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Article ; Online: Need for guidance and training for physicians when communicating with under 18-year-old relative in critical care.

Molokhia, Ashraf / Richmond, Georgia / Rochester, Alana / Breeze, Richard

2023 Volume 49, Issue 8, Page(s) 1021–1022

MeSH term(s)	Humans ; Adolescent ; Physicians ; Critical Care
Language	English
Publishing date	2023-07-04
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	80387-x
ISSN	1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
ISSN (online)	1432-1238
ISSN	0340-0964 ; 0342-4642 ; 0935-1701
DOI	10.1007/s00134-023-07139-z
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Article ; Online: Death in the ICU from COVID-19: more research on its effects on families needed.

Molokhia, Ashraf / Khaliq, Waqas

British journal of anaesthesia

2020 Volume 125, Issue 3, Page(s) e338–e339

MeSH term(s)	Betacoronavirus ; COVID-19 ; Coronavirus Infections/mortality ; Family ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral/mortality ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-06-17
Publishing country	England
Document type	Letter
ZDB-ID	80074-0
ISSN	1471-6771 ; 0007-0912
ISSN (online)	1471-6771
ISSN	0007-0912
DOI	10.1016/j.bja.2020.06.018
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Article: Death in the ICU from COVID-19: more research on its effects on families needed

Molokhia, Ashraf / Khaliq, Waqas

Br J Anaesth

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #633402
Database	COVID19

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Article ; Online: Death in the ICU from COVID-19

Molokhia, Ashraf / Khaliq, Waqas

British Journal of Anaesthesia

more research on its effects on families needed

2020 Volume 125, Issue 3, Page(s) e338–e339

Keywords	Anesthesiology and Pain Medicine ; covid19
Language	English
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
ZDB-ID	80074-0
ISSN	1471-6771 ; 0007-0912
ISSN (online)	1471-6771
ISSN	0007-0912
DOI	10.1016/j.bja.2020.06.018
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Cardiac arrest secondary to Covid19 pneumonia post full vaccination.

Mohamed, Eslam / Coyle, Peter / Kumar, T Suresh / Molokhia, Ashraf / Harris, Tim

The American journal of emergency medicine

2021 Volume 49, Page(s) 257–258

MeSH term(s)	COVID-19/complications ; COVID-19/prevention & control ; Heart Arrest/epidemiology ; Heart Arrest/etiology ; Humans ; Pneumonia/epidemiology ; Pneumonia/etiology ; Vaccination/methods ; Vaccination/standards ; Vaccination/statistics & numerical data ; COVID-19 Drug Treatment
Language	English
Publishing date	2021-06-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	605890-5
ISSN	1532-8171 ; 0735-6757
ISSN (online)	1532-8171
ISSN	0735-6757
DOI	10.1016/j.ajem.2021.06.027
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Article ; Online: Flow controlled ventilation in Acute Respiratory Distress Syndrome associated with COVID-19: A structured summary of a study protocol for a randomised controlled trial.

Roehrig, Stefan / Ait Hssain, Ali / Shallik, Nabil Al Hamid / Elsaid, Ingi Mohamed A / Mustafa, Salma Faisal / Smain, Osama A M / Molokhia, Ashraf Abdulla / Lance, Marcus D

Trials

2020 Volume 21, Issue 1, Page(s) 781

Abstract: Objectives: This study aims to demonstrate the positive effects on oxygenation of flow-controlled ventilation compared to conventionally ventilated patients in patients suffering from Acute respiratory distress syndrome (ARDS) associated with COVID-19 ... ...

Abstract	Objectives: This study aims to demonstrate the positive effects on oxygenation of flow-controlled ventilation compared to conventionally ventilated patients in patients suffering from Acute respiratory distress syndrome (ARDS) associated with COVID-19.We define ARDS according to the "Berlin" definition integrating the oxygenation index (P/F ratio), the level of Positive End Expiratory Pressure (PEEP), radiological and clinical findings. Trial design: This is a prospective, randomized (1:1 ratio), parallel group feasibility study in adult patients with proven COVID-19 associated ARDS. Participants: All adult patients admitted to the ICU of Hamad Medical Corporation facilities in Qatar because of COVID-19 infection who develop moderate to severe ARDS are eligible. The inclusion criteria are above 18 years of age, proven COVID-19 infection, respiratory failure necessitating intubation and mechanical ventilation, ARDS with a P/F ratio of at least 200mmHg or less and a minimum PEEP 5cmH2O, BMI less 30 kg/ m2. The following exclusion criteria: no written consent, chronic respiratory disease, acute or chronic cardiovascular disease, pregnancy or need for special therapy (prone position and/or Extracorporeal membrane oxygenation). Intervention and comparator: After randomisation, the group A patients will be ventilated with the test-device for 48 hours. The settings will be started with the pre-existing-PEEP. The upper pressure will be determined to achieve a tidal volume of 6 ml/kg lean body mass, while the respiratory rate will be set to maintain an arterial pH above 7.2. In group B, the ventilator settings will be adjusted by the attending ICU team in accordance with lung-protective ventilation strategy. All other treatment will be unchanged and according to our local policies/guidelines. Main outcomes: The primary end point is PaO2. As this is a dynamic parameter, we will record it every 6-8 hours and analyse it sequentially. Randomisation: The study team screens the ventilated patients who fulfil the inclusion criteria and randomise using a 1:1 allocation ratio after consenting using a closed envelope method. The latter were prepared and sealed in advance by an independent person. Blinding (masking): Due to the technical nature of the study (use of a specific ventilator) blinding is only possible for the data-analysts and the patients. Numbers to be randomised (sample size): The sample size calculation based on the assumption of an effect size (change in PaO2) of 1.5 SDS in the primary endpoint (PaO2), an intended power of 80%, an alpha error of 5% and an equal sample ratio results in n=7 patients needed to treat. However, to compensate for dropouts we will include 10 patients in each group, which means in total 20 patients. Trial status: The local registration number is MRC-05-018 with the protocol version number 3. The date of approval is 14 Trial registration: The protocol was registered before starting subject recruitment under the title: "Flow controlled ventilation in ARDS associated with COVID-19" in ClinicalTrials.org with the registration number: NCT04399317 . Registered on 22 May 2020. Full protocol: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.
MeSH term(s)	Betacoronavirus/pathogenicity ; COVID-19 ; Coronavirus Infections/diagnosis ; Coronavirus Infections/physiopathology ; Coronavirus Infections/therapy ; Coronavirus Infections/virology ; Feasibility Studies ; Host-Pathogen Interactions ; Humans ; Lung/physiopathology ; Lung/virology ; Pandemics ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/physiopathology ; Pneumonia, Viral/therapy ; Pneumonia, Viral/virology ; Prospective Studies ; Qatar ; Randomized Controlled Trials as Topic ; Respiration, Artificial/adverse effects ; Respiratory Distress Syndrome/diagnosis ; Respiratory Distress Syndrome/physiopathology ; Respiratory Distress Syndrome/therapy ; Respiratory Distress Syndrome/virology ; SARS-CoV-2 ; Time Factors ; Treatment Outcome
Keywords	covid19
Language	English
Publishing date	2020-09-11
Publishing country	England
Document type	Clinical Trial Protocol ; Letter
ZDB-ID	2040523-6
ISSN	1745-6215 ; 1468-6694 ; 1745-6215
ISSN (online)	1745-6215
ISSN	1468-6694 ; 1745-6215
DOI	10.1186/s13063-020-04708-1
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Flow controlled ventilation in Acute Respiratory Distress Syndrome associated with COVID-19

Stefan Roehrig / Ali Ait Hssain / Nabil Al Hamid Shallik / Ingi Mohamed A. Elsaid / Salma Faisal Mustafa / Osama A. M. Smain / Ashraf Abdulla Molokhia / Marcus D. Lance

Trials, Vol 21, Iss 1, Pp 1-

A structured summary of a study protocol for a randomised controlled trial

2020 Volume 2

Abstract: Abstract Objectives This study aims to demonstrate the positive effects on oxygenation of flow-controlled ventilation compared to conventionally ventilated patients in patients suffering from Acute respiratory distress syndrome (ARDS) associated with ... ...

Abstract	Abstract Objectives This study aims to demonstrate the positive effects on oxygenation of flow-controlled ventilation compared to conventionally ventilated patients in patients suffering from Acute respiratory distress syndrome (ARDS) associated with COVID-19.We define ARDS according to the “Berlin” definition integrating the oxygenation index (P/F ratio), the level of Positive End Expiratory Pressure (PEEP), radiological and clinical findings. Trial design This is a prospective, randomized (1:1 ratio), parallel group feasibility study in adult patients with proven COVID-19 associated ARDS. Participants All adult patients admitted to the ICU of Hamad Medical Corporation facilities in Qatar because of COVID-19 infection who develop moderate to severe ARDS are eligible. The inclusion criteria are above 18 years of age, proven COVID-19 infection, respiratory failure necessitating intubation and mechanical ventilation, ARDS with a P/F ratio of at least 200mmHg or less and a minimum PEEP 5cmH2O, BMI less 30 kg/ m2. The following exclusion criteria: no written consent, chronic respiratory disease, acute or chronic cardiovascular disease, pregnancy or need for special therapy (prone position and/or Extracorporeal membrane oxygenation). Intervention and comparator After randomisation, the group A patients will be ventilated with the test-device for 48 hours. The settings will be started with the pre-existing-PEEP. The upper pressure will be determined to achieve a tidal volume of 6 ml/kg lean body mass, while the respiratory rate will be set to maintain an arterial pH above 7.2. In group B, the ventilator settings will be adjusted by the attending ICU team in accordance with lung-protective ventilation strategy. All other treatment will be unchanged and according to our local policies/guidelines. Main outcomes The primary end point is PaO2. As this is a dynamic parameter, we will record it every 6-8 hours and analyse it sequentially. Randomisation The study team screens the ventilated patients who fulfil the inclusion ...
Keywords	COVID-19 ; randomised controlled trial ; protocol ; ARDS ; Flow Controlled Ventilation ; Mechanical ventilation ; Medicine (General) ; R5-920 ; covid19
Subject code	610
Language	English
Publishing date	2020-09-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Flow controlled ventilation in Acute Respiratory Distress Syndrome associated with COVID-19

Roehrig, Stefan / Ait Hssain, Ali / Shallik, Nabil Al Hamid / Elsaid, Ingi Mohamed A. / Mustafa, Salma Faisal / Smain, Osama A. M. / Molokhia, Ashraf Abdulla / Lance, Marcus D.

Trials

A structured summary of a study protocol for a randomised controlled trial

2020 Volume 21, Issue 1

Abstract	Abstract Objectives This study aims to demonstrate the positive effects on oxygenation of flow-controlled ventilation compared to conventionally ventilated patients in patients suffering from Acute respiratory distress syndrome (ARDS) associated with COVID-19.We define ARDS according to the “Berlin” definition integrating the oxygenation index (P/F ratio), the level of Positive End Expiratory Pressure (PEEP), radiological and clinical findings. Trial design This is a prospective, randomized (1:1 ratio), parallel group feasibility study in adult patients with proven COVID-19 associated ARDS. Participants All adult patients admitted to the ICU of Hamad Medical Corporation facilities in Qatar because of COVID-19 infection who develop moderate to severe ARDS are eligible. The inclusion criteria are above 18 years of age, proven COVID-19 infection, respiratory failure necessitating intubation and mechanical ventilation, ARDS with a P/F ratio of at least 200mmHg or less and a minimum PEEP 5cmH2O, BMI less 30 kg/ m2. The following exclusion criteria: no written consent, chronic respiratory disease, acute or chronic cardiovascular disease, pregnancy or need for special therapy (prone position and/or Extracorporeal membrane oxygenation). Intervention and comparator After randomisation, the group A patients will be ventilated with the test-device for 48 hours. The settings will be started with the pre-existing-PEEP. The upper pressure will be determined to achieve a tidal volume of 6 ml/kg lean body mass, while the respiratory rate will be set to maintain an arterial pH above 7.2. In group B, the ventilator settings will be adjusted by the attending ICU team in accordance with lung-protective ventilation strategy. All other treatment will be unchanged and according to our local policies/guidelines. Main outcomes The primary end point is PaO2. As this is a dynamic parameter, we will record it every 6-8 hours and analyse it sequentially. Randomisation The study team screens the ventilated patients who fulfil the inclusion criteria and randomise using a 1:1 allocation ratio after consenting using a closed envelope method. The latter were prepared and sealed in advance by an independent person. Blinding (masking) Due to the technical nature of the study (use of a specific ventilator) blinding is only possible for the data-analysts and the patients. Numbers to be randomised (sample size) The sample size calculation based on the assumption of an effect size (change in PaO2) of 1.5 SDS in the primary endpoint (PaO2), an intended power of 80%, an alpha error of 5% and an equal sample ratio results in n=7 patients needed to treat. However, to compensate for dropouts we will include 10 patients in each group, which means in total 20 patients. Trial Status The local registration number is MRC-05-018 with the protocol version number 3. The date of approval is 14 th April 2020. Recruitment began 28th May 2020 and is expected to end in September 2020. Trial registration The protocol was registered before starting subject recruitment under the title: “Flow controlled ventilation in ARDS associated with COVID-19” in ClinicalTrials.org with the registration number: NCT04399317 . Registered on 22 May 2020. Full protocol The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.
Keywords	Medicine (miscellaneous) ; Pharmacology (medical) ; covid19
Language	English
Publisher	Springer Science and Business Media LLC
Publishing country	us
Document type	Article ; Online
ZDB-ID	2040523-6
ISSN	1468-6694 ; 1745-6215 ; 1468-6708
ISSN (online)	1468-6694 ; 1745-6215
ISSN	1468-6708
DOI	10.1186/s13063-020-04708-1
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Flow controlled ventilation in Acute Respiratory Distress Syndrome associated with COVID-19: A structured summary of a study protocol for a randomised controlled trial

Roehrig, Stefan / Ait Hssain, Ali / Shallik, Nabil Al Hamid / Elsaid, Ingi Mohamed A / Mustafa, Salma Faisal / Smain, Osama A M / Molokhia, Ashraf Abdulla / Lance, Marcus D

Trials

Abstract: OBJECTIVES: This study aims to demonstrate the positive effects on oxygenation of flow-controlled ventilation compared to conventionally ventilated patients in patients suffering from Acute respiratory distress syndrome (ARDS) associated with COVID-19.We ...

Abstract	OBJECTIVES: This study aims to demonstrate the positive effects on oxygenation of flow-controlled ventilation compared to conventionally ventilated patients in patients suffering from Acute respiratory distress syndrome (ARDS) associated with COVID-19.We define ARDS according to the "Berlin" definition integrating the oxygenation index (P/F ratio), the level of Positive End Expiratory Pressure (PEEP), radiological and clinical findings. TRIAL DESIGN: This is a prospective, randomized (1:1 ratio), parallel group feasibility study in adult patients with proven COVID-19 associated ARDS. PARTICIPANTS: All adult patients admitted to the ICU of Hamad Medical Corporation facilities in Qatar because of COVID-19 infection who develop moderate to severe ARDS are eligible. The inclusion criteria are above 18 years of age, proven COVID-19 infection, respiratory failure necessitating intubation and mechanical ventilation, ARDS with a P/F ratio of at least 200mmHg or less and a minimum PEEP 5cmH2O, BMI less 30 kg/ m2. The following exclusion criteria: no written consent, chronic respiratory disease, acute or chronic cardiovascular disease, pregnancy or need for special therapy (prone position and/or Extracorporeal membrane oxygenation). INTERVENTION AND COMPARATOR: After randomisation, the group A patients will be ventilated with the test-device for 48 hours. The settings will be started with the pre-existing-PEEP. The upper pressure will be determined to achieve a tidal volume of 6 ml/kg lean body mass, while the respiratory rate will be set to maintain an arterial pH above 7.2. In group B, the ventilator settings will be adjusted by the attending ICU team in accordance with lung-protective ventilation strategy. All other treatment will be unchanged and according to our local policies/guidelines. MAIN OUTCOMES: The primary end point is PaO2. As this is a dynamic parameter, we will record it every 6-8 hours and analyse it sequentially. RANDOMISATION: The study team screens the ventilated patients who fulfil the inclusion criteria and randomise using a 1:1 allocation ratio after consenting using a closed envelope method. The latter were prepared and sealed in advance by an independent person. BLINDING (MASKING): Due to the technical nature of the study (use of a specific ventilator) blinding is only possible for the data-analysts and the patients. NUMBERS TO BE RANDOMISED (SAMPLE SIZE): The sample size calculation based on the assumption of an effect size (change in PaO2) of 1.5 SDS in the primary endpoint (PaO2), an intended power of 80%, an alpha error of 5% and an equal sample ratio results in n=7 patients needed to treat. However, to compensate for dropouts we will include 10 patients in each group, which means in total 20 patients. TRIAL STATUS: The local registration number is MRC-05-018 with the protocol version number 3. The date of approval is 14th April 2020. Recruitment began 28th May 2020 and is expected to end in September 2020. TRIAL REGISTRATION: The protocol was registered before starting subject recruitment under the title: "Flow controlled ventilation in ARDS associated with COVID-19" in ClinicalTrials.org with the registration number: NCT04399317 . Registered on 22 May 2020. FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #751154
Database	COVID19

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Article ; Online: AVPR1A and SLC6A4 polymorphisms in choral singers and non-musicians: a gene association study.

Morley, Andrew P / Narayanan, Madan / Mines, Rebecca / Molokhia, Ashraf / Baxter, Sebastian / Craig, Gavin / Lewis, Cathryn M / Craig, Ian

PloS one

2012 Volume 7, Issue 2, Page(s) e31763

Abstract: Amateur choral singing is a common pastime and worthy of study, possibly conferring benefits to health and social behaviour. Participants might be expected to possess musical ability and share some behavioural characteristics. Polymorphisms in genes ... ...

Abstract	Amateur choral singing is a common pastime and worthy of study, possibly conferring benefits to health and social behaviour. Participants might be expected to possess musical ability and share some behavioural characteristics. Polymorphisms in genes concerned with serotonergic neurotransmission are associated with both behaviour and musical aptitude. Those investigated previously include the variable number tandem repeats RS1, RS3 and AVR in the AVPR1A (arginine vasopressin receptor 1a) gene and STin2 in the SLC6A4 (solute carrier family 6 [neurotransmitter transporter, serotonin], member 4) gene, as well as the SLC6A4 promoter region polymorphism, 5-HTTLPR. We conducted a genetic association study on 523 participants to establish whether alleles at these polymorphisms occur more commonly in choral singers than in those not regularly participating in organised musical activity (non-musicians). We also analysed tagging single nucleotide polymorphisms (SNPs) for AVPR1A and SLC6A4 to determine whether other variants in these genes were associated with singer/non-musician status. At the STin2 polymorphism, overall association with singer/non-musician status was evident at P = 0.006. The 9-repeat (P = 0.04) and 12-repeat (P = 0.04) alleles were more common in singers and the 10-repeat allele less so (P = 0.009). Odds ratios were 0.73 (95% CI 0.57-0.94) for the 10-repeat allele and 2.47 (95% CI 0.88-6.94) for the rarer 9-repeat allele. No overall association was detected at P<0.05 between any other polymorphism and singer/non-musician status. Our null findings with respect to RS3, RS1 and AVR, polymorphisms associated with musical ability by other authors, suggest that choir membership may depend partly on factors other than musical ability. In a related musical project involving one participating choir, a new 40-part unaccompanied choral work, "Allele", was composed and broadcast on national radio. In the piece, each singer's part incorporated their personal RS3 genotype.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Alleles ; Female ; Genotype ; Haplotypes ; Homozygote ; Humans ; Male ; Middle Aged ; Minisatellite Repeats ; Models, Genetic ; Music ; Odds Ratio ; Phenotype ; Polymorphism, Genetic ; Receptors, Vasopressin/genetics ; Serotonin Plasma Membrane Transport Proteins/genetics
Chemical Substances	Receptors, Vasopressin ; SLC6A4 protein, human ; Serotonin Plasma Membrane Transport Proteins
Language	English
Publishing date	2012-02-22
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0031763
Database	MEDical Literature Analysis and Retrieval System OnLINE

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