LIVIVO - Search results -

Search results

Result 1 - 10 of total 99

Search options

Article ; Online: Is REBOA the Last Card to Control a Massive Gastrointestinal Bleeding?

Rodríguez-Holguín, Fernando / Salcedo, Alexander / Leib, Philip / Caicedo, Yaset / Serna, José Julián / Toro, Luis / Carvajal, Sandra / Riascos, Manolo / Parra, Michael W / García, Alberto / Ordoñez, Carlos A

The Journal of surgical research

2024 Volume 296, Page(s) 735–741

Abstract: Introduction: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a potential tool for the management of massive gastrointestinal bleeding (MGB). This study aims to describe the experience of the use of REBOA as adjunctive therapy in ... ...

Abstract	Introduction: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a potential tool for the management of massive gastrointestinal bleeding (MGB). This study aims to describe the experience of the use of REBOA as adjunctive therapy in patients with MGB and to evaluate its effectiveness. Methods: Serial cases of patients with hemorrhagic shock secondary to MGB in whom REBOA was placed were collected. Patient demographics, bleeding severity, etiology, management, and clinical outcomes were recorded. Results: Between 2017 and 2020, five cases were analyzed. All patients had a severe gastrointestinal bleeding (Glasgow Blatchford Bleeding Score range 12-17; Clinical Rockal Score range 5-9). The etiologies of MGB were perforated gastric or duodenal ulcers, esophageal varices, and vascular lesions. Systolic blood pressure increased after REBOA placement and total occlusion time was 25-60 min. REBOA provided temporary hemorrhage control in all cases and allowed additional hemostatic maneuvers to be performed. Three patients survived more than 24 h. All patients died in index hospitalization. The main cause of death was related to hemorrhagic shock. Conclusions: Endovascular aortic occlusion can work as a bridge to further resuscitation and attempts at hemostasis in patients with MGB. REBOA provides hemodynamic support and may be used simultaneously with other hemostatic maneuvers, facilitating definitive hemorrhage control.
MeSH term(s)	Humans ; Shock, Hemorrhagic/therapy ; Aorta ; Resuscitation ; Gastrointestinal Hemorrhage/etiology ; Gastrointestinal Hemorrhage/therapy ; Balloon Occlusion ; Endovascular Procedures ; Hemostatics ; Injury Severity Score
Chemical Substances	Hemostatics
Language	English
Publishing date	2024-02-17
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.2023.12.040
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 178: 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: Damage control in the intensive care unit: what should the intensive care physician know and do?

Vargas, Mónica / García, Alberto / Caicedo, Yaset / Parra, Michael W / Ordoñez, Carlos A

Colombia medica (Cali, Colombia)

2021 Volume 52, Issue 2, Page(s) e4174810

Abstract: Damage control surgery has transformed the management of severely injured trauma patients. It was initially described as a three-step process that included bleeding control, abdominal cavity contamination, and resuscitation in the intensive care unit ( ... ...

Abstract	Damage control surgery has transformed the management of severely injured trauma patients. It was initially described as a three-step process that included bleeding control, abdominal cavity contamination, and resuscitation in the intensive care unit (ICU) before definitive repair of the injuries. When the patient is admitted into the ICU, the physician should identify all the physiological alterations to establish resuscitation management goals. These strategies allow an early correction of trauma-induced coagulopathy and hypoperfusion increasing the likelihood of survival. The objective of this article is to describe the physiological alterations in a severely injured trauma patient who undergo damage control surgery and to establish an adequate management approach. The physician should always be aware and correct the hypothermia, acidosis, coagulopathy and hypocalcemia presented in the severely injured trauma patients.
MeSH term(s)	Blood Coagulation Disorders/etiology ; Blood Coagulation Disorders/therapy ; Critical Care ; Humans ; Intensive Care Units ; Physicians ; Resuscitation ; Wounds and Injuries/therapy
Language	English
Publishing date	2021-06-30
Publishing country	Colombia
Document type	Journal Article ; Review
ZDB-ID	2059694-7
ISSN	1657-9534 ; 0120-8322
ISSN (online)	1657-9534
ISSN	0120-8322
DOI	10.25100/cm.v52i2.4810
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article ; Online: Indication and survival bias: Threats to resuscitative endovascular balloon occlusion of the aorta outcomes research.

Manzano Nunez, Ramiro / Naranjo, Maria Paula / Ordoñez, Carlos A

The journal of trauma and acute care surgery

2017 Volume 84, Issue 1, Page(s) 214

MeSH term(s)	Aorta/surgery ; Balloon Occlusion ; Constriction ; Outcome Assessment (Health Care) ; Resuscitation ; Retrospective Studies ; Thoracotomy ; Torso
Language	English
Publishing date	2017-07-21
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	2651070-4
ISSN	2163-0763 ; 2163-0755
ISSN (online)	2163-0763
ISSN	2163-0755
DOI	10.1097/TA.0000000000001647
Database	MEDical Literature Analysis and Retrieval System OnLINE

In stock of ZB MED Cologne/Königswinter

Zs.A 127: 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 ▾
- See ZB MED holdings
- Order with fees

Article ; Online: Hypertonic saline infusion does not improve the chance of primary fascial closure after damage control laparotomy: a randomized controlled trial.

García, Alberto F / Manzano-Nunez, Ramiro / Carrillo, Diana Cristina / Chica-Yanten, Julian / Naranjo, María Paula / Sánchez, Álvaro I / Mejía, Jorge Humberto / Ospina-Tascón, Gustavo Adolfo / Ordoñez, Carlos A / Bayona, Juan Gabriel / Puyana, Juan Carlos

World journal of emergency surgery : WJES

2023 Volume 18, Issue 1, Page(s) 4

Abstract: Background: Previous observational studies showed higher rates of abdominal wall closure with the use of hypertonic saline in trauma patients with abdominal injuries. However, no randomized controlled trials have been performed on this matter. This ... ...

Abstract	Background: Previous observational studies showed higher rates of abdominal wall closure with the use of hypertonic saline in trauma patients with abdominal injuries. However, no randomized controlled trials have been performed on this matter. This double-blind randomized clinical trial assessed the effect of 3% hypertonic saline (HS) solution on primary fascial closure and the timing of abdominal wall closure among patients who underwent damage control laparotomy for bleeding control. Methods: Double-blind randomized clinical trial. Patients with abdominal injuries requiring damage control laparotomy (DCL) were randomly allocated to receive a 72-h infusion (rate: 50 mL/h) of 3% HS or 0.9 N isotonic saline (NS) after the index DCL. The primary endpoint was the proportion of patients with abdominal wall closure in the first seven days after the index DCL. Results: The study was suspended in the first interim analysis because of futility. A total of 52 patients were included. Of these, 27 and 25 were randomly allocated to NS and HS, respectively. There were no significant differences in the rates of abdominal wall closure between groups (HS: 19 [79.2%] vs. NS: 17 [70.8%]; p = 0.71). In contrast, significantly higher hypernatremia rates were observed in the HS group (HS: 11 [44%] vs. NS: 1 [3.7%]; p < 0.001). Conclusion: This double-blind randomized clinical trial showed no benefit of HS solution in primary fascial closure rates. Patients randomized to HS had higher sodium concentrations after the first day and were more likely to present hypernatremia. We do not recommend using HS in patients undergoing damage control laparotomy. Trial registration The trial protocol was registered in clinicaltrials.gov (identifier: NCT02542241).
MeSH term(s)	Humans ; Laparotomy/methods ; Hypernatremia/etiology ; Retrospective Studies ; Fascia ; Abdominal Injuries/surgery
Language	English
Publishing date	2023-01-09
Publishing country	England
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	2233734-9
ISSN	1749-7922 ; 1749-7922
ISSN (online)	1749-7922
ISSN	1749-7922
DOI	10.1186/s13017-023-00475-x
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article ; Online: Damage control approach to refractory neurogenic shock: a new proposal to a well-established algorithm.

Parra, Michael W / Ordoñez, Carlos A / Mejia, David / Caicedo, Yaset / Lobato, Javier Mauricio / Castro, Oscar Javier / Uribe, Jose Alfonso / Velásquez, Fernando

Colombia medica (Cali, Colombia)

2021 Volume 52, Issue 2, Page(s) e4164800

Abstract: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is commonly used as an adjunct to resuscitation and bridge to definitive control of non-compressible torso hemorrhage in patients with hemorrhagic shock. It has also been performed for ... ...

Abstract	Resuscitative endovascular balloon occlusion of the aorta (REBOA) is commonly used as an adjunct to resuscitation and bridge to definitive control of non-compressible torso hemorrhage in patients with hemorrhagic shock. It has also been performed for patients with neurogenic shock to support the central aortic pressure necessary for cerebral, coronary and spinal cord perfusion. Although volume replacement and vasopressors are the cornerstones of the management of neurogenic shock, we believe that a REBOA can be used as an adjunct in carefully selected cases to prevent prolonged hypotension and the risk of further anoxic spinal cord injury. This manuscript aims to propose a new damage control algorithmic approach to refractory neurogenic shock that includes the use of a REBOA in Zone 3. There are still unanswered questions on spinal cord perfusion and functional outcomes using a REBOA in Zone 3 in trauma patients with refractory neurogenic shock. However, we believe that its use in these case scenarios can be beneficial to the overall outcome of these patients.
MeSH term(s)	Algorithms ; Balloon Occlusion ; Endovascular Procedures ; Humans ; Resuscitation ; Shock, Hemorrhagic/therapy
Language	English
Publishing date	2021-06-30
Publishing country	Colombia
Document type	Journal Article ; Review
ZDB-ID	2059694-7
ISSN	1657-9534 ; 0120-8322
ISSN (online)	1657-9534
ISSN	0120-8322
DOI	10.25100/cm.v52i2.4800
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article ; Online: Hybrid trauma service: on the leading edge of damage Control.

Palacios-Rodríguez, Helmer Emilio / Hiroe, Nao / Guzmán-Rodríguez, Mónica / Caicedo, Yaset / Saldarriaga, Luis / Ordoñez, Carlos A / Funabiki, Tomohiro

Colombia medica (Cali, Colombia)

2021 Volume 52, Issue 2, Page(s) e4014686

Abstract: Trauma damage control seeks to limit life-threatening bleeding. Sequential diagnostic and therapeutic approaches are the current standard. Hybrid Room have reduced hemostasis time by integrating different specialties and technologies. Hybrid Rooms seek ... ...

Abstract	Trauma damage control seeks to limit life-threatening bleeding. Sequential diagnostic and therapeutic approaches are the current standard. Hybrid Room have reduced hemostasis time by integrating different specialties and technologies. Hybrid Rooms seek to control bleeding in an operating room equipped with specialized personnel and advanced technology including angiography, tomography, eFAST, radiography, endoscopy, infusers, cell retrievers, REBOA, etc. Trauma Hybrid Service is a concept that describes a vertical work scheme that begins with the activation of Trauma Code when admitting a severely injured patient, initiating a continuous resuscitation process led by the trauma surgeon who guides transfer to imaging, angiography and surgery rooms according to the patient's condition and the need for specific interventions. Hybrid rooms integrate different diagnostic and therapeutic tools in one same room, reducing the attention time and increasing all interventions effectiveness.
MeSH term(s)	Advanced Trauma Life Support Care ; Colombia ; Diagnostic Imaging/methods ; Hemorrhage/therapy ; Hemostatic Techniques ; Hospital Rapid Response Team/organization & administration ; Humans ; Operating Rooms/organization & administration ; Patient Care Team/organization & administration ; Resuscitation/methods
Language	English
Publishing date	2021-05-05
Publishing country	Colombia
Document type	Journal Article ; Review
ZDB-ID	2059694-7
ISSN	1657-9534 ; 0120-8322
ISSN (online)	1657-9534
ISSN	0120-8322
DOI	10.25100/cm.v52i2.4686
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article ; Online: Do all patients with placenta accreta spectrum require endovascular balloons?

Nieto-Calvache, Albaro José / Rodríguez Holguín, Fernando / Ordoñez, Carlos A / Sánchez Ortíz, Álvaro / Vergara-Galliadi, Lina María

American journal of obstetrics & gynecology MFM

2021 Volume 3, Issue 6, Page(s) 100364

MeSH term(s)	Balloon Occlusion ; Cesarean Section ; Female ; Humans ; Placenta Accreta/diagnostic imaging ; Pregnancy
Language	English
Publishing date	2021-03-27
Publishing country	United States
Document type	Letter ; Comment
ISSN	2589-9333
ISSN (online)	2589-9333
DOI	10.1016/j.ajogmf.2021.100364
Database	MEDical Literature Analysis and Retrieval System OnLINE

Full text online

Accessible to users with ZB MED library card

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 ▾
- Full text online
- Order with fees

Article ; Online: Risk factors for posttraumatic empyema in diaphragmatic injuries.

García, Alberto Federico / Rodríguez, Fernando / Sánchez, Álvaro / Caicedo-Holguín, Isabella / Gallego-Navarro, Carlos / Naranjo, María Paula / Caicedo, Yaset / Burbano, Daniela / Currea-Perdomo, Diana Felisa / Ordoñez, Carlos A / Puyana, Juan Carlos

World journal of emergency surgery : WJES

2022 Volume 17, Issue 1, Page(s) 47

Abstract: Background: Penetrating diaphragmatic injuries are associated with a high incidence of posttraumatic empyema. We analyzed the contribution of trauma severity, specific organ injury, contamination severity, and surgical management to the risk of ... ...

Abstract	Background: Penetrating diaphragmatic injuries are associated with a high incidence of posttraumatic empyema. We analyzed the contribution of trauma severity, specific organ injury, contamination severity, and surgical management to the risk of posttraumatic empyema in patients who underwent surgical repair of diaphragmatic injuries at a level 1 trauma center. Methods: This is a retrospective review of the patients who survived more than 48 h. Univariate OR calculations were performed to identify potential risk factors. Multiple logistic regression was used to calculate adjusted ORs and identify independent risk factors. Results: We included 192 patients treated from 2011 to 2020. There were 169 (88.0) males. The mean interquartile range, (IQR) of age, was 27 (22-35) years. Gunshot injuries occurred in 155 subjects (80.7%). Mean (IQR) NISS and ATI were 29 (18-44) and 17 (10-27), respectively. Thoracic AIS was > 3 in 38 patients (19.8%). Hollow viscus was injured in 105 cases (54.7%): stomach in 65 (33.9%), colon in 52 (27.1%), small bowel in 42 (21.9%), and duodenum in 10 (5.2%). Visible contamination was found in 76 patients (39.6%). Potential thoracic contamination was managed with a chest tube in 128 cases (66.7%), with transdiaphragmatic pleural lavage in 42 (21.9%), and with video-assisted thoracoscopy surgery or thoracotomy in 22 (11.5%). Empyema occurred in 11 patients (5.7%). Multiple logistic regression identified thoracic AIS > 3 (OR 6.4, 95% CI 1.77-23. 43), and visible contamination (OR 5.13, 95% IC 1.26-20.90) as independent risk factors. The individual organ injured, or the method used to manage the thoracic contamination did not affect the risk of posttraumatic empyema. Conclusion: The severity of the thoracic injury and the presence of visible abdominal contamination were identified as independent risk factors for empyema after penetrating diaphragmatic trauma.
MeSH term(s)	Adult ; Empyema/complications ; Empyema/surgery ; Humans ; Male ; Risk Factors ; Thoracic Injuries/complications ; Thoracic Injuries/surgery ; Thoracotomy/adverse effects ; Thoracotomy/methods ; Wounds, Penetrating/surgery
Language	English
Publishing date	2022-09-13
Publishing country	England
Document type	Journal Article
ZDB-ID	2233734-9
ISSN	1749-7922 ; 1749-7922
ISSN (online)	1749-7922
ISSN	1749-7922
DOI	10.1186/s13017-022-00453-9
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article ; Online: Outcomes and management approaches of resuscitative endovascular balloon occlusion of the aorta based on the income of countries.

Manzano-Nunez, Ramiro / McGreevy, David / Orlas, Claudia P / García, Alberto F / Hörer, Tal M / DuBose, Joseph / Ordoñez, Carlos A

World journal of emergency surgery : WJES

2020 Volume 15, Issue 1, Page(s) 57

Abstract: Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) could provide a survival benefit to severely injured patients as it may improve their initial ability to survive the hemorrhagic shock. Although the evidence supporting the ... ...

Abstract	Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) could provide a survival benefit to severely injured patients as it may improve their initial ability to survive the hemorrhagic shock. Although the evidence supporting the use of REBOA is not conclusive, its use has expanded worldwide. We aim to compare the management approaches and clinical outcomes of trauma patients treated with REBOA according to the countries' income based on the World Bank Country and Lending Groups. Methods: We used data from the AORTA (USA) and the ABOTrauma (multinational) registries. Patients were stratified into two groups: (1) high-income countries (HICs) and (2) low-to-middle income countries (LMICs). Propensity score matching extracted 1:1 matched pairs of subjects who were from an LMIC or a HIC based on age, gender, the presence of pupillary response on admission, impeding hypotension (SBP ≤ 80), trauma mechanism, ISS, the necessity of CPR on arrival, the location of REBOA insertion (emergency room or operating room) and the amount of PRBCs transfused in the first 24 h. Logistic regression (LR) was used to examine the association of LMICs and mortality. Results: A total of 817 trauma patients from 14 countries were included. Blind percutaneous approach and surgical cutdown were the preferred means of femoral cannulation in HICs and LIMCs, respectively. Patients from LMICs had a significantly higher occurrence of MODS and respiratory failure. LR showed no differences in mortality for LMICs when compared to HICs; neither in the non-matched cohort (OR = 0.63; 95% CI: 0.36‑1.09; p = 0.1) nor in the matched cohort (OR = 1.45; 95% CI: 0.63‑3,33; p = 0.3). Conclusion: There is considerable variation in the management practices of REBOA and the outcomes associated with this intervention between HICs and LMICs. Although we found significant differences in multiorgan and respiratory failure rates, there were no differences in the risk-adjusted odds of mortality between the groups analyzed. Trauma surgeons practicing REBOA around the world should joint efforts to standardize the practice of this endovascular technology worldwide.
MeSH term(s)	Adult ; Balloon Occlusion/methods ; Developed Countries ; Developing Countries ; Endovascular Procedures/methods ; Female ; Humans ; Male ; Middle Aged ; Propensity Score ; Registries ; Resuscitation/methods ; Shock, Hemorrhagic/mortality ; Shock, Hemorrhagic/therapy ; Survival Analysis ; Wounds and Injuries/mortality ; Wounds and Injuries/therapy
Keywords	covid19
Language	English
Publishing date	2020-10-12
Publishing country	England
Document type	Comparative Study ; Journal Article
ISSN	1749-7922
ISSN (online)	1749-7922
DOI	10.1186/s13017-020-00337-w
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: Critical systolic blood pressure threshold for endovascular aortic occlusion-A multinational analysis to determine when to place a REBOA.

The journal of trauma and acute care surgery

2023 Volume 96, Issue 2, Page(s) 247–255

Abstract: Background: Systolic blood pressure (SBP) is a potential indicator that could guide when to use a resuscitative endovascular balloon occlusion of the aorta (REBOA) in trauma patients with life-threatening injuries. This study aims to determine the ... ...

Abstract	Background: Systolic blood pressure (SBP) is a potential indicator that could guide when to use a resuscitative endovascular balloon occlusion of the aorta (REBOA) in trauma patients with life-threatening injuries. This study aims to determine the optimal SBP threshold for REBOA placement by analyzing the association between SBP pre-REBOA and 24-hour mortality in severely injured hemodynamically unstable trauma patients. Methods: We performed a pooled analysis of the aortic balloon occlusion (ABO) trauma and AORTA registries. These databases record the details related to the use of REBOA and include data from 14 countries worldwide. We included patients who had suffered penetrating and/or blunt trauma. Patients who arrived at the hospital with a SBP pre-REBOA of 0 mm Hg and remained at 0 mm Hg after balloon inflation were excluded. We evaluated the impact that SBP pre-REBOA had on the probability of death in the first 24 hours. Results: A total of 1,107 patients underwent endovascular aortic occlusion, of these, 848 met inclusion criteria. The median age was 44 years (interquartile range [IQR], 27-59 years) and 643 (76%) were male. The median injury severity score was 34 (IQR, 25-45). The median SBP pre-REBOA was 65 mm Hg (IQR, 49-88 mm Hg). Mortality at 24 hours was reported in 279 (32%) patients. Math modeling shows that predicted probabilities of the primary outcome increased steadily in SBP pre-REBOA below 100 mm Hg. Multivariable mixed-effects analysis shows that when SBP pre-REBOA was lower than 60 mm Hg, the risk of death was more than 50% (relative risk, 1.5; 95% confidence interval, 1.17-1.92; p = 0.001). Discussion: In patients who do not respond to initial resuscitation, the use of REBOA in SBPs between 60 mm Hg and 80 mm Hg may be a useful tool in resuscitation efforts before further decompensation or complete cardiovascular collapse. The findings from our study are clinically important as a first step in identifying candidates for REBOA. Level of evidence: Prognostic and Epidemiological; Level IV.
MeSH term(s)	Humans ; Male ; Adult ; Middle Aged ; Female ; Blood Pressure ; Aorta/injuries ; Balloon Occlusion ; Shock, Hemorrhagic/therapy ; Injury Severity Score ; Resuscitation ; Arterial Occlusive Diseases ; Endovascular Procedures ; Retrospective Studies
Language	English
Publishing date	2023-10-19
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.0000000000004160
Database	MEDical Literature Analysis and Retrieval System OnLINE

In stock of ZB MED Cologne/Königswinter

Zs.A 127: 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 ▾
- 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

More links

Kategorien

Order via subito

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

More links

Kategorien

Order via subito

More links

Kategorien

Order via subito

More links

Kategorien

Order via subito

Full text online

More links

Kategorien

Order via subito

Inter-library loan at ZB MED

More links

Kategorien

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