche
Overweight
Parity
Pregnancy
Risk factors
Abstract
The incidence of breast cancer in Denmark has increased about 2-3% every year in the past decades. In this review the established risk factors for the disease are presented and the changes over time in these factors are described. It is concluded that a large part of the rise in incidence can be explained by changes in established risk factors. The potential measures for prevention of the disease seem to be changes in birth patterns and and increased focus on obesity and alcohol use.
PubMed ID
16336852 View in PubMed
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Breast-cancer risk following long-term oestrogen- and oestrogen-progestin-replacement therapy.

https://arctichealth.org/en/permalink/ahliterature21085
Source
Int J Cancer. 1999 May 5;81(3):339-44
Publication Type
Article
Date
May-5-1999
Author
C. Magnusson
J A Baron
N. Correia
R. Bergström
H O Adami
I. Persson
Author Affiliation
Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden. Cecilia.Magnusson@mep.ki.se
Source
Int J Cancer. 1999 May 5;81(3):339-44
Date
May-5-1999
Language
English
Publication Type
Article
Keywords
Breast Neoplasms - etiology
Estrogens - adverse effects
Female
Hormone Replacement Therapy - adverse effects
Humans
Progestins - adverse effects
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Risk
Abstract
While use of hormone-replacement therapy (HRT) effectively alleviates menopausal symptoms and prevents osteoporosis and possibly cardiovascular disease, there is concern of a detrimental impact on breast-cancer risk. There is a particular lack of data regarding the effect of long-term use of oestrogen-progestin combinations on breast-cancer risk. We conducted a large epidemiological study in Sweden, where combined oestrogen-progestin treatment has been predominant, to examine the influence of different regimens of menopausal hormone therapy on breast-cancer risk. In this population-based case-control study, 3,345 women aged 50 to 74 years with invasive breast cancer (84% of all eligible) and 3,454 controls of similar age (82% of all selected) were included. Mailed questionnaires and telephone interviews were used to collect detailed information on use of hormone replacement and on potential confounding factors. Odds ratios (OR) and 95% confidence intervals (CI) were estimated through multiple logistic regression. There was a trend of increasing breast-cancer risk with duration of oestrogen/oestrogen-progestin use (OR for women treated at least 10 years, 2.43; 95% CI, 1.79-3.30, as compared to never-users), with statistically significant estimates only for women with BMI
PubMed ID
10209946 View in PubMed
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Breast cancer with different prognostic characteristics developing in Danish women using hormone replacement therapy.

https://arctichealth.org/en/permalink/ahliterature17617
Source
Br J Cancer. 2004 Aug 16;91(4):644-50
Publication Type
Article
Date
Aug-16-2004
Author
C. Stahlberg
A T Pedersen
Z J Andersen
N. Keiding
Y A Hundrup
E B Obel
S. Møller
F. Rank
B. Ottesen
E. Lynge
Author Affiliation
Department of Gynaecology and Obstetrics, Juliane Marie Centre, H:S Rigshospitalet, University of Copenhagen, Denmark. c.stahlberg@dadlnet.dk
Source
Br J Cancer. 2004 Aug 16;91(4):644-50
Date
Aug-16-2004
Language
English
Publication Type
Article
Keywords
Aged
Breast Neoplasms - epidemiology - etiology - pathology
Carcinoma, Ductal, Breast - epidemiology - etiology - pathology
Cohort Studies
Denmark - epidemiology
Epidemiologic Studies
Female
Hormone Replacement Therapy - adverse effects
Humans
Incidence
Middle Aged
Postmenopause
Prognosis
Registries - statistics & numerical data
Research Support, Non-U.S. Gov't
Risk factors
Survival Analysis
Abstract
The aim of this study is to investigate the risk of developing prognostic different types of breast cancer in women using hormone replacement therapy (HRT). A total of 10 874 postmenopausal Danish Nurses were followed since 1993. Incident breast cancer cases and histopathological information were retrieved through the National Danish registries. The follow-up ended on 31 December 1999. Breast cancer developed in 244 women, of whom 172 were invasive ductal carcinomas. Compared to never users, current users of HRT had an increased risk of a hormone receptor-positive breast cancer, but a neutral risk of receptor-negative breast cancer, relative risk (RR) 3.29 (95% confidence interval (CI): 2.27-4.77) and RR 0.99 (95% CI: 0.42-2.36), respectively (P for difference=0.013). The risk of being diagnosed with low histological malignancy grade was higher than high malignancy grade with RR 4.13 (95% CI: 2.43-7.01) and RR 2.17 (95% CI: 1.42-3.30), respectively (P=0.063). For breast cancers with other prognostic characteristics, the risk was increased equally for the favourable and non favourable types. Current users of HRT experience a two- to four-fold increased risk of breast cancer with various prognostic characteristics, both the favourable and non favourable types. For receptor status, the risk with HRT was statistically significantly higher for hormone receptor-positive breast cancer compared to receptor-negative breast cancer.
PubMed ID
15238982 View in PubMed
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A cohort study of oral contraceptive use and risk of benign breast disease.

https://arctichealth.org/en/permalink/ahliterature201655
Source
Int J Cancer. 1999 Jul 19;82(2):191-6
Publication Type
Article
Date
Jul-19-1999
Author
T E Rohan
A B Miller
Author Affiliation
Department of Public Health Sciences, University of Toronto, Canada. tom.rohan@utoronto.ca
Source
Int J Cancer. 1999 Jul 19;82(2):191-6
Date
Jul-19-1999
Language
English
Publication Type
Article
Keywords
Adult
Breast Diseases - epidemiology - pathology - prevention & control
Cell Division
Cohort Studies
Contraceptives, Oral, Hormonal - adverse effects
Diet
Drug Utilization
Female
Fibrocystic Breast Disease - chemically induced - epidemiology - pathology
Hormone Replacement Therapy - adverse effects
Humans
Incidence
Life Style
Mass Screening
Middle Aged
Ontario - epidemiology
Questionnaires
Reproductive history
Risk
Smoking - epidemiology
Abstract
The purpose of the cohort study reported here was to investigate the association between oral contraceptive use and risk of benign breast disease (BBD), overall and by histological subtype, within the 56,537 women in the Canadian National Breast Screening Study (NBSS) who completed self-administered lifestyle and dietary questionnaires. The NBSS is a randomized controlled trial of screening for breast cancer in women aged 40-59 at recruitment. Cases were the 2,116 women in the dietary cohort who were diagnosed with biopsy-confirmed incident BBD. For comparative purposes, a subcohort consisting of a random sample of 5,681 women (including 197 subjects with incident BBD) was selected from the full dietary cohort. After exclusions for various reasons, the analyses were based on 2,116 cases and 5,338 non-cases. There was an inverse association between use of oral contraceptives and risk of all types of BBD combined. The reduction in risk was confined largely to proliferative forms of BBD (BPED), and in particular, to those forms of BPED without histological atypia, in whom there was a progressive reduction in risk with increasing duration of use (the IRR (95% CI) for use of more than 7 years was 0.64 (0.47-0.87)); risk of BPED with atypia was increased somewhat in association with oral contraceptive use (the IRR (95% CI) for use of more than 7 years was 1.43 (0.68-3.01 )), but not in a dose-dependent manner. The results were similar when examined separately in the screened and control arms of the NBSS and for screen-detected and interval-detected BPED.
PubMed ID
10389751 View in PubMed
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Combined hormone therapy in postmenopausal women with features of metabolic syndrome. Results from a population-based study of Swedish women: Women's Health in the Lund Area study.

https://arctichealth.org/en/permalink/ahliterature9399
Source
Menopause. 2004 Sep-Oct;11(5):549-55
Publication Type
Article
Author
Yasameen A Shakir
Göran Samsioe
Christina Nerbrand
Jonas Lidfeldt
Author Affiliation
Department of Obstetrics and Gynecology, Lund University Hospital, Lund, Sweden.
Source
Menopause. 2004 Sep-Oct;11(5):549-55
Language
English
Publication Type
Article
Keywords
Aged
Analysis of Variance
Blood glucose
Body mass index
Cohort Studies
Comparative Study
Drug Therapy, Combination
Estradiol - therapeutic use
Female
Glucose Tolerance Test
Health Surveys
Hormone Replacement Therapy - adverse effects - methods
Humans
Metabolic Syndrome X - diagnosis - therapy
Middle Aged
Norethindrone - analogs & derivatives - therapeutic use
Postmenopause - drug effects - physiology
Probability
Research Support, Non-U.S. Gov't
Risk assessment
Statistics, nonparametric
Sweden
Urban Population
Women's health
Abstract
OBJECTIVE: To delineate the influence of hormone therapy (HT) on features of metabolic syndrome with special reference to the composition and mode of administration of three specific HT regimens, all containing estradiol (E2) + norethisterone. DESIGN: The Women's Health in the Lund Area project screened all women (n = 10,766), born between 1935 and 1945. Complete data were obtained from 6,917 women. Those at or above defined cutoff limits were considered positively screened (n = 3,593) for metabolic syndrome. All of them were invited to undergo an oral glucose tolerance test; 2,923 women accepted. After excluding 200 women with impaired fasting glucose, 2,723 women were included in the present analysis. Serum lipids were determined by conventional standard methods at the department of clinical chemistry of Lund University Hospital. RESULTS: According to World Health Organization criteria, 2,123 women had normal glucose tolerance and 600 women had impaired glucose tolerance (IGT). IGT was less common (P = 0.001) among users of a transdermal patch [CYC-TRANS; E2 50 microg + norethisterone acetate (NETA) 250microg] compared with the two-combined oral regimen [CON-O (continuous oral E2 2 mg + NETA 1 mg) + CYC-O (sequential oral E2 2 mg + NETA 1 mg)]. Furthermore, IGT was more common among CON-O users when compared with either the CYC-O + CYC-TRANS group (P = 0.002) or the CYC-TRANS only group (P = 0.001). There were no significant differences between CYC-O versus CYC-TRANS or CON-O. Serum levels of total cholesterol were higher in the CYC-TRANS group than in the combined CON-O + CYC-O group (P
PubMed ID
15356408 View in PubMed
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91 records – page 1 of 10.