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Cerezo GH, Vicario A, Conti P, Forcada P, De Cerchio AE, Llorens M, Sposito P, Del Sueldo M, Morales M, Perez MA, Waisman G. P4785Utility of the clock drawing test as cognitive screening in patients with arterial hypertension. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- G H Cerezo
- Cardiovascular Institute of Buenos Aires (ICBA), Unidad Corazόn Cerebro, Buenos Aires, Argentina
| | - A Vicario
- Cardiovascular Institute of Buenos Aires (ICBA), Unidad Corazόn Cerebro, Buenos Aires, Argentina
| | - P Conti
- Cardiovascular Institute of Buenos Aires (ICBA), Unidad Corazόn Cerebro, Buenos Aires, Argentina
| | - P Forcada
- Cardiovascular Institute of Buenos Aires (ICBA), Unidad Corazόn Cerebro, Buenos Aires, Argentina
| | - A E De Cerchio
- Cardiovascular Institute of Buenos Aires (ICBA), Unidad Corazόn Cerebro, Buenos Aires, Argentina
| | - M Llorens
- Cardiovascular Institute of Buenos Aires (ICBA), Unidad Corazόn Cerebro, Buenos Aires, Argentina
| | - P Sposito
- Cardiovascular Institute of Buenos Aires (ICBA), Unidad Corazόn Cerebro, Buenos Aires, Argentina
| | - M Del Sueldo
- Cardiovascular Institute of Buenos Aires (ICBA), Unidad Corazόn Cerebro, Buenos Aires, Argentina
| | - M Morales
- Cardiovascular Institute of Buenos Aires (ICBA), Unidad Corazόn Cerebro, Buenos Aires, Argentina
| | - M A Perez
- Cardiovascular Institute of Buenos Aires (ICBA), Unidad Corazόn Cerebro, Buenos Aires, Argentina
| | - G Waisman
- Cardiovascular Institute of Buenos Aires (ICBA), Unidad Corazόn Cerebro, Buenos Aires, Argentina
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Vicario A, Cerezo G, Conti P, Forcada P, Cerchio AD, Llorens M, Sposito P, Waisman G, Morales M, Perez M. UTILITY OF THE CLOCK DRAWING TEST AS COGNITIVE SCREENING IN PATIENTS WITH ARTERIAL HYPERTENSION. J Hypertens 2018. [DOI: 10.1097/01.hjh.0000539330.79690.16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Benchimol J, Boietti B, Elizondo C, Giunta D, Barrientos S, Camera L, Waisman G. ONE-YEAR MORTALITY AFTER HIP FRACTURE IN OLD AND VERY OLD PATIENTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- J. Benchimol
- Internal Medicine, Hospital Italiano de Buenos Aires (Argentina), Ciudad de Buenos Aires, Argentina
| | - B. Boietti
- Internal Medicine, Hospital Italiano de Buenos Aires (Argentina), Ciudad de Buenos Aires, Argentina
| | - C. Elizondo
- Internal Medicine, Hospital Italiano de Buenos Aires (Argentina), Ciudad de Buenos Aires, Argentina
| | - D. Giunta
- Internal Medicine, Hospital Italiano de Buenos Aires (Argentina), Ciudad de Buenos Aires, Argentina
| | - S. Barrientos
- Internal Medicine, Hospital Italiano de Buenos Aires (Argentina), Ciudad de Buenos Aires, Argentina
| | - L. Camera
- Internal Medicine, Hospital Italiano de Buenos Aires (Argentina), Ciudad de Buenos Aires, Argentina
| | - G. Waisman
- Internal Medicine, Hospital Italiano de Buenos Aires (Argentina), Ciudad de Buenos Aires, Argentina
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Waisman G. [Arterial hypertension in the elderly]. Hipertens Riesgo Vasc 2017; 34:61-64. [PMID: 28433228 DOI: 10.1016/j.hipert.2017.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 03/18/2017] [Indexed: 11/17/2022]
Affiliation(s)
- G Waisman
- Instituto Universitario del Hospital Italiano de Buenos Aires; Sección Hipertensión Arterial y Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.
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Barochiner J, Alfie J, Aparicio L, Rada M, Morales M, Cuffaro P, Galarza C, Waisman G. Orthostatic hypotension in treated hypertensive patients. Rom J Intern Med 2012; 50:203-209. [PMID: 23330287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Orthostatic hypotension (OH) is a risk factor for morbidity and mortality and one of the causes of non compliance to treatment among medicated hypertensive subjects. Our objective was to assess the prevalence of OH among treated hypertensive patients and its association with clinical characteristics and antihypertensive drug class. METHODS This was a cross-sectional study in which we assessed the prevalence of OH, defined according to the American Autonomic Society and American Academy of Neurology guidelines, among adult treated hypertensive patients who performed a home blood pressure monitoring at our institution. We also determined the prevalence of OH according to age group (< 65, 65-79 and > 80), antihypertensive drug class, office and home hypertension control status. RESULTS We included 302 medicated patients in the study. Mean age was 66.6 (+13.8), 67% were women. We found a 9.7% global prevalence of OH, which was significantly higher among older individuals (3.6% among patients < 65 years-old, 12.2% in the 65-79 year-old group and 16.7% among octogenarians, p = 0.02) and those who consumed alpha-blockers (75 vs. 8.5%, p < 0.01). Uncontrolled hypertensive patients at office and/or at home had also a significantly higher prevalence of OH: uncontrolled vs. controlled office blood pressure (BP), 14.3 vs. 6.5%, p = 0.03 and uncontrolled vs. controlled home BP, 15.1 vs. 6.6%, p = 0.02. Remarkably, 64% of patients with OH had their BP under control when considering office-standing BP. CONCLUSION OH is a prevalent entity among treated hypertensive patients and systematic measurement of standing BP should be mandatory in the evaluation of these patients.
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Affiliation(s)
- Jessica Barochiner
- Hypertension Section, Internal Medicine Department, Hospital Italiano de Buenos Aires, Argentina.
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Alonzo C, Zurru M, Brescacin L, Brienza S, Martinez R, Ortega F, Orzuza G, Villarroel V, Camera L, Waisman G, Cristiano E. Non-Hospitalized Stroke: Patient's Underestimation or Doctor's Misdiagnosis? (P07.027). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p07.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Zurru M, Brescacin L, Alonzo C, Villarroel V, Orzuza G, Martinez R, Brienza S, Ortega F, Waisman G, Camera L, Cristiano E. Inflammatory Markers in Different Stroke Subtypes (P05.239). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p05.239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Alonzo C, Zurru M, Brescacin L, Ortega F, Orzuza G, Villarroel V, Brienza S, Martinez R, Camera L, Waisman G, Cristiano E. High Prevalence of In-Hospital Stroke in an Intensive Coronary Unit (P03.029). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p03.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Zurru M, Brescacin L, Alonzo C, Schapira M, Orzuza G, Villarroel V, Ortega F, Brienza S, Martinez R, Camera L, Waisman G, Cristiano E. Predictors of Progression to Dementia in Non-Demented Patients with Memory Complaint (P01.085). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p01.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Musso CG, Michelangelo H, Reynaldi J, Martinez B, Vidal F, Quevedo M, Parot M, Waisman G, Algranati L. Combination of oral activated charcoal plus low protein diet as a new alternative for handling in the old end-stage renal disease patients. Saudi J Kidney Dis Transpl 2010; 21:102-104. [PMID: 20061701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
Chronic dialysis is a valid therapeutic option in very elderly ESRD patients, even though the decision to dialyze or not has little impact on survival. Additionally, very old patients usually do not agree with starting chronic dialysis. Even though, activated charcoal is a cheap treatment for working as adsorbent for nitrogenous products its utility is very limited. We studied the combination of a low protein diet and oral activated charcoal to reduce serum urea and creatinine levels in very old ESRD patients who had refused to start chronic dialysis. Nine lucid, very old > 80 years, ESRD patients who had refused to start dialysis were prescribed a treatment based on a combination of a very low protein diet and oral activated charcoal (30 gram/day). None of the patients had anuria, oliguria, edema, significant metabolic acidosis or hyperkalemia. None of them had significant gastrointestinal symptoms. After one week and ten months of charcoal use significant decrease in blood urea and creatinine levels was observed and none of them required emergency dialysis during this time. In conclusion, in patients more than 80 years of age low protein diet and oral activated charcoal may control the uremic symptoms effectively.
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Affiliation(s)
- C G Musso
- Nephrology Division, Hospital Italiano De Buenos Aires, Argentina.
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Macías J, Robles NR, Herrera J, Ayus JC, Calabria F, Domínguez A, Ferder L, Grande Villoria J, Guillén F, Ingaramo R, Juncos L, López-Dóriga P, López Novoa JM, Martell N, Martínez Maldonado M, Núñez A, Prado F, Pupi LM, Ribera JM, Roldán C, Rodicio JL, Ruilope LM, Rodrigo A, Waisman G. [Recommendations for diagnosis and treatment of aged hypertensives]. Nefrologia 2007; 27:270-8. [PMID: 17725447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Affiliation(s)
- J Macías
- Unidad de Hipertensión Arterial, Hospital Infanta Cristina, Ctra. de Portugal, Badajoz
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Díaz J, Achilli F, Figar S, Waisman G, Langlois E, Galarza C, Camera L, González B de Quirós F. [Prevention of cardiovascular diseases by an antihypertensive program in the elderly, a cohort study]. An Med Interna 2005; 22:167-71. [PMID: 16004512 DOI: 10.4321/s0212-71992005000400003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
INTRODUCTION We started on year 2000 a Complex Intervention Program addressed at hypertension control among our patients. AIM To compare the risk of cardiovascular events and of dying in hypertensive patients under Program care. METHOD We started follow-up of a cohort of 1922 patients over 65 years in August 2000. Hipertension diagnosis was ascertained if patient reported to be hypertensive, or was under anti hypertensive treatment or if he/she had two blood pressure measurements = 140/90 mm Hg. Cardiovascular events were considered to be admissions due to coronary disease, cardiac insufficiency or stroke. Incidence is reported by 100 person years follow-up. Relative risks between hypertensive and normotensive patients were calculated and Cox regresión was used to adjust for potential confounders. We compared time to first cardiovascular event and to death with Log Rank Test. RESULTS Fourty eight point three percent of patients were hypertensive and differed from normotensive patients as to age (79 (5) years vs. 77 (5) p < 0.001), proportion of diabetic patients (16.1% vs. 7.6% p < 0.001). Mean follow-up time was 28 months. Mortality RR was 1.04 (95% CI 0.69-1.58). As to incidence of cardiovascular events it was 1.86 in normotensive vs. 3.02 (RR 1.62 95% CI 1.09-2.42). When adjusted by age, sex, smoking, dislipemia and diabetes, OR was 1.3 (95% CI 0.86-1.98). CONCLUSIONS Hypertension did not increase the risk in cardiovascular events among our hypertensive patients at 2.3 years follow-up.
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Affiliation(s)
- J Díaz
- Programa de Medicina Geriátrica, Sección de Hipertensión Arterial, Servicio de Clínica Medica y Gerencia Médica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
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Krmar RT, Ferraris JR, Ramirez JA, Ruiz S, Salomon A, Galvez HM, Janson JJ, Galarza CR, Waisman G. Ambulatory blood pressure monitoring after recovery from hemolytic uremic syndrome. Pediatr Nephrol 2001; 16:812-6. [PMID: 11605788 DOI: 10.1007/s004670100679] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [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: 11/29/2022]
Abstract
The outcome of acute renal failure due to diarrhea-associated hemolytic uremic syndrome (D+ HUS) is generally predicted to be good. However, there are only a few long-term observations with detailed reports on long-term sequelae. Specifically, adequate long-term blood pressure (BP) evaluations are scarce. The present study evaluated BP in pediatric patients after childhood D+ HUS. The study group comprised 28 patients (20 males) aged 6-23.5 years (median 10.1 years). All patients had a history of D+ HUS at a median age of 1.1 years (range 0.5-6 years). Based on the duration of oliguria and/or anuria, the primary disease was classified as mild (n=6), moderate (n=6), or severe (n=16). The BP in these patients was studied at a median time of 8.4 years (range 2.3-22.9 years) after manifestation of D+ HUS by means of office BP measurements and 24-h ambulatory BP monitoring (ABPM) using a Spacelabs 90207 oscillometric monitor. Measurements were compared with normal values of published standards for healthy children and adolescents. Conventional office BP measurements were above the 95th percentile in 1 patient. By ABPM, 2 patients were diagnosed to have mean systolic daytime and nighttime values in the hypertensive range, and systolic and diastolic hypertension was confirmed in the first patient. All these patients had a severe form of D+ HUS in the past. By applying ABPM, BP anomalies were detected in 5 additional patients. Elevated systolic BP loads were found in 4 patients, and daytime systolic and diastolic hypertension in the other 1. At the time of the study, 2 of them were classified as "recovered." The late outcome of D+ HUS may be worse than anticipated. BP anomalies as long-term sequelae of D+ HUS could be identified by ABPM but not by office BP measurements. These findings may represent an isolated sign of residual renal disturbance.
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Affiliation(s)
- R T Krmar
- Department of Molecular Medicine, Karolinska Institutet, Karolinska Hospital, Stockholm, Sweden.
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Krmar RT, Ferraris JR, Ramirez JA, Galarza CR, Waisman G, Janson JJ, Llapur CJ, Sorroche P, Legal S, Cámera MI. Hyperhomocysteinemia in stable pediatric, adolescents, and young adult renal transplant recipients. Transplantation 2001; 71:1748-51. [PMID: 11455253 DOI: 10.1097/00007890-200106270-00008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [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: 11/26/2022]
Abstract
BACKGROUND High total plasma homocysteine (tHcy) levels are accompanied by an increased risk for premature development of atherosclerosis and atherothrombosis. Adult renal transplant recipients have elevated tHcy levels. Corresponding data in pediatric, adolescent, and young adult renal transplant recipients are scarce. We investigated whether tHcy levels were elevated in stable renal transplant recipients who received kidney grafts before age 18. METHODS This cross-sectional study was conducted during routine posttransplantation follow-up. Fasting tHcy levels, serum creatinine, and lipoprotein profile were measured in 38 clinically stable renal transplant recipients with different degrees of renal function. No patient was receiving B vitamin or folic acid supplementation. Estimated glomerular filtration rate (GFR) was assessed according to Schwartz's formula. All patients followed a triple-drug immunosuppressive regimen, with the exception of three patients (deflazacort and azathioprine). Forty-one apparently healthy subjects constituted the control group. tHcy levels were determined by fluorescence polarization immunoassay in an IMx analyzer. RESULTS Mean tHcy levels in transplant recipients were significantly higher than in controls (16.8+/-8.7 micromol/L and 9.5+/-2.3 micromol/L, respectively; P<0.01). A significant positive correlation between tHcy and serum creatinine levels was observed for both transplant recipients (rS=0.70, P<0.01) and controls (rS=0.54, P<0.01). In transplant recipients, tHcy correlated negatively with estimated GFR (rS=[minus]0.47, P<0.05). Fasting tHcy levels in excess of 14.6 micromol/L (>95th percentile in controls) were present in 19 (50%) patients; 14 of these patients had an estimated GFR<60 ml/min per 1.73 m2. When the renal transplant recipients were analyzed by renal function, mean tHcy was significantly higher in patients with an estimated GFR<60 ml/min per 1.73 m2 compared with patients with an estimated GFR> or =60 ml/min per 1.73 m2 (20.5+/-9.9 vs. 13.2+/-5.8 micromol/L, P<0.01). Both groups were significantly different from controls (P<0.01). No relationship was found between tHcy level and either cumulative cyclosporine or cumulative methylprednisone doses. No differences were observed in tHcy levels or lipoprotein profile between patients who were receiving deflazacort and those on methylprednisone. CONCLUSIONS Hyperhomocysteinemia in renal transplant recipients is a common condition. Testing for fasting tHcy level might be a useful tool to identify patients at increased risk for development of vascular disease.
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Affiliation(s)
- R T Krmar
- Servicio de Nefrología Pediátrica, Unidad de Hipertensión Arterial del Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Argentina.
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Przygoda P, Janson J, O'Flaherty M, Waisman G, Galarza CR, Alfie J, Cámera LA, Cámera MI, Mayorga LM. Lack of effective blood pressure control among an elder hypertensive population in Buenos Aires. Am J Hypertens 1998; 11:1024-7. [PMID: 9715797 DOI: 10.1016/s0895-7061(98)00043-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [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: 02/08/2023] Open
Abstract
Our purpose was to determine the level of awareness, treatment, and control of hypertension in a population of subjects aged 65 or more. We studied a random sample from the national health care program in Buenos Aires. Letters were mailed to 1000 selected individuals. Among those eligible, 41.4% (n = 414) were enrolled. The mean age was 73.8 years and 68% were women. Prevalence of hypertension in our sample was 77.5% (n = 321). Awareness of hypertension was 60.7% (n = 195). Fifty-four percent (n = 173) of the hypertensive subjects were receiving pharmacologic treatment and only 18.5% (n = 32) of them were controlled. These results show that there is a low level of awareness, pharmacologic treatment, and control of hypertension in the studied elderly subjects.
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Affiliation(s)
- P Przygoda
- Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Argentina.
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Lugones L, Alflet J, Belardo A, Tutzer M, Galarza CR, Waisman G, Cámera MI. F212 Systemic hemodynamic changes during unopposed and combined hormone replacement therapy (HRT). Maturitas 1996. [DOI: 10.1016/s0378-5122(97)81176-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Waisman G, Catoggio LJ, Fongi EG, Belziti C, Precerutti JA. Systemic lupus erythematosus and endocarditis. Clin Exp Rheumatol 1986; 4:292-4. [PMID: 3769246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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