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Patel B, Bharath A, Bowe D, Tyler J. A one-stop shoulder clinic to save time and resources. Future Healthc J 2023; 10:56-58. [PMID: 37786492 PMCID: PMC10538675 DOI: 10.7861/fhj.2022-0126] [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] [Indexed: 03/14/2023]
Abstract
There is now a need more than ever to streamline services. A one-stop shoulder clinic was introduced during the COVID-19 pandemic. A total of 861 patients were seen, saving 794 future appointments. 111 patients had an ultrasound scan and 285 patients had an ultrasound-guided procedure, saving an average waiting time of 134 days. 327 patients had physiotherapy, and the average Oxford Shoulder Score improved by 8.56 at 1 year.
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Affiliation(s)
| | | | - David Bowe
- Airedale NHS Foundation Trust, Keighley, UK
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Valsamis EM, Beard D, Carr A, Collins GS, Brealey S, Rangan A, Santos R, Corbacho B, Rees JL, Pinedo-Villanueva R. Mapping the Oxford Shoulder Score onto the EQ-5D utility index. Qual Life Res 2023; 32:507-518. [PMID: 36169788 PMCID: PMC9911508 DOI: 10.1007/s11136-022-03262-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE In order to enable cost-utility analysis of shoulder pain conditions and treatments, this study aimed to develop and evaluate mapping algorithms to estimate the EQ-5D health index from the Oxford Shoulder Score (OSS) when health outcomes are only assessed with the OSS. METHODS 5437 paired OSS and EQ-5D questionnaire responses from four national multicentre randomised controlled trials investigating different shoulder pathologies and treatments were split into training and testing samples. Separate EQ-5D-3L and EQ-5D-5L analyses were undertaken. Transfer to utility (TTU) regression (univariate linear, polynomial, spline, multivariable linear, two-part logistic-linear, tobit and adjusted limited dependent variable mixture models) and response mapping (ordered logistic regression and seemingly unrelated regression (SUR)) models were developed on the training sample. These were internally validated, and their performance evaluated on the testing sample. Model performance was evaluated over 100-fold repeated training-testing sample splits. RESULTS For the EQ-5D-3L analysis, the multivariable linear and splines models had the lowest mean square error (MSE) of 0.0415. The SUR model had the lowest mean absolute error (MAE) of 0.136. Model performance was greatest in the mid-range and best health states, and lowest in poor health states. For the EQ-5D-5L analyses, the multivariable linear and splines models had the lowest MSE (0.0241-0.0278) while the SUR models had the lowest MAE (0.105-0.113). CONCLUSION The developed models now allow accurate estimation of the EQ-5D health index when only the OSS responses are available as a measure of patient-reported health outcome.
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Affiliation(s)
- Epaminondas M. Valsamis
- grid.4991.50000 0004 1936 8948Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, OX3 7LD UK
| | - David Beard
- grid.4991.50000 0004 1936 8948Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, OX3 7LD UK
| | - Andrew Carr
- grid.4991.50000 0004 1936 8948Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, OX3 7LD UK
| | - Gary S. Collins
- grid.4991.50000 0004 1936 8948Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Centre for Statistics in Medicine, University of Oxford, Oxford, OX3 7LD UK
| | - Stephen Brealey
- grid.5685.e0000 0004 1936 9668Department of Health Sciences, York Trials Unit, University of York, York, YO10 5DD UK
| | - Amar Rangan
- grid.5685.e0000 0004 1936 9668Department of Health Sciences, York Trials Unit, University of York, York, YO10 5DD UK
| | - Rita Santos
- grid.5685.e0000 0004 1936 9668Centre for Health Economics, University of York, York, YO10 5DD UK
| | - Belen Corbacho
- grid.5685.e0000 0004 1936 9668Department of Health Sciences, York Trials Unit, University of York, York, YO10 5DD UK
| | - Jonathan L. Rees
- grid.4991.50000 0004 1936 8948Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, OX3 7LD UK
| | - Rafael Pinedo-Villanueva
- grid.4991.50000 0004 1936 8948Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, OX3 7LD UK
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Scheer JH, Tillander BM, Dånmark I, Björnsson Hallgren HC. Solely sutures is a reliable fixation for valgus-impacted proximal humeral fractures. J Clin Orthop Trauma 2020; 15:130-135. [PMID: 33717927 PMCID: PMC7920155 DOI: 10.1016/j.jcot.2020.10.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/06/2020] [Accepted: 10/07/2020] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Valgus impacted proximal humeral fractures with substantial displacement may severely compromise shoulder function and open reduction can therefore be considered. Internal fixation hardware may eventually however constitute problems. In a small subset of these fractures, in which there is no medial comminution and intact blood supply it is possible to use a least possible fixation method with solely sutures through the tendons of the rotator cuff and the shaft as described by Bigliani 1990. The aim of the present study was to investigate the outcome of this fixation method in a retrospective series of patients. METHODS Twenty-seven patients, 23 women and 4 men, with a mean age of 66 years (53-83) and minimum follow-up time of 2 years (2-11 years) accepted follow-up with standard shoulder radiographs and 22 were examined with Oxford Shoulder Score (OSS), Constant-Murley (CM) shoulder score and Numeric Rating Scale for pain (NRS). Reoperations or adverse events were recorded. RESULTS The median OSS was 45 (range 5-48) and CM 63 (range 21-98). The relative CM score was 81% of the uninjured side and median NRS 0 (range 0-5). No reoperations were undertaken. One patient had a complete avascular necrosis (AVN), 3 patients had a partial AVN of the humeral head and two a partial resorption of the greater tuberosity. CONCLUSION The use of sutures only for fixation of displaced valgus-impacted proximal humeral fractures provided a relatively reliable outcome with good functional scores and no reoperations. There appears to be no need for the use of hardware for fixation of this rare subset of fractures.
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Affiliation(s)
- Johan H. Scheer
- Corresponding author. Department of Orthopedics, Linköping University Hospital, Linköping S-581 85, Sweden.
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Bejer A, Szczepanik M, Płocki J, Szymczyk D, Kulczyk M, Pop T. Translation, cross-cultural adaptation and validation of the polish version of the Oxford Shoulder Score in patients undergoing arthroscopic rotator cuff repair. Health Qual Life Outcomes 2019; 17:191. [PMID: 31888693 PMCID: PMC6937923 DOI: 10.1186/s12955-019-1263-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 03/19/2019] [Accepted: 12/18/2019] [Indexed: 01/22/2023] Open
Abstract
Background The Oxford Shoulder Score (OSS) is a simple and reliable, joint-specific, self-reported outcome measure. It can be applied in patients with shoulder disease other than instability. The purpose of this study was to perform a translation, cultural adaptation of the Polish version of the OSS and to evaluate its selected psychometric properties in patients after arthroscopic rotator cuff repair. Methods Sixty-nine subjects participated in the study, with a mean age 55.5 (ranging from 40 to 65 years). The OSS has been translated using the widely accepted guidelines. All patients completed the Polish version of OSS (OSS-PL), the short version of the Disabilities of Arm, Shoulder and Hand Questionnaire (QuickDASH), the Short Form-36 v. 2.0 (SF-36) and the 7-point Global Rating of Change Scale (GRC). Results High internal consistency of 0.96 was found using Cronbach’s alpha coefficient. Reliability of the OSS resulted in Intraclass Correlation Coefficient (ICC) = 0.99, Standard Error of Measurement (SEM) = 1.14 and Minimal Detectable Change (MDC) = 3.15. The validity analysis showed a moderate (General health r = 0.34) to high (Physical role functioning r = 0.82) correlation between the OSS-PL and SF-36 and a high correlation between the OSS-PL and the QuickDASH (r = − 0.92). Conclusions The Polish version of OSS is a reliable and valid, self-reported questionnaire, which can be applied in patients with a rotator cuff tear undergoing reconstruction surgery. The very good psychometric properties of the Polish version of the OSS indicate that it can be used in clinical practice and scientific research.
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Affiliation(s)
- Agnieszka Bejer
- Medical College of Rzeszow University, Institute of Health Sciences, ul. Warzywna 1A, 35-310, Rzeszów, Poland.,The Holy Family Specialist Hospital, Rudna Mała, Poland
| | - Magdalena Szczepanik
- Medical College of Rzeszow University, Institute of Health Sciences, ul. Warzywna 1A, 35-310, Rzeszów, Poland.
| | - Jędrzej Płocki
- The Holy Family Specialist Hospital, Rudna Mała, Poland.,Department of Physiotherapy, University of Information Technology and Management, Faculty of Medicine, Rzeszow, Poland
| | - Daniel Szymczyk
- Medical College of Rzeszow University, Institute of Health Sciences, ul. Warzywna 1A, 35-310, Rzeszów, Poland
| | - Marek Kulczyk
- The Holy Family Specialist Hospital, Rudna Mała, Poland
| | - Teresa Pop
- Medical College of Rzeszow University, Institute of Health Sciences, ul. Warzywna 1A, 35-310, Rzeszów, Poland
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Xu S, Chen JY, Lie HME, Hao Y, Lie DTT. Minimal Clinically Important Difference of Oxford, Constant, and UCLA shoulder score for arthroscopic rotator cuff repair. J Orthop 2019; 19:21-27. [PMID: 32021030 DOI: 10.1016/j.jor.2019.11.037] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 11/24/2019] [Indexed: 10/25/2022] Open
Abstract
Aim To determine the Minimal Clinically Important Difference (MCID) for Constant-Murley score (CMS), University of California Los Angeles (UCLA) shoulder score, and Oxford Shoulder Scores (OSS) after arthroscopic rotator cuff (RC) repairs. Material and methods 306 patients were followed up for 24-month. MCID for CMS, UCLA and OSS were determined using simple linear regression according to patient satisfaction and expectation fulfilment. Results The following MCID were identified:12-month: CMS 6.7, UCLA 3.0, OSS 3.3.24-month: CMS 6.3, UCLA 2.9, OSS 2.7. Conclusions The various MCID could assist in meaningful interpretation of these scores and to power future comparative studies. Level of evidence III.
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Affiliation(s)
- Sheng Xu
- Singapore General Hospital, Department of Orthopedic Surgery, Singapore
| | | | - Hannah Mei En Lie
- Singapore General Hospital, Department of Orthopedic Surgery, Singapore
| | - Ying Hao
- Singapore General Hospital, Health Service Research Institute, Singapore
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Haviv B, Rutenberg TF, Yaari L, Khatib M, Rath E, Yassin M. Which patients are less likely to improve after arthroscopic rotator cuff repair? Acta Orthop Traumatol Turc 2019; 53:356-359. [PMID: 30853399 PMCID: PMC6819785 DOI: 10.1016/j.aott.2019.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 12/05/2018] [Accepted: 02/05/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate which specific factors influence the improvement in function and to estimate the time to obtain pain relief following arthroscopic rotator cuff repair. METHODS A total of 97 patients (57 men and 40 women; mean age: 55.5 ± 9.3 years) who had arthroscopic rotator cuff repair between 2013 and 2016 were included into the study. Multivariable stepwise analysis included preoperative variables (age, gender, body mass index, comorbidities, occupation and participation in sports, Oxford shoulder score at baseline, preceding injury and duration of preoperative symptoms) and arthroscopic findings (size of rotator cuff tear, pathology of the long head of the biceps and cartilage lesions). The change in the Oxford shoulder score at the last follow-up was modeled as a function of the above predictor variables. The time to regain a visual analogue scale (VAS) under two points following surgery was considered the time to regain substantial pain relief. RESULTS The mean follow-up time was 33.2 ± 14.4 months. Twenty three patients had partial thickness and seventy four had full thickness supraspinatus tears. In third of the patients the tears were defined as large full thickness. At the last follow-up the mean Oxford shoulder score improved from 13.8 ± 4.8 to 42.1 ± 7.2 points (P < 0.001). The mean VAS improved from a preoperative score of 6.7 ± 1.3 points to 1.5 ± 0.6 points postoperatively (P < 0.001) and 80 (83%) patients declared they were satisfied to have had the operation. The mean time interval for substantial pain relief was 4.9 ± 3.6 months. Patients with higher preoperative Oxford shoulder score and larger tear size were correlated with lesser improvement in Oxford shoulder score (R = 0.5, P = 0.001). CONCLUSION Arthroscopic rotator cuff repair improved pain and function at an average follow-up of three years. A substantial pain relief was regained within five months from surgery. Larger rotator cuff tear size and more favorable preoperative function were predictors of worse postoperative function. LEVEL OF EVIDENCE Level IV, Therapeutic study.
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Affiliation(s)
- Barak Haviv
- Arthroscopy and Sports Injuries Unit, Hasharon Hospital, Rabin Medical Center, Petach-Tikva, Israel; Orthopedic Department, Sackler Faculty of Medicine, Tel-Aviv University, Israel; Orthopedic Department, Hasharon Hospital, Rabin Medical Center, Petach-Tikva, Israel.
| | - Tal Frenkel Rutenberg
- Orthopedic Department, Beilinson Hospital, Rabin Medical Center, Petach-Tikva, Israel
| | - Lee Yaari
- Arthroscopy and Sports Injuries Unit, Hasharon Hospital, Rabin Medical Center, Petach-Tikva, Israel; Orthopedic Department, Hasharon Hospital, Rabin Medical Center, Petach-Tikva, Israel
| | - Muhammad Khatib
- Orthopedic Department, Hasharon Hospital, Rabin Medical Center, Petach-Tikva, Israel
| | - Ehud Rath
- Orthopedic Department, Sackler Faculty of Medicine, Tel-Aviv University, Israel
| | - Mustafa Yassin
- Orthopedic Department, Sackler Faculty of Medicine, Tel-Aviv University, Israel; Orthopedic Department, Hasharon Hospital, Rabin Medical Center, Petach-Tikva, Israel
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Sharma N, El Refaiy A, Sibly TF. Short-term results of rotator cuff repair using GraftJacket as an interpositional tissue-matched thickness graft. J Orthop 2018; 15:732-735. [PMID: 29881229 DOI: 10.1016/j.jor.2018.05.037] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 05/06/2018] [Indexed: 11/16/2022] Open
Abstract
We report outcomes of using GraftJacket to repair massive rotator-cuff-tears. Twenty patients with a mean age of 64.6y over 12-month duration were reviewed. Two patients had a single GraftJacket repair (group1), whilst 18 had the GraftJacket sheet doubled (group2). Pre and post oxford shoulder scores (OSS) and patient related outcome measures were evaluated. A statistically significant improvement of OSS was demonstrated in-group 2 from a mean of 22 to 45.5 (p < 0.00148) over a follow up of 18 months. GraftJacket is a safe and effective procedure to use as an interpositional graft and doubling the graft may improve outcomes.
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Affiliation(s)
- Nikhil Sharma
- Hereford County Hospital, Wye Valley NHS Trusts, United Kingdom
| | - Ahmed El Refaiy
- Hereford County Hospital, Wye Valley NHS Trusts, United Kingdom
| | - T F Sibly
- Hereford County Hospital, Wye Valley NHS Trusts, United Kingdom
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Dawson J, Harris KK, Doll H, Fitzpatrick R, Carr A. A comparison of the Oxford shoulder score and shoulder pain and disability index: factor structure in the context of a large randomized controlled trial. Patient Relat Outcome Meas 2016; 7:195-203. [PMID: 27920590 PMCID: PMC5123655 DOI: 10.2147/prom.s115488] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background To explore and compare the factor structure of the 12-item Oxford shoulder score (OSS) and 13-item shoulder pain and disability index (SPADI). Methods Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) of data from 660 patients attending 46 hospitals in the UK. Complete OSS and SPADI data were available for 648 (98.2%) and 628 (95.2%) participants, respectively. Results For both instruments, either one or two factors were indicated, depending on the extraction method. On EFA, most OSS items loaded saliently on either of two “Pain” (4 items) and “Function” (8 items) factors, although some items cross-loaded. Cronbach’s alphas were 0.75, 0.90, and 0.91 for “Pain” and “Function” subscales, and all 12 OSS items, respectively. CFA suggested marginally better fit for two factors, with neither one- nor two-factor models rejected. EFA indicated two factors for the SPADI, with three of the eight “Disability” items contributing to an 8-item “Pain factor”, with 2 items within the 5-item “Disability factor” cross-loading. Cronbach’s alpha was 0.87 and 0.93 for the original 5- and 8-item pain and disability scales; 0.94 for all 13 SPADI items, respectively. CFA suggested marginally better fit for the two-factor (original conceptualization) model of the SPADI, with neither one- nor two-factor models rejected. Conclusion EFA and CFA demonstrated that, in addition to single summary scales usage, separate information on pain and self-reported disability/function can be extracted in a meaningful way, as subscales, from both the OSS and the SPADI. This information can help researchers in choosing primary study endpoints appropriately.
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Affiliation(s)
| | - Kristina K Harris
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford
| | - Helen Doll
- ICON Patient Reported Outcomes, Oxford, UK
| | | | - Andrew Carr
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford
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Ebrahimzadeh MH, Birjandinejad A, Razi S, Mardani-Kivi M, Reza Kachooei A. Oxford Shoulder Score: A Cross-Cultural Adaptation and Validation Study of the Persian Version in Iran. Iran J Med Sci 2015; 40:404-10. [PMID: 26379346 PMCID: PMC4567599] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 03/15/2014] [Accepted: 04/27/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND Oxford shoulder score is a specific 12-item patient-reported tool for evaluation of patients with inflammatory and degenerative disorders of the shoulder. Since its introduction, it has been translated and culturally adapted in some Western and Eastern countries. The aim of this study was to translate the Oxford Shoulder Score (OSS) in Persian and to test its validity and reliability in Persian speaking population in Iran. METHODS One hundred patients with degenerative or inflammatory shoulder problem participated in the survey in 2012. All patients completed the Persian version of OSS, Persian DASH and the SF-36 for testing validity. Randomly, 37 patients filled out the Persian OSS again three days after the initial visit to assess the reliability of the questionnaire. RESULTS Cronbach's alpha coefficient was 0.93. The intraclass correlation coefficient was 0.93. In terms of validity, there was a significant correlation between the Persian OSS and DASH and SF-36 scores (P < 0.001). CONCLUSION The Persian version of the OSS proved to be a valid, reliable, and reproducible tool as demonstrated by high Cronbach's alpha and Pearson's correlation coefficients. The Persian transcript of OSS is administrable to Persian speaking patients with shoulder condition and it is understandable by them.
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Affiliation(s)
- Mohammad H. Ebrahimzadeh
- Associate Professor, Shoulder and Knee Surgeon Director, Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Birjandinejad
- Associate Professor of Orthopedic Surgery, Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shiva Razi
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Mardani-Kivi
- Assistant Professor of Orthopedic Surgery, Orthopedic Research Center, Guilan University of Medical Sciences, Rasht, Guilan, Iran
| | - Amir Reza Kachooei
- Assistant Professor, Mashhad University of Medical Sciences, Mashhad, Iran,Research Fellow, Massachusetts General Hospital, Harvard Medical School, Boston, USA,Correspondence: Amir Reza Kachooei, MD; Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Yawkey Building, Suite 2100, Boston, MA 02114, USA Tel: +1 6176693887 Fax: +1 617 7248532
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