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  1. Article ; Online: Strategies For Enhancing Equity, Diversity, and Inclusion in Medical School Admissions-A Canadian Medical School's Journey.

    Joy, Tisha R

    Frontiers in public health

    2022  Volume 10, Page(s) 879173

    Abstract: Background: Medical schools aim to select and train future physicians representative of and able to serve their diverse population needs. Enhancing equity, diversity, and inclusion (EDI) in admissions processes includes identifying and mitigating ... ...

    Abstract Background: Medical schools aim to select and train future physicians representative of and able to serve their diverse population needs. Enhancing equity, diversity, and inclusion (EDI) in admissions processes includes identifying and mitigating barriers for those underrepresented in medicine (URM).
    Summary of innovations: In 2017, Schulich School of Medicine and Dentistry (Western University, Ontario, Canada) critically reviewed its general Admissions pathways for the Doctor of Medicine (MD) program. Till that time, interview invitations were primarily based on academic metrics rather than a holistic review as for its Indigenous MD Admissions pathway. To help diversify the Canadian physician workforce, Schulich Medicine utilized a multipronged approach with five key changes implemented over 2 years into the general MD Admissions pathways: 1. A voluntary applicant diversity survey (race, socioeconomic status, and community size) to examine potential barriers within the Admissions process; 2. Diversification of the admissions committee and evaluator pool with the inclusion of an Equity Representative on the admissions committee; 3. A biosketch for applicants' life experiences; 4. Implicit bias awareness training for Committee members, file reviewers and interviewers; and 5. A specific pathway for applicants with financial, sociocultural, and medical barriers (termed ACCESS pathway). Diversity data before (Class of 2022) vs. after (Class of 2024) these initiatives and of the applicant pool vs. admitted class were examined.
    Conclusion: For the Class of 2024, the percentage of admitted racialized students (55.2%), those with socioeconomic challenges (32.3%), and those from remote/rural/small town communities (18.6%) reflected applicant pool demographics (52.8, 29.9, and 17.2%, respectively). Additionally, 5.3% (vs. 5.6% applicant pool) of admitted students had applied through ACCESS. These data suggest that barriers within the admissions process for these URM populations were potentially mitigated by these initiatives. The initiatives broadly improved representation of racialized students, LGBTQ2S+, and those with disability with statistically significant increases in representation of those with socioeconomic challenges (32.3 vs. 19.3%,
    MeSH term(s) Canada ; Humans ; Minority Groups ; School Admission Criteria ; Schools, Medical ; Social Class
    Language English
    Publishing date 2022-06-24
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2711781-9
    ISSN 2296-2565 ; 2296-2565
    ISSN (online) 2296-2565
    ISSN 2296-2565
    DOI 10.3389/fpubh.2022.879173
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Strategies For Enhancing Equity, Diversity, and Inclusion in Medical School Admissions–A Canadian Medical School's Journey

    Tisha R. Joy

    Frontiers in Public Health, Vol

    2022  Volume 10

    Abstract: BackgroundMedical schools aim to select and train future physicians representative of and able to serve their diverse population needs. Enhancing equity, diversity, and inclusion (EDI) in admissions processes includes identifying and mitigating barriers ... ...

    Abstract BackgroundMedical schools aim to select and train future physicians representative of and able to serve their diverse population needs. Enhancing equity, diversity, and inclusion (EDI) in admissions processes includes identifying and mitigating barriers for those underrepresented in medicine (URM).Summary of InnovationsIn 2017, Schulich School of Medicine and Dentistry (Western University, Ontario, Canada) critically reviewed its general Admissions pathways for the Doctor of Medicine (MD) program. Till that time, interview invitations were primarily based on academic metrics rather than a holistic review as for its Indigenous MD Admissions pathway. To help diversify the Canadian physician workforce, Schulich Medicine utilized a multipronged approach with five key changes implemented over 2 years into the general MD Admissions pathways: 1. A voluntary applicant diversity survey (race, socioeconomic status, and community size) to examine potential barriers within the Admissions process; 2. Diversification of the admissions committee and evaluator pool with the inclusion of an Equity Representative on the admissions committee; 3. A biosketch for applicants' life experiences; 4. Implicit bias awareness training for Committee members, file reviewers and interviewers; and 5. A specific pathway for applicants with financial, sociocultural, and medical barriers (termed ACCESS pathway). Diversity data before (Class of 2022) vs. after (Class of 2024) these initiatives and of the applicant pool vs. admitted class were examined.ConclusionFor the Class of 2024, the percentage of admitted racialized students (55.2%), those with socioeconomic challenges (32.3%), and those from remote/rural/small town communities (18.6%) reflected applicant pool demographics (52.8, 29.9, and 17.2%, respectively). Additionally, 5.3% (vs. 5.6% applicant pool) of admitted students had applied through ACCESS. These data suggest that barriers within the admissions process for these URM populations were potentially mitigated by these initiatives. The ...
    Keywords diversity ; equity ; inclusion ; medical school admissions ; Canada ; physician workforce ; Public aspects of medicine ; RA1-1270
    Language English
    Publishing date 2022-06-01T00:00:00Z
    Publisher Frontiers Media S.A.
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Improving the efficiency of virtual insulin teaching for patients admitted to hospital through the COVID-19 pandemic: a quality improvement initiative.

    Tong, Jeffery / Meehan, Rebecca / Iannicello, Dane / Li, Raymond / Joy, Tisha / Spaic, Tamara / Tung, Tsan-Hua / Clemens, Kristin K

    BMJ open quality

    2023  Volume 12, Issue 2

    Abstract: Background: Throughout the COVID-19 pandemic, many areas of medicine transitioned to virtual care. For patients with diabetes admitted to hospital, this included diabetes education and insulin teaching. Shifting to a virtual model of insulin teaching ... ...

    Abstract Background: Throughout the COVID-19 pandemic, many areas of medicine transitioned to virtual care. For patients with diabetes admitted to hospital, this included diabetes education and insulin teaching. Shifting to a virtual model of insulin teaching created new challenges for inpatient certified diabetes educators (CDE).
    Objective: We advanced a quality improvement project to improve the efficiency of safe and effective virtual insulin teaching throughout the COVID-19 pandemic. Our primary aim was to reduce the mean time between CDE referral to successful inpatient insulin teach by 0.5 days.
    Design, setting, participants: We conducted this initiative at two large academic hospitals between April 2020 and September 2021. We included all admitted patients with diabetes who were referred to our CDE for inpatient insulin teaching and education.
    Intervention: Alongside a multidisciplinary team of project stakeholders, we created and studied a CDE-led, virtual (video conference or telephone) insulin teaching programme. As tests of change, we added a streamlined method to deliver insulin pens to the ward for patient teaching, created a new electronic order set and included patient-care facilitators in the scheduling process.
    Main outcome and measures: Our main outcome measure was the mean time between CDE referral and successful insulin teach-back. Our process measure was the percentage of successful insulin pen deliveries to the ward for teaching. As balance measures, we captured the percentage of patients with a successful insulin teach, the time between insulin teach and hospital discharge, and readmissions to hospital for diabetes-related complications.
    Results: Our tests of change improved the efficiency of safe and effective virtual insulin teaching by 0.27 days. The virtual model appeared less efficient than usual in-person care.
    Conclusions: In our centre, virtual insulin teaching supported patients admitted to hospital through the pandemic. Improving the administrative efficiency of virtual models and leveraging key stakeholders remain important for long-term sustainability.
    MeSH term(s) Humans ; Insulin/therapeutic use ; COVID-19 ; Pandemics ; Quality Improvement ; Diabetes Mellitus/drug therapy ; Hospitals
    Chemical Substances Insulin
    Language English
    Publishing date 2023-06-16
    Publishing country England
    Document type Journal Article
    ISSN 2399-6641
    ISSN (online) 2399-6641
    DOI 10.1136/bmjoq-2023-002305
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Improving the efficiency of virtual insulin teaching for patients admitted to hospital through the COVID-19 pandemic

    Jeffery Tong / Tamara Spaic / Kristin K Clemens / Rebecca Meehan / Dane Iannicello / Raymond Li / Tisha Joy / Tsan-Hua Tung

    BMJ Open Quality, Vol 12, Iss

    a quality improvement initiative

    2023  Volume 2

    Abstract: Background Throughout the COVID-19 pandemic, many areas of medicine transitioned to virtual care. For patients with diabetes admitted to hospital, this included diabetes education and insulin teaching. Shifting to a virtual model of insulin teaching ... ...

    Abstract Background Throughout the COVID-19 pandemic, many areas of medicine transitioned to virtual care. For patients with diabetes admitted to hospital, this included diabetes education and insulin teaching. Shifting to a virtual model of insulin teaching created new challenges for inpatient certified diabetes educators (CDE).Objective We advanced a quality improvement project to improve the efficiency of safe and effective virtual insulin teaching throughout the COVID-19 pandemic. Our primary aim was to reduce the mean time between CDE referral to successful inpatient insulin teach by 0.5 days.Design, setting, participants We conducted this initiative at two large academic hospitals between April 2020 and September 2021. We included all admitted patients with diabetes who were referred to our CDE for inpatient insulin teaching and education.Intervention Alongside a multidisciplinary team of project stakeholders, we created and studied a CDE-led, virtual (video conference or telephone) insulin teaching programme. As tests of change, we added a streamlined method to deliver insulin pens to the ward for patient teaching, created a new electronic order set and included patient-care facilitators in the scheduling process.Main outcome and measures Our main outcome measure was the mean time between CDE referral and successful insulin teach-back. Our process measure was the percentage of successful insulin pen deliveries to the ward for teaching. As balance measures, we captured the percentage of patients with a successful insulin teach, the time between insulin teach and hospital discharge, and readmissions to hospital for diabetes-related complications.Results Our tests of change improved the efficiency of safe and effective virtual insulin teaching by 0.27 days. The virtual model appeared less efficient than usual in-person care.Conclusions In our centre, virtual insulin teaching supported patients admitted to hospital through the pandemic. Improving the administrative efficiency of virtual models and leveraging key ...
    Keywords Medicine (General) ; R5-920
    Subject code 027
    Language English
    Publishing date 2023-06-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article: Management strategies in patients with statin-associated muscle symptoms: What is the best strategy?

    Joy, Tisha R / Brennan, Emily T

    Journal of clinical lipidology

    2016  Volume 10, Issue 5, Page(s) 1067–1072

    MeSH term(s) Dose-Response Relationship, Drug ; Drug Substitution/methods ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects ; Lipid Metabolism/drug effects ; Medication Therapy Management ; Muscular Diseases/etiology ; Muscular Diseases/prevention & control
    Chemical Substances Hydroxymethylglutaryl-CoA Reductase Inhibitors
    Language English
    Publishing date 2016-06-25
    Publishing country United States
    Document type Editorial
    ZDB-ID 2365061-8
    ISSN 1876-4789 ; 1933-2874
    ISSN (online) 1876-4789
    ISSN 1933-2874
    DOI 10.1016/j.jacl.2016.06.008
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Management Strategies for Statin-Associated Muscle Symptoms: How Useful Is Same-Statin Rechallenge?

    Brennan, Emily T / Joy, Tisha R

    The Canadian journal of cardiology

    2017  Volume 33, Issue 5, Page(s) 666–673

    Abstract: Background: Statin-associated muscle symptoms (SAMS) are common. Rechallenge with the same statin (same-statin rechallenge) has recently been included as part of a proposed scoring index for diagnosing SAMS, but data regarding tolerability and efficacy ... ...

    Abstract Background: Statin-associated muscle symptoms (SAMS) are common. Rechallenge with the same statin (same-statin rechallenge) has recently been included as part of a proposed scoring index for diagnosing SAMS, but data regarding tolerability and efficacy of same-statin rechallenge, compared with other strategies, is minimal. In this study we evaluated the tolerability, percent change in low-density lipoprotein cholesterol (LDL-C), and proportion of patients achieving their LDL-C targets among 3 common management strategies-same-statin rechallenge, switching to a different statin (statin switch), and use of nonstatin medications only.
    Methods: We performed a retrospective analysis of 118 patients referred to our tertiary care centre for management of SAMS, defined as development of muscle-related symptoms with 2 or more statins. Baseline and last follow-up lipid parameters were documented. Patients were classified as tolerant of a strategy if, at their last follow-up, they remained on that strategy.
    Results: After a median follow-up of 17 months, most (n = 79; 67%) patients were able to tolerate a statin. Tolerability was similar among the 3 treatment strategies (71% same-statin rechallenge vs 53% statin switch vs 57% for nonstatin therapy only; P = 0.11). Those in the same-statin rechallenge and statin switch groups achieved greater LDL-C reductions compared with those who only tolerated nonstatins (-38.8 ± 3.4% vs -36.4 ± 2.9% vs -17.3 ± 4.5%; P = 0.0007). A greater proportion of patients in the same-statin rechallenge group achieved their target LDL-C compared with those in the nonstatin therapy only group (50% vs 15%; odds ratio, 6.8; 95% confidence interval, 1.5-40.7; P = 0.04).
    Conclusions: Among individuals with a history of SAMS, most will tolerate statin therapy. Same-statin rechallenge was highly tolerable and efficacious. Thus, same-statin rechallenge might warrant increased utilization.
    MeSH term(s) Aged ; Canada/ethnology ; Cholesterol, LDL/analysis ; Cholesterol, LDL/metabolism ; Drug Substitution/methods ; Female ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects ; Hypercholesterolemia/drug therapy ; Hypercholesterolemia/epidemiology ; Hypercholesterolemia/metabolism ; Lipid Metabolism/drug effects ; Male ; Medication Therapy Management ; Middle Aged ; Muscular Diseases/chemically induced ; Muscular Diseases/diagnosis ; Muscular Diseases/epidemiology ; Muscular Diseases/prevention & control ; No-Observed-Adverse-Effect Level ; Retrospective Studies ; Treatment Outcome
    Chemical Substances Cholesterol, LDL ; Hydroxymethylglutaryl-CoA Reductase Inhibitors
    Language English
    Publishing date 2017-05
    Publishing country England
    Document type Journal Article
    ZDB-ID 632813-1
    ISSN 1916-7075 ; 0828-282X
    ISSN (online) 1916-7075
    ISSN 0828-282X
    DOI 10.1016/j.cjca.2017.02.013
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  7. Article ; Online: Novel therapeutic agents for lowering low density lipoprotein cholesterol.

    Joy, Tisha R

    Pharmacology & therapeutics

    2012  Volume 135, Issue 1, Page(s) 31–43

    Abstract: Elevated low density lipoprotein cholesterol (LDL-C) levels have been associated with an increased risk for cardiovascular disease (CVD). Despite a 25-30% reduction in CVD risk with LDL-C reducing strategies, there is still a significant residual risk. ... ...

    Abstract Elevated low density lipoprotein cholesterol (LDL-C) levels have been associated with an increased risk for cardiovascular disease (CVD). Despite a 25-30% reduction in CVD risk with LDL-C reducing strategies, there is still a significant residual risk. Moreover, achieving target LDL-C values in individuals at high CVD risk is sometimes limited because of tolerability and/or efficacy. Thus, novel therapeutic agents are currently being developed to lower LDL-C levels further. This review will highlight some of these therapeutic agents including anti-sense oligonucleotides focused on apolipoprotein B, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, microsomal triglyceride transfer protein inhibitors, and thyromimetics. For each therapeutic class, an overview of the mechanism of action, pharmacokinetic data, and efficacy/safety evidence will be provided.
    MeSH term(s) Animals ; Anticholesteremic Agents/adverse effects ; Anticholesteremic Agents/pharmacokinetics ; Anticholesteremic Agents/therapeutic use ; Apolipoproteins B/blood ; Apolipoproteins B/genetics ; Biomarkers/blood ; Biomimetic Materials/therapeutic use ; Cardiovascular Diseases/blood ; Cardiovascular Diseases/etiology ; Cardiovascular Diseases/genetics ; Cardiovascular Diseases/prevention & control ; Carrier Proteins/antagonists & inhibitors ; Carrier Proteins/metabolism ; Cholesterol, LDL/blood ; Down-Regulation ; Humans ; Hypercholesterolemia/blood ; Hypercholesterolemia/complications ; Hypercholesterolemia/drug therapy ; Hypercholesterolemia/genetics ; Oligonucleotides, Antisense/therapeutic use ; Proprotein Convertase 9 ; Proprotein Convertases/antagonists & inhibitors ; Proprotein Convertases/metabolism ; Protein Kinase Inhibitors/therapeutic use ; Serine Endopeptidases/metabolism ; Thyroid Hormones/metabolism ; Treatment Outcome
    Chemical Substances Anticholesteremic Agents ; Apolipoproteins B ; Biomarkers ; Carrier Proteins ; Cholesterol, LDL ; Oligonucleotides, Antisense ; Protein Kinase Inhibitors ; Thyroid Hormones ; microsomal triglyceride transfer protein ; PCSK9 protein, human (EC 3.4.21.-) ; Proprotein Convertase 9 (EC 3.4.21.-) ; Proprotein Convertases (EC 3.4.21.-) ; Serine Endopeptidases (EC 3.4.21.-)
    Language English
    Publishing date 2012-07
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 194735-7
    ISSN 1879-016X ; 0163-7258
    ISSN (online) 1879-016X
    ISSN 0163-7258
    DOI 10.1016/j.pharmthera.2012.03.005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Novel HDL-based therapeutic agents.

    Joy, Tisha R

    Pharmacology & therapeutics

    2012  Volume 135, Issue 1, Page(s) 18–30

    Abstract: Reduction in low-density lipoprotein cholesterol (LDL-C) levels has been associated with a 25-30% reduction in cardiovascular disease risk. However, there still remains a significant and quantifiable risk. Since epidemiologic data have demonstrated that ... ...

    Abstract Reduction in low-density lipoprotein cholesterol (LDL-C) levels has been associated with a 25-30% reduction in cardiovascular disease risk. However, there still remains a significant and quantifiable risk. Since epidemiologic data have demonstrated that low levels of high-density lipoprotein cholesterol (HDL-C) are associated with an increased risk for cardiovascular disease, novel therapeutic agents are currently being developed to either raise HDL-C levels or enhance HDL functionality. This review will highlight some of these therapeutic agents including cholesteryl ester transfer protein inhibitors, apolipoprotein A-I mimetics, RVX-208, and apolipoprotein A-I based infusion therapies. For each therapeutic class, an overview of the mechanism of action, pharmacokinetic data, and efficacy/safety evidence will be provided.
    MeSH term(s) Animals ; Apolipoprotein A-I/therapeutic use ; Biomarkers/blood ; Cardiovascular Diseases/blood ; Cardiovascular Diseases/etiology ; Cardiovascular Diseases/prevention & control ; Cholesterol Ester Transfer Proteins/antagonists & inhibitors ; Cholesterol Ester Transfer Proteins/blood ; Cholesterol, HDL/blood ; Cholesterol, LDL/blood ; Dyslipidemias/blood ; Dyslipidemias/complications ; Dyslipidemias/drug therapy ; Humans ; Hypolipidemic Agents/adverse effects ; Hypolipidemic Agents/pharmacokinetics ; Hypolipidemic Agents/therapeutic use ; Molecular Mimicry ; Quinazolines/therapeutic use ; Treatment Outcome
    Chemical Substances Apolipoprotein A-I ; Biomarkers ; CETP protein, human ; Cholesterol Ester Transfer Proteins ; Cholesterol, HDL ; Cholesterol, LDL ; Hypolipidemic Agents ; Quinazolines ; apabetalone (8R4A7GDZ1D)
    Language English
    Publishing date 2012-03-23
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 194735-7
    ISSN 1879-016X ; 0163-7258
    ISSN (online) 1879-016X
    ISSN 0163-7258
    DOI 10.1016/j.pharmthera.2012.03.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Bilateral adrenal histoplasmosis manifesting as primary adrenal insufficiency.

    Robinson, Lilian J / Lu, Mary / Elsayed, Sameer / Joy, Tisha R

    CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne

    2019  Volume 191, Issue 44, Page(s) E1217–E1221

    MeSH term(s) Adrenal Glands/diagnostic imaging ; Adrenal Glands/pathology ; Adrenal Insufficiency/diagnostic imaging ; Adrenal Insufficiency/drug therapy ; Adrenal Insufficiency/microbiology ; Adrenal Insufficiency/pathology ; Aged ; Antifungal Agents/therapeutic use ; Diagnosis, Differential ; Fatigue/microbiology ; Female ; Glucocorticoids/therapeutic use ; Histoplasmosis/diagnostic imaging ; Histoplasmosis/drug therapy ; Histoplasmosis/pathology ; Humans ; Hyperpigmentation/microbiology ; Hyperpigmentation/pathology ; Mineralocorticoids/therapeutic use ; Muscle Weakness/diagnostic imaging ; Muscle Weakness/microbiology ; Muscle Weakness/pathology ; Tomography, X-Ray Computed ; Treatment Outcome ; Weight Loss
    Chemical Substances Antifungal Agents ; Glucocorticoids ; Mineralocorticoids
    Language English
    Publishing date 2019-11-04
    Publishing country Canada
    Document type Case Reports ; Journal Article
    ZDB-ID 215506-0
    ISSN 1488-2329 ; 0008-4409 ; 0820-3946
    ISSN (online) 1488-2329
    ISSN 0008-4409 ; 0820-3946
    DOI 10.1503/cmaj.190710
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Novel HDL-based therapeutic agents

    Joy, Tisha R

    Pharmacology and therapeutics. 2012 July, v. 135, no. 1

    2012  

    Abstract: Reduction in low-density lipoprotein cholesterol (LDL-C) levels has been associated with a 25–30% reduction in cardiovascular disease risk. However, there still remains a significant and quantifiable risk. Since epidemiologic data have demonstrated that ... ...

    Abstract Reduction in low-density lipoprotein cholesterol (LDL-C) levels has been associated with a 25–30% reduction in cardiovascular disease risk. However, there still remains a significant and quantifiable risk. Since epidemiologic data have demonstrated that low levels of high-density lipoprotein cholesterol (HDL-C) are associated with an increased risk for cardiovascular disease, novel therapeutic agents are currently being developed to either raise HDL-C levels or enhance HDL functionality. This review will highlight some of these therapeutic agents including cholesteryl ester transfer protein inhibitors, apolipoprotein A-I mimetics, RVX-208, and apolipoprotein A-I based infusion therapies. For each therapeutic class, an overview of the mechanism of action, pharmacokinetic data, and efficacy/safety evidence will be provided.
    Keywords apolipoprotein A-I ; cardiovascular diseases ; cholesteryl ester transfer protein ; high density lipoprotein cholesterol ; low density lipoprotein cholesterol ; mechanism of action ; pharmacokinetics ; risk
    Language English
    Dates of publication 2012-07
    Size p. 18-30.
    Publishing place Elsevier Inc.
    Document type Article
    ZDB-ID 194735-7
    ISSN 1879-016X ; 0163-7258
    ISSN (online) 1879-016X
    ISSN 0163-7258
    DOI 10.1016/j.pharmthera.2012.03.004
    Database NAL-Catalogue (AGRICOLA)

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