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Stefani L, Sofi F, Magro S, Mascherini G, Petri C, Galanti G. Exercise and Cancer Survivors: Lessons Learned from a Multi-Faceted Model for Exercise Prescription. J Funct Morphol Kinesiol 2018; 3:jfmk3030038. [PMID: 33466967 PMCID: PMC7739294 DOI: 10.3390/jfmk3030038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 06/01/2018] [Accepted: 06/22/2018] [Indexed: 01/20/2023] Open
Abstract
Cancer is the second leading cause of death, and the most common diagnosis among the general population is breast and colon cancer. Recently, an increasing number of new cases of invasive breast and colon cancer have been estimated, and more people die from these diseases. In addition to the genetic pattern, diet and lifestyle including smoking, alcohol consumption, and sedentary behaviour have also been identified as potential risks factors. Recent studies of cancer survivors have shown the beneficial effects of regular physical activity to reduce the prevalence of comorbidity, muscle atrophy, weight changes, reduced aerobic capacity, fatigue, depression, and reduced quality of life. Dedicated and individual programs are crucial for achieving the goals of improving quality of life and reducing comorbidities. A multidisciplinary approach is fundamental: lifestyle assessment, including estimating the level of physical activity, as well as nutritional habits, may be the first step. A periodic cardiovascular examination is crucial for detecting asymptomatic early myocardial failure. According to current ACSM guidelines, different levels of exercise (low-moderate 40% and moderate up to 60% of the maximal HR) may be prescribed, and patients enrolled may follow the exercise program if in the absence of contraindications. The current paper reports observations from our clinical practice and provides practical strategies that bridge contemporary, published guidelines into practice within a multi-disciplinary team working with cancer survivors in Italy.
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Affiliation(s)
- Laura Stefani
- Unit of Sports Medicine, Department of Experimental and Clinical Medicine, University of Florence, 50141 Florence, Italy
- Correspondence: ; Tel.: +39-3477689030
| | - Francesco Sofi
- Unit of Clinical Nutrition, Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Simone Magro
- Unit of Sports Medicine, Department of Experimental and Clinical Medicine, University of Florence, 50141 Florence, Italy
| | - Gabriele Mascherini
- Unit of Sports Medicine, Department of Experimental and Clinical Medicine, University of Florence, 50141 Florence, Italy
| | - Cristian Petri
- Unit of Sports Medicine, Department of Experimental and Clinical Medicine, University of Florence, 50141 Florence, Italy
| | - Giorgio Galanti
- Unit of Sports Medicine, Department of Experimental and Clinical Medicine, University of Florence, 50141 Florence, Italy
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2
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Vercelli M, Lillini R, Quaglia A, Capocaccia R, Vercelli M, Lillini L, Quaglia A, Capocaccia R, De Angelis R, Gatta G, Tagliabue G, Pannozzo F, Ramazzotti V, Fusco M, Cilia S, De Felice E, Vattiato R, Senatore R, Zucchetto A, Buzzoni C, Tognazzo S, Bellù F, Piffer S, Cusimano R, Zarcone M, Cirilli C, Stracci F, Ferretti S, Cesaraccio R, Rosso S, Giacomin A, Cuccaro F, Michiara M. Italian Regional Health System Structure and Expected Cancer Survival. TUMORI JOURNAL 2018. [DOI: 10.1177/1636.17892] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Marina Vercelli
- Liguria Region Cancer Registry, Descriptive Epidemiology Unit, IRCCS Azienda Ospedaliera Universitaria San Martino – IST Istituto Nazionale per la Ricerca sul Cancro, Genoa
- Department of Health Sciences, University of Genoa, Genoa
| | - Roberto Lillini
- Liguria Region Cancer Registry, Descriptive Epidemiology Unit, IRCCS Azienda Ospedaliera Universitaria San Martino – IST Istituto Nazionale per la Ricerca sul Cancro, Genoa
- National Center of Epidemiology, Surveillance and Promotion of Health, National Institute of Health, Rome
- “Vita & Salute” San Raffaele University, Milan, Italy
| | - Alberto Quaglia
- Liguria Region Cancer Registry, Descriptive Epidemiology Unit, IRCCS Azienda Ospedaliera Universitaria San Martino – IST Istituto Nazionale per la Ricerca sul Cancro, Genoa
| | - Riccardo Capocaccia
- Liguria Region Cancer Registry, Descriptive Epidemiology Unit, IRCCS Azienda Ospedaliera Universitaria San Martino – IST Istituto Nazionale per la Ricerca sul Cancro, Genoa
- National Center of Epidemiology, Surveillance and Promotion of Health, National Institute of Health, Rome
| | - M Vercelli
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - L Lillini
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - A Quaglia
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - R Capocaccia
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - R De Angelis
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - G Gatta
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - G Tagliabue
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - F Pannozzo
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - V Ramazzotti
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - M Fusco
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - S Cilia
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - E De Felice
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - R Vattiato
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - R Senatore
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - A Zucchetto
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - C Buzzoni
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - S Tognazzo
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - F Bellù
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - S Piffer
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - R Cusimano
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - M Zarcone
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - C Cirilli
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - F Stracci
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - S Ferretti
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - R Cesaraccio
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - S Rosso
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - A Giacomin
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - F Cuccaro
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
| | - M Michiara
- Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS
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Micheli A, Berrino F, Paci E, Verdecchia A, Pierotti MA. Strategies for Cancer Control in Italy. TUMORI JOURNAL 2018. [DOI: 10.1177/030089160709300402] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Andrea Micheli
- Unità di Epidemiologia Descrittiva e
Programmazione Sanitaria, Fondazione IRCCS “Istituto Nazionale dei Tumori”,
Milan
| | - Franco Berrino
- Unità di Epidemiologia Eziologia e
Prevenzione, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan
| | - Eugenio Paci
- Unità di Epidemiologia clinica e
descrittiva, Centro per lo Studio e la Prevenzione Oncologica, CSPO, Florence
| | - Arduino Verdecchia
- Reparto di Epidemiologia dei Tumori,
Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto
Superiore di Sanità, Rome
| | - Marco A Pierotti
- Direzione Scientifica, Fondazione
IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
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4
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Fiorito G, Di Gaetano C, Guarrera S, Rosa F, Feldman MW, Piazza A, Matullo G. The Italian genome reflects the history of Europe and the Mediterranean basin. Eur J Hum Genet 2015; 24:1056-62. [PMID: 26554880 DOI: 10.1038/ejhg.2015.233] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 09/22/2015] [Accepted: 09/30/2015] [Indexed: 11/09/2022] Open
Abstract
Recent scientific literature has highlighted the relevance of population genetic studies both for disease association mapping in admixed populations and for understanding the history of human migrations. Deeper insight into the history of the Italian population is critical for understanding the peopling of Europe. Because of its crucial position at the centre of the Mediterranean basin, the Italian peninsula has experienced a complex history of colonization and migration whose genetic signatures are still present in contemporary Italians. In this study, we investigated genomic variation in the Italian population using 2.5 million single-nucleotide polymorphisms in a sample of more than 300 unrelated Italian subjects with well-defined geographical origins. We combined several analytical approaches to interpret genome-wide data on 1272 individuals from European, Middle Eastern, and North African populations. We detected three major ancestral components contributing different proportions across the Italian peninsula, and signatures of continuous gene flow within Italy, which have produced remarkable genetic variability among contemporary Italians. In addition, we have extracted novel details about the Italian population's ancestry, identifying the genetic signatures of major historical events in Europe and the Mediterranean basin from the Neolithic (e.g., peopling of Sardinia) to recent times (e.g., 'barbarian invasion' of Northern and Central Italy). These results are valuable for further genetic, epidemiological and forensic studies in Italy and in Europe.
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Affiliation(s)
- Giovanni Fiorito
- Department of Medical Sciences, University of Turin, Turin, Italy.,HuGeF Human Genetics Foundation, Turin, Italy
| | - Cornelia Di Gaetano
- Department of Medical Sciences, University of Turin, Turin, Italy.,HuGeF Human Genetics Foundation, Turin, Italy
| | - Simonetta Guarrera
- Department of Medical Sciences, University of Turin, Turin, Italy.,HuGeF Human Genetics Foundation, Turin, Italy
| | - Fabio Rosa
- HuGeF Human Genetics Foundation, Turin, Italy
| | | | - Alberto Piazza
- Department of Medical Sciences, University of Turin, Turin, Italy.,HuGeF Human Genetics Foundation, Turin, Italy
| | - Giuseppe Matullo
- Department of Medical Sciences, University of Turin, Turin, Italy.,HuGeF Human Genetics Foundation, Turin, Italy
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Crispo A, Barba M, Malvezzi M, Arpino G, Grimaldi M, Rosso T, Esposito E, Sergi D, Ciliberto G, Giordano A, Montella M. Cancer mortality trends between 1988 and 2009 in the metropolitan area of Naples and Caserta, Southern Italy: Results from a joinpoint regression analysis. Cancer Biol Ther 2013; 14:1113-22. [PMID: 24025410 DOI: 10.4161/cbt.26425] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Mortality data by geographic area and trend-based surveillance are particularly relevant in orienting public health decisions targeting specific populations. We analyzed overall and site-specific cancer mortality between 1988 and 2009 in the metropolitan area of Naples and Caserta in southern Italy. Age-standardized mortality rates (SMR) were computed for each 5-y age group, by gender, primitive cancer site and specific Province in the overall population and age-defined subgroups. Cancer mortality trends were quantified by annual percent change (APC) and 95% confidence interval (CI). From Naples and Caserta, the reduction observed between 1988 and 2009 in SMR in males, but not in females, was significantly lower compared with the decrease reported at a national level (-11.4% and -28.4%, respectively). In elderly men, differences between local and national SMR were more pronounced (+13.6% compared with -2.7%). In males, the joinpoint regression analysis showed the following APC and 95% CI: -0.9%/year (-1.2; -0.7) and -0.6%/year (-1.0; -0.2) for Naples and Caserta, respectively. In females, estimates were -0.6%/year (-0.8; -0.5) and -0.7%/year (-1.2; -0.3). The overall orientation toward declining cancer mortality trends appeared in antithesis with the slight, but significant, increase for some tumors (e.g., pancreatic cancer in both genders). A complex mixture of heterogeneous factors concurs to explain the evidence observed including lifestyle, access to screening procedures, advancements in cancer diagnosis and treatment. Further details might eventually derive from biomonitoring studies for ascertaining the causal link between exposure to potential contaminants in air, water, and soil and cancer-related outcomes in the area of interest.
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Affiliation(s)
- Anna Crispo
- Epidemiology Unit; National Cancer Institute G. Pascale Foundation; Naples, Italy
| | - Maddalena Barba
- Medical Oncology B-Scientific Direction; Regina Elena National Cancer Institute; Rome, Italy
| | - Matteo Malvezzi
- Department of Epidemiology; Mario Negri Institute; Milan, Italy
| | - Grazia Arpino
- Department of Oncology and Experimental-Clinical Endocrinology; Federico II University of Naples; Naples, Italy
| | - Maria Grimaldi
- Epidemiology Unit; National Cancer Institute G. Pascale Foundation; Naples, Italy
| | - Tiziana Rosso
- Department of Epidemiology; Mario Negri Institute; Milan, Italy
| | - Emanuela Esposito
- Epidemiology Unit; National Cancer Institute G. Pascale Foundation; Naples, Italy
| | - Domenico Sergi
- Medical Oncology B; Regina Elena National Cancer Institute; Rome, Italy
| | - Gennaro Ciliberto
- Scientific Director; Cancer Institute G. Pascale Foundation; Naples, Italy
| | - Antonio Giordano
- Sbarro Institute for Cancer Research and Molecular Medicine and Center of Biotechnology; College of Science and Technology; Temple University; Philadelphia, PA USA; Department of Pathology & Oncology; University of Siena; Siena, Italy
| | - Maurizio Montella
- Epidemiology Unit; National Cancer Institute G. Pascale Foundation; Naples, Italy
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Vercelli M, Lillini R, Capocaccia R, Quaglia A. Use of SERTS (Socio-Economic, health Resources and Technologic Supplies) models to estimate cancer survival at provincial geographical level. Cancer Epidemiol 2012; 36:566-74. [PMID: 22906484 DOI: 10.1016/j.canep.2012.07.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Revised: 07/24/2012] [Accepted: 07/25/2012] [Indexed: 11/24/2022]
Abstract
AIM The main aim of this work is to compute expected cancer survival for Italian provinces by Socio-Economic and health Resources and Technologic Supplies (SERTS) models, based on demographic, socioeconomic variables and information describing the health care system (SEH). METHODS Five-year age-standardised relative survival rates by gender for 11 cancer sites and all cancers combined of patients diagnosed in 1995-1999, were obtained from the Italian Association of Cancer Registries (CRs) database. The SEH variables describe at provincial level macro-economy, demography, labour market, health resources in 1995-2005. A principal components factor analysis was applied to the SEH variables to control their strong mutual correlation. For every considered cancer site, linear regression models were estimated considering the 5-RS% as dependent variable and the principal components factors of the SEH variables as independent variables. RESULTS The model composition was correlated to the characteristics of take in charge of patients. SEH factors were correlated with the observed survival for all cancer combined and colon-rectum in both sexes, prostate, kidney and non Hodgkin's lymphomas in men, breast, corpus uteri and melanoma in women (R(2) from 40% to 85%). In the provinces without any CR the survival was very similar with that of neighbouring provinces with analogous social, economic and health characteristics. CONCLUSIONS The SERTS models allowed us to interpret the survival outcome of oncologic patients with respect to the role of the socio-economic and health related system characteristics, stressing how the peculiarities of the take in charge at the province level could address the decisions regarding the allocation of resources.
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Affiliation(s)
- Marina Vercelli
- Liguria Region Cancer Registry, Descriptive Epidemiology Unit, IRCCS Azienda Ospedaliera Universitaria San Martino - IST Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy.
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7
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Clèries R, Ribes J, Buxo M, Ameijide A, Marcos-Gragera R, Galceran J, Miguel Martínez J, Yasui Y. Bayesian approach to predicting cancer incidence for an area without cancer registration by using cancer incidence data from nearby areas. Stat Med 2012; 31:978-87. [PMID: 22237653 DOI: 10.1002/sim.4463] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2010] [Revised: 10/10/2011] [Accepted: 10/17/2011] [Indexed: 11/12/2022]
Abstract
This paper compares three different methods for performing cancer incidence prediction in an area without a cancer registry under a Bayesian framework, using linear and log-linear age-period models with either age-specific slopes or a common slope across age groups. The three methods assume that a nearby area with a cancer registration has similar incidence and mortality patterns as the area of interest without a cancer registry where the cancer incidence prediction is carried out. The three methods differ in modeling strategies: (i) modeling the incidence rate directly; (ii) modeling the ratio of the number of incident cases to that of mortality cases; and (iii) modeling the difference between the incidence rate and the mortality rate. Strategy (iii) is a new approach in this type of projection. Empirical assessment is made using real data from the cancer registry of Tarragona, Spain, to predict cancer incidence in Girona, Spain, and vice versa. Predictions of short-term (3-4 years) incidence were made for 2001 in Tarragona using observed cancer incidence and mortality data for 1994-1998 from Girona. Short-term predictions were made for 2002 in Girona using Tarragona's 1994-1998 data. Additionally, long-term (10 years) incidence rate predictions were made for 2002 in Girona using data from Tarragona for the period 1985-1992. Our results suggest that extrapolating time-trends of incidence rates minus mortality rates may have the best predictive performance overall. These methods of population-level disease-incidence prediction are highly relevant to health care planning and policy decisions.
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Affiliation(s)
- Ramon Clèries
- Cancer Registry of Catalonia - Plan for Oncology of the Catalan Government, IDIBELL, Hospital Duran i Reynals, Catalonia, Spain.
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8
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Fusco M, Pezzi A, Benatti P, Roncucci L, Chiodini P, Di Maio G, Di Napoli R, de Leon MP. Clinical features and colorectal cancer survival: An attempt to explain differences between two different Italian regions. Eur J Cancer 2010; 46:142-9. [PMID: 19695865 DOI: 10.1016/j.ejca.2009.07.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2009] [Revised: 07/09/2009] [Accepted: 07/17/2009] [Indexed: 11/29/2022]
Affiliation(s)
- Mario Fusco
- Registro Tumori Regione Campania c/o ASL Napoli 4, Italy
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9
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Masseria C. Colorectal cancer in Italy: a review of current national and regional practice on screening and treatment. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2010; 10 Suppl 1:S41-S49. [PMID: 20012136 DOI: 10.1007/s10198-009-0191-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Colorectal cancer (CRC) is one of the most prevalent and deadly cancers in Italy. Its burden is expected to remain significant in the coming years, although it is mostly a preventable disease. Prevention and screening programmes will play an important role in the fight against CRC. A national formal screening programme was introduced in the 2003-2005 and 2005-2007 national health programmes, leaving the planning and implementation, respectively, to each region and local health unit. In 2007, screening programmes covered 46.6% of the eligible population, with a higher coverage in the North (71.6%) and in the Centre (52.1%) than in the South (7%). The majority of programmes used the guaiac faecal occult blood test (FOBT) as first-line test. Only few programmes used the flexible sigmoidoscopy, or a combination of both tests. The quality and efficacy of the screening programmes are evaluated using ad hoc indicators with acceptable and desirable targets. In Italy, there are formal guidelines for population-based and opportunistic screening, diagnosis, surgery, adjuvant and neoadjuvant treatments and surveillance, differentiating colon cancer from rectal cancer and advanced CRC. Guidelines are updated yearly. Overall, Italy is well positioned in the fight against CRC. Although many regions lag behind in the uptake of screening programmes, they are in the process of introducing them.
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10
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Genta RM. From the Alps to Sicily: a panorama of Italian lymphomas. Dig Liver Dis 2009; 41:463-4. [PMID: 19446506 DOI: 10.1016/j.dld.2009.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2009] [Accepted: 04/21/2009] [Indexed: 12/11/2022]
Affiliation(s)
- R M Genta
- Caris Diagnostics, Irving, TX, United States.
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