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Yang R, Lu X, Alomeir N, Quataert S, Wu T, Xiao J. Association between Salivary Hormones, Dental Caries, and Cariogenic Microorganisms during Pregnancy. J Clin Med 2024; 13:3183. [PMID: 38892893 PMCID: PMC11173116 DOI: 10.3390/jcm13113183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/08/2024] [Accepted: 05/27/2024] [Indexed: 06/21/2024] Open
Abstract
Objective: This study aimed to identify the salivary levels of six hormones (progesterone, estradiol, testosterone, cortisol, thyroxine T3, and triiodothyronine T4) in pregnant women, and to assess the association between salivary hormones, dental caries, and cariogenic microorganisms. Methods: This cross-sectional study included 181 low-income US pregnant women who were in their third trimester. Demographic details, oral hygiene practices, and medical backgrounds were obtained via questionnaires and medical records. Calibrated dentists obtained data on plaque index and caries status through comprehensive oral examinations. Unstimulated saliva was collected 2 h before eating and brushing. Salivary hormones were measured with a multiplex assay. Oral Streptococcus mutans (S. mutans) and Candida albicans (C. albicans) were quantified via colony-forming unit (CFU) counts. A latent model was used to generate clusters of pregnant women based on salivary hormone levels, followed by post-clustering analysis. Factors associated with salivary cariogenic microorganisms were further evaluated via multiple regression analyses. Results: Estradiol, progesterone, testosterone, cortisol, T3, and T4 in saliva were detectable at rates of 92%, 97%, 77%, 99%, 71%, and 50%, respectively. Three distinct participant clusters (high, intermediate, and low) were identified based on salivary hormone levels. Intermediate-level and high-level clusters had increased numbers of decayed teeth, decayed surfaces, ICDAS scores, and salivary S. mutans and C. albicans, compared to the low-level cluster (p < 0.05). Covariate analysis demonstrated that the high-level cluster was positively associated with salivary carriage of S. mutans (CFU/mL) (p < 0.05). Participants with higher levels of progesterone, estradiol, testosterone, and cortisol were associated with a high carriage status of S. mutans in saliva (>105 CFU/mL) (p < 0.05). Conclusions: This study demonstrated the feasibility of detecting salivary hormones during pregnancy and revealed the positive association between salivary steroid hormones and cariogenic pathogens.
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Affiliation(s)
- Ruqian Yang
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY 14620, USA; (R.Y.); (N.A.)
| | - Xingyi Lu
- Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY 14620, USA; (X.L.); (T.W.)
| | - Nora Alomeir
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY 14620, USA; (R.Y.); (N.A.)
| | - Sally Quataert
- Immunology and Microbiology, University of Rochester Medical Center, Rochester, NY 14620, USA;
| | - Tongtong Wu
- Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY 14620, USA; (X.L.); (T.W.)
| | - Jin Xiao
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY 14620, USA; (R.Y.); (N.A.)
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Behluli E, Veseli E, Veseli A. Evaluation of oral health status in pregnant women and its correlation with calcium and phosphate levels. Folia Med (Plovdiv) 2024; 66:203-212. [PMID: 38690815 DOI: 10.3897/folmed.66.e119961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 03/25/2024] [Indexed: 05/03/2024] Open
Abstract
AIM This study aimed to analyze the oral health conditions of pregnant women. The analysis involves evaluating two key indices: the decayed, missing, and filled teeth (DMFT) index and the basic erosive wear examination (BEWE) index. Furthermore, this study investigated potential correlations between calcium (Ca) and phosphate (P) levels within specific time intervals and the aforementioned oral health indices.
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Byrd M, Davis E, Blostein F, Bhaumik D, Shaffer JR, McNeil DW, Marazita ML, Foxman B. Risk of Postpartum Dental Caries: Survival Analysis of Black/African American and White Women in Appalachia. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2024; 5:108-119. [PMID: 38404680 PMCID: PMC10890941 DOI: 10.1089/whr.2023.0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/13/2024] [Indexed: 02/27/2024]
Abstract
Background Pregnancy is associated with increased risk of caries, but the extent this increase extends into the postpartum period is poorly understood. Study Objective Describe the epidemiology of dental decay in the postpartum period among Black/African American and White American women and explore associations with potentially modifiable risk factors. Materials and Methods We analyzed data from 1,131 Black/African American and White women participating in Center for Oral Health Research in Appalachia cohorts. Women were enrolled during the first two trimesters of pregnancy. Calibrated dental professionals completed dental examinations at the prenatal enrollment visit, and 2-month, 1-year, 2-year, and 3-year postpartum visits. Results Between the prenatal visit and 2-month visit, the incidence of decayed, missing, and filled teeth (DMFT) increase was 6.92/100 person-months, compared to 3.6/100 person-months between the 2-month and 1-year visit. In a multivariate Cox proportional hazard regression predicting incidence of caries up to 3-years postpartum, being younger, having less than college education, a household income <$50,000, smoking cigarettes, a DMFT >0, a very poor or poor Oral hygiene Rating Index, lower salivary pH at enrollment, or frequently drinking 100% juice increased the hazard of new dental caries. Adjusting for race/ethnic group did not affect the direction or magnitude of observed associations. Conclusions The strong associations of prior DMFT and Oral Rating Index with occurrence of new dental caries postpartum suggests that targeting young women for interventions to improve oral health may be more valuable for reducing caries incidence during pregnancy and in the postpartum period than targeting women only during pregnancy.
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Affiliation(s)
- Morgan Byrd
- Department of Epidemiology, Center of Molecular and Clinical Epidemiology of Infectious Diseases, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Elyse Davis
- Department of Epidemiology, Center of Molecular and Clinical Epidemiology of Infectious Diseases, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Freida Blostein
- Department of Epidemiology, Center of Molecular and Clinical Epidemiology of Infectious Diseases, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Deesha Bhaumik
- Department of Epidemiology, Center of Molecular and Clinical Epidemiology of Infectious Diseases, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - John R. Shaffer
- Department of Oral and Craniofacial Sciences, Center for Craniofacial and Dental Genetics, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pennsylvania, Pennsylvania, USA
| | - Daniel W. McNeil
- Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - Mary L. Marazita
- Department of Oral and Craniofacial Sciences, Center for Craniofacial and Dental Genetics, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pennsylvania, Pennsylvania, USA
- Clinical Translational Science, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Betsy Foxman
- Department of Epidemiology, Center of Molecular and Clinical Epidemiology of Infectious Diseases, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
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Bossouf A, Sabourin C, Fuchs F, Giraudeau N, Inquimbert C. Interprofessional survey on knowledge and attitudes of midwives regarding oral health, in France. Eur J Midwifery 2023; 7:37. [PMID: 38045473 PMCID: PMC10690821 DOI: 10.18332/ejm/172881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 09/19/2023] [Accepted: 10/03/2023] [Indexed: 12/05/2023] Open
Abstract
INTRODUCTION Oral health is essential for psychosocial well-being and general health. For expectant mothers, pregnancy increases the risk of oral diseases and has a subsequent impact on the oral health of a child once born. Midwives are in charge of pregnancy monitoring, childbirth and newborns' first days of life. They could have an important role in prevention. However, limited studies evaluating the knowledge, attitudes and practices on oral health among midwives have been conducted in Europe. METHODS We performed a cross-sectional study using a self-administered questionnaire. Two local midwifery associations sent out the questionnaire by email and social media networks to all registered midwives and practicing in the department of Herault (n=613), between April and May 2022. Statistical analyses on quantitative data and descriptive analyses of qualitative free-text responses were performed. RESULTS In total, 167 midwives were included. We found a lack of knowledge on many oral health topics and this was stated as the main reason that only 29% of midwives provided oral health information to their patients. Only 30% of the midwives had a training module on oral health during their initial training, and less than half of them considered the training adequate. To improve their lack of knowledge, participants expressed a preference for digital communication methods for themselves; however, they favored in-person interaction for public interventions. CONCLUSIONS This study showed a lack of training and knowledge about oral health among midwives and a lack of oral health discussion with expectant mothers who are a high-risk population for oral diseases.
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Affiliation(s)
- Abid Bossouf
- Department of Public Health, Faculty of Dental Medicine, University of Montpellier, Montpellier, France
- Center for Latin European Political Studies, UMR 5112, CNRS, University of Montpellier, Montpellier, France
| | - Céline Sabourin
- Department of Public Health, Faculty of Dental Medicine, University of Montpellier, Montpellier, France
- Team of Criminal Law and Forensic Sciences of Montpellier, UR-UM212, University of Montpellier, Montpellier, France
| | - Florent Fuchs
- Department of Obstetrics and Gynecology, Montpellier University Hospital Center, Montpellier, France
- National Institute of Health and Medical Research, Centre for Epidemiology and Population Health, Reproduction and child development, Paris, France
- Desbrest Institute of Epidemiology and Public Health, University of Montpellier, Montpellier, France
| | - Nicolas Giraudeau
- Department of Public Health, Faculty of Dental Medicine, University of Montpellier, Montpellier, France
- Center for Latin European Political Studies, UMR 5112, CNRS, University of Montpellier, Montpellier, France
| | - Camille Inquimbert
- Department of Public Health, Faculty of Dental Medicine, University of Montpellier, Montpellier, France
- Desbrest Institute of Epidemiology and Public Health, University of Montpellier, Montpellier, France
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Zhou X, Zhong Y, Pan Z, Zhang J, Pan J. Physiology of pregnancy and oral local anesthesia considerations. PeerJ 2023; 11:e15585. [PMID: 37404472 PMCID: PMC10315135 DOI: 10.7717/peerj.15585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/26/2023] [Indexed: 07/06/2023] Open
Abstract
Background Safe and effective local anesthesia is a prerequisite for emergency oral surgeries and most dental treatments. Pregnancy is characterized by complex physiological changes, and increased sensitivity to pain. Pregnant women are particularly vulnerable to oral diseases, such as caries, gingivitis, pyogenic granuloma and third molar pericoronitis. Maternally administered drugs can affect the fetus through the placenta. Therefore, many physicians and patients are reluctant to provide or accept necessary local anesthesia, which leads to delays in the condition and adverse consequences. This review is intended to comprehensively discuss the instructions for local anesthesia in the oral treatment of pregnant patients. Methodology An in-depth search on Medline, Embase, and the Cochrane Library was performed to review articles concerned with maternal and fetal physiology, local anesthetic pharmacology, and their applications for oral treatment. Results Standard oral local anesthesia is safe throughout the pregnancy. At present, 2% lidocaine with 1:200,000 epinephrine is considered to be the anesthetic agent that best balances safety and efficacy for pregnant women. Maternal and fetal considerations must be taken into account to accommodate the physiological and pharmacological changes in the gestation period. Semi-supine position, blood pressure monitoring, and reassurance are suggested for high-risk mothers to reduce the risk of transient changes in blood pressure, hypoxemia, and hypoglycemia. For patients with underlying diseases, such as eclampsia, hypertension, hypotension, and gestational diabetes, the physicians should use epinephrine cautiously and control the dose of anesthetic. New local anesthesia formulations and equipment, which contribute to minimizing injection pain and relieving the anxiety, have and are being developed but remain understudied. Conclusions Understanding the physiological and pharmacological changes during pregnancy is essential to ensure the safety and efficiency of local anesthesia. Optimal outcomes for the mother and fetus hinge on a robust understanding of the physiologic alterations and the appropriate selection of anesthetic drugs and approaches.
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Affiliation(s)
- Xueer Zhou
- State Key Laboratory of Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yunyu Zhong
- State Key Laboratory of Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Zijian Pan
- State Key Laboratory of Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jiankang Zhang
- State Key Laboratory of Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- Chengdu Advanced Medical Science Center, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jian Pan
- State Key Laboratory of Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- Chengdu Advanced Medical Science Center, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
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Davis E, Martinez G, Blostein F, Marshall T, Jones A, Jansen E, McNeil D, Neiswanger K, Marazita M, Foxman B. Dietary Patterns and Risk of a New Carious Lesion Postpartum: A Cohort Study. J Dent Res 2022; 101:295-303. [PMID: 34609222 PMCID: PMC8982010 DOI: 10.1177/00220345211039478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Dental caries (cavities), one of the most common infectious diseases, is caused by a number of factors. Oral microbes, dietary practices, sociodemographic factors, and dental hygiene all inform caries risk. Assessing the impact of diet is complicated as individuals eat foods in combinations, and the interactions among the foods may alter caries risk. Our study aimed to prospectively assess the association between dietary patterns and caries risk in the postpartum period, a potentially sensitive period for caries development. We analyzed in-person dental assessments and telephone food frequency questionnaires (FFQs) from 879 Caucasian women participating in the Center for Oral Health Research in Appalachia Cohort 2 (COHRA2) that were collected biannually for up to 6 y. One-week recall of food intake frequency was assessed using a Likert scale. We used principal component analysis to summarize the FFQ data; the top 2 components described 15% and 12% of the variance in FFQ data. The first component was characterized by high consumption of fruits and vegetables, while the second component was heavily influenced by desserts and crackers. We used a modified Poisson model to predict the risk of an increase in the number of decayed, missing, and filled teeth in the postpartum period by 1) dietary patterns and 2) individual foods and beverages at the previous study visit, after controlling for other known risk factors, including history of carious lesions. Eating a dietary pattern high in desserts and crackers was associated with a 20% increase in the number of decayed, missing, and filled teeth in the postpartum period (95% confidence interval, 1.03-1.39). However, this effect was attenuated among those who also consumed a dietary pattern high in fruits and vegetables. Dietary patterns should be considered when devising interventions aimed at preventing dental caries.
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Affiliation(s)
- E. Davis
- Center for Molecular and Clinical
Epidemiology of Infectious Diseases, Department of Epidemiology, University of
Michigan School of Public Health, Ann Arbor, MI, USA
| | - G. Martinez
- Center for Molecular and Clinical
Epidemiology of Infectious Diseases, Department of Epidemiology, University of
Michigan School of Public Health, Ann Arbor, MI, USA
| | - F. Blostein
- Center for Molecular and Clinical
Epidemiology of Infectious Diseases, Department of Epidemiology, University of
Michigan School of Public Health, Ann Arbor, MI, USA
| | - T. Marshall
- Department of Preventive and Community
Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - A.D. Jones
- Department of Nutritional Sciences,
University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - E. Jansen
- Department of Nutritional Sciences,
University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - D.W. McNeil
- Center for Oral Health Research in
Appalachia (COHRA) University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychology, West Virginia
University, Department of Dental Practice & Rural Health, West Virginia
University School of Dentistry, Morgantown, WV Morgantown, WV, USA
| | - K. Neiswanger
- Center for Oral Health Research in
Appalachia (COHRA) University of Pittsburgh, Pittsburgh, PA, USA
- Center for Craniofacial and Dental
Genetics, Department of Oral and Craniofacial Sciences, School of Dental Medicine,
University of Pittsburgh, Pittsburgh, PA, USA
| | - M.L. Marazita
- Center for Oral Health Research in
Appalachia (COHRA) University of Pittsburgh, Pittsburgh, PA, USA
- Center for Craniofacial and Dental
Genetics, Department of Oral and Craniofacial Sciences, School of Dental Medicine,
University of Pittsburgh, Pittsburgh, PA, USA
- Department of Human Genetics, Graduate
School of Public Health, Clinical and Translational Sciences, School of Medicine,
University of Pittsburgh, Pittsburgh, PA, USA
| | - B. Foxman
- Center for Molecular and Clinical
Epidemiology of Infectious Diseases, Department of Epidemiology, University of
Michigan School of Public Health, Ann Arbor, MI, USA
- B. Foxman, Center for Molecular and
Clinical Epidemiology of Infectious Diseases, Department of Epidemiology,
University of Michigan School of Public Health, 1415 Washington Heights, Ann
Arbor, MI 48109, USA.
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Gorji NE, Nasiri P, Shafaroudi AM, Shahhosseini Z, Hamzehgardeshi Z, Moosazadeh M. Relationship between DMFT index and number of pregnancies: a cross-sectional study on enrollment phase of the Tabari Cohort Study. BMC Oral Health 2021; 21:643. [PMID: 34911517 PMCID: PMC8672515 DOI: 10.1186/s12903-021-02004-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 12/03/2021] [Indexed: 11/10/2022] Open
Abstract
Background People of all age and gender groups are at risk of dental diseases; however, some groups, such as pregnant women, are more vulnerable than others due to their specific physiological situations. The protection of maternal and fetal is critical. Therefore, the present study intended to investigate the relationship between the Decayed, Missing, and Filled Teeth (DMFT) index and the number of pregnancies. Methods The present cross-sectional study was performed using the Tabari Cohort Study (T.C.S.) data. Data of 5,496 women enrolled in the T.C.S. were included in the study. After obtaining the approval of the Ethics Committee, the related data on the variables of age, age at the first pregnancy, number of pregnancies, total number of teeth at the time of examination, number of DMFT, employment status, socioeconomic status, educational level, residence location, body mass index, and the status of diabetes mellitus, hypertension, and cardiovascular diseases were extracted. Finally, data analysis was performed in the STATA software (version 14). Results The mean DMFT index in women with 1, 2, 3, 4, 5, 6, and more than six pregnancies were obtained at 12.74 ± 7.11, 13.09 ± 7.06, 14.80 ± 7.81, 17.07 ± 8.11, 19.82 ± 9.02, 22.89 ± 8.98, and 26.17 ± 8.01, respectively (P < 0.001). Using the multivariate linear regression and adjusting the effect of potential confounding variables, it was found that the DMFT index increased by 34% for each unit increase in the number of pregnancies (β = 0.34, P < 0.001). Conclusions According to our results, there was a significant relationship between the DMFT index and the number of pregnancies. The DMFT index was increased with an increased number of pregnancies. Therefore, oral healthcare promotion should receive special attention in healthcare planning and related policies by raising awareness and providing easy access to dental services for women of childbearing age, especially pregnant women.
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Affiliation(s)
- Nadia Elyassi Gorji
- Dentistry Student, Student Research Committee, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | - Pegah Nasiri
- Dentistry Student, Student Research Committee, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ali Malekzadeh Shafaroudi
- Dentistry Student, Student Research Committee, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zohreh Shahhosseini
- Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zeinab Hamzehgardeshi
- Department of Reproductive Health and Midwifery, Sexual and Reproductive Health Research Center, School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmood Moosazadeh
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.
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Bovbjerg ML, Pillai S, Cheyney M. Current Resources for Evidence-Based Practice, January 2021. J Obstet Gynecol Neonatal Nurs 2021; 50:102-115. [DOI: 10.1016/j.jogn.2020.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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