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1.
Clin J Oncol Nurs ; 26(5): 461-462, 2022 Sep 15.
Article in English | MEDLINE | ID: mdl-36108213

ABSTRACT

To Err is Human: Building a Safer Health System, the Institute of Medicine's consequential 2000 report, focused attention on medical errors, championing preventive strategies to improve patient safety in hospitals. In the c.


Subject(s)
Medical Errors , Patient Safety , Delivery of Health Care , Hospitals , Humans , Medical Errors/prevention & control
2.
Bogotá; s.n; 2012. 116 p. tab.
Thesis in Spanish | LILACS (Americas), BDENF, COLNAL | ID: biblio-1392688

ABSTRACT

La seguridad del paciente es una preocupación mundial, en Colombia es liderada por el Sistema Obligatorio de Garantía de calidad en salud con el objetivo de prevenir la presencia de situaciones que afecten la seguridad del paciente durante la atención, reducir y de ser posible eliminar la ocurrencia de Eventos adversos para garantizar instituciones seguras y competitivas. Lo que se obtiene a través de los componentes obligatorios del sistema de garantía de la calidad, uno de ellos Auditoria para el Mejoramiento Continuo, cuyo objetivo es realizar seguimiento y control a todos los procesos, como una estrategia que garantice atenciones más seguras. Los informes de auditoría reflejan datos que son el resultado de la revisión y análisis integral de todas las atenciones realizadas, basan sus análisis en los atributos de calidad de la atención en salud, asume los lineamientos contractualmente definidos y acoge las normas vigentes frente a las atenciones en salud brindadas a las personas que las requieren. El Programa creado como una estrategia por el ministerio de la protección social involucra a todos los profesionales de salud y los compromete a asegurar la calidad del servicio en todos los ámbito; enfermería tiene a cargo la responsabilidad de brindar la atención directa, por lo tanto debe contribuir a la detección oportuna de atenciones inseguras y brindar cuidados oportunos, de calidad en lo posible libres de riesgo. Esta investigación se abordó como un estudio cuantitativo, retrospectivo de tipo descriptivo, para determinar la presencia de indicios de atención insegura, errores y eventos adversos que ocurrieron durante las atenciones realizadas en una IPS de II nivel de complejidad y que fueron presentados como atenciones no conformes en general en los informes de auditoría, para luego especificar cuáles de ellos son atribuidos específicamente a las acciones de enfermería. Los resultados obtenidos muestran un comportamiento similar a los estudios realizados por la Organización Mundial y permiten a los directivos de las instituciones, definir estrategias de mejoramiento continuo y establecer una estrategia permanente de evaluación y control, que permita a los profesionales de enfermería implementarla como herramienta que garantice la calidad del cuidado durante la atención.


Patient safety is a global concern, in Colombia is led by the Mandatory System of Quality Assurance in Health with the goal of preventing the occurrence of situations that affect patient safety during care, reduce and possibly eliminate the occurrence Adverse Event to ensure safe and competitive institutions. What we get through the mandatory components of system quality assurance, one auditing for continuous improvement, which aims to track and control all processes, as a strategy to ensure safer care. Audit reports show data that is the result of the comprehensive review and analysis of all patients attended, based their analysis on the quality attributes of health care, assumed contractually defined guidelines and welcomes the current rules about the attentions extended to health than those required. The program was created by the ministry of social protection, and involves all health professionals and make them promise to ensuring the quality of service in all aspects ; nursing has in its shoulders the responsibility of providing direct care, therefore must contribute to the timely detection of unsafe care and provide timely care, with quality and free of any risk. The research was approached as a quantitative, descriptive, retrospective study, to determine the presence of signs of unsafe care, mistakes and adverse events that occurred during care attention in an IPS on level II of complexity that were presented as "nonconforming attentions" generally in the audit reports, and then specify which of them are specifically attributed to nursing actions. The results show a behavior similar to studies by the World Health Organization and allow managers of institutions, defining continuous improvement strategies and establish a permanent strategy evaluation and control, enabling nurses to implement it as a tool ensure the quality of care for attention.


Subject(s)
Humans , Male , Female , Quality of Health Care , Health Strategies , Medical Errors , Patient Safety , Nursing Care
3.
Prim Dent J ; 11(3): 31-38, 2022 Sep.
Article in English | MEDLINE | ID: mdl-36073040

ABSTRACT

Local Safety Standards for Invasive Procedures (LocSSIPs) offer a valuable way of mitigating wrong tooth extraction and other patient safety incidents during a patient's dental care journey. This paper aims to guide primary care dental practitioners in creating tailored, co-produced LocSSIPs with guidance on analysis of work systems and consideration of the patient's care journey, and provides the building blocks to create a detailed LocSSIP with a background of understanding of the importance of human factors and non-technical skills.


Subject(s)
Dentists , Medical Errors , Dental Care , Humans , Medical Errors/prevention & control , Primary Health Care , Professional Role , Tooth Extraction/methods
6.
J Patient Saf ; 18(6): 617-623, 2022 Sep 01.
Article in English | MEDLINE | ID: mdl-35985043

ABSTRACT

INTRODUCTION: Surgical errors often occur because of human factor-related issues. A medical data recorder (MDR) may be used to analyze human factors in the operating room. The aims of this study were to assess intraoperative safety threats and resilience support events by using an MDR and to identify frequently discussed safety and quality improvement issues during structured postoperative multidisciplinary debriefings using the MDR outcome report. METHODS: In a cross-sectional study, 35 standard laparoscopic procedures were performed and recorded using the MDR. Outcome data were analyzed using the automated Systems Engineering Initiative for Patient Safety model. The video-assisted MDR outcome report reflects on safety threat and resilience support events (categories: person, tasks, tools and technology, psychical and external environment, and organization). Surgeries were debriefed by the entire team using this report. Qualitative data analysis was used to evaluate the debriefings. RESULTS: A mean (SD) of 52.5 (15.0) relevant events were identified per surgery. Both resilience support and safety threat events were most often related to the interaction between persons (272 of 360 versus 279 of 400). During the debriefings, communication failures (also category person) were the main topic of discussion. CONCLUSIONS: Patient safety threats identified by the MDR and discussed by the operating room team were most frequently related to communication, teamwork, and situational awareness. To create an even safer operating culture, educational and quality improvement initiatives should aim at training the entire operating team, as it contributes to a shared mental model of relevant safety issues.


Subject(s)
Patient Safety , Safety Management , Cross-Sectional Studies , Humans , Medical Errors/prevention & control , Operating Rooms , Patient Care Team
7.
Aquichan ; 22(3): e2232, jul. 28, 2022.
Article in English | LILACS (Americas), BDENF, COLNAL | ID: biblio-1382360

ABSTRACT

Objetivo: o objetivo deste estudo foi determinar a segurança em pacientes internados com covid-19 em comparação com os que não tinham covid-19 e encontrar fatores predisponentes de erros de enfermagem segundo a percepção de enfermeiros. Materiais e método: trata-se de pesquisa descritivo-comparativa, que utilizou dados de pesquisas com 800 enfermeiros em oito hospitais iranianos em 2021, com base em três questionários com alta confiabilidade e validade, elaborados por pesquisadores, que incluíam dados sociodemográficos, índices de segurança do paciente e fatores predisponentes de erros de enfermagem. Os dados coletados foram analisados com ANOVA, teste t independente e software SPSS22. Resultados: as pontuações médias de segurança dos pacientes com e sem covid-19 foram 3,42 ± 0,17 e 3,74 ± 0,06, respectivamente. As maiores diferenças em segurança do paciente foram atribuídas às dimensões de controle de infecções (0,66) e queda do paciente (0,56). As causas mais comuns dos erros de enfermagem estiveram relacionadas com o aspecto gerencial (2,67 ± 1,39) e os fatores predisponentes mais comuns dos erros de enfermagem foram a alta carga de trabalho, a baixa proporção de enfermeiros por paciente e a fadiga. Conclusões: os pacientes com covid-19 têm menor segurança do que os que não apresentam a doença. Além disso, a gestão inadequada e a alta carga de trabalho levam a erros de enfermagem. Portanto, as autoridades devem elaborar estratégias adequadas para reduzir a carga de trabalho dos profissionais de saúde e melhorar a segurança do paciente, em especial daqueles com covid-19.


Objetivos: el presente estudio tuvo como objetivo determinar la seguridad en pacientes hospitalizados con covid-19 en comparación con los que no tenían covid-19 y encontrar factores predisponentes de errores de enfermería según la percepción de los enfermeros. Métodos: esta investigación descriptiva-comparativa empleó datos de encuestas de 800 enfermeros en ocho hospitales iraníes en 2021 mediante tres cuestionarios con alta confiabilidad y validez elaborados por investigadores que incluían datos sociodemográficos, indicadores de seguridad del paciente y factores predisponentes de errores de enfermería. Los datos recopilados se analizaron mediante ANOVA, prueba t independiente y el software SPSS22. Resultados: las puntuaciones medias de seguridad de los pacientes con y sin covid-19 fueron 3,42 ± 0,17 y 3,74 ± 0,06, respectivamente. Las mayores diferencias en seguridad del paciente se atribuyeron a las dimensiones de control de infecciones (0,66) y caída del paciente (0,56). Por otra parte, las causas más comunes de los errores de enfermería estuvieron relacionadas con el aspecto gerencial (2,67 ± 1,39), y los factores predisponentes más comunes de los errores de enfermería fueron la alta carga de trabajo, la baja proporción de enfermeros por pacientes y la fatiga. Conclusiones: los pacientes con covid-19 tienen menor seguridad que los que no presentan la enfermedad. Además, la gestión inadecuada y la alta carga de trabajo conducen a errores de enfermería. Por lo tanto, las autoridades deben diseñar estrategias adecuadas para reducir la carga de trabajo de los enfermeros y mejorar la seguridad del paciente, en especial en aquellos con covid-19.


Objectives: The present study aims to determine Patient Safety in hospitalized patients with COVID-19 compared to non-COVID-19 ones and find predisposing factors of nursing errors according to nurses' perceptions. Methods: This descriptive-comparative research employed data from 800 nurses in eight Iranian hospitals in 2021 using three researcher-made questionnaires of sociodemographic, patient safety indicators, and predisposing factors of nursing errors, with high reliability and validity. The collected data were analyzed using ANOVA, independent t-test, and the SPSS22 software. Results: The mean patient safety scores in patients with and without COVID-19 were 3.42 ± 0.17 and 3.74 ± 0.06, respectively. The highest differences in patient safety were attributed to infection control (0.66) and patient fall (0.56) dimensions. The most common causes of nursing errors were related to management (2.67 ± 1.39), and the most common predisposing factors of nursing errors were high workload, low ratio of nurses to patients, and fatigue. Conclusions: COVID-19 patients have lower safety than non-COVID ones. Also, improper management and high workload lead to nursing errors. Therefore, the authorities must devise appropriate strategies to reduce the nurses' workload and improve patient safety, especially in COVID-19 patients.


Subject(s)
Patient Isolation , Medical Errors , Patient Safety , COVID-19 , Nurses
8.
Med. infant ; 29(2): 123-131, Junio 2022. Tab, ilus
Article in Spanish | LILACS (Americas), BINACIS, UNISALUD | ID: biblio-1381849

ABSTRACT

Introducción: El uso de herramientas estandarizadas como estrategia de comunicación para brindar información relevante, precisa y actualizada, forma parte de las iniciativas de calidad en las instituciones que cumplen altos estándares en la atención de pacientes. Objetivo: Describir la implementación de un programa de traspaso (IPASS) en unidades de cuidados intensivos pediátricos específicos. Material y métodos: Estudio cuasi-experimental antes y después de una intervención, no controlado, utilizando como sujetos a los profesionales de la salud involucrados en traspasos de pacientes de la unidad de terapia intensiva cardiovascular (UCI 35) e inmunosuprimidos (UCI 72). La intervención consistió en la introducción de un paquete de medidas de estandarización del traspaso de pacientes que consta de: una herramienta escrita, una mnemotecnia oral, una capacitación de trabajo en equipo, observación y devolución estandarizada de los traspasos, basados en la metodología IPASS. Se realizó además una encuesta de percepción de seguridad, tanto en la etapa pre y post intervención. Se comparó el cumplimiento de cada componente del traspaso antes y después de la intervención mediante la prueba de chi2 . Resultados: Se realizaron 101 observaciones de traspaso y 56 encuestas. La mediana de pacientes por cada observación fue 6 (r: 4 a 12) y el tiempo promedio de 26± 11 min. Conclusiones: El uso de un paquete de medidas de estandarización del traspaso de pacientes posquirúrgicos cardiovasculares e inmunosuprimidos aumentó significativamente la presencia de información clave sobre criticidad de la enfermedad, acciones y situaciones de contingencia, junto con la inclusión de la síntesis por el receptor del traspaso (AU)


Introduction: The use of standardized tools as a communication strategy to provide relevant, accurate, and up-to-date information is part of quality initiatives in institutions that adhere to high standards in patient care. Objective: To describe the implementation of a handoff program (IPASS) in specific pediatric intensive care units. Methods: An uncontrolled, quasi-experimental, beforeand-after study. Subjects were healthcare providers involved in patient handoffs in the cardiovascular (ICU 35) and immunocompromised-patient (ICU 72) intensive care units. The intervention consisted of the introduction of a bundle to standardize patient handoff consisting of: a written tool, an oral mnemonic, teamwork training, observation, and standardized feedback for handoffs based on the IPASS methodology. A safety perception survey was also carried out, both in the pre- and post-intervention stage. Compliance with each handoff component before and after the intervention was compared using the Chi-squared test. Results: 101 handoff observations and 56 surveys were conducted. The median number of patients per observation was 6 (r: 4 to 12) and the mean handoff time was 26±11 min. Conclusions: The use of a standardized handoff bundle for post-surgical cardiovascular and immunocompromised patients significantly increased the availability of key information on disease severity, actions, and contingency situations, as well as a synthesis by the handoff receiver (AU)


Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Intensive Care Units, Pediatric , Medical Errors/prevention & control , Quality Improvement , Patient Safety , Patient Handoff/standards , Patient Handoff/statistics & numerical data , Surveys and Questionnaires
10.
J Patient Saf ; 18(5): 382-388, 2022 08 01.
Article in English | MEDLINE | ID: mdl-35948288

ABSTRACT

OBJECTIVES: In 2019, the Korean National Patient Safety Incidents Inquiry was conducted in the Republic of Korea to identify the national-level incidence of adverse events. This study determined the incidence and detailed the characteristics of adverse events at 15 regional public hospitals in the Republic of Korea. METHODS: Medical records data of 500 randomly selected patients (discharged in 2016) were extracted from each of the 15 studied hospitals and reviewed in 3 stages. First, for each hospital, 2 nurses independently reviewed the medical records, using 41 screening criteria. Second, 2 physicians independently reviewed the records of those patients with at least 1 screening criterion from the first stage for adverse events occurrence and their characteristics. Third, a 9-member committee conducted a final review and compiled the final adverse event report. RESULTS: Among 7500 patients, 4159 (55.5%) had at least 1 screening criterion; 745 (9.9%) experienced 901 adverse events (incidence, 12.0%). By type of institution, adverse event incidence varied widely from 1.2% to 45.6%. In 1032 adverse events, the majority (33.5%) were "patient care-related." By severity, the majority (638; 70.8%) were temporary, requiring intervention, whereas 38 (4.2%) resulted in death. The preventability score was high for "patient care-related" and "diagnosis-related" adverse events. Duration of hospitalization was extended for 463 (44.9%) adverse events, with "diagnosis-related" (30.8%) and "surgery/procedural-related" (30.1%) types extended by at least 21 days. CONCLUSIONS: A review of medical records aids in identifying adverse events in medical institutions with varying characteristics, thus helping prioritize interventions to reduce their incidence.


Subject(s)
Hospitals, Public , Medical Errors , Patient Safety , Hospitalization , Humans , Medical Errors/prevention & control , Medical Records , Republic of Korea
11.
J Patient Saf ; 18(5): 444-448, 2022 08 01.
Article in English | MEDLINE | ID: mdl-35948293

ABSTRACT

OBJECTIVE: The aim of this study was to analyze the strength of safety measures described in incident reports in outpatient care. METHODS: An incident reporting project in German outpatient care included 184 medical practices with differing fields of specialization. The practices were invited to submit anonymous incident reports to the project team 3 times for 17 months. Using a 14-item coding scheme based on international recommendations, we deductively coded the incident reports and safety measures. Safety measures were classified as "strong" (likely to be effective and sustainable), "intermediate" (possibly effective and sustainable), or "weak" (less likely to be effective and sustainable). RESULTS: The practices submitted 245 incident reports. In 160 of them, 243 preventive measures were described, or an average of 1.5 per report. The number of documented measures varied from 1 in 67% to 4 in 5% of them. Four preventive measures (2%) were classified as strong, 37 (15%) as intermediate, and 202 (83%) as weak. The most frequently mentioned measures were "new procedure/policy" (n = 121) and "information/notification/warning" (n = 45). CONCLUSIONS: The study provides examples of critical incidents in medical practices and for the first time examines the strength of ensuing measures introduced in outpatient care. Overall, the proportion of weak measures is (too) high, indicating that practices need more support in identifying strong measures.


Subject(s)
Medical Errors , Patient Safety , Humans , Medical Errors/prevention & control , Risk Management
12.
São Paulo; s.n; 2017. 237 p
Thesis in Portuguese | LILACS (Americas), BDENF | ID: biblio-1381337

ABSTRACT

Introdução: o aumento da cobertura vacinal reduziu a incidência das doenças imunopreveníveis, elevando os casos de Evento Adverso Pós-Vacinação e Erro de imunização. Objetivo: analisar os erros de imunização e a percepção de vacinadores sobre os fatores que contribuem para a sua ocorrência. Método: abordagem mista, desenvolvida em duas fases: primeira, quantitativa, descritiva, documental, retrospectiva, no período de 2003 a 2013. Utilizados dados secundários do Brasil e primários e secundários do Paraná Sistema de Informação de Eventos Adversos Pós-Vacinação e relatório de erros de imunização do Programa de Imunização. A segunda, qualitativa, exploratória, prospectiva, tendo como referencial a Teoria do Erro Humano, realizada com vacinadores da Região Metropolitana de Curitiba que notificaram erro de imunização em 2013. Classificação do erro de imunização: com evento adverso e sem evento adverso. Para o cálculo das taxas de incidência de erro e diagrama de dispersão, foi utilizado o software SPSS versão 23.0 ajustados pelo Modelo de Regressão Linear Simples. Na fase II, os dados foram coletados por meio de entrevistas e observação não participante, analisados segundo Bardin, utilizando o Web Qualitative Data Analysis WebQDA. Resultados: de 2003 a 2013, no Brasil e no Paraná, o abscesso subcutâneo quente foi o erro de imunização com evento adverso mais frequente. Os menores de um ano foram os mais atingidos pelos erros e a BCG teve taxa de incidência mais elevada. A incidência do erro de imunização com evento adverso aumentou ao longo do período, enquanto o sem evento adverso, elevou-se expressivamente em 2012. A análise da tendência no Paraná de 2003 a 2018, revelou crescimento anual, com elevação contínua da incidência, para ambos, mostrando ainda que a elevação dos percentuais e taxas ocorreu nas campanhas de vacinação, introdução de novas vacinas e mudanças no Calendário Nacional de Vacinação. Nas observações das 26 salas de vacinação, identificou-se: refrigerador não exclusivo, falhas na higienização das mãos (78%), não abordagem sobre possíveis contraindicações ou adiamento da vacinação. Foram entrevistados 115 vacinadores, 96% mulheres, 42% entre 30 a 39 anos, 54% com nível médio de escolaridade e 53% formados há cinco anos ou mais. Atuavam na sala de vacinação entre 3 a 11 anos, 71% realizavam atividades concomitantes em outros setores e 76% não tinham outro emprego. A entrevista revelou que 47% dos vacinadores tinham conhecimento de erro de imunização no seu trabalho, 8,7% estiveram envolvidos em erros e 1,7% referiram haver subnotificação. Dos discursos dos vacinadores emergiram três categorias analíticas: fatores humanos (57,3%), institucionais/organizacionais (34%) e ambientais (8,7%). Das categorias empíricas, destacou-se fatores psicológicos (43,2%) e das subcategorias: distração (21,4%) e estresse (20,9%). Conclusões: o erro de imunização é causado pela interação de múltiplos fatores. Mantendo-se os cenários, as incidências de erro de imunização, com ou sem evento adverso, tendem a continuar ascendentes até 2018. Campanhas, novas vacinas e mudanças no calendário de vacinação aumentam o risco de erro de imunização. Na visão dos vacinadores, a ocorrência de erro de imunização está relacionada, principalmente, a fatores psicológicos e gestão de pessoas. A maioria dos erros de imunização é potencialmente prevenível, desde que a sua ocorrência e causas sejam identificadas.


Introduction: the increase in vaccination coverage reduced the incidence of vaccine-preventable diseases, increasing the number of cases of Adverse Events Following Vaccination and Immunization Error. Objective: to analyze the immunization errors and the perception of vaccinators on the factors that contribute to their occurrence. Method: mixed approach, developed in two phases: the first being quantitative, descriptive, documentary, retrospective, in the period from 2003 to 2013. Secondary data from Brazil and primary data from Paraná were used Surveillance System of Adverse Events Following Vaccination and immunization error reports of the Immunization Program. The second, qualitative, exploratory, prospective phase had as reference the Theory of Human Error, performed with vaccinators of the Metropolitan Region of Curitiba who reported immunization errors in 2013. Classification of immunization error: with and without adverse event. For the calculation of the incidence rates of error and dispersion diagram, the SPSS software version 23.0 was used, adjusted through the Simple Linear Regression Model. In phase II, the data were collected through interviews and non-participant observation, analyzed according to Bardin, using the Web Qualitative Data Analysis WebQDA software. Results: from 2003 to 2013, in Brazil and Paraná, warm subcutaneous abscess was the most frequent immunization error with adverse event. Children under one year old were the most affected by the errors and BCG had higher incidence rate. The incidence of immunization error with adverse event increased over the period, while its incidence without adverse event increased significantly in 2012. The analysis of the trend in Paraná from 2003 to 2018 showed annual growth, with continuous increase in incidence, for both, also showing that the increase of the percentages and rates occurred during the vaccination campaigns, introduction of new vaccines and changes in the National Vaccination Calendar. During the observation of the 26 vaccination rooms, the following were identified: non-exclusive cooler, failures in the sanitation of hands (78%), no addressing of the possible contraindications or postponement of vaccination. 115 vaccinators were interviewed, 96% women, 42% between 30 and 39 years of age, 54% with average level of education and 53% graduated for five years or more. They had been working in the vaccination room for 3 to 11 years, 71% performed concomitant activities in other sectors and 76% did not have another job. The interview revealed that 47% of vaccinators were aware of immunization errors in their work, 8.7% were involved in errors and 1.7% declared there being underreporting. The speeches of the vaccinators resulted in three analytical categories: human (57.3%), institutional/organizational (34%) and environmental (8.7%) factors. Those which stood out, of the empirical categories, were the psychological factors (43.2%), and of the subcategories, distraction (21.4%) and stress (20.9%). Immunization error is caused by the interaction between multiple factors. Conclusions: if kept constant, the scenarios and incidence of immunization errors, with or without adverse event, tend to continue increasing up to 2018. Campaigns, new vaccines and changes in the vaccination calendar increase the risk of immunization error. For the vaccinators, the occurrence of immunization error is related mainly to psychological factors and people management. Most immunization errors are potentially preventable, provided their occurrence and causes are identified.


Subject(s)
Public Health Nursing , Immunization , Vaccination , Medical Errors
15.
In. Tejera, Darwin; Soto Otero, Juan Pablo; Taranto Díaz, Eliseo Roque; Manzanares Castro, William. Bioética en el paciente grave. Montevideo, Cuadrado, 2017. p.319-324.
Monography in Spanish | LILACS (Americas), BNUY, UY-BNMED | ID: biblio-1380990
16.
In. Tejera, Darwin; Soto Otero, Juan Pablo; Taranto Díaz, Eliseo Roque; Manzanares Castro, William. Bioética en el paciente grave. Montevideo, Cuadrado, 2017. p.65-76.
Monography in Spanish | LILACS (Americas), BNUY, UY-BNMED | ID: biblio-1380798
17.
In. Tejera, Darwin; Soto Otero, Juan Pablo; Taranto Díaz, Eliseo Roque; Manzanares Castro, William. Bioética en el paciente grave. Montevideo, Cuadrado, 2017. p.77-87.
Monography in Spanish | LILACS (Americas), BNUY, UY-BNMED | ID: biblio-1380808
19.
AORN J ; 116(2): 111-115, 2022 08.
Article in English | MEDLINE | ID: mdl-35880926
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