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Schaefer M, Laurent V, Grandmougin A, Vuitton L, Bourreille A, Luc A, Clerc-Urmes I, Orry X, Frampas E, De Billy M, Pouillon L, Le Berre C, Gay C, Meyer J, Baumann C, Peyrin-Biroulet L. A Magnetic Resonance Imaging Index to Predict Crohn's Disease Postoperative Recurrence: The MONITOR Index. Clin Gastroenterol Hepatol 2022; 20:e1040-e1049. [PMID: 34216820 DOI: 10.1016/j.cgh.2021.06.035] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/01/2021] [Accepted: 06/25/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND & AIMS We developed and validated a magnetic resonance imaging-based index to predict Crohn's disease (CD) postoperative recurrence (POR). METHODS Patients with CD who underwent a postoperative evaluation for recurrence (with colonoscopy and MRI no longer than 105 days apart) were included between 2006 and 2016 in University Hospital of Nancy, France. MRI items with good levels of intra-rater and inter-rater agreement (Gwet's coefficient ≥0.5) were selected. The MRI in Crohn's Disease to Predict Postoperative Recurrence (MONITOR) index's performance was assessed in terms of the area under the receiver operating characteristic curve (AUROC) and accuracy, by considering the Rutgeerts score as the gold standard. The MONITOR index was validated with a bootstrap method and an independent cohort. RESULTS Seventy-three MRI datasets were interpreted by 2 radiologists. Seven items (bowel wall thickness, contrast enhancement, T2 signal increase, diffusion-weighted signal increase, edema, ulcers, and the length of the diseased segment) had a Gwet's coefficient ≥0.5 and were significantly associated with the Rutgeerts score, leading to their inclusion in the MONITOR index. All the items had a weighting of 1, except the "ulcers" item weighting 2.5, reflecting the higher adjusted odds ratio. The AUROC [95% confidence interval] for the prediction of endoscopic POR (Rutgeerts score >i1) was 0.80 [0.70-0.90]. The optimal threshold was a MONITOR index ≥1, giving a sensitivity of 79%, a specificity of 55%, a predictive positive value of 68%, and a predictive negative value of 68%. The bootstrap validation gave an AUROC of 0.85 [0.73-0.97]. In the validation cohort, a MONITOR index ≥1 gave a sensitivity of 87%, a specificity of 75%, a predictive positive value of 84.6%, and a predictive negative value of 75%. CONCLUSIONS The MONITOR index is an efficient, reliable, easy-to-apply tool that can be used in clinical practice to predict the POR of CD.
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Affiliation(s)
- Marion Schaefer
- Department of Hepatogastroenterology, Nancy University Hospital, Vandoeuvre-lès-Nancy
| | - Valérie Laurent
- Central Department of Radiology, Nancy University Hospital, Vandoeuvre-lès-Nancy
| | - Aurélie Grandmougin
- Central Department of Radiology, Nancy University Hospital, Vandoeuvre-lès-Nancy
| | - Lucine Vuitton
- Department of Gastroenterology, Besançon University Hospital, Besancon
| | | | - Amandine Luc
- Unit of Methodology, Data Management and Statistic, Nancy University Hospital, Vandoeuvre-lès-Nancy
| | - Isabelle Clerc-Urmes
- Unit of Methodology, Data Management and Statistic, Nancy University Hospital, Vandoeuvre-lès-Nancy
| | - Xavier Orry
- Central Department of Radiology, Nancy University Hospital, Vandoeuvre-lès-Nancy
| | - Eric Frampas
- Department of Radiology, Nantes University Hospital, Nantes
| | | | - Lieven Pouillon
- Department of Hepatogastroenterology, Nancy University Hospital, Vandoeuvre-lès-Nancy
| | | | - Claire Gay
- Department of Gastroenterology, Besançon University Hospital, Besancon
| | - Jeremy Meyer
- Department of Radiology, Nantes University Hospital, Nantes
| | - Cédric Baumann
- Unit of Methodology, Data Management and Statistic, Nancy University Hospital, Vandoeuvre-lès-Nancy
| | - Laurent Peyrin-Biroulet
- Department of Hepatogastroenterology, Nancy University Hospital, Vandoeuvre-lès-Nancy; INSERM U1256, Nutrition-Génétique et Exposition aux Risques Environnementaux, Faculté de Médecine, Université de Lorraine, Vandoeuvre-les-Nancy, France.
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Pulcini C, Clerc-Urmes I, Attinsounon CA, Fougnot S, Thilly N. Antibiotic resistance of Enterobacteriaceae causing urinary tract infections in elderly patients living in the community and in the nursing home: a retrospective observational study. J Antimicrob Chemother 2020; 74:775-781. [PMID: 30508107 DOI: 10.1093/jac/dky488] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 11/02/2018] [Accepted: 11/03/2018] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Although nursing homes are thought to be significant reservoirs of antibiotic-resistant bacteria, very few large population-based studies comparing antibiotic resistance prevalence in nursing homes and in the community have adjusted for patient characteristics. Our objective was to compare the prevalence of antibiotic resistance of Enterobacteriaceae cultured from urine samples of nursing home residents with that of community-dwelling adults, all aged 65 years or older. METHODS This study analysed around 20 000 positive urine samples sent to a large laboratory in north-eastern France from 2014 to 2017, collected from individuals aged 65 years or older. A multivariable logistic regression model adjusted for patient characteristics (gender, age, year of sampling, presence of urinary catheter and number of urine samples/year) compared the resistance of Escherichia coli, Proteus mirabilis and Klebsiella pneumoniae to amoxicillin/clavulanate, nitrofurantoin, trimethoprim/sulfamethoxazole, nalidixic acid, ofloxacin, ciprofloxacin and ceftriaxone, as well as their possible EBSL production, in nursing home residents and community-dwellers. RESULTS Nursing home residents had a higher adjusted OR (aOR) of Enterobacteriaceae (E. coli, P. mirabilis or K. pneumoniae) resistant to amoxicillin/clavulanate (aOR 1.38, 95% CI 1.27-1.50), ciprofloxacin (aOR 1.33, 95% CI 1.20-1.49) and ceftriaxone (aOR 1.37, 95% CI 1.15-1.63) or producing an ESBL (aOR 1.43, 95% CI 1.18-1.72), but did not differ in resistance to nitrofurantoin or trimethoprim/sulfamethoxazole. CONCLUSIONS Elderly people in nursing homes had a risk around 40% higher than their community-dwelling peers of having antibiotic-resistant Enterobacteriaceae cultured from their urine samples. Antibiotic stewardship and infection prevention and control programmes should be implemented in nursing homes.
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Affiliation(s)
- Céline Pulcini
- Université de Lorraine, APEMAC, Nancy, France.,Université de Lorraine, CHRU-Nancy, Infectious Diseases Department, Nancy, France
| | - Isabelle Clerc-Urmes
- Université de Lorraine, CHRU-Nancy, Clinical Research Support Unit, Nancy, France
| | - Cossi Angelo Attinsounon
- Université de Lorraine, CHRU-Nancy, Infectious Diseases Department, Nancy, France.,Université de Parakou, CHUD Borgou, Unité d'Enseignement et de Recherche en Maladies Infectieuses et Tropicales, Parakou Bénin
| | | | - Nathalie Thilly
- Université de Lorraine, APEMAC, Nancy, France.,Université de Lorraine, CHRU-Nancy, Clinical Research Support Unit, Nancy, France
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Roux C, Gandjbakhch F, Pierreisnard A, Couderc M, Lukas C, Masri R, Sommier JP, Clerc-Urmes I, Baumann C, Chary-Valckenaere I, Loeuille D. Ultrasonographic criteria for the diagnosis of erosive rheumatoid arthritis using osteoarthritic patients as controls compared to validated radiographic criteria. Joint Bone Spine 2019; 86:467-474. [PMID: 30711693 DOI: 10.1016/j.jbspin.2019.01.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 12/12/2018] [Accepted: 01/23/2019] [Indexed: 02/08/2023]
Abstract
OBJECTIVES The aims of this study were to compare characteristics of radiography (RX) and ultrasound (US) erosive lesions in rheumatoid arthritis (RA) and osteoarthritis (OA) patients (prevalence, topography and severity), to determine thresholds for the diagnosis of erosive RA based on US and to evaluate the performance of US and RX to establish a diagnosis of erosive RA differentiated from hand OA. METHODS Patients fulfilling ACR 1987 and/or ACR/EULAR 2010 criteria for RA or ACR hand OA criteria were prospectively included. A modified Sharp erosion score was assessed by two blinded readers and one adjudicator for discordant cases (number of eroded joints ≤ three). Erosions in US were scored on six bilateral joints (MCP2-3, 5; MTP2-3, 5) with a four-grade scale to calculate total US score for erosions (USSe). RESULTS A total of 168 patients were included: 122 RA (32 early RA < 2 years; 90 late RA ≥ 2 years); 46 OA patients. On RX: 42 RA patients (6 early; 36 late) and 5 OA patients were eroded according to EULAR 2013 definition criteria with sensitivity at 34.4% and specificity at 89.1%. On US, 95 RA patients (21 early; 74 late) and 12 OA patients were eroded. Considering at least two joint facets eroded or at least one joint facet eroded at grade 2 on US, sensitivities were good (68-72.1%) and specificities excellent (89.1-100%). Agreement between RX and US was excellent (90-92%). The positive and negative likehood ratios were respectively 3.16 and 0.73 for radiography and 6.64 and 0.31 for US (for two facets eroded). CONCLUSION USSe can differentiate RA from OA in erosive disease and detect two times more patients with erosive RA than RX with excellent specificity and agreement.
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Affiliation(s)
- Camille Roux
- Department of rheumatology, university hospital of Nancy, 54500 Vandoeuvre-lès-Nancy, France.
| | | | - Audrey Pierreisnard
- Department of rheumatology, academic hospital Pitié Salpêtrière, 75013 Paris, France
| | - Marion Couderc
- Department of rheumatology, university hospital of Clermont- Ferrand, 63000 Clermont- Ferrand, France
| | - Cédric Lukas
- Department of rheumatology, university hospital of Lapeyronie, 34000 Montpellier, France
| | - Racha Masri
- Department of rheumatology, university hospital of Nancy, 54500 Vandoeuvre-lès-Nancy, France
| | - Jean-Philippe Sommier
- Department of rheumatology, university hospital of Nancy, 54500 Vandoeuvre-lès-Nancy, France
| | - Isabelle Clerc-Urmes
- Platform of clinical research support PARC (MDS unity), university Hospital of Nancy, 54500 Vandoeuvre-lès-Nancy, France
| | - Cédric Baumann
- Platform of clinical research support PARC (MDS unity), university Hospital of Nancy, 54500 Vandoeuvre-lès-Nancy, France
| | - Isabelle Chary-Valckenaere
- Department of rheumatology, university hospital of Nancy, 54500 Vandoeuvre-lès-Nancy, France; Inserm, CIC-EC CIE6, university hospital of Nancy, epidemiology and clinical evaluation, 54500 Vandoeuvre-lès-Nancy, France
| | - Damien Loeuille
- Department of rheumatology, university hospital of Nancy, 54500 Vandoeuvre-lès-Nancy, France; Inserm, CIC-EC CIE6, university hospital of Nancy, epidemiology and clinical evaluation, 54500 Vandoeuvre-lès-Nancy, France
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Busson A, Thilly N, Laborde-Castérot H, Alla F, Messikh Z, Clerc-Urmes I, Mebazaa A, Soudant M, Agrinier N. Effectiveness of guideline-consistent heart failure drug prescriptions at hospital discharge on 1-year mortality: Results from the EPICAL2 cohort study. Eur J Intern Med 2018; 51:53-60. [PMID: 29305071 DOI: 10.1016/j.ejim.2017.12.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 12/12/2017] [Accepted: 12/17/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND We aimed to assess the effectiveness of recommended drug prescriptions at hospital discharge on 1-year mortality in patients with heart failure (HF) and reduced ejection fraction (HFREF). MATERIALS AND METHODS We used data from the EPICAL2 cohort study. HF patients ≥18years old with left ventricular ejection fraction (LVEF) <40% and alive at discharge were included and followed up for mortality. Socio-demographic, clinical and therapeutic data were collected at admission. Therapeutic data were collected at discharge and at 6month. Prescription of an angiotensin-converting enzyme (ACE) inhibitor (or an angiotensin II receptor blocker [ARB] in case of ACE inhibitor intolerance) and a β-blocker at discharge were considered "guideline-consistent discharge prescription" (GCDP). A frailty Cox model after propensity score (PS) matching was used to assess the association of GCDP with survival. RESULTS Among 624 patients included, the mean (SD) age was 73.6 (12.8) years; 65% were male. A total of 412 (65.6%) patients received GCDP, and 82.8% still had guideline consistent prescription at 6months. A total of 166 patients died during the follow-up, 78 in the GCDP group and 88 in the other group. Before PS matching, patients with GCDP were younger (|StDiff|=48.32%) and had higher body mass index (BMI) (|StDiff|=11.71%), lower LVEF (|StDiff|=23.13%) and lower Charlson index (|StDiff|=55.27%) than patients without GCDP. After PS matching, all characteristics were balanced between the two treatment groups, and GCDP was associated with reduced mortality (pooled HR=0.51, 95% CI [0.35-0.73]). CONCLUSION Prescription of ACE (or ARB) inhibitors and β-blockers for patients with HFREF may be low despite the evidence for morbidity and mortality improvement with these medications but remains associated with reduced 1-year mortality in unselected HFREF patients.
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Affiliation(s)
- Amandine Busson
- Inserm, CHRU Nancy, Université de Lorraine, CIC-1433, Epidémiologie Clinique, F-54000, Nancy, France; Université de Lorraine, EA 4360 Apemac, F-54000, Nancy, France
| | - Nathalie Thilly
- Inserm, CHRU Nancy, Université de Lorraine, CIC-1433, Epidémiologie Clinique, F-54000, Nancy, France; Université de Lorraine, EA 4360 Apemac, F-54000, Nancy, France
| | | | - François Alla
- Inserm, CHRU Nancy, Université de Lorraine, CIC-1433, Epidémiologie Clinique, F-54000, Nancy, France; Université de Lorraine, EA 4360 Apemac, F-54000, Nancy, France
| | - Ziyad Messikh
- Inserm, CHRU Nancy, Université de Lorraine, CIC-1433, Epidémiologie Clinique, F-54000, Nancy, France
| | - Isabelle Clerc-Urmes
- Inserm, CHRU Nancy, Université de Lorraine, CIC-1433, Epidémiologie Clinique, F-54000, Nancy, France
| | - Alexandre Mebazaa
- Inserm U942, Paris F-75000, France; University Paris Diderot, Sorbonne Paris Cité, Paris F-75000, France; Department of Anesthesia and Critical Care, Hôpitaux Universitaires Saint-Louis Lariboisière, APHP, Paris F-75000, France
| | - Marc Soudant
- Inserm, CHRU Nancy, Université de Lorraine, CIC-1433, Epidémiologie Clinique, F-54000, Nancy, France
| | - Nelly Agrinier
- Inserm, CHRU Nancy, Université de Lorraine, CIC-1433, Epidémiologie Clinique, F-54000, Nancy, France; Université de Lorraine, EA 4360 Apemac, F-54000, Nancy, France.
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Martin A, Thilly N, Ayav C, Clerc-Urmes I, Held P, Frimat L, Peters NO. Étude T2HD. Anticoagulants oraux et antiagrégants plaquettaires : pratiques, bénéfices et risques chez l’hémodialysé chronique. Données observationnelles. Nephrol Ther 2016; 12:156-65. [DOI: 10.1016/j.nephro.2015.08.005] [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] [Received: 05/10/2015] [Revised: 08/05/2015] [Accepted: 08/31/2015] [Indexed: 11/30/2022]
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Tiotiu A, Clerc-Urmes I, Chabot F, Martinet Y. Clinical benefits and risks associated with darbepoetin alfa and epoetin alfa treatment in patients with lung cancer and chemotherapy-induced anemia. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e21635] [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: 11/20/2022] Open
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Rauch A, Teixeira PAG, Gillet R, Perez M, Clerc-Urmes I, Lombard C, Blum A. Analysis of the position of the branches of the ulnar nerve in Guyon's canal using high-resolution MRI in positions adopted by cyclists. Surg Radiol Anat 2016; 38:793-9. [PMID: 26740001 DOI: 10.1007/s00276-015-1612-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 12/21/2015] [Indexed: 11/24/2022]
Abstract
PURPOSE To study variations in the anatomical relationships of the branches of the ulnar nerve in Guyon's canal relative to the hamulus of hamate (HH) in a grip encountered among cyclists. MATERIALS AND METHODS Forty-seven wrist examinations were performed on a 3-T MRI (soft antenna, 16 channels) in propeller sequence in the plane perpendicular to the carpus in 28 healthy volunteers in three cycling positions (neutral, hyperextension and ulnar deviation). The positions and distance between the superficial (SB) and deep (DB) branches of the ulnar nerve with respect to the HH were determined on the section passing through the HH. RESULTS The mean distances between the SB (d s) and DP (d p) and HH were 2.4 and 0.6 mm, respectively. The d s in hyperextension and ulnar deviation were 2.2 mm (P = 0.3) and 3 mm (P = 0.07), respectively. The d p in hyperextension and ulnar deviation were 0.3 mm (P = 0.02) and 0.5 mm (P = 0.15), respectively. Hyperextended, 60 % of SB and 40 % of DB were close to the HH, and 26 % of DB came directly in contact with it. In ulnar deviation, 30 % of SB and 29 % of DB approached HH, and 47 % of DB were in contact with it. CONCLUSION This study shows that SB and DB positions of the ulnar nerve vary with respect to the HH depending on the position of the wrist, and such differences may promote Guyon's canal syndrome in cyclists.
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Affiliation(s)
- Aymeric Rauch
- Guilloz Imaging Department, CHU Nancy - Hôpital Central, Rue du Maréchal de Lattre de Tassigny, 54000, Nancy, France.
| | - Pedro Augusto Gondim Teixeira
- Guilloz Imaging Department, CHU Nancy - Hôpital Central, Rue du Maréchal de Lattre de Tassigny, 54000, Nancy, France
| | - Romain Gillet
- Guilloz Imaging Department, CHU Nancy - Hôpital Central, Rue du Maréchal de Lattre de Tassigny, 54000, Nancy, France
| | - Manuela Perez
- Anatomy Department, Faculty of Medicine, 9 Avenue de la Forêt de Haye, 54500, Vandoeuvre-Les-Nancy, France
| | - Isabelle Clerc-Urmes
- ESPRI-BioBase Unit, CHU Nancy - Hôpitaux de Brabois, Allée du Morvan, 54500, Vandoeuvre-Les-Nancy, France
| | - Charles Lombard
- Guilloz Imaging Department, CHU Nancy - Hôpital Central, Rue du Maréchal de Lattre de Tassigny, 54000, Nancy, France
| | - Alain Blum
- Guilloz Imaging Department, CHU Nancy - Hôpital Central, Rue du Maréchal de Lattre de Tassigny, 54000, Nancy, France
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Collette C, Frimat L, Ayav C, Clerc-Urmes I, Martin A, Agrinier N, Laborde-Castérot H, Peters N, Thilly N. Risque hémorragique associé aux pratiques de prescription des antiagrégants plaquettaires et des anticoagulants oraux chez les hémodialysés chroniques. Nephrol Ther 2015. [DOI: 10.1016/j.nephro.2015.07.215] [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: 11/24/2022]
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Ayav C, Legendre C, Frimat L, Hourmant M, Rostaing L, Hiesse C, Mourad G, Glotz D, Speyer E, Clerc-Urmes I, Briançon S, Kessler M. Impact de la dialyse avant greffe rénale avec donneur vivant sur la qualité de vie et la réinsertion professionnelle des receveurs. Nephrol Ther 2015. [DOI: 10.1016/j.nephro.2015.07.061] [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: 11/25/2022]
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Martin A, Thilly N, Ayav C, Clerc-Urmes I, Held P, Frimat L, Peters N. Étude T2HD, anticoagulants oraux et antiagrégants plaquettaires : pratiques, bénéfices et risques chez l’hémodialysé chronique. Données observationnelles. Nephrol Ther 2015. [DOI: 10.1016/j.nephro.2015.07.020] [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: 10/23/2022]
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Lupi-Pegurier L, Clerc-Urmes I, Abu-Zaineh M, Paraponaris A, Ventelou B. Density of dental practitioners and access to dental care for the elderly: A multilevel analysis with a view on socio-economic inequality. Health Policy 2011; 103:160-7. [DOI: 10.1016/j.healthpol.2011.09.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2010] [Revised: 08/30/2011] [Accepted: 09/30/2011] [Indexed: 11/30/2022]
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