Ιατρικά Άρθρα: 10/08/18

Δευτέρα 8 Οκτωβρίου 2018

Comparison of an indirect impression scanning system and two direct intraoral scanning systems in vivo

Abstract

Objectives

This in vivo study aimed to compare the marginal discrepancies of zirconia copings manufactured on the basis of two direct intraoral scanning systems and the indirect digitization of a conventional impression.

Materials and methods

A total of 63 teeth in 23 patients were prepared to receive full-coverage crowns. Subsequently, these teeth were intraorally scanned using CEREC AC Omnicam and Cara TRIOS and a conventional impression was taken with the scannable PVS Flexitime Fast & Scan. The conventional impression was then extraorally digitized using a D700 laboratory scanner. The zirconia copings were manufactured on the basis of the resulting datasets. Silicone replicas of the copings were produced and sectioned for the measurement of the marginal discrepancy under a digital microscope.

Results

The statistical analysis showed no significant differences between the two intraoral scanners, the CEREC AC Omnicam (86.09 μm ± 61.46 μm) and the Cara TRIOS (88.95 μm ± 54.46 μm). However, the discrepancies of the zirconia copings obtained from the laboratory scans of conventional impressions (143.29 μm ± 100.71 μm) showed significant differences. Both intraoral scanners achieved a marginal discrepancy below 100 μm, whereas the laboratory scan exhibited considerably higher values.

Conclusions

The intraoral scanners tested allow for the production of single-tooth-restorations with an adequate marginal fit, whereas the production of restorations on the basis of the scan of a conventional impression led to vast marginal gaps.

Clinical relevance

The method of digitizing a conventional impression using a laboratory scanner seemed to have reached its limits in the clinical environment.

https://ift.tt/2ymYKhx

Are dairy products containing probiotics beneficial for oral health? A systematic review and meta-analysis

Abstract

Objectives

To evaluate the effect of probiotic containing in dairy products on oral and salivary parameters.

Material and methods

Electronic searches were performed based on the PICO criteria. Randomized controlled trials in adults/children (P) in which dairy products containing probiotics (I) were compared to controls (C) for establishment of oral health (O) were included. Risk of bias and data extraction were performed. The meta-analysis evaluated the influence of probiotics on Streptococcus mutans (SM), Lactobacillus spp. (LB), and yeast counts, plaque index, and salivary pH. Random or fixed effect models were used, and heterogeneity was tested.

Results

Thirty-two studies were included in the qualitative synthesis, and 24 in the meta-analysis. For dichotomous results, individuals who consumed probiotics exhibited decreased scores in SM concentrations (RD 0.15 [0.02, 0.28] p = 0.03, I² = 70%), but no change was observed for LB (RD 0.10 [− 0.03, 0.23] p = 0.13, I² = 94%), or yeast levels (RD 0.05 [− 0.02, 0.12] p = 0.7, I² = 48%). For continuous analysis, both probiotic and control groups presented similar results for SM and LB (MD − 0.55 [− 1.16, 0.07] p = 0.08, I² = 62%, and RD 0.10 [− 0.03, 0.23] p = 0.13, I² = 94%, respectively). The consumption of probiotics increased salivary pH (MD 0.20 [0.04, 0.35] p = 0.01, I² = 46%) and plaque index (MD 0.38 [0.11, 0.65] p = 0.005, I² = 0%). The probiotic milk reduced SM (MD − 0.59 [− 0.96, − 0.22] p = 0.002, I² = 0%), and the probiotic yogurt decreased LB counts (RD 0.35 [0.19, 0.51] p < 0.0001, I² = 0%).

Conclusions

In general, dairy probiotics were effective in reducing SM, increasing salivary pH, and promoting a higher plaque index. Liquid matrices, such as milk and yogurt, seem to be more effective in reducing SM and LB levels.

Clinical relevance

Consumption of dairy products containing probiotics could be a supporting method in caries prevention.

https://ift.tt/2OgnfIf

Selenium (Se) uptake and dynamic changes of Se content in soil–plant systems

Abstract

In this study, we collected crop plants and associated soil samples and determined these for selenium (Se) content to analyze the uptake, enrichment, and translocation of Se in the different soil–plant systems of an agricultural production area, elucidate the dynamic mechanisms relating to Se content in plants and soil during different growth periods, and screen plants for high Se enrichment ability. Bioconcentration factor determinations indicated that the grains of rice have the strongest Se enrichment ability, followed by soybean and corn. Translocation factor analysis indicated that the grains of rice and corn have similar low translocation abilities for Se compared with soybean. Within the study area, the Se content in plants was closely related to the soil available Se content and varied considerably among different growth periods and plant organs. This study provides a theoretical basis for the development and utilization of local agricultural products.

https://ift.tt/2ILzhmU

Morin Exerts Anti-Diabetic Effects in Human HepG2 Cells Via Down-Regulation of miR-29a

Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-0650-4082

Diabetes mellitus is a complex metabolic disease around the world that is characterized by hyperglycemia resulting from impaired insulin secretion, insulin action, or both. MicroRNA-29a is an important regulator of insulin signaling and gluconeogenesis pathways through IRS2, PI3K and PEPCK expressions which up regulates in Diabetes. Morin is a substantial bioflavonoid which has insulin mimetic effect, and interacting with nucleic acids and proteins. In this study HepG2 cells, were exposed to high glucose to induce diabetic condition. We have determined whether high glucose stimulation might promotes miR-29a expression level in HepG2 cells and subsequently evaluated the Morin treatment effects on this state. In HepG2 cells, high glucose increases miR-29a expression level and decreases its target genes, IRS2 and PI3K expression, and increases associated downstream gene in gluconeogenic pathway, PEPCK. Morin treatment down regulates miR-29a expression level and improves insulin signaling and glucose metabolism. To confirm the inhibitory effects of Morin on miR-29a, we have transfected cells with mimic and inhibitor-miR-29a. This study for the first time identifies that Morin improves diabetic condition through down regulation of the miR-29a level, and suggest that this new inhibitor of miR-29a may be a useful biomedicine to treat diabetes.
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Article in Thieme eJournals:
Table of contents | Abstract | Full text

https://ift.tt/2NvQPE5

Do Hospital Doctors Screen for Diabetes?

01-2018-0007-dia_10-1055-a-0598-4682-1.j

Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-0598-4682

Background One in five hospitalized patients presents with previously undetected diabetes mellitus (DM). We assessed whether hospital doctors measure HbA1c in hospitalized patients and act consequently. Methods Data from patients hospitalized between January 2013 and December 2014 in a Swiss teaching hospital was collected. We assessed the frequency of HbA1c measurements and the number of newly detected prediabetes or DM. We also examined whether HbA1c values were associated with the antidiabetic drugs prescription and reporting of DM in the discharge letter. Results Of the 2618 patients studied, 298 (11.4%) had HbA1c measured, of whom 136 (45.6%) had no previous history of DM. Of the 136 patients without history of DM, 51 (37.5%) had prediabetic state and 23 (16.9%) had DM. Newly detected prediabetes or DM were reported in 5.8% (3/51) and 65.8% of cases (15/23), respectively. Only half of patients (11/23, 47.8%) with newly detected DM received antidiabetic drug treatment at discharge. Patients with newly detected DM (n=23) had a longer length of stay (median and interquartile range: 16 [9–25] versus 10 [8–16] days, p=0.028) compared to patients without DM, while no such differences were found regarding in-hospital mortality. Conclusions Hospital doctors seldom prescribe HbA1c measurement in medical hospitalized patients. Prescription of HbA1c measurement leads to a high detection rate (53%) of (pre)DM among patients unaware of their status, but management and reporting of these conditions at discharge could be further improved.
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Article in Thieme eJournals:
Table of contents | Abstract | Full text

https://ift.tt/2Cv2UII

Indirect Evaluation of Bone Saturation with Zoledronic Acid After Long‐Term Dosing

AbstractBackground.Zoledronic acid (ZA), a potent bisphosphonate used for treatment of bone metastasis, has high bone affinity. This post hoc analysis evaluated the effects of long‐term treatment and reduction in dosing frequency of ZA on bone saturation.Materials and Methods.Pharmacokinetic data from three independent studies, OPTIMIZE‐2 (patients receiving ≥9 doses of bisphosphonates) and two phase I studies, CZOL4460503 and CZOL4460506 (patients who were bisphosphonate naïve/bisphosphonate free for ≥1 year after previous dosing), were pooled. Serial urine and plasma samples were used as surrogate markers to determine ZA plasma area under the curve (AUC) over 6 hours (AUC0–6h) and dose excreted in urine over 6 hours (urine0–6h). Potential relationships between the number of years for which patients had been treated previously at time of study entry and AUC0–6h or urine0–6h were analyzed graphically.Results.Creatinine clearances for patients were similar across the three studies and at all time points analyzed. The levels of AUC0–6h ZA in plasma at week 0 in every (q) 4 and q12 weekly arms of OPTIMIZE‐2 were 0.366 h × mg/L and 0.397 h × mg/L compared with 0.345 h × mg/L and 0.356 h × mg/L in CZOL4460503 and CZOL4460506, respectively. In OPTIMIZE‐2, the AUC0–6h ZA plasma levels were the same (0.428 h × mg/L) at week 36 in both q4 and q12 arms. The levels of ZA urine0–6h at week 36 in OPTIMIZE‐2 (q4 and q12 week arms), CZOL4460503, and CZOL4460506 were 36.6%, 30.8%, 26.5%, and 27.3%, respectively.Conclusion.Long‐term ZA treatment may not impact bone saturation, and ZA dosing frequency does not seem to influence drug retention rates.Implications for Practice.Zoledronic acid (ZA), used along with standard antineoplastic therapy to treat bone metastases associated with solid tumors and multiple myeloma, requires frequent (every 3–4 or every 12 weeks) long‐term administration. This may result in bone saturation and subsequently lead to a higher risk of adverse events such as osteonecrosis of the jaw and atypical fractures. This post hoc analysis used surrogate markers to demonstrate that prolonged ZA administration does not cause bone saturation. Furthermore, reduction in ZA dosing frequency does not affect its retention level in bones over time. These findings will help in addressing clinicians' concerns regarding prolonged ZA administration.

https://ift.tt/2Cxlu3c

Phase I/II Trial of Vandetanib and Bortezomib in Adults with Locally Advanced or Metastatic Medullary Thyroid Cancer

Lessons Learned. Vandetanib at a dose of 300 mg orally every day plus bortezomib 1.3 mg/m2 intravenously on days 1, 4, 8, and 11 could be administered safely.Assessing outcomes in 17 patients with medullary thyroid cancer, investigators considered the combination to be more difficult to administer than single‐agent vandetanib and that achieving better outcomes was unlikely. Consequently, a planned phase II study was terminated early.Background.The proto‐oncogene RET (REarranged during Transfection) has a critical role in the pathogenesis of medullary thyroid cancer (MTC). Vandetanib (V), a multitargeted tyrosine kinase inhibitor approved for the treatment of MTC, is thought to inhibit RET in MTC. Supported by preclinical studies demonstrating that bortezomib (B) administration lowered RET mRNA and protein levels, we conducted a phase I study in advanced solid tumors of vandetanib in combination with bortezomib. The goal was to establish an RP2D (recommended phase II dose) for the combination of vandetanib plus bortezomib, a regimen envisioned as a dual strategy for targeting RET in MTC.Methods.Patients with advanced solid tumors were treated with escalating doses of bortezomib or vandetanib to assess the safety and tolerability of daily oral vandetanib and intravenous (IV) bortezomib administered on days 1, 4, 8, and 11 of a 28‐day cycle. Intrapatient dose escalation was allowed.Results.Twenty‐two patients were enrolled and received escalating mg/m2 bortezomib and mg vandetanib (number of patients) at initial doses of 1 and 100 (3), 1.3 and 100 (6), 1.3 and 200 (6), and 1.3 and 300 (7), respectively. Patients received a median of four cycles of bortezomib/vandetanib (range: 1–10), with 13 patients escalating to 1.3/200 and 10 to 1.3/300. G3 toxicities occurring in more than one patient included hypertension (24%), fatigue (19%), thrombocytopenia (10%), diarrhea (10%), and arthralgia (10%). There were no drug‐related G4/5 toxicities. There was one dose‐limiting toxicity, G3 thrombocytopenia, at bortezomib/vandetanib doses of 1.3/200 in cycle 2 that resolved without intervention. Four patients with a diagnosis of MTC (27%) had a partial response (PR).Conclusion.The MTD of the combination was established as bortezomib, 1.3 mg/m2 IV days 1, 4, 8, and 11 with vandetanib 300 mg p.o. daily. RECIST responses were observed in patients with a diagnosis of MTC.

https://ift.tt/2CyEAG4

Clinical Benefit to an Aurora A Kinase Inhibitor in a Patient with Metastatic Integrase Interactor 1‐Deficient Carcinoma

AbstractIntegrase interactor 1 (INI‐1)‐deficient carcinoma is a rare cancer characterized by the loss of the SWItch/Sucrose Non‐Fermentable‐related matrix‐associated actin‐dependent regulator of chromatin subfamily B member 1 gene (SMARCB1) and tends to follow an aggressive clinical course. There is no currently available standard therapy option, although a few promising treatment strategies, including enhancer of zeste homolog 2 (EZH2) inhibition, are under active investigation. This report describes a 30‐year‐old woman with INI‐1‐deficient carcinoma who progressed on combination chemotherapy and an EZH2 inhibitor. Next‐generation‐sequencing‐based targeted cancer‐related gene assay confirmed SMARCB1 loss and revealed other mutations in breast cancer 1 gene and checkpoint kinase 2 gene, which may have impacted her clinical course. After discussion at the molecular tumor board, she was offered alisertib, an aurora A kinase inhibitor, on a single‐patient expanded‐use program and achieved prolonged disease stabilization. Aurora A kinase inhibition may have an important role in the management of patients with INI‐1‐deficient tumors, warranting further evaluation in clinical studies.Key Points. Loss of the SWItch/Sucrose Non‐Fermentable‐related matrix‐associated actin‐dependent regulator of chromatin subfamily B member 1 gene (SMARCB1), which encodes integrase interactor 1 (INI‐1), is associated with various mesenchymal malignancies, but a few carcinomas with rhabdoid features have been recently described as a distinct entity.INI‐1‐deficient carcinoma can be very aggressive, and there is no known treatment option available.There are encouraging preliminary data with an enhancer of zeste homolog 2 inhibitor, tazematostat, in INI‐1‐deficient malignancies, including INI‐1‐deficient carcinomas.Loss of INI‐1 can activate aurora A kinase (AurkA), and inhibition of AurkA by alisertib could be a viable option and warrants further investigation in this cancer.Clinical genomic profiling can confirm diagnosis of molecularly defined malignancy and provide insights on therapeutic options.

https://ift.tt/2NqW0W5

I-131 as adjuvant treatment for differentiated thyroid carcinoma may cause an increase in the incidence of secondary haematological malignancies: an “inconvenient” truth?

https://ift.tt/2ILqEsD

Characterization of composted sewage sludge during the maturation process: a pilot scale study

Abstract

This paper determines the impact of the maturation process of composted sewage sludge on the quality of the final product and assesses the stabilization effect. The samples of composted sewage sludge were taken from a wastewater treatment plant located in Pomerania in northern Poland. The sewage sludge was composted in an open windrow composting plant with the addition of straw and wood chips in the turning windrow. The aeration of the sewage sludge mixture was conducted based on two methods. The first phase (intensive degradation phase of 6 to 8 weeks) was characterized by frequently turning; the second phase for maturation used aeration channels (2 to 3 months). In three sampling campaigns samples were taken from the same windrow after 2 (no. 1), 8 (no. 2), and 12 weeks (no. 3) of maturation. Fresh samples were used for analyzing the stabilization parameter as static respiration activity (AT₄). Furthermore, the values of pH, organic matter (OM), total organic carbon (TOC), elementary composition, nutrients, total content, and mobile forms of heavy metals were analyzed in the compost samples. A significant decrease was found in the stabilization parameter (AT₄) during the maturation of tested materials. In turn, no significant differences were found in the elementary composition. The concentration of most metals increased in the final product. The total content of heavy metals in the final product did not exceed the limit values for the agricultural use of sewage sludge, compost from municipal waste, and for organic fertilizers. There were no significant changes in the percentage of bioavailable and mobile forms of heavy metals during compost maturation. Zinc was characterized by the highest level of mobile and bioavailable forms, which may cause bioaccumulation after the fertilization of soil. The study has shown that the process of maturation of compost from sewage sludge not affects changes in the content of heavy metal forms. The scope of this study has been planned on a wider scale for different variants of sewage sludge composting, in order to evaluate the process.

https://ift.tt/2OboVm9

Letter about: nocturnal enuresis in children between laser acupuncture and medical treatment—a comparative study

https://ift.tt/2C3FMQw

Long-term scopolamine treatment and dental caries

Abstract

Objectives

To investigate whether scopolamine, an anticholinergic agent which induces hyposalivation, represents a risk factor for the occurrence of dental caries.

Materials and methods

A retrospective cohort study was carried out among sailors treated with scopolamine for seasickness. The study population included 370 young healthy male adults (18–30 years old) who served in the Israel Navy between 2012 and 2016. Of these, 66 subjects who were chronically treated with intermittent administration of scopolamine, either by the oral or transdermal route, were assigned to the study group. Documented subject characteristics included age, socioeconomic status, level of education, body mass index, smoking history, and dental hygiene. Follow-up lasted 1 to 3.5 years.

Results

Two- to 3.5-year follow-up revealed a higher risk of dental caries in 15 of 16 subjects (93.8%) treated with an average of 50.9 mg scopolamine, in contrast to only 71 of 108 control subjects (65.7%) (RR = 1.43, p = 0.02 [95% CI = 1.18–1.72]). Follow-up for 1–1.5 years revealed a lower occurrence of dental caries in both the study group (11/22, 50.0%) and the control group (46/104, 44.2%). Follow-up of 1.5–2 years also revealed less dental caries, in 16/28 subjects (57.1%) in the study group and 51/92 subjects (55.4%) in the control group. The differences were not statistically significant.

Conclusions

In healthy young adults, prolonged intermittent use of scopolamine was found to be a risk factor for the development of dental caries.

Clinical significance

Dental care and hygiene should be intensified when administering hyposalivatory anticholinergic agents.

https://ift.tt/2yjteks

Ion release, antimicrobial and physio-mechanical properties of glass ionomer cement containing micro or nanosized hexametaphosphate, and their effect on enamel demineralization

Abstract

Objectives

To evaluate the effects of hexametaphosphate microparticles (mHMP) or nanoparticles (nHMP) incorporated in glass ionomer cement (GIC) on antimicrobial and physico-mechanical properties, fluoride (F) release, and enamel demineralization.

Material and methods

HMP solutions were obtained at concentrations of 1, 3, 6, 9, and 12%, for screening of antimicrobial activity. Next, mHMP or nHMP at 6, 9, and 12% were incorporated into a resin-modified GIC and the antibacterial activity was evaluated. The resistance to diametral tensile and compressive strength, surface hardness, and degree of monomer conversion as well as F and HMP releases of GICs were determined. Furthermore, specimens were attached to enamel blocks and submitted to pH-cycling, and mineral loss was determined. Parametric and non-parametric tests were performed, after checking data homoscedasticity (p < 0.05).

Results

HMP solutions at 6, 9, and 12% demonstrated the best antibacterial activity. GIC containing HMP showed better antibacterial effects at 9 and 12% for nHMP. Regarding F and HMP releases, the highest levels of release occurred for groups containing 9 and 12% nHMP. With the increase in HMP concentration, there was lower mineral loss. However, the incorporation of mHMP or nHMP in GIC reduced values of physico-mechanical properties when compared to the control GIC.

Conclusions

nHMP improves antimicrobial activity and fluoride release, and decreases enamel demineralization, but reduces the physico-mechanical properties of GIC.

Clinical relevance

The association of GIC/HMP could be an alternative material for patients at high risk for dental caries and could be indicated for low-stress regions or provisional restorations.

https://ift.tt/2Cxow7s

Radiotherapy in palliation of thoracic tumors: a phase I–II study (SHARON project)

Abstract

The main clinical goal for patients with advanced or metastatic thoracic cancer is palliation of tumor-related symptoms and improvement of quality of life. The aim of this phase I–II trial was to define the maximum tolerated dose (MTD) of a short-course of palliative radiotherapy (RT) and to evaluate its efficacy in terms of palliative response. A phase I trial was planned with escalating dose increments. Total doses ranged from 16 to 20 Gy delivered (BID) in two consecutive days. Dose limiting toxicity was defined as any acute grade ≥ 3 toxicity based on the RTOG scale. MTD was used in the phase II trial to evaluate the efficacy of this regimen using a two stage Simon's design. Fifty-four patients were enrolled. The upper dose level of 20 Gy was defined as the MTD. In patients treated with this dose, the overall palliative response rate was 96.5% (CI 0.95: 81.3–99.9%). Complete pain relief rate was 50.0%. Median survival without symptomatic progression was 3 months. The tested short course accelerated regimen was well tolerated and effective in the palliative setting of metastatic or locally advanced chest cancer. A phase III trial is ongoing to validate this RT schedule.

Trial registration: NCT03465553.

https://ift.tt/2CvcdID

Dermatologic Conditions of the Early Post-Transplant Period in Hematopoietic Stem Cell Transplant Recipients

Abstract

Hematopoietic stem cell transplants (HSCTs) are used to treat a variety of conditions, including hematologic malignancies, bone marrow failure syndromes, and immunodeficiencies. Over 60,000 HSCTs are performed annually worldwide, and the numbers continue to increase. Indeed, as new conditioning regimens develop, more and more individuals, including those of older age, will be eligible for transplants. Nevertheless, although HSCTs are clearly a life-saving and necessary treatment for thousands of patients per year, there is still substantial morbidity and mortality associated with the procedure. Of note, skin eruptions in the post-HSCT period are frequent and often significantly reduce quality of life in recipients. Moreover, these cutaneous findings sometimes herald an underlying systemic condition, presenting possible opportunities for timelier intervention. Dermatologists therefore play a vital role in distinguishing life-threatening conditions from benign issues and prompting recognition of critical complications earlier in their course. This article aims to review the major dermatologic conditions occurring in the early post-HSCT period.

https://ift.tt/2QBwgYZ

Long-term survival of patients after ipilimumab and hypofractionated brain radiotherapy for brain metastases of malignant melanoma: sequence matters

Abstract

Purpose

Since the introduction of ipilimumab (IPI) for the treatment of patients with metastatic malignant melanoma, we have observed remarkable responses after hypofractionated whole brain irradiation (WBRT) or stereotactic radiotherapy (STX) for brain metastases of malignant melanoma. We sought to investigate the impact of the sequence of these treatment modalities.

Methods

We retrospectively evaluated the survival of melanoma patients with brain metastases who were treated with WBRT or STX and received IPI in close temporal relation between October 2010 and March 2015. Follow-up was obtained until November 2016. A total of 27 patients with advanced melanoma and brain metastases who were treated with WBRT before 2010, and who had not received IPI, served as historical controls.

Results

We identified a total of 41 patients of whom 15 were treated with STX, 7 with a combination of STX and WBRT and 19 with WBRT alone. All patients received at least 2 doses of IPI. The median time interval between radiotherapy and IPI was 2 months. Patients treated with IPI after radiotherapy had a censored median survival of 11 months, compared with 3 months for the patients who received IPI prior to radiotherapy. Patients who received IPI before radiotherapy showed a similar survival as historical controls, who had not received IPI. We observed long-term survivors after radiotherapy of brain metastases followed by IPI.

Conclusions

These data suggest that the sequence of RT and immune checkpoint inhibition with IPI may be crucial for the success of combined modality treatment of melanoma brain metastases.

https://ift.tt/2PjLd1v

Gonadotropin replacement in male thalassemia major patients with arrested puberty and acquired hypogonadotropic hypogonadism (AAH): preliminary results and potential factors affecting induction of spermatogenesis

https://ift.tt/2yolXQv

Gonadotropin replacement in male thalassemia major patients with arrested puberty and acquired hypogonadotropic hypogonadism (AAH): preliminary results and potential factors affecting induction of spermatogenesis

https://ift.tt/2yolXQv

Alteration of serum and tissue tumor necrosis factor alpha levels: A possible mechanism of action of oral pulse steroids in the treatment of alopecia areata

Journal of Cosmetic Dermatology, EarlyView.

https://ift.tt/2NsKcTa

Improvement of alopecia areata with apremilast

Australasian Journal of Dermatology, EarlyView.

https://ift.tt/2QB04oB

Chondrodysplasia punctata (CDPX2) in a male caused by single‐gene mosaicism: A 20‐year follow‐up

Australasian Journal of Dermatology, EarlyView.

https://ift.tt/2O9NUGo

Sentinel lymph node biopsy remains the most accurate method of obtaining staging and prognostic information for patients with primary cutaneous melanomas

Australasian Journal of Dermatology, EarlyView.

https://ift.tt/2QAcrBd

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Δευτέρα 8 Οκτωβρίου 2018

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