Endocrinologia Diabetes Y Nutricion最新文献

{"title":"Increased incidence of pediatric type 1 diabetes during the pandemic in Biscay, Spain","authors":"Concepción Fernández-Ramos ,&nbsp;Eunate Arana-Arri ,&nbsp;Amaia Vela ,&nbsp;Inés Urrutia ,&nbsp;Borja Santos Zorrozua ,&nbsp;Itxaso Rica","doi":"10.1016/j.endien.2024.09.002","DOIUrl":"10.1016/j.endien.2024.09.002","url":null,"abstract":"<div><h3>Objective</h3><div>To update the incidence rate (IR) and trends of type 1 diabetes mellitus (T1DM) in children aged 0–14 years from 2003 to 2022, in Biscay, Spain.</div></div><div><h3>Subjects and method</h3><div>We used the capture–recapture method: primary cases were prospectively extracted from the hospital registry and a secondary independent data source was obtained from diabetes associations and a public health database. The IRs standardized by age and sex were calculated using the direct method, assuming an equal distribution in each age/sex group. The IR occurring during the various COVID-19 waves was compared with the pre-pandemic IR.</div></div><div><h3>Results</h3><div>A total of 378 new cases were identified. The mean age at diagnosis was 9.7 years (5.8–11.9). The completeness of ascertainment was 99.1%. The mean annual age-standardized IR was 12.92 (95%CI, 11.35–13.91). The mean IRs for the 0–4, 5–9, and 10–14 age groups were 7.67, 13.41 and 17.83 cases/100,000 children/year, respectively. The IR trend was statistically significant in the entire group and in the 5–9 year-old group with a mean annual increase of 1.9% (95%CI, 0.1–3.8) and 3.3% (95%CI, 1.002–1.065); <em>p</em> <!-->=<!--> <!-->0.039.</div><div>The 5-year period analysis confirmed that the increase was significant only in the last 5 years (20%). When 2020–2022 (pandemic) and 2017–2019 (pre-pandemic) periods were compared this difference goes up to 44.5%; <em>p</em> <!-->=<!--> <!-->0.029.</div></div><div><h3>Conclusions</h3><div>After a long period of stability in the IR of T1DM in children younger than 15 years of age in Biscay, Spain, an increase in recent years has been reported, which is consistent with the SARS-CoV2 pandemic, with the largest increase being reported in the 5-to 9-year-old age group.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"71 8","pages":"Pages 332-339"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical significance of pituitary adenoma consistency in patients undergoing endoscopic transsphenoidal surgery","authors":"Alberto Acitores Cancela ,&nbsp;Víctor Rodríguez Berrocal","doi":"10.1016/j.endien.2024.09.003","DOIUrl":"10.1016/j.endien.2024.09.003","url":null,"abstract":"","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"71 8","pages":"Pages 321-323"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring plantar pressure distribution in patients with newly diagnosed diabetes: Implications for foot ulcer prevention in an overweight Mexican population","authors":"Francis Rojas-Torres ,&nbsp;Héctor Infanzón-Talango ,&nbsp;Ana Cristina García-Ulloa ,&nbsp;Sergio Hernández-Jiménez ,&nbsp;Gerardo Rodríguez-Reyes","doi":"10.1016/j.endien.2024.09.007","DOIUrl":"10.1016/j.endien.2024.09.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Elevated plantar pressure (PP) constitutes a risk factor for developing foot ulcers. Once present, elevated PP increases morbidity and mortality in patients with diabetes. Given the high prevalence of overweight and obesity in the Mexican population, this study aimed to describe the magnitudes and the distribution of the PP observed in a sample of newly diagnosed patients with diabetes, adjusting for body mass index (BMI) groups (normal weight, overweight, grade I obesity, and grade II and III obesity).</div></div><div><h3>Materials and methods</h3><div>A total of 250 volunteers attending a comprehensive care program for the management of type 2 diabetes received foot assessments that included vascular and neurological evaluation, the identification of musculoskeletal changes, and measurements of PP.</div></div><div><h3>Results</h3><div>Diabetic neuropathy and peripheral arterial disease were present in 21.6% and 11.2% of all participants. Musculoskeletal alterations were present in 70.8% of participants. A positive and significant correlation (<em>p</em> <!-->&lt;<!--> <!-->0.001) was observed between BMI and the peak PP of all anatomical regions assessed. After adjusting for BMI, significant differences (<em>p</em> <!-->&lt;<!--> <!-->0.001) were seen between groups. The metatarsal region, particularly under the third metatarsal head, denoted the highest magnitudes across all BMI.</div></div><div><h3>Conclusions</h3><div>Periodic PP assessment is recommended to identify the distribution of high-pressure points along the plantar surface. However, as a preventive measure, it is suggested to encourage patients with diabetes and overweight or obesity to wear appropriate footwear and pressure-relief insoles to relieve high-pressure areas – often seen in these populations – to help prevent foot complications.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"71 8","pages":"Pages 340-347"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Executive summary of the Spanish consensus for the diagnosis, management, and follow-up of primary hyperaldosteronism","authors":"Marta Araujo-Castro ,&nbsp;Paola Parra Ramírez ,&nbsp;Felicia A. Hanzu ,&nbsp;On behalf the following medical Spanish societies: SEEN, SEC, SEN, SEMI, SERAM, SERVEI, SEQC(ML), AEC","doi":"10.1016/j.endien.2024.09.005","DOIUrl":"10.1016/j.endien.2024.09.005","url":null,"abstract":"<div><div>Primary hyperaldosteronism (PH) is the most common cause of secondary hypertension (HTN) and is associated with a higher cardiometabolic risk than essential HTN. Nevertheless, PH remains clearly underdiagnosed. An early diagnosis and adequate treatment of this disease are essential to reduce the cardiometabolic morbimortality associated with aldosterone excess. PH follow-up is equally essential; however, there is little consensus on how it should be performed, being a topic rarely mentioned by the different clinical practice guidelines. The aim of this executive summary is to summarize the recommendations made in the Spanish consensus of PH for the diagnosis, management, and follow-up of these patients. The Spanish consensus was reached from a multidisciplinary perspective through a nominal group consensus approach by experts from the Spanish Society of Endocrinology and Nutrition (SEEN), the Spanish Society of Cardiology (SEC), the Spanish Society of Nephrology (SEN), the Spanish Society of Internal Medicine (SEMI), the Spanish Society of Radiology (SERAM), the Spanish Society of Vascular and Interventional Radiology (SERVEI), the Spanish Society of Laboratory Medicine (SEQC(ML)), the Spanish Society of Anatomic-Pathology (EAP), and the Spanish Association of Surgeons (AEC).</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"71 8","pages":"Pages 355-364"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integration of big data analytics in the investigation of the relationship between acromegaly and cancer","authors":"Pedro Iglesias ,&nbsp;Javier Arias ,&nbsp;Guillermo López ,&nbsp;Iago Romero ,&nbsp;Juan J. Díez","doi":"10.1016/j.endien.2024.09.001","DOIUrl":"10.1016/j.endien.2024.09.001","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the association between acromegaly and cancer and different types of cancer by using natural language processing systems and big data analytics.</div></div><div><h3>Material and methods</h3><div>We conducted an observational, retrospective study utilizing data from the electronic health records (EHRs) of Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain. Information from the EHRs was extracted using artificial intelligence techniques and analyzed using Savana Manager 4.0 software.</div></div><div><h3>Results</h3><div>Out of a total of 708,047 registered patients (54.7% females), 544 patients (0.08%; 330 women, 60.7%; mean age at diagnosis 53.0<!--> <!-->±<!--> <!-->15.8 yr) were diagnosed with acromegaly. The incidence of cancer was higher in patients with acromegaly vs those without this condition (7.7% vs 3.9%, <em>p</em> <!-->&lt;<!--> <!-->0.001; OR, 2.047, 95%CI, 1.493–2.804). Male acromegalic patients had a higher prevalence of cancer vs females (57.1% vs 42.9%, <em>p</em> <!-->=<!--> <!-->0.012). A significantly higher prevalence of colorectal cancer (2.9% vs 1.4%, <em>p</em> <!-->=<!--> <!-->0.006), bladder cancer (1.1% vs 0.3%, <em>p</em> <!-->=<!--> <!-->0.005), and lymphoma (1.1% vs 0.3%, <em>p</em> <!-->=<!--> <!-->0.009) was observed in patients with acromegaly vs those without the condition. Acromegalic men had significantly higher prevalence rates of colorectal cancer (4.7% vs 1.3%, <em>p</em> <!-->=<!--> <!-->0.001), bladder cancer (2.8% vs 0.4%, <em>p</em> <!-->&lt;<!--> <!-->0.001), breast cancer (0.9% vs 0.2%, <em>p</em> <!-->=<!--> <!-->0.042), gastric cancer (0.9% vs 0.1%, <em>p</em> <!-->=<!--> <!-->0.011), lymphoma (1.4% vs 0.3%, <em>p</em> <!-->=<!--> <!-->0.037), and liver cancer (0.9% vs 0.1%, <em>p</em> <!-->=<!--> <!-->0.012) vs non-acromegalic men. On the other hand, acromegalic women showed a higher prevalence of thyroid cancer (1.2% vs 0.4%, <em>p</em> <!-->=<!--> <!-->0.043) vs non-acromegalic women.</div></div><div><h3>Conclusion</h3><div>Our study, based on artificial intelligence techniques and analysis of real-world data and information, revealed a significant association between acromegaly and cancer in our hospital population, mainly acromegalic men, with a higher frequency of colorectal cancer, bladder cancer and lymphoma in particular.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"71 8","pages":"Pages 324-331"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the presence and type of cardiovascular disease on the risk of mortality in type 2 diabetic patients: The DIABET-IC trial","authors":"José Antonio Gimeno Orna ,&nbsp;Ana Belén Mañas Martínez ,&nbsp;Luis Rodríguez Padial ,&nbsp;Manuel Anguita Sánchez ,&nbsp;Vivencio Barrios ,&nbsp;Javier Muñiz García ,&nbsp;Antonio Pérez Pérez ,&nbsp;on behalf of DIABET-IC researchers","doi":"10.1016/j.endien.2024.07.001","DOIUrl":"10.1016/j.endien.2024.07.001","url":null,"abstract":"<div><h3>Introduction</h3><p>All-cause mortality and cardiovascular mortality (CVM) risk can be very high in adults with type 2 diabetes mellitus (DM2) with previous cardiovascular disease (CVD). Our objective was to determine this risk among the different clinical spectrum of CVD.</p></div><div><h3>Material and methods</h3><p>The DIABET-IC trial is a multicenter, prospective, observational, and analytical study. Consecutive subjects with DM2 attending our outpatients’ clinics were recruited. Data on clinical features, lab test results, and echocardiographic measures were collected.</p><p>Patients were categorized depending on the presence and type of CVD: heart failure (HF), coronary artery disease (CAD), cerebrovascular disease (CVD) and peripheral artery disease (PAD).</p><p>All-cause mortality and CVM were the dependent variables analyzed. Mortality rate was expressed as deaths per 1000 patients-year. Cox proportional hazards regressions models were used to establish the mortality risk associated with every type of CVD.</p></div><div><h3>Results</h3><p>We studied a total of 1246 patients (mean age, 6.3 (SD, 9.9) years; 31.6%, female) with an initial prevalence of CVD of 59.3%. A total of 122 deaths (46 due to CVD) occurred at the 2.6-year follow-up. All-cause and MCV rates associated with the presence of PAD (85.6/1000 and 33.6/1000, respectively) and HF (72.9/1000 and 28.7/1000 respectively) were the most elevated of all.</p><p>In multivariate analysis, HF increased all-cause mortality risk (HR, 1.63; CI 95% 1.03–2.58; P<!--> <!-->=<!--> <!-->.037) and the risk of CVM (HR, 3.41; 95% CI, 1.68–6.93; P<!--> <!-->=<!--> <!-->.001).</p></div><div><h3>Conclusions</h3><p>Mortality among DM2 patients is highly increased in the presence of HF and PAD. This justifies the screening of these conditions to intensify therapeutic strategies.</p></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"71 7","pages":"Pages 278-289"},"PeriodicalIF":1.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gangliocytic paraganglioma: A case report","authors":"Álvaro Valverde Márquez ,&nbsp;Cristina Robles Lázaro ,&nbsp;José Antonio Muñoz León ,&nbsp;Ximena Carolina Vivas Vaca ,&nbsp;María Teresa Mories Álvarez","doi":"10.1016/j.endien.2024.03.023","DOIUrl":"10.1016/j.endien.2024.03.023","url":null,"abstract":"<div><p>Paragangliomas (PGLs) are rare and encapsulated neuroendocrine tumors (NET), located in the adrenal gland or the extra-adrenal paraganglia. Extra-adrenal PGLs may develop a gangliocytic component with ganglion cells which are called gangliocytic paragangliomas (GPs). The most common location is the duodenum, and they appear with digestive symptoms or as an incidental finding.</p><p>We described a 43 years old patient, with epigastric pain, nausea and vomiting. The CT-scan reveals a nodular image in the duodenum. An ultrasound-guided FNA was performed and the pathological report revealed neuroendocrine cell groups and neural tissue. Surgery was the chosen treatment. As the patient did not present lymphatic or pancreatic parenchyma invasion, radiotherapy (RT) was not administered.</p><p>The management of GPs is not well established and multidisciplinary team approach is recommended to lead to therapeutic options. Surgical resection is still key in the treatment, and adjuvant RT may be considered in cases of lymph node invasion.</p></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"71 7","pages":"Pages 317-320"},"PeriodicalIF":1.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional structure of a high resolution thyroid nodule unit. Economic impact and results of its implementation in an Endocrinology department","authors":"Javier Bodoque Cubas ,&nbsp;José Fernández Sáez ,&nbsp;Sergio Martínez Hervás ,&nbsp;José Vicente Gil Boix ,&nbsp;Juan José Salazar González ,&nbsp;Raquel María Pallarés Gasulla ,&nbsp;Marcella Miret Llauradó ,&nbsp;Iñaki Argüelles Jiménez ,&nbsp;Santiago Tofé Povedano","doi":"10.1016/j.endien.2024.04.004","DOIUrl":"10.1016/j.endien.2024.04.004","url":null,"abstract":"<div><h3>Background and objective</h3><p>The high incidence of nodular thyroid pathology has led to growing concern about the economic impact that this pathology represents on the healthcare system. There are conclusive data about the cost-effectiveness of high-resolution units for nodular thyroid pathology; however, their implementation is not homogeneous in the Endocrinology and Nutrition services of our country. The objective of the present study was to evaluate the economic impact of the implementation of the high-resolution thyroid nodule unit (HRTNU) in our center.</p></div><div><h3>Patients and methods</h3><p>The present work is a prospective, observational and descriptive study carried out in 1314 patients (82% women, mean age 58 years ds = 11) evaluated at the HRTNU during the period of August 2022–August 2023. Demographic data (age and sex) were analyzed, referral center and consultation type, number of total consultations and neck ultrasound performed, number of fine needle aspiration (FNAB) performed, and cytology results were analyzed.</p></div><div><h3>Results</h3><p>In the period from August 2022 to August 2023, a total of 1314 patients were evaluated (neck ultrasound and clinical consultation) and a total of 133 FNAB were performed, of which only 2.26% were non-diagnostic. Compared to the percentage of unsatisfactory FNAB from the previous year August 2021–July 2022 of 25%, a mean saving of 9931.43 euros was estimated. 84.47% of the patients evaluated for the first time by the HRTNU were discharged, estimating a mean saving of 133,200 euros.</p></div><div><h3>Conclusions</h3><p>The implementation of a HRTNU at the Endocrinology and Nutrition departments, coordinated with primary and specialized care, is a cost-effectiveness alternative, as it reduces the number of medical consultations and is accompanied by a higher rate of diagnostic FNAB.</p></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"71 7","pages":"Pages 290-297"},"PeriodicalIF":1.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of oral supplementation with whey protein on muscle mass in adults with type 2 diabetes mellitus: a systematic review of randomized controlled trials","authors":"David López-Daza ,&nbsp;Natalia López-Ucrós ,&nbsp;Cristina Posada-Álvarez ,&nbsp;Patricia Savino-Lloreda","doi":"10.1016/j.endien.2024.07.002","DOIUrl":"10.1016/j.endien.2024.07.002","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the overall effect of whey protein supplementation on skeletal muscle mass in adults with type 2 diabetes mellitus (T2DM).</p></div><div><h3>Methods</h3><p>Systematic review of reports on corporal muscle mass from clinical trials that assessed the use of whey protein supplementation by means of validated techniques in patients with T2DM. PubMed, SCOPUS, Web of Science, LILACS, and SciELO databases were searched up to April 2022. Risk of bias was assessed by the Cochrane Collaboration Risk of Bias tool. We conducted a qualitative synthesis of information.</p></div><div><h3>Results</h3><p>Four studies (424 participants) that met the selection criteria were identified out of 1,787 records. Of these, 3 studies assessed the total muscle mass using dual-energy X-ray absorptiometry (DXA), and 1 reported changes to the transverse diameter of the vastus lateralis muscle with ultrasound imaging. In the intervention groups, DXA assessments demonstrated an increase in total muscle mass in 3 studies and in the appendicular muscle mass in 2. Changes to the proportion of muscle mass were not seen in the DXA studies and only a discrete difference was seen in the comparative groups studied by ultrasound imaging.</p></div><div><h3>Conclusion</h3><p>Following the administration of whey protein supplementation in patients with T2DM, a partially positive effect was seen in skeletal muscle mass gain with a moderate certainty of evidence.</p></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"71 7","pages":"Pages 308-316"},"PeriodicalIF":1.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142044699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revolutionizing the management of diabetes: The promise of connected insulin pens and caps","authors":"Fernando Gómez-Peralta,&nbsp;Cristina Abreu","doi":"10.1016/j.endien.2024.04.005","DOIUrl":"10.1016/j.endien.2024.04.005","url":null,"abstract":"","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"71 7","pages":"Pages 275-277"},"PeriodicalIF":1.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142044551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}