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Characteristics and risk factors for SARS-CoV-2 in children tested in the early phase of the pandemic: a cross-sectional study, Italy, 23 February to 24 May 2020. Euro Surveill 2021; 26:2001248. [PMID: 33834960 PMCID: PMC8034058 DOI: 10.2807/1560-7917.es.2021.26.14.2001248] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 11/19/2020] [Indexed: 12/14/2022] Open
Abstract
BackgroundVery few studies describe factors associated with COVID-19 diagnosis in children.AimWe here describe characteristics and risk factors for COVID-19 diagnosis in children tested in 20 paediatric centres across Italy.MethodsWe included cases aged 0-18 years tested between 23 February and 24 May 2020. Our primary analysis focused on children tested because of symptoms/signs suggestive of COVID-19.ResultsAmong 2,494 children tested, 2,148 (86.1%) had symptoms suggestive of COVID-19. Clinical presentation of confirmed COVID-19 cases included besides fever (82.4%) and respiratory signs or symptoms (60.4%) also gastrointestinal (18.2%), neurological (18.9%), cutaneous (3.8%) and other unspecific influenza-like presentations (17.8%). In multivariate analysis, factors significantly associated with SARS-CoV-2 positivity were: exposure history (adjusted odds ratio (AOR): 39.83; 95% confidence interval (CI): 17.52-90.55; p < 0.0001), cardiac disease (AOR: 3.10; 95% CI: 1.19-5.02; p < 0.0001), fever (AOR: 3.05%; 95% CI: 1.67-5.58; p = 0.0003) and anosmia/ageusia (AOR: 4.08; 95% CI: 1.69-9.84; p = 0.002). Among 190 (7.6%) children positive for SARS-CoV-2, only four (2.1%) required respiratory support and two (1.1%) were admitted to intensive care; all recovered.ConclusionRecommendations for SARS-CoV-2 testing in children should consider the evidence of broader clinical features. Exposure history, fever and anosmia/ageusia are strong risk factors in children for positive SARS-CoV-2 testing, while other symptoms did not help discriminate positive from negative individuals. This study confirms that COVID-19 was a mild disease in the general paediatric population in Italy. Further studies are needed to understand risk, clinical spectrum and outcomes of COVID-19 in children with pre-existing conditions.
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COVID-19-related thrombotic microangiopathy in a cirrhotic patient. Dig Liver Dis 2020; 52:946. [PMID: 32641274 PMCID: PMC7294259 DOI: 10.1016/j.dld.2020.06.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 06/10/2020] [Accepted: 06/12/2020] [Indexed: 12/11/2022]
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Impact of new HCV therapies on liver transplantation: the European Liver Transplant Registry study. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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The optimal timing of hepatitis C therapy in liver transplant-eligible patients: Cost-effectiveness analysis of new opportunities. J Viral Hepat 2018; 25:791-801. [PMID: 29406608 DOI: 10.1111/jvh.12877] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 01/15/2018] [Indexed: 02/06/2023]
Abstract
Different strategies of DAAs treatment are currently possible both pre- and postliver transplantation (LT). Clinical and economic consequences of these strategies still need to be adequately investigated; this study aims at assessing their cost-effectiveness. A decision analytical model was created to simulate the progression of HCV-infected patients listed for decompensated cirrhosis (DCC) or for hepatocellular carcinoma (HCC). Three DAAs treatment strategies were compared: (i) a 12-week course of DAAs prior to transplantation (PRE-LT), (ii) a 4-week course of DAAs starting at the time of transplantation (PERI-LT) and (iii) a 12-week course of DAAs administered at disease recurrence (POST-LT). The population was substratified according to HCC presence and, in those without HCC, according to the MELD score at listing. Data on DAAs effectiveness were estimated using a cohort of patients still followed by 11 transplant centres of the European Liver and Intestine Transplant Association and by data available in the literature. In this study, PRE-LT treatment strategy was dominant for DCC patients with MELD<16 and cost-effective for those with MELD16-20, while POST-LT strategy emerged as cost-effective for DCC patients with MELD>20 and for those with HCC. Sensitivity analyses confirmed PRE-LT as the cost-effective strategy for patients with MELD≤20. In conclusion, PRE-LT treatment is cost-effective for patients with MELD≤20 without HCC, while treatments after LT are cost-effective in cirrhotic patients with MELD>20 and in those with HCC. It is worth reminding, though, that the final choice of a specific regimen at the patient level will have to be personalized based on clinical, social and transplant-related factors.
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The optimal timing of HCV therapy in liver transplant: cost and effectiveness of new opportunities. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Hepatology: Fitz-Hugh-Curtis syndrome: pelvic inflammatory disease with perihepatitis. J Gastroenterol Hepatol 2014; 29:1853. [PMID: 25392921 DOI: 10.1111/jgh.12810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
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Coping and parental role competence of mothers of preterm infant. Minerva Pediatr 2014; 66:177-186. [PMID: 24826974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM The study was aimed at obtaining knowledge about mothers' experiences of preterm birth. The objective of the study is to explore coping strategies and self- perceived parental competence, in mothers of infant born moderately and severely preterm and admitted to the Neonatal Intensive Care Unit (NICU). METHODS The study involved a group of 16 mothers of moderately preterm children (weeks' gestational age: mean=34, SD=2 and birth weight: mean=2000 g, SD=200 g) and a group of 14 mothers of severely preterm children (weeks' gestational age: mean=29, SD=2 and birth weight: mean=1700 g, SD=350 g). The following instruments were used with mothers to investigate focus areas of research: Coping Orientation to the Problems Experienced-New Italian Version (COPE-NVI), to analyse coping strategies of mothers, and a Q-sort, a self report on maternal competence. RESULTS Data did not show statistically significant differences between the two groups of mothers, both in regard to considered coping strategies (social support, avoidance, problem focused orientation, transcendent orientation, positive aptitude), and the indicators of maternal self-perceived competence (coping, scaffolding, caregiving) (Mann-Whitney U test(n1=16 and n2=14)>0.05). CONCLUSION This study, highlighting the lack of differences between the two groups of mothers involved, seems to point out that, beyond the levels of prematurity, the condition of preterm birth itself is precisely the main stressor factor for mothers.
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Systematic review with meta-analysis: the haemodynamic effects of carvedilol compared with propranolol for portal hypertension in cirrhosis. Aliment Pharmacol Ther 2014; 39:557-68. [PMID: 24461301 DOI: 10.1111/apt.12634] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2013] [Revised: 12/09/2013] [Accepted: 01/06/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND Propranolol is recommended for prophylaxis of variceal bleeding in cirrhosis. Carvedilol is a nonselective beta-blocker with a mild anti-alfa-1-adrenergic activity. Several studies have compared carvedilol and propranolol, yielding inconsistent results. AIM To perform a systematic review and meta-analysis of the randomised clinical trials comparing carvedilol with propranolol for hepatic vein pressure gradient reduction. METHODS Studies were searched on the MEDLINE, EMBASE and Cochrane library databases up to November 2013. The weighted mean difference in percent hepatic vein pressure gradient reduction and the relative risk of failure to achieve a hemodynamic response (reduction ≥20% of baseline or to ≤12 mmHg) with each drug were used as measures of treatment efficacy. RESULTS Five studies (175 patients) were included. Indication to treatment was primary prophylaxis of variceal bleeding in 76% of patients. There were overall three acute (60-90 min after drug administration) and three long-term (after 7-90 days of therapy) comparisons. The summary mean weighted difference in % of reduction in hepatic vein pressure gradient was: acute -7.70 (CI -12.40, -3.00), long-term -6.81 (CI -11.35, -2.26), overall -7.24 (CI -10.50, -3.97), favouring carvedilol. The summary relative risk of failure to achieve a hemodynamic response with carvedilol was 0.66 (CI 0.44, 1.00). Adverse events were nonsignificantly more frequent and serious with carvedilol. However, quality of trials was mostly unsatisfactory. CONCLUSIONS Carvedilol reduces portal hypertension significantly more than propranolol. However, available data do not allow a satisfactory comparison of adverse events. These results suggest a potential for a cautious clinical use.
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[Narrative inquiries representations and self-esteem in the child affected by tumor: a pre-test pilot study]. Minerva Pediatr 2010; 62:43-50. [PMID: 20212397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
AIM The contribution reports on a pre-test pilot study, based on the single-case method (N>1 and N=1 one by one), aimed to investigate whether resilience factors regards self-narrative representation, self-esteem and their likely correlations in child suffering from tumour. METHODS The administration of specific investigation instruments (TMA - multidimensional self-esteem test, and a narrative inquiry framed on purpose) has been planned by the survey. The participating subjects set up a group of 7 children, 10 year olds, suffering from tumour. The individuation of such subjects has been carried out in terms of some "drawing variables" such as the existence of tumour, its diagnosis (12 months before commencing the research), the continuity of medical treatment and the lack of terminal stage of disease. RESULTS The study has highlighted the lack of a statistically remarkable impairment of self-narrative and self-esteem in children suffering from tumour belonging to the reference group. These levels of self-narrative and self-esteem are possible resilience factors in children suffering from tumour. CONCLUSION The acquired data about specific resilience elements in child suffering from tumor directs to research with national and international sample.
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Abstract
To provide a review of studies on prognosis in ulcerative colitis by reviewing the relevant population-based cohort studies. On the basis of incidence and population studies, ulcerative colitis has a favourable clinical course, with good quality of life, a chronic course characterized by at least one relapse, and a surgery rate of 30% after 10 years from diagnosis. Patients affected by severe ulcerative colitis have a higher risk of colectomy, and some clinical variables may predict the disease's clinical course. Most patients respond to steroids and only a low percentage become dependent, or non-responders to steroids. Patients who have a long-lasting ulcerative colitis (>10 years) or are affected by an extensive disease have an increased risk of developing colorectal cancer, while those treated with immunosuppressants for long period of time may have an increased risk of developing lymphomas. Data on mortality in ulcerative colitis patients are not homogeneous, but if a real risk exists it is in patients with extensive or severe disease. The evidence that patients with severe ulcerative colitis are often non-smokers may explain why in one study the mortality rate was lower.
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[School in hospital: an opportunity for the hospitalized child to overcome the illness risk]. Minerva Pediatr 2004; 56:431-44. [PMID: 15457141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
AIM The paper reports research on the subject of "Overcoming the illness risk in the School in Hospital service" the aim of which was to monitor this particular service so as to assess whether or not the activities proposed are directed by the model of overcoming inherent risks as defined and reported here. Four research directions were taken to verify the hypothesis whereby the service takes on a supportive-transformative value which enables the hospitalized child to study through his/her illness and is thus able to develop by activating support, protection and diagnosis functions. METHODS The investigation was carried out using the single case methodology which provided for continuous observation lasting for the entire hospital period in the paediatric wards of 2 hospital in Sicily. The research involved 58 children aged between 7 and 12; chronically ill or long-stay patients, and 100 mothers of hospitalized children. The research also observed the effects of the intervention activated by "School in Hospital" on the child and on his reference models. Various instruments of an observational, projective and psycho-social investigation type were utilized in relation to the 2 main subjects of the research, the development outcomes on the subjects involved and the activities proposed by the service. RESULTS The overall results confirm the supportive-transformative value of the "School in Hospital" service. CONCLUSIONS The data obtained suggest that the service should be promoted within hospital structures as a specific form of the caring approach.
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Abstract
AIMS/BACKGROUND This study estimated the prevalence of HCV infection and relationship with viremia in a general population. The inhabitants of Albavilla town were personally invited to participate. METHODS Out of 3997 inhabitants falling within the age range 18-85 years, 2403 (participation rate 60.1%) were examined for transaminases, HCVAb, HCVRNA, genotype and immunoblot assay. The following information was collected: sex, age, blood transfusions, surgery, use of glass syringes, drug addiction, alcohol consumption, tattoos and body mass index. RESULTS 115 (4.8%) were HCVAb+, the prevalence being 1.2% under 40 years. Transfusion in the past was the only risk factor for HCV infection. Among the HCVAb+ subjects, 71 (61.7%) were HCVRNA+. 40.8% of the HCVAb+/HCVRNA+ group had normal ALT, compared with 68% of those with HCVAb+/HCVRNA-. The HCV genotypes in the 71 HCVRNA+ subjects were: 2a/2c in 58 (81.7%), 40% of them with normal ALT;1b in 11 (15.5%), none with normal ALT; genotype 3 in two (2.8%). CONCLUSION The prevalence of HCVAb in this general population was 4.8%. About 3% were HCVRNA positive and of these genotype 2a/ 2c was present in 81.6%.
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Serum cholesterol and chronic hepatitis C. THE ITALIAN JOURNAL OF GASTROENTEROLOGY 1996; 28:436-40. [PMID: 9032585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Total serum cholesterol levels have been studied in 100 patients with histological diagnoses of chronic hepatitis B and 100 wit chronic Hepatitis C, all without cirrhosis, and two age- and sex-matched control groups (B and C). Mean serum cholesterol levels of the groups were compared also in relation to sex, liver function, duration of the disease, alcohol intake, mass index, liver enzymes, presence of liver steatosis and severity of the liver disease on the basis of the histological activity index. The percentages of patients with serum cholesterol level < 150 mg/dl and > 240 mg/dl were also calculated. The mean serum cholesterol level was significantly lower in hepatitis C: 176 md/dl vs 194 mg/dl of hepatitis B (p = 0.004) and 198 of control C (p = 0.000). Twenty eight hepatitis C patients had serum cholesterol < 150 mg/dl vs 10 with hepatitis B (p = 0.001). In multivariate regression analysis, only the type of virus infection was independent related to serum cholesterol level (p = 0.0063).
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[Spontaneous course of idiopathic scoliosis. Review of 347 cases]. LA CHIRURGIA DEGLI ORGANI DI MOVIMENTO 1987; 72:359-64. [PMID: 3447826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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[Non-invasive therapy of congenital scoliosis]. LA CHIRURGIA DEGLI ORGANI DI MOVIMENTO 1986; 71:45-50. [PMID: 3720411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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18
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[Rotatory subluxation of the atlas after tonsillectomy]. LA CHIRURGIA DEGLI ORGANI DI MOVIMENTO 1982; 68:261-5. [PMID: 7187887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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[Volkmann's syndrome of the forearm in a newborn infant]. LA CHIRURGIA DEGLI ORGANI DI MOVIMENTO 1982; 68:121-5. [PMID: 7187648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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[Verification of a method of radiologic study on the parallelism of L5-S1 as an early sign of disk herniation]. LA CHIRURGIA DEGLI ORGANI DI MOVIMENTO 1981; 67:701-3. [PMID: 7186454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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[Clinical trial of a new synthetic spasmolytic agent in obstetrics]. LA CLINICA TERAPEUTICA 1980; 95:377-92. [PMID: 6111410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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[Proprioceptive neuromuscular facilitation in paralysis of the anterior serratus]. LA CHIRURGIA DEGLI ORGANI DI MOVIMENTO 1980; 66:775-7. [PMID: 7347652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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[Trigger-finger in obstetrical paralysis]. LA CHIRURGIA DEGLI ORGANI DI MOVIMENTO 1980; 66:423-425. [PMID: 7344848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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[Forced mobilization under anesthesia]. LA CHIRURGIA DEGLI ORGANI DI MOVIMENTO 1980; 66:409-13. [PMID: 7344847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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[So-called obstetrical fractures of the forearm]. LA CHIRURGIA DEGLI ORGANI DI MOVIMENTO 1980; 66:531-2. [PMID: 7318568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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[Neurotomy in spastic paralysis. Long-term follow-up. Re-innervation]. LA CHIRURGIA DEGLI ORGANI DI MOVIMENTO 1980; 66:473-9. [PMID: 7318561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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[Volkmann's syndrome of the lower extremity. Early bloodless treatment]. LA CHIRURGIA DEGLI ORGANI DI MOVIMENTO 1980; 66:355-8. [PMID: 7307674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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[Electric stimulation test in myelomeningocele]. LA CHIRURGIA DEGLI ORGANI DI MOVIMENTO 1979; 65:303-7. [PMID: 400585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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[Comparative studies of clinical examination, electrical examination, and electromyography (EMG) in 30 patients suffering from lumbar backache (EMG examination of the paravertebral muscles)]. LA CHIRURGIA DEGLI ORGANI DI MOVIMENTO 1979; 65:35-41. [PMID: 162046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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[Orthopedic treatment of kyphoscoliosis in adolescents]. Acta Orthop Belg 1967; 33:703-9. [PMID: 5583950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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[Orthopedic therapy of kyphoscoliosis in adolescents]. BULLETTINO DELLE SCIENZE MEDICHE 1967; 139:218-26. [PMID: 5607425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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