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  1. Article ; Online: Safety and effectiveness of bDMARDs during pregnancy in patients with rheumatic diseases: Real-world data from the BIOBADASER registry.

    Membrive-Jiménez, Cristina / Sánchez-Piedra, Carlos / Martínez-González, Olga / García-González, Javier / Expósito-Pérez, Lorena / Bohórquez-Heras, Cristina / Campos-Fernández, Cristina / Sanchez-Alonso, Fernando / Cáliz-Cáliz, Rafael / Castrejón-Fernández, Isabel

    Reumatologia clinica

    2023  Volume 19, Issue 9, Page(s) 500–506

    Abstract: Introduction: Inflammatory rheumatic diseases usually affect women of childbearing age treated with biologic drugs. However, there is a lack of literature on the efficacy and toxicity of biologic disease-modifying drugs during pregnancy. The aim of this ...

    Abstract Introduction: Inflammatory rheumatic diseases usually affect women of childbearing age treated with biologic drugs. However, there is a lack of literature on the efficacy and toxicity of biologic disease-modifying drugs during pregnancy. The aim of this study was to determine the presence of pregnant patients treated with bDMARDs in a real-world dataset and to examine the impact of pregnancy and lactation on the evolution of rheumatic disease in a registry of Spanish patients.
    Method: This was a multicentre prospective study with a real-world setting. Information was obtained from BIOBADASER registry. Patients included are women who got pregnant until November 2020 from 19 rheumatology units. We conducted proportions, means, and standard deviations (SD) to describe the study population and the use of treatments. T-test and Chi-square test were applied to assess differences between groups.
    Result: Ninety cases of pregnancy were registered (n=68 full-term pregnancies; n=22 spontaneous miscarriages). Most of the cases discontinued bDMARDs during pregnancy (78.9%) but 13 cases continued treatment during pregnancy, mainly using certolizumab pegol. These cases were obtaining better management of rheumatic disease, although the differences were not statistically significant [DAS28-CRP, 2.9 (SD: 1.6) vs. 2.0 (1.2), p=.255; DAS28-ESR, 2.2 (1.0) vs. 1.7 (.5), p=.266]. No serious adverse events were reported during pregnancy and lactation.
    Conclusion: Being pregnant is still an uncommon condition in patients with rheumatic diseases and using bDMARDs. Our results show that rheumatic disease tended to progress better during pregnancy in patients who continued to take bDMARDs.
    MeSH term(s) Pregnancy ; Humans ; Female ; Male ; Prospective Studies ; Rheumatic Diseases/drug therapy ; Registries ; Rheumatology ; Biological Products
    Chemical Substances Biological Products
    Language English
    Publishing date 2023-11-07
    Publishing country Spain
    Document type Journal Article
    ISSN 2173-5743
    ISSN (online) 2173-5743
    DOI 10.1016/j.reumae.2023.02.005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Multidisciplinary Unit Improves Pregnancy Outcomes in Women with Rheumatic Diseases and Hereditary Thrombophilias: An Observational Study.

    Añón-Oñate, Isabel / Cáliz-Cáliz, Rafael / Rosa-Garrido, Carmen / Pérez-Galán, María José / Quirosa-Flores, Susana / Pancorbo-Hidalgo, Pedro L

    Journal of clinical medicine

    2021  Volume 10, Issue 7

    Abstract: Rheumatic diseases (RD) and hereditary thrombophilias (HT) can be associated with high-risk pregnancies. This study describes obstetric outcomes after receiving medical care at a multidisciplinary consultation (MC) and compares adverse neonatal outcomes ( ...

    Abstract Rheumatic diseases (RD) and hereditary thrombophilias (HT) can be associated with high-risk pregnancies. This study describes obstetric outcomes after receiving medical care at a multidisciplinary consultation (MC) and compares adverse neonatal outcomes (ANOs) before and after medical care at an MC. This study is a retrospective observational study among pregnant women with RD and HT treated at an MC of a university hospital (southern Spain) from 2012 to 2018. Absolute risk reduction (ARR) and number needed to treat (NNT) were calculated. A total of 198 pregnancies were registered in 143 women (112 with RD, 31 with HT), with 191 (96.5%) pregnancies without ANOs and seven (3.5%) pregnancies with some ANOs (five miscarriages and two foetal deaths). Results previous to the MC showed 60.8% of women had more than one miscarriage, with 4.2% experiencing foetal death. MC reduced the ANO rate by AAR = 60.1% (95%CI: 51.6-68.7%). The NNT to avoid one miscarriage was 1.74 (95%CI: 1.5-2.1) and to avoid one foetal death NNT = 35.75 (95CI%: 15.2-90.9). A total of 84.8% of newborns and 93.2% of women did not experience any complication. As a conclusion, the follow-up of RD or HT pregnant women in the MC drastically reduced the risk of ANOs in this population with a previous high risk.
    Language English
    Publishing date 2021-04-03
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm10071487
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  3. Article ; Online: Sclerostin as a biomarker of cardiovascular risk in women with systemic lupus erythematosus.

    Garcia-de Los Ríos, Carlos / Medina-Casado, Marta / Díaz-Chamorro, Antonio / Sierras-Jiménez, María / Lardelli-Claret, Pablo / Cáliz-Cáliz, Rafael / Sabio, José Mario

    Scientific reports

    2022  Volume 12, Issue 1, Page(s) 21621

    Abstract: Cardiovascular disease is one of the main causes of death in patients with systemic lupus erythematosus (SLE). On the other hand, sclerostin is a reliable and early biomarker of vascular calcification. This study aimed to estimate the association between ...

    Abstract Cardiovascular disease is one of the main causes of death in patients with systemic lupus erythematosus (SLE). On the other hand, sclerostin is a reliable and early biomarker of vascular calcification. This study aimed to estimate the association between sclerostin and two markers of cardiovascular risk, carotid atherosclerotic plaque (CP) and carotid-femoral pulse wave velocity (PWV), in women with SLE. The presence of CP (determined by carotid artery ultrasound) and PWV were measured in 68 women with SLE and preserved renal function. None of the participants had a history of cardiovascular disease. Serum levels of sclerostin were determined using the ELISA method. Other factors associated with increased cardiovascular risk were also measured. The association between sclerostin, CP and PWV was assessed using Receiver Operating Characteristic (ROC) curves and multivariate regression models. The area under the ROC curve was 0.785 (95% confidence interval [CI] 0.662-0.871) for CP and 0.834 (95% CI 0.729-0.916) for dichotomized PWV. After adjusting for other cardiovascular risk factors, it was found that a 10-units increase in sclerostin values was associated with a 44% increase in the odds of CP (95% CI 1-105), but no adjusted association was observed between sclerostin and PWV. Predictive models included age (for both outcomes), hypertension, Framingham risk score and C-reactive protein (for PWV), but not sclerostin. Sclerostin is associated with the presence of CP in women with SLE. Further research should confirm its possible role as a biomarker of cardiovascular risk in these patients.
    MeSH term(s) Humans ; Female ; Cardiovascular Diseases/etiology ; Cardiovascular Diseases/complications ; Pulse Wave Analysis ; Risk Factors ; Cross-Sectional Studies ; Lupus Erythematosus, Systemic/complications ; Biomarkers ; Heart Disease Risk Factors
    Chemical Substances Biomarkers
    Language English
    Publishing date 2022-12-14
    Publishing country England
    Document type Journal Article
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-022-25651-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: High-sensitivity cardiac troponin I is a biomarker for increased arterial stiffness in systemic lupus erythematous women with normal kidney function.

    Sabio, J M / Garcia-de Los Ríos, Carlos / Medina-Casado, Marta / Del Mar Del Águila-García, María / Cáliz-Cáliz, Rafael / Díaz-Chamorro, Antonio

    Rheumatology international

    2022  Volume 43, Issue 2, Page(s) 253–263

    Abstract: Cardiovascular disease (CVD) is a main cause of death in patients with systemic lupus erythematous (SLE). Algorithms for cardiovascular risk stratification in general population underestimate the risk for CVD in SLE. Our study aimed to determine whether ... ...

    Abstract Cardiovascular disease (CVD) is a main cause of death in patients with systemic lupus erythematous (SLE). Algorithms for cardiovascular risk stratification in general population underestimate the risk for CVD in SLE. Our study aimed to determine whether serum high-sensitivity cardiac troponin I (hs-cTnI) might help to identify SLE patients with subclinical atherosclerosis. Arterial stiffness was assessed measuring the carotid-femoral pulse wave velocity (PWV) in 68 SLE women with a normal or almost normal kidney function and in 71 controls of similar characteristics. None of the participants had a history of an overt CVD. Serum hs-cTnI level was measured using the chemiluminescence method. Factors associated with an increased PWV (iPWV) were identified and multivariate analysis was performed. When detectable, patients tended to have had higher hs-cTnI levels than controls [2.9 (2.3-4.0) vs 2.4 (2.2-4.1); p = 0.098] and were more likely to have detectable hs-cTnI [50% vs 28%, odds ratio (OR) 7.0; 95% confidence interval (CI) 0.008-0.013]. Also, patients with iPWV were more likely to have detectable hs-cTnI than those with normal PWV (OR 6.4; 95% CI 0.019-0.026). In the multivariate analysis, the age at SLE diagnosis (OR 1.24; 95% CI 1.04-1.48), systolic blood pressure (OR 1.28; 95% CI 1.10-1.48) and detectable hs-cTnI level (OR 2.04; 95% CI 1.18-3.50) were independently associated with an iPWV. The negative predictive value of having an iPWV with undetectable hs-cTnI levels was 88%. Hs-cTnI may be a useful biomarker for the identification of SLE patients with iPWV as a surrogated marker of subclinical atherosclerosis. Specifically targeted prospective studies are needed to confirm this hypothesis.
    MeSH term(s) Humans ; Female ; Troponin I ; Lupus Erythematosus, Systemic/complications ; Lupus Erythematosus, Systemic/diagnosis ; Vascular Stiffness/physiology ; Pulse Wave Analysis ; Biomarkers ; Atherosclerosis/diagnosis ; Atherosclerosis/complications ; Cardiovascular Diseases/etiology ; Kidney
    Chemical Substances Troponin I ; Biomarkers
    Language English
    Publishing date 2022-09-12
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 8286-7
    ISSN 1437-160X ; 0172-8172
    ISSN (online) 1437-160X
    ISSN 0172-8172
    DOI 10.1007/s00296-022-05204-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Madelung's deformity.

    Añón Oñate, Isabel / Pérez Albaladejo, Lorena / Ferrer González, Miguel Ángel / Cáliz Cáliz, Rafael

    Reumatologia clinica

    2018  Volume 15, Issue 6, Page(s) e161–e162

    Title translation Deformidad de Madelung.
    MeSH term(s) Adult ; Diagnosis, Differential ; Female ; Growth Disorders/diagnosis ; Growth Disorders/diagnostic imaging ; Growth Disorders/therapy ; Hand/diagnostic imaging ; Humans ; Osteochondrodysplasias/diagnosis ; Osteochondrodysplasias/diagnostic imaging ; Osteochondrodysplasias/therapy ; Radiography
    Language Spanish
    Publishing date 2018-01-19
    Publishing country Spain
    Document type Case Reports ; Letter
    ISSN 2173-5743
    ISSN (online) 2173-5743
    DOI 10.1016/j.reuma.2017.12.005
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  6. Article: Tocilizumab in COVID-19: Factors Associated With Mortality Before and After Treatment.

    Sarabia De Ardanaz, Luis / Andreu-Ubero, Jose M / Navidad-Fuentes, Miriam / Ferrer-González, Miguel Ángel / Ruíz Del Valle, Victor / Salcedo-Bellido, Inmaculada / Barrios-Rodríguez, Rocío / Cáliz-Cáliz, Rafael / Requena, Pilar

    Frontiers in pharmacology

    2021  Volume 12, Page(s) 620187

    Abstract: Tocilizumab (TCZ) has been administered in SARS-CoV-2 pneumonia but the factors associated with mortality before and after treatment remain unclear. Cox regression models were used to estimate the predictors of time to death in a cohort of hospitalized ... ...

    Abstract Tocilizumab (TCZ) has been administered in SARS-CoV-2 pneumonia but the factors associated with mortality before and after treatment remain unclear. Cox regression models were used to estimate the predictors of time to death in a cohort of hospitalized patients with COVID-19 receiving TCZ. In addition, the mean differences between discharged and deceased patients in laboratory parameters measured before and 3, 6 and 9 days after TCZ administration were estimated with weighted generalized estimation equations. The variables associated with time to death were immunosuppression (Hazard Ratio-HR 3.15; 95% confidence interval-CI 1.17, 8.51), diabetes mellitus (HR 2.63; 95% CI 1.23-5.64), age (HR 1.05; 95% CI 1.02-1.09), days since diagnosis until TCZ administration (HR 1.05, 95% CI 1.00-1.09), and platelets (HR 0.27; 95% CI: 0.11, 0.69). In the post-TCZ analysis and compared to discharged patients, deceased patients had more lactate dehydrogenase (
    Language English
    Publishing date 2021-07-01
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2587355-6
    ISSN 1663-9812
    ISSN 1663-9812
    DOI 10.3389/fphar.2021.620187
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  7. Article ; Online: Symmetry Criterion for Patients with Rheumatoid Arthritis of the Foot: A Cross-Sectional Study.

    Sanchez-Castillo, Jose Alberto / Reinoso-Cobo, Andres / Gijon-Nogueron, Gabriel / Caliz-Caliz, Rafael / Exposito-Ruiz, Manuela / Ramos-Petersen, Laura / Ortega-Avila, Ana Belen

    International journal of environmental research and public health

    2021  Volume 18, Issue 7

    Abstract: Objective: The aim of the study was to analyze the feet of rheumatoid arthritis (RA) patients, to determine the degree to which both feet were affected, primarily analyzing the severity of RA in both feet looking at structure and morphology, and ... ...

    Abstract Objective: The aim of the study was to analyze the feet of rheumatoid arthritis (RA) patients, to determine the degree to which both feet were affected, primarily analyzing the severity of RA in both feet looking at structure and morphology, and secondly looking at the symmetry in terms of the anthropometrics and posture.
    Method: This cross-sectional study was conducted from January to December 2018. The data from 229 patients with RA and with foot pain and no RA recruited (Granada, Spain) were analyzed. Two researchers independently interviewed the patients to obtain the study data. The clinical data were obtained using specific foot health and quality of life questionnaires and a validated platform for foot measurement. Anthropometric measurements were obtained by means of a foot measurement platform and the Foot Posture Index (FPI). The bivariate analysis was performed with the Student's
    Results: In the RA group, anthropometric measurements revealed significant differences between the left and right feet in 13 of the 23 parameters considered, as follows: (non-load-bearing) foot length, length of the first metatarsophalangeal joint, maximum height of the internal longitudinal arch, and width of the midfoot (
    Conclusions: In patients with RA, statistically significant differences were found in the Foot Posture Index and in several parameters related to foot structure and morphology. From this, we conclude that from a morphological, structural, and postural standpoint, a pattern of symmetric joint involvement should not be viewed as a specific criterion for RA in the foot.
    MeSH term(s) Arthritis, Rheumatoid ; Cross-Sectional Studies ; Foot ; Humans ; Quality of Life ; Spain
    Language English
    Publishing date 2021-03-31
    Publishing country Switzerland
    Document type Journal Article
    ISSN 1660-4601
    ISSN (online) 1660-4601
    DOI 10.3390/ijerph18073619
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  8. Article ; Online: Rituximab in refractory autoimmune hemolytic anemia in systemic lupus erythematosus.

    Pavo-Blanco, María / Novella-Navarro, Marta / Cáliz-Cáliz, Rafael / Ferrer-González, Miguel A

    Reumatologia clinica

    2017  Volume 14, Issue 4, Page(s) 248–249

    Title translation Rituximab en la anemia hemolítica autoinmune refractaria en lupus eritematoso sistémico.
    MeSH term(s) Adult ; Anemia, Hemolytic, Autoimmune/drug therapy ; Anemia, Hemolytic, Autoimmune/etiology ; Female ; Humans ; Immunologic Factors/therapeutic use ; Lupus Erythematosus, Systemic/complications ; Rituximab/therapeutic use
    Chemical Substances Immunologic Factors ; Rituximab (4F4X42SYQ6)
    Language Spanish
    Publishing date 2017-09-01
    Publishing country Spain
    Document type Case Reports ; Letter
    ISSN 2173-5743
    ISSN (online) 2173-5743
    DOI 10.1016/j.reuma.2017.07.023
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  9. Article ; Online: Recommendations by the Spanish Society of Rheumatology on risk management of biological treatment and JAK inhibitors in patients with rheumatoid arthritis.

    Balsa, Alejandro / Díaz Del Campo Fontecha, Petra / Silva Fernández, Lucía / Valencia Martín, José / Nistal Martínez, Virginia / León Vázquez, Fernando / Hernández Hernández, M Vanesa / Corominas, Héctor / Cáliz Cáliz, Rafael / Aguado García, José María / Candelas Rodríguez, Gloria / Ibargoyen Roteta, Nora / Martí Carvajal, Arturo / Plana Farras, M Nieves / Puñal Riobóo, Janet / Park, Hye Sang / Triñanes Pego, Yolanda / Villaverde García, Virginia

    Reumatologia clinica

    2023  Volume 19, Issue 10, Page(s) 533–548

    Abstract: Objective: To present recommendations based on the available evidence and the consensus of experts, for risk management of biological treatment and JAK inhibitors in patients with rheumatoid arthritis.: Methods: Clinical research questions relevant ... ...

    Abstract Objective: To present recommendations based on the available evidence and the consensus of experts, for risk management of biological treatment and JAK inhibitors in patients with rheumatoid arthritis.
    Methods: Clinical research questions relevant to the purpose of the document were identified. These questions were reformulated in PICO format (patient, intervention, comparison, outcome or outcome) by a panel of experts, selected based on their experience in the area. A systematic review of the evidence was carried out, grading according to the GRADE criteria (Grading of Recommendations Assessment, Development, and Evaluation). Specific recommendations were then formulated.
    Results: 6 PICO questions were proposed by the panel of experts based on their clinical relevance and the existence of recent information regarding the risk of occurrence of serious infections, the risk of reactivation of the hepatitis B virus, the risk of reactivation of the virus varicella-zoster, the risk of appearance of skin (melanoma and non-melanoma) or haematological cancer, the risk of appearance of thromboembolic disease and the risk of progression of the human papilloma virus. A total of 28 recommendations were formulated, structured by question, based on the evidence found and the consensus of the experts.
    Conclusions: The SER recommendations on risk management of treatment with biologic therapies and JAK inhibitors in rheumatoid arthritis are presented.
    MeSH term(s) Humans ; Arthritis, Rheumatoid/drug therapy ; Arthritis, Rheumatoid/epidemiology ; Biological Therapy ; Janus Kinase Inhibitors/therapeutic use ; Rheumatology ; Risk Management ; Systematic Reviews as Topic ; Practice Guidelines as Topic
    Chemical Substances Janus Kinase Inhibitors
    Language English
    Publishing date 2023-11-25
    Publishing country Spain
    Document type Journal Article
    ISSN 2173-5743
    ISSN (online) 2173-5743
    DOI 10.1016/j.reumae.2023.07.004
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  10. Article ; Online: Comparative effectiveness of treatment with the first TNF antagonist in monotherapy, the first TNF antagonist plus one conventional synthetic disease-modifying antirheumatic drug, and the first TNF antagonist plus two or more conventional synthetic disease-modifying antirheumatic drugs in patients with rheumatoid arthritis.

    Hernández-Cruz, Blanca / Márquez-Saavedra, Esther / Caliz-Caliz, Rafael / Navarro-Sarabia, Federico

    Arthritis research & therapy

    2016  Volume 18, Issue 1, Page(s) 259

    Abstract: Background: Rheumatoid arthritis (RA) patients are treated with a mean of 3-4 conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) with or without glucocorticoids (GCs), before the first biologic prescription. The main reasons for ... ...

    Abstract Background: Rheumatoid arthritis (RA) patients are treated with a mean of 3-4 conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) with or without glucocorticoids (GCs), before the first biologic prescription. The main reasons for change are inefficacy in 30-40 % of patients, and toxicity ≈ 10 %. Thus, they are treated with the first TNF antagonists in monotherapy. The aim of this study was to analyse the csDMARD and GC prescription patterns before and during treatment with the first TNF antagonist, and compare their effectiveness in three groups of patients.
    Methods: An observational, prospective, multicentre study in common clinical practice was designed. Treating rheumatologists recorded patient variables, including previous and concomitant csDMARDs and GCs in a database. The data were analysed using descriptive, inferential and multivariate statistics.
    Results: There were 1136 patients included; 21 % received the first TNF antagonist in monotherapy, 67 % received the first TNF antagonist plus one csDMARD, and 12 % the first TNF antagonist plus two or more csDMARDs. Most patients were female (73 %), RF+, and ACPA+, and had erosions; mean age was 53.2 (±13.0) years, and duration of disease was 9.1 (±7.6) years. They had high activity with DAS28 of 5.8 ± 1.1, and poor physical function with HAQ of 1.43 ± 0.63, and significant differences between groups in clinical variables and comorbidities; 94 % had received treatment with GCs, MTX, LFN, or SSZ at any time before the first TNF antagonist, 5 % (n = 52) had been treated with CLQ or HCLQ, and 1 % (n = 13) had received neither GCs nor csDMARDs. Before the first TNF antagonist, the drugs most commonly used were GCs (78 %), MTX (50 %), LFN (44 %), and SSZ (21 %). Concomitantly with the first TNF antagonist, 977 patients (85 %) were receiving GCs, MTX, LFN, or SSZ; 15 % (n = 173) received their first TNF antagonist without any concomitant GCs or csDMARDs, true monotherapy, and 6 % received their first TNF antagonist with GCs. The drug most commonly used at the time of first TNF antagonist initiation was MTX (58 %). All treatment groups had clinically and statistically significant improvements in DAS and HAQ scores. Effectiveness analysis (controlling for confounders) showed mean drug survival of 16.7, 20.1 and 11.7 months in each group, respectively (p < 0.001). The model that best explained a good EULAR response included the baseline and 6-month DAS28.
    Conclusions: The three groups of patiernts, have different comorbidities and disease characteristics. Treatment with low or very low doses of GCs is common. True monotherapy with the first TNF antagonist without prednisone or csDMARDs is infrequent. After controlling for potential confounders, effectiveness was a little different.
    MeSH term(s) Adult ; Aged ; Antirheumatic Agents/therapeutic use ; Arthritis, Rheumatoid/drug therapy ; Female ; Humans ; Male ; Middle Aged ; Practice Patterns, Physicians' ; Prospective Studies ; Treatment Outcome ; Tumor Necrosis Factor-alpha/antagonists & inhibitors
    Chemical Substances Antirheumatic Agents ; Tumor Necrosis Factor-alpha
    Language English
    Publishing date 2016-11-08
    Publishing country England
    Document type Comparative Study ; Journal Article ; Multicenter Study ; Observational Study
    ZDB-ID 2107602-9
    ISSN 1478-6362 ; 1478-6354
    ISSN (online) 1478-6362
    ISSN 1478-6354
    DOI 10.1186/s13075-016-1137-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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