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Bocconcelli M, Natalucci V, Ferri Marini C, Annibalini G, Sisti D, Lucertini F, Vallorani L, De Santi M, Rocchi M, Barocci S, Flori M, Brandi G, Catalano V, Villarini A, Barbieri E, Emili R. 181P A randomized controlled trial on the efficacy of supervised exercise training in reducing IGF-1 levels in breast cancer survivors of the Movis’ cohort. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.216] [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: 11/30/2022] Open
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2
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Guerra F, Marchese P, Flori M, Pimpini L, Scarano M, Scappini L, Contadini D, Stronati G, Massara F, Gennaro F, Busacca P, Antonicelli R, Grossi P, Dello Russo A. Sacubitril/valsartan therapy and supraventricular arrhythmias detected through remote monitoring in heart failure patients. Europace 2021. [DOI: 10.1093/europace/euab116.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Sacubitril/valsartan (S/V) has demonstrated a significant benefit in decreasing mortality and morbidity in patients with heart failure with reduced ejection fraction (HFrEF) when compared to angiotensin inhibition. Recent studies demonstrated that the benefits of S/V encompass a positive cardiac remodeling, leading to a reduction of ventricular arrhythmias. The effect of S/V on the supraventricular arrhythmic burden is still unknown.
Purpose
To evaluate the effect of sacubitril/valsartan on the supraventricular arrhythmic burden in HFrEF patients with an implantable cardioverter defibrillator (ICD) or cardiac resynchronisation therapy-defibrillator (CRT-D) and remote monitoring.
Methods
The SAVE THE RHYTHM is a multicentre, observational, prospective registry is enrolling all patients with HFrEF, ICD or CRT-D actively followed through remote monitoring and starting treatment with sacubitril/valsartan. All patients are followed-up at least one year after sacubitril/valsartan start. The primary endpoint is the number of sustained atrial tachycardia or AF (AT/AF). Secondary endpoints include incidence of AT/AF in the total population, total burden of AT/AF (defined as the percentage of time in AT/AF per day), mean number of premature ventricular contractions (PVC) per hour and percentage of biventricular pacing per day (in patients with CRT-D). All primary and secondary endpoints are collected through remote monitoring.
Results
At the time of the second ad interim analysis, 188 patients (85.2% male, age 68 ± 10 years) were consecutively enrolled. In patients without permanent AF, treatment with S/V was associated with a reduced incidence of AT/AF episodes, which changed from 32.6% (before treatment start) to 24.3%, 20.5% and 6.9% according to the sacubitril/valsartan dose (24/26 mg, 49/51 mg and 97/103 mg respectively; p= 0.041). A significant decrease in the median annual number of AT/AF episodes was also seen in these patients (16/year before treatment; 12/year at 24/26 mg; 6/year at 49/51 mg and 1/year at 97/103 mg; p = 0.046). No significant differences were reported in terms of PVC or biventricular pacing (all p = NS). Patients with permanent AF experienced no benefits from sacubitril/valsartan therapy in terms of arrhythmic burden reduction. No new diagnosis of clinical AF was made after starting treatment with sacubitrl/valsartan in all patients.
Conclusions
Preliminary data suggest that therapy with S/V could reduce the episodes of AT/AF in patients with HFrEF and remote monitoring, and the benefit seems related to the maximum tolerated dose of S/V. No positive effect has been noted in patients with permanent AF.
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Affiliation(s)
- F Guerra
- Marche Polytechnic University of Ancona, Cardiology and Arrhythmology Clinic, Ancona, Italy
| | - P Marchese
- Cardiology ASUR-AV5 Mazzoni Hospital, Department of Cardiology, Ascoli Piceno, Italy
| | - M Flori
- Urbino Hospital, Department of Cardiology, Urbino, Italy
| | - L Pimpini
- National Institute of Hospital and Care for Elderly (INRCA), Department of Cardiology, Ancona, Italy
| | - M Scarano
- "Madonna del Soccorso" Hospital, Cardiology Unit, San Benedetto del Tronto, Italy
| | - L Scappini
- AO Ospedali Riuniti Marche Nord, Cardiology Department, Pesaro, Italy
| | - D Contadini
- General Hospital, Cardiology Department, Macerata, Italy
| | - G Stronati
- Marche Polytechnic University of Ancona, Cardiology and Arrhythmology Clinic, Ancona, Italy
| | - F Massara
- Marche Polytechnic University of Ancona, Cardiology and Arrhythmology Clinic, Ancona, Italy
| | - F Gennaro
- Cardiology ASUR-AV5 Mazzoni Hospital, Department of Cardiology, Ascoli Piceno, Italy
| | - P Busacca
- Urbino Hospital, Department of Cardiology, Urbino, Italy
| | - R Antonicelli
- National Institute of Hospital and Care for Elderly (INRCA), Department of Cardiology, Ancona, Italy
| | - P Grossi
- Cardiology ASUR-AV5 Mazzoni Hospital, Department of Cardiology, Ascoli Piceno, Italy
| | - A Dello Russo
- Marche Polytechnic University of Ancona, Cardiology and Arrhythmology Clinic, Ancona, Italy
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Guerra F, Pimpini L, Flori M, Contadini D, Stronati G, Gioacchini F, Massara M, Gennaro F, Antonicelli R, Busacca P, Luzi M, Dello Russo A, Marchese P. Sacubitril/valsartan reduces atrial fibrillation and supraventricular arrhythmias in patients with HFrEF and remote monitoring: preliminary data from the SAVE THE RHYTHM. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0926] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Sacubitril/valsartan, the first combined angiotensin receptor-neprilysin inhibitor, has demonstrated a significant benefit compared to angiotensin inhibitor in decreasing ventricular arrhythmias and appropriate implantable cardioverter defibrillator (ICD) shocks in patients with heart failure with reduced ejection fraction (HFrEF). At present, there is no study which evaluates the effect of sacubitril/valsartan on the supraventricular arrhythmic burden in HFrEF patients with an ICD or cardiac resynchronisation therapy-defibrillator (CRT-D) and remote monitoring.
Purpose
To evaluate the effect of sacubitril/valsartan on the supraventricular arrhythmic burden in HFrEF patients with an ICD or CRTD and remote monitoring.
Methods
The SAVETHERHYTHM ((SAacubitril Valsartan rEal-world registry evaluating THE arRHYTHMia burden in HFrEF patients with implantable cardioverter defibrillator) is a multicentre, observational, prospective registry enrolling all patients with HFrEF, ICD or CRT-D actively followed through remote monitoring and starting treatment with sacubitril/valsartan. All patients are followed-up for at least one year after sacubitril/valsartan start. The primary endpoint is the mean number of sustained atrial tachycardia or atrial fibrillation (AT/AF) episodes per month. Secondary endpoints include the total burden of AT/AF (defined as the percentage of time in AT/AF per day), the mean number of premature ventricular contractions (PVC) per hour and the percentage of biventricular pacing per day (in patients with CRT-D). All primary and secondary endpoints are collected through remote monitoring.
Results
At the time of the first ad interim analysis, 60 patients (85.2% male, age 69±10 years) were consecutively enrolled. After treatment with sacubitril/valsartan, patients with at least one episode of AT/AF per month decreased from 32.8% to 21.3% (p=0.015). A significant decrease in number of AT/AF episodes (from 4.3 to 1.2 per year), in AT/AF burden (from 12% to 9%) and in number of PVC (from 83 to 74 per hour) were seen in patients with a previous diagnosis of paroxysmal or persistent AF (n=15; all p<0.05). Patients with permanent AF (n=7) experienced no benefits from sacubitril/valsartan therapy in terms of arrhythmic burden reduction. Patients with no previous history of AF (n=38) showed a decrease in number of AT/AF episodes (from 2.0 to 0.8 per year) and in number of PVC (from 77 to 49 per hour, all p<0.05). No new diagnosis of clinical AF was made after starting treatment with sacubitrl/valsartan, and patients with subclinical AT/AF episodes decreased from 8% to 3%.
Conclusions
Preliminary data suggest that therapy with sacubitril/valsartan could decrease arrhythmic burden in patients with non-permanent AF and reduce subclinical AT/AF episodes in patients with no history of AF. No positive effect has been noted in patients with permanent AF.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- F Guerra
- Marche Polytechnic University of Ancona, Cardiology and Arrhythmology Clinic, Ancona, Italy
| | - L Pimpini
- National Institute of Hospital and Care for Elderly (INRCA), Department of Cardiology, Ancona, Italy
| | - M Flori
- Ospedale della Misericordia, Department of Cardiology, Urbino, Italy
| | - D Contadini
- General Hospital, Department of Cardiology, Macerata, Italy
| | - G Stronati
- Marche Polytechnic University of Ancona, Cardiology and Arrhythmology Clinic, Ancona, Italy
| | - F Gioacchini
- Marche Polytechnic University of Ancona, Cardiology and Arrhythmology Clinic, Ancona, Italy
| | - M.F Massara
- Marche Polytechnic University of Ancona, Cardiology and Arrhythmology Clinic, Ancona, Italy
| | - F Gennaro
- Cardiology ASUR-AV5 Mazzoni Hospital, Department of Cardiology, Ascoli Piceno, Italy
| | - R Antonicelli
- National Institute of Hospital and Care for Elderly (INRCA), Department of Cardiology, Ancona, Italy
| | - P Busacca
- Ospedale della Misericordia, Department of Cardiology, Urbino, Italy
| | - M Luzi
- General Hospital, Department of Cardiology, Macerata, Italy
| | - A Dello Russo
- Marche Polytechnic University of Ancona, Cardiology and Arrhythmology Clinic, Ancona, Italy
| | - P Marchese
- Cardiology ASUR-AV5 Mazzoni Hospital, Department of Cardiology, Ascoli Piceno, Italy
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Emili R, Natalucci V, Marini C, Lucertini F, Vallorani L, Annibalini G, De Santi M, Donati Zeppa S, Agostini D, Gervasi M, Panico A, Sisti D, Rocchi M, Barocci S, Flori M, Brandi G, Stocchi V, Catalano V, Villarini A, Barbieri E. 238P Beneficial effects of exercise in oncology - MoviS: ‘Movement and Health Beyond Care’. Ann Oncol 2020. [PMCID: PMC7506414 DOI: 10.1016/j.annonc.2020.08.359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Boiffard E, Dimet J, Baron O, Billon O, Boivineau C, Charvet M, Doizon T, Federspiel C, Flori M, Georges JL, Haddad G, Lipp D, Nguyen JO, Mouhoub D, Pernollet P, Philippot M, Pouliquen H, Roy N, Trebouet E, Turlotte G, Zeninari B, Orion L. [An independent observatory in Vendée on ST-elevated acute myocardial infarction (the OVISCA Register). A Departmental evaluation of demographic trends, mortality and delays before treatment]. Ann Cardiol Angeiol (Paris) 2019; 68:300-305. [PMID: 31542204 DOI: 10.1016/j.ancard.2019.08.008] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 08/28/2019] [Indexed: 11/17/2022]
Abstract
AIM Mortality from acute myocardial infarction has been falling during the past 30 years. The aim of the study was to evaluate the temporal trends of demographics, mortality rates, and time to treatment in patients admitted for acute ST elevation myocardial infarction (STEMI) in Vendée. PATIENTS AND METHODS From 2008 to 2016, 1994 patients hospitalised in CHD Vendée for STEMI <48hours were included. Two groups were compared, 838 patients admitted between 2008 and 2011 (group 1), and 1156 admitted between 2013 and 2016 (group 2). RESULTS Between the 2 periods, mean age was comparable (63.8 vs. 64.4 years), the gender ratio decreased (from 3.15 to 2.79 ; P=0.25). The mean duration of hospital stay was 0.8 day shorter (P=0.008). Treatment at discharge was optimum in 97.5% patients versus 92% (P<0.001). Left ventricular ejection fraction was comparable (50.6% vs. 50.2%). There was a non-significant trend to a decrease in hospital mortality (from 6.3% to 4.4%; p=0.12), and 6-month mortality (from 6.9% to 5.9%; P=0.51). There was a reduction in the use of emergency call-outs (74.9% to 68.9%; P<0.01), but an increase in direct presentations from 44% to 48.7% (P<0.05). The time before calling was comparable (2.5hours vs. 2.3hours; P=04.7). The "door-to-balloon" time decreased (0.71 vs. 0.55hour; P<0.001). The mean time between pain and angioplasty increased (5.7 vs. 6.8hours; P<0.05). CONCLUSIONS In vendee, from 2011 to 2016, hospital and 6-month mortality of STEMI trend to decrease non-significantly. The door to balloon time decreased, although emergency call-out rates and delays did not. Considerable efforts are still required with respect to patient information and education. Our registry offers an excellent tool to improve practices, the aim being to ensure its integration in the CRAC-France PCI registry.
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Affiliation(s)
- E Boiffard
- Cardiology department, CHD Vendée, Boulevard Moreau, 85000, La Roche-sur-Yon, France.
| | - J Dimet
- Clinical Research Centre, Mont-de-Marsan Hospital, 40000, Mont-de-Marsan, France
| | - O Baron
- Cardiology department, CHD Vendée, Boulevard Moreau, 85000, La Roche-sur-Yon, France
| | - O Billon
- Cardiology department, CHD Vendée, Boulevard Moreau, 85000, La Roche-sur-Yon, France
| | - C Boivineau
- Cardiology department, CHD Vendée, Boulevard Moreau, 85000, La Roche-sur-Yon, France
| | - M Charvet
- Post-emergency medical monitoring, polyclinique de l'Europe, 44600 Saint-Nazaire, France
| | - T Doizon
- General medicine department, CHD Vendée, 85400, Luçon, France
| | - C Federspiel
- Cardiology department, CHD Vendée, Boulevard Moreau, 85000, La Roche-sur-Yon, France
| | - M Flori
- Cardiology department, CHD Vendée, Boulevard Moreau, 85000, La Roche-sur-Yon, France
| | - J-L Georges
- Service de cardiologie centre hospitalier de Versailles, 78150 Le Chesnay, France
| | - G Haddad
- Cardiology department, CHD Vendée, Boulevard Moreau, 85000, La Roche-sur-Yon, France
| | - D Lipp
- Cardiology department, CHD Vendée, Boulevard Moreau, 85000, La Roche-sur-Yon, France
| | - J-O Nguyen
- Cardiology department, CHD Vendée, Boulevard Moreau, 85000, La Roche-sur-Yon, France
| | - D Mouhoub
- Cardiology department, CHD Vendée, Boulevard Moreau, 85000, La Roche-sur-Yon, France
| | - P Pernollet
- Cardiology department, CH Côte-de-Lumière, 85100, Les Sables d'Olonne, France
| | - M Philippot
- Medical Information Service, CHD Vendée, 85000, La Roche-sur-Yon, France
| | - H Pouliquen
- Cardiology department, CHD Vendée, Boulevard Moreau, 85000, La Roche-sur-Yon, France
| | - N Roy
- Cardiology department, CHD Vendée, Boulevard Moreau, 85000, La Roche-sur-Yon, France
| | - E Trebouet
- Emergency Department, CHD Vendée, 85000, La Roche-sur-Yon, France
| | - G Turlotte
- Cardiology department, CHD Vendée, Boulevard Moreau, 85000, La Roche-sur-Yon, France
| | - B Zeninari
- Cardiology department, CHD Vendée, Boulevard Moreau, 85000, La Roche-sur-Yon, France
| | - L Orion
- Cardiology department, CHD Vendée, Boulevard Moreau, 85000, La Roche-sur-Yon, France
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Merle B, Dupraz C, Haesebaert J, Barraud L, Aussedat M, Motteau C, Simon V, Schott AM, Flori M. Osteoporosis prevention: where are the barriers to improvement in a French general population? A qualitative study. Osteoporos Int 2019; 30:177-185. [PMID: 30306220 DOI: 10.1007/s00198-018-4720-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 09/24/2018] [Indexed: 11/26/2022]
Abstract
UNLABELLED We conducted a qualitative study with French men and women in order to provide insight into individuals' experiences, behaviors, and perceptions about osteoporosis (OP) and OP care. The data showed that both sexes, but especially men, were unfamiliar with OP, did not always feel concerned, and mistrusted pharmacological treatments. INTRODUCTION To engage actively in osteoporosis (OP) prevention, people need to have basic knowledge about the disease. The aim of this qualitative study was to explore knowledge and representations of OP care and prevention among both men and women. METHODS Focus groups were conducted in the Rhône-Alpes Region, France, with women aged 50-85 years and men aged 60-85 years, with or without a history of fragility fracture and/or an OP diagnosis (respectively referred to as "aware" or "unaware"). A total of 45 women (23 "aware" and 22 "unaware" in 5 and 4 focus groups, respectively) and 53 men (19 "aware" and 34 "unaware" in 3 and 4 focus groups, respectively) were included. A thematic analysis of transcripts was performed to explore knowledge and representations about OP, risk factors, prevention, and treatment. RESULTS The data showed that both sexes, but especially men, had limited knowledge of OP and considered it as a natural aging process not related to fragility fractures. They generally did not feel concerned by OP and no important difference was observed between "aware" and "unaware" patients. Women expressed their fear of the disease, associated with aging and the end of life, while men considered it to be a women's disease only. Both sexes were aware of OP risk factors, but were suspicious towards treatments because of the associated side effects. CONCLUSION Understanding people's representation of OP might help to provide patients with relevant information in order to optimize their preventive behavior and decrease the burden of the disease.
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Affiliation(s)
- B Merle
- INSERM Research Unit 1033, Université Lyon 1, Lyon, France.
| | - C Dupraz
- Collège Universitaire Médecine Générale, Université Lyon 1, Lyon, France
| | - J Haesebaert
- Hospices Civils de Lyon, HESPER EA 7425, Université Lyon 1, Lyon, France
| | - L Barraud
- Collège Universitaire Médecine Générale, Université Lyon 1, Lyon, France
| | - M Aussedat
- Collège Universitaire Médecine Générale, Université Lyon 1, Lyon, France
| | - C Motteau
- Collège Universitaire Médecine Générale, Université Lyon 1, Lyon, France
| | - V Simon
- Collège Universitaire Médecine Générale, Université Lyon 1, Lyon, France
| | - A M Schott
- Hospices Civils de Lyon, HESPER EA 7425, Université Lyon 1, Lyon, France
| | - M Flori
- Collège Universitaire Médecine Générale, Université Lyon 1, Lyon, France
- EA 4129-Parcours Santé Systémique, Université Lyon 1, Lyon, France
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Guerra F, Flori M, Contadini D, Menditto A, Baiocco E, Mancini G, Pistelli M, Olivieri A, Leoni P, Berardi R, Capucci A. P4357Left ventricular torsion and rigid body rotation pattern in patients treated with anthracycline. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4357] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Guerra F, Flori M, Bonelli P, Patani F, Capucci A. Electrical storm and heart failure worsening in implantable cardiac defibrillator patients. Europace 2014; 17:247-54. [DOI: 10.1093/europace/euu298] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Guerra F, Shkoza M, Scappini L, Flori M, Capucci A. Role of electrical storm as a mortality and morbidity risk factor and its clinical predictors: a meta-analysis. Europace 2013; 16:347-53. [DOI: 10.1093/europace/eut304] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Craig VJ, Tzankov A, Flori M, Schmid CA, Bader AG, Müller A. Systemic microRNA-34a delivery induces apoptosis and abrogates growth of diffuse large B-cell lymphoma in vivo. Leukemia 2012; 26:2421-4. [PMID: 22522790 DOI: 10.1038/leu.2012.110] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Badet-Phan A, Moreau A, Colin C, Canoui-Poitrine F, Schott-Pethelaz AM, Flori M. Obstacles au dépistage du cancer du col de l'utérus rencontrés par les médecins généralistes chez les femmes âgées de 50 à 65 ans. ACTA ACUST UNITED AC 2012. [DOI: 10.3917/pos.434.0261] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Flori M. Generalized pustular psoriasis responding to combined treatment with low doses of cyclosporin, 6-methyl-prednisolone and etretinate. J Eur Acad Dermatol Venereol 1997. [DOI: 10.1016/s0926-9959(96)00587-9] [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: 10/17/2022]
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