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Abdullahi A, Wong TWL, Ng SSM. Effects of home-based neurostimulation on outcomes after stroke: a systematic review and meta-analysis. Neurol Sci 2024:10.1007/s10072-024-07633-2. [PMID: 38940876 DOI: 10.1007/s10072-024-07633-2] [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: 06/02/2023] [Accepted: 06/05/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND Home-based rehabilitation is a cost-effective means of making services available for patients. The aim of this study is to determine the evidence in the literature on the effects of home-based neurostimulation in patients with stroke. METHOD We searched PubMED, Embase, Web of Science, Scopus, and CENTRAL for randomized controlled trials on the subject matter using keywords such as stroke, electrical stimulation and transcranial direct current stimulation. Information on participants' characteristics and mean scores on the outcomes of interest were extracted. Risks of bias and methodological quality of the included studies were assessed using Cochrane Risks of bias tool and PEDro scale respectively. The data was analyzed using both narrative and quantitative syntheses. In the quantitative synthesis, meta-analysis was carried out using random effect model analysis. RESULT The results showed that, home-based neurostimulation is superior to the control at improving upper limb muscle strength (SMD = 0.72, 95% CI = 0.08 to 1.32, p = 0.03), functional mobility (SMD = -0.39, 95% CI = -0.65 to 0.14, p = 0.003) and walking endurance (SMD = 0.33, 95% CI = 0.08 to 0.59, p = 0.01) post intervention; and upper limb motor function (SMD = 0.9, 95% CI = 0.10 to 1.70, p = 0.03), functional mobility (SMD = -0.30, 95% CI = -0.56 to -0.05, p = 0.02) and walking endurance (SMD = 0.33, 95% CI = 0.08 to 0.59, p = 0.01) at follow-up. CONCLUSIONS Home-based neurostimulation can be used to improve upper and lower limb function after stroke.
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Affiliation(s)
- Auwal Abdullahi
- Formerly, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, Hong Kong, China
| | - Thomson W L Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, Hong Kong, China
| | - Shamay S M Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, Hong Kong, China.
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2
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Kalogeropoulos A, Savvidou OD, Bissias C, Sarafis P, Savvidis M, Tanos A, Pikoulis E, Papagelopoulos PJ, Exadaktylos A, Eggli S. Milder impact of the COVID-19 pandemic on the practice of orthopaedic surgery in Greece and Cyprus than other European countries. Knee Surg Sports Traumatol Arthrosc 2023; 31:110-120. [PMID: 36114340 PMCID: PMC9483367 DOI: 10.1007/s00167-022-07159-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 09/06/2022] [Indexed: 01/25/2023]
Abstract
PURPOSE The aim of this study was to highlight the impact of the COVID-19 pandemic on the practice of orthopaedics in Greece and Cyprus. METHODS The survey used the online questionnaire from AGA (Gesellschaft für Arthroskopie und Gelenkchirurgie; Society for Arthroscopy and Joint Surgery) to facilitate the comparison between different European countries. The questionnaire was distributed online to members of the HAOST (Hellenic Association of Orthopaedic Surgery and Trauma), the ΟΤΑΜΑΤ (Orthopaedic and Trauma Association of Macedonia and Thrace) and the CAOST (Cypriot Association of Orthopaedic Surgery and Trauma). The questionnaire consisted of 29 questions, which included demographic data, questions on the impact of the pandemic on the practice of orthopaedic surgery and questions on the impact on the personal and family life of orthopaedic surgeons. RESULTS The questionnaire was sent to 1350 orthopaedic surgeons in Greece and Cyprus, 303 of whom responded (response rate 22.44%). 11.2% of the participants reported cancellation of overall orthopaedic procedures. According to 35.6-49.8% of the participants, arthroscopic procedures were continued. As regards elective primary arthroplasties, 35.3% of the participants reported that these continued to be performed at their hospitals. Post-operative follow-ups as well as physiotherapy were affected by the pandemic, and changes were also observed in the habits of orthopaedic surgeons in their personal and family lives. CONCLUSION The orthopaedic service in Greece and Cyprus decreased during the first wave of the COVID-19 pandemic. Arthroscopic procedures and total joint replacements decreased significantly, but not to the same extent as in other countries. Health systems were not fully prepared for the first wave of the pandemic and the various countries took social measures at different times and to different extents. Thus, studying the impact of the pandemic on the practice of orthopaedic surgery in different countries can help health systems to better prepare for future pandemics; public health can then be shielded and hospitals can continue to provide high-quality orthopaedic care. LEVEL OF EVIDENCE Level V.
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Affiliation(s)
| | - Olga D. Savvidou
- 1st Department of Orthopedic Surgery, National and Kapodistrian University of Athens, ATTIKON” University General Hospital, Athens, Greece
| | | | - Pavlos Sarafis
- Department of Nursing, University of Thessaly, Volos, Greece
| | | | | | - Emmanouil Pikoulis
- 3rd Department of General Surgery, National and Kapodistrian University of Athens, ATTIKON” University General Hospital, Athens, Greece
| | - Panayiotis J. Papagelopoulos
- 1st Department of Orthopedic Surgery, National and Kapodistrian University of Athens, ATTIKON” University General Hospital, Athens, Greece
| | | | - Stefan Eggli
- Orthopädie Und Traumatologie, Sonnenhofspital, Buchserstrasse 30, 3006 Bern, Switzerland
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Groot L, Vliet Vlieland TP, Peter WF, Yildiz Ü, Reijman M, Gademan MG. The impact of the COVID-19 pandemic on different aspects of the delivery of physical therapy after total hip or knee surgery: Perspectives of patients and physical therapists. Musculoskeletal Care 2022; 20:964-971. [PMID: 35674185 PMCID: PMC9347837 DOI: 10.1002/msc.1648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 05/09/2022] [Indexed: 01/01/2023]
Affiliation(s)
- Lichelle Groot
- Department of Orthopedic SurgeryErasmus MCUniversity Medical Centre RotterdamRotterdamThe Netherlands,Department of Orthopaedics, Rehabilitation and Physical TherapyLeiden University Medical Centre (LUMC)LeidenThe Netherlands
| | - Thea P.M. Vliet Vlieland
- Department of Orthopaedics, Rehabilitation and Physical TherapyLeiden University Medical Centre (LUMC)LeidenThe Netherlands
| | - Wilfred F.H. Peter
- Department of Orthopaedics, Rehabilitation and Physical TherapyLeiden University Medical Centre (LUMC)LeidenThe Netherlands
| | - Ümit Yildiz
- Department of Orthopaedics, Rehabilitation and Physical TherapyLeiden University Medical Centre (LUMC)LeidenThe Netherlands
| | - Max Reijman
- Department of Orthopedic SurgeryErasmus MCUniversity Medical Centre RotterdamRotterdamThe Netherlands
| | - Maaike G.J. Gademan
- Department of Orthopaedics, Rehabilitation and Physical TherapyLeiden University Medical Centre (LUMC)LeidenThe Netherlands,Department of Clinical EpidemiologyLeiden University Medical Center (LUMC)LeidenThe Netherlands
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Cho K, Kang A. Home-based rehabilitation in patients over 60 with stabilized ankylosing spondylitis during the COVID-19 pandemic. J Back Musculoskelet Rehabil 2022; 35:261-269. [PMID: 34806597 DOI: 10.3233/bmr-210153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND COVID-19 has become a significant healthcare issue, particularly challenging for patients with ankylosing spondylitis (AS), because immune-related diseases and their treatments could adversely affect the susceptibility to or severity of a viral infection. OBJECTIVE This study is conducted to present an exercise rehabilitation program that patients older than 60 years with AS can do at home during the COVID-19 pandemic. METHODS Three Delphi surveys were conducted to reach a consensus on home-based rehabilitation programs. This study recruited ten experts and performed three Delphi rounds for a month. RESULTS The expert panel suggested that home-based rehabilitation for the patients should be carried out with a clear rehabilitation goal. Their final recommendations are to institute a program aimed to ease symptoms, such as pain and stiffness; encourage patients to consult with experts regularly to ensure that they perform exercise rehabilitation properly at home; add fast walking and stretching to the rehabilitation program; and see if indoor cycling, Pilates, or yoga could be appropriate. CONCLUSIONS This study suggests that patients with AS over 60 should repeat low-intensity exercises, such as stretching, for an hour a day, four to six times a week during the COVID-19 pandemic.
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Affiliation(s)
- Kyunghwan Cho
- Department of Health Rehabilitation, Hanshin University, Korea
| | - Austin Kang
- Department of Forensic Medicine, Seoul National University, Korea
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Negm AM, Salopek A, Zaide M, Meng VJ, Prada C, Chang Y, Zanwar P, Santos FH, Philippou E, Rosario ER, Faieta J, Falvey JR, Kumar A, Reistetter TA, Dal Bello-Haas V, Bean JF, Bhandari M, Heyn PC. Rehabilitation Care at the Time of Coronavirus Disease-19 (COVID-19) Pandemic: A Scoping Review of Health System Recommendations. Front Aging Neurosci 2022; 13:781271. [PMID: 35058770 PMCID: PMC8764235 DOI: 10.3389/fnagi.2021.781271] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 11/29/2021] [Indexed: 12/13/2022] Open
Abstract
Purpose: The coronavirus disease-19 (COVID-19) was declared a pandemic by the World Health Organization in March 2020. COVID-19, caused by SARS-CoV-2 has imposed a significant burden on health care systems, economies, and social systems in many countries around the world. The provision of rehabilitation services for persons with active COVID-19 infection poses challenges to maintaining a safe environment for patients and treating providers. Materials and Methods: Established frameworks were used to guide the scoping review methodology. Medline, Embase, Pubmed, CINAHL databases from inception to August 1, 2020, and prominent rehabilitation organizations' websites were searched. Study Selection: We included articles and reports if they were focused on rehabilitation related recommendations for COVID-19 patients, treating providers, or the general population. Data Extraction: Pairs of team members used a pre-tested data abstraction form to extract data from included full-text articles. The strength and the quality of the extracted recommendations were evaluated by two reviewers using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Results: We retrieved 6,468 citations, of which 2,086 were eligible for review, after duplicates were removed. We excluded 1,980 citations based on title and abstract screening. Of the screened full-text articles, we included all 106 studies. A summary of recommendations is presented. We assessed the overall evidence to be strong and of fair quality. Conclusion: The rehabilitation setting, and processes, logistics, and patient and healthcare provider precaution recommendations identified aim to reduce the spread of SARS-CoV-2 infection and ensure adequate and safe rehabilitation services, whether face-to-face or through teleservices. The COVID-19 pandemic is rapidly changing. Further updates will be needed over time in order to incorporate emerging best evidence into rehabilitation guidelines.
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Affiliation(s)
- Ahmed M. Negm
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Adrian Salopek
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Mashal Zaide
- Faculty of Sciences, McMaster University, Hamilton, ON, Canada
| | - Victoria J. Meng
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Carlos Prada
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | | | - Preeti Zanwar
- Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, PA, United States
- NIA Funded U.S. Network on Life Course and Health Dynamics and Disparities in the 21st Century America, University of Southern California, Los Angeles, CA, United States
| | - Flavia H. Santos
- University College Dublin (UCD), Centre for Disability Studies, School of Psychology, University College Dublin, Dublin, Ireland
| | - Elena Philippou
- Department of Life and Health Sciences, School of Sciences and Engineering, University of Nicosia, Nicosia, Cyprus
- Department of Nutritional Sciences, King’s College London, London, United Kingdom
| | - Emily R. Rosario
- Casa Colina Hospital and Centers for Healthcare, Pomona, CA, United States
| | - Julie Faieta
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jason R. Falvey
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD, United States
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Amit Kumar
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ, United States
| | - Timothy A. Reistetter
- Department of Occupational Therapy, School of Health Professions, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | | | - Jonathan F. Bean
- New England Geriatric, Research, Department of PM&R, Harvard Medical School, Education and Clinical Center, VA Boston Healthcare System, Boston, MA, United States
- Spaulding Rehabilitation Hospital, Boston, MA, United States
| | - Mohit Bhandari
- Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Patricia C. Heyn
- Marymount Center for Optimal Aging, School of Health Sciences, Marymount University, Arlington, VA, United States
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Arzani P, Khalkhali Zavieh M, Khademi-Kalantari K, Akbarzadeh Baghban A. Opportunities and barriers for telerehabilitation during Coronavirus outbreak. Med J Islam Repub Iran 2021; 35:100. [PMID: 34956946 PMCID: PMC8683792 DOI: 10.47176/mjiri.35.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Indexed: 11/09/2022] Open
Affiliation(s)
- Parisa Arzani
- Department of Physiotherapy, School of Rehabilitation, Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Minoo Khalkhali Zavieh
- Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Khosro Khademi-Kalantari
- Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Akbarzadeh Baghban
- Proteomics Research Center, Department of Basic Science, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Chatterji G, Patel Y, Jain V, Geevarughese NM, Haq RU. Impact of COVID-19 on Orthopaedic Care and Practice: A Rapid Review. Indian J Orthop 2021; 55:839-852. [PMID: 33776130 PMCID: PMC7980796 DOI: 10.1007/s43465-021-00354-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 01/05/2021] [Indexed: 02/04/2023]
Abstract
INTRODUCTION The COVID-19 pandemic has led to a large body of literature regarding the impact of COVID-19 on orthopaedic care and practice. This rapid review aims to synthesize this published literature to give the orthopaedic fraternity an overview about the best practices that need to be followed during this period. METHODOLOGY A rapid review was conducted following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement for rapid reviews on the impact of COVID-19 on orthopaedic care and practice. A Pubmed search was done to identify all literature related to the impact of COVID-19 on orthopaedic care and practice, published between December 2019 and October 2020 using a predefined search strategy. The final review included 375 peer-reviewed articles addressing the objectives. RESULTS The majority of articles were expert opinions ( 37.1%) and narrative reviews (13.1%). There were 17.3% retrospective studies and 2.1% prospective studies with only one randomized control trial and ten systematic reviews. 83.8% of articles had levels of evidence IV and V, 79.5% of the articles were published in core-orthopaedic journals. Maximum publications were from the United States of America (31.7%), followed by India (11.5%). European countries together contributed to 32.0% of all publications. CONCLUSION COVID-19 has had a significant impact on all aspects of orthopaedic care and practice. The pandemic has affected outpatient clinics, emergency and elective surgery, rehabilitation, resident training, personnel management, use of personal protective equipment, telemedicine and all sub-specialities of orthopaedics. Orthopaedic practice will require the incorporation of new technologies, restructuring of health systems and reorganizing of training programs for optimal patient care. There would also be a need for frequent review of emerging literature to provide evidence-based guidelines to the orthopaedic fraternity which will not only help in mitigation of transmission of disease but also ensure continuity of optimum patient care. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s43465-021-00354-0.
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Affiliation(s)
- Gautam Chatterji
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh India
| | - Yogesh Patel
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh India
| | - Vaibhav Jain
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh India
| | | | - Rehan Ul Haq
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh India
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Chhabra HS, Bagaraia V, Keny S, Kalidindi KKV, Mallepally A, Dhillon MS, Malhotra R, Rajasekharan S. COVID-19: Current Knowledge and Best Practices for Orthopaedic Surgeons. Indian J Orthop 2020; 54:411-425. [PMID: 32425237 PMCID: PMC7232909 DOI: 10.1007/s43465-020-00135-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 05/02/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND A mysterious cluster outbreak of pneumonia in Wuhan, China in December 2019 was traced to Severe Acute Respiratory Syndrome Coronavirus 2 and declared a Pandemic by WHO on 11th March 2020. The pandemic has spread rapidly causing widespread devastation globally. PURPOSE This review provides a brief understanding of pathophysiology, clinical features, diagnosis and management of COVID-19 and highlights the current knowledge as well as best practices for orthopaedic surgeons. These are likely to change as knowledge and evidence is gained. RESULTS Orthopaedic surgeons, like other front-line workers, carry the risk of getting infected during their practice, which as such is already substantially affected. Implementation of infection prevention and control as well as other safety measures for health care workers assumes great importance. All patients/visitors and staff visiting the hospital should be screened. Conservative treatment should be the first line of treatment except for those requiring urgent/emergent care. During lockdown all elective surgeries are to be withheld. All attempts should be made to reduce hospital visits and telemedicine is to be encouraged. Inpatient management of COVID-19 patients requires approval from concerned authorities. All patients being admitted to the hospital in and around containment zones should be tested for COVID-19. There are special considerations for anaesthesia with preference for regional anaesthesia. A separate Operation room with specific workflow should be dedicated for COVID-19 positive cases. CONCLUSIONS Despite the magnitude of challenge, the pandemic offers significant lessons for the orthopaedic surgeon who should seek the opportunity within the adversity and use this time wisely to achieve his/her Ikigai.
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Affiliation(s)
- Harvinder Singh Chhabra
- Department of Spine Service and Medical Director, Indian Spinal Injuries Center, Vasant Kunj, New Delhi, 110070 India
| | - Vaibhav Bagaraia
- Department of Orthopaedics, Sir HN Reliance Foundation Hospital, Mumbai, 431202 India
| | - Swapnil Keny
- Grant Medical College and Sir JJ Hospital, Mumbai, 400008 India
- Sir H.N Reliance Hospital, Mumbai, 431202 India
| | | | - Abhinandan Mallepally
- Department of Spine Service, Indian Spinal Injuries Center, Vasant Kunj, New Delhi, 110070 India
| | | | - Rajesh Malhotra
- J P N Apex Trauma Centre and COVID-19 Facility, Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, 110029 India
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Roman-Belmonte JM, De la Corte-Rodriguez H, Rodriguez-Merchan EC, Muñoz-De la Torre E, Vazquez-Sasot A. Strengthening with Blood Flow Restriction: Can it be a Useful Option in the Rehabilitation of Patients with Coronavirus? THE ARCHIVES OF BONE AND JOINT SURGERY 2020; 8:553-556. [PMID: 32884979 PMCID: PMC7443069 DOI: 10.22038/abjs.2020.48575.2409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Juan M. Roman-Belmonte
- Department of Physical Medicine and Rehabilitation, “Cruz Roja San José y Santa Adela” Hospital, Madrid, Spain
| | | | | | - Elena Muñoz-De la Torre
- Department of Physical Medicine and Rehabilitation, “Cruz Roja San José y Santa Adela” Hospital, Madrid, Spain
| | - Aranzazu Vazquez-Sasot
- Department of Physical Medicine and Rehabilitation, “Cruz Roja San José y Santa Adela” Hospital, Madrid, Spain
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