LIVIVO - Search results -

Search results

Result 1 - 9 of total 9

Search options

Article ; Online: Frailty modifies the effect of polypharmacy and multimorbidity on the risk of death among nursing home residents

Maria Beatrice Zazzara / Emanuele Rocco Villani / Katie Palmer / Daniela Fialova / Andrea Corsonello / Luca Soraci / Domenico Fusco / Maria Camilla Cipriani / Michael Denkinger / Graziano Onder / Rosa Liperoti

Frontiers in Medicine, Vol

Results from the SHELTER study

2023 Volume 10

Abstract: BackgroundFrailty, disability, and polypharmacy are prevalent in nursing home (NH) residents, often co-occurring with multimorbidity. There may be a complex interplay among them in terms of outcomes such as mortality. Aims of the study were to (i) assess ...

Abstract	BackgroundFrailty, disability, and polypharmacy are prevalent in nursing home (NH) residents, often co-occurring with multimorbidity. There may be a complex interplay among them in terms of outcomes such as mortality. Aims of the study were to (i) assess whether nursing home residents with polypharmacy (5–9 medications) or hyperpolypharmacy (≥10 drugs), have an increased risk of death and (ii) whether any association is modified by the co-presence of frailty or disability.MethodsCohort study with longitudinal mortality data including 4,023 residents from 50 European and 7 Israeli NH facilities (mean age = 83.6 years, 73.2% female) in The Services and Health for Elderly in Long Term care (SHELTER) cohort study. Participants were evaluated with the interRAI-LongTerm Care assessment tool. Frailty was evaluated with the FRAIL-NH scale. Hazard ratio (HR) of death over 12 months was assessed with stratified Cox proportional hazards models adjusted for demographics, facilities, and cognitive status.Results1,042 (25.9%) participants were not on polypharmacy, 49.8% (n = 2,002) were on polypharmacy, and 24.3% (n = 979) on hyperpolypharmacy. Frailty and disability mostly increased risk of death in the study population (frailty: HR = 1.85, 95%CI 1.49–2.28; disability: HR = 2.10, 95%CI 1.86–2.47). Among non-frail participants, multimorbidity (HR = 1.34, 95%CI = 1.01–1.82) and hyperpolypharmacy (HR = 1.61, 95%CI = 1.09–2.40) were associated with higher risk of death. Among frail participants, no other factors were associated with mortality. Polypharmacy and multimorbidity were not associated with mortality after stratification for disability.ConclusionsFrailty and disability are the strongest predictors of death in NH residents. Multimorbidity and hyperpolypharmacy increase mortality only in people without frailty. These findings may be relevant to identify patients who could benefit from tailored deprescription.
Keywords	drugs ; hyperpolypharmacy ; frailty ; long-term care facility ; mortality ; Medicine (General) ; R5-920
Subject code	360
Language	English
Publishing date	2023-02-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

Full text online

Full text

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: Association between Older Age and Psychiatric Symptoms in a Population of Hospitalized Patients with COVID-19

Maria Camilla Cipriani / Cristina Pais / Vezio Savoia / Cinzia Falsiroli / Andrea Bellieni / Antonella Cingolani / Massimo Fantoni / Daniela Pia Rosaria Chieffo / Gabriele Sani / Francesco Landi / Giovanni Landi / Rosa Liperoti

Journal of Personalized Medicine, Vol 13, Iss 973, p

2023 Volume 973

Abstract: Increased rates of anxiety and depression have been reported for older adults during the COVID-19 pandemic. However, little is known regarding the onset of mental health morbidity during the acute phase of the disease and the role of age as potential ... ...

Abstract	Increased rates of anxiety and depression have been reported for older adults during the COVID-19 pandemic. However, little is known regarding the onset of mental health morbidity during the acute phase of the disease and the role of age as potential independent risk factor for psychiatric symptoms. The cross-sectional association between older age and psychiatric symptoms has been estimated in a sample of 130 patients hospitalized for COVID-19 during the first and second wave of the pandemic. Compared to younger patients, those who were 70 years of age or older resulted at a higher risk of psychiatric symptoms measured on the Brief Psychiatric Symptoms Rating Scale (BPRS) (adjusted (adj.) odds ratio (OR) 2.36, 95% confidence interval (CI) 1.05–5.30) and delirium (adj. OR 5.24, 95% CI 1.63–16.8)). No association was found between older age and depressive symptoms or anxiety. Age was associated with psychiatric symptoms independently of gender, marital status, history of psychiatric illness, severity of disease and cardiovascular morbidity. Older adults appear at high risk of developing psychiatric symptoms related to COVID-19 disease during hospital stay. Multidisciplinary preventive and therapeutic interventions should be implemented to reduce the risk of psychiatric morbidity and related adverse health care outcomes among older hospital inpatients with COVID-19.
Keywords	older adults ; COVID-19 ; psychiatric symptoms ; delirium ; hospitalization ; Medicine ; R
Subject code	150
Language	English
Publishing date	2023-06-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

Full text online

Full text

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.

Book ; Online: Table_1_Neuropsychiatric Symptoms in Elderly With Dementia During COVID-19 Pandemic

Alessio Simonetti / Cristina Pais / Melissa Jones / Maria Camilla Cipriani / Delfina Janiri / Laura Monti / Francesco Landi / Roberto Bernabei / Rosa Liperoti / Gabriele Sani

Definition, Treatment, and Future Directions.docx

2020

Abstract: Background Neuropsychiatric symptoms (NPS) of dementia, such as anxiety, depression, agitation, and apathy, are complex, stressful, and costly aspects of care, and are associated to poor health outcomes and caregiver burden. A steep worsening of such ... ...

Abstract	Background Neuropsychiatric symptoms (NPS) of dementia, such as anxiety, depression, agitation, and apathy, are complex, stressful, and costly aspects of care, and are associated to poor health outcomes and caregiver burden. A steep worsening of such symptoms has been reported during Coronavirus Disease 2019 (COVID-19) pandemic. However, their causes, their impact on everyday life, and treatment strategies have not been systematically assessed. Therefore, the aim of this review is to provide a detailed description of behavioral and psychopathological alterations in subjects with dementia during COVID-19 pandemic and the associated management challenges. Methods A PubMed search was performed focusing on studies reporting alterations in behavior and mood and treatment strategies for elderly patients with dementia, in accordance with PRISMA guidelines. The following search strategy was utilized: (COVID* OR coronavirus OR “corona vir” OR SARS-CoV-2) AND (dementia OR demented OR dement OR alzheimer* OR “pick’s disease” OR “lewy body” OR “mild cognitive” OR mild cognitive impairment OR MCI). Results Apathy, anxiety and agitation are the most frequently NPS during the COVID-19 pandemic and are mainly triggered by protracted isolation. Most treatment strategies rely on pharmacotherapy; technology is increasingly utilized with mixed results. Conclusions NPS of dementia during COVID-19 appear to arise from social restrictions occurring as a consequence of the pandemic. Implementation of caregiver support and the presence of skilled nursing home staff are required to restore social interaction and adjust technological support to the patients’ needs.
Keywords	Psychiatry (incl. Psychotherapy) ; dementia ; COVID-19 ; apathy ; anxiety ; agitation ; treatment ; covid19
Subject code	150
Publishing date	2020-09-29T04:45:07Z
Publishing country	uk
Document type	Book ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

Full text online

Full text

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: Neuropsychiatric Symptoms in Elderly With Dementia During COVID-19 Pandemic

Alessio Simonetti / Cristina Pais / Melissa Jones / Maria Camilla Cipriani / Delfina Janiri / Laura Monti / Francesco Landi / Roberto Bernabei / Rosa Liperoti / Gabriele Sani

Frontiers in Psychiatry, Vol

Definition, Treatment, and Future Directions

2020 Volume 11

Abstract: BackgroundNeuropsychiatric symptoms (NPS) of dementia, such as anxiety, depression, agitation, and apathy, are complex, stressful, and costly aspects of care, and are associated to poor health outcomes and caregiver burden. A steep worsening of such ... ...

Abstract	BackgroundNeuropsychiatric symptoms (NPS) of dementia, such as anxiety, depression, agitation, and apathy, are complex, stressful, and costly aspects of care, and are associated to poor health outcomes and caregiver burden. A steep worsening of such symptoms has been reported during Coronavirus Disease 2019 (COVID-19) pandemic. However, their causes, their impact on everyday life, and treatment strategies have not been systematically assessed. Therefore, the aim of this review is to provide a detailed description of behavioral and psychopathological alterations in subjects with dementia during COVID-19 pandemic and the associated management challenges.MethodsA PubMed search was performed focusing on studies reporting alterations in behavior and mood and treatment strategies for elderly patients with dementia, in accordance with PRISMA guidelines. The following search strategy was utilized: (COVID* OR coronavirus OR “corona vir” OR SARS-CoV-2) AND (dementia OR demented OR dement OR alzheimer* OR “pick’s disease” OR “lewy body” OR “mild cognitive” OR mild cognitive impairment OR MCI).ResultsApathy, anxiety and agitation are the most frequently NPS during the COVID-19 pandemic and are mainly triggered by protracted isolation. Most treatment strategies rely on pharmacotherapy; technology is increasingly utilized with mixed results.ConclusionsNPS of dementia during COVID-19 appear to arise from social restrictions occurring as a consequence of the pandemic. Implementation of caregiver support and the presence of skilled nursing home staff are required to restore social interaction and adjust technological support to the patients’ needs.
Keywords	dementia ; COVID-19 ; apathy ; anxiety ; agitation ; treatment ; Psychiatry ; RC435-571 ; covid19
Subject code	150
Language	English
Publishing date	2020-09-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

Full text online

Full text

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: Applying the FAIR4Health Solution to Identify Multimorbidity Patterns and Their Association with Mortality through a Frequent Pattern Growth Association Algorithm

Jonás Carmona-Pírez / Beatriz Poblador-Plou / Antonio Poncel-Falcó / Jessica Rochat / Celia Alvarez-Romero / Alicia Martínez-García / Carmen Angioletti / Marta Almada / Mert Gencturk / A. Anil Sinaci / Jara Eloisa Ternero-Vega / Christophe Gaudet-Blavignac / Christian Lovis / Rosa Liperoti / Elisio Costa / Carlos Luis Parra-Calderón / Aida Moreno-Juste / Antonio Gimeno-Miguel / Alexandra Prados-Torres

International Journal of Environmental Research and Public Health, Vol 19, Iss 2040, p

2022 Volume 2040

Abstract: The current availability of electronic health records represents an excellent research opportunity on multimorbidity, one of the most relevant public health problems nowadays. However, it also poses a methodological challenge due to the current lack of ... ...

Abstract	The current availability of electronic health records represents an excellent research opportunity on multimorbidity, one of the most relevant public health problems nowadays. However, it also poses a methodological challenge due to the current lack of tools to access, harmonize and reuse research datasets. In FAIR4Health, a European Horizon 2020 project, a workflow to implement the FAIR (findability, accessibility, interoperability and reusability) principles on health datasets was developed, as well as two tools aimed at facilitating the transformation of raw datasets into FAIR ones and the preservation of data privacy. As part of this project, we conducted a multicentric retrospective observational study to apply the aforementioned FAIR implementation workflow and tools to five European health datasets for research on multimorbidity. We applied a federated frequent pattern growth association algorithm to identify the most frequent combinations of chronic diseases and their association with mortality risk. We identified several multimorbidity patterns clinically plausible and consistent with the bibliography, some of which were strongly associated with mortality. Our results show the usefulness of the solution developed in FAIR4Health to overcome the difficulties in data management and highlight the importance of implementing a FAIR data policy to accelerate responsible health research.
Keywords	FAIR principles ; multimorbidity ; mortality ; research data management ; pathfinder case study ; privacy-preserving distributed data mining ; Medicine ; R
Language	English
Publishing date	2022-02-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

Full text online

Full text

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: The “develOpment of metabolic and functional markers of Dementia IN Older people” (ODINO) Study

Anna Picca / Daniela Ronconi / Hélio J. Coelho-Junior / Riccardo Calvani / Federico Marini / Alessandra Biancolillo / Jacopo Gervasoni / Aniello Primiano / Cristina Pais / Eleonora Meloni / Domenico Fusco / Maria Rita Lo Monaco / Roberto Bernabei / Maria Camilla Cipriani / Emanuele Marzetti / Rosa Liperoti

Journal of Personalized Medicine, Vol 10, Iss 22, p

Rationale, Design and Methods

2020 Volume 22

Abstract: Mild cognitive impairment (MCI), also termed mild neurocognitive disorder, includes a heterogeneous group of conditions characterized by declines in one or more cognitive domains greater than that expected during “normal” aging but not severe enough to ... ...

Abstract	Mild cognitive impairment (MCI), also termed mild neurocognitive disorder, includes a heterogeneous group of conditions characterized by declines in one or more cognitive domains greater than that expected during “normal” aging but not severe enough to impair functional abilities. MCI has been associated with an increased risk of developing dementia and even considered an early stage of it. Therefore, noninvasively accessible biomarkers of MCI are highly sought after for early identification of the condition. Systemic inflammation, metabolic perturbations, and declining physical performance have been described in people with MCI. However, whether biological and functional parameters differ across MCI neuropsychological subtypes is presently debated. Likewise, the predictive value of existing biomarkers toward MCI conversion into dementia is unclear. The “develOpment of metabolic and functional markers of Dementia IN Older people” (ODINO) study was conceived as a multi-dimensional investigation in which multi-marker discovery will be coupled with innovative statistical approaches to characterize patterns of systemic inflammation, metabolic perturbations, and physical performance in older adults with MCI. The ultimate aim of ODINO is to identify potential biomarkers specific for MCI subtypes and predictive of MCI conversion into Alzheimer’s disease or other forms of dementia over a three-year follow-up. Here, we describe the rationale, design, and methods of ODINO.
Keywords	aging ; biomarkers ; cytokines ; cognitive decline ; Alzheimer’s disease ; metabolomics ; Medicine ; R
Language	English
Publishing date	2020-04-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

Full text online

Full text

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: Calf circumference, frailty and physical performance among older adults living in the community

Landi, Francesco / Andrea Russo / Anna Maria Martone / Ettore Capoluongo / Graziano Onder / Matteo Tosato / Roberto Bernabei / Rosa Liperoti

Clinical nutrition. 2014 June, v. 33, no. 3

2014

Abstract: Lean body mass loss has been indicated as a reliable marker of frailty and poor physical performance among older individuals. We evaluated the relationship between calf circumference and frailty, physical performance, muscle strength, and functional ... ...

Abstract	Lean body mass loss has been indicated as a reliable marker of frailty and poor physical performance among older individuals. We evaluated the relationship between calf circumference and frailty, physical performance, muscle strength, and functional status in persons aged 80 years or older.Data are from the baseline evaluation of the Aging and Longevity Study in the Sirente geographic area (ilSIRENTE Study) (n = 357). The calf circumference was measured at the point of greatest circumference. Frailty was categorized according to the present of slow gait speed, weakness, weight loss, energy expenditure and exhaustion. Physical performance was assessed using the physical performance battery score, which is based on three timed tests: 4-m walking speed test, the balance test and the chair stand test. Analyses of covariance were performed to evaluate the relationship between different calf circumference and physical function.After adjustment for potential confounders, which included age, gender, education, body mass index, sensory impairments, cerebrovascular diseases, albumin, reactive C protein, interleukine-6, and cholesterol, physical performance (SPPB score: 7.27 versus 6.18, p = 0.02) and muscle strength (Hand Grip: 32 kg versus 28 kg, p = 0.03) measures significantly improved as calf circumference increased. The frailty index score was significantly lower among subjects with higher calf circumference (1.66 versus 2.17, p = 0.01).The present study suggests that among community-dwelling older people, calf circumference may be positively related to lower frailty index and higher functional performance. As such, calf circumference is a valuable tool for guiding public health policy and clinical decisions.
Keywords	albumins ; analysis of covariance ; batteries ; body mass index ; calf circumference ; cerebrovascular disorders ; cholesterol ; education ; elderly ; energy expenditure ; functional status ; gait ; gender ; health policy ; interleukin-6 ; lean body mass ; longevity ; muscle strength ; walking ; weight loss
Language	English
Dates of publication	2014-06
Size	p. 539-544.
Publishing place	Elsevier Ltd
Document type	Article
ZDB-ID	604812-2
ISSN	1532-1983 ; 0261-5614
ISSN (online)	1532-1983
ISSN	0261-5614
DOI	10.1016/j.clnu.2013.07.013
Database	NAL-Catalogue (AGRICOLA)

In stock of ZB MED Cologne/Königswinter

Zs.A 1774: 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 ▾
- See ZB MED holdings
- Order with fees

Article ; Online: FAIR4Health

Christian Lovis / Christophe Gaudet-Blavignac / Miriam Quintero / Patrick Weber / Kevin Ashley / Manuel M. Perez-Perez / Carlos Luis Parra Calderón / Laurence Horton / Celia Alvarez-Romero / A. Anil Sinaci / Alicia Martínez-García / Eva Méndez / Mert Gencturk / Rosa Liperoti / Tony Hernández-Pérez / Matthias Löbe / Carmen Angioletti / Thomas M. Deserno / Nagarajan Ganapathy /

Elisio Costa / Marta Almada / Giorgio Cangioli / Catherine Chronaki / Beatriz Poblador-Plou / Ronald Cornet / Antonio Gimeno-Miguel / Jonás Carmona-Pírez / Alexandra Prados-Torres / Antonio Poncel-Falcó / Bojan Zaric / Tomi Kovacevic / Sanja Hromis / Darijo Bokan / Carlos Rapallo Fernández / Jelena Djekic Malbasa / Jessica Rochat / Teresa Velázquez Fernández

Open Research Europe, Vol

Findable, Accessible, Interoperable and Reusable data to foster Health Research [version 2; peer review: 1 approved, 2 approved with reservations]

2022 Volume 2

Abstract: Due to the nature of health data, its sharing and reuse for research are limited by ethical, legal and technical barriers. The FAIR4Health project facilitated and promoted the application of FAIR principles in health research data, derived from the ... ...

Abstract	Due to the nature of health data, its sharing and reuse for research are limited by ethical, legal and technical barriers. The FAIR4Health project facilitated and promoted the application of FAIR principles in health research data, derived from the publicly funded health research initiatives to make them Findable, Accessible, Interoperable, and Reusable (FAIR). To confirm the feasibility of the FAIR4Health solution, we performed two pathfinder case studies to carry out federated machine learning algorithms on FAIRified datasets from five health research organizations. The case studies demonstrated the potential impact of the developed FAIR4Health solution on health outcomes and social care research. Finally, we promoted the FAIRified data to share and reuse in the European Union Health Research community, defining an effective EU-wide strategy for the use of FAIR principles in health research and preparing the ground for a roadmap for health research institutions. This scientific report presents a general overview of the FAIR4Health solution: from the FAIRification workflow design to translate raw data/metadata to FAIR data/metadata in the health research domain to the FAIR4Health demonstrators’ performance.
Keywords	FAIR principles ; health research data management ; HL7 FHIR ; health data ; data sharing ; data reuse ; eng ; Science ; Q ; Social Sciences ; H
Subject code	306
Language	English
Publishing date	2022-05-01T00:00:00Z
Publisher	F1000 Research Ltd
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

Full text online

Full text

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: Inappropriate drugs in elderly patients with severe cognitive impairment

Giuseppe Colloca / Matteo Tosato / Davide L Vetrano / Eva Topinkova / Daniela Fialova / Jacob Gindin / Henriëtte G van der Roest / Francesco Landi / Rosa Liperoti / Roberto Bernabei / Graziano Onder / SHELTER project

PLoS ONE, Vol 7, Iss 10, p e

results from the shelter study.

2012 Volume 46669

Abstract: BACKGROUND: It has been estimated that Nursing Home (NH) residents with impaired cognitive status receive an average of seven to eight drugs daily. The aim of this study was to determine prevalence and factors associated with use of inappropriate drugs ... ...

Abstract	BACKGROUND: It has been estimated that Nursing Home (NH) residents with impaired cognitive status receive an average of seven to eight drugs daily. The aim of this study was to determine prevalence and factors associated with use of inappropriate drugs in elderly patients with severe cognitive impairment living in NH in Europe. METHODS: Cross-sectional data from a sample of 1449 NH residents with severe cognitive impairment, participating in the Services and Health for Elderly in Long TERm care (SHELTER) study were analysed. Inappropriate drug use was defined as the use of drugs classified as rarely or never appropriate in patients with severe cognitive impairment based on the Holmes criteria published in 2008. RESULTS: Mean age of participating residents was 84.2±8.9 years, 1087 (75.0%) were women. Inappropriate drug use was observed in 643 (44.9%) residents. Most commonly used inappropriate drugs were lipid-lowering agents (9.9%), antiplatelet agents (excluding Acetylsalicylic Acid - ASA -) (9.9%), acetylcholinesterase, inhibitors (7.2%) and antispasmodics (6.9%). Inappropriate drug use was directly associated with specific diseases including diabetes (OR 1.64; 95% CI 1.21-2.24), heart failure (OR 1.48; 95% CI 1.04-2.09), stroke (OR 1.43; 95% CI 1.06-1.93), and recent hospitalization (OR 1.69; 95% CI 1.20-2.39). An inverse relation was shown between inappropriate drug use and presence of a geriatrician in the facility (OR 0.55; 95% CI 0.39-0.77). CONCLUSION: Use of inappropriate drugs is common among older EU NH residents. Determinants of inappropriate drug use include comorbidities and recent hospitalization. Presence of a geriatrician in the facility staff is associated with a reduced rate of use of these medications.
Keywords	Medicine ; R ; Science ; Q
Subject code	616
Language	English
Publishing date	2012-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

Full text online

Full text

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.

To top

Full text online

More links

Kategorien

Inter-library loan at ZB MED

Full text online

More links

Kategorien

Inter-library loan at ZB MED

Full text online

More links

Kategorien

Inter-library loan at ZB MED

Full text online

More links

Kategorien

Inter-library loan at ZB MED

Full text online

More links

Kategorien

Inter-library loan at ZB MED

Full text online

More links

Kategorien

Inter-library loan at ZB MED

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

Full text online

More links

Kategorien

Inter-library loan at ZB MED

Full text online

More links

Kategorien

Inter-library loan at ZB MED