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Marín Posada S, Posada Zapata IC. Menosprecio y riesgo en hombres que tienen sexo con hombres viviendo con VIH en Medellín. HACIA LA PROMOCIÓN DE LA SALUD 2020. [DOI: 10.17151/hpsal.2020.25.1.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objetivo: comprender los significados de menosprecio construidos por hombres que tienen sexo con hombres (HSH) viviendo con VIH y su relación con prácticas de riesgo, en el área metropolitana de Medellín, 2016. Métodos: enfoque cualitativo. Se realizaron 11 entrevistas que fueron codificadas y analizadas siguiendo el método de Teoría Fundada propuesto por Strauss y Corbin. El muestreo tuvo dos momentos, en el primero se desarrolló un muestreo intencional estratificado y en el segundo un muestreo teórico. Participaron 8 HSH con VIH mayores de 18 años y residentes del área metropolitana de Medellín. Resultados: los significados de menosprecio derivados de experiencias de menosprecio vividas en diferentes escenarios de socialización por HSH con VIH permiten comprender prácticas de riesgo en este grupo poblacional. Discusión: las prácticas de cuidado y de riesgo de HSH con VIH están influenciadas por un contexto relacional donde se llevan a cabo interacciones de reconocimiento y menosprecio. En esta trama la heteronormatividad es un elemento central que atraviesa los vínculos en escenarios privados (familia, amigos, pareja) y públicos (instituciones educativas, de salud, etc.); de modo que las prácticas de cuidado-riesgo merecen ser comprendidas en clave de justicia social y no sólo como aptitudes meramente individuales.
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Perales J, Checa I, Espejo B. Current active and passive smoking among adults living with same sex partners in Spain. GACETA SANITARIA 2018; 32:547-552. [DOI: 10.1016/j.gaceta.2017.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 03/15/2017] [Accepted: 03/16/2017] [Indexed: 10/19/2022]
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Mirandola M, Gios L, Joanna Davis R, Furegato M, Breveglieri M, Folch C, Staneková D, Nita I, Stehlíková D. Socio-demographic factors predicting HIV test seeking behaviour among MSM in 6 EU cities. Eur J Public Health 2017; 27:313-318. [PMID: 27615734 DOI: 10.1093/eurpub/ckw144] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background HIV testing is generally accepted as being the lynchpin of a prevention strategy to tackle the HIV epidemic among MSM. However, few studies have analysed in detail the factors that influence HIV test seeking behaviour. Methods The objective of this article is to analyse the relationship between HIV test seeking behaviour and individual, social and demographic factors in a sample of MSM recruited though a multi-centre bio-behavioural cross-sectional study. A multi-level analysis was conducted to identify factors associated with HIV test seeking behaviour. Results A total of 2400 men were included in the sample. Age, self-reported sexual orientation, residence, household composition, educational status and perceived homonegativity all seem to impact on test seeking behaviour. Conclusions The results suggest the need for more targeted testing promotion strategies among MSM that take structural and environmental factors into consideration, as part of a comprehensive public health strategy to address the HIV epidemic.
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Affiliation(s)
- Massimo Mirandola
- CReMPE - Regional Coordination Centre for European Project Management Veneto Region - Department of Health, Verona University Hospital, Verona, Italy.,Infectious Diseases Section, Department of Pathology, Verona University Hospital - Veneto Region, Verona, Italy
| | - Lorenzo Gios
- CReMPE - Regional Coordination Centre for European Project Management Veneto Region - Department of Health, Verona University Hospital, Verona, Italy
| | - Ruth Joanna Davis
- CReMPE - Regional Coordination Centre for European Project Management Veneto Region - Department of Health, Verona University Hospital, Verona, Italy
| | - Martina Furegato
- CReMPE - Regional Coordination Centre for European Project Management Veneto Region - Department of Health, Verona University Hospital, Verona, Italy
| | - Michele Breveglieri
- CReMPE - Regional Coordination Centre for European Project Management Veneto Region - Department of Health, Verona University Hospital, Verona, Italy
| | - Cinta Folch
- Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Danica Staneková
- NRC for HIV/AIDS, Slovak Medical University, Bratislava, Slovak Republic
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Diez M, Bleda MJ, Varela JR, Ordonana J, Azpiri MA, Vall M, Santos C, Viloria L, de Armas C, Urena JM, Trullen J, Pueyo I, Martinez B, Puerta T, Vera M, Sanz I, Junquera ML, Landa MC, Martinez E, Camara MM, Belda J, Bru FJ, Diaz A. Trends in HIV testing, prevalence among first-time testers, and incidence in most-at-risk populations in Spain: the EPI-VIH Study, 2000 to 2009. ACTA ACUST UNITED AC 2014; 19:20971. [PMID: 25443036 DOI: 10.2807/1560-7917.es2014.19.47.20971] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
During 2000 to 2009, data on people undergoing HIV testing and on those newly diagnosed with HIV were collected in a network of 20 Spanish clinics specialising in sexually transmitted infections and/or HIV testing and counselling. The number of tests performed, overall and disaggregated by different variables, was obtained. HIV prevalence among first-time testers and HIV incidence among repeat testers were calculated. To evaluate trends, joinpoint regression models were fitted. In total, 236,939 HIV tests were performed for 165,745 individuals. Overall HIV prevalence among persons seeking HIV testing was 2.5% (95% CI: 2.4 to 2.6). Prevalence was highest in male sex workers who had sex with other men (19.0% (95% CI: 16.7 to 21.4)) and was lowest in female sex workers (0.8% (95% CI: 0.7 to 0.9)). Significant trends in prevalence were observed in men who have sex with men (MSM) (increasing) and heterosexual individuals (decreasing). The incidence analysis included 30,679 persons, 64,104 person-years (py) of follow-up and 642 seroconversions. The overall incidence rate (IR) was 1.0/100 py (95% CI: 0.9/100 to 1.1/100). Incidence was significantly higher in men and transgender females than in women (1.8/100 py (95% CI: 1.6 to 1.9), 1.2/100 py (95% CI: 0.5 to 2.8) and 0.1/100 py (95% CI: 0.09 to 0.2) respectively) and increased with age until 35–39 years. IRs in MSM and people who inject drugs were significantly greater than in heterosexual individuals (2.5/100 py (95% CI: 2.3 to 2.7), 1.6/100 py (95% CI: 1.1 to 2.2) and 0.1/100 py (95% CI: 0.09 to 0.2) respectively), and an upward trend was observed in MSM. Our results call for HIV prevention to be reinforced in MSM and transgender women in Spain.
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Affiliation(s)
- M Diez
- Plan Nacional sobre el sida, Ministerio de Sanidad, Servicios Sociales e Igualdad, Madrid, Spain
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Ferrer L, Furegato M, Foschia JP, Folch C, González V, Ramarli D, Casabona J, Mirandola M. Undiagnosed HIV infection in a population of MSM from six European cities: results from the Sialon project. Eur J Public Health 2014; 25:494-500. [PMID: 25161202 DOI: 10.1093/eurpub/cku139] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES The purpose of this article is to assess the distribution of undiagnosed HIV infection in men who have sex with men (MSM) in Southern and Eastern European countries, to describe the differences in epidemiology and behaviour between undiagnosed, diagnosed HIV-positive and HIV-negative MSM and to identify factors associated with undiagnosed HIV infection in the study population. METHODS A multi-centre biological and behavioural cross-sectional study was conducted in 2008. Time-location sampling was used to recruit men attending different venues. A self-administered questionnaire was completed and oral fluid samples were collected to estimate HIV prevalence. RESULTS HIV prevalence was 17% in Barcelona, 12% in Verona, 6% in Bratislava, 5% in Ljubljana, 5% in Bucharest and 3% in Prague while undiagnosed HIV infection was 47, 62, 67, 83, 85 and 57%, respectively. Diagnosed HIV-positive men reported more casual partners than HIV-negative MSM (mean: 19 and 9, respectively) (P < 0.001), and they were more likely to self-reported condyloma in the last year than undiagnosed HIV-positive and HIV-negative men (15, 1 and 3%, respectively) (P < 0.001). Factors associated with undiagnosed HIV infection included attending sex-focused venues (OR = 2.49), reporting syphilis in the previous 12 months (OR = 2.56), using poppers at last sexual intercourse (OR = 3.36) and having had an HIV test in the previous year (OR = 2.00). CONCLUSIONS Many HIV infections remain undiagnosed, and there is evidence of the persistence of frequent risk behaviours and sexually transmitted infections (STI) despite knowledge of HIV-positive status, emphasising the need for a multidimensional approach to HIV/STI prevention. Access to HIV testing should be considered a priority in prevention programs targeted at MSM, especially in Eastern Europe.
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Affiliation(s)
- Laia Ferrer
- 1 Center for Epidemiological Studies on STI and AIDS of Catalonia (CEEISCAT), Agència Salut Pública de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain 2 Institut d'Investigació Germans Trias i Pujol (IGTP), Badalona, Spain 3 CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Martina Furegato
- 4 Regional Center for Health Promotion, Veneto Region, Verona, Italy
| | | | - Cinta Folch
- 1 Center for Epidemiological Studies on STI and AIDS of Catalonia (CEEISCAT), Agència Salut Pública de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain 2 Institut d'Investigació Germans Trias i Pujol (IGTP), Badalona, Spain 3 CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain 5 Departament de Pediatria, d'Obstetrícia i Ginecologia i de Medicina Preventiva i de Salut Pública, Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
| | - Victoria González
- 1 Center for Epidemiological Studies on STI and AIDS of Catalonia (CEEISCAT), Agència Salut Pública de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain 2 Institut d'Investigació Germans Trias i Pujol (IGTP), Badalona, Spain 3 CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain 6 Microbiology Service, Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Dunia Ramarli
- 7 Immunology Section, Verona University Hospital, Verona, Italy
| | - Jordi Casabona
- 1 Center for Epidemiological Studies on STI and AIDS of Catalonia (CEEISCAT), Agència Salut Pública de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain 2 Institut d'Investigació Germans Trias i Pujol (IGTP), Badalona, Spain 3 CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain 5 Departament de Pediatria, d'Obstetrícia i Ginecologia i de Medicina Preventiva i de Salut Pública, Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
| | - Massimo Mirandola
- 8 Infectious Diseases Section, Department of Pathology, Verona University Hospital, Verona, Italy
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[Attitudes toward online HIV/sexually-transmitted infection prevention programs and Internet user profiles among men who have sex with men]. GACETA SANITARIA 2011; 26:123-30. [PMID: 22047624 DOI: 10.1016/j.gaceta.2011.06.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2010] [Revised: 05/20/2011] [Accepted: 06/02/2011] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To describe the attitudes of men who have sex with men (MSM) toward online HIV/sexually-transmitted infection (STI) prevention programs and to identify and characterize user profiles with regard to their attitudes toward online prevention programs. METHOD A survey in gay venues or via the internet was completed by 2,044 participants from Madrid, Barcelona, Bilbao and San Sebastián (Spain). The survey explored socio-demographic variables, sexual behavior and other risk behaviors associated with HIV infection, as well as attitudes toward online prevention programs. The statistical analysis included factor analysis and non-hierarchical cluster analysis. RESULTS Most MSM had positive attitudes towards online HIV/STI prevention programs. Factor analysis revealed two factors: online prevention aimed at interaction and online prevention aimed at information. Based on these factors, three user profiles were identified: users oriented toward informative and interactive online prevention (53.5%), users oriented toward interactive online prevention (25.9%) and users were not oriented toward online prevention (20.7%). On characterizing these profiles, we observed a significant presence of men who were not interested in online prevention among those with a lower educational level, bisexual men and HIV-positive men. Conversely, those most receptive to online prevention were men self-identified as gay, those with a bachelors degree, those who had been tested for HIV and those who were HIV-negative. CONCLUSION The internet can facilitate sexual health promotion among MSM. Characterization of user profiles offers the possibility of segmenting prevention programs and of combining online and offline strategies.
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Fernández-Dávila P, Zaragoza Lorca K. Hombres jóvenes que tienen sexo con hombres: ¿un colectivo en alto riesgo para la infección por el VIH? GACETA SANITARIA 2011; 25:372-8. [DOI: 10.1016/j.gaceta.2011.05.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2010] [Revised: 04/18/2011] [Accepted: 05/13/2011] [Indexed: 11/29/2022]
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Hurtado I, Alastrue I, Pavlou M, Tasa T, Pérez-Hoyos S. Increased syphilis trend among patients in an AIDS information and prevention center. GACETA SANITARIA 2011; 25:368-71. [PMID: 21715060 DOI: 10.1016/j.gaceta.2010.04.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2009] [Revised: 03/24/2010] [Accepted: 04/11/2010] [Indexed: 10/18/2022]
Abstract
OBJECTIVE A rebound of syphilis cases has recently been observed. This study describes the trend in syphilis infection among persons attending the AIDS information and prevention center of Valencia, Spain. METHODS We performed a cohort study of all persons attended from 2000 to 2006. The calendar effect was assessed by a logistic regression model adjusted by sexual and sociodemographic variables. RESULTS A total of 71% were heterosexuals (HT) and 19% were men who had sex with men (MSM). Among the 10,850 users of the center, the prevalence of syphilis was 0.7%. Among MSM, the prevalence of syphilis was 2.4% for the whole period and was 4.6% for 2006. Multivariate analysis showed that the risk of infection was lower in persons with a university education (OR=0.10; 95%CI: 0.03-0.59) than in those without. The risk was higher in persons who took drugs (OR=5.49; 95%CI: 1.55-19.43) or who practiced prostitution (OR=6.83; 95%CI: 2.52-18.53). In 2006, the risk of having syphilis was greater (OR=5.05; 95%CI: 1.12-22.72). CONCLUSIONS Syphilis infection increased substantially among MSM. In this collective, the prevalence of infection is related to educational level, prostitution and the use of non-injected recreational drugs.
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Affiliation(s)
- Isabel Hurtado
- The Biomedical Research Center Network for Epidemiology and Public Health, Spain. hurtado
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Incremento en la prevalencia del VIH y en las conductas de riesgo asociadas en hombres que tienen sexo con hombres: 12 años de encuestas de vigilancia conductual en Cataluña. GACETA SANITARIA 2010; 24:40-6. [DOI: 10.1016/j.gaceta.2009.06.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2009] [Revised: 05/05/2009] [Accepted: 06/28/2009] [Indexed: 11/23/2022]
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Fernández-Dávila P, Zaragoza Lorca K. Internet y riesgo sexual en hombres que tienen sexo con hombres. GACETA SANITARIA 2009; 23:380-7. [DOI: 10.1016/j.gaceta.2008.11.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2008] [Revised: 09/13/2008] [Accepted: 11/05/2008] [Indexed: 11/16/2022]
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Folch C, Esteve A, Zaragoza K, Muñoz R, Casabona J. Correlates of intensive alcohol and drug use in men who have sex with men in Catalonia, Spain. Eur J Public Health 2009; 20:139-45. [PMID: 19564240 DOI: 10.1093/eurpub/ckp091] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The objectives of the study were to determine the prevalence of alcohol and drug use before or during sex among men who have sex with men (MSM) in Catalonia during 2006, and to identify factors associated with variables of intensive alcohol and drug use. METHODS Cross-sectional study using self-administered questionnaires. Men were recruited in saunas, sex shops, bars and a public park and by mail to all the members of the Catalonia Gay Federation. RESULTS 19.6% of men said they were frequent users of alcohol, some type of drug (21.7%), or that they were multidrug users (18%) in the last 12 months. The multivariate analysis showed an association between having suffered discrimination and frequent alcohol and multidrug use. Being human immunodeficiency virus (HIV)-positive was associated with frequent use of drugs and multidrug use. Associations between substance use and sexual risk behaviour also emerged. CONCLUSION The high percentage of MSM who use alcohol and drugs before and during sex and association between these substances and sexual risk behaviours reveals the need to intensify interventions to reduce their levels of use and/or to reduce the associated damage and risks. These programs must try to cover MSM-specific psychosocial aspects and include prevention for HIV-positive men.
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Affiliation(s)
- Cinta Folch
- Centre for Sexually Transmitted Infection and AIDS Epidemiological Studies of Catalonia (CEEISCAT) - ICO, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
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Dougan S, Evans BG, Elford J. Sexually transmitted infections in Western Europe among HIV-positive men who have sex with men. Sex Transm Dis 2008; 34:783-90. [PMID: 17495592 DOI: 10.1097/01.olq.0000260919.34598.5b] [Citation(s) in RCA: 138] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Since 1996, there has been a resurgence in sexually transmitted infections (STIs) among men who have sex with men (MSM) in Western Europe. This has coincided with a significant decrease in HIV-associated mortality following the introduction of highly active antiretroviral therapies (HAART) and a corresponding increase in the number of MSM living with HIV. Levels of unprotected anal intercourse have also increased. In this article, we use STI surveillance data from a number of Western European countries to better understand the contribution of HIV-positive MSM to the recent increase in STIs. METHODS Published literature, surveillance reports, and ad hoc publications relating to HIV prevalence trends and STIs among HIV-positive MSM in Western Europe were reviewed. RESULTS Post-HAART, HIV prevalence among community samples of MSM ranged from 5% to 18%. HIV prevalence among MSM diagnosed with an STI was substantially higher. On average, HIV prevalence among MSM diagnosed with syphilis in 11 countries was 42% (range 14%-59%). Most HIV-positive MSM with syphilis were aware of their HIV status. In England and Wales, 32% of MSM with gonorrhea were HIV-positive in 2004. Outbreaks of lymphogranuloma venereum have been documented in 9 countries; HIV-positive MSM accounted for 75% of cases on average (range 0%-92%). Cases of sexually transmitted hepatitis C have been predominantly identified among HIV-positive MSM in Rotterdam, Paris, Amsterdam, and the United Kingdom. CONCLUSIONS In Western Europe, STIs have been disproportionately diagnosed among HIV-positive MSM post-HAART. Improved survival coupled with serosorting among HIV-positive MSM appears to explain the high prevalence of HIV among MSM with STIs. STI transmission among HIV-positive men will have contributed substantially to increasing STI trends seen among MSM in Western Europe, since 1996. These findings highlight the need for routine STI testing among HIV-positive MSM as well as safer sex messages highlighting the implications of STI coinfection.
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Affiliation(s)
- Sarah Dougan
- City University, Institute of Health Sciences, St. Bartholomew School of Nursing and Midwifery, London, United Kingdom.
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Fernández-Dávila P. «Amigos con derecho a roce»: una oportunidad para contraer la infección por el virus de la inmunodeficiencia humana en hombres homo/bixesuales con prácticas sexuales de alto riesgo. GACETA SANITARIA 2007; 21:471-8. [DOI: 10.1157/13112240] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Baumann RJ, Espinosa PS. Neuroepidemiology of HIV/AIDS. HANDBOOK OF CLINICAL NEUROLOGY 2007; 85:3-31. [PMID: 18808973 DOI: 10.1016/s0072-9752(07)85002-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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