دورية أكاديمية
Influence of peritoneal dialysis catheter type on complications and long-term outcomes: an updated systematic review and meta-analysis.
| العنوان: | Influence of peritoneal dialysis catheter type on complications and long-term outcomes: an updated systematic review and meta-analysis. |
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| المؤلفون: | Esagian SM; Surgery Working Group, Society of Junior Doctors, Athens, Greece., Spinos D; Surgery Working Group, Society of Junior Doctors, Athens, Greece.; Derby Royal Hospital, University Hospitals of Derby and Burton NHS Trust, Derby, UK., Vasilopoulou A; Surgery Working Group, Society of Junior Doctors, Athens, Greece.; Department of General Surgery, Veterans Administration Hospital (NIMTS), Athens, Greece., Syrigos N; Surgery Working Group, Society of Junior Doctors, Athens, Greece.; Department of Medicine, School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece., Bishawi M; Department of Surgery, Duke University Medical Center, 2301 Erwin Rd, Durham, NC, 27710, USA., Lehrich RW; Division of Nephrology, Department of Medicine, Duke University Medical Center, Durham, NC, USA., Middleton JP; Division of Nephrology, Department of Medicine, Duke University Medical Center, Durham, NC, USA., Suhocki PV; Department of Radiology, Duke University Medical Center, Durham, NC, USA., Pappas TN; Department of Surgery, Duke University Medical Center, 2301 Erwin Rd, Durham, NC, 27710, USA., Economopoulos KP; Surgery Working Group, Society of Junior Doctors, Athens, Greece. economopoulos@sni.gr.; Department of Surgery, Duke University Medical Center, 2301 Erwin Rd, Durham, NC, 27710, USA. economopoulos@sni.gr. |
| المصدر: | Journal of nephrology [J Nephrol] 2021 Dec; Vol. 34 (6), pp. 1973-1987. Date of Electronic Publication: 2021 Mar 22. |
| نوع المنشور: | Journal Article; Meta-Analysis; Review; Systematic Review |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer Country of Publication: Italy NLM ID: 9012268 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1724-6059 (Electronic) Linking ISSN: 11218428 NLM ISO Abbreviation: J Nephrol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2014- : Heidelberg : Springer Original Publication: Rome : Acta Medica, |
| مواضيع طبية MeSH: | Peritoneal Dialysis*/adverse effects , Peritonitis*, Catheterization/adverse effects ; Catheters, Indwelling/adverse effects ; Consensus ; Humans |
| مستخلص: | Background: There is currently no consensus regarding the optimal type of peritoneal dialysis catheter (PDC). We compared the outcomes of PDCs according to the number of cuffs, intercuff and intraperitoneal segment shape, and presence of a weighted tip. Methods: A systematic review of the literature was performed using the MEDLINE and Cochrane Library databases (end-of-search date: October 16th, 2019). We included studies comparing double-cuff vs. single-cuff, swan-neck vs. straight-neck, coiled-tip vs. straight-tip, and weighted vs. non-weighted PDCs for the outcomes of interest. We performed meta-analyses using the random-effects model. We assessed the risk of bias using the Newcastle-Ottawa scale and the Cochrane Collaboration's Tool. Results: In total, 38 studies were identified, of which 20 were randomized controlled trials (RCTs) and 18 were observational studies. No statistically significant differences were detected between double-cuff vs. single-cuff, swan-neck vs. straight-neck, and coiled-tip vs. straight tip PDCs in any of the outcomes of interest. Weighted catheters were associated with significantly lower rates of tunnel infection (relative risk [RR] 0.52, 95% confidence interval [CI] 0.31-0.95, p = 0.03), migration (RR 0.07, 95% CI 0.03-0.16, p < 0.001), drainage failure (RR 0.62, 95% CI 0.39-0.96, p = 0.03), cuff extrusion (RR 0.40, 95% CI 0.21-0.74, p < 0.001), and complication-related removal (RR 0.53, 95% CI 0.44-0.64, p < 0.001). Discussion: Among the different types of PDCs, weighted catheters result in lower complication rates and superior long-term outcomes compared to non-weighted catheters. Other aspects of the catheter design do not significantly affect PDC outcomes. Protocol Registration: PROSPERO 2020 CRD42020158177. (© 2021. Italian Society of Nephrology.) |
| References: | Collins AJ, Foley RN, Gilbertson DT, Chen S-C (2015) United States Renal Data System public health surveillance of chronic kidney disease and end-stage renal disease. Kidney Int Suppl 5:2–7. https://doi.org/10.1038/kisup.2015.2. (PMID: 10.1038/kisup.2015.2) Maiorca R, Vonesh EF, Cavalli P et al (1991) A multicenter, selection-adjusted comparison of patient and technique survivals on CAPD and hemodialysis. Perit Dial Int J Int Soc Perit Dial 11:118–127. (PMID: 10.1177/089686089101100204) Fenton SS, Schaubel DE, Desmeules M et al (1997) Hemodialysis versus peritoneal dialysis: a comparison of adjusted mortality rates. Am J Kidney Dis Off J Natl Kidney Found 30:334–342. https://doi.org/10.1016/s0272-6386(97)90276-6. (PMID: 10.1016/s0272-6386(97)90276-6) Hagen SM, Lafranca JA, IJzermans JNM, Dor FJMF (2014) A systematic review and meta-analysis of the influence of peritoneal dialysis catheter type on complication rate and catheter survival. Kidney Int 85:920–932. https://doi.org/10.1038/ki.2013.365. (PMID: 10.1038/ki.2013.36524088961) Gallieni M, Giordano A, Pinerolo C, Cariati M (2015) Type of peritoneal dialysis catheter and outcomes. J Vasc Access 16(Suppl 9):S68-72. https://doi.org/10.5301/jva.5000369. (PMID: 10.5301/jva.500036925751555) Di Paolo N, Capotondo L, Sansoni E et al (2004) The self-locating catheter: clinical experience and follow-up. Perit Dial Int 24:359–364. https://doi.org/10.1177/089686080402400411. (PMID: 10.1177/08968608040240041115335150) Negoi D, Prowant BF, Twardowski ZJ (2006) Current trends in the use of peritoneal dialysis catheters. Adv Perit Dial Conf Perit Dial 22:147–152. Kolesnyk I, Dekker FW, Boeschoten EW, Krediet RT (2010) Time-dependent reasons for peritoneal dialysis technique failure and mortality. Perit Dial Int J Int Soc Perit Dial 30:170–177. https://doi.org/10.3747/pdi.2008.00277. (PMID: 10.3747/pdi.2008.00277) (1996) Adequacy of dialysis and nutrition in continuous peritoneal dialysis: association with clinical outcomes. Canada-USA (CANUSA) Peritoneal Dialysis Study Group. J Am Soc Nephrol JASN 7:198–207. Digenis GE, Abraham G, Savin E et al (1990) Peritonitis-related deaths in continuous ambulatory peritoneal dialysis (CAPD) patients. Perit Dial Int J Int Soc Perit Dial 10:45–47. (PMID: 10.1177/089686089001000112) Moreiras Plaza M, Cuíña L, Goyanes GR et al (1999) Mechanical complications in chronic peritoneal dialysis. Clin Nephrol 52:124–130. (PMID: 10480224) Flayou K, Ouzeddoun N, Bayahia R et al (2016) Mechanical complications of continuous ambulatory peritoneal dialysis: experience at the Ibn Sina University Hospital. Saudi J Kidney Dis Transplant Off Publ Saudi Cent Organ Transplant Saudi Arab 27:107–110. https://doi.org/10.4103/1319-2442.174089. (PMID: 10.4103/1319-2442.174089) Twardowski ZJ, Prowant BF, Nichols WK et al (1998) Six-year experience with Swan neck presternal peritoneal dialysis catheter. Perit Dial Int J Int Soc Perit Dial 18:598–602. (PMID: 10.1177/089686089801800607) Swartz R, Messana J, Rocher L et al (1990) The curled catheter: dependable device for percutaneous peritoneal access. Perit Dial Int J Int Soc Perit Dial 10:231–235. (PMID: 10.1177/089686089001000309) Figueiredo A, Goh B-L, Jenkins S et al (2010) Clinical practice guidelines for peritoneal access. Perit Dial Int J Int Soc Perit Dial 30:424–429. https://doi.org/10.3747/pdi.2010.00087. (PMID: 10.3747/pdi.2010.00087) Strippoli GFM, Tong A, Johnson D et al (2004) Catheter type, placement and insertion techniques for preventing peritonitis in peritoneal dialysis patients. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD004680.pub2. (PMID: 10.1002/14651858.CD004680.pub215495125) Htay H, Johnson DW, Craig JC et al (2019) Catheter type, placement and insertion techniques for preventing catheter-related infections in chronic peritoneal dialysis patients. Cochrane Database Syst Rev 5:CD004680. https://doi.org/10.1002/14651858.CD004680.pub3. (PMID: 10.1002/14651858.CD004680.pub331149735) Xie J, Kiryluk K, Ren H et al (2011) Coiled versus straight peritoneal dialysis catheters: a randomized controlled trial and meta-analysis. Am J Kidney Dis Off J Natl Kidney Found 58:946–955. https://doi.org/10.1053/j.ajkd.2011.06.026. (PMID: 10.1053/j.ajkd.2011.06.026) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration|The BMJ. https://www.bmj.com/content/339/bmj.b2700 . Accessed 8 Aug 2020. Wohlin C (2014) Guidelines for snowballing in systematic literature studies and a replication in software engineering. In: Proceedings of the 18th international conference on evaluation and assessment in software engineering. Association for Computing Machinery, London, England, United Kingdom, pp 1–10. Wells G, Shea B, O’Connell D et al (2000) The Newcastle–Ottawa Scale (NOS) for assessing the quality of non-randomized studies in meta-analysis. Higgins JPT, Altman DG, Gøtzsche PC et al (2011) The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ 343:d5928. https://doi.org/10.1136/bmj.d5928. (PMID: 10.1136/bmj.d5928220082173196245) Higgins JPT, Thomas J, Chandler J et al (2019) Cochrane handbook for systematic reviews of interventions. Wiley. (PMID: 10.1002/9781119536604) Hozo SP, Djulbegovic B, Hozo I (2005) Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol 5:13. https://doi.org/10.1186/1471-2288-5-13. (PMID: 10.1186/1471-2288-5-13158401771097734) DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7:177–188. https://doi.org/10.1016/0197-2456(86)90046-2. (PMID: 10.1016/0197-2456(86)90046-23802833) Egger M, Smith GD, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315:629–634. https://doi.org/10.1136/bmj.315.7109.629. (PMID: 10.1136/bmj.315.7109.62993105639310563) Akyol AM, Porteous C, Brown MW (1990) A comparison of two types of catheters for continuous ambulatory peritoneal dialysis (CAPD). Perit Dial Int J Int Soc Perit Dial 10:63–66. (PMID: 10.1177/089686089001000117) Banin VB, Ponce D, Dias DB et al (2019) Influence of the intra-peritoneal segment of the swan neck peritoneal catheter on infectious and mechanical complications and technique survival. Clin Exp Nephrol 23:135–141. https://doi.org/10.1007/s10157-018-1618-7. (PMID: 10.1007/s10157-018-1618-730043086) Chow KM, Wong SSM, Ng JKC et al (2020) Straight versus coiled peritoneal dialysis catheters: a randomized controlled trial. Am J Kidney Dis Off J Natl Kidney Found 75:39–44. https://doi.org/10.1053/j.ajkd.2019.05.024. (PMID: 10.1053/j.ajkd.2019.05.024) Danielsson A, Blohmé L, Tranaeus A, Hylander B (2002) A prospective randomized study of the effect of a subcutaneously “buried” peritoneal dialysis catheter technique versus standard technique on the incidence of peritonitis and exit-site infection. Perit Dial Int J Int Soc Perit Dial 22:211–219. (PMID: 10.1177/089686080202200208) Eklund BH, Honkanen EO, Kala AR, Kyllönen LE (1994) Catheter configuration and outcome in patients on continuous ambulatory peritoneal dialysis: a prospective comparison of two catheters. Perit Dial Int J Int Soc Perit Dial 14:70–74. (PMID: 10.1177/089686089401400114) Eklund BH, Honkanen EO, Kala AR, Kyllonen LE (1995) Peritoneal dialysis access: prospective randomized comparison of the Swan neck and Tenckhoff catheters. Perit Dial Int 15:353–356. (PMID: 10.1177/089686089501500412) Eklund B, Honkanen E, Kyllönen L et al (1997) Peritoneal dialysis access: prospective randomized comparison of single-cuff and double-cuff straight Tenckhoff catheters. Nephrol Dial Transplant Off Publ Eur Dial Transpl Assoc Eur Ren Assoc 12:2664–2666. https://doi.org/10.1093/ndt/12.12.2664. (PMID: 10.1093/ndt/12.12.2664) Johnson DW, Wong J, Wiggins KJ et al (2006) A randomized controlled trial of coiled versus straight swan-neck Tenckhoff catheters in peritoneal dialysis patients. Am J Kidney Dis 48:812–821. https://doi.org/10.1053/j.ajkd.2006.08.010. (PMID: 10.1053/j.ajkd.2006.08.01017060001) Li C-L, Cui T-G, Gan H-B et al (2009) A randomized trial comparing conventional swan-neck straight-tip catheters to straight-tip catheters with an artificial subcutaneous swan neck. Perit Dial Int 29:278–284. https://doi.org/10.1177/089686080902900311. (PMID: 10.1177/08968608090290031119458299) Lo W-K, Lui S-L, Li F-K et al (2003) A prospective randomized study on three different peritoneal dialysis catheters. Perit Dial Int J Int Soc Perit Dial 23(Suppl 2):S127-131. (PMID: 10.1177/089686080302302s26) Lye WC, Kour NW, van der Straaten JC et al (1996) A prospective randomized comparison of the swan neck, coiled, and straight Tenckhoff catheters in patients on CAPD. Perit Dial Int J Int Soc Perit Dial 16(Suppl 1):S333-335. (PMID: 10.1177/089686089601601S64) Nielsen PK, Hemmingsen C, Friis SU et al (1995) Comparison of straight and curled Tenckhoff peritoneal dialysis catheters implanted by percutaneous technique: a prospective randomized study. Perit Dial Int J Int Soc Perit Dial 15:18–21. (PMID: 10.1177/089686089501500104) Ouyang C-J, Huang F-X, Yang Q-Q et al (2015) Comparing the incidence of catheter-related complications with straight and coiled tenckhoff catheters in peritoneal dialysis patients-a single-center prospective randomized trial. Perit Dial Int J Int Soc Perit Dial 35:443–449. https://doi.org/10.3747/pdi.2013.00016. (PMID: 10.3747/pdi.2013.00016) Rubin J, Didlake R, Raju S, Hsu H (1990) A prospective randomized evaluation of chronic peritoneal catheters. Insertion site and intraperitoneal segment. ASAIO Trans 36:M497-500. (PMID: 10.1097/00002216-199010000-00011) Sanchez-Canel JJ, Garcia-Perez H, Garcia-Calvo R et al (2016) Prospective randomized study comparing a single-cuff self-locating catheter with a single-cuff straight Tenckhoff catheter in peritoneal dialysis. Perit Dial Int J Int Soc Perit Dial 36:52–59. https://doi.org/10.3747/pdi.2013.00315. (PMID: 10.3747/pdi.2013.00315) Scott PD, Bakran A, Pearson R et al (1994) Peritoneal dialysis access. Prospective randomized trial of 3 different peritoneal catheters–preliminary report. Perit Dial Int J Int Soc Perit Dial 14:289–290. (PMID: 10.1177/089686089401400320) Stegmayr BG, Wikdahl AM, Bergström M et al (2005) A randomized clinical trial comparing the function of straight and coiled Tenckhoff catheters for peritoneal dialysis. Perit Dial Int J Int Soc Perit Dial 25:85–88. (PMID: 10.1177/089686080502500115) Stegmayr BG, Sperker W, Nilsson CH et al (2015) Few outflow problems with a self-locating catheter for peritoneal dialysis: a randomized trial. Medicine (Baltim) 94:e2083. https://doi.org/10.1097/MD.0000000000002083. (PMID: 10.1097/MD.0000000000002083) Yip T, Lui SL, Tse KC et al (2010) A prospective randomized study comparing Tenckhoff catheters inserted using the triple incision method with standard swan neck catheters. Perit Dial Int J Int Soc Perit Dial 30:56–62. https://doi.org/10.3747/pdi.2008.00240. (PMID: 10.3747/pdi.2008.00240) Cavagna R, Tessarin C, Tarroni G et al (1999) The self-locating catheter: clinical evaluation and comparison with the Tenckhoff catheter. Perit Dial Int 19:540–543. https://doi.org/10.1177/089686089901900608. (PMID: 10.1177/08968608990190060810641774) Diaz-Buxo JA, Geissinger WT (1984) Single cuff versus double cuff Tenckhoff catheter. Perit Dial Int 4:100–102. https://doi.org/10.1177/089686088400402S08. (PMID: 10.1177/089686088400402S08) Favazza A, Petri R, Montanaro D et al (1995) Insertion of a straight peritoneal catheter in an arcuate subcutaneous tunnel by a tunneler: long-term experience. Perit Dial Int J Int Soc Perit Dial 15:357–362. (PMID: 10.1177/089686089501500413) Filiopoulos V, Biblaki D, Takouli L et al (2016) Swan-neck versus straight peritoneal dialysis catheter: long-term effect on patient and method survival. Indian J Nephrol 26:343–346. https://doi.org/10.4103/0971-4065.167274. (PMID: 10.4103/0971-4065.167274277956285015512) Flanigan MJ, Ngheim DD, Schulak JA et al (1987) The use and complications of three peritoneal dialysis catheter designs. A retrospective analysis. ASAIO Trans 33:33–38. (PMID: 3828160) Gadallah MF, Mignone J, Torres C et al (2000) The role of peritoneal dialysis catheter configuration in preventing catheter tip migration. Adv Perit Dial Conf Perit Dial 16:47–50. Hwang TL, Huang CC (1994) Comparison of swan neck catheter with Tenckhoff catheter for CAPD. Adv Perit Dial Conf Perit Dial 10:203–205. Kim D, Burke D, Izatt S et al (1984) Single- or double-cuff peritoneal catheters? A prospective comparison. Trans Am Soc Artif Intern Organs 30:232–235. (PMID: 6533890) Lanuza M, Minguela JI, Rodado R et al (2006) Our nine-year experience with the self-locating catheter: comparison of malfunction rate with other Tenckhoff catheter variants. Int J Artif Organs 29:138–141. https://doi.org/10.1177/039139880602900114. (PMID: 10.1177/03913988060290011416485249) Lewis MA, Smith T, Postlethwaite RJ, Webb NJ (1997) A comparison of double-cuffed with single-cuffed Tenckhoff catheters in the prevention of infection in pediatric patients. Adv Perit Dial Conf Perit Dial 13:274–276. Nessim SJ, Bargman JM, Jassal SV (2010) Relationship between double-cuff versus single-cuff peritoneal dialysis catheters and risk of peritonitis. Nephrol Dial Transplant Off Publ Eur Dial Transpl Assoc Eur Ren Assoc 25:2310–2314. https://doi.org/10.1093/ndt/gfq002. (PMID: 10.1093/ndt/gfq002) Pacitti A (2006) The catheter as Ariadne’s thread to follow the path of peritoneal dialysis (PD) through the long-term experience of a center. Int J Artif Organs. https://doi.org/10.1177/039139880602900113. (PMID: 10.1177/03913988060290011316485248) Singh S, Prakash J, Singh RG et al (2015) Comparison of conventional straight and swan-neck straight catheters inserted by percutaneous method for continuous ambulatory peritoneal dialysis: a single-center study. Int Urol Nephrol 47:1735–1738. https://doi.org/10.1007/s11255-015-1081-2. (PMID: 10.1007/s11255-015-1081-226329738) Stonelake S, Baharani J, Thomas M et al (2019) Outcomes of the weighted peritoneal dialysis catheter in patients at risk of percutaneous catheter failure. Perit Dial Int J Int Soc Perit Dial 39:142–146. https://doi.org/10.3747/pdi.2017.00233. (PMID: 10.3747/pdi.2017.00233) Warchol S, Ziolkowska H, Roszkowska-Blaim M (2003) Exit-site infection in children on peritoneal dialysis: comparison of two types of peritoneal catheters. Perit Dial Int J Int Soc Perit Dial 23:169–173. (PMID: 10.1177/089686080302300213) Xie JY, Chen N, Ren H et al (2009) Prospective studies on applications of a two-cuff swan neck catheter and a Tenckhoff catheter to Chinese CAPD patients. Clin Nephrol 72:373–379. https://doi.org/10.5414/cnp72373. (PMID: 10.5414/cnp7237319863880) Wu C-C, Su P-F, Chiang S-S (2007) A prospective study to compare subcutaneously buried peritoneal dialysis catheter technique with conventional technique. Blood Purif 25:229–232. https://doi.org/10.1159/000101027. (PMID: 10.1159/00010102717384502) Liu WJ, Hooi LS (2010) Complications after Tenckhoff catheter insertion: a single-centre experience using multiple operators over four years. Perit Dial Int J Int Soc Perit Dial 30:509–512. https://doi.org/10.3747/pdi.2009.00083. (PMID: 10.3747/pdi.2009.00083) Tiong HY, Poh J, Sunderaraj K et al (2006) Surgical complications of Tenckhoff catheters used in continuous ambulatory peritoneal dialysis. Singap Med J 47:707–711. Briggs VR, Shrestha BM, Wilkie ME (2014) Respecting shape memory to optimize peritoneal dialysis catheter outcomes. Kidney Int 86:880–882. https://doi.org/10.1038/ki.2014.238. (PMID: 10.1038/ki.2014.23825360492) Paolo N, Petrini G, Garosi G et al (1995) A new self-locating peritoneal catheter. Perit Dial Int J Int Soc Perit Dial 16:623–627. https://doi.org/10.1177/089686089601600613. (PMID: 10.1177/089686089601600613) Kathuria P, Twardowski ZJ, Nichols WK (2009) Peritoneal dialysis access and exit-site care including surgical aspects. In: Khanna R, Krediet RT (eds) Nolph and Gokal’s textbook of peritoneal dialysis. Springer US, Boston, pp 371–446. (PMID: 10.1007/978-0-387-78940-8_14) Crabtree JH, Shrestha BM, Chow K-M et al (2019) Creating and maintaining optimal peritoneal dialysis access in the adult patient: 2019 update. Perit Dial Int 39:414–436. https://doi.org/10.3747/pdi.2018.00232. (PMID: 10.3747/pdi.2018.00232) Russo R, Manili L, Tiraboschi G et al (2006) Patient re-training in peritoneal dialysis: why and when it is needed. Kidney Int Suppl. https://doi.org/10.1038/sj.ki.5001929. (PMID: 10.1038/sj.ki.500192917080104) Di Paolo N, Sansoni E, Cappelletti F et al (2006) The self-locating catheter: review and cost analysis. Int J Artif Organs 29:113–122. https://doi.org/10.1177/039139880602900111. (PMID: 10.1177/03913988060290011116485246) Esagian SM, Sideris GA, Bishawi M et al (2020) Surgical versus percutaneous catheter placement for peritoneal dialysis: an updated systematic review and meta-analysis. J Nephrol. https://doi.org/10.1007/s40620-020-00896-w. (PMID: 10.1007/s40620-020-00896-w33197001) Elbokl M, Momciu B, Kishibe T et al (2020) Peritoneal dialysis access outcomes reported in randomized controlled trials: a systematic review. Perit Dial Int J Int Soc Perit Dial. https://doi.org/10.1177/0896860820966898. (PMID: 10.1177/0896860820966898) |
| فهرسة مساهمة: | Keywords: Coiled catheter; Double-cuff catheter; Self-locating catheter; Single-cuff catheter; Swan-neck catheter; Tenckhoff catheter |
| تواريخ الأحداث: | Date Created: 20210322 Date Completed: 20220128 Latest Revision: 20220428 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1007/s40620-021-01016-y |
| PMID: | 33751498 |
| قاعدة البيانات: | MEDLINE |
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| DOI: | 10.1007/s40620-021-01016-y |