LIVIVO - Search results -

Search results

Result 1 - 10 of total 715

Search options

Article ; Online: Obesity and atopy.

Boulet, L-P

Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology

2015 Volume 45, Issue 1, Page(s) 75–86

Abstract: The prevalence of obesity has increased worldwide, and weight gain has been shown to influence the development and clinical expression of various conditions including asthma. The relationships between atopy and obesity remain uncertain, both in adults ... ...

Abstract	The prevalence of obesity has increased worldwide, and weight gain has been shown to influence the development and clinical expression of various conditions including asthma. The relationships between atopy and obesity remain uncertain, both in adults and in children. Although there are physiopathologic mechanisms which could explain how obesity could influence the immune system and promote the process of sensitization, evidences in favour of a possible role of obesity on the development of atopy have been inconsistent. Furthermore, the bulk of evidence suggests that atopy does not mediate the relationship between obesity and asthma, although in some populations, particularly in children and women, such association has been reported. Such lack of relationship has also been found with rhinoconjunctivitis although it has been observed for atopic dermatitis. Several factors may explain these variable results, including populational or environmental characteristics, socioeconomic status, confounding factors, in addition to sample size, and methodology of the performed studies. The possibility that obesity influences atopy through its effects on sex hormones is suggested by a more frequent link between atopy and obesity in women, particularly postpuberal. Further research should be conducted on the influence of weight gain on atopy and atopic diseases.
MeSH term(s)	Adolescent ; Adult ; Animals ; Asthma/epidemiology ; Asthma/etiology ; Asthma/immunology ; Child ; Child, Preschool ; Conjunctivitis/complications ; Conjunctivitis/epidemiology ; Conjunctivitis/immunology ; Dermatitis, Atopic/epidemiology ; Dermatitis, Atopic/etiology ; Dermatitis, Atopic/immunology ; Female ; Humans ; Male ; Obesity/complications ; Obesity/epidemiology ; Obesity/immunology ; Rhinitis/complications ; Rhinitis/epidemiology ; Rhinitis/immunology ; Sex Characteristics
Language	English
Publishing date	2015-01
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	645204-8
ISSN	1365-2222 ; 0954-7894 ; 0960-2178
ISSN (online)	1365-2222
ISSN	0954-7894 ; 0960-2178
DOI	10.1111/cea.12435
Database	MEDical Literature Analysis and Retrieval System OnLINE

Full text online

Accessible to users with ZB MED library card

In stock of ZB MED Cologne/Königswinter

Zs.A 767: Show issues

Location:
Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
Jg. 1995 - 2021: Lesesall (1.OG)
ab Jg. 2022: Lesesaal (EG)

Order via subito

This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

Details ▾

Article ; Online: Asthma and obesity.

Boulet, L-P

Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology

2013 Volume 43, Issue 1, Page(s) 8–21

Abstract: The prevalence and incidence of asthma have increased among obese children and adults, particularly among women. Obesity seems to be a predisposing factor for the development of asthma, but the underlying mechanisms of its influence are still uncertain. ... ...

Abstract	The prevalence and incidence of asthma have increased among obese children and adults, particularly among women. Obesity seems to be a predisposing factor for the development of asthma, but the underlying mechanisms of its influence are still uncertain. Various hypotheses have been proposed to explain the link between obesity and asthma such as a common genetic predisposition, developmental changes, altered lung mechanics, the presence of a systemic inflammatory process, and an increased prevalence of associated comorbid conditions. Over-diagnosis of asthma does not seem to be more frequent in obese compared to non-obese subjects, but the added effects of obesity on respiratory symptoms can affect asthma control assessment. Obesity can make asthma more difficult to control and is associated with a reduced beneficial effect of asthma medications. This could be due to a change in asthma phenotype, particularly evidenced as a less eosinophilic type of airway inflammation combined to the added effects of changes in lung mechanics. Weight loss is associated with a universal improvement of asthma and should be part of asthma management in the obese patient. Additional research should be conducted to better determine how obesity influences the development and clinical expression of asthma, establish the optimal management of asthma in this population and determine how obesity affects long-term asthma outcomes in these patients.
MeSH term(s)	Asthma/epidemiology ; Asthma/etiology ; Female ; Humans ; Male ; Obesity/complications ; Obesity/epidemiology ; Prevalence
Language	English
Publishing date	2013-01
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	645204-8
ISSN	1365-2222 ; 0954-7894 ; 0960-2178
ISSN (online)	1365-2222
ISSN	0954-7894 ; 0960-2178
DOI	10.1111/j.1365-2222.2012.04040.x
Database	MEDical Literature Analysis and Retrieval System OnLINE

Full text online

Accessible to users with ZB MED library card

In stock of ZB MED Cologne/Königswinter

Zs.A 767: Show issues

Location:
Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
Jg. 1995 - 2021: Lesesall (1.OG)
ab Jg. 2022: Lesesaal (EG)

Order via subito

Details ▾

Article: Molecular mapping of neuronal architecture using STORM microscopy and new fluorescent probes for SMLM imaging.

Breton, Victor / Nazac, Paul / Boulet, David / Danglot, Lydia

Neurophotonics

2024 Volume 11, Issue 1, Page(s) 14414

Abstract: Imaging neuronal architecture has been a recurrent challenge over the years, and the localization of synaptic proteins is a frequent challenge in neuroscience. To quantitatively detect and analyze the structure of synapses, we recently developed free ... ...

Abstract	Imaging neuronal architecture has been a recurrent challenge over the years, and the localization of synaptic proteins is a frequent challenge in neuroscience. To quantitatively detect and analyze the structure of synapses, we recently developed free SODA software to detect the association of pre and postsynaptic proteins. To fully take advantage of spatial distribution analysis in complex cells, such as neurons, we also selected some new dyes for plasma membrane labeling. Using Icy SODA plugin, we could detect and analyze synaptic association in both conventional and single molecule localization microscopy, giving access to a molecular map at the nanoscale level. To replace those molecular distributions within the neuronal three-dimensional (3D) shape, we used MemBright probes and 3D STORM analysis to decipher the entire 3D shape of various dendritic spine types at the single-molecule resolution level. We report here the example of synaptic proteins within neuronal mask, but these tools have a broader spectrum of interest since they can be used whatever the proteins or the cellular type. Altogether with SODA plugin, MemBright probes thus provide the perfect toolkit to decipher a nanometric molecular map of proteins within a 3D cellular context.
Language	English
Publishing date	2024-03-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	2781943-7
ISSN	2329-4248 ; 2329-423X
ISSN (online)	2329-4248
ISSN	2329-423X
DOI	10.1117/1.NPh.11.1.014414
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article ; Online: Influence of comorbid conditions on asthma.

Boulet, L-P

The European respiratory journal

2009 Volume 33, Issue 4, Page(s) 897–906

Abstract: Various conditions such as rhinosinusitis, gastro-oesophageal reflux disease, psychological disturbances, chronic infections and obstructive sleep apnoea are often observed in asthmatic patients and may affect asthma control and outcomes. These ... ...

Abstract	Various conditions such as rhinosinusitis, gastro-oesophageal reflux disease, psychological disturbances, chronic infections and obstructive sleep apnoea are often observed in asthmatic patients and may affect asthma control and outcomes. These comorbidities may change the asthma phenotype, be part of the same pathophysiological process, act as confounding factors in the diagnosis or assessment of control of asthma, and/or result from specific environmental exposures. The influences of these conditions on asthma are variable and for many of them still uncertain; nevertheless, they may alter asthma responses to current therapy. A systematic evaluation and an appropriate treatment of asthma-associated comorbid conditions should be part of asthma management, particularly for severe disease. With regard to clinical research, associated conditions may influence the results of trials and should be taken into account in the subjects' inclusion criteria and analysis of data.
MeSH term(s)	Asthma/physiopathology ; Asthma/prevention & control ; Causality ; Clinical Trials as Topic ; Comorbidity ; Humans ; Phenotype ; Risk Factors ; Severity of Illness Index
Language	English
Publishing date	2009-04
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	639359-7
ISSN	1399-3003 ; 0903-1936
ISSN (online)	1399-3003
ISSN	0903-1936
DOI	10.1183/09031936.00121308
Database	MEDical Literature Analysis and Retrieval System OnLINE

In stock of ZB MED Cologne/Königswinter

Zs.A 2322: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 292: Show issues

Order via subito

Details ▾
- See ZB MED holdings
- Order with fees

Article ; Online: Asymptomatic airway hyperresponsiveness: what does it mean?

Boulet, L-P

The European respiratory journal

2008 Volume 32, Issue 4, Page(s) 1118–1119

MeSH term(s)	Adolescent ; Asthma/etiology ; Bronchial Hyperreactivity/complications ; Bronchial Hyperreactivity/diagnosis ; Bronchial Provocation Tests ; Health Surveys ; Humans ; Hypersensitivity/etiology ; Inflammation ; Spirometry
Language	English
Publishing date	2008-10
Publishing country	England
Document type	Comment ; Letter
ZDB-ID	639359-7
ISSN	1399-3003 ; 0903-1936
ISSN (online)	1399-3003
ISSN	0903-1936
DOI	10.1183/09031936.00109308
Database	MEDical Literature Analysis and Retrieval System OnLINE

In stock of ZB MED Cologne/Königswinter

Zs.A 2322: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 292: Show issues

Order via subito

Details ▾
- See ZB MED holdings
- Order with fees

Article ; Online: L'asthme de la personne âgée.

Robitaille, C / Boulet, L-P

Revue des maladies respiratoires

2014 Volume 31, Issue 6, Page(s) 478–487

Abstract: Asthma is a common condition in the elderly although often confounded with chronic obstructive pulmonary disease (COPD) in this population. Asthma in the elderly seems to represent a specific phenotype characterized by more severe, but often less ... ...

Title translation	Asthma in the elderly.
Abstract	Asthma is a common condition in the elderly although often confounded with chronic obstructive pulmonary disease (COPD) in this population. Asthma in the elderly seems to represent a specific phenotype characterized by more severe, but often less perceived, airway obstruction, a neutrophilic or mixed-type of airway inflammation and frequent comorbidities. Patients aged 65 years and over have an increased asthma-related morbidity and mortality compared to younger patients, probably due to difficulties in regard to diagnosis, assessment of the disease severity and treatment. Research is urgently needed to determine the optimal treatment of the aged patient. In this document we will review the state of knowledge on this topic and discuss the challenges of multidisciplinary asthma management in the elderly.
MeSH term(s)	Age Factors ; Age of Onset ; Aged ; Aged, 80 and over ; Aging/physiology ; Asthma/diagnosis ; Asthma/epidemiology ; Asthma/therapy ; Diagnosis, Differential ; Female ; Humans
Language	French
Publishing date	2014-06
Publishing country	France
Document type	Case Reports ; English Abstract ; Journal Article ; Review
ZDB-ID	605743-3
ISSN	1776-2588 ; 0301-0279 ; 0761-8425
ISSN (online)	1776-2588
ISSN	0301-0279 ; 0761-8425
DOI	10.1016/j.rmr.2014.03.001
Database	MEDical Literature Analysis and Retrieval System OnLINE

In stock of ZB MED Cologne/Königswinter

Zs.A 1945: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 94: Show issues

Order via subito

Details ▾
- See ZB MED holdings
- Order with fees

Article ; Online: Improving knowledge transfer on chronic respiratory diseases: a Canadian perspective. How to translate recent advances in respiratory diseases into day-to-day care.

Boulet, L-P

The journal of nutrition, health & aging

2008 Volume 12, Issue 10, Page(s) 758S–763S

Abstract: Background: Chronic diseases represent an increasing burden for health care systems. Ongoing research efforts provide regularly new scientific evidence on how optimize current medical care. In regard to respiratory diseases, as for other health problems, ...

Abstract	Background: Chronic diseases represent an increasing burden for health care systems. Ongoing research efforts provide regularly new scientific evidence on how optimize current medical care. In regard to respiratory diseases, as for other health problems, optimal management of these conditions has been summarized in recent consensus guidelines but implementation of these recommendations is still poor. Not only are the key messages of such guidelines often unknown to the practitioner and the patient but even when it is, they are often insufficiently integrated into current care, often related to behavioral, organizational and communication barriers. Methods: Literature review on the topic of Clinical Practice Guidelines implementation and reference to recent projects aimed at improving management of asthma in the province of Quebec and elsewhere, as models for such implementation process. Results: The basic principles of an effective translation of current knowledge into day-to-day care are known, but healthcare delivery structures, practice tools and resources, and regional/local leadership should be available to make it happen. Ideally, implementation requires a multidisciplinary effort of care providers, specialists, general practitioners, allied health professionals, patients and their family. The general public, health administrators and policy makers should also be aware of the consequences of poor management of these diseases and be supportive of the proposed initiatives. Finally, these last should be adequately evaluated to ensure their effectiveness and determine if they should be improved. Recently projects performed in Quebec have proposed disease management models to identify asthma care gaps and improve translation of current Guidelines into day-to-day care. Conclusions: Although the human and socio-economical burden of chronic diseases is still increasing, their current management is still often deficient. In the recent decades, Practice Guidelines have been developed to guide Practitioners towards optimal care, but implementation of these Guides is still poor. Recent Canadian and International initiatives have proposed valid models to help address current care gaps.
MeSH term(s)	Asthma/therapy ; Canada ; Chronic Disease ; Evidence-Based Medicine ; Humans ; Information Dissemination ; Models, Organizational ; Practice Guidelines as Topic ; Primary Health Care ; Technology Transfer
Language	English
Publishing date	2008-11-26
Publishing country	France
Document type	Journal Article
ZDB-ID	2081921-3
ISSN	1760-4788 ; 1279-7707
ISSN (online)	1760-4788
ISSN	1279-7707
DOI	10.1007/BF03028626
Database	MEDical Literature Analysis and Retrieval System OnLINE

Full text online

Accessible to users with ZB MED library card

In stock of ZB MED Bonn / Germany

Z 7466: Show issues

Order via subito

Inter-library loan at ZB MED

Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

Details ▾

Article ; Online: Inhaled Corticosteroids and Adult Asthma.

Boulet, Louis-Philippe / Nair, Parameswaran

American journal of respiratory and critical care medicine

2019 Volume 200, Issue 12, Page(s) 1556–1557

MeSH term(s)	Adrenal Cortex Hormones ; Adult ; Asthma ; Humans
Chemical Substances	Adrenal Cortex Hormones
Language	English
Publishing date	2019-07-24
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	1180953-x
ISSN	1535-4970 ; 0003-0805 ; 1073-449X
ISSN (online)	1535-4970
ISSN	0003-0805 ; 1073-449X
DOI	10.1164/rccm.201907-1301LE
Database	MEDical Literature Analysis and Retrieval System OnLINE

In stock of ZB MED Cologne/Königswinter

Uh II Zs.80: Show issues

Location:
Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
ab Jg. 2022: Lesesaal (EG)

Order via subito

Details ▾
- See ZB MED holdings
- Order with fees

Article ; Online: Interpretable machine learning to predict adverse perinatal outcomes: examining marginal predictive value of risk factors during pregnancy.

Lee, Sun Ju / Garcia, Gian-Gabriel P / Stanhope, Kaitlyn K / Platner, Marissa H / Boulet, Sheree L

American journal of obstetrics & gynecology MFM

2023 Volume 5, Issue 10, Page(s) 101096

Abstract: ... perinatal outcomes (P<.001, all visits). At visit 1, endoglin was also a valuable predictor (P<.001 ... At visit 2, free beta human chorionic gonadotropin (P=.001) and uterine artery pulsatility index (P=.023 ... were also valuable predictors. At visit 3, cervical length was also a valuable predictor (P<.001 ...

Abstract	Background: The timely identification of nulliparas at high risk of adverse fetal and neonatal outcomes during pregnancy is crucial for initiating clinical interventions to prevent perinatal complications. Although machine learning methods have been applied to predict preterm birth and other pregnancy complications, many models do not provide explanations of their predictions, limiting the clinical use of the model. Objective: This study aimed to develop interpretable prediction models for a composite adverse perinatal outcome (stillbirth, neonatal death, estimated Combined Apgar score of <10, or preterm birth) at different points in time during the pregnancy and to evaluate the marginal predictive value of individual predictors in the context of a machine learning model. Study design: This was a secondary analysis of the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be data, a prospective cohort study in which 10,038 nulliparous pregnant individuals with singleton pregnancies were enrolled. Here, interpretable prediction models were developed using L1-regularized logistic regression for adverse perinatal outcomes using data available at 3 study visits during the pregnancy (visit 1: 6 0/7 to 13 6/7 weeks of gestation; visit 2: 16 0/7 to 21 6/7 weeks of gestation; visit 3: 22 0/7 to 29 6/7 weeks of gestation). We identified the important predictors for each model using SHapley Additive exPlanations, a model-agnostic method of computing explanations of model predictions, and evaluated the marginal predictive value of each predictor using the DeLong test. Results: Our interpretable machine learning model had an area under the receiver operating characteristic curves of 0.617 (95% confidence interval, 0.595-0.639; all predictor variables at visit 1), 0.652 (95% confidence interval, 0.631-0.673; all predictor variables at visit 2), and 0.673 (95% confidence interval, 0.651-0.694; all predictor variables at visit 3). For all visits, the placental biomarker inhibin A was a valuable predictor, as including inhibin A resulted in better performance in predicting adverse perinatal outcomes (P<.001, all visits). At visit 1, endoglin was also a valuable predictor (P<.001). At visit 2, free beta human chorionic gonadotropin (P=.001) and uterine artery pulsatility index (P=.023) were also valuable predictors. At visit 3, cervical length was also a valuable predictor (P<.001). Conclusion: Despite various advances in predictive modeling in obstetrics, the accurate prediction of adverse perinatal outcomes remains difficult. Interpretable machine learning can help clinicians understand how predictions are made, but barriers exist to the widespread clinical adoption of machine learning models for adverse perinatal outcomes. A better understanding of the evolution of risk factors for adverse perinatal outcomes throughout pregnancy is necessary for the development of effective interventions.
MeSH term(s)	Female ; Humans ; Infant, Newborn ; Pregnancy ; Placenta ; Pregnancy Outcome/epidemiology ; Pregnancy Trimester, Third ; Premature Birth/diagnosis ; Premature Birth/epidemiology ; Premature Birth/etiology ; Prospective Studies ; Risk Factors ; Ultrasonography, Prenatal/methods ; Machine Learning
Language	English
Publishing date	2023-07-15
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ISSN	2589-9333
ISSN (online)	2589-9333
DOI	10.1016/j.ajogmf.2023.101096
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Inter-library loan at ZB MED

Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

Article ; Online: Understanding the role of childhood nurture, abuse, and stability on gestational diabetes in the Coronary Artery Risk Development in Young Adults study (CARDIA).

Stanhope, Kaitlyn K / Gunderson, Erica P / Suglia, Shakira F / Boulet, Sheree L / Jamieson, Denise J / Kiefe, Catarina I / Kershaw, Kiarri N

Annals of epidemiology

2024 Volume 91, Page(s) 30–36

Abstract: Background: To estimate associations between facets of the maternal childhood family environment with gestational diabetes (GDM) and to test mediation by pre-pregnancy waist circumference.: Methods: We used data from CARDIA, a cohort of individuals ... ...

Abstract	Background: To estimate associations between facets of the maternal childhood family environment with gestational diabetes (GDM) and to test mediation by pre-pregnancy waist circumference. Methods: We used data from CARDIA, a cohort of individuals aged 18-30 years at baseline (1985-86), followed over 30 years (2016). We included participants with one or more pregnancies ≥ 20 weeks after baseline, without pre-pregnancy diabetes. The primary exposure was the Childhood Family Environment Scale (assessed year 15), including the total score and abuse, nurture, and stability subscales as continuous, separate exposures. The outcome was GDM (self-reported at each visit for each pregnancy). We fit log binomial models with generalized estimating equations to calculate risk ratios (RR) and 95% confidence intervals (CI), adjusting for age at delivery, parity, race (Black or White), and parental education. We used regression models with bootstrapped CIs to test mediation and effect modification by excess abdominal adiposity at the last preconception CARDIA visit (waist circumference ≥ 88 cm). Results: We included 1033 individuals (46% Black) with 1836 pregnancies. 130 pregnancies (7.1%) were complicated by GDM. For each 1 point increase on the abuse subscale (e.g., from "rarely or never" to "some or little of the time") there was a 30% increased risk of GDM (RR: 1.3, 95% CI: 1.0, 1.7). There was evidence of effect modification but not mediation by preconception abdominal adiposity. Conclusions: A more adverse childhood family environment was associated with increased risk of GDM, with a stronger association among individuals with preconception waist circumference ≥ 88 cm.
MeSH term(s)	Pregnancy ; Female ; Young Adult ; Humans ; Child ; Diabetes, Gestational/epidemiology ; Coronary Vessels ; Prediabetic State
Language	English
Publishing date	2024-01-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	1074355-8
ISSN	1873-2585 ; 1047-2797
ISSN (online)	1873-2585
ISSN	1047-2797
DOI	10.1016/j.annepidem.2024.01.007
Database	MEDical Literature Analysis and Retrieval System OnLINE

In stock of ZB MED Cologne/Königswinter

Zs.A 3225: Show issues

Location:
Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
Jg. 1995 - 2021: Lesesall (2.OG)
ab Jg. 2022: Lesesaal (EG)

Order via subito

Details ▾
- See ZB MED holdings
- Order with fees

To top

Full text online

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

Full text online

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

More links

Kategorien

Order via subito

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

Full text online

More links

Kategorien

In stock of ZB MED Bonn / Germany

Order via subito

Inter-library loan at ZB MED

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

More links

Kategorien

Order via subito

Inter-library loan at ZB MED

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito