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Carmassi C, Corsi M, Gesi C, Bertelloni C, Pedrinelli V, Massimetti G, Bonuccelli A, Orsini A, Dell’Osso L. Post-traumatic Stress Spectrum and Adult Autism Subthreshold Spectrum in Parents of Children with Epilepsy: Correlations and Gender Differences. Eur Psychiatry 2020. [DOI: 10.1016/j.eurpsy.2017.01.1305] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
IntroductionData that assess the co-morbidity between post-traumatic stress symptoms and autism spectrum are scarce. Nevertheless, some authors suggested that subjects with autism spectrum disorder (ASD), due to their difficulty in understanding the codes of communication, empathy, expression, are lower resilience to traumas.ObjectivesThe aim of this study was to explore in a sample of parents of children with epilepsy, the presence of correlations between the symptoms of post-traumatic stress and adult autism subthreshold spectrum.MethodsSeventy-seven parents completed the Trauma and Loss Spectrum Self-Report (TALS-SR), specifically modified for one's son epileptic disease, and 72 parents completed the AdAS Spectrum (Adult Autism subthreshold Spectrum).ResultsEight subjects (11.1%) presented a total score ≥45 at the AdAS Spectrum, corresponding to the satisfaction of a symptomatic ASD criteria and indicative of the Adult Autism Spectrum subthreshold. More specifically, a total score ≥45 was found in 7 (15.9%) of mothers and 1 (3.6%) of the fathers, with no statistically significant differences between the two groups (P = 0.139).Noteworthy correlations between TALS and AdAS, emerged only in the subgroup of the fathers. In particular, a relevant number of moderate to good correlations emerged between the Domain II (reactions to the events of loss) of the TALS-SR and the AdAS Domain III (non verbal communication), Domain VI (restricted interests and ruminations) and total score.ConclusionsResults indicate that this peculiar psychopathological model could lead to increased vulnerability to effects of the trauma, in particular in male.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Orsini A, Costagliola G, Perna D, Esposito MG, Bonfiglio L, Striano P, Peroni D, Consolini R, Bonuccelli A. Efficacy and tolerability of mycophenolate mofetil in a pediatric Rasmussen syndrome. Epilepsy Behav Rep 2019; 13:100334. [PMID: 32140679 PMCID: PMC7044645 DOI: 10.1016/j.ebr.2019.100334] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 09/04/2019] [Accepted: 09/10/2019] [Indexed: 11/29/2022] Open
Abstract
Rasmussen syndrome (RS) is a chronic encephalopathy with uncertain etiology and immune-mediated pathogenesis. The only definitive treatment is represented by functional hemispherectomy. We describe the case of a 6.5-year-old female patient who developed several episodes of focal, unilateral clonic seizures. Following laboratory and instrumental investigations, the patient was diagnosed as having RS. A treatment with corticosteroids, intravenous immunoglobulin, and the antiseizure medication (carbamazepine and levetiracetam) did not completely control the seizures. Therefore, the patient was treated with mycophenolate mofetil (MMF), showing a good clinical response, with reduction of the seizures, and stability of the radiological findings. This case suggests the potential utility of MMF in the immune approach to RS. Rasmussen encephalitis (RE) is an immune-mediated disease of unknown etiology. Current definitive treatment for RE is represented by hemispherectomy. The immune approach of RE has been performed with several agents. In this case, mycophenolate mofetil was successfully used in a patient with RE.
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Affiliation(s)
- A Orsini
- Pediatric Neurology, Pediatric Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Italy
| | - G Costagliola
- Pediatric Immunology, Pediatric Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Italy
| | - D Perna
- Pediatric Neurology, Pediatric Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Italy
| | - M G Esposito
- Pediatric Neurology, Pediatric Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Italy
| | - L Bonfiglio
- Pediatric Neurorehabilitation, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Italy
| | - P Striano
- Paediatric Neurology and Muscular Diseases Unit, "G. Gaslini" Institute, Genova, Italy.,Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genova, Italy
| | - D Peroni
- Pediatric Neurology, Pediatric Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Italy.,Pediatric Immunology, Pediatric Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Italy
| | - R Consolini
- Pediatric Immunology, Pediatric Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Italy
| | - A Bonuccelli
- Pediatric Neurology, Pediatric Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Italy
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Orsini A, Sammartino I, Valetto A, Bertini V, Marchese P, Bonuccelli A, Peroni DG. Methylenetetrahydrofolate reductase polymorphism (MTHFR C677T) and headache in children: a retrospective study from a tertiary level outpatient service. Ital J Pediatr 2018; 44:106. [PMID: 30170616 PMCID: PMC6119283 DOI: 10.1186/s13052-018-0546-1] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 08/21/2018] [Indexed: 01/03/2023] Open
Abstract
Background In adult studies the MTHFR C677T polymorphism has been associated with an increased risk of migraine, but little research has been done in this area in children. Methods A retrospective study of children referred with headache to a tertiary level Paediatric Neurology Service between 2008 and 2012. This study included only patients who had been genotyped for the MTHFR C677T polymorphism. An evaluation of homocysteine serum levels was necessary to exclude other types of migraine. Conclusion Compared with the wild-type genotype, the T/T genotype was associated with an increased risk of any type of migraine, though the statistical significance was greatest in migraine with aura. The homocysteine serum levels were significantly higher in migraine with aura compared to migraine without aura. In a pediatric population MTHFR T/T homozygosity influences susceptibility to migraine.
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Affiliation(s)
- A Orsini
- Pediatric Neurology, Pediatric Department, Azienda Ospedaliera Universitaria Pisana, Via Roma 57, 56100, Pisa, Italy
| | - I Sammartino
- Pediatric Neurology, Pediatric Department, Azienda Ospedaliera Universitaria Pisana, Via Roma 57, 56100, Pisa, Italy
| | - A Valetto
- Cytogenetics Unit, Medicine of Laboratory Department, Azienda Ospedaliera Universitaria Pisana, Pisa, 56100, Italy
| | - V Bertini
- Cytogenetics Unit, Medicine of Laboratory Department, Azienda Ospedaliera Universitaria Pisana, Pisa, 56100, Italy
| | - P Marchese
- Pediatric Neurology, Pediatric Department, Azienda Ospedaliera Universitaria Pisana, Via Roma 57, 56100, Pisa, Italy.
| | - A Bonuccelli
- Pediatric Neurology, Pediatric Department, Azienda Ospedaliera Universitaria Pisana, Via Roma 57, 56100, Pisa, Italy
| | - D G Peroni
- Pediatric Neurology, Pediatric Department, Azienda Ospedaliera Universitaria Pisana, Via Roma 57, 56100, Pisa, Italy
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Dell'Osso L, Corsi M, Gesi C, Bertelloni CA, Massimetti G, Peroni D, Bonuccelli A, Orsini A, Carmassi C. Adult Autism Subthreshold Spectrum (AdAS Spectrum) in parents of pediatric patients with epilepsy: Correlations with post-traumatic stress symptoms. Compr Psychiatry 2018; 83:25-30. [PMID: 29549876 DOI: 10.1016/j.comppsych.2018.02.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 07/12/2017] [Revised: 01/22/2018] [Accepted: 02/07/2018] [Indexed: 12/28/2022] Open
Abstract
Increasing literature has shown the usefulness of a dimensional approach to mental disorders, particularly when exploring subjects exposed to traumatic experiences such as a severe illness in one's child. Recent evidence suggests an increased vulnerability in subjects with autism spectrum symptoms to develop post-traumatic stress symptoms. The aim of the present study was to evaluate the presence of adult autism subthreshold spectrum in a sample of parents of children with epilepsy and its impact on post-traumatic stress spectrum symptoms in the same study sample. Results revealed noteworthy correlations between post-traumatic stress symptoms and adult autism subthreshold spectrum (AdAS Spectrum) only in the subgroup of the fathers. In particular, were evidenced correlations between AdAS Spectrum domain of rumination and narrow interests and some TALS-SR nuclear domains: reaction to traumatic events, reexperiencing and arousal. These findings corroborate the hypothesis that subthreshold autistic features may influence the possible psychopathological reaction to trauma.
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Affiliation(s)
- L Dell'Osso
- Psychiatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy.
| | - M Corsi
- Psychiatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy
| | - C Gesi
- Psychiatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy
| | - C A Bertelloni
- Psychiatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy
| | - G Massimetti
- Psychiatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy.
| | - D Peroni
- Pediatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy.
| | - A Bonuccelli
- Pediatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy
| | - A Orsini
- Pediatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy
| | - C Carmassi
- Psychiatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy.
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Orsini A, Bonuccelli A, Striano P, Azzara A, Costagliola G, Consolini R, Peroni DG, Valetto A, Bertini V. Generalized epilepsy and mild intellectual disability associated with 13q34 deletion: A potential role for SOX1 and ARHGEF7. Seizure 2018; 59:38-40. [PMID: 29734022 DOI: 10.1016/j.seizure.2018.04.016] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 04/19/2018] [Accepted: 04/21/2018] [Indexed: 10/17/2022] Open
Abstract
Terminal deletions of long arm of chromosome 13 are rare and poorly characterized by cytogenetic studies, making for difficult genotype-phenotype correlations. We report two siblings presenting generalized epilepsy, intellectual disability, and genitourinary tract defects. Array CGH detected a 1.3 Mb deletion at 13q34; it contains two protein-coding genes, SOX1 and ARHGEF7, whose haploinsufficiency can contribute to the epileptic phenotype.
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Affiliation(s)
- A Orsini
- U.O Pediatria, Azienda Ospedaliera Universitaria Pisana, Università di Pisa, Italy.
| | - A Bonuccelli
- U.O Pediatria, Azienda Ospedaliera Universitaria Pisana, Università di Pisa, Italy
| | - P Striano
- Neurologia Pediatrica e Malattie Muscolari, Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili, Istituto 'G. Gaslini', Università di Genova, Italy
| | - A Azzara
- SOD Citogenetica, Azienda Ospedaliera Universitaria Pisana, Italy
| | - G Costagliola
- U.O Pediatria, Azienda Ospedaliera Universitaria Pisana, Università di Pisa, Italy
| | - R Consolini
- U.O Pediatria, Azienda Ospedaliera Universitaria Pisana, Università di Pisa, Italy
| | - D G Peroni
- U.O Pediatria, Azienda Ospedaliera Universitaria Pisana, Università di Pisa, Italy
| | - A Valetto
- SOD Citogenetica, Azienda Ospedaliera Universitaria Pisana, Italy
| | - V Bertini
- SOD Citogenetica, Azienda Ospedaliera Universitaria Pisana, Italy
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Carmassi C, Corsi M, Gesi C, Bertelloni C, Faggioni F, Calderani E, Massimetti G, Peroni D, Bonuccelli A, Orsini A, Dell’Osso L. Full and Partial DSM-5 PTSD in Parents of Children with Epilepsy: Exploring Gender Differences. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.1307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
IntroductionIncreasing literature suggests the need to explore PTSD and post-traumatic stress symptoms among parents and caregivers of children with acute and chronic illnesses but scant data are available on epilepsy.ObjectivesThe aim of this study was to estimate full and partial PTSD rates among parents of children with epilepsy according to DSM-5 criteria. Further, aim of this study was to examine eventual gender differences between mothers and fathers.MethodsOne hundred and thirty-eight parents, 91 mothers (65.9%) and 47 (34.1%) fathers, of children diagnosed with epilepsy were interviewed using the SCID-5.ResultsFull and partial DSM-5 PTSD were reported by 10.4% and 37.3% of patients, respectively. Significant gender differences, with the mother more affected, emerged in the rates of partial A PTSD rates (P = 0.048) and in the endorsement rates of criterion B (intrusion symptoms) (P = 0.047), criterion D (negative alterations in cognitions and mood) (P = 0.010) and criterion E (alterations in arousal and reactivity) (P < 0.001) too.ConclusionsThis is the first study to identify post-traumatic symptoms in caregivers of pediatric patients with epilepsy with the use of current diagnostic criteria and the relevance of the results suggests the need for further studies on this risk population.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Bertini V, Orsini A, Bonuccelli A, Cambi F, Del Pistoia M, Vannozzi I, Toschi B, Saggese G, Simi P, Valetto A. 17q12 microduplications: a challenge for clinicians. Am J Med Genet A 2016; 167A:674-6. [PMID: 25691423 DOI: 10.1002/ajmg.a.36905] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 06/24/2014] [Accepted: 11/14/2014] [Indexed: 11/10/2022]
Abstract
In the recent years, some cases of 17q12 deletions and duplications have been reported, but the clinical impact of these imbalances is still to be fully elucidated. In particular, 17q12 duplications elude syndrome classification, since they are associated with a wide phenotypic spectrum, ranging from very mild to quite severe phenotypes. Here, two unrelated patients with the same 1.2 Mb microduplication of 17q12 are reported. Comparing these patients' phenotype with those previously published, it emerges that the more patients reported, the more difficult is finding common characteristics, even in presence of exactly the same genetic anomaly. The role of the genes duplicated in this region and the impact of this chromosomal imbalance are discussed.
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Affiliation(s)
- V Bertini
- Cytogenetics and Molecular Genetics Unit, Children Department, AOUP, Pisa, Italy
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Gatteschi L, Angelini F, Bonuccelli A, Marzatico F, Rubenni M, Zeppilli P. Fluid balance and body composition analysis in female soccer players effect of the match. J Int Soc Sports Nutr 2011. [PMCID: PMC3238165 DOI: 10.1186/1550-2783-8-s1-p31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Gadducci A, Fabrini MG, Bonuccelli A, Fanucchi A, Perutelli A, Facchini V. Recurrence patterns in patients with early stage cervical cancer treated with radical hysterectomy and external pelvic irradiation. Anticancer Res 1995; 15:1071-7. [PMID: 7645928] [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: 01/26/2023]
Abstract
One hundred and fifty patients with clinical FIGO stage IB-II cervical cancer who underwent radical surgery followed by external pelvic irradiation between 1978 and 1991 were reviewed. Until June 1994, 28 (18.7%) patients developed recurrent disease. Seventeen (60.7%) of them experienced a pelvic failure, 7 (25.0%) an extrapelvic failure and 4 (14.3%) both a pelvic and an extrapelvic failure. The median time to recurrence was 16 months for patients with pelvic failure (range = 4-50 months), 27 months for those with extrapelvic failure (range = 6-49 months), and 21 months for those with both pelvic and extrapelvic failure (range u 8-56 months). Recurrence rates were significantly related to surgical-pathologic stage, tumor size and lymph node status, but not to histologic type. An extrapelvic recurrence, alone or associated with a pelvic failure, was found in 0.9% of 117 patients with negative lymph nodes, 6.2% of 16 patients with one or two positive lymph nodes, and 52.9% of 17 patients with three or more positive lymph nodes, (p = 0.0001). It is worth noting that 9 (81.8%) out of the 11 patients who developed extrapelvic recurrences had three or more involved lymph nodes. The number of positive lymph nodes (p = 0.0001) and the tumor size (p = 0.0046) were independent prognostic variables for disease-free survival.
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Affiliation(s)
- A Gadducci
- Department of Gynecology and Obstetrics, University of Pisa, Italy
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Gadducci A, Fabrini MG, Bonuccelli A, Moda S, Fanucchi A, Laddaga M, Facchini V. Analysis of treatment failures in patients with early-stage uterine leiomyosarcoma. Anticancer Res 1995; 15:485-8. [PMID: 7763027] [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: 01/27/2023]
Abstract
This retrospective study aimed to investigate the treatment failures in 26 patients with stages I-II uterine leiomyosarcoma (> or = 10 mitoses per 10 high-power field (HPF) who underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy +/- adjuvant external pelvic irradiation. Thirteen (50%) patients developed recurrent disease, after a median time of 10 months from surgery (range = 4-72 months). Recurrence was pelvic in 3 (23%) patients, extrapelvic in 9 (69%) patients, and both pelvic and extrapelvic in 1 (8%) patient. Disease-free survival was better for premenopausal than for postmenopausal patients (p = 0.002) and for patients with < 20 mitoses per 10 HPF than for those with > or = 20 mitoses per 10 HPF (p = 0.006). In conclusion, patients with early-stage disease who had undergone locoregional treatment experienced a high recurrence rate. Most of the treatment failures were extrapelvic. Multicentric randomized trials on the role of adjuvant chemotherapy are advocated.
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Affiliation(s)
- A Gadducci
- Department of Gynecology and Obstetrics, University of Pisa, Italy
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Ferdeghini M, Gadducci A, Prontera C, Bonuccelli A, Annicchiarico C, Fanucchi A, Facchini V, Bianchi R. Serum interleukin-6 levels in uterine malignancies. Preliminary data. Anticancer Res 1994; 14:735-7. [PMID: 8010733] [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: 01/28/2023]
Abstract
Interleukin-6 (IL-6) was measured with an enzyme-immunoassay in blood samples drawn at diagnosis from 37 patients with endometrial cancer, 36 with cervical cancer, 9 with cervical intraepithelial neoplasia (CIN) and 68 with benign uterine disease. The minimal detectable dose of IL-6 was 3 pg/mL. Detectable serum IL-6 levels were found in 9% of patients with benign uterine diseases, 11% of patients with CIN, 44% of patients with cervical cancer and 11% of patients with endometrial cancer. As regards cervical cancer, serum IL-6 levels > 3 pg/mL were found in 36.0% of 25 patients with stage Ib-IIa disease and in 64% of 11 patients with stage IIb-IV disease. As regards endometrial cancer, serum detectable IL-6 levels were observed in 0% of 30 patients with stage I-II disease and in 57% of 7 patients with stage III-IV disease (p = 0.0005). These preliminary data suggest that IL-6 may be involved in the progression of uterine malignancies.
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Affiliation(s)
- M Ferdeghini
- Istituto di Medicina Nucleare, Università di Pisa, Italy
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Buttitta F, Gadducci A, Marchetti A, Morganti M, Pellegrini S, Bonuccelli A, Facchini V. P53 overexpression in stage I of endomeitrial adenocarcinoma. Pharmacotherapy 1993. [DOI: 10.1016/0753-3322(93)90180-s] [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]
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