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The 10-year COPD Programme in Finland: effects on quality of diagnosis, smoking, prevalence, hospital admissions and mortality.

https://arctichealth.org/en/permalink/ahliterature135938
Source
Prim Care Respir J. 2011 Jun;20(2):178-83
Publication Type
Article
Date
Jun-2011
Author
Vuokko L Kinnula
Tuula Vasankari
Eva Kontula
Anssi Sovijarvi
Olli Saynajakangas
Anne Pietinalho
Author Affiliation
Department of Medicine, Division of Pulmonary Medicine, University of Helsinki, Helsinki, Finland. vuokko.kinnula@helsinki.fi
Source
Prim Care Respir J. 2011 Jun;20(2):178-83
Date
Jun-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Diagnostic Techniques, Respiratory System - standards
Female
Finland - epidemiology
Hospitalization - trends
Humans
Male
Middle Aged
Prevalence
Program Evaluation - methods
Pulmonary Disease, Chronic Obstructive - diagnosis - epidemiology - therapy
Quality Assurance, Health Care
Retrospective Studies
Smoking - adverse effects - epidemiology
Smoking Cessation - statistics & numerical data
Survival Rate - trends
Young Adult
Abstract
The Finnish National Programme for Chronic Bronchitis and Chronic Obstructive Pulmonary Disease (COPD) 1998-2007 was set up to reduce the prevalence of COPD, improve COPD diagnosis and care, reduce the number of moderate to severe cases of the disease, and reduce hospitalisations and treatment costs due to COPD. Over 900 events for 25,000 participating healthcare workers were arranged. The major strengths of this programme included multidisciplinary strategies and web-based guidelines in nearly all primary health care centres around the country.
Data from national registries, epidemiological studies and questionnaires were used to measure whether the goals had been reached.
The prevalence of COPD remained unchanged. Smoking decreased in males from 30% to 26% (p
Notes
Comment In: Prim Care Respir J. 2011 Jun;20(2):109-1021603847
PubMed ID
21431275 View in PubMed
Less detail

Acute and chronic respiratory symptoms among primary care patients who smoke crack cocaine.

https://arctichealth.org/en/permalink/ahliterature118607
Source
J Urban Health. 2013 Jun;90(3):542-51
Publication Type
Article
Date
Jun-2013
Author
Pamela Leece
Nikhil Rajaram
Susan Woolhouse
Margaret Millson
Author Affiliation
Public Health and Preventive Medicine Residency Program, University of Toronto, Toronto, Ontario, Canada.
Source
J Urban Health. 2013 Jun;90(3):542-51
Date
Jun-2013
Language
English
Publication Type
Article
Keywords
Administration, Inhalation
Adult
Asthma - diagnosis - epidemiology - etiology
Confounding Factors (Epidemiology)
Crack Cocaine
Female
Health Surveys
Humans
Male
Middle Aged
Ontario - epidemiology
Pilot Projects
Prevalence
Primary Health Care
Pulmonary Disease, Chronic Obstructive - diagnosis - epidemiology - etiology
Smoking - adverse effects - epidemiology
Substance-Related Disorders - complications
Abstract
Among inner-city populations in Canada, the use of crack cocaine by inhalation is prevalent. Crack smoking is associated with acute respiratory symptoms and complications, but less is known about chronic respiratory problems related to crack smoking. There is also a gap in the literature addressing the management of respiratory disease in primary health care among people who smoke crack. The purpose of our study was to assess the prevalence of acute and chronic respiratory symptoms among patients who smoke crack and access primary care. We conducted a pilot study among 20 patients who currently smoke crack (used within the past 30 days) and who access the "drop-in clinic" at an inner-city primary health care center. Participants completed a 20- to 30-min interviewer-administered survey and provided consent for a chart review. We collected information on respiratory-related symptoms, diagnoses, tests, medications, and specialist visits. Data were analyzed using frequency tabulations in SPSS (version 19.0). In the survey, 95 % (19/20) of the participants reported having at least one respiratory symptom in the past week. Thirteen (13/19, 68.4 %) reported these symptoms as bothersome. Chart review indicated that 12/20 (60 %) had a diagnosis of either asthma or chronic obstructive pulmonary disease (COPD), and four participants (4/20, 20 %) had a diagnosis of both asthma and COPD. Majority of the participants had been prescribed an inhaled medication (survey 16/20, 80 %; chart 12/20, 60 %). We found that 100 % (20/20) of the participants currently smoked tobacco, and 16/20 (80 %) had smoked both tobacco and marijuana prior to smoking crack. Our study suggests that respiratory symptoms and diagnoses of asthma and COPD are prevalent among a group of patients attending an inner-city clinic in Toronto and who also smoke crack. The high prevalence of smoking tobacco and marijuana among our participants is a major confounder for attributing respiratory symptoms to crack smoking alone. This novel pilot study can inform future research evaluating the primary health care management of respiratory disease among crack smokers, with the aim of improving health and health care delivery.
Notes
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PubMed ID
23188552 View in PubMed
Less detail

Acute exacerbation of chronic obstructive pulmonary disease: influence of social factors in determining length of hospital stay and readmission rates.

https://arctichealth.org/en/permalink/ahliterature154563
Source
Can Respir J. 2008 Oct;15(7):361-4
Publication Type
Article
Date
Oct-2008
Author
Alyson W M Wong
Wen Q Gan
Jane Burns
Don D Sin
Sephan F van Eeden
Author Affiliation
The James iCAPTURE Centre for Cardiovascular and pulmonary Research, Heart and Lung Institute, St Paul's Hospital, Providence Healthcare, University of British Columbia, Vancouver, British Columbia, Canada.
Source
Can Respir J. 2008 Oct;15(7):361-4
Date
Oct-2008
Language
English
Publication Type
Article
Keywords
British Columbia - epidemiology
Female
Follow-Up Studies
Humans
Length of Stay - statistics & numerical data
Male
Marital Status - statistics & numerical data
Middle Aged
Outcome Assessment (Health Care)
Patient Readmission - statistics & numerical data
Prognosis
Pulmonary Disease, Chronic Obstructive - diagnosis - epidemiology
Recurrence
Respiratory Function Tests
Retrospective Studies
Risk factors
Social Environment
Socioeconomic Factors
Abstract
Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is the leading reason for hospitalization in Canada and a significant financial burden on hospital resources. Identifying factors that influence the time a patient spends in the hospital and readmission rates will allow for better use of scarce hospital resources.
To determine the factors that influence length of stay (LOS) in the hospital and readmission for patients with AECOPD in an inner-city hospital.
Using the Providence Health Records, a retrospective review of patients admitted to St Paul's Hospital (Vancouver, British Columbia) during the winter of 2006 to 2007 (six months) with a diagnosis of AECOPD, was conducted. Exacerbations were classified according to Anthonisen criteria to determine the severity of exacerbation on admission. Severity of COPD was scored using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. For comparative analysis, severity of disease (GOLD criteria), age, sex and smoking history were matched.
Of 109 admissions reviewed, 66 were single admissions (61%) and 43 were readmissions (39%). The number of readmissions ranged from two to nine (mean of 3.3 readmissions). More than 85% of admissions had the severity of COPD equal to or greater than GOLD stage 3. The significant indicators for readmission were GOLD status (P
Notes
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Comment In: Can Respir J. 2008 Oct;15(7):343-419069593
PubMed ID
18949105 View in PubMed
Less detail

The added value of hybrid ventilation/perfusion SPECT/CT in patients with stable COPD or apparently healthy smokers. Cancer-suspected CT findings in the lungs are common when hybrid imaging is used.

https://arctichealth.org/en/permalink/ahliterature266278
Source
Int J Chron Obstruct Pulmon Dis. 2015;10:25-30
Publication Type
Article
Date
2015
Author
Jonas Jögi
Hanna Markstad
Ellen Tufvesson
Leif Bjermer
Marika Bajc
Source
Int J Chron Obstruct Pulmon Dis. 2015;10:25-30
Date
2015
Language
English
Publication Type
Article
Keywords
Aged
Case-Control Studies
Comorbidity
Female
Heart Failure - epidemiology - radiography - radionuclide imaging
Humans
Lung - radiography - radionuclide imaging
Lung Neoplasms - diagnosis - epidemiology - radiography - radionuclide imaging
Male
Middle Aged
Multimodal Imaging
Perfusion Imaging - methods
Predictive value of tests
Prospective Studies
Pulmonary Disease, Chronic Obstructive - diagnosis - epidemiology - radiography - radionuclide imaging
Pulmonary Embolism - epidemiology - radiography - radionuclide imaging
Pulmonary Emphysema - diagnosis - epidemiology - radiography - radionuclide imaging
Severity of Illness Index
Smoking - adverse effects - epidemiology
Sweden - epidemiology
Tomography, Emission-Computed, Single-Photon
Tomography, X-Ray Computed
Abstract
Ventilation/perfusion (V/P) single-photon emission computed tomography (SPECT) is recognized as a diagnostic method with potential beyond the diagnosis of pulmonary embolism. V/P SPECT identifies functional impairment in diseases such as heart failure (HF), pneumonia, and chronic obstructive pulmonary disease (COPD). The development of hybrid SPECT/computed tomography (CT) systems, combining functional with morphological imaging through the addition of low-dose CT (LDCT), may be useful in COPD, as these patients are prone to lung cancer and other comorbidities. The aim of this study was to investigate the added value of LDCT among healthy smokers and patients with stable COPD, when examined with V/P SPECT/CT hybrid imaging. Sixty-nine subjects, 55 with COPD (GOLD I-IV) and 14 apparently healthy smokers, were examined with V/P SPECT and LDCT hybrid imaging. Spirometry was used to verify COPD grade. Only one apparently healthy smoker and three COPD patients had a normal or nearly normal V/P SPECT. All other patients showed various degrees of airway obstruction, even when spirometry was normal. The same interpretation was reached on both modalities in 39% of the patients. LDCT made V/P SPECT interpretation more certain in 9% of the patients and, in 52%, LDCT provided additional diagnoses. LDCT better characterized the type of emphysema in 12 patients. In 19 cases, tumor-suspected changes were reported. Three of these 19 patients (ie, 4.3% of all subjects) were in the end confirmed to have lung cancer. The majority of LDCT findings were not regarded as clinically significant. V/P SPECT identified perfusion patterns consistent with decompensated left ventricular HF in 14 COPD patients. In 16 patients (23%), perfusion defects were observed. HF and perfusion defects were not recognized with LDCT. In COPD patients and long-time smokers, hybrid imaging had added value compared to V/P SPECT alone, by identifying patients with lung malignancy and more clearly identifying emphysema. V/P SPECT visualizes comorbidities to COPD not seen with LDCT, such as pulmonary embolism and left ventricular HF.
Notes
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PubMed ID
25565797 View in PubMed
Less detail

Age at diagnosis of smoking-related disease.

https://arctichealth.org/en/permalink/ahliterature186128
Source
Health Rep. 2003 Feb;14(2):9-19
Publication Type
Article
Date
Feb-2003
Author
Jiajian Chen
Author Affiliation
East-West Centre, Honolulu, Hawaii, USA.
Source
Health Rep. 2003 Feb;14(2):9-19
Date
Feb-2003
Language
English
Publication Type
Article
Keywords
Adolescent
Adolescent Behavior
Adult
Age Distribution
Age of Onset
Arthritis, Rheumatoid - epidemiology - etiology
Canada - epidemiology
Female
Heart Diseases - epidemiology - etiology
Humans
Life tables
Male
Prevalence
Proportional Hazards Models
Pulmonary Disease, Chronic Obstructive - diagnosis - epidemiology - etiology
Smoking - adverse effects - epidemiology
Abstract
This study assesses the relationship between the age of daily smoking initiation and the age at diagnosis of chronic obstructive pulmonary disease (COPD), heart disease and rheumatoid arthritis.
The data are from the 2000/01 Canadian Community Health Survey (CCHS). The sample for the analysis consisted of 34,144 respondents aged 35 to 64 living in private households in the provinces and territories.
The life table approach was used to estimate the cumulative incidence of smoking-related disease. Cox proportional hazards regression models were used to estimate the relative risks of disease by the age when daily smoking began.
For both sexes, the younger the individuals were when they became daily smokers, the sooner they were diagnosed with COPD, heart disease or rheumatoid arthritis. Even when education, household income and number of cigarettes smoked per day were taken into account, adolescent starters were at increased risk of these diseases, compared with never-smokers.
PubMed ID
12658861 View in PubMed
Less detail

The association between circulating adiponectin levels, lung function and adiposity in subjects from the general population; data from the Akershus Sleep Apnea Project.

https://arctichealth.org/en/permalink/ahliterature299198
Source
BMC Pulm Med. 2018 Apr 02; 18(1):54
Publication Type
Journal Article
Date
Apr-02-2018
Author
Nina F Caspersen
Helge Røsjø
Allan Flyvbjerg
Mette Bjerre
Anna Randby
Harald Hrubos-Strøm
Torbjørn Omland
Gunnar Einvik
Author Affiliation
Division of Medicine, Akershus University Hospital, Lørenskog, Norway.
Source
BMC Pulm Med. 2018 Apr 02; 18(1):54
Date
Apr-02-2018
Language
English
Publication Type
Journal Article
Keywords
Abdominal Fat - pathology
Adiponectin - blood
Adiposity
Adult
Age Factors
Body mass index
Correlation of Data
Female
Humans
Male
Metabolic Syndrome - diagnosis - epidemiology
Middle Aged
Norway - epidemiology
Pulmonary Disease, Chronic Obstructive - diagnosis - epidemiology - metabolism - physiopathology
Registries - statistics & numerical data
Respiratory Function Tests - methods - statistics & numerical data
Severity of Illness Index
Sex Factors
Smoking - epidemiology
Abstract
Circulating adiponectin (ADPN) levels are inversely associated with disease severity in patients with chronic obstructive pulmonary disease (COPD), while studies assessing the relationship between ADPN and lung function in subjects from the general population have shown diverging results. Accordingly, we hypothesized that ADPN would be associated with lung function in a population-based sample and tested how abdominal adiposity, metabolic syndrome, and systemic inflammation influenced this association.
We measured total ADPN in serum, forced vital capacity (FVC) and forced expiratory volume during the 1st second (FEV1) in 529 participants (median 50 years, 54.6% males) recruited from the general population. We assessed the association between ADPN and lung function by multivariate linear regression analyses and adjusted for age, gender, height, smoking habits, weight, body mass index, waist-hip ratio, metabolic syndrome, obstructive sleep apnoea (OSA) and C-reactive protein.
The median (interquartile range) level of serum ADPN was 7.6 (5.4-10.4) mg/L. ADPN levels were positively associated with FVC % of predicted (beta 3.4 per SD adiponectin, p
PubMed ID
29609563 View in PubMed
Less detail

Asthma and COPD among aboriginals in Alberta, Canada.

https://arctichealth.org/en/permalink/ahliterature189768
Source
Chest. 2002 Jun;121(6):1841-6
Publication Type
Article
Date
Jun-2002
Author
Don D Sin
Heather Wells
Lawrence W Svenson
S F Paul Man
Author Affiliation
Department of Medicine, Pulmonary Division, University of Alberta, Edmonton, Alberta, Canada. don.sin@ualberta.ca
Source
Chest. 2002 Jun;121(6):1841-6
Date
Jun-2002
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Alberta
Asthma - diagnosis - epidemiology
Child
Child, Preschool
Emergency Service, Hospital - statistics & numerical data
Female
Humans
Indians, North American
Infant
Male
Middle Aged
Pulmonary Disease, Chronic Obstructive - diagnosis - epidemiology
Retrospective Studies
Abstract
Aboriginals in Canada bear a disproportionately higher burden of some chronic illnesses than nonaboriginals. Although there is a greater prevalence of smoking, poor housing, and overcrowding in aboriginal than nonaboriginal communities, the rates of office and emergency visits for asthma and COPD among aboriginals are not well known.
To determine whether aboriginals require higher rates of asthma and COPD emergency and office visits than nonaboriginals.
Population-based cohort of people residing in Alberta, Canada (population 2.8 million) between April 1, 1996, and March 31, 1997.
Retrospective cohort study.
We observed that aboriginals were 2.1 times (95% confidence interval [CI], 2.0 to 2.2) and 1.6 times (95% CI, 1.6 to 1.6) more likely to have an emergency and office visit for asthma or COPD, respectively, when compared to age-matched and sex-matched nonaboriginals. However, they were 55% (95% CI, 52 to 58%) less likely to see a specialist and 66% (95% CI, 63 to 70%) less likely to undergo spirometry than nonaboriginals.
These findings indicate that aboriginals bear a disproportionately higher burden of asthma and COPD than nonaboriginals. However, lower use of spirometry and specialist services suggests that there might be access barriers to quality health care for aboriginals in Canada.
PubMed ID
12065347 View in PubMed
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Asthma, chronic obstructive pulmonary disease, or both? Diagnostic labeling and spirometry in primary care patients aged 40 years or more.

https://arctichealth.org/en/permalink/ahliterature129159
Source
Int J Chron Obstruct Pulmon Dis. 2011;6:597-603
Publication Type
Article
Date
2011
Author
Hasse Melbye
Elin Drivenes
Lene G Dalbak
Tone Leinan
Svein Høegh-Henrichsen
Anders Ostrem
Author Affiliation
General Practice Research Unit, Department of Community Medicine, University of Tromsø, Norway. hasse.melbye@uit.no
Source
Int J Chron Obstruct Pulmon Dis. 2011;6:597-603
Date
2011
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Asthma - diagnosis - epidemiology - physiopathology
Chi-Square Distribution
Comorbidity
Diagnosis, Differential
Female
Forced expiratory volume
Humans
Lung - physiopathology
Male
Middle Aged
Norway - epidemiology
Practice Guidelines as Topic
Predictive value of tests
Primary Health Care
Prospective Studies
Pulmonary Disease, Chronic Obstructive - diagnosis - epidemiology - physiopathology
Registries
Spirometry
Vital Capacity
Abstract
To describe symptoms and lung function in patients registered with asthma or chronic obstructive pulmonary disease (COPD) in primary care and to examine how spirometry findings fit with general practitioners' (GPs) diagnoses.
Patients aged =40 years with a diagnosis of asthma or COPD registered in the electronic medical record during the previous 5 years were recruited at seven GP offices in Norway in 2009-2010. Registered diagnosis, spirometry results, comorbidity, and reported symptoms were compared.
Among 376 patients, 62% were women. Based on Global Initiative for Chronic Obstructive Lung Diseases criteria, a spirometry diagnosis of COPD could be made in 68.1% of the patients with a previous COPD diagnosis and in 17.1% of those diagnosed with asthma only (P
Notes
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PubMed ID
22135492 View in PubMed
Less detail

Atherosclerotic plaques in the internal carotid artery and associations with lung function assessed by different methods.

https://arctichealth.org/en/permalink/ahliterature127425
Source
Clin Physiol Funct Imaging. 2012 Mar;32(2):120-5
Publication Type
Article
Date
Mar-2012
Author
Sophia Frantz
Ulf Nihlén
Magnus Dencker
Gunnar Engström
Claes-Göran Löfdahl
Per Wollmer
Author Affiliation
Clinical Physiology and Nuclear Medicine unit, Department of Clinical Sciences, Lund University, Malmö, Sweden. sophia.frantz@med.lu.se
Source
Clin Physiol Funct Imaging. 2012 Mar;32(2):120-5
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Aged
Carotid Artery Diseases - epidemiology - physiopathology - ultrasonography
Carotid Artery, Internal - ultrasonography
Cross-Sectional Studies
Female
Forced expiratory volume
Humans
Linear Models
Logistic Models
Lung - physiopathology
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Plaque, Atherosclerotic - epidemiology - physiopathology - ultrasonography
Plethysmography, Whole Body
Predictive value of tests
Pulmonary Diffusing Capacity
Pulmonary Disease, Chronic Obstructive - diagnosis - epidemiology - physiopathology
Questionnaires
Respiratory Function Tests
Risk assessment
Risk factors
Severity of Illness Index
Smoking - epidemiology
Spirometry
Sweden - epidemiology
Vital Capacity
Abstract
Previous studies on associations between reduced lung function and cardiovascular disease (CVD) have mainly been based on forced expiratory volume in 1-s (FEV(1) ) and vital capacity (VC). This study examined potential associations between five different lung function variables and plaques in the internal carotid artery (ICA).
Subjects (n = 450) from a previous population-based respiratory questionnaire survey [current smokers without lower respiratory symptoms, subjects with a self-reported diagnosis of chronic obstructive pulmonary disease (COPD) and never-smokers without lower respiratory symptoms] were examined using spirometry, body plethysmography and measurements of diffusing capacity for CO (D(L,CO) ). Plaques in the ICA were assessed by ultrasonography.
Two hundred and twenty subjects were current smokers, 139 ex-smokers and 89 never-smokers. COPD was diagnosed in 130 subjects (GOLD criteria). Plaques in the ICA were present in 231 subjects (52%). General linear analysis with adjustment for established risk factors for atherosclerosis, including C-reactive protein, showed that D(L,CO) was lower [77.4% versus 83.7% of predicted normal (PN), P = 0.014] and residual volume (RV) was higher (110.3% versus 104.8% of PN, P = 0.020) in subjects with than without plaques in the ICA. This analysis did not show any statistically significant association between plaques and FEV(1) or VC.
The occurrence of plaques in the ICA was associated with low D(L,CO) and high RV, but not significantly with FEV(1) or COPD status. The results suggest that the relationships between reduced lung function, COPD and CVD are complex and not only linked to bronchial obstruction and low-grade systemic inflammation.
PubMed ID
22296632 View in PubMed
Less detail

Benzodiazepine use in COPD: empirical evidence from Norway.

https://arctichealth.org/en/permalink/ahliterature272220
Source
Int J Chron Obstruct Pulmon Dis. 2015;10:1695-702
Publication Type
Article
Date
2015
Author
Thomas Halvorsen
Pål E Martinussen
Source
Int J Chron Obstruct Pulmon Dis. 2015;10:1695-702
Date
2015
Language
English
Publication Type
Article
Keywords
Aged
Benzodiazepines - adverse effects - therapeutic use
Comorbidity
Drug Prescriptions
Drug Utilization Review
Female
Humans
Lung - drug effects - physiopathology
Male
Mental Disorders - diagnosis - drug therapy - epidemiology - psychology
Middle Aged
Norway - epidemiology
Pulmonary Disease, Chronic Obstructive - diagnosis - epidemiology - physiopathology
Risk assessment
Risk factors
Sex Factors
Abstract
The common comorbidities associated with COPD include, among others, anxiety, depression, and insomnia, for which the typical treatment involves the use of benzodiazepines (BZD). However, these medicines should be used with extra caution among COPD patients, since treatment with traditional BZD may compromise respiratory function.
This study investigated the use of BZD among persons suffering from COPD by analyzing three relevant indicators: 1) the sum of defined daily doses (DDD); 2) the number of prescribers involved; and 3) the number of different types of BZD used.
The study builds on a linkage of national prescription data and patient-administrative data, which includes all Norwegian drug prescriptions to persons hospitalized with a COPD diagnosis during 2009, amounting to a total of 5,380 observations. Regression techniques were used to identify the patients and the clinical characteristics associated with BZD use.
Of the 5,380 COPD patients treated in hospital during 2009, 3,707 (69%) were dispensed BZD during the following 12 months. Moreover, they were dispensed on average 197.08 DDD, had 1.22 prescribers, and used 0.98 types of BZD during the year. Women are more likely to use BZD for all levels of BZD use. Overnight planned care not only increases the risk of BZD use (DDD), but also the number of prescribers and the types of BZD in use.
In light of the high levels of BZD prescription found in this study, especially among women, it is recommended that general practitioners, hospital specialists, and others treating COPD patients should aim to acquire a complete picture of their patients' BZD medication before more is prescribed in order to keep the use to a minimum.
Notes
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PubMed ID
26356249 View in PubMed
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