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  1. Book: Renal transplantation

    Torpey, Nicholas

    (Oxford specialist handbooks)

    2010  

    Author's details ed. by Nicholas Torpey
    Series title Oxford specialist handbooks
    Language English
    Size XXV, 436 S., [1] Bl. : Ill., graph. Darst., 18 cm
    Publisher Oxford Univ. Press
    Publishing place Oxford
    Publishing country Great Britain
    Document type Book
    HBZ-ID HT016223963
    ISBN 978-0-19-921566-9 ; 0-19-921566-9
    Database Catalogue ZB MED Medicine, Health

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    2010 A 744 order for loan Magazin

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  2. Article ; Online: Use of rituximab in SARS-CoV-2-positive renal transplant recipient with EBV reactivation and probable haemophagocytic lymphohistiocytosis.

    Chan, Derek / Karimi, Sabina / Follows, George / Torpey, Nicholas / Suchanek, Ondrej

    CEN case reports

    2022  Volume 12, Issue 1, Page(s) 27–31

    Abstract: We present a case of a rapid clinical recovery in a critically ill kidney transplant recipient with SARS-CoV-2 positivity, Epstein-Barr virus (EBV) reactivation and probable secondary hemophagocytic lymphohistiocytosis (HLH) treated with etoposide-free ... ...

    Abstract We present a case of a rapid clinical recovery in a critically ill kidney transplant recipient with SARS-CoV-2 positivity, Epstein-Barr virus (EBV) reactivation and probable secondary hemophagocytic lymphohistiocytosis (HLH) treated with etoposide-free regimen, based on dexamethasone and a single dose of rituximab. Although rituximab is often a part of EBV-HLH treatment strategy, its use in simultaneous Coronavirus 2019 disease (COVID-19) and solid-organ transplantation has not been reported yet. We review the current evidence for the potential of SARS-CoV-2 to trigger EBV reactivation, leading to a severe clinical illness. Finally, we compare the clinical features of hyper-inflammatory response typical for severe COVID-19 and classical secondary HLH and discuss the benefits of therapeutic B-cell depletion in both conditions.
    MeSH term(s) Humans ; COVID-19/complications ; Epstein-Barr Virus Infections/complications ; Epstein-Barr Virus Infections/diagnosis ; Epstein-Barr Virus Infections/drug therapy ; Herpesvirus 4, Human ; Kidney Transplantation ; Lymphohistiocytosis, Hemophagocytic/diagnosis ; Lymphohistiocytosis, Hemophagocytic/drug therapy ; Lymphohistiocytosis, Hemophagocytic/etiology ; Rituximab/therapeutic use ; SARS-CoV-2
    Chemical Substances Rituximab (4F4X42SYQ6)
    Language English
    Publishing date 2022-06-22
    Publishing country Japan
    Document type Case Reports ; Review ; Journal Article
    ZDB-ID 2660492-9
    ISSN 2192-4449 ; 2192-4449
    ISSN (online) 2192-4449
    ISSN 2192-4449
    DOI 10.1007/s13730-022-00711-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Book: Renal transplantation

    Torpey, Nicholas

    (Oxford specialist handbooks ; Oxford medical publications)

    2010  

    Author's details edited by Nicholas Torpey ... [et al.]
    Series title Oxford specialist handbooks
    Oxford medical publications
    MeSH term(s) Kidney Transplantation
    Language English
    Size xxv, 436 p., [2] p. of plates :, ill. (some col.) ;, 19 cm.
    Publisher Oxford University Press
    Publishing place Oxford ; New York
    Document type Book
    ISBN 9780199215669 ; 0199215669
    Database Catalogue of the US National Library of Medicine (NLM)

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  4. Article ; Online: A Case of Thrombotic Microangiopathy and Acute Sarcoidosis.

    Martinelli, Anthony W / Dunn, William / McClure, Mark E / Walker, Ieuan / Stewart, Andrew / Karia, Sumit / Preston, Stephen D / Thiru, Sathia / Torpey, Nicholas / Ojha, Sanjay / Symington, Emily / Nathan, James A

    Chest

    2022  Volume 162, Issue 5, Page(s) e245–e248

    Abstract: Although sarcoidosis is an established cause of multiorgan dysfunction, acute presentation with thrombotic microangiopathy resulting in severe renal and hematological sequelae has not been reported. We describe the case of a patient presenting with ... ...

    Abstract Although sarcoidosis is an established cause of multiorgan dysfunction, acute presentation with thrombotic microangiopathy resulting in severe renal and hematological sequelae has not been reported. We describe the case of a patient presenting with hypercalcemia, pancreatitis, and acute renal failure, followed by microangiopathic hemolytic anemia. Although there were no significant respiratory symptoms, thoracic radiology and mediastinal lymph node biopsy results were in keeping with sarcoidosis as the underlying cause of this multisystem presentation. Corticosteroids were commenced with clinical and biochemical improvement. This novel case highlights the need to consider sarcoidosis as part of the differential diagnosis for unusual multiorgan presentations and for early multidisciplinary involvement in such cases to permit optimal treatment.
    MeSH term(s) Humans ; Thrombotic Microangiopathies/diagnosis ; Thrombotic Microangiopathies/etiology ; Kidney ; Acute Kidney Injury/therapy ; Biopsy/adverse effects ; Sarcoidosis/complications ; Sarcoidosis/diagnosis ; Sarcoidosis/pathology
    Language English
    Publishing date 2022-11-07
    Publishing country United States
    Document type Case Reports
    ZDB-ID 1032552-9
    ISSN 1931-3543 ; 0012-3692
    ISSN (online) 1931-3543
    ISSN 0012-3692
    DOI 10.1016/j.chest.2022.06.023
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Ui III Zs.45: Show issues Location:
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    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 349: Show issues

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  5. Article ; Online: Validation of a Capillary Dry Blood Sample MITRA-Based Assay for the Quantitative Determination of Systemic Tacrolimus Concentrations in Transplant Recipients.

    Undre, Nasrullah / Dawson, Ian / Aluvihare, Varuna / Kamar, Nassim / Saliba, Faouzi / Torpey, Nicholas / Anaokar, Swapneel / Kazeem, Gbenga / Hussain, Imran

    Therapeutic drug monitoring

    2020  Volume 43, Issue 3, Page(s) 358–363

    Abstract: Background: Tacrolimus is a narrow therapeutic index medication, which requires therapeutic drug monitoring to optimize dosing based on systemic exposure. MITRA microsampling offers a convenient, minimally invasive approach for the collection of ... ...

    Abstract Background: Tacrolimus is a narrow therapeutic index medication, which requires therapeutic drug monitoring to optimize dosing based on systemic exposure. MITRA microsampling offers a convenient, minimally invasive approach for the collection of capillary blood samples from a finger prick versus conventional venous blood sampling for quantitation of tacrolimus blood concentrations. However, the suitability of MITRA microsampling for the determination of tacrolimus concentrations requires assessment in clinical settings.
    Methods: Paired venous (2 mL) and capillary (10 μL) blood samples were collected pre-tacrolimus dose and 1 and 3 hours postdose during routine outpatient visits from stable adult liver or kidney transplant patients receiving prolonged-release tacrolimus. Tacrolimus concentrations were determined by liquid chromatography-tandem mass spectrometry, and the concentrations obtained by the 2 sampling methods were compared by linear regression and Bland-Altman agreement analyses.
    Results: Samples were available for 82 transplant recipients (kidney, n = 41; liver, n = 41). A high correlation was observed between tacrolimus concentrations in capillary and venous blood samples (Pearson correlation coefficient, 0.97; Lin concordance coefficient, 0.87; slope of the fitted line, >1.0). Tacrolimus concentrations in capillary samples were 22.5% higher on average than in the corresponding venous blood samples (95% limits of agreement, 0.5%-44.6%). Similar results were observed in both transplant subgroups.
    Conclusions: MITRA finger prick sampling provides a convenient alternative to venipuncture for therapeutic drug monitoring in transplant recipients maintained on prolonged-release tacrolimus. When using the finger prick MITRA method, the positive bias in tacrolimus concentrations observed with this technique, when compared with venipuncture, needs to be taken into consideration.
    MeSH term(s) Adult ; Aged ; Chromatography, Liquid ; Dried Blood Spot Testing ; Drug Monitoring ; Female ; Humans ; Immunosuppressive Agents/pharmacokinetics ; Kidney Transplantation ; Male ; Middle Aged ; Tacrolimus/pharmacokinetics ; Transplant Recipients
    Chemical Substances Immunosuppressive Agents ; Tacrolimus (WM0HAQ4WNM)
    Language English
    Publishing date 2020-12-04
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Validation Study
    ZDB-ID 424443-6
    ISSN 1536-3694 ; 0163-4356
    ISSN (online) 1536-3694
    ISSN 0163-4356
    DOI 10.1097/FTD.0000000000000847
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1503: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
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  6. Article ; Online: Renal transplantation during the SARS-CoV-2 pandemic in the UK: Experience from a large-volume center.

    Georgiades, Fanourios / Summers, Dominic M / Butler, Andrew J / Russell, Neil K I / Clatworthy, Menna R / Torpey, Nicholas

    Clinical transplantation

    2020  Volume 35, Issue 1, Page(s) e14150

    Abstract: There is uncertainty about the safety of kidney transplantation during the SARS-CoV-2 pandemic due to the risk of donor transmission, nosocomial infection and immunosuppression use. We describe organ donation and transplant practice in the UK and assess ... ...

    Abstract There is uncertainty about the safety of kidney transplantation during the SARS-CoV-2 pandemic due to the risk of donor transmission, nosocomial infection and immunosuppression use. We describe organ donation and transplant practice in the UK and assess whether kidney transplantation conferred a substantial risk of harm. Data from the UK transplant registry were used to describe kidney donation and transplant activity in the UK, and a detailed analysis of short-term, single-center, patient results in two periods: during the pre-pandemic era from 30th December 2019 to 8th March 2020 ("Pre-COVID era") and the 9th March 2020 to 19th May 2020 ("COVID era"). Donor and recipient numbers fell by more than half in the COVID compared to the pre-COVID era in the UK, but there were more kidney transplants performed in our center (42 vs. 29 COVID vs. pre-COVID respectively). Overall outcomes, including re-operation, delayed graft function, primary non-function, acute rejection, length of stay and graft survival were similar between COVID and pre-COVID era. 6/71 patients became infected with SARS-CoV-2 but all were discharged without critical care requirement. Transplant outcomes have remained similar within the COVID period and no serious sequelae of SARS-CoV-2 infection were observed in the peri-transplant period.
    MeSH term(s) Adult ; COVID-19/complications ; COVID-19/immunology ; COVID-19/virology ; Female ; Graft Rejection/epidemiology ; Graft Rejection/immunology ; Graft Rejection/virology ; Hospitals, High-Volume/statistics & numerical data ; Humans ; Kidney Transplantation/adverse effects ; Male ; Middle Aged ; Retrospective Studies ; SARS-CoV-2/isolation & purification ; Transplant Recipients/statistics & numerical data ; United Kingdom/epidemiology
    Keywords covid19
    Language English
    Publishing date 2020-11-23
    Publishing country Denmark
    Document type Journal Article
    ZDB-ID 639001-8
    ISSN 1399-0012 ; 0902-0063
    ISSN (online) 1399-0012
    ISSN 0902-0063
    DOI 10.1111/ctr.14150
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    Zs.A 2204: Show issues Location:
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  7. Article ; Online: SARS-COV-2 vaccine responses in renal patient populations.

    Smith, Rona M / Cooper, Daniel J / Doffinger, Rainer / Stacey, Hannah / Al-Mohammad, Abdulrahman / Goodfellow, Ian / Baker, Stephen / Lear, Sara / Hosmilo, Myra / Pritchard, Nicholas / Torpey, Nicholas / Jayne, David / Yiu, Vivien / Chalisey, Anil / Lee, Jacinta / Vilnar, Enric / Cheung, Chee Kay / Jones, Rachel B

    BMC nephrology

    2022  Volume 23, Issue 1, Page(s) 199

    Abstract: Background: Dialysis patients and immunosuppressed renal patients are at increased risk of COVID-19 and were excluded from vaccine trials. We conducted a prospective multicentre study to assess SARS-CoV-2 vaccine antibody responses in dialysis patients ... ...

    Abstract Background: Dialysis patients and immunosuppressed renal patients are at increased risk of COVID-19 and were excluded from vaccine trials. We conducted a prospective multicentre study to assess SARS-CoV-2 vaccine antibody responses in dialysis patients and renal transplant recipients, and patients receiving immunosuppression for autoimmune disease.
    Methods: Patients were recruited from three UK centres (ethics:20/EM/0180) and compared to healthy controls (ethics:17/EE/0025). SARS-CoV-2 IgG antibodies to spike protein were measured using a multiplex Luminex assay, after first and second doses of Pfizer BioNTech BNT162b2(Pfizer) or Oxford-AstraZeneca ChAdOx1nCoV-19(AZ) vaccine.
    Results: Six hundred ninety-two patients were included (260 dialysis, 209 transplant, 223 autoimmune disease (prior rituximab 128(57%)) and 144 healthy controls. 299(43%) patients received Pfizer vaccine and 379(55%) received AZ. Following two vaccine doses, positive responses occurred in 96% dialysis, 52% transplant, 70% autoimmune patients and 100% of healthy controls. In dialysis patients, higher antibody responses were observed with the Pfizer vaccination. Predictors of poor antibody response were triple immunosuppression (adjusted odds ratio [aOR]0.016;95%CI0.002-0.13;p < 0.001) and mycophenolate mofetil (MMF) (aOR0.2;95%CI 0.1-0.42;p < 0.001) in transplant patients; rituximab within 12 months in autoimmune patients (aOR0.29;95%CI 0.008-0.096;p < 0.001) and patients receiving immunosuppression with eGFR 15-29 ml/min (aOR0.031;95%CI 0.11-0.84;p = 0.021). Lower antibody responses were associated with a higher chance of a breakthrough infection.
    Conclusions: Amongst dialysis, kidney transplant and autoimmune populations SARS-CoV-2 vaccine antibody responses are reduced compared to healthy controls. A reduced response to vaccination was associated with rituximab, MMF, triple immunosuppression CKD stage 4. Vaccine responses increased after the second dose, suggesting low-responder groups should be prioritised for repeated vaccination. Greater antibody responses were observed with the mRNA Pfizer vaccine compared to adenovirus AZ vaccine in dialysis patients suggesting that Pfizer SARS-CoV-2 vaccine should be the preferred vaccine choice in this sub-group.
    MeSH term(s) Autoimmune Diseases ; BNT162 Vaccine ; COVID-19/prevention & control ; COVID-19 Vaccines ; Humans ; Mycophenolic Acid ; Renal Dialysis ; Rituximab ; SARS-CoV-2 ; Viral Vaccines
    Chemical Substances COVID-19 Vaccines ; Viral Vaccines ; Rituximab (4F4X42SYQ6) ; Mycophenolic Acid (HU9DX48N0T) ; BNT162 Vaccine (N38TVC63NU)
    Language English
    Publishing date 2022-05-31
    Publishing country England
    Document type Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 2041348-8
    ISSN 1471-2369 ; 1471-2369
    ISSN (online) 1471-2369
    ISSN 1471-2369
    DOI 10.1186/s12882-022-02792-w
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Renal transplantation during the SARS-CoV-2 pandemic in the UK: experience from a large volume centre

    Georgiades, Fanourios / Summers, Dominic M / Butler, Andrew J / Russell, Neil K I / Clatworthy, Menna R / Torpey, Nicholas

    Clin Transplant

    Abstract: There is uncertainty about the safety of kidney transplantation during the SARS-CoV-2 pandemic due to the risk of donor transmission, nosocomial infection and immunosuppression use. We describe organ donation and transplant practice in the UK and assess ... ...

    Abstract There is uncertainty about the safety of kidney transplantation during the SARS-CoV-2 pandemic due to the risk of donor transmission, nosocomial infection and immunosuppression use. We describe organ donation and transplant practice in the UK and assess whether kidney transplantation conferred a substantial risk of harm. Data from the UK transplant registry were used to describe kidney donation and transplant activity in the UK, and a detailed analysis of short-term, single-centre, patient results in two periods: during the pre-pandemic era from 30th December 2019 to 8th March 2020 ("Pre-COVID era") and the 9th March 2020 to 19th May 2020 ("COVID era"). Donor and recipient numbers fell by more than half in the COVID compared to the pre-COVID era in the UK, but there were more kidney transplants performed in our centre (42 vs 29 COVID vs pre-COVID respectively). Overall outcomes, including re-operation, delayed graft function, primary non function, acute rejection, length of stay and graft survival were similar between COVID and pre-COVID era. 6/71 patients became infected with SARS-CoV-2 but all were discharged without critical care requirement. Transplant outcomes have remained similar within the COVID period and no serious sequelae of SARS-CoV-2 infection were observed in the peri-transplant period.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #917739
    Database COVID19

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  9. Article ; Online: Guidelines on the use of irradiated blood components.

    Foukaneli, Theodora / Kerr, Paul / Bolton-Maggs, Paula H B / Cardigan, Rebecca / Coles, Alasdair / Gennery, Andrew / Jane, David / Kumararatne, Dinakantha / Manson, Ania / New, Helen V / Torpey, Nicholas

    British journal of haematology

    2020  Volume 191, Issue 5, Page(s) 704–724

    MeSH term(s) Blood Component Transfusion ; Blood Preservation ; Humans
    Language English
    Publishing date 2020-08-18
    Publishing country England
    Document type Journal Article ; Practice Guideline ; Systematic Review
    ZDB-ID 80077-6
    ISSN 1365-2141 ; 0007-1048
    ISSN (online) 1365-2141
    ISSN 0007-1048
    DOI 10.1111/bjh.17015
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  10. Article ; Online: Clinical-pathological correlations in post-transplant thrombotic microangiopathy.

    Broecker, Verena / Bardsley, Victoria / Torpey, Nicholas / Perera, Ranmith / Montero, Rosa / Dorling, Anthony / Bentall, Andrew / Neil, Desley / Willicombe, Michelle / Berry, Miriam / Roufosse, Candice

    Histopathology

    2019  Volume 75, Issue 1, Page(s) 88–103

    Abstract: Aims: Post-transplant thrombotic microangiopathy (TMA) is a rare and clinically challenging finding in renal transplant biopsies. In addition to recurrent atypical haemolytic uraemic syndrome, TMA in renal transplants is associated with various ... ...

    Abstract Aims: Post-transplant thrombotic microangiopathy (TMA) is a rare and clinically challenging finding in renal transplant biopsies. In addition to recurrent atypical haemolytic uraemic syndrome, TMA in renal transplants is associated with various conditions, such as calcineurin inhibitor (CNI) treatment, antibody-mediated rejection (ABMR), viral infections, sepsis, pregnancy, malignancies, and surgery. The therapeutic implications of this diagnosis are considerable. In order to better understand post-transplant TMA and to identify histological or clinical differences between associated causes, we conducted a multicentre retrospective study.
    Methods and results: Clinical parameters and transplant renal biopsy findings from 81 patients with TMA were analysed. Biopsies from 38 patients were also analysed with electron microscopy. On the basis of clinical-pathological correlation, TMA was attributed to a main aetiology, whenever possible. TMA occurred at a median of 30 days post-transplantation. Systemic features of TMA were present in only 18% of cases. Twenty-two per cent of cases were attributed to CNI and 11% to ABMR. Although other potentially contributing factors were found in 56% of patients, in most cases (63%) no clearly attributable cause of TMA was identified. Histological differences between groups were minimal. The detection of ultrastructural features that are usually associated with ABMR may help to establish ABMR as the cause of TMA.
    Conclusions: Although CNI and ABMR appear to be the main contributors to post-transplant TMA, the aetiology of most cases is probably multifactorial, and TMA cannot be unequivocally attributed to a single underlying aetiology. Morphological features of TMA are not discriminating, but electron microscopy may help to identify ABMR-associated TMA.
    MeSH term(s) Adolescent ; Adult ; Calcineurin Inhibitors/adverse effects ; Female ; Graft Rejection/complications ; Graft Rejection/immunology ; Graft Rejection/pathology ; Humans ; Kidney Transplantation/adverse effects ; Male ; Middle Aged ; Postoperative Complications/etiology ; Postoperative Complications/immunology ; Postoperative Complications/pathology ; Retrospective Studies ; Risk Factors ; Thrombotic Microangiopathies/etiology ; Thrombotic Microangiopathies/immunology ; Thrombotic Microangiopathies/pathology ; Young Adult
    Chemical Substances Calcineurin Inhibitors
    Language English
    Publishing date 2019-03-09
    Publishing country England
    Document type Journal Article ; Multicenter Study
    ZDB-ID 131914-0
    ISSN 1365-2559 ; 0309-0167
    ISSN (online) 1365-2559
    ISSN 0309-0167
    DOI 10.1111/his.13855
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