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Cobellis G, Torino G, Lisi G, Ilari M, Bindi E. Pneumovesicoscopic management of bladder neoplasms in children: three case reports. Pediatr Med Chir 2023; 45. [PMID: 37428106 DOI: 10.4081/pmc.2023.307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 06/19/2023] [Indexed: 07/11/2023] Open
Abstract
Urothelial bladder neoplasms (UBN) are uncommon in children and are poorly understood. Their management is contentious, and there are currently no pediatric guidelines available, making it difficult to envision a surgical approach that can be defined as the gold standard for the treatment of these diseases. Pneumovesicoscopy, which has already been used to treat other urological diseases, could be a promising treatment option for selected cases of this group of pathologies. We present our experience with three pediatric UBN cases in which pneumovesicoscopy was used for complete excision of a perimeatal papilloma in two cases and biopsy of a botryoid rhabdomyosarcoma in one. The pneumovesicoscopic approach, in our experience, provided a viable alternative technique for the management of selected cases of UBN.
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Affiliation(s)
- Giovanni Cobellis
- Pediatric Surgical Unit Salesi Children's Hospital, Ancona; Università Politecnica delle Marche, Ancona.
| | | | | | - Michele Ilari
- Pediatric Surgical Unit Salesi Children's Hospital, Ancona.
| | - Edoardo Bindi
- Pediatric Surgical Unit Salesi Children's Hospital, Ancona; Università Politecnica delle Marche, Ancona.
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Bindi E, Nino F, Pierangeli F, Ilari M, Bollettini T, Chiarella E, Mariscoli F, Gentilucci G, Cruccetti A, Cobellis G. Transumbilical laparoscopic-assisted appendectomy <em>versus</em> laparoscopic appendectomy in children: a single center experience. Pediatr Med Chir 2023; 45. [PMID: 37114377 DOI: 10.4081/pmc.2023.306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 03/19/2023] [Indexed: 04/29/2023] Open
Abstract
Laparoscopic Appendectomy (LPSA) is the first choice for appendectomy in pediatric surgery. Trans-Umbilical Laparoscopic Assisted Appendicectomy (TULAA) is another used technique. We compared both these procedures used for the treatment of acute appendicitis. The study was conducted between January 2019 to December 2020. Patients were divided into two groups: LPSA and TULAA groups. The collected data were: operative time, number of conversions, time of canalization and hospital stay. A total of 181 patients were included: 73 were kept in the LPSA and 108 in the TULAA group. Mean operative time was 70.9 minutes (range 45-130 min) for LPS and 56.4 (30-145 min) for TULAA group (p <0.0001). Complications rate showed no statistically significant difference between both the two groups. However, conversions showed a statistically significant difference (p=0.04). Both techniques showed similar results. TULAA technique takes a significantly shorter operating time. The selection between LPSA and TULAA techniques depends on the experience of the surgeon's work and the personal laparoscopic learning curve. In our experience LPSA was a useful technique to improve the laparoscopic skill of the pediatric surgery residents.
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Affiliation(s)
- Edoardo Bindi
- Pediatric Surgery Unit, Salesi Children's Hospital, Ancona, Italy; Università Politecnica of Marche, Ancona.
| | - Fabiano Nino
- Pediatric Surgery Unit, Salesi Children's Hospital, Ancona.
| | | | - Michele Ilari
- Pediatric Surgery Unit, Salesi Children's Hospital, Ancona.
| | | | | | | | | | - Alba Cruccetti
- Pediatric Surgery Unit, Salesi Children's Hospital, Ancona.
| | - Giovanni Cobellis
- Pediatric Surgery Unit, Salesi Children's Hospital, Ancona, Italy; Università Politecnica of Marche, Ancona.
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Zangari A, Cerigioni E, Nino F, Guidi R, Gulia C, Piergentili R, Ilari M, Mazzoni N, Cobellis G. Dog bite injuries in a tertiary care children's hospital: A seven-year review. Pediatr Int 2021; 63:575-580. [PMID: 32979010 DOI: 10.1111/ped.14484] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 09/02/2020] [Accepted: 09/10/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Dog bites are a major cause of traumatic injury in children. The aim of this study was to determine the experience, management, and outcome of dog bite injuries in our department. METHODS We retrospectively reviewed the clinical records for 127 patients (mean age 7.15 ± 4.24 years, range 1 to 17 years; 68 males) affected by dog-related injuries, from 2012 to 2018. Characteristics of patients and dogs, type and severity of injuries, circumstances of the accidents, treatment and outcome were analyzed. RESULTS Of 141 wounds, 73 (51.8%) affected the head and neck, 62 (44%) the limbs, and six (4.2%) affected the trunk. According to the Mcheik classification, 107 lesions (75.9%) were stage 1, 26 (18.4%) stage 2, and eight (5.7%) stage 3. Seventy-eight percent of the cases involved known dogs. The breed of the dog was recorded in 62/127 cases (48.8%) and the most common were mongrels (23/62, 37.1%). Seventy-five percent of the attacks occurred during spring and summer. All patients underwent antibiotic prophylaxis and immediate surgical repair. Wound infection was observed in two patients. Three unsightly scars required rectification, with good cosmetic results in all cases. CONCLUSIONS Our results are consistent with previous data showing that the typical dog-related injury occurs from a known dog, during spring and summer, and in younger boys, who are frequently exposed to head and neck wounds. Our experience showed the feasibility and safety of primary repair and antibiotic prophylaxis in all patients, with very low incidence of infection and good cosmetic results.
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Affiliation(s)
- Andrea Zangari
- Department of Pediatric Surgery, San Camillo-Forlanini Hospital, Roma, Italy
| | | | - Fabiano Nino
- Pediatric Surgery Unit, Salesi Children's Hospital, Ancona, Italy
| | - Roberto Guidi
- Pediatric Emergency Unit, Salesi Children's Hospital, Ancona, Italy
| | - Caterina Gulia
- Urology Department, Ospedale Misericordia, Grosseto, Italy
| | - Roberto Piergentili
- Institute of Molecular Biology and Pathology IBPM, National Research Council, Roma, Italy
| | - Michele Ilari
- Pediatric Surgery Unit, Salesi Children's Hospital, Ancona, Italy
| | - Nadia Mazzoni
- Pediatric Emergency Unit, Salesi Children's Hospital, Ancona, Italy
| | - Giovanni Cobellis
- Pediatric Surgery Unit, Marche Polytechnic University, Salesi Children's Hospital, Ancona, Italy
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Bindi E, Cruccetti A, Ilari M, Mariscoli F, Carnielli VP, Simonini A, Cobellis G. Meckel's diverticulum perforation in a newborn positive to Sars-Cov-2. J Pediatr Surg Case Rep 2020; 62:101641. [PMID: 32904556 PMCID: PMC7456189 DOI: 10.1016/j.epsc.2020.101641] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 08/18/2020] [Revised: 08/24/2020] [Accepted: 08/27/2020] [Indexed: 01/10/2023] Open
Abstract
The health emergency linked to the Sars-Cov-2 infection represented an absolutely new problem for all health professionals. In particular, the information regarding the spread of the virus in the pediatric field and its manifestations are still incomplete. In this paper we present a case of neonatal infection which, as far as we know, represents one of the few published cases and which occurred in a patient who came to our attention for acute abdomen from intestinal perforation. The perforation was caused by Meckel's diverticulum, an event considered infrequent in the first year of life and almost exceptional in the neonatal period. This case required particular management, putting pediatric surgeons in front of new and difficult to solve problems. New onset clinical events, such as this one described, represent an opportunity for sharing useful data for the creation of universal protocols for the management of patients with problems that are becoming common and of which little is known.
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Affiliation(s)
- E Bindi
- Pediatric Surgical Unit, Salesi Children's Hospital, Ancona, Italy
| | - A Cruccetti
- Pediatric Surgical Unit, Salesi Children's Hospital, Ancona, Italy
| | - M Ilari
- Pediatric Surgical Unit, Salesi Children's Hospital, Ancona, Italy
| | - F Mariscoli
- Pediatric Surgical Unit, Salesi Children's Hospital, Ancona, Italy
| | - V P Carnielli
- Neonatology Unit, Salesi Children's Hospital, Ancona, Italy
- University Politecnica delle Marche, Ancona, Italy
| | - A Simonini
- Pediatric Intensive Care Unit, Salesi Children's Hospital, Ancona, Italy
| | - G Cobellis
- Pediatric Surgical Unit, Salesi Children's Hospital, Ancona, Italy
- University Politecnica delle Marche, Ancona, Italy
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Nino F, Ilari M, Noviello C, Santoro L, Rätsch IM, Martino A, Cobellis G. Genetics of Vesicoureteral Reflux. Curr Genomics 2016; 17:70-9. [PMID: 27013925 PMCID: PMC4780477 DOI: 10.2174/1389202916666151014223507] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 06/29/2015] [Accepted: 07/05/2015] [Indexed: 12/13/2022] Open
Abstract
Vesicoureteral reflux (VUR) is the retrograde passage of urine from the bladder to the upper urinary tract. It is the most common congenital urological anomaly affecting 1-2% of children and 30-40% of patients with urinary tract infections. VUR is a major risk factor for pyelonephritic scarring and chronic renal failure in children. It is the result of a shortened intravesical ureter with an enlarged or malpositioned ureteric orifice. An ectopic embryonal ureteric budding development is implicated in the pathogenesis of VUR, which is a complex genetic developmental disorder. Many genes are involved in the ureteric budding formation and subsequently in the urinary tract and kidney development. Previous studies demonstrate an heterogeneous genetic pattern of VUR. In fact no single major locus or gene for primary VUR has been identified. It is likely that different forms of VUR with different genetic determinantes are present. Moreover genetic studies of syndromes with associated VUR have revealed several possible candidate genes involved in the pathogenesis of VUR and related urinary tract malformations. Mutations in genes essential for urinary tract morphogenesis are linked to numerous congenital syndromes, and in most of those VUR is a feature. The Authors provide an overview of the developmental processes leading to the VUR. The different genes and signaling pathways controlling the embryonal urinary tract development are analyzed. A better understanding of VUR genetic bases could improve the management of this condition in children.
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Affiliation(s)
- F Nino
- Pediatric Surgery Unit - Salesi Children s Hospital - UniversitPolitecnica delle Marche - Ancona,Italy
| | - M Ilari
- Pediatric Surgery Unit - Salesi Children s Hospital - UniversitPolitecnica delle Marche - Ancona,Italy
| | - C Noviello
- Pediatric Surgery Unit - Salesi Children s Hospital - UniversitPolitecnica delle Marche - Ancona,Italy
| | - L Santoro
- Clinics of Pediatrics - Pediatric Nephrology Unit - Salesi Children s Hospital - Universit Politecnica delle Marche - Ancona, Italy
| | - I M Rätsch
- Clinics of Pediatrics - Pediatric Nephrology Unit - Salesi Children s Hospital - Universit Politecnica delle Marche - Ancona, Italy
| | - A Martino
- Pediatric Surgery Unit - Salesi Children s Hospital - UniversitPolitecnica delle Marche - Ancona,Italy
| | - G Cobellis
- Pediatric Surgery Unit - Salesi Children s Hospital - UniversitPolitecnica delle Marche - Ancona,Italy
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Zangari A, Ilari M, Nino F, Ascanio M. Report of a malignant melanoma arising in a small congenital nevus in a 3-year-old child. J Indian Assoc Pediatr Surg 2013; 18:165-6. [PMID: 24347875 PMCID: PMC3853863 DOI: 10.4103/0971-9261.121122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Andrea Zangari
- Pediatric Surgery Department, Salesi Children's Hospital, Ancona, Italy
| | - Michele Ilari
- Pediatric Surgery Department, Salesi Children's Hospital, Ancona, Italy
| | - Fabiano Nino
- Pediatric Surgery Department, Salesi Children's Hospital, Ancona, Italy
| | - Martino Ascanio
- Pediatric Surgery Department, Salesi Children's Hospital, Ancona, Italy
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Zangari A, Bernardini ML, Tallarico R, Ilari M, Giangiacomi M, Offidani AM, Martino A. Indications for excision of nevi and melanoma diagnosed in a pediatric surgical unit. J Pediatr Surg 2007; 42:1412-6. [PMID: 17706506 DOI: 10.1016/j.jpedsurg.2007.03.044] [Citation(s) in RCA: 7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND/PURPOSE Childhood melanoma is rare but increasing in incidence. Its management relies on early diagnosis. The purpose of this study is to discuss surgical indications of nevi and diagnosis of melanoma in a pediatric surgical unit. METHODS Data relative to the patients who underwent removal of nevi in our pediatric surgical unit from 1999 to 2005 were reviewed to identify indications, histology, and melanoma occurrence. RESULTS The most frequent indication was atypical nevus. Compound nevus was the most common finding, followed by congenital and Spitz nevi. Melanoma was diagnosed in 3 excised nevi, and in 1 case it occurred as a metastatic disease. CONCLUSIONS Our data showed a pattern of indications for surgery similar to that described in the literature, with a high detection rate of melanoma, nonetheless showing that some rare conditions may delay diagnosis.
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Affiliation(s)
- Andrea Zangari
- Paediatric Surgery Unit, Salesi Children's Hospital, Ancona, Italy.
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Abstract
We report an unusual case of spontaneous haemothorax in a 13-year-old girl with isolated costal exostosis. Surgical excision of the exostosis was performed with complete resolution. Costal exostosis should be considered in the differential diagnosis of spontaneous haemothorax in children in order to avoid unnecessary investigation and to establish an adequate treatment plan.
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Affiliation(s)
- A Martino
- Division of Paediatric Surgery, Salesi Children's Hospital, Ancona, Italy
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Morini F, Ilari M, Casati A, Piserà A, Oriolo L, Cozzi DA. Posterior urethral valves and mirror image anomalies in monozygotic twins. Am J Med Genet 2002; 111:210-2. [PMID: 12210353 DOI: 10.1002/ajmg.10563] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Monozygotic (MZ) twins with both posterior urethral valves (PUV) and additional mirror image malformations are described. This association suggests that an early embryonic event may lead to MZ twinning, PUV, and mirror image anomalies.
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Affiliation(s)
- Francesco Morini
- Pediatric Surgery Unit, Policlinico Umberto I, University of Rome La Sapienza, Rome, Italy
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Morini F, Cozzi DA, Ilari M, Casati A, Cozzi F. Pattern of cardiovascular anomalies associated with esophageal atresia: support for a caudal pharyngeal arch neurocristopathy. Pediatr Res 2001; 50:565-8. [PMID: 11641448 DOI: 10.1203/00006450-200111000-00005] [Citation(s) in RCA: 21] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Patients with cephalic neurocristopathy (an abnormality of neural crest differentiation) present a striking pattern of associated cardiovascular anomalies (CVA). Therefore, to support the hypothesis that esophageal atresia (EA) may be related to a defective contribution from the cephalic neural crest, we studied the pattern of CVA associated with EA. Medical records of 99 patients with isolated EA, 101 with isolated anorectal malformations (ARM) and 15 with both EA and ARM, consecutively admitted to our unit, were reviewed. The prevalence and pattern of CVA associated with isolated EA or isolated ARM were compared on the assumption that the cranial or caudal location of a major malformation is related to a different regional patterning of associated anomalies. The prevalence of CVA was 39% in patients with isolated EA and 7% in those with isolated ARM (p < 0.01). Neural crest-related CVA (aortic arch anomalies, conotruncal defects, and superior vena cava malformations) accounted for 72% of all CVA in patients with isolated EA versus 14% in those with isolated ARM (p < 0.02). In patients with isolated EA, anomalies of the fourth and sixth aortic arch derivatives accounted for 75% of all neural crest related CVA. The present pattern of CVA in infants with EA supports the concept that EA may be related to an abnormal contribution from caudal portion of cephalic neural crest.
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Affiliation(s)
- F Morini
- Pediatric Surgery Unit, University of Rome "La Sapienza," Rome, Italy
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Ilari M, Grieco G. [Iridogoniodysgenesis associated with somatic anomalies]. Riv Eur Sci Med Farmacol 1987; 9:87-90. [PMID: 3508581] [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: 01/06/2023]
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Zardi O, Adorisio E, Guglielmi G, Pastore A, Ilari M, Nemesio R, Gozzer G, Infussi F, Bruno M. [Type B viral encephalitis: HBsAg testing in saliva and cerebrospinal fluid]. G Batteriol Virol Immunol 1983; 76:282-9. [PMID: 6681022] [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: 01/21/2023]
Abstract
The AA, taking the latest reports as a starting point, are attempting a first epidemiological reconsideration of Hepatitis, Virus B. They have found that the disease, which was generally thought not to be contagious, is actually deceptive in its potential for transmission from person to person. Hospital personnel, in particular, are greatly at risk as are their families.
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Calzolari E, Ilari M, Tognazzi F, Morelli R. [Endo-cervical aspiration, vaginal cytology and bacterioscopic observation in CU-improved IUD carriers]. Patol Clin Ostet Ginecol 1980; 8:378-82. [PMID: 12310938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
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Brenciaglia MI, Ilari M, Lorino G, Luciano R, Mancini C, Spitali R. [Relationships between mycoplasma and vaginitis. Experimental clinical study of 400 cases of vaginal diseases treated with the combination of amphotericin B and tetracycline]. Minerva Ginecol 1980; 32:223-7. [PMID: 7375068] [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: 01/24/2023]
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Calzolari E, Ilari M, Salmaggi P, Zichella L. [Preliminary evaluation of an endocervical aspirator for the study of exfoliative cytology of the endocervix and endometrium]. Minerva Ginecol 1976; 28:997-1002. [PMID: 1012592] [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: 12/25/2022]
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Carenza L, Marzetti L, Ilari M, Laudisio V. [Value of colpocytology as a placental function test during normal and pathological pregnancy]. Minerva Ginecol 1969; 21:1366-71. [PMID: 5378769] [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: 01/14/2023]
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Ilari M, Bracali R, Corrado F. [Pregnancy at term. (Bio-chronological evaluation criteria)]. Quad Clin Ostet Ginecol 1968; 23:1151-1160. [PMID: 5744182] [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: 05/21/2023]
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Laudisio V, Leone M, Ilari M. [The combination of gonad stimulating therapy with estrogenic drugs in the treatment of endocrine sterility]. Quad Clin Ostet Ginecol 1968; 23:86-92. [PMID: 5735185] [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: 01/16/2023]
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