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Tan H, Nakovics H, Zeng H, Copello A, Akhtar S, Lee AM, Kiefer F, Vollstädt-Klein S. Assessment of automated craving across substances and across cultures: stability-analysis of the Craving Automated Scale (CAS). J Addict Dis 2021; 40:405-414. [PMID: 34967698 DOI: 10.1080/10550887.2021.2015053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND The transition from hedonic to compulsive use in Substance Use Disorders (SUD) is a critical point in SUD progression and hence relevant for assessment and treatment. To measure the habitual patterns of substance consumption, the Craving Automated Scales (CAS) for alcohol (CAS-A), substances (CAS-S) and cigarette smoking (CAS-CS) were developed and introduced to different countries. In this study, we aimed to investigate the structural stability of CAS across substances and cultures. METHODS This study analyzed the CAS-scores of a sample of 370 participants in Germany, China and the UK, including 262 opioid-users, 65 smokers and 43 alcohol-users. We performed stability analyses to check the stability (i. e. factorial invariance) of factor solutions. Based on confirmed stability of the general factor (gfactor) solution and the calculations rule obtained in the previous validation of CAS-alcohol (CAS-A), the factor structures of CAS-A, CAS-S and CAS-CS were compared. RESULTS The gfactor solutions based on calculations rule shows good stability, with the mean stability coefficients of 0.990 and 0.977 for CAS-S and CAS-CS respectively. The gfactor patterns were similar for CAS-A, CAS-S and CAS-CS, as well as across samples (Germany, China and the UK), with most factor-loadings larger than 0.7. Based on these findings, CAS-S and CAS-CS were also associated with established clinical measures of SUD. CONCLUSIONS Our findings suggest the two-gfactor solution based on a proposed calculation rule has a high stability across substances and cultures. This could be in line with common neurobiological mechanisms underlying habitual substance use. Moreover, comparing CAS with established clinical tools suggests that CAS might assess the automated behavior in substance consumption in a more sophisticated way.
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Affiliation(s)
- H Tan
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical, Faculty of Mannheim, University of Heidelberg, Mannheim, Germany
| | - H Nakovics
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical, Faculty of Mannheim, University of Heidelberg, Mannheim, Germany
| | - H Zeng
- Department of Psychology, Guangzhou University, Guangzhou, China
| | - A Copello
- School of Psychology, University of Birmingham, Birmingham, UK
| | - S Akhtar
- Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | - A M Lee
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical, Faculty of Mannheim, University of Heidelberg, Mannheim, Germany
| | - F Kiefer
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical, Faculty of Mannheim, University of Heidelberg, Mannheim, Germany.,Feuerlein Center on Translational Addiction Medicine, University of Heidelberg, Heidelberg, Germany
| | - S Vollstädt-Klein
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical, Faculty of Mannheim, University of Heidelberg, Mannheim, Germany.,Mannheim Center for Translational Neurosciences (MCTN), Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany
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Abstract
The impact of increased online gaming play time on psychological wellbeing was examined focusing on the Multiplayer Online Battle Arena (MOBA) game genre. This relationship was explored with respect to motivators for playing and resilience factors. A cross-sectional, online questionnaire design was employed with participants (N = 165) to examine the relationship between weekly average hours played and psychological wellbeing. Five previously reported motivators for playing were tested as mediating variables. In addition, exploratory analyses were conducted to determine the moderating effects of self-esteem and self-efficacy on 'escapist' gaming and psychological wellbeing. Results revealed a significant correlation with higher levels of play time associated with poorer psychological wellbeing. This relationship was partially mediated by 'escapist' motivation. Self-esteem was found to moderate the negative impact of 'escapist' gaming on psychological wellbeing. Research and the associated clinical implications are discussed.
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Affiliation(s)
- C Goh
- School of Psychology, University of Birmingham, Edgbaston, B15 2TT, UK
| | - C Jones
- School of Psychology, University of Birmingham, Edgbaston, B15 2TT, UK
- Birmingham and Solihull Mental Health Foundation Trust, Edgbaston, UK
| | - A Copello
- School of Psychology, University of Birmingham, Edgbaston, B15 2TT, UK.
- Birmingham and Solihull Mental Health Foundation Trust, Edgbaston, UK.
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Dale V, Heather N, Adamson S, Coulton S, Copello A, Godfrey C, Hodgson R, Orford J, Raistrick D, Tober G. Predicting drinking outcomes: Evidence from the United Kingdom Alcohol Treatment Trial (UKATT). Addict Behav 2017; 71:61-67. [PMID: 28273487 DOI: 10.1016/j.addbeh.2017.02.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 02/13/2017] [Accepted: 02/14/2017] [Indexed: 11/26/2022]
Abstract
AIMS To explore client characteristics that predict drinking outcomes using data from the UK Alcohol Treatment Trial (UKATT). METHODS Multiple linear regression was used to determine if there were any characteristics, measured before the start of treatment, that could predict drinking outcomes at three and 12months, as measured by percent day abstinent (PDA) and drinks per drinking day (DDD) over the preceding 90days. RESULTS Lower baseline DDD score and greater confidence to resist drinking predicted lower DDD at both three and twelve months following entry to treatment. In addition to baseline PDA and having greater confidence to resist heavy drinking, female gender, aiming for abstinence, more satisfaction with family life and a social network that included less support for drinking were predictors of percent days abstinent. CONCLUSIONS Overall the strongest and most consistent predictors of outcome were confidence to avoid heavy drinking and social support for drinking. More predictors were identified for percent of days abstinent than for drinks per drinking day. For percent of days abstinent, a number of client characteristics at baseline consistently predicted outcome at both month three and month twelve.
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Graham HL, Copello A, Griffith E, Freemantle N, McCrone P, Clarke L, Walsh K, Stefanidou CA, Rana A, Birchwood M. Pilot randomised trial of a brief intervention for comorbid substance misuse in psychiatric in-patient settings. Acta Psychiatr Scand 2016; 133:298-309. [PMID: 26590876 PMCID: PMC5091625 DOI: 10.1111/acps.12530] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/26/2015] [Indexed: 12/30/2022]
Abstract
OBJECTIVE This proof of principle study evaluated the effectiveness and feasibility of a brief motivational intervention, delivered in mental health in-patient settings, to improve engagement in treatment for drug and alcohol misuse. METHOD A randomised controlled trial using concealed randomisation, blind, independent assessment of outcome at 3 months. Participants were 59 new adult admissions, to six acute mental health hospital units in one UK mental health service, with schizophrenia related or bipolar disorder diagnoses, users of community mental health services and also misusing alcohol and/or drugs. Participants were randomised to Brief Integrated Motivational Intervention (BIMI) with Treatment As Usual (TAU), or TAU alone. The BIMI took place over a 2-week period and encouraged participants to explore substance use and its impact on mental health. RESULTS Fifty-nine in-patients (BIMI n = 30; TAU n = 29) were randomised, the BIMI was associated with a 63% relative odds increase in the primary outcome engagement in treatment [OR 1.63 (95% CI 1.01-2.65; P = 0.047)], at 3 months. Qualitative interviews with staff and participants indicated that the BIMI was both feasible and acceptable. CONCLUSION Mental health hospital admissions present an opportunity for brief motivational interventions focussed on substance misuse and can lead to improvements in engagement.
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Affiliation(s)
- H L Graham
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - A Copello
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - E Griffith
- School of Psychology, University of Bath, Claverton Down, Bath, UK
| | - N Freemantle
- Department of Primary Care and Population Health, Upper Third Floor, UCL Medical School (Royal Free Campus), London, UK
| | - P McCrone
- Health Service and Population Research Department, Institute of Psychiatry, Kings College London, London, UK
| | - L Clarke
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - K Walsh
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - C A Stefanidou
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - A Rana
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - M Birchwood
- Division of Mental Health and Wellbeing, University of Warwick, Coventry, UK
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Dale V, Coulton S, Godfrey C, Copello A, Hodgson R, Heather N, Orford J, Raistrick D, Slegg G, Tober G. Exploring treatment attendance and its relationship to outcome in a randomized controlled trial of treatment for alcohol problems: secondary analysis of the UK Alcohol Treatment Trial (UKATT). Alcohol Alcohol 2011; 46:592-9. [PMID: 21733833 DOI: 10.1093/alcalc/agr079] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIMS To identify client characteristics that predict attendance at treatment sessions and to investigate the effect of attendance on outcomes using data from the UK Alcohol Treatment Trial. METHODS Logistic regression was used to determine whether there were characteristics that could predict attendance and then continuation in treatment. Linear regression was used to explore the effects of treatment attendance on outcomes. RESULTS There were significant positive relationships between treatment attendance and outcomes at Month 3. At Month 12, these relationships were only significant for dependence and alcohol problems for those randomized to motivational enhancement therapy (MET). There were significant differences between groups in attendance, with MET clients more likely to attend than clients allocated to social behaviour and network therapy (SBNT). MET clients were also more likely to attend all sessions (three sessions) compared with SBNT (eight sessions). MET clients with larger social networks and those with confidence in their ability not to drink excessively were more likely to attend. SBNT clients with greater motivation to change and those with more negative short-term alcohol outcome expectancies were more likely to attend. No significant predictors were found for retention in treatment for MET. For those receiving SBNT, fewer alcohol problems were associated with continuation in treatment. CONCLUSION Attending more sessions was associated with better outcomes. An interpretation of these findings is that, to improve outcomes, methods should be developed and used to increase attendance rates. Different characteristics were identified that predicted attendance and continuation in treatment for MET and SBNT.
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Affiliation(s)
- V Dale
- Department of Health Sciences, ARRC 005A, University of York, Heslington, York YO10 5DD, UK.
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Arcidiacono C, Velleman R, Procentese F, Berti P, Albanesi C, Sommantico M, Copello A. Italian families living with relatives with alcohol or drugs problems. Drugs: Education, Prevention and Policy 2010. [DOI: 10.3109/09687630902824262] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Day E, Best D, Copello A, Young H, Khoosal N, Modern N. Characteristics of drug‐using patients and treatment provided in primary and secondary settings. Journal of Substance Use 2009. [DOI: 10.1080/14659890701639816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Copello A, Templeton L, Krishnan M, Orford J, Velleman R. A Treatment Package to Improve Primary Care Services for Relatives of People with Alcohol and Drug Problems. ACTA ACUST UNITED AC 2009. [DOI: 10.3109/16066350009005591] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Orford J, Hodgson R, Copello A, Krishnan M, de Madariaga M, Coulton S. What Was Useful about That Session? Clients' and Therapists' Comments after Sessions in the UK Alcohol Treatment Trial (UKATT). Alcohol Alcohol 2009; 44:306-13. [DOI: 10.1093/alcalc/agn112] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Tober G, Godfrey C, Parrott S, Copello A, Farrin A, Hodgson R, Kenyon R, Morton V, Orford J, Russell I, Slegg G. SETTING STANDARDS FOR TRAINING AND COMPETENCE: THE UK ALCOHOL TREATMENT TRIAL. Alcohol Alcohol 2005; 40:413-8. [PMID: 16027128 DOI: 10.1093/alcalc/agh181] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIMS To examine factors that influence the recruitment and training of therapists and their achievement of competence to practise two psychological therapies for alcohol dependence, and the resources required to deliver this. METHODS The protocol for the UK Alcohol Treatment Trial required trial therapists to be competent in one of the two trial treatments: Social Behaviour and Network Therapy (SBNT) or Motivational Enhancement Therapy (MET). Therapists were randomised to practise one or other type of therapy. To ensure standardisation and consistent delivery of treatment in the trial, the trial training centre trained and supervised all therapists. RESULTS Of 76 therapists recruited and randomised, 72 commenced training and 52 achieved competence to practise in the trial. Length of prior experience did not predict completion of training. However, therapists with a university higher qualification, and medical practitioners compared to other professionals, were more likely to complete. The average number of clients needed to be treated before the trainee achieved competence was greater for MET than SBNT, and there was a longer duration of training for MET. CONCLUSIONS Training therapists of differing professional backgrounds, randomised to provide a specific therapy type, is feasible. Supervision after initial training is important, and adds to the training costs.
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Affiliation(s)
- G Tober
- Leeds Addiction Unit, 19 Springfield Mount, Leeds, UK.
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Graham HL, Maslin J, Copello A, Birchwood M, Mueser K, McGovern D, Georgiou G. Drug and alcohol problems amongst individuals with severe mental health problems in an inner city area of the UK. Soc Psychiatry Psychiatr Epidemiol 2001; 36:448-55. [PMID: 11766977 DOI: 10.1007/s001270170023] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND The extent and impact of drug and alcohol use among those with severe mental health problems has been well documented in the US. However, little is known of the nature of this problem in the UK, particularly in community treatment settings. This paper outlines findings from a large-scale survey conducted across community-based Mental Health and Substance Misuse services, which aimed to ascertain the prevalence of drug and alcohol problems among those with severe mental health problems. METHOD An assessment instrument was completed by keyworkers for each of their clients, which included mental health diagnosis and an adapted version of the Clinician Rating Scales for Alcohol and Drug Use. RESULTS From a sample of 3079 clients across services, 1369 clients were identified with a severe mental illness diagnosis. According to their key-workers, 24% of these clients (324/1369) had used alcohol and/or drugs problematically during the past year. These individuals were most likely to have a diagnosis within the schizophrenia cluster, were mainly white males in their mid-30s, and tended to be located within Mental Health services in Assertive Outreach teams and to be higher utilisers of crises/emergency services. CONCLUSIONS It can be concluded that similar to other studies in inner city areas of the UK, problem substance use is common amongst those with severe mental health problems within Northern Birmingham.
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Affiliation(s)
- H L Graham
- Northern Birmingham Mental Health NHS Trust and School of Psychology, University of Birmingham, UK
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Orford J, Natera G, Velleman R, Copello A, Bowie N, Bradbury C, Davies J, Mora J, Nava A, Rigby K, Tiburcio M. Ways of coping and the health of relatives facing drug and alcohol problems in Mexico and England. Addiction 2001; 96:761-74. [PMID: 11331034 DOI: 10.1046/j.1360-0443.2001.96576111.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIMS To compare two contrasting socio-cultural groups in terms of parameters relating to the stress - coping - health model of alcohol, drugs and the family, and to test hypotheses derived from the model in each of the two groups separately. DESIGN Cross-sectional, comparative and correlational, using standard questionnaire data, supplemented by qualitative interview data to illuminate the findings. PARTICIPANTS One hundred close relatives, mainly partners or parents, from separate families in Mexico City, and 100 from South West England. Data sources. Coping Questionnaire (CQ), Family Environment Scale (FES), Symptom Rating Test (SRT), Semi-structured interview. FINDINGS Mean symptom scores were high in both groups, and not significantly different. The hypothesis that relatives in Mexico City, a more collectivist culture, would show more tolerant - inactive coping was not supported, but there was support for the prediction that relatives in South West England would show more withdrawal coping. This result may be as much due to differences in poverty and social conditions as to differences in individualism - collectivism. As predicted by the stress - coping - health model, tolerant - inactive coping was correlated with symptoms, in both groups, after controlling for family conflict, but there was only limited support for a moderating role of coping. Wives of men with alcohol problems in Mexico City, and wives of men with other drug problems in South West England, reported particularly high levels of both engaged and tolerant - inactive coping. CONCLUSIONS Tolerant - inactive coping may be bad for relatives' health: causality may be inferred but is not yet proved. Certain groups are more at risk of coping in this way. Qualitative data help understand the nature of tolerant - inactive coping and why it occurs despite the view of relatives themselves that it is counter-productive.
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Affiliation(s)
- J Orford
- School of Psychology, University of Birmingham, Edgbaston, UK.
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Abstract
There is much debate in the addiction literature about the extent to which excessive drinking affects nondrinking family members. The issue is considered in this review by examining and evaluating research relating to the effects of drinking on children, family systems, and partners of drinkers. The latter group have, historically, been blamed and apologized for their partner's drinking, although more recent theories have adopted a stress and coping paradigm, thus normalizing individuals and their behaviors. Conceptualizations of spouses over the last five decades are described and evaluated in the second part of the review. Finally, the review considers the impact of the recent stress and coping paradigm on clinical interventions for excessive drinkers and their families, and suggestions are made for future research.
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Affiliation(s)
- C Hurcom
- School of Psychology, University of Birmingham, Edgbaston, United Kingdom
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Orford J, Natera G, Davies J, Nava A, Mora J, Rigby K, Bradbury C, Bowie N, Copello A, Velleman R. Tolerate, engage or withdraw: a study of the structure of families coping with alcohol and drug problems in south west England and Mexico City. Addiction 1998; 93:1799-813. [PMID: 9926569 DOI: 10.1046/j.1360-0443.1998.931217996.x] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIMS To explore the structure underlying individual differences in the ways family members cope with drinking or drug problems. DESIGN Cross-sectional interview and questionnaire study of a series of family members in two contrasting socio-cultural groups. SETTING Mexico City and South West England. PARTICIPANTS Two hundred and seven family members from separate families, three-quarters women, one-quarter men, mostly partners or parents. DATA Long semi-structured interviews; the Coping Questionnaire (CQ). FINDINGS Factor and subscale analyses of the CQ data and textual analysis of the interview reports were used to test the hypothesis that the underlying structure to coping could be described in terms of eight or nine coherent and distinct ways of coping. Neither form of analysis gave strong support to this hypothesis. CONCLUSIONS It is concluded that the structure of coping can best be described in terms of three broad coping positions: tolerating, engaging and withdrawing. These conclusions challenge some previous assumptions about functional and dysfunctional ways of coping with excessive appetitive behaviour in the family.
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Affiliation(s)
- J Orford
- School of Psychology, University of Birmingham, UK
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Corti RE, Outeda JL, Corti RN, Copello A. [Esophageal involvement in progressive systemic sclerosis]. Arq Gastroenterol 1982; 19:64-72. [PMID: 7185355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The authors present 17 patients with progressive systemic sclerosis studied at the Hospital Nacional de Gastroenterología "Dr. Carlos Bonorino Udaondo" (Buenos Aires), in the period between 1976-1980. Clinical, radiological, endoscopical and manometrical studies of the digestive tract was performed, showing frequent compromise in this collagen disease.
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Copello A, Pataro AH, Pagani A. [On 2 rarities of appendicular pathology]. Prensa Med Argent 1965; 52:2180-1. [PMID: 5879628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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