scholarly journals Comparison all-cause mortality between individuals with COVID-19 and propensity-score-matched individuals without COVID-19 in South Korea

2021 ◽  
Author(s):  
Tak Kyu Oh ◽  
In-Ae Song ◽  
Kyoung-Ho Song ◽  
Young-Tae Jeon
Keyword(s):  
Propensity Score ◽  
South Korea ◽  
Cox Regression ◽  
Age Groups ◽  
Population Based ◽  
Control Group ◽  
Cox Regression Analysis ◽  
Risk Of Death ◽  
High Hazard Ratio ◽  
All Cause Mortality

Abstract Background We compared all-cause mortality between individuals in South Korea with and without coronavirus disease (COVID-19), using propensity score (PS)-matching. Methods This population-based cohort study used data from the National Health Insurance Service COVID-19 cohort database. In the database, we included individuals (COVID-19 patients, control population, and test-negative individuals) aged 20 years or older, regardless of hospitalization. The primary endpoint was all-cause mortality between January 1, 2020 and August 27, 2020. Results A total of 328,374 adults were included in the study: 7,713 and 320,660 in the COVID-19 group and the control group, respectively. After PS-matching, a total of 15,426 individuals (7,713 per group) were included in the analysis. All-cause mortality 3.2% (248/7,713) and 1.6% (126/7,713) in the COVID-19 group and the control group, respectively. In Cox regression analysis after PS-matching, the risk of death in the COVID-19 group was twice as high (hazard ratio: 2.00; 95% confidence interval: 1.61 to 2.48; P<0.001) than that in the control group. Among patients aged ≥60 years, the COVID-19 group had a 2.32-fold higher all-cause mortality compared with the control group, while statistically statistical differences were not observed in the age groups 20–39 years (P=0.339) and 40–59 years (P=0.562). Conclusions In South Korea, all-cause mortality was twice as high among individuals with COVID-19 than among those with similar underlying risks, primarily because of the elevated COVID-19-associated mortality in those aged ≥60 years. Our results highlight the need for prevention of COVID-19 with respect to mortality as a public health outcome.

scholarly journals The Association between Homocysteinemia and Mortality in Pre-dialysis CKD patients: A Propensity-Score Matched Analysis Using NHANES-National Death Index Link

2021 ◽  
Author(s):  
Je Hun Song ◽  
Hyuk Huh ◽  
Eunjin Bae ◽  
Jeonghwan Lee ◽  
Jung Pyo Lee ◽  
...  
Keyword(s):  
Risk Factor ◽  
Propensity Score ◽  
Proportional Hazards ◽  
Cox Regression ◽  
Cox Proportional Hazards ◽  
Mortality Data ◽  
Protein Energy Wasting ◽  
Cox Regression Analysis ◽  
Cox Proportional Hazards Models ◽  
All Cause Mortality

Abstract Background: Hyperhomocysteinemia (HHcy) is considered a risk factor for cardiovascular disease (CVD) including chronic kidney disease (CKD). In this study, we investigated the association between serum homocysteine (Hcy) level and mortality according to the presence of CKD.Methods: Our study included data of 9,895 participants from the 1996–2016 National Health and Nutrition Examination Surveys (NHANES). Moreover, linked mortality data were included and classified into four groups according to the Hcy level. Multivariable-adjusted Cox proportional hazards models using propensity-score were used to examine dose-response associations between Hcy level and mortality.Results: Of 9,895 participants, 1032 (21.2%) participants were diagnosed with CKD. In a multivariate Cox regression analysis including all participants, Hcy level was associated with all-cause mortality, compared with the 1st quartile in Model 3 (2nd quartile: hazard ratio (HR) 1.751, 95% confidence interval (CI) 1.348-2.274, p<0.001; 3rd quartile: HR 2.220, 95% CI 1.726-2.855, p<0.001; 4th quartile: HR 3.776, 95% CI 2.952-4.830, p<0.001). In the non-CKD group, there was a significant association with all-cause mortality; however, this finding was not observed in the CKD group. The observed pattern was similar after propensity score matching. In the non-CKD group, overall mortality increased in proportion to Hcy concentration (2nd quartile: HR 2.195, 95% CI 1.299-3.709, p = 0.003; 3rd quartile: HR 2.607, 95% CI 1.570-4.332, p<0.001; 4th quartile: HR 3.720, 95% CI 2.254-6.139, p<0.001). However, the risk of all-cause mortality according to the quartile of Hcy level did not increase in the CKD groupConclusion: This study found a correlation between the Hcy level and mortality rate only in the non-CKD group. This altered risk factor patterns may be attributed to protein-energy wasting or chronic inflammation status that is accompanied by CKD.

scholarly journals 505Maternal autoimmune disease and increased attention deficit/hyperactivity disorder among offspring: A cohort study and meta-analysis

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Timothy Nielsen ◽  
Natasha Nassar ◽  
Antonia Shand ◽  
Russell Dale ◽  
Samantha Lain
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Autoimmune Disease ◽  
Propensity Score ◽  
Attention Deficit ◽  
Cox Regression ◽  
Meta Analysis ◽  
Population Based ◽  
Prescription Data ◽  
Cox Regression Analysis ◽  
Hyperactivity Disorder

Abstract Background Maternal autoimmune disease (AD) has been associated with increased neurodevelopmental disorders in the offspring, but few studies have assessed Attention Deficit/Hyperactivity Disorder (ADHD). Methods Population-based record linkage study of 831,718 singleton term births in New South Wales, Australia, 2000-2010. Any maternal AD and specific autoimmune conditions were identified from hospital admission data, and ADHD in children was ascertained from stimulant prescription data (up to 2014). The association between maternal AD and ADHD was examined using Cox regression analysis after propensity score matching (1:4) to control for maternal confounders. A systematic review and meta-analyses were conducted, and pooled hazard ratios (HR) were calculated using random-effects meta-analysis with inverse variance weights. Results Of 831,718 births, 12,767 (1.5%) women had AD. In a propensity score-matched cohort (n = 63,050) maternal AD was associated with ADHD in offspring: “any AD” (HR 1.30, 95%CI 1.15-1.46), type-1 diabetes (T1D) (HR 2.23, 95%CI 1.66-3.00), psoriasis (HR 1.66, 95%CI 1.02-2.70) and rheumatic fever/carditis (HR 1.75, 95%CI 1.06-2.89). Five studies including ours were identified and included in the meta-analysis. Any AD (2 studies: HR 1.20, 95%CI 1.03-1.38), T1D (4 studies: HR 1.53, 95%CI 1.27-1.85), hyperthyroidism (3 studies: HR 1.15, 95%CI 1.06-1.26), and psoriasis (2 studies: HR 1.31, 95%CI 1.10-1.56) were associated with ADHD. Conclusions Maternal ADs were associated with increased ADHD among offspring, suggesting shared underlying genetic vulnerability or a role for maternal immune activation in fetal neurodevelopment. Future studies are required to understand causal mechanisms and identify interventions. Key messages Maternal ADs are associated with increased ADHD among offspring.

scholarly journals Death Associated With Coronavirus (COVID-19) Infection in Individuals With Severe Mental Disorders in Sweden During the Early Months of the Outbreak—An Exploratory Cross-Sectional Analysis of a Population-Based Register Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Martin Maripuu ◽  
Marie Bendix ◽  
Louise Öhlund ◽  
Micael Widerström ◽  
Ursula Werneke
Keyword(s):  
Age Groups ◽  
Population Based ◽  
Register Study ◽  
Control Group ◽  
Swedish Population ◽  
Cross Sectional ◽  
Risk Of Death ◽  
Increased Risk ◽  
Somatic Comorbidity ◽  
Set Up

Background: Individuals with severe mental disorder (SMD) have a higher risk of somatic comorbidity and mortality than the rest of the population. We set up a population-based study to assess whether individuals with SMD had a higher risk of death associated with a COVID-19 infection (COVID-19 associated death) than individuals without SMD.Methods: Exploratory analysis with a cross-sectional design in the framework of a population-based register study covering the entire Swedish population. The Swedish Board for Health and Welfare (Socialstyrelsen) provided anonymized tabulated summary data for further analysis. We compared numbers of COVID-19 associated death in individuals with SMD (cases) and without SMD (controls). We calculated the odds ratio (OR) for the whole sample and by age group and four comorbidities, namely diabetes, cardiovascular disease, hypertension, chronic lung disease.Results: The sample comprised of 7,923,859 individuals, 103,999 with SMD and 7,819,860 controls. There were 130 (0.1%) COVID-19 associated deaths in the SMD group and 4,945 (0.06%) in the control group, corresponding to an OR of 1.98 (CI 1.66-2.35; p &lt; 0.001). The odds were 4-fold for the age groups between 60 and 79 years and 1.5-fold for cardiovascular diseases. Individuals with SMD without any of the risk factors under study had 3-fold odds of COVID-19 associated death.Conclusion: Our preliminary results identify individuals with SMD as a further group at increased risk of COVID-19 associated death. In regard to comorbidities, future studies should explore the potential confounding or mediation role in the relationship between SMD and COVID-19 associated deaths.

scholarly journals Risk of brain herniation after craniotomy with lumbar spinal drainage: a propensity score analysis

2019 ◽  
Vol 130 (5) ◽  
pp. 1710-1720 ◽  
Author(s):  
Yasushi Motoyama ◽  
Tsukasa Nakajima ◽  
Yoshiaki Takamura ◽  
Tsutomu Nakazawa ◽  
Daisuke Wajima ◽  
...  
Keyword(s):  
Propensity Score ◽  
Cox Regression ◽  
Propensity Score Analysis ◽  
Control Group ◽  
Deep Approach ◽  
Brain Herniation ◽  
Cox Regression Analysis ◽  
Group A ◽  
Group B ◽  
Lumbar Spinal

OBJECTIVELumbar spinal drainage (LSD) during neurosurgery can have an important effect by facilitating a smooth procedure when needed. However, LSD is quite invasive, and the pathology of brain herniation associated with LSD has become known recently. The objective of this study was to determine the risk of postoperative brain herniation after craniotomy with LSD in neurosurgery overall.METHODSIncluded were 239 patients who underwent craniotomy with LSD for various types of neurological diseases between January 2007 and December 2016. The authors performed propensity score matching to establish a proper control group taken from among 1424 patients who underwent craniotomy and met the inclusion criteria during the same period. The incidences of postoperative brain herniation between the patients who underwent craniotomy with LSD (group A, n = 239) and the matched patients who underwent craniotomy without LSD (group B, n = 239) were compared.RESULTSBrain herniation was observed in 24 patients in group A and 8 patients in group B (OR 3.21, 95% CI 1.36–8.46, p = 0.005), but the rate of favorable outcomes was higher in group A (OR 1.79, 95% CI 1.18–2.76, p = 0.005). Of the 24 patients, 18 had uncal herniation, 5 had central herniation, and 1 had uncal and subfalcine herniation; 8 patients with other than subarachnoid hemorrhage were included. Significant differences in the rates of deep approach (OR 5.12, 95% CI 1.8–14.5, p = 0.002) and temporal craniotomy (OR 10.2, 95% CI 2.3–44.8, p = 0.002) were found between the 2 subgroups (those with and those without herniation) in group A. In 5 patients, brain herniation proceeded even after external decompression (ED). Cox regression analysis revealed that the risk of brain herniation related to LSD increased with ED (hazard ratio 3.326, 95% CI 1.491–7.422, p < 0.001). Among all 1424 patients, ED resulted in progression or deterioration of brain herniation more frequently in those who underwent LSD than it did in those who did not undergo LSD (OR 9.127, 95% CI 1.82–62.1, p = 0.004).CONCLUSIONSBrain herniation downward to the tentorial hiatus is more likely to occur after craniotomy with LSD than after craniotomy without LSD. Using a deep approach and craniotomy involving the temporal areas are risk factors for brain herniation related to LSD. Additional ED would aggravate brain herniation after LSD. The risk of brain herniation after placement of a lumbar spinal drain during neurosurgery must be considered even when LSD is essential.

Lipoprotein(a) level and MIF gene variant predict incident metabolic syndrome and mortality

2016 ◽  
Vol 64 (2) ◽  
pp. 392-399 ◽  
Author(s):  
Altan Onat ◽  
Günay Can ◽  
Neslihan Çoban ◽  
İbrahim Dönmez ◽  
Hakan Çakır ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Cox Regression ◽  
Disease Risk ◽  
Smoking Status ◽  
Density Lipoprotein ◽  
Population Based ◽  
Serum Lipoprotein ◽  
Risk Of Death ◽  
All Cause Mortality ◽  
Middle Aged Adults

Owing to the scarcity of available information, we aimed to assess the association of migration inhibitory factor (MIF)-173 G/C genotypes and serum lipoprotein(Lp)(a) with incident metabolic syndrome (MetS) and all-cause mortality, respectively. In population based, middle-aged adults (n=1297), stratified by gender and presence of MetS, we used Lp(a) quintiles to identify non-linear associations with outcomes using Cox regression models, adjusted for MIF genotype, age, smoking status, high density lipoprotein cholesterol, and systolic blood pressure. After 5.2 years of follow-up, 151 cases of incident MetS and 123 deaths were recorded. For incident MetS, adjusted HRs increased in each gender across four declining quintiles, starting from the highest quintile in men and from quintile 4 in women. The MIF CC-GC genotype appeared to contribute to the risk estimates in men. Similarly adjusted models in the whole sample disclosed that all-cause mortality tended to be inversely associated with Lp(a) quintiles and yielded an HR (2.42 (95% CI 1.03 to 5.81)) in men in quintile 2, whereas the MIF genotype additively predicted mortality (HR 1.79 (95% CI 1.01 to 3.18)) only in men. Excess risk of death was additively conferred on Turkish men by the MIF CC-GC genotype and by apparently reduced circulating Lp(a) assays, supporting the notion that ‘low’ serum Lp(a), mediating autoimmune activation, is a major determinant of metabolic disease risk and death. Damaged MIF protein and more complex autoimmune activation in women may be responsible from lack of relationship to MetS/mortality.

With versus Without Primary Tumor Radiotherapy in Patients with Unresectable Stage IV Rectal or Rectosigmoid Cancer: A Propensity Score Matching Analysis for Survival

2020 ◽  
Author(s):  
Gang Wang ◽  
Ling Wen Wang ◽  
Jie Hai Jin ◽  
min Hong Dong ◽  
wei Wei Chen ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Primary Tumor ◽  
Cox Regression ◽  
Stage Iv ◽  
Rectosigmoid Cancer ◽  
Cox Regression Analysis ◽  
Risk Of Death ◽  
Kaplan Meier ◽  
The Impact

Abstract Background: To evaluate the impact of primary tumor radiotherapy on survival in patients with unresectable metastatic rectal or rectosigmoid cancer. Methods: Form September 2008 to September 2017, 350 patients with unresectable metastatic rectal or rectosigmoid cancer were retrospectively reviewed in our center. All patients received at least 4 cycles of chemotherapy, and were divided into two groups according to with primary tumor radiotherapy or without. 163 patients received primary tumor radiotherapy, and the median radiation dose was 56.69Gy(50.4-60). Survival curves were estimated from the Kaplan–Meier procedure to roughly compare survival among two groups. Subsequently, 18-month survival was used as the outcome variable for this study. This study mainly evaluated the impact of primary tumor radiotherapy on survival of these patients through a series of multivariate Cox regression analyses after propensity score matching (PSM). Results: The median follow-up time was 21 months. All 350 patients received a median of 7 cycles of chemotherapy (range 4-12), 163 (46.67%) patients received primary tumor radiotherapy for local symptoms. The Kaplan–Meier survival curves showed a significant overall survival (OS) advantage for primary tumor radiotherapy group to without radiotherapy (20.07 vs 17.33 months; P=0.002). In this study, multivariate Cox regression analysis after adjusted covariates, multivariate Cox regression analysis after PSM, and inverse probability of treatment weighting (IPTW) analysis and propensity score (PS)-adjusted model analysis consistently showed that primary tumor radiotherapy could effectively reduce the risk of death for these patients at 18 months (HR: 0.62, 95% CI 0.40-0.98; HR:0.79, 95% CI:0.93-1.45; HR: 0.70, 95% CI 0.55-0.99 and HR: 0.74, 95% CI:0.59-0.94). Conclusion: Compared with patients with stage IV rectal or rectosigmoid cancer who did not receive primary tumor radiotherapy, received primary tumor radiotherapy reduced the risk of death in these patients. The radical doses（59.4Gy/ 33 fractions or 60Gy/ 30 fractions） of radiation for primary tumors might be considered for unresectable metastatic rectal or rectosigmoid cancer, not just for relieve symptoms. Keywords: Stage IV Rectal cancer, primary tumor radiotherapy, propensity score matching.

scholarly journals Incidence of pneumonia in nursing home residents in Germany: results of a claims data analysis

2018 ◽  
Vol 146 (9) ◽  
pp. 1123-1129 ◽  
Author(s):  
A. M. Fassmer ◽  
O. Spreckelsen ◽  
F. Hoffmann
Keyword(s):  
Cox Regression ◽  
Age Groups ◽  
Nursing Home Residents ◽  
The Elderly ◽  
Population Based ◽  
Insurance Fund ◽  
Cox Regression Analysis ◽  
Using Data ◽  
Claims Data Analysis ◽  
Incident Cases

AbstractPneumonia is one of the most common infectious diseases with a high mortality, especially in the elderly population. To date, there have been only a few population-based studies dealing with the incidence of pneumonia in nursing homes (NHs). We conducted a cohort study using data from a large German statutory health insurance fund. Between 2010 and 2014, 127 227 NH residents 65 years and older were analysed. For the calculation of incidences per 100 person-years (PY) and 95% confidence intervals (CIs), we assessed the first diagnosis of pneumonia during the time in NH. We compared the rates between sexes, age groups, care levels, and comorbidities and we performed a multivariate Cox regression analysis. The mean age in the cohort was 84.0 years (74.6% female). A total of 19 183 incident cases led to an overall 5-year-incidence of 11.8 per 100 PY (95% CI 11.7–12.0). The incidence in men was substantially higher than in women. Rates were highest in the first month after NH placement. Our study revealed that the incidence of pneumonia is high in German NH residents and especially in males. Due to demographic changes, pneumonia will likely be increasingly relevant in the health care of the elderly and institutionalised population.

scholarly journals Marital Status, An Independent Predictor for Survival of Gastric Neuroendocrine Neoplasm Patients: A Population-based, Propensity Score-matched Study

2020 ◽  
Author(s):  
Yu-Jie Zhou ◽  
Xiao-Fan Lu ◽  
Kenneth I. Zheng ◽  
Qi-Wen Wang ◽  
Jin-Nan Chen ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Propensity Score ◽  
Marital Status ◽  
Protective Factor ◽  
Cox Regression ◽  
Independent Prognostic Factor ◽  
Neuroendocrine Neoplasm ◽  
Prognostic Impact ◽  
Cox Regression Analysis ◽  
Risk Of Death

Abstract Background: Marital status proves to be an independent prognostic factor in a variety of cancers. However, its prognostic impact on gastric neuroendocrine neoplasms (G-NEN) has not been investigated.Methods: We identified 3947 G-NEN patients from the Surveillance, Epidemiology, and End Results (SEER) database. Meanwhile, propensity scores for marital status were used to match 506 unmarried patients with 506 married patients. We used Kaplan–Meier method and multivariate Cox regression to analyse the association between marital status and the overall survival (OS) and G-NEN cause-specific survival (CSS) before matching and after matching.Results: Married patients enjoyed better OS and CSS, compared with divorced/separated, single, and widowed patients. Multivariate Cox regression analysis indicated that unmarried status was associated with higher mortality hazards for both OS and CSS among G-NEN patients. Additionally, widowed individuals had the highest risks of overall and cancer-specific mortality compared to other unmarried groups in both males and females. Furthermore, marital status remained an independent prognostic and protective factor for both OS and CSS in 1:1 propensity score-matched analysis.Conclusion: Marital status was an independent prognostic factor for G-NEN. Meanwhile, widowed patients with G-NEN had the highest risk of death compared with single, married, and divorced/separated patients.

scholarly journals Corticosteroid therapy for corona virus disease 2019-related acute respiratory distress syndrome: a cohort study with propensity score analysis

2020 ◽  
Author(s):  
Chaomin Wu ◽  
Dongni Hou ◽  
Chunling Du ◽  
Yanping Cai ◽  
Junhua Zheng ◽  
...  
Keyword(s):  
Propensity Score ◽  
Corticosteroid Therapy ◽  
Cox Regression ◽  
Propensity Score Analysis ◽  
Corticosteroid Treatment ◽  
Hospital Death ◽  
Cox Regression Analysis ◽  
Risk Of Death ◽  
Systemic Corticosteroids ◽  
The Impact

Abstract Background The impact of corticosteroid therapy on outcomes of patients with Coronavirus disease-2019 (COVID-19) is highly controversial. We aimed to compare the risk of death between COVID-19-related ARDS patients with corticosteroid treatment and those without. Methods In this single-centre retrospective observational study, patients with ARDS caused by COVID-19 between 24 December 2019 and 24 February 2020 were enrolled. The primary outcome was 60-day in-hospital death. The exposure was prescribed systemic corticosteroids or not. Time-dependent Cox regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for 60-day in-hospital mortality. Results A total of 382 patients including 226 (59.2%) patients who received systemic corticosteroids and 156 (40.8%) patients with standard treatment were analyzed. The maximum dose of corticosteroids was 80.0 (IQR 40.0–80.0) mg equivalent methylprednisolone per day, and duration of corticosteroid treatment was 7.0 (4.0–12.0) days in total. In Cox regression analysis using corticosteroid treatment as a time-varying variable, corticosteroid treatment was associated with a significant reduction in risk of in-hospital death within 60 days (HR, 0.48; 95% CI, 0.25, 0.93; p = 0.0285). The association remained significantly after adjusting for age, sex, Sequential Organ Failure Assessment score at hospital admission, propensity score of corticosteroid treatment, and comorbidities (HR: 0.51; CI: 0.27, 0.99; p = 0.0471). Corticosteroids were not associated with delayed viral RNA clearance in our cohort. Conclusion In this clinical practice setting, low-to-moderate dose corticosteroid treatment was associated with reduced risk of death in COVID-19 patients who developed ARDS.

scholarly journals Postpartum Depression and Subsequent Autoimmune Diseases in Taiwan

2018 ◽  
Vol 15 (8) ◽  
pp. 1783 ◽  
Author(s):  
Chien-Yu Lin ◽  
Cheng-Kai Li ◽  
Jui-Ming Liu ◽  
Ren-Jun Hsu ◽  
Heng-Chang Chuang ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Postpartum Depression ◽  
Autoimmune Diseases ◽  
Pernicious Anemia ◽  
Cox Regression ◽  
Population Based ◽  
Control Group ◽  
Graves Disease ◽  
Research Database ◽  
Cox Regression Analysis

Postpartum depression (PPD) is one of the most common examples of postnatal morbidity, but the subsequent risks of autoimmune diseases in patients with PPD have yet to be fully investigated. This nationwide population-based study utilized data of the National Health Insurance Research Database of Taiwan for the period from 1996 to 2013. In total, 45,451 women with primiparity were identified. Among them, 542 patients with PPD were enrolled as a study group while 2165 matched patients without PPD were enrolled as a control group. The demographic characteristics and comorbidities of the patients were analyzed, and Cox regression analysis was applied to calculate the hazard ratios for the risk of autoimmune diseases. Of the 2707 women enrolled in this study, 469 (17.3%) patients with newly diagnosed autoimmune diseases were identified, including 123 (22.7%) in the PPD group and 346 (16%) in the non-PPD group. After adjusting for confounding factors, it was determined that the patients with PPD had a significantly higher risk of subsequent autoimmune diseases (adjusted hazard ratio (aHR): 1.61, 95% confidence interval (CI): 1.30–1.99; p < 0.001). Specifically, increased risks of pernicious anemia (aHR: 3.85, 95% CI: 2.06–7.22), rheumatoid arthritis (aHR: 2.62, 95% CI: 1.28–5.39), and Graves’ disease (aHR: 1.57, 95% CI: 1.05–2.33) were observed in the PPD group. This study demonstrated that patients with PPD have higher risks of subsequent autoimmune diseases, especially pernicious anemia, rheumatoid arthritis, and Graves’ disease. This useful information provides physicians with clues regarding the associations between autoimmune diseases and PPD.

Sign in / Sign up

Export Citation Format

Share Document