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Katrapati P, Weiss JP, Baning D, Zawaneh M, Su W, Tung R. Pulsed Field Ablation for Incessant Scar-Related Ventricular Tachycardia: First U.S. Report. Heart Rhythm 2024:S1547-5271(24)02515-3. [PMID: 38677358 DOI: 10.1016/j.hrthm.2024.04.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 04/18/2024] [Accepted: 04/20/2024] [Indexed: 04/29/2024]
Affiliation(s)
- Praneeth Katrapati
- Banner - University Medical Center Phoenix, The University of Arizona College of Medicine - Phoenix, Phoenix AZ
| | - J Peter Weiss
- Banner - University Medical Center Phoenix, The University of Arizona College of Medicine - Phoenix, Phoenix AZ
| | - David Baning
- Banner - University Medical Center Phoenix, The University of Arizona College of Medicine - Phoenix, Phoenix AZ
| | - Michael Zawaneh
- Banner - University Medical Center Phoenix, The University of Arizona College of Medicine - Phoenix, Phoenix AZ
| | - Wilber Su
- Banner - University Medical Center Phoenix, The University of Arizona College of Medicine - Phoenix, Phoenix AZ
| | - Roderick Tung
- Banner - University Medical Center Phoenix, The University of Arizona College of Medicine - Phoenix, Phoenix AZ.
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Alviar CL, Li BK, Keller NM, Bohula-May E, Barnett C, Berg DD, Burke JA, Chaudhry SP, Daniels LB, DeFilippis AP, Gerber D, Horowitz J, Jentzer JC, Katrapati P, Keeley E, Lawler PR, Park JG, Sinha SS, Snell J, Solomon MA, Teuteberg J, Katz JN, van Diepen S, Morrow DA. Prognostic performance of the IABP-SHOCK II Risk Score among cardiogenic shock subtypes in the critical care cardiology trials network registry. Am Heart J 2024; 270:1-12. [PMID: 38190931 PMCID: PMC11032171 DOI: 10.1016/j.ahj.2023.12.018] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 12/27/2023] [Accepted: 12/28/2023] [Indexed: 01/10/2024]
Abstract
BACKGROUND Risk stratification has potential to guide triage and decision-making in cardiogenic shock (CS). We assessed the prognostic performance of the IABP-SHOCK II score, derived in Europe for acute myocardial infarct-related CS (AMI-CS), in a contemporary North American cohort, including different CS phenotypes. METHODS The critical care cardiology trials network (CCCTN) coordinated by the TIMI study group is a multicenter network of cardiac intensive care units (CICU). Participating centers annually contribute ≥2 months of consecutive medical CICU admissions. The IABP-SHOCK II risk score includes age > 73 years, prior stroke, admission glucose > 191 mg/dl, creatinine > 1.5 mg/dl, lactate > 5 mmol/l, and post-PCI TIMI flow grade < 3. We assessed the risk score across various CS etiologies. RESULTS Of 17,852 medical CICU admissions 5,340 patients across 35 sites were admitted with CS. In patients with AMI-CS (n = 912), the IABP-SHOCK II score predicted a >3-fold gradient in in-hospital mortality (low risk = 26.5%, intermediate risk = 52.2%, high risk = 77.5%, P < .0001; c-statistic = 0.67; Hosmer-Lemeshow P = .79). The score showed a similar gradient of in-hospital mortality in patients with non-AMI-related CS (n = 2,517, P < .0001) and mixed shock (n = 923, P < .001), as well as in left ventricular (<0.0001), right ventricular (P = .0163) or biventricular (<0.0001) CS. The correlation between the IABP-SHOCK II score and SOFA was moderate (r2 = 0.17) and the IABP-SHOCK II score revealed a significant risk gradient within each SCAI stage. CONCLUSIONS In an unselected international multicenter registry of patients admitted with CS, the IABP- SHOCK II score only moderately predicted in-hospital mortality in a broad population of CS regardless of etiology or irrespective of right, left, or bi-ventricular involvement.
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Affiliation(s)
- Carlos L Alviar
- The Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, NY;.
| | - Boyangzi K Li
- Division of Cardiology, University of Miami, Miami, FL
| | - Norma M Keller
- The Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, NY
| | - Erin Bohula-May
- Levine Cardiac Intensive Care Unit, Brigham and Women's Hospital, Boston, MA
| | - Christopher Barnett
- Division of Cardiology, University of California San Francisco, San Francisco, CA
| | - David D Berg
- Levine Cardiac Intensive Care Unit, Brigham and Women's Hospital, Boston, MA
| | - James A Burke
- Division of Cardiology, Lehigh Valley Health Network, Allentown, PA
| | | | - Lori B Daniels
- Division of Cardiovascular Medicine, University of California San Diego, La Jolla, CA
| | | | - Daniel Gerber
- Division of Cardiology, Stanford University, Stanford, CA
| | - James Horowitz
- The Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, NY
| | - Jacob C Jentzer
- Division of Cardiovascular Medicine, Mayo Clinic, Minnesota, CA
| | | | - Ellen Keeley
- Division of Cardiology, University of Florida, Gainesville, FL
| | - Patrick R Lawler
- McGill University Health Centre, Montreal, Quebec, Canada;; Peter Munk Cardiac Centre, Toronto General Hospital, Toronto, Ontario, Canada
| | - Jeong-Gun Park
- Levine Cardiac Intensive Care Unit, Brigham and Women's Hospital, Boston, MA
| | - Shashank S Sinha
- Inova Fairfax Medical Campus, Inova Heart and Vascular Institute, Falls Church, VA
| | - Jeffrey Snell
- Division of Cardiology, Rush University, Chicago, IL
| | - Michael A Solomon
- Critical Care Medicine Department, National Institutes of Health Clinical Center and Cardiovascular Branch, National Heart, Lung, and Blood Institute of the National Institutes of Health, Bethesda, MD
| | | | - Jason N Katz
- The Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, NY
| | - Sean van Diepen
- Department of Critical Care Medicine and Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - David A Morrow
- Levine Cardiac Intensive Care Unit, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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Liao Y, Tomaiko-Clark ED, Martinez J, Shinoda Y, Morris MF, Liu Z, Shatz DY, Katrapati P, Sahara N, Weiss JP, Zawaneh MS, Tung R, Bai R, Su W. Incidence of cryoballoon expansion dislodgement during pulmonary vein isolation-An underappreciated frequent cause of incomplete isolation. Pacing Clin Electrophysiol 2024; 47:347-352. [PMID: 38140909 DOI: 10.1111/pace.14910] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 11/08/2023] [Accepted: 12/10/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND Cryoballoon ablation for atrial fibrillation (AF) requires adequate contact between the pulmonary vein (PV) antrum and cryoballoon. The surge of intraballoon pressure during the initial phase of ablation may change the balloon's shape and compliance, resulting in balloon dislodgement and loss of PV occlusion. Without continuous monitoring, this phenomenon is often undetected but can be associated with incomplete PV isolation (PVI). METHODS Primary cryoablation of AF was performed in 15 patients. PV occlusion status pre- and post-freezing were analyzed with intracardiac echocardiography (ICE) and dielectric imaging-based occlusion tool (DIOT) to calculate the incidence of expansion dislodgement of cryoballoon. RESULTS A total of 105 cryoablation applications were performed on 57 veins, including three common ostiums of left pulmonary veins. In the evaluation of PV occlusion, both modalities reported consistent results in 86.7% of the assessments. Despite complete PV occlusion before ablation, peri-balloon leak after initiation of freezing was detected by ICE in 5/22 (22.7%) applications and by DIOT in 8/25 (32%) applications. CONCLUSION Incidence of expansion dislodgement of the cryoballoon was detected in one-fourth to one-third of cryoablation applications depending on the imaging modality used, which was clinically frequent and significant.
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Affiliation(s)
- Yu Liao
- Division of Cardiology, Banner University Medical Center Phoenix, University of Arizona College of Medicine, Phoenix, Arizona, USA
- National Cheng Kung University Hospital, Tainan, Taiwan
| | | | - Jake Martinez
- Division of Cardiology, Banner University Medical Center Phoenix, University of Arizona College of Medicine, Phoenix, Arizona, USA
| | - Yasutoshi Shinoda
- Division of Cardiology, Banner University Medical Center Phoenix, University of Arizona College of Medicine, Phoenix, Arizona, USA
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Michael F Morris
- Division of Radiology, Banner University Medical Center Phoenix, University of Arizona College of Medicine, Phoenix, Arizona, USA
| | - Zhao Liu
- EPD Solutions, Best, Netherlands
| | - Dalise Yi Shatz
- University of Arizona College of Medicine, Phoenix, Arizona, USA
| | - Praneeth Katrapati
- Division of Cardiology, Banner University Medical Center Phoenix, University of Arizona College of Medicine, Phoenix, Arizona, USA
| | - Naohiko Sahara
- Division of Cardiology, Banner University Medical Center Phoenix, University of Arizona College of Medicine, Phoenix, Arizona, USA
- Toho University Ohashi Medical Center, Tokyo, Japan
| | - J Peter Weiss
- Division of Cardiology, Banner University Medical Center Phoenix, University of Arizona College of Medicine, Phoenix, Arizona, USA
- University of Arizona College of Medicine, Phoenix, Arizona, USA
| | - Michael S Zawaneh
- Division of Cardiology, Banner University Medical Center Phoenix, University of Arizona College of Medicine, Phoenix, Arizona, USA
- University of Arizona College of Medicine, Phoenix, Arizona, USA
| | - Roderick Tung
- Division of Cardiology, Banner University Medical Center Phoenix, University of Arizona College of Medicine, Phoenix, Arizona, USA
- University of Arizona College of Medicine, Phoenix, Arizona, USA
| | - Rong Bai
- Division of Cardiology, Banner University Medical Center Phoenix, University of Arizona College of Medicine, Phoenix, Arizona, USA
- University of Arizona College of Medicine, Phoenix, Arizona, USA
| | - Wilber Su
- Division of Cardiology, Banner University Medical Center Phoenix, University of Arizona College of Medicine, Phoenix, Arizona, USA
- University of Arizona College of Medicine, Phoenix, Arizona, USA
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Katrapati P, Tung R. Nuances in conduction system pacing reporting: Value of prospective and adjudicated data. Heart Rhythm 2023; 20:1626-1628. [PMID: 37757961 DOI: 10.1016/j.hrthm.2023.09.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 09/21/2023] [Accepted: 09/21/2023] [Indexed: 09/29/2023]
Affiliation(s)
- Praneeth Katrapati
- Division of Cardiology, Banner - University Medical Center Phoenix, The University of Arizona College of Medicine - Phoenix, Phoenix, Arizona
| | - Roderick Tung
- Division of Cardiology, Banner - University Medical Center Phoenix, The University of Arizona College of Medicine - Phoenix, Phoenix, Arizona.
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Katrapati P, Bai R. Freezing the left atrial posterior wall to make real icing on the cake. J Cardiovasc Electrophysiol 2023; 34:2053-2054. [PMID: 37671690 DOI: 10.1111/jce.16049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 09/07/2023]
Affiliation(s)
- Praneeth Katrapati
- Division of Cardiology, Banner University Medical Center Phoenix, University of Arizona College of Medicine, Phoenix, Arizona, USA
| | - Rong Bai
- Division of Cardiology, Banner University Medical Center Phoenix, University of Arizona College of Medicine, Phoenix, Arizona, USA
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Toft LE, Richie J, Wright JM, Amraotkar A, Katrapati P, Fulmer S, Dainty KN, Chugh SS, Halperin H. A New Era of Lay Rescuer CPR Training. J Am Coll Cardiol 2022; 80:2251-2253. [DOI: 10.1016/j.jacc.2022.09.040] [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] [Received: 07/08/2022] [Revised: 08/31/2022] [Accepted: 09/26/2022] [Indexed: 11/29/2022]
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Abstract
• Midventricular TTC is a rare variant comprising 14.6% of stress cardiomyopathies. • TTC includes midventricular dyskinesis with normal basal and apical contractility. • Etiologies for all Takotsubo variants include physical/emotion stressors. • Pathophysiology remains unknown, although some theories exist.
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Affiliation(s)
- Mladen Grigorov
- Department of Internal Medicine, University of Louisville School of Medicine, Louisville, Kentucky
| | - Jeffrey Spindel
- Department of Internal Medicine, University of Louisville School of Medicine, Louisville, Kentucky
| | - Praneeth Katrapati
- Department of Medicine, Division of Cardiovascular Medicine, University of Louisville School of Medicine, Louisville, Kentucky
| | - Marcus Stoddard
- Department of Medicine, Division of Cardiovascular Medicine, University of Louisville School of Medicine, Louisville, Kentucky
| | - Marina Varbanova
- Department of Anesthesiology, Division of Anesthesiology and Perioperative Medicine, University of Louisville School of Medicine, Louisville, Kentucky
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Belur AD, Katrapati P, Singh V. A FATAL CASE OF CARDIAC METASTASIS OF SQUAMOUS CELL CANCER OF THE SKIN. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)03760-3] [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: 11/26/2022]
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Berg DD, Alviar CL, Bhatt AS, Baird-Zars VM, Barnett CF, Daniels LB, Defilippis AP, Fagundes A, Katrapati P, Kenigsberg BB, Guo J, Keller N, Lopes MS, Mody A, Papolos AI, Phreaner N, Sedighi R, Sinha SS, Toomu S, Varshney AS, Morrow DA, Bohula EA. Epidemiology of Acute Heart Failure in Critically Ill Patients with COVID-19: An Analysis from the Critical Care Cardiology Trials Network. J Card Fail 2022; 28:675-681. [PMID: 35051622 PMCID: PMC8762923 DOI: 10.1016/j.cardfail.2021.12.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/08/2021] [Accepted: 12/23/2021] [Indexed: 01/18/2023]
Abstract
Background Acute heart failure (HF) is an important complication of coronavirus disease 2019 (COVID-19) and has been hypothesized to relate to inflammatory activation. Methods We evaluated consecutive intensive care unit (ICU) admissions for COVID-19 across 6 centers in the Critical Care Cardiology Trials Network, identifying patients with vs without acute HF. Acute HF was subclassified as de novo vs acute-on-chronic, based on the absence or presence of prior HF. Clinical features, biomarker profiles and outcomes were compared. Results Of 901 admissions to an ICU due to COVID-19, 80 (8.9%) had acute HF, including 18 (2.0%) with classic cardiogenic shock (CS) and 37 (4.1%) with vasodilatory CS. The majority (n = 45) were de novo HF presentations. Compared to patients without acute HF, those with acute HF had higher cardiac troponin and natriuretic peptide levels and similar inflammatory biomarkers; patients with de novo HF had the highest cardiac troponin levels. Notably, among patients critically ill with COVID-19, illness severity (median Sequential Organ Failure Assessment, 8 [IQR, 5–10] vs 6 [4–9]; P = 0.025) and mortality rates (43.8% vs 32.4%; P = 0.040) were modestly higher in patients with vs those without acute HF. Conclusions Among patients critically ill with COVID-19, acute HF is distinguished more by biomarkers of myocardial injury and hemodynamic stress than by biomarkers of inflammation.
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Affiliation(s)
- David D Berg
- Levine Cardiac Intensive Care Unit, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Carlos L Alviar
- The Leon H. Charney Division of Cardiovascular Medicine, New York University Langone Medical Center, New York, New York
| | - Ankeet S Bhatt
- Levine Cardiac Intensive Care Unit, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Vivian M Baird-Zars
- Levine Cardiac Intensive Care Unit, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Christopher F Barnett
- Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, California; Medstar Heart and Vascular Institute, Medstar Washington Hospital Center, Washington, D.C
| | - Lori B Daniels
- Division of Cardiovascular Medicine, Department of Medicine, University of California San Diego, La Jolla, California
| | - Andrew P Defilippis
- Division of Cardiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Antonio Fagundes
- Levine Cardiac Intensive Care Unit, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Praneeth Katrapati
- Division of Cardiovascular Medicine, Department of Medicine, University of Louisville, Louisville, Kentucky
| | - Benjamin B Kenigsberg
- Medstar Heart and Vascular Institute, Medstar Washington Hospital Center, Washington, D.C
| | - Jianping Guo
- Levine Cardiac Intensive Care Unit, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Norma Keller
- The Leon H. Charney Division of Cardiovascular Medicine, New York University Langone Medical Center, New York, New York
| | - Mathew S Lopes
- Levine Cardiac Intensive Care Unit, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Anika Mody
- Division of Cardiovascular Medicine, Department of Medicine, University of California San Diego, La Jolla, California
| | - Alexander I Papolos
- Medstar Heart and Vascular Institute, Medstar Washington Hospital Center, Washington, D.C
| | - Nicholas Phreaner
- Division of Cardiovascular Medicine, Department of Medicine, University of California San Diego, La Jolla, California
| | - Romteen Sedighi
- Division of Cardiovascular Medicine, Department of Medicine, University of California San Diego, La Jolla, California
| | - Shashank S Sinha
- Inova Heart and Vascular Institute, Inova Fairfax Medical Center, Falls Church, Virginia
| | - Sandeep Toomu
- Division of Cardiovascular Medicine, Department of Medicine, University of California San Diego, La Jolla, California
| | - Anubodh S Varshney
- Levine Cardiac Intensive Care Unit, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - David A Morrow
- Levine Cardiac Intensive Care Unit, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
| | - Erin A Bohula
- Levine Cardiac Intensive Care Unit, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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Desai V, Agarwal A, Katrapati P, Stoddard M. MANAGEMENT OF POST-TRAUMATIC VENTRICULAR SEPTAL DEFECT. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)03764-5] [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: 11/27/2022]
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Pillarella J, Albers L, Katrapati P, Abramov D, Birks E, Vijayakrishnan R. Safety and Efficacy of Home Inotropes as Bridge to LVAD and Transplant. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.978] [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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Katrapati P, Panda M. 163 ACCURACY OF SELF-AUDITS IN AN OUTPATIENT RESIDENT CLINIC:. J Investig Med 2005. [DOI: 10.2310/6650.2005.00006.162] [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: 11/18/2022]
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Katrapati P, Panda M. 241 ACCURACY AND USEFULNESS OF SELF-AUDITS IN AN OUTPATIENT RESIDENT CLINIC:. J Investig Med 2005. [DOI: 10.2310/6650.2005.00006.240] [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: 11/18/2022]
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