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Fanizza FA, Stump H, Carter E, Prohaska E. Evaluation of a pharmacist-led penicillin allergy testing service in a community health system. J Am Pharm Assoc (2003) 2023; 63:169-172. [PMID: 36041964 DOI: 10.1016/j.japh.2022.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/02/2022] [Accepted: 08/02/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Roughly 10% of the U.S. population has a documented penicillin (PCN) allergy. Among these individuals, over 95% are able to tolerate PCNs. The inability to use PCNs can result in suboptimal outcomes. In August 2019, Lawrence Memorial Hospital Health System implemented a pharmacist-led PCN allergy testing service to assist with delabeling PCN allergies and increase access to this class of antibiotics. OBJECTIVES The primary objective was to describe the number of patients who underwent PCN allergy testing and were delabeled from PCN allergy. A secondary objective was to report the number of patients who received and tolerated PCN antibiotics after being delabeled from PCN allergy. METHODS This retrospective chart review was conducted during the initial 17 months of a pharmacist-led PCN allergy testing service. Eligible patients with a history of an immunoglobulin E (IgE)-mediated reaction underwent a 3-step test that consisted of a scratch test, an intradermal test, and an oral challenge. Eligible patients who did not have a history of IgE-mediated reaction underwent a 2-step graded oral challenge. Descriptive statistics were used for data analysis. RESULTS Between August 2019 and January 2022, 70 patients underwent testing, and 66 patients were delabeled from PCN allergy. Four patients who underwent the 3-step test developed reactions of mild to moderate severity. All patients who underwent the graded oral challenge were delabeled from PCN allergy. The rate of PCN allergy was 5.7%, whereas the rate of type I IgE-mediated reaction was 1.4%. All 23 patients who received an antibiotic from the PCN class after a negative allergy test tolerated the PCN antibiotic without an incident. CONCLUSION PCN allergy testing is an effective way to delabel PCN allergies from most patients presenting with a PCN allergy history. Skin testing followed by an oral challenge or a graded oral challenge alone are safe methods for conducting PCN allergy testing in the primary care setting.
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Ragucci KR, O'Bryant CL, Campbell KB, Buck ML, Dager WE, Donovan JL, Emerson K, Gubbins PO, Haight RJ, Jackevicius C, Murphy JE, Prohaska E. The need for PGY2-trained clinical pharmacy specialists. Pharmacotherapy 2014; 34:e65-73. [PMID: 24752824 DOI: 10.1002/phar.1430] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The American College of Clinical Pharmacy and other stakeholder organizations seek to advance clinical pharmacist practitioners, educators, and researchers. Unfortunately, there remains an inadequate supply of residency-trained clinical specialists to meet the needs of our health care system, and nonspecialists often are called on to fill open specialist positions. The impact of clinical pharmacy specialists on pharmacotherapy outcomes in both acute care and primary care settings demonstrates the value of these specialists. This commentary articulates the need for postgraduate year two (PGY2)-trained clinical specialists within the health care system by discussing various clinical and policy rationales, interprofessional support, economic justifications, and their impact on quality of care and drug safety. The integrated practice model that has grown out of the American Society of Health-System Pharmacists Pharmacy Practice Model Initiative (PPMI) could threaten the growth and development of future clinical specialists. Therefore, the ways in which PGY2-trained clinical pharmacist specialists are deployed in the PPMI require further consideration. PGY2 residencies provide education and training opportunities that cannot be achieved in traditional professional degree programs or postgraduate year one residencies. These specialists are needed to provide direct patient care to complex patient populations and to educate and train pharmacy students and postgraduate residents. Limitations to training and hiring PGY2-trained clinical pharmacy specialists include site capacity limitations and lack of funding. A gap analysis is needed to define the extent of the mismatch between the demand for specialists by health care systems and educational institutions versus the capacity to train clinical pharmacists at the specialty level.
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Abstract
BACKGROUND Abstract presentations at professional meetings provide a medium for disseminating the findings of scholarly activity. Rates of abstract publication from various biomedical disciplines have been evaluated, with pharmacy noted to be lower than other specialties. Previous research on pharmacy abstract publication rates was conducted for a limited number of professional meetings but has not been assessed using Google Scholar. OBJECTIVE To determine the full publication rate of abstracts presented at the 2005 American College of Clinical Pharmacy (ACCP) Spring and Annual Meetings, American Pharmacists Association (APhA) Annual Meeting, and American Society of Health-System Pharmacists (ASHP) Summer and Midyear Clinical Meetings. METHODS Publication status was assessed for abstracts presented during the 2005 ACCP Spring and Annual Meetings, APhA Annual Meeting, and ASHP Summer and Midyear Clinical Meetings using PubMed and Google Scholar. Data collected included abstract category, study category, practice site, database(s) in which publication appeared, time in months to publication, publication type, and journal of publication. RESULTS Evaluation of 2,000 abstracts presented in 2005 revealed an overall full publication rate of 19.8% (n = 384). Nearly all pharmacy abstracts were published as manuscripts (98.4%; n=378) and indexed in PubMed and Google Scholar (91.9%; n = 353), although a significant percentage were indexed in Google Scholar only (7.8%; n = 30). The mean time to full publication was 16.8 months (SD ±11.9 months). CONCLUSIONS Results were consistent with previously reported full publication rates of abstracts from pharmacy association meetings, indicating that abstracts presented at pharmacy meetings continue to have a lower full publication rate than other health disciplines.
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Affiliation(s)
- Emily Prohaska
- Clinical Coordinator, Tria Health, Overland Park, Kansas
| | - Joyce Generali
- Director, Drug Information Center, The University of Kansas Hospital, Kansas City, Kansas
- Clinical Professor, Department of Pharmacy Practice, The University of Kansas School of Pharmacy, Lawrence, Kansas
| | - Kevin Zak
- Senior Pharmacist, Center for Drug Policy, Partners HealthCare, Inc, Needham, Massachusetts
| | - Dennis Grauer
- Associate Clinical Professor, Department of Pharmacy Practice, The University of Kansas School of Pharmacy, Lawrence, Kansas
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Prohaska E, Neuwirth E. Zur entzündlichen Aktivität der Spondylitis ankylosans: Stellenwert der quantitativen CRP - Bestimmung für Diagnostik und Therapiekontrolle. AKTUEL RHEUMATOL 2008. [DOI: 10.1055/s-2008-1048005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Heep M, Odenbreit S, Beck D, Decker J, Prohaska E, Rieger U, Lehn N. Mutations at four distinct regions of the rpoB gene can reduce the susceptibility of Helicobacter pylori to rifamycins. Antimicrob Agents Chemother 2000; 44:1713-5. [PMID: 10817737 PMCID: PMC89941 DOI: 10.1128/aac.44.6.1713-1715.2000] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The transformation of a panel of rpoB mutations (codons 525 to 586) from rifampin-resistant donor strains into Helicobacter pylori 2802A confirmed the MICs associated with the respective mutations. RpoB V149X random mutations were generated and induced different levels of resistance, depending on the replacement amino acid. Mutagenesis of the rpoB gene at codon position 701 (R701H) induced low-level resistance.
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Affiliation(s)
- M Heep
- Institut für Medizinische Mikrobiologie, Universität Regensburg, Regensburg, Germany.
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Decker J, Weinberger K, Prohaska E, Hauck S, Kösslinger C, Wolf H, Hengerer A. Characterization of a human pancreatic secretory trypsin inhibitor mutant binding to Legionella pneumophila as determined by a quartz crystal microbalance. J Immunol Methods 2000; 233:159-65. [PMID: 10648865 DOI: 10.1016/s0022-1759(99)00187-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We describe the isolation from a large phagemid library of a human pancreatic secretory trypsin inhibitor (hPSTI) mutant that binds to Legionella pneumophila. To gain further insight into the binding kinetics of the isolated hPSTI mutant, an immunosensing system based on a quartz crystal microbalance (QCM) was used. In contrast to ELISA procedures, k(on) and k(off) rates could be derived from the QCM sensograms. Thus, it is possible to characterize specific intermolecular interactions between proteins and phages isolated from large phage display libraries by QCM.
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Affiliation(s)
- J Decker
- Institute of Medical Microbiology and Hygiene, University of Regensburg, Franz Josef Strauss Allee 11, 93053, Regensburg, Germany
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Hengerer A, Decker J, Prohaska E, Hauck S, Kösslinger C, Wolf H. Quartz crystal microbalance (QCM) as a device for the screening of phage libraries. Biosens Bioelectron 1999; 14:139-44. [PMID: 10101836 DOI: 10.1016/s0956-5663(98)00111-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
An immunosensing system based on a quartz crystal microbalance (QCM) is presented for the selection of both antigen specific recombinant antibodies and antigen specific human pancreatic secretory trypsin inhibitor (hPSTI) mutants isolated from large phage libraries. The QCM was integrated into a flow injection analysis system for the straightforward analysis of large sample numbers. Measurements were performed using a biotinylated antigen immobilized by streptavidin onto the gold surface of the quartz crystal and phages displaying recombinant antibodies or hPSTI mutants. The results obtained by the QCM were in accordance to those of a well established enzyme linked immunosorbent assay (ELISA). Therefore, the QCM is well suited for the detection of single high affinity clones isolated from large phage display libraries.
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Affiliation(s)
- A Hengerer
- University of Regensburg, Institute for Medical Microbiology and Hygiene, Germany.
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Prohaska E, Dorn U, Ellegast H, Wenger E, Hawel R. [Spondylodiscitis as a dominant early symptom of juvenile ankylosing spondylitis]. Z Rheumatol 1991; 50:181-4. [PMID: 1927065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A 12-year-old female (HLA-B27 negative) presented with unilateral low back pain and sterno-clavicular arthritis. Six months after onset the clinical and radiological findings determined spondylodiscitis L1/2. On the basis of the clinical findings (oligoarthritis, symptomatic sacroilitis, spondylodiscitis), juvenile ankylosing spondylitis was suspected. The diagnosis was corroborated 18 months after the first occurrence of symptoms by the appearance of typical changes in the sacroiliac joint that are indicative of juvenile ankylosing spondylitis. Because of persisting antibodies against Borrelia burgdorferi, the possibility of B. burgdorferi-induced reactive arthritis with involvement of the axial division of the skeletal system was considered. After 3.5 years of observation the condition showed a benign course with radiologically observable consolidation of the spondylodiscitis. To our knowledge, this is the second case described of juvenile ankylosing spondylitis with spondylodiscitis as a dominating feature.
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Affiliation(s)
- E Prohaska
- Rehabilitationszentrum für Erkrankungen des rheumatischen Formenkreises Bad Hofgastein
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Prohaska E, Obererlacher J, Hawel R, Petershofer H. [Spinal involvement in chronic Reiter's syndrome]. Z Rheumatol 1986; 45:155-60. [PMID: 3776363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
From a retrospective analysis (1980-1984) we found 32 cases of chronic Reiter's syndrome with spinal involvement on the radiographs (as sacroiliitis, parasyndesmophytes, and rarely syndesmophytes). In these 32 case histories spinal pain was a rather frequent symptom, often beginning with the onset of the disease, whereas severe functional spinal impairment was seldom found. Joints were only mildly affected, organic symptoms were found chiefly in clinical history, but were often incomplete. Trigger infections were known in 40%, and 87% of the patients were HLA B27 positive. These 32 patients with mainly spinal symptoms represent 75% of all cases (n = 43) suffering from chronic Reiter's syndrome within the period of observation. Previous observations as well as our experience point to the fact that the chronic course of disease in Reiter's syndrome mainly affects the spinal structure with comparatively mild clinical symptoms.
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Prohaska E, Ellegast H, Petershofer H, Hawel R, Obererlacher J. [Special disco-vertebral forms of ankylosing spondylitis]. Z Rheumatol 1984; 43:303-10. [PMID: 6524116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
In a retrospective study 10 cases (6 males, 4 females) of special disco-vertebral forms of ankylosing spondylitis were evaluated. In all cases radiographs showed bilateral sacroiliitis and destructive-sclerotic disco-vertebral lesions but hardly any syndesmophytes considered typical for ankylosing spondylitis. We found a rather striking diversity of morphologic changes caused by spondylodiscitis, polysegmental involvement, the simultaneous and successive appearance (in the cause of the disease) of shiny corner, as well as anterior spondylitis and spondylodiscitis. All cases had clinical and humoral signs of disease activity, and some even had extravertebral manifestations. Radiographs and clinical findings indicate that an inflammatory process causes the disco-vertebral lesions. The special forms of ankylosing spondylitis as described in this article are in accordance with the polymorphism frequently observed in this disease.
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Haydl H, Petershofer H, Ellegast HH, Prohaska E. [Diagnosis of psoriatic osteoarthropathy: comparison of clinical, radiologic and scintigraphic findings]. Wien Klin Wochenschr 1984; 96:337-43. [PMID: 6475084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Among the group of seronegative spondarthritides psoriatic osteoarthropathy can be differentiated from rheumatoid arthritis as a separate disease with generalized osseous proliferation. 33 cases were evaluated and clinical data, X-ray films and nuclear bone scans were compared. Pathological alterations in the bone structure can be found by bone scintigraphy already at very early, even subclinical stages of the disease, thus allowing early diagnosis. In a high percentage of our cases pathological alterations could be demonstrated by scintigraphy long before they were revealed on X-ray films. Scintigraphic methods may help to evaluate the activity of the disease. Furthermore, in many of our cases, localization and concentration of the tracer in the skeleton were so typical, that they may be considered pathognomonic for psoriatic osteoarthropathy. Thus bone scanning appears to be a useful tool for the diagnostic evaluation and follow up in cases of psoriatic arthropathy, in particular if the low exposure to radiation is taken into account.
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Abstract
In a retrospective analysis of 770 cases of ankylosing spondylitis or allied disorders 146 patients (19 percent) were found to have isolated sacroiliitis without involvement of the spine. The mean disease duration of isolated sacroiliitis was 11.9 years. The conclusions were based on anamnestic, clinical and radiological data. Of those patients with isolated sacroiliitis 29 percent were female, compared to 11 percent of female patients with typical spinal disease. Cases restricted to the sacroiliac joints for a longer period can be observed frequently in younger patients and may be regarded as an abortive and monosymptomatic form of ankylosing spondylitis insofar as other seronegative spondarthritides can be excluded.
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Ellegast HH, Haydl H, Petershofer H, Prohaska E. [Radiology of osteoarthropathia psoriatica]. Rontgenpraxis 1984; 37:75-82. [PMID: 6719274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Prohaska E, Moritz E. [Combination of ankylosing spondylitis with dermatomyositis and atypical gout (isolated gout kidney)]. Z Rheumatol 1983; 42:44-6. [PMID: 6845889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
In a 58-year-old man with the clinical and radiological signs of definite ankylosing spondylitis in its final stages, HLA B 27 positive, an onset of dermatomyositis was observed with characteristic clinical, histological, and pathological findings, and with high titers of ANA. It had been discovered years before that a gouty kidney with pyelonephritis accompanied the advanced ankylosing spondylitis. On the basis of these findings a triple association of etiologically different diseases could be diagnosed. After treatment with cortisone, allopurinol, and azathioprine appeared an acute and no longer controllable panmyelophthisis. That a malignant tumor could have caused the dermatomyositis was excluded by autopsy. Diagnostic questions concerning the gouty kidney as well as factors explaining the acute and deadly progress of a panmyelophthisis after the administration of a rather mild immunosuppressive agent are discussed.
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Prohaska E, Neumüller J, Partsch G, Eberl R. [Antinuclear antibodies in ankylosing spondylitis (author's transl)]. Wien Klin Wochenschr 1980; 92:876-9. [PMID: 6971529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Antinuclear antibodies (ANA) were found in 19.1% of patients suffering from ankylosing spondylitis (n = 320). This figure is significantly higher than the results obtained in a control group. ANA were present in all stages of the disease, including the abortive form of isolated sacroiliitis. ANA were also found in different stages of activity. In addition, ANA-positive cases showed a higher inflammatory activity. In females ANA were more frequently found than in males. There was a positive correlation between ANA and HLA B27 in 87.2%.
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Prohaska E, Neumüller J, Partsch G, Eberl R. [Immunological features in ankylosing spondylitis (author's transl)]. Wien Klin Wochenschr 1978; 90:185-6. [PMID: 305686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Sera from 50 patients with various stages of ankylosing spondylitis were tested for the presence of antinuclear antibodies (ANA), anti-DNA antibodies, rheumatoid factor and antistreptolysin. Antinuclear antibodies (immunofluorescent technique) were detected in the sera of 10 patients (20%), associated in one case with anti-DNA antibodies (immunofluorescent technique). The disease activity in ANA-positive cases was low to moderate.
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Klotz HG, Prohaska E. [Incidence and clinical aspects of gout]. Med Klin 1973; 68:387-92. [PMID: 4692423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Klotz H, Prohaska E, Salmhofer H, Schmid L. [Gout from the view of a special hospital for rheumatic patients]. Wien Klin Wochenschr 1971; 83:177-80. [PMID: 5314855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Prohaska E, Chlud K, Pfaller C. [On the treatment of chronic polyarthritis with cytostatic drugs. II. Oral application of Trenimon. Clinical and serological studies]. Z Rheumaforsch 1968; 27:39-47. [PMID: 5715915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Chlud K, Prohaska E, Zeitlhofer J, Pfaller C, Friza B. [Immunosuppressive treatment of progressive chronic polyarthritis. Experiences with an antimitotic drug from the podophyllin series (Proresid)]. Munch Med Wochenschr 1968; 110:88-97. [PMID: 5695131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Prohaska E. [Behavior of the rheumatoid factor under long-term penicillamine therapy in primary chronic polyarthritis and lupus erythematosus disseminatus]. Wien Z Inn Med 1966; 47:196-202. [PMID: 6005164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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