leprosy

麻风病
  • 文章类型: Journal Article
    (1)背景:麻风病的全球负担并没有平均分配;大多数病例是在巴西诊断的,印度,和印度尼西亚。了解在高流行和低流行地区使用的主动病例检测(ACD)方法对于未来筛查计划的发展至关重要。(2)方法:系统检索三个数据库,PubMed,Embase和WebofScience,是针对英语论文进行的,自2000年以来发表,其中讨论了使用主动病例检测方法进行麻风病筛查。本文利用综合筛选作用模型(I-SAM)作为分析这些方法的工具。(3)结果:来自11个不同国家的23篇论文。论文确定了6种不同的主动案例检测方法:家庭接触/社会接触识别;上门案例检测;筛查问卷分发;快速村庄调查;基于学校的筛查;和基于监狱的筛查。15个位于高流行区,其中8个位于低流行区。(4)结论:选择合适的主动病例查找方法,必须考虑麻风病的流行。这些发现有助于制定政策,从而可以设计更成功的未来麻风病病例检测计划,最终减轻全球疾病负担,实现世界卫生组织的零麻风病目标。
    (1) Background: The global burden of leprosy is not shared equally; with the majority of cases being diagnosed in Brazil, India, and Indonesia. Understanding the methods of active case detection (ACD) used in high and low endemic regions is vital for the development of future screening programs. (2) Methods: A systematic search of three databases, PubMed, Embase and Web of Science, was conducted for English language papers, published since the year 2000, which discussed the use of active case detection methods for leprosy screening. The paper utilised the Integrated Screening Action Model (I-SAM) as a tool for the analysis of these methods. (3) Results: 23 papers were identified from 11 different countries. The papers identified 6 different methods of active case detection: Household contact/social contact identification; door-to-door case detection; screening questionnaire distribution; rapid village surveys; school-based screening; and prison-based screening. 15 were located in high endemic regions and 8 of these were located in low endemic regions. (4) Conclusions: For selecting the appropriate methods of active case finding, the leprosy endemicity must be taken into consideration. The findings contribute to policy decision making allowing for more successful future leprosy case detection programs to be designed, ultimately reducing the global burden of the disease, and achieving the WHO\'s aim of zero leprosy.
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  • 文章类型: Journal Article
    麻风病仍然主要在中低收入国家发现。打破麻风病传播链需要各种方式,特别是通过健康教育增加麻风病预防知识。尽管有几项研究提到了健康教育的有效性,关于使用的最佳方法仍然存在不确定性。因此,本综述研究符合系统评价和荟萃分析(PRISMA)2020版首选报告项目。搜索涉及PubMed的相关文献,ScienceDirect,ERIC,科克伦,和ProQuest数据库,用于2000年至2023年期间发表的研究,纳入标准包括增加知识,改变态度和行为,增加正面的污名。研究的质量是使用关键评估技能计划进行评估的,以及使用CochraneRoB工具的偏差风险。对数据库的总体搜索共得到184,681篇文章。只有六项研究有资格纳入本综述。在符合条件的研究中使用了各种教育方法,包括MHMobile,关于麻风病游戏的神话或真相,海报,小叶,社区会议,远程教育网络,讨论列表,聊天,活动日记,图像3D视频,关于视频流的课程,视频会议,案例模拟,讲座,和接触干预(教育,证词(直接接触),视频,和漫画)。所有使用的方法都有可能提高知识,态度,并实践并减少对麻风病的负面污名。在预防麻风病方面,没有比其他方法更好的健康教育方法。
    Leprosy is still found mainly in lower-middle-income countries. Breaking the chain of leprosy transmission requires various ways, especially by increasing knowledge of leprosy prevention through health education. Although several studies have mentioned the effectiveness of health education, there is still uncertainty about the best method to use. Therefore, the review question should be answered: what forms of health education have been developed about Leprosy in the community? This review study complies with the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) version 2020. The search for relevant literature involved PubMed, ScienceDirect, ERIC, Cochrane, and ProQuest databases for the studies published in the 2000 to 2023 period with the inclusion criteria such as increasing knowledge, changing attitudes and behavior, and increasing positive stigma. The quality of the study was assessed using the Critical Appraisal Skills Program, and the Risk of Bias using the Cochrane RoB tool. Overall search on databases resulted in a total of 184,681 articles. Only six studies were eligible to be included in this review. Various educational methods were used in the eligible studies, including MH Mobile, the myth or truth on Leprosy game, posters, leaflets, community meetings, tele-education the web, discussion lists, chats, activity diaries, iconographic 3D videos, classes on video streaming, video conference, case simulation, lecture, and the contact intervention (education, testimonies (direct contact), videos, and comics). All of the methods used had the potential to improve knowledge, attitude, and practice and reduce negative stigma regarding Leprosy. There is no method of health education superior to another on Leprosy prevention.
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  • 文章类型: Journal Article
    麻风病是一种传染病,仍然是公共卫生问题。它是由耐酸的麻风芽孢杆菌引起的,主要影响皮肤和周围神经,可能导致长期残疾和耻辱。然而,当前和以前的努力集中在开发更好的麻风病诊断和治疗干预措施,它的预防需要解决。在这次审查中,我们组织目前发表的论文,并提供有关全球流行病学的最新信息,诊断,治疗,和预防麻风病。几个在线数据库,包括MEDLINE(国家医学图书馆,贝塞斯达,MD),PubMed,EMBASE,WebofScience,和谷歌学者,进行了搜索,以收集相关的已发表论文。作为一个公共卫生问题,世界卫生组织设定了消除麻风病的目标,每10,000人的患病率<1例,这一目标在2000年实现,到2010年在大多数国家实现,主要是由于从1980年开始使用药物治疗麻风病,以及自1995年以来患者免费获得治疗。尽管诊断和治疗技术有所改善,麻风病的新发生仍然是全球严重的疾病负担.随着麻风病诊断和治疗技术的不断进步,获得更多相关的医疗保健知识和预防麻风病残疾至关重要。
    Leprosy is an infectious disease that remains a public health concern. It is caused by acid-fast Bacillus leprae, which primarily affects the skin and peripheral nerves, potentially leading to long-term disability and stigma. However, current and previous efforts have focused on developing better diagnostic and therapeutic interventions for leprosy, and its prevention needs to be addressed. In this review, we organize the currently published papers and provide updates on the global epidemiology, diagnosis, treatment, and prevention of leprosy. Several online databases, including MEDLINE (National Library of Medicine, Bethesda, MD), PubMed, EMBASE, Web of Science, and Google Scholar, were searched to collect relevant published papers. As a public health issue, the World Health Organization set the goal of leprosy elimination with a prevalence of <1 case per 10,000 people, which was achieved in 2000 and in most countries by 2010, mainly owing to the treatment of leprosy using drugs starting in 1980 and no-cost access for patients since 1995. Although diagnostic and therapeutic techniques have improved, the new occurrence of leprosy remains a critical global disease burden. With continuous technological improvements in diagnosing and treating leprosy, obtaining more relevant healthcare knowledge and preventing leprosy disability are crucial.
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  • 文章类型: Journal Article
    目的:鉴定和合成,从文学,麻风病导致的身体残疾对卫生保健网络内接受护理的个人生活质量的影响。
    方法:这是根据JBI建议进行的范围审查。搜索中使用的数据库包括在线医学文献分析和检索系统,科克伦图书馆,WebofScience,丁香花,护理和相关健康文献的累积指数,Scopus,Embase,麻风病信息服务,谷歌学者。
    结果:确定了1690份文件,其中36人被列入审查范围。麻风病引起的身体残疾影响日常活动领域的生活质量,社会经济方面,心理健康,疼痛,和整体福祉。
    结论:我们确定了身体残疾对生活质量造成的损害,强调预防的必要性,促销,和康复行动,比如筛查,案件管理,和健康教育。
    OBJECTIVE: to identify and synthesize, from the literature, the impacts of physical disability caused by leprosy on the quality of life of individuals receiving care within the Health Care Network.
    METHODS: this is a scoping review conducted following the JBI recommendations. The databases used in the search included the Medical Literature Analysis and Retrieval System Online, Cochrane Library, Web of Science, Lilacs, Cumulative Index to Nursing and Allied Health Literature, Scopus, Embase, Leprosy Information Services, and Google Scholar.
    RESULTS: 1690 documents were identified, of which 36 were included in the review. Physical disability caused by leprosy affects the quality of life in the areas of daily activities, socioeconomic aspects, psychological well-being, pain, and overall well-being.
    CONCLUSIONS: we identified the impairments caused by physical disability in the quality of life, highlighting the need for prevention, promotion, and rehabilitation actions, such as screening, case management, and health education.
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  • 文章类型: Journal Article
    对象:虽然布鲁里溃疡,结核病,麻风病是三种最常见的分枝杆菌疾病,这些感染的一个健康方面仍然知之甚少。这篇叙述性综述旨在探索有关这些感染的病原体的动物水库和其他环境来源的科学文献。它们在传播给人类中的作用以及“一个健康”相关控制工作的研究/实际实施。
    方法:使用在线数据库PubMed进行文献综述,Scopus,ProQuest和谷歌学者,回顾过去15年用英语写的文章。灰色文学,由政府间机构出版,也被审查了。
    结果:对于布鲁里溃疡的病原体,有证据表明负鼠是一种可能的动物宿主,因此在疾病向人类传播中具有积极作用。牛和一些野生动物物种被认为是结核病病原体的既定动物水库,人类感染中不可忽视的比例是人畜共患的。Armadillos构成了麻风病病原体的既定动物库,认为可以将疾病从Armadillos传播给人类。宽松的环境,土壤和其他水生来源可能代表了感染人类的可行布鲁里溃疡和麻风病病原体的进一步非生物储库。持续调查和实施公共卫生措施,在所有三种疾病中都可以发现靶向(sapro)人畜共患传播。
    结论:布鲁里溃疡,结核病和麻风病表现出重要的但仍然知之甚少一个健康方面。尽管各自的致病性分枝杆菌具有微生物亲和力,他们的动物水库有很大的差异,正在观察到潜在的环境来源和人畜共患传播方式。这些差异是否反映了这些疾病之间的实际差异,或者更确切地说,知识差距尚不清楚。为了改善疾病控制,迫切需要对所有三种疾病的人畜共患方面进行进一步调查,并制定与“一个健康”相关的干预措施。
    ΟBJECTIVES: Although Buruli ulcer, tuberculosis, and leprosy are the three most common mycobacterial diseases, One Health dimensions of these infections remain poorly understood. This narrative review aims at exploring the scientific literature with respect to the presence of animal reservoir(s) and other environmental sources for the pathogens of these infections, their role in transmission to humans and the research on/practical implementation of One Health relevant control efforts.
    METHODS: The literature review was conducted using the online databases PubMed, Scopus, ProQuest and Google Scholar, reviewing articles that were written in English in the last 15 years. Grey literature, published by intergovernmental agencies, was also reviewed.
    RESULTS: For the pathogen of Buruli ulcer, evidence suggests possums as a possible animal reservoir and thus having an active role in disease transmission to humans. Cattle and some wildlife species are deemed as established animal reservoirs for tuberculosis pathogens, with a non-negligible proportion of infections in humans being of zoonotic origin. Armadillos constitute an established animal reservoir for leprosy pathogens with the transmission of the disease from armadillos to humans being deemed possible. Lentic environments, soil and other aquatic sources may represent further abiotic reservoirs for viable Buruli ulcer and leprosy pathogens infecting humans. Ongoing investigation and implementation of public health measures, targeting (sapro)zoonotic transmission can be found in all three diseases.
    CONCLUSIONS: Buruli ulcer, tuberculosis and leprosy exhibit important yet still poorly understood One Health aspects. Despite the microbiological affinity of the respective causative mycobacteria, considerable differences in their animal reservoirs, potential environmental sources and modes of zoonotic transmission are being observed. Whether these differences reflect actual variations between these diseases or rather knowledge gaps remains unclear. For improved disease control, further investigation of zoonotic aspects of all three diseases and formulation of One Health relevant interventions is urgently needed.
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  • 文章类型: Case Reports
    背景:麻风病是由麻风分枝杆菌(M.leprae)负责畸形和不可逆的周围神经损伤,并具有广泛的临床和血清学表现。麻风病主要影响周围神经,很少出现中枢神经系统受累。在某些情况下,诊断麻风病仍然很困难,特别是当感染涉及罕见的临床表现和皮肤外部位时。麻风病的诊断和治疗延迟可能导致不可逆的损伤和死亡。
    方法:我们报告了一例30岁女性,表现为“反复高烧,头痛14天”。入学那天,观察到眉毛脱落的体征和全身散落的红色硬结斑块。患者的诊断基于临床特征,使用脑脊液(CSF)的宏基因组下一代测序(mNGS)和狭缝皮肤涂片的组合。在确认李斯特菌脑膜炎和多杆菌麻风病伴结节性麻风红斑(ENL)后,2型反应,她接受了氨苄西林钠治疗,氨苯砜,利福平,氯法齐明,甲基强的松龙,还有沙利度胺.在1年的随访中,头痛的频率和严重程度显着降低,并且发现皮肤损伤改善的良好临床反应。
    结论:这个案例突出了考虑麻风病的重要性,这是一种罕见且未被充分认识的疾病,在风湿性皮疹的鉴别诊断中,即使在这种疾病不是地方病的地区,医生应该警惕中枢神经系统感染的可能性。此外,mNGS可以作为传统诊断方法的补充诊断工具,提高麻风病的诊断准确性。
    BACKGROUND: Leprosy is a chronic infectious disease caused by Mycobacterium leprae (M. leprae) that is responsible for deformities and irreversible peripheral nerve damage and has a broad spectrum of clinical and serological manifestations. Leprosy primarily affects the peripheral nerves and rarely presents with central nervous system involvement. Diagnosing leprosy can still be difficult in some cases, especially when the infection involves uncommon clinical manifestations and extracutaneous sites. Delayed diagnosis and treatment of leprosy may lead to irreversible damage and death.
    METHODS: We report a case of a 30-year-old female presenting with \"repeated high fever with symptoms of headache for 14 days\". On the day of admission, physical signs of lost eyebrows and scattered red induration patches all over her body were observed. The patient\'s diagnosis was based on the clinical characteristics using a combination of metagenomic next-generation sequencing (mNGS) of cerebrospinal fluid (CSF) and slit-skin smear. After confirming Listeria meningitis and multibacillary leprosy with erythema nodosum leprosum (ENL), a type 2 reaction, she was treated with ampicillin sodium, dapsone, rifampicin, clofazimine, methylprednisolone, and thalidomide. At the 1-year follow-up, the frequency and severity of headaches have significantly decreased and a good clinical response with improved skin lesions was found.
    CONCLUSIONS: This case highlights the importance of considering leprosy, which is a rare and underrecognized disease, in the differential diagnosis of skin rashes with rheumatic manifestations, even in areas where the disease is not endemic, and physicians should be alerted about the possibility of central nervous system infections. In addition, mNGS can be used as a complementary diagnostic tool to traditional diagnostic methods to enhance the diagnostic accuracy of leprosy.
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  • 文章类型: Journal Article
    当前的荟萃分析旨在探讨自然抗性相关巨噬细胞蛋白1(NRAMP1)(3'-非翻译区[3'-UTR])和核苷酸结合寡聚化结构域2(NOD2[rs8057341])基因多态性之间的潜在相关性。数据来自与麻风病相关的NOD2和NRAMP1基因多态性的病例对照研究。麻风病在全球范围内成为妇女中特别独特的疾病。NRAMP1(3'-UTR)和NOD2(rs8057341)遗传变异在麻风病的进展中起着至关重要的作用。在几个数据库中对相关的病例对照研究进行了系统回顾,包括ScienceDirect,PubMed,谷歌学者,和Embase。利用MetaGenyo和ReviewManager5.4版本,进行了统计分析。该研究包括9项病例对照研究,总计3281名对照和3062名麻风病人。目的是研究NRAMP1(3'-UTR)和NOD2(rs8057341)基因多态性与麻风病风险之间的潜在关联。审查方法已在PROSPERO(ID520883)中注册。研究结果揭示了NRAMP1(3'-UTR)和NOD2(rs8057341)基因多态性与麻风病风险之间的紧密关联。尽管漏斗图分析没有确定发表偏倚,支持这些发现并阐明潜在的基因-基因和基因-环境相互作用需要进一步的全面流行病学研究。这项研究在两个遗传模型中确定了NOD2(rs8057341)基因的多态性与麻风病易感性之间的强相关性。需要进一步的全面流行病学调查来验证这些发现,并探索这些基因与环境因素之间的潜在相互作用。
    The current meta-analysis aims to explore the potential correlation between natural resistance-associated macrophage protein 1 (NRAMP1) (3\'-Untranslated region [3\'-UTR]) and nucleotide-binding oligomerization domain-2 (NOD2 [rs8057341]) gene polymorphisms and their association with leprosy susceptibility in both Asian and Caucasian populations. Datas were retrieved from case control studies with NOD 2 and NRAMP 1 gene polymorphism associated with leprosy disease. Leprosy emerges as a particularly distinctive ailment among women on a global scale. The NRAMP1 (3\'-UTR) and NOD2 (rs8057341) genetic variations play a crucial role in the progression of leprosy. A systematic review of relevant case-control studies was conducted across several databases, including ScienceDirect, PubMed, Google Scholar, and Embase. Utilizing MetaGenyo and Review Manager 5.4 Version, statistical analyses were carried out. Nine case-control studies totaling 3281 controls and 3062 leprosy patients are included in the research, with the objective of examining the potential association between NRAMP1 (3\'-UTR) and NOD2 (rs8057341) gene polymorphisms and leprosy risk. The review methodology was registered in PROSPERO (ID520883). The findings reveal a robust association between NRAMP1 (3\'-UTR) and NOD2 (rs8057341) gene polymorphisms and leprosy risk across various genetic models. Although the funnel plot analysis did not identify publication bias, bolstering these findings and elucidating potential gene-gene and gene-environment interactions require further comprehensive epidemiological research. This study identified a strong correlation between polymorphisms in the NOD2 (rs8057341) genes and susceptibility to leprosy across two genetic models. Further comprehensive epidemiological investigations are warranted to validate these findings and explore potential interactions between these genes and environmental factors.
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  • 文章类型: Journal Article
    IndicusPranii分枝杆菌(MIP)疫苗是印度开发的用于麻风病的灭活疫苗,具有免疫治疗和免疫预防作用。MIP,早先被称为welchii分枝杆菌,是一种生长迅速的非致病性分枝杆菌。这种细菌的新颖性是由于其作为免疫治疗剂的翻译应用。皮内给药时,该疫苗在宿主中诱导针对麻风分枝杆菌的细胞介导的免疫。它导致更快的临床和组织病理学改善,快速细菌清除,以及麻风病人的麻风病人的lepromin转换。MIP疫苗在增强多药治疗(MDT)的治疗功效中的有益作用,特别是高度杆菌化的麻风病人,在印度的各种研究中都有很好的记录。疫苗在反应状态中的作用是有争议的,在不同的研究中有不同的结果。总的来说,发现它可以降低2型lepra反应的频率,并且对顽固性结节性麻黄红斑有用。即使1型反应的可能性增加,在各种研究中,疫苗并未导致额外的神经功能损伤.在接受MIP管理的麻风病家庭接触者中,据指出,它可以提供长达10年的疾病保护。在国家麻风病计划中,这可能是一项具有成本效益的战略。除了局部注射部位反应,疫苗相对安全,但不建议在怀孕和哺乳。本文概述了MIP疫苗在麻风病中的临床应用。它还考虑了该疫苗在疾病相关并发症管理和实现零麻风病的长期目标方面的未来可能应用。
    Mycobacterium Indicus Pranii (MIP) vaccine is a killed vaccine developed in India for leprosy with immunotherapeutic as well as immunoprophylactic effects. MIP, earlier known as Mycobacterium welchii, is a rapidly growing non-pathogenic mycobacterium. The novelty of this bacterium is due to its translational application as an immunotherapeutic agent. When administered intradermally, the vaccine induces cell-mediated immunity in the host towards Mycobacterium leprae. It leads to faster clinical and histopathological improvement, rapid bacillary clearance, and also lepromin conversion in anergic leprosy patients. The beneficial role of the MIP vaccine in augmenting the therapeutic efficacy of Multidrug Therapy (MDT), particularly in highly bacillated leprosy patients, is well documented in various studies from India. The role of the vaccine in reactional states is controversial, with varied results in different studies. Overall, it is found to decrease the frequency of type 2 lepra reactions and is useful in recalcitrant erythema nodosum leprosum. Even though there may be an increased likelihood of type 1 reactions, no additional nerve function impairment is attributed to the vaccine in various studies. In household contacts of leprosy who are administered MIP, it is noted to confer protection from disease lasting up to 10 years. It may prove to be a cost-effective strategy in national leprosy programmes. Apart from local injection site reactions, the vaccine is relatively safe, but it is not recommended in pregnancy and lactation. This article provides an overview of the MIP vaccine\'s clinical application in the context of leprosy spanning over 40 years. It also considers the vaccine\'s possible future applications in the management of disease-related complications and achieving the long-term goal of zero leprosy.
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  • 文章类型: Journal Article
    目的:确定初级卫生保健专业人员面对麻风病的做法。
    方法:范围审查,在2022年11月至2023年1月之间进行,根据JBI提出的方法结构进行,并在六个数据库和其他文献中进行系统审查和Meta分析扩展的清单首选报告项目。
    结果:样本由11篇文章组成,2008年至2022年出版。研究结果分为三类:早期诊断和及时治疗;身体残疾预防;家庭和社会接触监测。
    结论:有必要将实施的做法与巴西国家麻风病控制和消除计划建议的做法保持一致,因为有些在研究中没有发现,这意味着对针对患者需求的合格援助的损失,以控制和消除麻风病。
    OBJECTIVE: to identify Primary Health Care professionals\' practice in the face of leprosy.
    METHODS: a scoping review, carried out between November 2022 and January 2023, conducted according to the methodological structure proposed by JBI and checklist Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews in six databases and additional literature.
    RESULTS: the sample consisted of 11 articles, published between 2008 and 2022. The findings were synthesized into three categories: Early diagnosis and timely treatment; Physical disability prevention; and Household and social contact surveillance.
    CONCLUSIONS: there is a need to align the practices carried out with those recommended by the Brazilian National Program for Leprosy Control and Elimination, as some were not identified in studies, which implies losses to qualified assistance directed to patient demands, with a view to control and elimination of leprosy.
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  • 文章类型: Case Reports
    直到现在,麻风病仍然是世界上的一个问题和挑战,因为它可以导致受影响的个体的残疾和发病率,包括由于出现2型麻风反应或结节性麻风红斑(ENL)引起的问题。ENL的临床表现可以以非典型和严重的形式出现,称为ENL坏死(ENN),这成为诊断和治疗中的一个问题。我们报告了一名17岁的女性,患有麻风病和ENN,她接受了类固醇和甲氨蝶呤联合治疗。服用这种疗法四个月后,患者身体上的溃疡得到改善,留下萎缩性和肥厚性疤痕.新奥的不寻常临床表现造成诊断困难,因为它的外观不符合典型模式,使正确识别具有挑战性。此外,管理ENN病例可能需要除了单独使用类固醇之外的补充治疗。
    Until now, leprosy remains a problem and challenge in the world because it can cause disability and morbidity in affected individuals, including problems due to the emergence of type 2 lepra reaction or erythema nodosum leprosum (ENL). The clinical picture of ENL can appear in an atypical and severe form, called ENL necroticans (ENN), which becomes a problem in diagnosis and therapy. We report a 17-year-old female with lepromatous leprosy and ENN who received therapy in the form of a combination of steroids and methotrexate. Four months after consuming this therapy, the ulcers on the patient\'s body improved, leaving atrophic and hypertrophic scars. ENN\'s unusual clinical presentation poses diagnostic difficulties in that its appearance does not follow the typical patterns, making it challenging to identify correctly. Furthermore, managing cases of ENN may necessitate supplementary treatment beyond steroids alone.
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