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Dzudie A, Njume E, Mfekeu LK, Djomou A, Ba H, Ndom MS, Nkoke C, Ndongo S, Boombhi J, Kamdem F, Mouandjo JPD, Mouliom SA, Kouam CK, Meli H, Monkam Y, Awungia A, Serah A, Tantchou C, Ndjebet J, Menanga A, Beaney T, Clarke J, Poulter NR, Kengne AP, Kingue S. May Measurement Month 2019: an analysis of blood pressure screening results from Cameroon. Eur Heart J Suppl 2021; 23:B33-B36. [PMID: 34248429 PMCID: PMC8263083 DOI: 10.1093/eurheartj/suab056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The multi-country May Measurement Month (MMM) screening campaign aims to raise awareness on blood pressure (BP) and hypertension in individuals and communities, and measure BP, ideally, of those who had no BP measurement in the preceding year. We here report key findings from the Cameroon arm of MMM 2019. An opportunistic sample of adults (≥18 years) was included from 5 May to 5 June 2019 across 15 sites (markets, churches, homes, motor parks, workplaces, and hospitals/clinics). Data collection, cleaning, the definition of hypertension, and statistical analysis followed the standard protocol. The mean age of the 30 187 participants screened was 36.9 (SD: 14.9) years, 50.4% were female (5% of whom were pregnant), and 94.4% were screened out of the hospital/clinic settings. After multiple imputation of missing data, 6286 (20.8%) had hypertension, 24.0% were taking antihypertensive medication, and 705 (11.2%) of all participants with hypertension had controlled BP. In linear regression models adjusted for age, sex, and antihypertensive medicines use, a previous diagnosis of hypertension, a history of stroke, and use of antihypertensive medicines were significant predictors of systolic and diastolic BP levels. BPs were also significantly higher when measured in public outdoors, public indoors (diastolic BP only), workplaces, and other unspecified areas compared to hospitals/clinic settings. MMM19 is the largest ever BP screening campaign in a single month, in Cameroon and despite the limitations resulting from non-random sample selection, the opportunistic screening allows access to awareness and screening for hypertension out of the hospital/clinic settings.
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Affiliation(s)
- Anastase Dzudie
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon.,Clinical Research Education, Networking and Consultancy, Carrefour Tam-Tam, Opposite Neptune Station, PO Box 3787, Yaounde, Cameroon
| | - Epie Njume
- Clinical Research Education, Networking and Consultancy, Carrefour Tam-Tam, Opposite Neptune Station, PO Box 3787, Yaounde, Cameroon
| | - Liliane Kuate Mfekeu
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon
| | - Armel Djomou
- Fondation Coeur et Vie, Carrefour Zachman, Ndogbong, Douala, Cameroon
| | - Hamadou Ba
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon
| | - Marie Solange Ndom
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon
| | - Clovis Nkoke
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon.,Clinical Research Education, Networking and Consultancy, Carrefour Tam-Tam, Opposite Neptune Station, PO Box 3787, Yaounde, Cameroon
| | - Sylvie Ndongo
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon
| | - Jerome Boombhi
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon
| | - Felicite Kamdem
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon
| | | | | | - Charles Kouam Kouam
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon
| | - Herve Meli
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon
| | - Yves Monkam
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon
| | - Alexis Awungia
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon
| | - Ambang Serah
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon
| | - Cabral Tantchou
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon
| | - Jules Ndjebet
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon
| | - Alain Menanga
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK.,Department of Primary Care and Public Health, Imperial College London, St Dunstan's Road, London W6 8RP, UK
| | - Jonathan Clarke
- Department of Mathematics, Huxley Building, South Kensington Campus, Imperial College London, London SW7 2AZ, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Andre Pascal Kengne
- Clinical Research Education, Networking and Consultancy, Carrefour Tam-Tam, Opposite Neptune Station, PO Box 3787, Yaounde, Cameroon.,Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Samuel Kingue
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon
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Dzudie A, Fomo MF, Teuwafeu DG, Nkoke C, Kenfack A, Bonghaseh DT, Ekaney D, Tantchou A, Tantchou C, Ngoa LSE, Kengne AP, Choukem SP. Prescription of pharmacotherapy and blood pressure control among hypertensive outpatients in two semi-urban hospitals in Cameroon: a cross-sectional study. Pan Afr Med J 2021; 37:122. [PMID: 33425155 PMCID: PMC7755361 DOI: 10.11604/pamj.2020.37.122.21156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 02/02/2020] [Indexed: 11/11/2022] Open
Abstract
Introduction several international guidelines are available on drug treatment for hypertension, but the control of hypertension remains very poor in sub-Saharan Africa (SSA). We investigated the commonly prescribed antihypertensive drugs and their association with blood pressure (BP) control in adult Cameroonians. Methods we consecutively recruited hypertensive outpatients attending the Buea and Limbe Regional Hospitals (southwest region of Cameroon). Controlled BP was defined as BP < 140/90mmHg in hypertensive patients aged 60 years or younger, diabetics or patients with chronic kidney disease or a BP < 150/90mmHg in non-diabetic hypertensive patients older than 60 years of age (JNC8). Results of the 408 participants included (mean age 61.1 years), 67% were female. The median duration of hypertension was 6 years and the median duration of the current treatment was 22 weeks. Commonly prescribed antihypertensives were calcium channel blockers (CCB, 35.1%), thiazide/thiazide-like diuretics (TD/TLD, 26.1%) and angiotensin-converting enzyme inhibitors (ACEI, 19.5%). The median monthly cost of antihypertensive was 10279.6 CFA (approximately equal to US$ 172). Seventy percent (70%) of participants were receiving at least 2 drugs, with ACEI+TD/TLD, CCB+TD/TLD, and ACEI+CCB+TD/TLD being the most frequent combination. The rate of BP control was 52% overall, and 60% in participants on monotherapy. Conclusion CCBs were the most prescribed single antihypertensive drugs in this setting while ACEI+TD/TLD was the most common combination. About half of patients were at target BP control levels Improving availability and affordability of these medications may improve hypertension management and control.
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Affiliation(s)
- Anastase Dzudie
- Department of Physiology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.,Clinical Research Education Networking and Consultancy (CRENC), Douala, Cameroon.,Department of Internal Medicine and Subspecialties, Douala General Hospital, Douala, Cameroon
| | - Messaline Fodom Fomo
- Clinical Research Education Networking and Consultancy (CRENC), Douala, Cameroon
| | | | - Clovis Nkoke
- Clinical Research Education Networking and Consultancy (CRENC), Douala, Cameroon.,Department of Internal Medicine, Buea Regional Hospital, Buea, Cameroon
| | - Azabji Kenfack
- Department of Physiology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Divine Tim Bonghaseh
- Clinical Research Education Networking and Consultancy (CRENC), Douala, Cameroon.,Health and Human Development (2HD) Research Network, Douala, Cameroon.,Baptist Hospital Mutengene, Mutengene, Cameroon
| | - Domin Ekaney
- Clinical Research Education Networking and Consultancy (CRENC), Douala, Cameroon.,Sub-divisional Hospital Batoke, Limbe, Cameroon
| | | | | | - Laurent Serges Etoundi Ngoa
- Department of Physiology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Andre Pascal Kengne
- Clinical Research Education Networking and Consultancy (CRENC), Douala, Cameroon.,Non-communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Simeon Pierre Choukem
- Department of Internal Medicine and Subspecialties, Douala General Hospital, Douala, Cameroon.,Health and Human Development (2HD) Research Network, Douala, Cameroon.,Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
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Dzudie A, Ngongang Ouankou C, Nganhyim L, Mouliom S, Ba H, Kamdem F, Ndjebet J, Nzali A, Tantchou C, Nkoke C, Barche B, Abanda M, Metogo Mbengono UA, Hentchoya R, Petipe Nkappe C, Ouankou M, Kouam Kouam C, Mintom P, Boombhi J, Kuate Mfeukeu L, Ngatchou W, Kingue S, Ngowe Ngowe M. Long-term prognosis of patients with permanent cardiac pacemaker indication in three referral cardiac centers in Cameroon: Insights from the National pacemaker registry. Ann Cardiol Angeiol (Paris) 2020; 70:18-24. [PMID: 32778387 DOI: 10.1016/j.ancard.2020.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 07/21/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND There is evidence that cardiac pacemakers improve symptoms and quality of life in patients with severe bradycardia. Globally, the number of pacemaker implantations is on the rise. However, the associated high-cost limits pacemaker's accessibility in low resource settings. This study aimed to investigate access to pacemakers and the long-term outcome of patients requiring a pacemaker. METHOD We conducted a cohort study in 03 health care structures in Cameroon. Participants aged at least 18 years with indication for a permanent pacemaker between January 2010 and May 2016 were included. Clinical profile, electrocardiography, pacemaker implantation parameters were recorded. Long-term survival was studied by event-free analysis using the Kaplan-Meier method. RESULTS In total, 147 participants (mean age 67.7±13.7 years, female 58.5%) were included. Fatigue (78.7%), dyspnoea (77.2%), dizziness (47.1%) and palpitations (40.4%) were the main symptoms while syncope was present in 35.7% of patients. The main indication for cardiac pacemaker was atrioventricular block (85.3%). Forty (27.2%) could not be implanted with 34 (85%) of participants highlighting cost of intervention as main reason. VVIR was the main mode of stimulation (70.5%). Of 125 patients in which follow-up was ascertained, 17(13.5%) died after a median survival time of 2.8 years post diagnosis [IQR: 1.8-4.2]. The survival curve was better in participants with a pacemaker with a Hazard ratio of 2.7 [CI: 1.0-7.3, P=0.045]. CONCLUSION Our patients with severe heart blocks presented late and more than a quarter did not have access to pacemaker but its implantation multiplied the survival rate by 2.7 times at approximately 3 years post diagnosis. Improving early detection of heart blocks and access to cardiac pacing to reduce mortality shall be a key future priority.
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Affiliation(s)
- A Dzudie
- Cardiology and Cardiac Pacing Unit, Douala General Hospital, P.O Box 4856 Douala, Cameroon; Clinical Research Education Networking & Consultancy (CRENC), Douala, Cameroon; Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon.
| | | | - L Nganhyim
- Clinical Research Education Networking & Consultancy (CRENC), Douala, Cameroon
| | - S Mouliom
- Cardiology and Cardiac Pacing Unit, Douala General Hospital, P.O Box 4856 Douala, Cameroon
| | - H Ba
- Faculty of Medicine and Phramaceutical Sciences, University of Douala, Douala, Cameroon
| | - F Kamdem
- Faculty of Medicine and Phramaceutical Sciences, University of Douala, Douala, Cameroon
| | - J Ndjebet
- Douala Cardiovascular Centre, Douala, Cameroon
| | - A Nzali
- Deido District Hospital, Douala, Cameroon
| | | | - C Nkoke
- Clinical Research Education Networking & Consultancy (CRENC), Douala, Cameroon; Buea Regional Hospital, Buea, Cameroon
| | - B Barche
- Clinical Research Education Networking & Consultancy (CRENC), Douala, Cameroon; Faculty of Medicine and Phramaceutical Sciences, University of Douala, Douala, Cameroon; Douala Cardiovascular Centre, Douala, Cameroon
| | - M Abanda
- Clinical Research Education Networking & Consultancy (CRENC), Douala, Cameroon
| | - U A Metogo Mbengono
- Faculty of Medicine and Phramaceutical Sciences, University of Douala, Douala, Cameroon; Intensive Care Unit, Douala General Hospital, Douala, Cameroon
| | - R Hentchoya
- Intensive Care Unit, Douala General Hospital, Douala, Cameroon
| | - C Petipe Nkappe
- Buea Regional Hospital, Buea, Cameroon; Guidelines Advisory Network, Paris, France
| | - M Ouankou
- Cardiology and Medical Centre, Yaounde, Cameroon
| | - C Kouam Kouam
- Service of internal medicine and cardiology, Bafoussam regional hospital, Bafoussam, Cameroon
| | - P Mintom
- Faculty of Medicine and Phramaceutical Sciences, University of Douala, Douala, Cameroon; Deido District Hospital, Douala, Cameroon
| | - J Boombhi
- Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
| | - L Kuate Mfeukeu
- Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
| | - W Ngatchou
- Faculty of Medicine and Phramaceutical Sciences, University of Douala, Douala, Cameroon
| | - S Kingue
- Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
| | - M Ngowe Ngowe
- Faculty of Medicine and Phramaceutical Sciences, University of Douala, Douala, Cameroon
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4
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Jeilan M, Rwebembera J, Aden H, Akinyi L, Ajijola OA, Chin A, Kaviraj B, Karaye KM, Mbakwem A, Murage B, Ngatcha M, Salim M, Tantchou C, Nel G, Bonny A, Tayebjee M. The inaugural meeting of the Africa Heart Rhythm Association (AFHRA). Cardiovasc J Afr 2020; 31:162-164. [PMID: 32627802 DOI: 10.5830/cvja-2020-019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Cardiorhythm Africa, the inaugural conference of AFHRA, was conceived during the biennial PASCAR congress held in Johannesburg in November 2019, with the ambition to be the largest ever pan-African conference focused purely on arrhythmia. Significant aims were to (1) bring together arrhythmia specialists from across Africa and from the diaspora; and (2) announce the newly formed African Heart Rhythm Association (AFHRA), an affiliate organisation of PASCAR formed from the amalgamation of the Cardiac Pacing and Arrhythmias taskforces. The meeting held in Nairobi (29-31 January 2020) was organised to provide a focus on resource-constrained arrhythmia management within the African context and novel/advanced and potentially home-grown solutions. There was full representation from all five PASCAR regions (North, East, West, Central and Southern Africa). This report summarises the scope and perspective of the first Cardiorhythm Africa meeting and presents the future directions for this annual meeting.
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Affiliation(s)
- Mohamed Jeilan
- Department of Cardiology, Aga Khan University Hospital, Nairobi, Kenya.
| | | | - Hassan Aden
- Department of Cardiology, Aga Khan University Hospital, Nairobi, Kenya
| | - Loreen Akinyi
- Africa Heart Rhythm Association (AFHRA), Nairobi, Kenya
| | - Olujimi A Ajijola
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Ashley Chin
- University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa
| | - Bundhoo Kaviraj
- Department of Cardiology, Dr AG Jeetoo Hospital, Port Louis, Mauritius
| | - Kamilu M Karaye
- Aminu Kano Teaching Hospital, Bayero University, Kano, Nigeria
| | - Amam Mbakwem
- University of Lagos and Department of Medicine, College of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
| | | | | | - Mohamed Salim
- Department of Cardiology, Aga Khan University Hospital, Mombasa, Kenya
| | | | - George Nel
- Pan-African Society of Cardiology (PASCAR), Johannesburg, South Africa
| | - Aimé Bonny
- Homeland Heart Centre and District Hospital of Bonassama, University of Douala, Douala, Cameroon
| | - Muzahir Tayebjee
- West Yorkshire Arrhythmia Service, Leeds General Infirmary, Leeds, UK
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Rwebembera J, Jeilan M, Ajijola OA, Talle M, Sani MU, Karaye KM, Yuyun MF, Nel G, Akinyi L, Subahi S, Aboulmaaty M, Sogade F, Aoudia Y, Mbakwem A, Tantchou C, Salim M, Tayebjee MH, Poku JW, Vezi B, Kaviraj B, Ngantcha M, Chin A, Bonny A. Cardiac Pacing Training in Africa. J Am Coll Cardiol 2020; 76:465-472. [DOI: 10.1016/j.jacc.2020.04.079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/20/2020] [Accepted: 04/21/2020] [Indexed: 10/23/2022]
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Giamberti A, Butera G, Mve Mvondo C, Cirri S, Varrica A, Moussaidi N, Isgrò G, Ambassa JC, Tantchou C, Giamberti G, Frigiola A. The Shisong Cardiac Center in Cameroon: An Example of a Long-Term Collaboration/Cooperation Toward Autonomy. Front Pediatr 2018; 6:188. [PMID: 30018948 PMCID: PMC6038727 DOI: 10.3389/fped.2018.00188] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 06/06/2018] [Indexed: 01/23/2023] Open
Abstract
Congenital heart diseases (CHD) are present in nearly 1% of live births; according to WHO, there are 1. 5 million newborns affected by CHD per year and more than 4 million children waiting for cardiac surgery treatment worldwide. The majority of these children (~90%) could be treated, saved and subsequently have a good quality of life but unfortunately, in developing countries with a suboptimal care or no access to care, they are destined to die. Cameroon, one of the 40 poorest countries in the world, is a typical example of this dramatic scenario and this is why we started a collaboration project with a local religious partner (Tertiary Sisters of Saint Francis) in 2001 with the aim of establishing the first cardiac surgery center in this country. There are various well-known organizational models to start a cooperation project in pediatric cardiac surgery in a developing country. In our case, the project included a long-term collaboration with a stable local partner, a big financial investment and a long period of development (10 years or more). It is probably the most difficult model but it is the only one with the greatest guarantee of success in terms of sustainability and autonomy. The aim of this study is to analyze the constructive and problematic aspects of the 17-year collaboration in this project, and to assess possible solutions regarding its critical issues. Although much has been done during this 17-year we are aware that there is still a lot that needs to be done.
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Affiliation(s)
- Alessandro Giamberti
- Department of Pediatric Cardiology and Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy.,Association "Bambini Cardiopatici nel Mondo" ONG, Milan, Italy
| | - Gianfranco Butera
- Department of Pediatric Cardiology and Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy.,Association "Bambini Cardiopatici nel Mondo" ONG, Milan, Italy
| | | | - Silvia Cirri
- Association "Bambini Cardiopatici nel Mondo" ONG, Milan, Italy
| | - Alessandro Varrica
- Department of Pediatric Cardiology and Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Nadia Moussaidi
- International Cooperation Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Giuseppe Isgrò
- Department of Anesthesiology and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy
| | | | | | - Giovanni Giamberti
- Purchase Department, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Alessandro Frigiola
- Department of Pediatric Cardiology and Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy.,Association "Bambini Cardiopatici nel Mondo" ONG, Milan, Italy
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