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Caocci G, Mulas O, Capodanno I, Bonifacio M, Annunziata M, Galimberti S, Luciano L, Tiribelli M, Martino B, Castagnetti F, Binotto G, Pregno P, Stagno F, Abruzzese E, Bocchia M, Gozzini A, Albano F, Fozza C, Luzi D, Efficace F, Simula MP, Scaffidi L, Baratè C, De Gregorio F, Stella R, Gugliotta G, Pirillo F, Trawinska MM, Sicuranza A, Cattaneo D, Attolico I, Scalzulli E, Iurlo A, Foà R, Breccia M, La Nasa G. Low-density lipoprotein (LDL) levels and risk of arterial occlusive events in chronic myeloid leukemia patients treated with nilotinib. Ann Hematol 2021; 100:2005-2014. [PMID: 33388860 DOI: 10.1007/s00277-020-04392-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 10/26/2020] [Accepted: 12/21/2020] [Indexed: 12/27/2022]
Abstract
Recommendations for dyslipidemia management aimed at reducing arterial occlusive events (AOEs) have been recently published. So far, no data have been reported on the management of dyslipidemia in chronic myeloid leukemia (CML) patients treated with nilotinib. We investigated 369 CML adult patients, stratified according to the new Systematic Coronary Risk Evaluation (SCORE) scoring system. Plasma levels of cholesterol, HDL, LDL, and triglycerides were measured prior to the start of nilotinib and after 3, 6, and 12 months. The 5-year cumulative incidence of AOEs was 15.9%. Patients with cholesterol levels > 200 mg/dL and LDL > 70 mg/dL 3 months after treatment showed a significantly higher incidence of AOEs (21.9 ± 4.6% vs 6.2 ± 2.5, P = 0.003). Patients belonging to the high and very high SCORE risk group showed a significant increase of AOEs (34.4 ± 6% vs 10 ± 2.1%, P < 0.001). In multivariate analysis, both high cholesterol and LDL levels and a high and very high SCORE risk remained significantly associated with the risk of AOEs (P = 0.008; HR = 3.5; 95% CI = 1.4-8.7 and P < 0.001; HR = 4.4; 95% CI = 2-9.8, respectively). Overall, 78 patients (21.1%) presented dyslipidemia at the time of CML diagnosis and 88 (23.3%) after starting nilotinib, but only 26 of them (29.5%) were treated with statins.Low LDL and cholesterol plasma levels are associated with a significant lower risk of AOEs in CML patients treated with nilotinib in the real life.
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Affiliation(s)
- Giovanni Caocci
- Hematology Unit, Businco Hospital, ARNAS Brotzu, Cagliari, Italy. .,Dipartimento di Scienze Mediche e Sanità Pubblica, Università di Cagliari, Cagliari, Italy.
| | - Olga Mulas
- Hematology Unit, Businco Hospital, ARNAS Brotzu, Cagliari, Italy.,Dipartimento di Scienze Mediche e Sanità Pubblica, Università di Cagliari, Cagliari, Italy
| | - Isabella Capodanno
- Hematology Unit, Azienda Unità Sanitaria Locale -IRCCS, Reggio Emilia, Italy
| | | | | | - Sara Galimberti
- Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Luigiana Luciano
- Hematology Unit, "Federico II" University of Naples, Naples, Italy
| | - Mario Tiribelli
- Division of Hematology and BMT, University of Udine, Udine, Italy
| | - Bruno Martino
- Hematology Unit, Azienda Ospedaliera "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
| | - Fausto Castagnetti
- Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | | | - Patrizia Pregno
- Hematology Unit, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza, Torino, Italy
| | - Fabio Stagno
- Hematology Unit, AOU Policlinico -V. Emanuele, Rodolico Hospital, Catania, Italy
| | | | - Monica Bocchia
- Haematology Unit, Azienda Ospedaliera Universitaria Senese, University of Siena, Siena, Italy
| | - Antonella Gozzini
- Hematology Unit, AOU Careggi, University of Florence, Florence, Italy
| | - Francesco Albano
- Department of Emergency and Organ Transplantation - Hematology Section, University of Bari, Bari, Italy
| | - Claudio Fozza
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Debora Luzi
- Division of Hematology, Hematology Unit, Santa Maria Hospital, Terni, Italy
| | - Fabio Efficace
- Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA), Rome, Italy
| | | | - Luigi Scaffidi
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Claudia Baratè
- Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | | | - Rossella Stella
- Division of Hematology and BMT, University of Udine, Udine, Italy
| | - Gabriele Gugliotta
- Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Francesca Pirillo
- Hematology Unit, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza, Torino, Italy
| | | | - Anna Sicuranza
- Haematology Unit, Azienda Ospedaliera Universitaria Senese, University of Siena, Siena, Italy
| | - Daniele Cattaneo
- Hematology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Immacolata Attolico
- Department of Emergency and Organ Transplantation - Hematology Section, University of Bari, Bari, Italy
| | - Emilia Scalzulli
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Policlinico Umberto 1, Rome, Italy
| | - Alessandra Iurlo
- Hematology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Robin Foà
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Policlinico Umberto 1, Rome, Italy
| | - Massimo Breccia
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Policlinico Umberto 1, Rome, Italy
| | - Giorgio La Nasa
- Hematology Unit, Businco Hospital, ARNAS Brotzu, Cagliari, Italy.,Dipartimento di Scienze Mediche e Sanità Pubblica, Università di Cagliari, Cagliari, Italy
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Mulas O, Caocci G, Annunziata M, Martino B, Luciano L, Castagnetti F, Pregno P, Galimberti S, Albano F, Orlandi EM, Sgherza N, Iurlo A, Bonifacio M, Binotto G, Gozzini A, Bocchia M, Abruzzese E, Fozza C, Simula MP, De Gregorio F, Gugliotta G, Pirillo F, Baratè C, Attolico I, Elena C, Cattaneo D, Scaffidi L, Sicuranza A, Trawinska MM, Scalzulli E, Foà R, Breccia M, La Nasa G. Favorable outcome of chronic myeloid leukemia co-expressing e13a2 and e14a2 transcripts, treated with nilotinib. Hematol Oncol 2020; 38:607-610. [PMID: 32602167 DOI: 10.1002/hon.2765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/04/2020] [Accepted: 06/18/2020] [Indexed: 11/09/2022]
Affiliation(s)
- Olga Mulas
- Department of Medical Sciences and Public Health, University of Cagliari, Businco Hospital, Cagliari, Italy
| | - Giovanni Caocci
- Department of Medical Sciences and Public Health, University of Cagliari, Businco Hospital, Cagliari, Italy
| | | | - Bruno Martino
- Haematology Unit, Azienda Ospedaliera "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
| | - Luigiana Luciano
- Haematology Unit "Federico II", University of Naples, Naples, Italy
| | - Fausto Castagnetti
- Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Patrizia Pregno
- Haematology Unit, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza, Torino, Italy
| | - Sara Galimberti
- Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Francesco Albano
- Haematology and Transplants Unit, University of Bari, Bari,, Italy
| | - Ester M Orlandi
- Haematology Unit, "Fondazione IRCCS Policlinico S. Matteo" University Hospital, Pavia, Italy
| | - Nicola Sgherza
- Haematology and Transplant Center, Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy
| | - Alessandra Iurlo
- Haematology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | | | - Antonella Gozzini
- Haematology Unit, AOU Careggi, University of Florence, Florence, Italy
| | - Monica Bocchia
- Haematology Unit, Azienda Ospedaliera Universitaria Senese, University of Siena, Siena, Italy
| | | | - Claudio Fozza
- Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - Maria P Simula
- Department of Medical Sciences and Public Health, University of Cagliari, Businco Hospital, Cagliari, Italy
| | | | - Gabriele Gugliotta
- Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Francesca Pirillo
- Haematology Unit, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza, Torino, Italy
| | - Claudia Baratè
- Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Imma Attolico
- Haematology and Transplants Unit, University of Bari, Bari,, Italy
| | - Chiara Elena
- Haematology Unit, "Fondazione IRCCS Policlinico S. Matteo" University Hospital, Pavia, Italy
| | - Daniele Cattaneo
- Haematology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Luigi Scaffidi
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Anna Sicuranza
- Haematology Unit, Azienda Ospedaliera Universitaria Senese, University of Siena, Siena, Italy
| | | | - Emilia Scalzulli
- Division of Haematology, Department of Precision and Translational Medicine, Policlinico Umberto I, Sapienza University, Rome, Italy
| | - Robin Foà
- Division of Haematology, Department of Precision and Translational Medicine, Policlinico Umberto I, Sapienza University, Rome, Italy
| | - Massimo Breccia
- Division of Haematology, Department of Precision and Translational Medicine, Policlinico Umberto I, Sapienza University, Rome, Italy
| | - Giorgio La Nasa
- Department of Medical Sciences and Public Health, University of Cagliari, Businco Hospital, Cagliari, Italy
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Caocci G, Mulas O, Annunziata M, Luciano L, Abruzzese E, Bonifacio M, Orlandi EM, Albano F, Galimberti S, Iurlo A, Pregno P, Sgherza N, Martino B, Binotto G, Castagnetti F, Gozzini A, Bocchia M, Fozza C, Stagno F, Simula MP, De Gregorio F, Trawinska MM, Scaffidi L, Elena C, Attolico I, Baratè C, Cattaneo D, Pirillo F, Gugliotta G, Sicuranza A, Molica M, La Nasa G, Foà R, Breccia M. Long-term mortality rate for cardiovascular disease in 656 chronic myeloid leukaemia patients treated with second- and third-generation tyrosine kinase inhibitors. Int J Cardiol 2020; 301:163-166. [DOI: 10.1016/j.ijcard.2019.10.036] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 09/30/2019] [Accepted: 10/21/2019] [Indexed: 11/28/2022]
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Caocci G, Mulas O, Abruzzese E, Luciano L, Iurlo A, Attolico I, Castagnetti F, Galimberti S, Sgherza N, Bonifacio M, Annunziata M, Gozzini A, Orlandi EM, Stagno F, Binotto G, Pregno P, Fozza C, Trawinska MM, De Gregorio F, Cattaneo D, Albano F, Gugliotta G, Baratè C, Scaffidi L, Elena C, Pirillo F, Scalzulli E, La Nasa G, Foà R, Breccia M. Arterial occlusive events in chronic myeloid leukemia patients treated with ponatinib in the real-life practice are predicted by the Systematic Coronary Risk Evaluation (SCORE) chart. Hematol Oncol 2019; 37:296-302. [PMID: 30892724 PMCID: PMC6766852 DOI: 10.1002/hon.2606] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 03/14/2019] [Indexed: 01/13/2023]
Abstract
Arterial occlusive events (AOEs) represent emerging complications in chronic myeloid leukemia (CML) patients treated with ponatinib. We identified 85 consecutive CML adult patients who were treated with ponatinib in 17 Italian centers. Patients were stratified according to the Systematic Coronary Risk Evaluation (SCORE) assessment, based on sex, age, smoking habits, systolic blood pressure, and total cholesterol levels. The 60‐month cumulative incidence rate of AOEs excluding hypertension was 25.7%. Hypertension was reported in 14.1% of patients. The median time of exposure to ponatinib was 28 months (range, 3‐69 months). Patients with a high to very high SCORE risk showed a significantly higher incidence rate of AOEs (74.3% vs 15.2%, P < 0.001). Patients aged ≥60 years showed a significantly higher incidence rate of AOEs (51.5% vs 16.9%, P = 0.008). In multivariate analysis, no association was found between AOEs and positive history of CV disease, age, dose of ponatinib, previous exposure to nilotinib, and comorbidities. Only the SCORE risk was confirmed as a significant predictive factor (P = 0.01; HR = 10.9; 95% C.I. = 1.7‐67.8). Patients aged ≥60 years who were treated with aspirin had a lower incidence rate of AOEs (33.3% vs 61.8%). Among the 14 reported AOEs, 78.6% of them showed grade 3 to 4 toxicity. This real‐life study confirmed the increased incidence of AOEs in CML patients treated with ponatinib, with high to very high SCORE risk. We suggest that patients aged ≥60 years who were treated with ponatinib should undergo prophylaxis with 100 mg/day of aspirin. Our findings emphasize personalized prevention strategies based on CV risk factors.
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Affiliation(s)
- Giovanni Caocci
- Hematology Unit, Businco Hospital, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Olga Mulas
- Hematology Unit, Businco Hospital, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Luigiana Luciano
- Hematology Unit "Federico II" University of Naples, Naples, Italy
| | - Alessandra Iurlo
- Hematology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Immacolata Attolico
- Department of Emergency and Organ Transplantation-Hematology Section, University of Bari, Bari, Italy
| | - Fausto Castagnetti
- Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Sara Galimberti
- Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Nicola Sgherza
- Hematology and Transplant Center, Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy
| | | | | | - Antonella Gozzini
- Hematology Unit, AOU Careggi, University of Florence, Florence, Italy
| | - Ester Maria Orlandi
- Division of Hematology, "Fondazione IRCCS Policlinico S. Matteo", Pavia, Italy
| | - Fabio Stagno
- Hematology Unit, AOU Policlinico-V. Emanuele, Rodolico Hospital, Catania, Italy
| | | | - Patrizia Pregno
- Hematology Unit, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza, Torino, Italy
| | - Claudio Fozza
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | | | | | - Daniele Cattaneo
- Hematology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Francesco Albano
- Department of Emergency and Organ Transplantation-Hematology Section, University of Bari, Bari, Italy
| | - Gabriele Gugliotta
- Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Claudia Baratè
- Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Luigi Scaffidi
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Chiara Elena
- Division of Hematology, "Fondazione IRCCS Policlinico S. Matteo", Pavia, Italy
| | - Francesca Pirillo
- Hematology Unit, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza, Torino, Italy
| | - Emilia Scalzulli
- Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy
| | - Giorgio La Nasa
- Hematology Unit, Businco Hospital, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Robin Foà
- Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy
| | - Massimo Breccia
- Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy
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Caocci G, Mulas O, Annunziata M, Luciano L, Bonifacio M, Orlandi EM, Pregno P, Galimberti S, Russo Rossi A, Abruzzese E, Iurlo A, Martino B, Sgherza N, Binotto G, Castagnetti F, Gozzini A, Fozza C, Bocchia M, Sicuranza A, Stagno F, Efficace F, Usala E, De Gregorio F, Scaffidi L, Elena C, Pirillo F, Baratè C, Trawinska MM, Cattaneo D, Labate C, Gugliotta G, Molica M, Specchia G, La Nasa G, Foà R, Breccia M. Cardiovascular toxicity in patients with chronic myeloid leukemia treated with second-generation tyrosine kinase inhibitors in the real-life practice: Identification of risk factors and the role of prophylaxis. Am J Hematol 2018; 93:E159-E161. [PMID: 29633312 DOI: 10.1002/ajh.25102] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 03/27/2018] [Accepted: 03/29/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Giovanni Caocci
- Department of Medical Sciences and Public Health; University of Cagliari; Cagliari
| | - Olga Mulas
- Businco Hospital; Hematology and Transplant Center; Cagliari
| | | | | | | | - Ester Maria Orlandi
- Hematology Unit, “Fondazione IRCCS Policlinico S. Matteo” University Hospital; Pavia
| | - Patrizia Pregno
- Hematology Unit, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza; Torino
| | - Sara Galimberti
- Department of Clinical and Experimental Medicine; Section of Hematology, University of Pisa; Pisa
| | | | | | - Alessandra Iurlo
- Hematology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico; Milano
| | - Bruno Martino
- Hematology Unit, Azienda Ospedaliera “Bianchi-Melacrino-Morelli”; Reggio Calabria
| | - Nicola Sgherza
- Casa Sollievo della Sofferenza Hospital; Hematology and Transplant Center; San Giovanni Rotondo
| | | | - Fausto Castagnetti
- Department of Experimental, Diagnostic and Specialty Medicine; S. Orsola-Malpighi Hospital, University of Bologna; Bologna
| | | | - Claudio Fozza
- Department of Clinical and Experimental Medicine; University of Sassari; Sassari
| | - Monica Bocchia
- Hematology Unit, Azienda Ospedaliera Universitaria Senese, University of Siena; Siena
| | - Anna Sicuranza
- Hematology Unit, Azienda Ospedaliera Universitaria Senese, University of Siena; Siena
| | | | - Fabio Efficace
- Italian Group for Adult Hematologic Diseases (GIMEMA); Data Center and Health Outcomes Research Unit; Rome
| | - Emilio Usala
- Businco Hospital; Hematology and Transplant Center; Cagliari
| | | | - Luigi Scaffidi
- Department of Medicine; Section of Hematology, University of Verona; Verona
| | - Chiara Elena
- Hematology Unit, “Fondazione IRCCS Policlinico S. Matteo” University Hospital; Pavia
| | - Francesca Pirillo
- Hematology Unit, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza; Torino
| | - Claudia Baratè
- Department of Clinical and Experimental Medicine; Section of Hematology, University of Pisa; Pisa
| | | | - Daniele Cattaneo
- Hematology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico; Milano
| | - Claudia Labate
- Hematology Unit, Azienda Ospedaliera “Bianchi-Melacrino-Morelli”; Reggio Calabria
| | - Gabriele Gugliotta
- Department of Experimental, Diagnostic and Specialty Medicine; S. Orsola-Malpighi Hospital, University of Bologna; Bologna
| | - Matteo Molica
- Division of Hematology, Department of Cellular Biotechnologies and Hematology; Policlinico Umberto I, Sapienza University; Rome Italy
| | | | - Giorgio La Nasa
- Department of Medical Sciences and Public Health; University of Cagliari; Cagliari
| | - Robin Foà
- Division of Hematology, Department of Cellular Biotechnologies and Hematology; Policlinico Umberto I, Sapienza University; Rome Italy
| | - Massimo Breccia
- Division of Hematology, Department of Cellular Biotechnologies and Hematology; Policlinico Umberto I, Sapienza University; Rome Italy
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Blasi S, Blasi G, Castaldo A, Pirillo F, Parodi M. [Direct bonded orthodontic brackets and adhesion of composites]. Dent Cadmos 1988; 56:78-86. [PMID: 3077772] [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: 01/04/2023]
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