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Weidacker K, Kärgel C, Massau C, Krueger THC, Walter M, Ponseti J, Walter H, Schiffer B. Interference inhibition in offending and non-offending pedophiles: A preliminary event-related fMRI study. Neuropsychologia 2022; 173:108301. [PMID: 35697089 DOI: 10.1016/j.neuropsychologia.2022.108301] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 11/05/2021] [Revised: 06/06/2022] [Accepted: 06/08/2022] [Indexed: 11/25/2022]
Abstract
The ability to inhibit behavior is thought to be an import skill for avoiding criminal conduct, especially when combined with personal predispositions or criminogenic needs such as a pedophilic preference disorder. While previous research emphasized the relationship between impulsivity and child sexual offending, not pedophilia per se, studies on the underlying neurobiological mechanisms in subdomains of impulsivity remained scarce. Here, we focused on interference inhibition and examined event-related functional magnetic resonance imaging (fMRI) data of three groups of men performing a color-word Stroop task: (1) pedophiles with a history of CSO (P+CSO, n = 11), (2) pedophiles without a history of CSO (P-CSO, n = 8) and (3) non-pedophilic, non-offending healthy controls (HC, n = 10). On the behavioral level, P+CSO revealed increased Stroop interference as compared to P-CSO and HC. Moreover, increased Stroop interference in P+CSO was accompanied by enhanced conflict-related activity in left superior parietal cortex and precentral gyrus as compared to P-CSO. Albeit behavioral analyses of error and post-error processing revealed no significant between-group differences, P-CSO showed increased post-error-related activity in left posterior cingulate, precuneus and middle temporal gyrus as compared to P+CSO. Our preliminary data highlight inhibition deficits in offending as compared to non-offending pedophiles or healthy men and suggest that functional alterations in attention reallocation and impulse suppression/control may moderate the risk for committing CSO in men suffering from pedophilia.
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Affiliation(s)
- K Weidacker
- School of Psychology, University of Swansea, Swansea, Wales, United Kingdom; Division of Forensic Psychiatry and Psychotherapy, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL-University Hospital, Ruhr University Bochum, Alexandrinenstr. 1-3; 44791 Bochum, Germany
| | - C Kärgel
- Division of Forensic Psychiatry and Psychotherapy, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL-University Hospital, Ruhr University Bochum, Alexandrinenstr. 1-3; 44791 Bochum, Germany
| | - C Massau
- Division of Forensic Psychiatry and Psychotherapy, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL-University Hospital, Ruhr University Bochum, Alexandrinenstr. 1-3; 44791 Bochum, Germany
| | - T H C Krueger
- Department of Clinical Psychiatry, Social Psychiatry, and Psychotherapy, Hanover Medical School, Hanover, Germany
| | - M Walter
- Department of Psychiatry and Psychotherapy, University Hospital Jena, Germany
| | - J Ponseti
- Institute of Sexual and Forensic Medicine, University Hospital Kiel, Germany
| | - H Walter
- Division of Mind and Brain, Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Germany
| | - B Schiffer
- Division of Forensic Psychiatry and Psychotherapy, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL-University Hospital, Ruhr University Bochum, Alexandrinenstr. 1-3; 44791 Bochum, Germany.
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Unterhorst K, Gerwinn H, Pohl A, Kärgel C, Massau C, Ristow I, Kneer J, Amelung T, Walter H, Beier K, Walter M, Schiffer B, Kruger THC, Stirn A, Ponseti J. An Exploratory Study on the Central Nervous Correlates of Sexual Excitation and Sexual Inhibition. J Sex Res 2020; 57:397-408. [PMID: 30489159 DOI: 10.1080/00224499.2018.1539462] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The Sexual Inhibition/Sexual Excitation Scales (SIS/SES) measure sexual excitation and sexual inhibition proneness. We used SIS and SES scores of 62 heterosexual teleiophilic men (Mage 34.3, SD = 9.9) to predict brain activation levels during the presentation of male and female visual sexual stimuli in a magnetic resonance imaging (MRI) scanner. Statistical analyses revealed significant correlations. SES and SIS1 scores were positively associated with brain activation in various brain regions during the presentation of both male and female stimuli. SIS2 turned out to be a weaker predictor of brain activation, still revealing one significant correlation in the right lateral orbitofrontal cortex. Significant regions for SES and SIS1 were, among others, primary and supplementary motor areas, the caudate nucleus, the dorsal anterior cingulate cortex, anterior insula, and prefrontal areas. Our study can be seen as an exploratory investigation of SIS and SES with means of functional brain imaging. The results provide a promising contribution to the assertion of neurophysiological systems of sexual inhibition and excitation proneness.
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Affiliation(s)
- K Unterhorst
- Institute for Sexual Medicine and Forensic Psychiatry and Psychotherapy, Center for Integrative Psychiatry
| | - H Gerwinn
- Institute for Sexual Medicine and Forensic Psychiatry and Psychotherapy, Center for Integrative Psychiatry
| | - A Pohl
- Institute for Sexual Medicine and Forensic Psychiatry and Psychotherapy, Center for Integrative Psychiatry
| | - C Kärgel
- Division of Forensic Psychiatry, Department of Psychiatry, Psychotherapy, and Preventive Medicine, LWL-University Hospital Bochum
- Institute of Forensic Psychiatry, University of Duisburg-Essen
| | - C Massau
- Division of Forensic Psychiatry, Department of Psychiatry, Psychotherapy, and Preventive Medicine, LWL-University Hospital Bochum
- Institute of Forensic Psychiatry, University of Duisburg-Essen
| | - I Ristow
- Clinical Affective Neuroimaging Laboratory, Otto von Guericke University Magdeburg
- Department of Behavioral Neurology, Leibniz Institute for Neurobiology
| | - J Kneer
- Division of Clinical Psychology and Sexual Medicine, Department of Clinical Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School
| | - T Amelung
- Institute of Sexology and Sexual Medicine, Charité-Universitätsmedizin Berlin
| | - H Walter
- Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin
| | - K Beier
- Institute of Sexology and Sexual Medicine, Charité-Universitätsmedizin Berlin
| | - M Walter
- Clinical Affective Neuroimaging Laboratory, Otto von Guericke University Magdeburg
- Department of Behavioral Neurology, Leibniz Institute for Neurobiology
- Department of Psychiatry, Eberhard Karls University of Tübingen
| | - B Schiffer
- Division of Forensic Psychiatry, Department of Psychiatry, Psychotherapy, and Preventive Medicine, LWL-University Hospital Bochum
- Institute of Forensic Psychiatry, University of Duisburg-Essen
| | - T H C Kruger
- Division of Clinical Psychology and Sexual Medicine, Department of Clinical Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School
| | - A Stirn
- Institute for Sexual Medicine and Forensic Psychiatry and Psychotherapy, Center for Integrative Psychiatry
| | - J Ponseti
- Institute for Sexual Medicine and Forensic Psychiatry and Psychotherapy, Center for Integrative Psychiatry
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Kneer J, Engel J, Veit M, Ponseti J, Walter M, Beier K, Walter H, Schiffer B, Schiltz K, Krueger T. 201 Neural mechanisms underlying pedophilia and sexual offending against children - first results of a multicenter study. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2018.04.169] [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: 10/28/2022]
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Kunath J, Granert O, Pohl A, Gerwinn H, Stirn A, Beier K, Walter H, Walter M, Schiffer B, Krüger T, Ponseti J. 204 The “functional magnetic resonance imaging” (fMRI) as a meaningful tool for the differentiation of sexual preferences. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2018.04.170] [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: 10/28/2022]
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Schiffer B, Amelung T, Pohl A, Kaergel C, Tenbergen G, Gerwinn H, Mohnke S, Massau C, Matthias W, Weiß S, Marr V, Beier KM, Walter M, Ponseti J, Krüger THC, Schiltz K, Walter H. Gray matter anomalies in pedophiles with and without a history of child sexual offending. Transl Psychiatry 2017; 7:e1129. [PMID: 28509903 PMCID: PMC5534964 DOI: 10.1038/tp.2017.96] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 03/28/2017] [Accepted: 03/29/2017] [Indexed: 12/21/2022] Open
Abstract
Pedophilia is a psychiatric disorder that is inter-related with but distinct from child sexual offending (CSO). Neural alterations reportedly contribute to both pedophilia and CSO, but until now, no study has distinguished the brain structural anomalies associated with pedophilia from those specifically associated with CSO in pedophilic men. Using high-resolution T1-weighted brain images and voxel-based morphometry, we analyzed the gray matter (GM) volume of the following 219 men recruited at four acquisition sites in Germany: 58 pedophiles with a history of CSO, 60 pedophiles without any history of CSO and 101 non-pedophilic, non-offending controls to control for the effects of age, education level, verbal IQ, sexual orientation and the acquisition site. Although there were no differences in the relative GM volume of the brain specifically associated with pedophilia, statistical parametric maps revealed a highly significant and CSO-related pattern of above vs below the 'normal' GM volume in the right temporal pole, with non-offending pedophiles exhibiting larger volumes than offending pedophiles. Moreover, regression analysis revealed that the lower GM volume of the dorsomedial prefrontal or anterior cingulate cortex was associated with a higher risk of re-offending in pedophilic child molesters. We believe our data provide the first evidence that CSO in pedophilia rather than pedophilia alone is associated with GM anomalies and thus shed new light on the results of previous studies on this topic. These results indicate the need for new neurobehavioral theories on pedophilia and CSO and may be potentially useful for treatment or prevention approaches that aim to reduce the risk of (re)offending in pedophilia.
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Affiliation(s)
- B Schiffer
- Division of Forensic Psychiatry, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL-University Hospital, Bochum, Germany
- Institute of Forensic Psychiatry, University of Duisburg-Essen, Duisburg, Germany
| | - T Amelung
- Institute of Sexology and Sexual Medicine, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - A Pohl
- Institute of Sexual Medicine and Forensic Psychiatry and Psychotherapy, Medical School, Kiel University, Kiel, Germany
| | - C Kaergel
- Division of Forensic Psychiatry, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL-University Hospital, Bochum, Germany
- Institute of Forensic Psychiatry, University of Duisburg-Essen, Duisburg, Germany
| | - G Tenbergen
- Hannover Medical School, Department of Psychiatry, Hannover, Germany
| | - H Gerwinn
- Institute of Sexual Medicine and Forensic Psychiatry and Psychotherapy, Medical School, Kiel University, Kiel, Germany
| | - S Mohnke
- Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - C Massau
- Division of Forensic Psychiatry, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL-University Hospital, Bochum, Germany
- Institute of Forensic Psychiatry, University of Duisburg-Essen, Duisburg, Germany
| | - W Matthias
- Hannover Medical School, Department of Psychiatry, Hannover, Germany
| | - S Weiß
- Institute of Forensic Psychiatry, University of Duisburg-Essen, Duisburg, Germany
| | - V Marr
- Department of Psychiatry, University of Magdeburg, Magdeburg, Germany
- Clinical Affective Neuroimaging Laboratory, Department for Behavioral Neurology, Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - K M Beier
- Institute of Sexology and Sexual Medicine, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - M Walter
- Department of Psychiatry, University of Magdeburg, Magdeburg, Germany
- Clinical Affective Neuroimaging Laboratory, Department for Behavioral Neurology, Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - J Ponseti
- Institute of Sexual Medicine and Forensic Psychiatry and Psychotherapy, Medical School, Kiel University, Kiel, Germany
| | - T H C Krüger
- Hannover Medical School, Department of Psychiatry, Hannover, Germany
| | - K Schiltz
- Department of Psychiatry, University of Magdeburg, Magdeburg, Germany
- Department of Forensic Psychiatry, Psychiatric Hospital of the University of Munich, Munich, Germany
| | - H Walter
- Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Berlin, Germany
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Ristow I, Li S, Demenescu R, Colic L, Li M, Walter H, Beier K, Krüger T, Schiffer B, Ponseti J, Walter M. EP 80. Sexual processing of pedophilic patients and healthy controls and the role of its metabolic markers – A fMRI and MRS study. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2016.05.129] [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: 11/28/2022]
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Ristow I, Li S, Demenescu L, Walter H, Beier K, Kruger T, Schiffer B, Ponseti J, Walter M. Abnormal amygdala functional connectivity during an fMRI expectancy task in pedophilia. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
IntroductionPedophilia is a disorder where sexual preferences of adults are directed towards children. This disorder impacts society with 1–2 out of every 10 children being sexually approached by an adult, often resulting in prolonged negative psychological effects. Prior research reported structural and functional amygdala alterations in pedophilia. As the neurophenomenological model of sexual arousal suggests the importance of the amygdala in the emotional component, we focused on amygdala functional connectivity in pedophilia.AimsTo investigate amygdala functional connectivity (FC) modulated by expectancy and salient stimuli in pedophilic patients.MethodsThirteen pedophilic patients and 13 matched healthy controls underwent a salience expectancy task in a 7T ultra high fMRI study. Subjects perceived pictures of naked adults and children. Half of the pictures were preceded by an expectancy cue. Participants were instructed to actively expect the picture depending on the cue. We conducted psychophysiological analysis (PPI) to examine amygdala FC changes in two amygdala sub-regions for child/adult stimuli during the expectancy period and the visual stimuli consummation period using as seed regions the basolateral (BLA) and central nucleus of the amygdala (CeA).ResultsHealthy controls, relative to patients showed significant stronger left CeA to right post-central gyrus FC during expectancy of adult > child picture. For picture condition (adult > child picture) we found significant stronger left CeA to left dorsolateral prefrontal cortex FC in patients compared to healthy controls.ConclusionThese findings add to the recent literature by indicating that amygdala dysfunctional connectivity is involved in development of deviant sexual behavior.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Ponseti J, Granert O, van Eimeren T, Jansen O, Wolff S, Beier K, Deuschl G, Bosinski H, Siebner H. Human face processing is tuned to sexual age preferences. Biol Lett 2014; 10:20140200. [PMID: 24850896 DOI: 10.1098/rsbl.2014.0200] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [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: 01/08/2023] Open
Abstract
Human faces can motivate nurturing behaviour or sexual behaviour when adults see a child or an adult face, respectively. This suggests that face processing is tuned to detecting age cues of sexual maturity to stimulate the appropriate reproductive behaviour: either caretaking or mating. In paedophilia, sexual attraction is directed to sexually immature children. Therefore, we hypothesized that brain networks that normally are tuned to mature faces of the preferred gender show an abnormal tuning to sexual immature faces in paedophilia. Here, we use functional magnetic resonance imaging (fMRI) to test directly for the existence of a network which is tuned to face cues of sexual maturity. During fMRI, participants sexually attracted to either adults or children were exposed to various face images. In individuals attracted to adults, adult faces activated several brain regions significantly more than child faces. These brain regions comprised areas known to be implicated in face processing, and sexual processing, including occipital areas, the ventrolateral prefrontal cortex and, subcortically, the putamen and nucleus caudatus. The same regions were activated in paedophiles, but with a reversed preferential response pattern.
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Affiliation(s)
- J Ponseti
- Institute of Sexual Medicine and Forensic Psychiatry and Psychotherapy, Christian-Albrechts University of Kiel, Medical School, Kiel, Germany
| | - O Granert
- Department of Neurology, Christian-Albrechts University of Kiel, Medical School, Kiel, Germany
| | - T van Eimeren
- Department of Neurology, Christian-Albrechts University of Kiel, Medical School, Kiel, Germany
| | - O Jansen
- Department of Radiology and Neuroradiology, Christian-Albrechts University of Kiel, Medical School, Kiel, Germany
| | - S Wolff
- Department of Radiology and Neuroradiology, Christian-Albrechts University of Kiel, Medical School, Kiel, Germany
| | - K Beier
- Institute of Sexology and Sexual Medicine, Charité Universitätsmedizin, Freie- and Humboldt University, Berlin, Germany
| | - G Deuschl
- Department of Neurology, Christian-Albrechts University of Kiel, Medical School, Kiel, Germany
| | - H Bosinski
- Practice for Sexual Medicine, Kiel, Germany
| | - H Siebner
- Department of Neurology, Christian-Albrechts University of Kiel, Medical School, Kiel, Germany Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
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Abstract
The aim of this study was to elucidate the relation between electrical activity in the corpus cavernosum (CC), penile responses and brain processes. EEG potentials, penile circumference and electrical activity of the CC (CC-EMG) were recorded simultaneously while male subjects were exposed to visual sexual stimuli. The trials were sorted by the penile response of the subjects (erection, maintenance or detumescence). The corresponding EEG recordings were subjected to independent component analysis (ICA) and then correlated with CC activity. We found that CC activity was decreased in the case of erection. EEG activity was found to be correlated with CC activity in most cases at the same instant or with subsequent CC activity. EEG activity at early time points after stimulus onset (<300 ms) was found to be correlated with CC activity, indicating penile response preparation at a pre-attentive processing level. These data indicate that (i) CC activity is under the control of brain processing and (ii) autonomous input reaches the CC in fractions of a second after sexual stimulus onset. Our experimental paradigm should be used for the study of psychogenic erectile dysfunctions and could help in the development of an objective measurement of this disturbance.
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Affiliation(s)
- J Ponseti
- Section of Sexual Medicine, Christian-Albrechts-University of Kiel, Arnold-Heller-Strasse 12, Kiel, Germany.
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Affiliation(s)
- J Ponseti
- Unidad Funcional de la Miastenia. Hospital General Universitario Vall d'Hebron. Barcelona
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Ponseti J, Dimopulos U, Hübscher W. [Methodology and didactics of training children and adolescents in topical treatment of atopic dermatitis]. Rehabilitation (Stuttg) 1998; 37:224-8. [PMID: 10063512] [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] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
There are increasing numbers of education programmes for children and young people with atopic dermatitis. These also include directions for the treatment of atopic dermatitis. However, the methods to be followed and the treatment to be applied are usually not clearly defined or explained. Presented are the key aspects of the local treatment of atopic dermatitis to be taught to children. The introduction of a basic therapeutic concept helps sort out which are the best preparations to use, some with and others without active ingredients. The interactions between basic care, active ingredients and skin conditions are explained in such a way that children can understand them.
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Affiliation(s)
- J Ponseti
- Fachklinik Therapeutikum Westfehmarn, Therapiezentrum für Kinder und Erwachsene mit allergischen Erkrankungen und chronischen Schmerzzuständen, Petersdorf a.F
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Ibars IB, Ponseti J, Español T, Matias-Guiu J, Codina-Puiggros A. High-dose intravenous gamma-globulin therapy for myasthenia gravis. J Neurol 1987; 234:363. [PMID: 3612211 DOI: 10.1007/bf00314298] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Cuevas J, Pelegri A, Ponseti J, Fort J, Cantarell C, Morlans M. [Spontaneous perforation of the colon. Chronic hemodialysis]. Med Clin (Barc) 1981; 77:261. [PMID: 7321644] [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: 01/24/2023]
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