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Article ; Online: Assessment of Thyroid Stiffness and Viscosity in Autoimmune Thyroiditis Using Novel Ultrasound-Based Techniques

Dana Stoian / Andreea Borlea / Ioan Sporea / Alexandru Popa / Luciana Moisa-Luca / Alina Popescu

Biomedicines, Vol 11, Iss 938, p

2023 Volume 938

Abstract: The estimation of viscosity by measuring the shear-wave dispersion (SWD) using ultrasound 2D shear-wave elastography (SWE) is becoming more and more popular. Recent research suggests that SWD can be used in addition to 2D-SWE (shear-wave speed) to ... ...

Abstract	The estimation of viscosity by measuring the shear-wave dispersion (SWD) using ultrasound 2D shear-wave elastography (SWE) is becoming more and more popular. Recent research suggests that SWD can be used in addition to 2D-SWE (shear-wave speed) to diagnose diffuse liver disease. Viscosity was studied for the assessment of normal thyroid tissue. This study aims to evaluate the use of viscosity measurements in patients with chronic autoimmune thyroiditis using the SuperSonic MACH ® 30 ultrasound machine (Hologic SuperSonic Imagine, Aix-en-Provence, France) which provides the Vi PLUS mode for viscosity and the 2D SWE PLUS mode for shear-wave speed measurements. Valid measurements were obtained in 308 cases, 153 with chronic autoimmune thyroiditis (CAT) and 155 with no thyroid pathology (95.95% feasibility of the methods). The differences between the healthy group and the CAT group were statistically significant both for Vi PLUS (2.5 ± 0.4 vs. 2.8 ± 0.5, p < 0.0001) and for 2D-SWE PLUS (13.5 ± 3.3 vs. 23.1 ± 8.3, p < 0.0001). The diagnostic performance was poor for Vi PLUS alone (AUC = 0.69; cut-off > 2.5 Pa·s, se = 68.6%; sp = 64.52%) and good for 2D-SWE PLUS alone (AUC = 0.861; cut-off > 18.4 kPa, se = 69.9%; sp = 92.2%). Vi PLUS correlated with 2D-SWE PLUS, with the presence of CAT, the thyroid volume, levothyroxine replacement therapy and age. Statistically significant differences were found between the CAT subgroup receiving thyroid replacement therapy and the subgroup without therapy: 24.74 ± 8.33 vs. 21.93 ± 8.12 kPa for 2D-SWE ( p = 0.0380) and 3 ± 0.5 vs. 2.7 ± 0.4 Pa·s for Vi PLUS ( p = 0.0193). Elastography-based methods improve the classic ultrasound evaluation: 2D-SWE PLUS performed somewhat better in distinguishing CAT from normal thyroid tissue, while Vi PLUS made a slightly better assessment regarding the functional status.
Keywords	hashimoto ; Vi PLUS ; shear-wave ; elastography ; dispersion ; Biology (General) ; QH301-705.5
Subject code	610
Language	English
Publishing date	2023-03-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Strain Versus 2D Shear-Wave Elastography Parameters—Which Score Better in Predicting Thyroid Cancer?

Andreea Borlea / Ioan Sporea / Alexandru Popa / Mihnea Derban / Laura Taban / Dana Stoian

Applied Sciences, Vol 12, Iss 11147, p

2022 Volume 11147

Abstract: The aim of this study is to assess the diagnostic performance of strain elastography (SE) versus 2D shear-wave elastography (2D-SWE) by providing a head-to-head comparison of the two methods. Ninety-four thyroid nodules were evaluated using conventional ... ...

Abstract	The aim of this study is to assess the diagnostic performance of strain elastography (SE) versus 2D shear-wave elastography (2D-SWE) by providing a head-to-head comparison of the two methods. Ninety-four thyroid nodules were evaluated using conventional ultrasound (B-mode) and SE, namely, real-time elastography (RTE) with a Hitachi Preirus machine (Hitachi Inc., Tokyo, Japan) and consecutively, 2D-SWE with SuperSonic Mach30 equipment (Supersonic Imagine, Aix-en-Provence, France). The results were compared in all cases to the pathology reports. Out of the 94 nodules, 29 (30.9%) were malignant. Both SE and 2D-SWE parameters proved to have excellent diagnostic quality, with comparable results. The mean elasticity index was the best parameter for the 2D-SWE (AUC 0.912); for a cut-off value of 30.5 kPa, it predicts thyroid malignancy with a sensitivity of 79.3%, specificity of 95.38%, NPV of 91.2% and PPV of 88.5%. The best parameter for SE was the strain ratio (cutoff > 3.9; sensitivity 82.7%; specificity 92.3%; AUC 0.905). When integrated in the ultrasound risk algorithm, both elastography methods improved the diagnostic performance: AUC 0.764 vs. 0.886 vs. 0.861 for B-modes: B-mode + 2D-SWE vs. B-mode + SE. We concluded that elastography adds diagnostic value in predicting malignancy, both when Hitachi RTE and SuperSonic 2D-SWE were used.
Keywords	risk stratification ; thyroid cancer ; strain ; 2D shear wave ; SWE ; thyroid elastography ; Technology ; T ; Engineering (General). Civil engineering (General) ; TA1-2040 ; Biology (General) ; QH301-705.5 ; Physics ; QC1-999 ; Chemistry ; QD1-999
Subject code	610
Language	English
Publishing date	2022-11-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Is Strain Elastography Useful in Diagnosing Chronic Autoimmune Thyroiditis in Children?

Cristina Mihaela Cepeha / Corina Paul / Andreea Borlea / Renata Bende / Monica Simina Mihuta / Dana Stoian

Applied Sciences, Vol 12, Iss 8881, p

2022 Volume 8881

Abstract: Strain elastography (SE) determines the level of tissue stiffness and thus helps in the diagnosis and differentiation of various pathologies. This paper aims to study the elastographic differences between healthy thyroid parenchyma and ones affected by ... ...

Abstract	Strain elastography (SE) determines the level of tissue stiffness and thus helps in the diagnosis and differentiation of various pathologies. This paper aims to study the elastographic differences between healthy thyroid parenchyma and ones affected by chronic autoimmune thyroiditis (CAT) in children. We included in our study 52 children diagnosed with CAT and 22 children with no thyroid pathology. After clinic examination and biological tests, an ultrasound was performed followed by SE using a Hitachi Preirus machine with a 5–15 multi-frequency linear probe. The mean strain ratio (SR) values were significantly lower in the control group compared with the CAT group (0.68 ± 0.2 vs. 1.19 ± 0.25; p < 0.0001). A mean value above 0.9 was found predictive for CAT with 84.62% Sensitivity(Se), 95.45% Specificity (Sp), 97.8% Positive Predictive Value (PPV), 72.4% Negative Predictive Value (NPV), and area under receiver operating characteristic (AUROC), 0.9. No differences were found between the two thyroid lobes. Also, we found no differences between girls and boys. Out of the 52 children with CAT, 39 were on therapy with levothyroxine. No differences were found between SR values in preexisting hypothyroid cases compared to euthyroid cases (1.24 ± 0.26 vs. 1.18 ± 0.25; p = 0.4615). Our results show that SE is a useful examination technique of children diagnosed with CAT, in accordance with other studies conducted on adults. This study lays the foundation for elastographic examination among children.
Keywords	strain ; elastography ; chronic autoimmune thyroiditis ; thyroid ; children ; Technology ; T ; Engineering (General). Civil engineering (General) ; TA1-2040 ; Biology (General) ; QH301-705.5 ; Physics ; QC1-999 ; Chemistry ; QD1-999
Subject code	610
Language	English
Publishing date	2022-09-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Links between High-Sensitivity C-Reactive Protein and Pulse Wave Analysis in Middle-Aged Patients with Hypertension and High Normal Blood Pressure

Ioana Mozos / Daniela Jianu / Cristina Gug / Dana Stoian

Disease Markers, Vol

2019 Volume 2019

Abstract: Arterial stiffness and arterial age provide valuable prognostic cardiovascular information. The present study aimed at assessing the levels of vitamin D, high-sensitivity C-reactive protein (hsCRP), low-density lipoprotein cholesterol (LDL), and oxidized ...

Abstract	Arterial stiffness and arterial age provide valuable prognostic cardiovascular information. The present study aimed at assessing the levels of vitamin D, high-sensitivity C-reactive protein (hsCRP), low-density lipoprotein cholesterol (LDL), and oxidized LDL (oxLDL) in a group of middle-aged hypertensive patients and their relationship with pulse wave velocity (PWV), central blood pressure, and early arterial aging (EAA), respectively. A total of 56 patients, aged 48±6 years, 57% males, with hypertension and high normal blood pressure (HNBP), were investigated using a Mobile-O-Graph, to assess central and peripheral blood pressure, PWV, and arterial age. Additionally, hsCRP, LDL, oxLDL, and 25-hydroxy vitamin D3 were assessed. PWV, 25-hydroxy vitamin D3, hsCRP, oxLDL, and LDL levels were 7.26±0.69 m/s, 25.99±11.17 microg/l, 0.48±0.44 mg/dl, 261.37±421 ng/ml, and 145.73±39.53 mg/dl, respectively. Significant correlations were obtained between oxLDL and pulse pressure amplification (rS=−0.347, p=0.028) and between hsCRP and LDL levels with PWV and EAA, respectively. ROC curve analysis revealed that hsCRP is a sensitive and specific predictor of EAA and increased PWV values. Concluding, vitamin D deficiency and increased hsCRP and LDL values are very common, and high oxidized LDL is related to pulse pressure amplification in patients with elevated blood pressure. Vitamin D level and high-sensitivity C-reactive protein and LDL provide valuable information in middle-aged hypertensive and HNBP patients related to arterial stiffness and early arterial aging, but only hsCRP is a sensitive predictor of EAA and PWV.
Keywords	Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2019-01-01T00:00:00Z
Publisher	Hindawi Limited
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Oscillometric Pulse Wave Analysis Is Useful in Evaluating the Arterial Stiffness of Obese Children with Relevant Cardiometabolic Risks

Monica Simina Mihuta / Corina Paul / Andreea Borlea / Cristina Mihaela Cepeha / Iulian Puiu Velea / Ioana Mozos / Dana Stoian

Journal of Clinical Medicine, Vol 11, Iss 5078, p

2022 Volume 5078

Abstract: Early detection of all complications of childhood obesity is imperative in order to minimize effects. Obesity causes vascular disruptions, including early increased arterial stiffness and high blood pressure. This study’s aim is to assess the reliability ...

Abstract	Early detection of all complications of childhood obesity is imperative in order to minimize effects. Obesity causes vascular disruptions, including early increased arterial stiffness and high blood pressure. This study’s aim is to assess the reliability of pulse wave analysis (PWA) in obese children and how additional risk factors influence the evaluated parameters. We analyzed 55 children aged 6–18 years old by measuring their pulse wave velocity (PWV), augmentation index (AIx), peripheral blood pressure (SBP, DBP), heart rate, central blood pressure (cSBP, cDBP) and central pulse pressure (cPP). We used the oscillometric IEM Mobil-O-Graph and performed a single-point brachial measurement. The subjects were divided into two groups: obese ( n = 30) and normal-weight ( n = 25) and were clinically and anamnestically assessed. BMI and waist circumference are significantly correlated to higher values for PWV, SBP, DBP, cSBP, and cDBP. Weight significantly predicts PWV, SBP, DBP and cPP. The risk factors that significantly influence the PWA and BP values are: a cardiometabolically risky pregnancy (higher PWV, AIx, SBP), active and passive smoking (higher PWV, SBP, cSBP, cDBP), sleep deprivation (higher PWV, SBP, cSBP) and sedentariness (higher PWV, AIx, peripheral and central BP). We conclude that obese children with specific additional cardiometabolic risk factors present increased arterial stiffness and higher blood pressure values.
Keywords	arterial stiffness ; cardiometabolic risk ; childhood obesity ; high blood pressure ; pulse wave analysis ; Medicine ; R
Subject code	610
Language	English
Publishing date	2022-08-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Thyroid Multimodal Ultrasound Evaluation—Impact on Presurgical Diagnosis of Intermediate Cytology Cases

Andreea Borlea / Dana Stoian / Laura Cotoi / Ioan Sporea / Fulger Lazar / Ioana Mozos

Applied Sciences, Vol 10, Iss 3439, p

2020 Volume 3439

Abstract: Fine needle aspiration (FNA) is recommended as the final evaluation in diagnosing thyroid nodules. Intermediate cytology is observed in about 15%–25% of the FNA results and has divergent recommendations: follow-up or surgery, either hemi- or total ... ...

Abstract	Fine needle aspiration (FNA) is recommended as the final evaluation in diagnosing thyroid nodules. Intermediate cytology is observed in about 15%–25% of the FNA results and has divergent recommendations: follow-up or surgery, either hemi- or total thyroidectomy. The present study aimed to assess the benefit of multimodal ultrasound (US) evaluation in clarifying the attitude in cases with intermediate cytology on FNA. Sixty-four successive cases with Bethesda III or IV cytology results were evaluated using two-dimensional B-mode US (2B), qualitative strain elastography, as well as planar and volumetric (3D) color Doppler using both a linear multifrequency probe and a linear volumetric probe (Hitachi Preirus Machine, Hitachi Inc. Japan). The analyzed nodules were all categorized as low, intermediate, or high risk, based on the following US criteria: taller-than-wide shape, marked hypoechogenicity, irregular borders, inhomogeneity, microcalcifications, or the presence of suspicious adenopathy. Elastographic criteria included stiff lesions, while volumetric Doppler criteria included moderate and marked perinodular vascularization, as suspicious for malignancy. The gold standard for the analysis was the result of the pathology report after thyroidectomy. Our results showed that the prevalence of cancer was 25% (16 cases). In five cases, borderline follicular neoplasia was identified, group which requires watchful waiting. These lesions were also considered as malignant in the final analysis, with a total number of 21 neoplasm cases. Sixteen of the 21 malignant nodules presented with high stiffness, while 15/21 had increased perinodular vascularization. Eight of the 21 cases displayed both important stiffness and perinodular vascularization. Cancer prevalence increased both with severity of stiffness (9.0%–15.0%–66.6%–80.0%) and intensity of vascularization in the adjacent perinodular parenchyma (18.2%–27.7%–35.29%–50.0%). Combining the use of grayscale US, elastography, and 3D Doppler in the evaluation of ...
Keywords	Bethesda III cytology ; cancer risk ; volumetric Doppler ; strain elastography ; multimodal ultrasound ; Technology ; T ; Engineering (General). Civil engineering (General) ; TA1-2040 ; Biology (General) ; QH301-705.5 ; Physics ; QC1-999 ; Chemistry ; QD1-999
Subject code	610
Language	English
Publishing date	2020-05-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Associations between Intrinsic Heart Rate, P Wave and QT Interval Durations and Pulse Wave Analysis in Patients with Hypertension and High Normal Blood Pressure

Ioana Mozos / Cristina Gug / Costin Mozos / Dana Stoian / Marius Pricop / Daniela Jianu

International Journal of Environmental Research and Public Health, Vol 17, Iss 4350, p

2020 Volume 4350

Abstract: The present study aimed to explore the relationship between electrocardiographic (ECG) and pulse wave analysis variables in patients with hypertension (HT) and high normal blood pressure (HNBP). A total of 56 consecutive, middle-aged hypertensive and ... ...

Abstract	The present study aimed to explore the relationship between electrocardiographic (ECG) and pulse wave analysis variables in patients with hypertension (HT) and high normal blood pressure (HNBP). A total of 56 consecutive, middle-aged hypertensive and HNBP patients underwent pulse wave analysis and standard 12-lead ECG. Pulse wave velocity (PWV), heart rate, intrinsic heart rate (IHR), P wave and QT interval durations were as follows: 7.26 ± 0.69 m/s, 69 ± 11 beats/minute, 91 ± 3 beats/minute, 105 ± 22 mm and 409 ± 64 mm, respectively. Significant correlations were obtained between PWV and IHR and P wave duration, respectively, between early vascular aging (EVA) and P wave and QT interval durations, respectively. Linear regression analysis revealed significant associations between ECG and pulse wave analysis variables but multiple regression analysis revealed only IHR as an independent predictor of PWV, even after adjusting for blood pressure variables and therapy. Receiver-operating characteristic (ROC) curve analysis revealed P wave duration (area under curve (AUC) = 0.731; 95% CI: 0.569–0.893) as a predictor of pathological PWV, and P wave and QT interval durations were found as sensitive and specific predictors of EVA. ECG provides information about PWV and EVA in patients with HT and HNBP. IHR and P wave durations are independent predictors of PWV, and P wave and QT interval may predict EVA.
Keywords	pulse wave velocity ; heart rate ; intrinsic heart rate ; QT interval ; P wave ; hypertension ; Medicine ; R
Subject code	535
Language	English
Publishing date	2020-06-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Crosstalk between Vitamins A, B12, D, K, C, and E Status and Arterial Stiffness

Ioana Mozos / Dana Stoian / Constantin Tudor Luca

Disease Markers, Vol

2017 Volume 2017

Abstract: Arterial stiffness is associated with cardiovascular risk, morbidity, and mortality. The present paper reviews the main vitamins related to arterial stiffness and enabling destiffening, their mechanisms of action, providing a brief description of the ... ...

Abstract	Arterial stiffness is associated with cardiovascular risk, morbidity, and mortality. The present paper reviews the main vitamins related to arterial stiffness and enabling destiffening, their mechanisms of action, providing a brief description of the latest studies in the area, and their implications for primary cardiovascular prevention, clinical practice, and therapy. Despite inconsistent evidence for destiffening induced by vitamin supplementation in several randomized clinical trials, positive results were obtained in specific populations. The main mechanisms are related to antiatherogenic effects, improvement of endothelial function (vitamins A, C, D, and E) and metabolic profile (vitamins A, B12, C, D, and K), inhibition of the renin-angiotensin-aldosterone system (vitamin D), anti-inflammatory (vitamins A, D, E, and K) and antioxidant effects (vitamins A, C, and E), decrease of homocysteine level (vitamin B12), and reversing calcification of arteries (vitamin K). Vitamins A, B12, C, D, E, and K status is important in evaluating cardiovascular risk, and vitamin supplementation may be an effective, individualized, and inexpensive destiffening therapy.
Keywords	Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2017-01-01T00:00:00Z
Publisher	Hindawi Limited
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Paradox of Sexual Dysfunction Observed during Pregnancy

Ana-Maria Cristina Daescu / Dan-Bogdan Navolan / Liana Dehelean / Mirela Frandes / Alexandru-Ioan Gaitoane / Andrei Daescu / Razvan-Ionut Daniluc / Dana Stoian

Healthcare, Vol 11, Iss 1914, p

2023 Volume 1914

Abstract: The aim of this study is to analyze the evolution of sexual function throughout pregnancy and highlight the predicting factors of sexual dysfunction in pregnant women. Our study included 144 participants, aged 16 to 45. Patients were evaluated three ... ...

Abstract	The aim of this study is to analyze the evolution of sexual function throughout pregnancy and highlight the predicting factors of sexual dysfunction in pregnant women. Our study included 144 participants, aged 16 to 45. Patients were evaluated three times during pregnancy by filling out the Female Sexual Function Index (FSFI) and the Body Exposure in Sexual Activities Questionnaire (BESAQ). At the time of the last evaluation, we asked patients to also fill out Beck’s Depression Inventory (BDI-II) and a questionnaire regarding their psychological status and relationship satisfaction. We observed that the FSFI lubrication, satisfaction, and pain domains and the FSFI total score significantly decreased from the 1st to the 3rd evaluation. We observed that an increase in BDI score and the presence of abortion in the patient’s history increase the risk of developing female sexual dysfunction (FSD). Higher BMIs were found to be a protective factor against FSD, as was being unmarried. The relationship satisfaction score was found to be an independent predictor of FSD. These findings support previous studies that indicate that pregnancy and postpartum sexuality are multifaceted phenomena and that psycho-social factors have a greater impact on sexuality than biological factors.
Keywords	pregnancy ; female sexual dysfunction ; FSFI ; BESAQ ; BDI-II ; Medicine ; R
Subject code	150
Language	English
Publishing date	2023-07-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Thyroid Autoimmune Disease—Impact on Sexual Function in Young Women

Ana-Maria Cristina Bortun / Viviana Ivan / Dan-Bogdan Navolan / Liana Dehelean / Andreea Borlea / Dana Stoian

Journal of Clinical Medicine, Vol 10, Iss 2, p

2021 Volume 369

Abstract: The important prevalence of autoimmune thyroid disease (AITD) in the general population was the main motivation for conducting the present study. The present paper aims to estimate the possible comorbidities related to female sexual dysfunction (FSD) and ...

Abstract	The important prevalence of autoimmune thyroid disease (AITD) in the general population was the main motivation for conducting the present study. The present paper aims to estimate the possible comorbidities related to female sexual dysfunction (FSD) and depression related to AITD. The study group consisted of 320 patients: 250 cases known with untreated AITD, divided into subgroups (euthyroid subgroup, subclinical hypothyroidism subgroup and clinical hypothyroidism subgroup); respectively 70 healthy females in the control group. Patients underwent thyroid evaluation, ovarian evaluation and laboratory assays. At the time of the diagnosis of autoimmune thyroid disease, psychometric scales were filled in by the patients: the Female Sexual Function Index 6 (FSFI-6) and the Beck’s Depression Inventory-II (BDI-II). It was observed that healthy patients had significantly higher FSFI scores than patients with AITD (28 vs. 27; p = 0.006). In the AITD group, the risk of FSD increases with the severity of thyroid disease. The most affected areas were: sexual desire ( p < 0.001), lubrication ( p = 0.001) and orgasm ( p = 0.008), followed by excitability and sexual satisfaction. The severity of hypothyroidism influences the degree of decrease in libido, central and peripheral excitability. Sexual satisfaction and orgasm were less influenced. The field related to pain seems uninfluenced by the presence of thyroid disease. The concomitant presence of depression and the value of thyroid-stimulating hormone (TSH) are risk factors in the development of FSD. Higher TSH value and BDI-II score increase the risk of female sexual dysfunction by 1.083 and 1.295 times, respectively. Our findings are significant and promising; they may help professionals dealing with sexual and reproductive health. Despite the importance of female sexual dysfunction and its prevalence, clinicians and patients often ignore it. In fact, only a small percentage of patients consult their doctors about sexual health, and their doctors do not often ask ...
Keywords	autoimmune thyroid disease ; female sexual dysfunction ; FSFI ; BDI-II ; Medicine ; R
Subject code	610
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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