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Article ; Online: The open abdomen: definitions, management principles, and nutrition support considerations.

Friese, Randall S

Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition

2012 Volume 27, Issue 4, Page(s) 492–498

Abstract: The use of the "open abdomen" as a technique in the management of the complex surgical patient stems from the concept of damage control. Damage control principles underscore the importance of an abbreviated laparotomy focused on control of hemorrhage and ...

Abstract	The use of the "open abdomen" as a technique in the management of the complex surgical patient stems from the concept of damage control. Damage control principles underscore the importance of an abbreviated laparotomy focused on control of hemorrhage and gastrointestinal contamination in patients presenting with significant physiologic compromise. Definitive repair of injuries is postponed and the abdomen is temporarily "closed" using one of a number of different techniques. The ultimate goal is formal abdominal fascial closure within 48-72 hours of the initial laparotomy. Frequently, daily trips to the operating room are required for incremental closure of the abdominal fascia. However, in some cases, fascial closure is not possible secondary to ongoing visceral edema and loss of the peritoneal domain. In these cases, the patient is left with an "open abdomen" until skin grafting over the exposed peritoneal organs can be performed. Patients with an open abdomen have peritoneal contents exposed to the atmosphere and require a complex dressing to maintain fascial domain and provide protection to exposed organs. These patients are typically critically ill and managed in the intensive care unit early in the disease process. The open abdomen has become an important tool for the management of physiologically unstable patients requiring emergent abdominal surgical procedures. These patients present unique challenges to the critical care and nutrition support teams. Careful attention to fluid and electrolyte management, meticulous wound care, prevention of enteroatmospheric fistula, and individualized nutrition support therapy are essential to successful recovery in this patient population.
MeSH term(s)	Abdomen/surgery ; Abdominal Wound Closure Techniques ; Fasciotomy ; Humans ; Intestinal Fistula/therapy ; Laparotomy/methods ; Nutritional Support/methods ; Wound Healing/drug effects
Language	English
Publishing date	2012-08
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	645074-x
ISSN	1941-2452 ; 0884-5336
ISSN (online)	1941-2452
ISSN	0884-5336
DOI	10.1177/0884533612446197
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Article: The Open Abdomen

Friese, Randall S

Nutrition in clinical practice. , v. 27, no. 4

Definitions, Management Principles, and Nutrition Support Considerations

2012

Abstract: The use of the “open abdomen” as a technique in the management of the complex surgical patient stems from the concept of damage control. Damage control principles underscore the importance of an abbreviated laparotomy focused on control of hemorrhage and ...

Abstract	The use of the “open abdomen” as a technique in the management of the complex surgical patient stems from the concept of damage control. Damage control principles underscore the importance of an abbreviated laparotomy focused on control of hemorrhage and gastrointestinal contamination in patients presenting with significant physiologic compromise. Definitive repair of injuries is postponed and the abdomen is temporarily “closed” using one of a number of different techniques. The ultimate goal is formal abdominal fascial closure within 48–72 hours of the initial laparotomy. Frequently, daily trips to the operating room are required for incremental closure of the abdominal fascia. However, in some cases, fascial closure is not possible secondary to ongoing visceral edema and loss of the peritoneal domain. In these cases, the patient is left with an “open abdomen” until skin grafting over the exposed peritoneal organs can be performed. Patients with an open abdomen have peritoneal contents exposed to the atmosphere and require a complex dressing to maintain fascial domain and provide protection to exposed organs. These patients are typically critically ill and managed in the intensive care unit early in the disease process. The open abdomen has become an important tool for the management of physiologically unstable patients requiring emergent abdominal surgical procedures. These patients present unique challenges to the critical care and nutrition support teams. Careful attention to fluid and electrolyte management, meticulous wound care, prevention of enteroatmospheric fistula, and individualized nutrition support therapy are essential to successful recovery in this patient population.
Keywords	abdomen ; edema ; electrolytes ; fascia ; fistula ; gastrointestinal system ; hemorrhage ; laparotomy ; nutrition ; patients ; skin grafting
Language	English
Dates of publication	2012-08
Size	p. 492-498.
Publishing place	SAGE Publications
Document type	Article
ZDB-ID	645074-x
ISSN	1941-2452 ; 0884-5336
ISSN (online)	1941-2452
ISSN	0884-5336
DOI	10.1177/0884533612446197
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Good night, sleep tight: the time is ripe for critical care providers to wake up and focus on sleep.

Friese, Randall S

Critical care (London, England)

2008 Volume 12, Issue 3, Page(s) 146

Abstract: The role of sleep during recovery from acute illness has been overlooked for decades. Advances in the support of critically ill patients have been made in mechanical ventilation, specialized nutrition support, highly specific antibiotic therapy, and ... ...

Abstract	The role of sleep during recovery from acute illness has been overlooked for decades. Advances in the support of critically ill patients have been made in mechanical ventilation, specialized nutrition support, highly specific antibiotic therapy, and early rehabilitation. However, the promotion of sleep - a basic tenet for survival - has been actively ignored by critical care providers. Bourne and coworkers recently conducted a small clinical trial that describes improved sleep efficiency with oral melatonin use in critically ill patients.
MeSH term(s)	Critical Illness ; Humans ; Intensive Care Units/organization & administration ; Sleep ; Sleep Deprivation
Language	English
Publishing date	2008-05-12
Publishing country	England
Document type	Comment ; Journal Article
ZDB-ID	2041406-7
ISSN	1466-609X ; 1364-8535
ISSN (online)	1466-609X
ISSN	1364-8535
DOI	10.1186/cc6884
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Article ; Online: Sleep and recovery from critical illness and injury: a review of theory, current practice, and future directions.

Friese, Randall S

Critical care medicine

2008 Volume 36, Issue 3, Page(s) 697–705

Abstract: Objective: The objectives of this article were to describe the deleterious effects of sleep deprivation, characterize sleep in patients cared for in an intensive care unit (ICU) environment, and propose an integrated strategy to improve sleep in ... ...

Abstract	Objective: The objectives of this article were to describe the deleterious effects of sleep deprivation, characterize sleep in patients cared for in an intensive care unit (ICU) environment, and propose an integrated strategy to improve sleep in critical care units. Study selection: Clinical trials and review articles assessing sleep deprivation, sleep in a critical care setting, and interventions to improve sleep in the critical care environment were identified through an in depth PubMed search. Conclusions: Sleep deprivation and disruption are particularly prevalent in patients cared for in the critical care environment. Although numerous observational studies during the past several decades have demonstrated that sleep in patients cared for in ICUs is highly abnormal, little is known about the effects of poor sleep quality on outcomes from critical illness or injury. Reasons for sleep deprivation during recovery from illness and injury in the ICU are multifactorial. Major contributing factors in this patient population are type and severity of underlying illness, the pathophysiology of acute illness/injury, pain from surgical procedures, and perhaps most importantly, the ICU environment itself. Sleep in ICU patients is characterized by prolonged sleep latencies, sleep fragmentation, decreased sleep efficiency, frequent arousals, a predominance of stage 1 and 2 nonrapid eye movement sleep, decreased or absent stage 3 and 4 nonrapid eye movement sleep, and decreased or absent rapid eye movement sleep. Optimizing patient comfort and ensuring that patients achieve adequate restorative sleep while cared for in the ICU is an arduous task. However, environmental alterations in the ICU may reliably improve sleep quality and subsequently alter outcomes during recovery from critical illness and injury.
MeSH term(s)	Animals ; Critical Care/trends ; Critical Illness/rehabilitation ; Forecasting ; Humans ; Sleep ; Sleep Deprivation/complications ; Sleep Deprivation/prevention & control ; Wounds and Injuries/rehabilitation
Language	English
Publishing date	2008-03
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	197890-1
ISSN	1530-0293 ; 0090-3493
ISSN (online)	1530-0293
ISSN	0090-3493
DOI	10.1097/CCM.0B013E3181643F29
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Article ; Online: Risk Factors for Perforated Appendicitis in the Acute Care Surgery Era-Minimizing the Patient's Delayed Presentation Factor.

Kulvatunyou, Narong / Zimmerman, Steven A / Joseph, Bellal / Friese, Randall S / Gries, Lynn / O'Keeffe, Terence / Stroster, John A / Tang, Andrew L

The Journal of surgical research

2019 Volume 238, Page(s) 113–118

Abstract: Background: Numerous factors contribute to advanced disease or increased complications in patients with acute appendicitis (AA). This study aimed to identify risk factors associated with AA perforation, including the effect of system time (ST) delay, ... ...

Abstract	Background: Numerous factors contribute to advanced disease or increased complications in patients with acute appendicitis (AA). This study aimed to identify risk factors associated with AA perforation, including the effect of system time (ST) delay, after controlling for patient time (PT) delay. In this study, PT was controlled (to less than or equal to 24 h) to better understand the effect of ST delay on AA perforation. Methods: Medical records of patients who underwent surgery for AA at a tertiary referral hospital from October 2009 through September 2013 were reviewed. Data collected included demographics, body mass index, presence of fecalith, PT (i.e., duration of time from symptom onset to arrival in emergency department), and ST (i.e., duration of time from arrival in emergency department to operating room). AA was classified as simple (acute, nonperforated) versus advanced (gangrenous, perforated). Results: Seven hundred forty-seven patients underwent surgery for AA. After excluding patients with PT > 24 h, 445 patients fit the study criteria, of which 358 patients with simple AA and 87 patients with advanced disease. Advanced appendicitis patients were older and had higher body mass index, longer PT, higher WBC, and higher incidence of fecaliths. Both groups had similar ST. Risk factors for advanced appendicitis after multiple regression analysis are age >50 y old, WBC >15,000, the presence of fecaliths, and PT delay >12 h. Conclusions: Once PT delay was limited to ≤24 h, the ST delay of >12 h did not adversely affect the incidence of advanced AA. Age >50 y, WBC >15,000, PT delay >12 h, and the presence of fecaliths were identified as risk factors associated with advanced AA.
MeSH term(s)	Adolescent ; Adult ; Age Factors ; Appendectomy/statistics & numerical data ; Appendicitis/complications ; Appendicitis/surgery ; Emergency Service, Hospital/statistics & numerical data ; Fecal Impaction/epidemiology ; Fecal Impaction/etiology ; Fecal Impaction/surgery ; Female ; Humans ; Incidence ; Intestinal Perforation/epidemiology ; Intestinal Perforation/etiology ; Intestinal Perforation/surgery ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Time Factors ; Time-to-Treatment/statistics & numerical data ; Young Adult
Language	English
Publishing date	2019-02-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	80170-7
ISSN	1095-8673 ; 0022-4804
ISSN (online)	1095-8673
ISSN	0022-4804
DOI	10.1016/j.jss.2019.01.031
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Article ; Online: Comparing Outcomes Between "Pull" Versus "Push" Percutaneous Endoscopic Gastrostomy in Acute Care Surgery: Under-Reported Pull Percutaneous Endoscopic Gastrostomy Incidence of Tube Dislodgement.

Kulvatunyou, Narong / Zimmerman, Steven A / Sadoun, Moutamn / Joseph, Bellal A / Friese, Randall S / Gries, Lynn M / O'Keeffe, Terence / Tang, Andrew L

The Journal of surgical research

2018 Volume 232, Page(s) 56–62

Abstract: Background: Percutaneous endoscopic gastrostomy (PEG) complications are often under-reported in the literature, especially regarding the incidence of tube dislodgement (TD). TD can cause significant morbidity depending on its timing. We compared ... ...

Abstract	Background: Percutaneous endoscopic gastrostomy (PEG) complications are often under-reported in the literature, especially regarding the incidence of tube dislodgement (TD). TD can cause significant morbidity depending on its timing. We compared outcomes between "push" and "pull" PEGs. We hypothesized that push PEGs, because of its T-fasteners and balloon tip, would have a lower incidence of TD and complications compared with pull PEGs. Methods: We performed a chart review of our prospectively maintained acute care surgery database for patients who underwent PEG tube placement from July 1, 2009 through June 30, 2013. Data regarding age, gender, body mass index, indications (trauma versus nontrauma), and complications (including TD) were extracted. Procedure-related complications were classified as either major if patients required an operative intervention or minor if they did not. We compared outcomes between pull PEG and push PEG. Multiple regression analysis was performed to identify risk factors associated with major complications. Results: During the 4-y study period, 264 patients underwent pull PEGs and 59 underwent push PEGs. Age, gender, body mass index, and indications were similar between the two groups. The overall complications (major and minor) were similar (20% pull versus 22% push, P = 0.61). The incidence of TD was also similar (12% pull versus 9% push, P = 0.49). However, TD associated with major complications was higher in pull PEGs but was not statistically significant (6% pull versus 2% push, P = 0.21). Multiple regression analysis showed that dislodged pull PEG was associated with major complications (odds ratio 29.5; 95% confidence interval, 11.3-76.9; P < 0.001). Conclusions: The incidence of pull PEG TD associated with major complications is under-recognized. Specific measures should be undertaken to help prevent pull PEG TD. Level of evidence: IV, therapeutic.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Critical Care ; Female ; Gastroscopy/adverse effects ; Gastrostomy/adverse effects ; Gastrostomy/methods ; Humans ; Male ; Middle Aged ; Postoperative Complications/epidemiology
Language	English
Publishing date	2018-07-03
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	80170-7
ISSN	1095-8673 ; 0022-4804
ISSN (online)	1095-8673
ISSN	0022-4804
DOI	10.1016/j.jss.2018.06.011
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Article ; Online: Biological validity to sleep measurements during critical illness.

Parthasarathy, Sairam / Friese, Randall S / Ayas, Najib T

Critical care medicine

2010 Volume 38, Issue 2, Page(s) 705–706

MeSH term(s)	Critical Illness ; Humans ; Hypercapnia/physiopathology ; Hypercapnia/therapy ; Respiration, Artificial/mortality ; Respiratory Insufficiency/physiopathology ; Respiratory Insufficiency/therapy ; Sleep/physiology ; Sleep Wake Disorders/diagnosis ; Sleep Wake Disorders/physiopathology ; Treatment Failure
Language	English
Publishing date	2010-02
Publishing country	United States
Document type	Comment ; Editorial
ZDB-ID	197890-1
ISSN	1530-0293 ; 0090-3493
ISSN (online)	1530-0293
ISSN	0090-3493
DOI	10.1097/CCM.0b013e3181cbb05f
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Article ; Online: Inhibition of sepsis-induced inflammatory response by β1-adrenergic antagonists.

Ibrahim-Zada, Irada / Rhee, Peter / Gomez, Christopher T / Weller, John / Friese, Randall S

The journal of trauma and acute care surgery

2014 Volume 76, Issue 2, Page(s) 320–7; discussion 327–8

Abstract: Background: Although previous studies have described potential benefits of nonselective β-adrenergic antagonist therapy in sepsis, there is a paucity of data on the use of β1-selective antagonists (B1AA). The purposes of this study were to describe the ... ...

Abstract	Background: Although previous studies have described potential benefits of nonselective β-adrenergic antagonist therapy in sepsis, there is a paucity of data on the use of β1-selective antagonists (B1AA). The purposes of this study were to describe the effects of B1AA on survival in septic animals and to explore for molecular mechanisms of potential treatment benefit. Methods: C57BL/6 male mice received intraperitoneal injection of lipopolysaccharide. Continuous infusion of a B1AA (esmolol) or an equal volume of saline (control) was initiated at 4 hours after injection. Kaplan-Meier survival analysis at 120 hours was used to explore for mortality differences. A subgroup of animals was sacrificed for microarray expression analysis. Top candidate genes were validated in vitro and in silico. Expression of our candidate genes in a human microarray database (GSE28750) was explored. Results: B1AA infusion resulted in increased survival (p = 0.001) at 120 hours. Mean survival difference was 23.6 hours (p = 0.002). Hazard ratio for mortality with B1AA is 0.43 (95% confidence interval, 0.26-0.72). Immunologic disease (p = 0.0003-0.036) and cell death/survival (p = 0.0001-0.042) were significantly associated with improved survival in septic mice treated with B1AA. Further analysis of the gene structure revealed that eight genes shared common promoter activating sequence for NFKB and/or BRCA1 motifs. Analysis of a human sepsis database identified the up-regulation of CAMP (p = 0.032) and TNFSF10 (p = 0.001) genes in septic patients compared with healthy controls. Conclusion: Continuous infusion of a B1AA initiated after septic insult improves survival at 5 days in a murine model. Benefits may be caused by modulation of gene expression in immunologic pathways leading to an increase in CAMP and TNFSF10 expression. This observed effect may be explained by the activation of NFKB and BRCA1 genes involved in immune response and cell repair pathways. Our findings support further investigation of the use of B1AA in the treatment of sepsis.
MeSH term(s)	Adrenergic beta-1 Receptor Antagonists/administration & dosage ; Animals ; BRCA1 Protein/genetics ; Disease Models, Animal ; Gene Expression Regulation ; Kaplan-Meier Estimate ; Lipopolysaccharides/pharmacology ; Male ; Mice ; Mice, Inbred C57BL ; Microarray Analysis ; Molecular Biology ; NF-kappa B p50 Subunit/genetics ; Propanolamines/administration & dosage ; RNA/genetics ; Random Allocation ; Real-Time Polymerase Chain Reaction/methods ; Reference Values ; Sepsis/drug therapy ; Sepsis/mortality ; Survival Analysis ; Systemic Inflammatory Response Syndrome/genetics ; Systemic Inflammatory Response Syndrome/mortality ; Systemic Inflammatory Response Syndrome/prevention & control
Chemical Substances	Adrenergic beta-1 Receptor Antagonists ; BRCA1 Protein ; Lipopolysaccharides ; NF-kappa B p50 Subunit ; Propanolamines ; Nfkb1 protein, mouse (147257-52-1) ; RNA (63231-63-0) ; esmolol (MDY902UXSR)
Language	English
Publishing date	2014-02
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2651070-4
ISSN	2163-0763 ; 2163-0755
ISSN (online)	2163-0763
ISSN	2163-0755
DOI	10.1097/TA.0000000000000113
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Article ; Online: Propranolol attenuates cognitive, learning, and memory deficits in a murine model of traumatic brain injury.

Zeeshan, Muhammad / Hamidi, Mohammad / OʼKeeffe, Terence / Bae, Esther H / Hanna, Kamil / Friese, Randall S / Kulvatunyou, Narong / Zakaria, El Rasheid / Gries, Lynn / Tang, Andrew / Joseph, Bellal

The journal of trauma and acute care surgery

2019 Volume 87, Issue 5, Page(s) 1140–1147

Abstract: Background: β-blockers have been shown to improve survival after traumatic brain injury (TBI); however, the impact of continuous dosage of β-blockers on cognitive function has not been elucidated. We hypothesized that a daily dose of propranolol can ... ...

Abstract	Background: β-blockers have been shown to improve survival after traumatic brain injury (TBI); however, the impact of continuous dosage of β-blockers on cognitive function has not been elucidated. We hypothesized that a daily dose of propranolol can improve memory, learning, and cognitive function following TBI. Study design: Twenty male C57BL mice were subjected to a cortical-controlled moderate TBI. Two hours after TBI, animals were randomly allocated to either the β-blocker group (n = 10) or the placebo group (n = 10). Mice in the β-blocker group received intraperitoneal 4 mg/kg propranolol every 24 hours for 7 days while the placebo group received 4 mg/kg normal saline. Baseline novel object recognition and classic maze tests were done prior to TBI and then daily from Day 1 through 7 after TBI. Animals were sacrificed on Day 7. Serum biomarkers were measured using ELISA and brain sections were analyzed using western blot and hematoxylin and eosin staining. Results: Both the β-blocker and placebo groups had lower recognition index scores compared with the baseline following TBI. β-blocker mice had significantly higher novel object recognition scores compared with placebo mice 2 days after TBI. The β-blocker group required less time to complete the maze-test compared to placebo group after Day 4. There was no difference regarding the serum levels of IL-1β, IL-6, and TNF-α. The β-blocker group had lower levels of UCHL-1 and higher levels of Hsp-70 in brain lysate. Hematoxylin and eosin staining revealed that more neurons in the hippocampal-CA1 area underwent apoptosis in the placebo group compared with the β-blocker group. Conclusion: Postinjury propranolol administration results in improved memory, learning and cognitive functions in a murine model of moderate TBI. Propranolol increases the expression of antiapoptotic protein (Hsp-70) and decreases cell death in the hippocampal-CA1 area compared with the placebo.
MeSH term(s)	Adrenergic beta-Antagonists/administration & dosage ; Animals ; Apoptosis/drug effects ; Brain Injuries, Traumatic/complications ; Brain Injuries, Traumatic/diagnosis ; Brain Injuries, Traumatic/pathology ; CA1 Region, Hippocampal/drug effects ; CA1 Region, Hippocampal/pathology ; Cognition/drug effects ; Disease Models, Animal ; HSP70 Heat-Shock Proteins/metabolism ; Humans ; Injections, Intraperitoneal ; Male ; Maze Learning ; Memory/drug effects ; Memory Disorders/diagnosis ; Memory Disorders/drug therapy ; Memory Disorders/etiology ; Memory Disorders/pathology ; Mice ; Neurons/drug effects ; Neurons/pathology ; Propranolol/administration & dosage
Chemical Substances	Adrenergic beta-Antagonists ; HSP70 Heat-Shock Proteins ; Propranolol (9Y8NXQ24VQ)
Language	English
Publishing date	2019-08-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	2651070-4
ISSN	2163-0763 ; 2163-0755
ISSN (online)	2163-0763
ISSN	2163-0755
DOI	10.1097/TA.0000000000002484
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Article ; Online: Sleep deprivation after septic insult increases mortality independent of age.

Friese, Randall S / Bruns, Brandon / Sinton, Christopher M

The Journal of trauma

2009 Volume 66, Issue 1, Page(s) 50–54

Abstract: Background: Sleep deprivation is a common problem in the intensive care unit. Animal models have demonstrated that sleep deprivation alone is associated with increased mortality. We have previously shown that septic insult with sleep deprivation results ...

Abstract	Background: Sleep deprivation is a common problem in the intensive care unit. Animal models have demonstrated that sleep deprivation alone is associated with increased mortality. We have previously shown that septic insult with sleep deprivation results in increased mortality in a murine model. The aging process is known to reduce the restorative phases of sleep. The purpose of this study was to evaluate the effect of age on mortality with sleep deprivation during recovery from septic insult. Methods: C57BL/6J male mice aged 2 months (young) or 9 months (old) underwent cecal ligation and puncture (CLP). Animals were randomized to receive sleep interruption (SI) for 48 hours or standard recovery (no SI). Sham animals underwent laparotomy and cecal manipulation without puncture. SI was achieved by securing animal housing to an orbital shaker set to repeatedly cycle at 30 rpm over 120 seconds (30 seconds on/90 seconds off). The primary outcome was survival at 5 days post-CLP. Kaplan-Meier survival analysis with log-rank test was used to explore differences in mortality. Results: SI resulted in an increase in time awake for both light and dark cycles (p < 0.001). Mortality after CLP with SI (n = 30) was 57% and mortality after CLP without SI (controls; n = 33) was 24%. SI was associated with a greater than 3-fold increase in mortality after CLP (RR = 3.29; 95% CI, 1.42-7.63). Young mice (n = 28) had a mortality of 31% with CLP alone increasing to 67% with SI (p = 0.03). Old mice (n = 35) had a mortality of 18% with CLP alone increasing to 50% with SI (p = 0.05). There was no difference in survival between young and old mice undergoing SI (p = 0.49). Conclusions: Sleep deprivation after septic insult increases mortality in both young and old mice. However, sleep deprivation after septic insult does not have a more profound effect on mortality in either age group. These findings suggest that sleep deprivation experienced in the intensive care unit setting during recovery from critical illness may increase mortality. This effect appears independent of increased age. Further studies evaluating extremes of age are warranted.
MeSH term(s)	Analysis of Variance ; Animals ; Disease Models, Animal ; Electroencephalography ; Electromyography ; Male ; Mice ; Mice, Inbred C57BL ; Random Allocation ; Sepsis/mortality ; Sleep Deprivation/mortality
Language	English
Publishing date	2009-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	219302-4
ISSN	1529-8809 ; 0022-5282 ; 1079-6061
ISSN (online)	1529-8809
ISSN	0022-5282 ; 1079-6061
DOI	10.1097/TA.0b013e318190c3a1
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In stock of ZB MED Cologne/Königswinter

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More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito