Switching treatment-resistant patients with schizophrenia or schizoaffective disorder to olanzapine: a one-year open-label study with five-year follow-up
Objective: To determine whether patients with treatment-resistant schizophrenia or schizoaffective disorder would respond when switched to olanzapine and whether they could maintain their response on this atypical anti psychotic. Research design and methods: In this single-center, observational, 1-y...
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| Veröffentlicht in: | Current medical research and opinion 2003, Vol.19 (6), p.473-480 |
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| creator | Karagianis, James L. LeDrew, Kellie K. Walker, Daniel J. |
| description | Objective: To determine whether patients with treatment-resistant schizophrenia or schizoaffective disorder would respond when switched to olanzapine and whether they could maintain their response on this atypical anti psychotic.
Research design and methods: In this single-center, observational, 1-year open-label study, a cohort of patients was switched to olanzapine due to failure on previous treatment. The patients were followed up (retrospectively) for an additional 5 years. Patients had schizophrenia or schizoaffective disorder and all but one were treatment-resistant. The starting dose was 10 mg/day, with dosage adjustments based on physician judgment.
Main outcome measures: The CGI-S and CGI-I scales were the primary outcome measures. During the observation period, positive and negative symptoms, hospital readmission rates and duration of hospitalization were measured, and treatment-emergent adverse events recorded.
Results: Mean age of patients (n = 25) was 39.7 years; 19 were male, and all were Caucasian. The mean number of antipsychotics used prior to olanzapine was 4.6 with risperidone (76%) being the most common. The mean duration of olanzapine therapy was 8.6 months. The average number of hospital admissions per patient dropped from 1.32 during the year prior to olanzapine therapy to 0.39 after starting olanzapine. Total number of hospital days was 1042 the year before and 258 the year after olanzapine treatment. The mean CGI-S score improved from markedly ill at baseline to borderline/mildly ill at study end. The mean CGI-I score was rated much improved at study end. Few adverse events occurred during the study. Twelve patients remained on olanzapine monotherapy after 5 years of treatment (mean duration of 62 months).
Conclusions: Olanzapine may be a treatment option for patients who fail to respond to treatment with other antipsychotics. Importantly, this is one of the first reports showing that patients with schizophrenia can be maintained on atypical antipsychotic monotherapy for at least 5 years. |
| doi_str_mv | 10.1185/030079903125002108 |
| format | Article |
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Research design and methods: In this single-center, observational, 1-year open-label study, a cohort of patients was switched to olanzapine due to failure on previous treatment. The patients were followed up (retrospectively) for an additional 5 years. Patients had schizophrenia or schizoaffective disorder and all but one were treatment-resistant. The starting dose was 10 mg/day, with dosage adjustments based on physician judgment.
Main outcome measures: The CGI-S and CGI-I scales were the primary outcome measures. During the observation period, positive and negative symptoms, hospital readmission rates and duration of hospitalization were measured, and treatment-emergent adverse events recorded.
Results: Mean age of patients (n = 25) was 39.7 years; 19 were male, and all were Caucasian. The mean number of antipsychotics used prior to olanzapine was 4.6 with risperidone (76%) being the most common. The mean duration of olanzapine therapy was 8.6 months. The average number of hospital admissions per patient dropped from 1.32 during the year prior to olanzapine therapy to 0.39 after starting olanzapine. Total number of hospital days was 1042 the year before and 258 the year after olanzapine treatment. The mean CGI-S score improved from markedly ill at baseline to borderline/mildly ill at study end. The mean CGI-I score was rated much improved at study end. Few adverse events occurred during the study. Twelve patients remained on olanzapine monotherapy after 5 years of treatment (mean duration of 62 months).
Conclusions: Olanzapine may be a treatment option for patients who fail to respond to treatment with other antipsychotics. Importantly, this is one of the first reports showing that patients with schizophrenia can be maintained on atypical antipsychotic monotherapy for at least 5 years.</description><identifier>ISSN: 0300-7995</identifier><identifier>EISSN: 1473-4877</identifier><identifier>DOI: 10.1185/030079903125002108</identifier><identifier>PMID: 14594518</identifier><identifier>CODEN: CMROCX</identifier><language>eng</language><publisher>Reading: Informa UK Ltd</publisher><subject>Adult ; Antipsychotic Agents - adverse effects ; Antipsychotic Agents - therapeutic use ; Atypical antipsychotics ; Benzodiazepines ; Biological and medical sciences ; Female ; Follow-Up Studies ; Hospitalization ; Humans ; Long-term therapy ; Male ; Medical sciences ; Neuropharmacology ; Olanzapine ; Pharmacology. Drug treatments ; Pirenzepine - adverse effects ; Pirenzepine - analogs & derivatives ; Pirenzepine - therapeutic use ; Psycholeptics: tranquillizer, neuroleptic ; Psychology. Psychoanalysis. Psychiatry ; Psychopharmacology ; Psychotic Disorders - drug therapy ; Schizoaffective disorder ; Schizophrenia ; Schizophrenia - drug therapy ; Severity of Illness Index ; Treatment Outcome ; Treatment-resistant patients</subject><ispartof>Current medical research and opinion, 2003, Vol.19 (6), p.473-480</ispartof><rights>2003 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted 2003</rights><rights>2004 INIST-CNRS</rights><rights>Copyright Librapharm 2003</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c463t-26f7fbb7ca38a3ef7a089d3b7f11ef0550d842a6274a800d6d0d17c980051f5b3</citedby><cites>FETCH-LOGICAL-c463t-26f7fbb7ca38a3ef7a089d3b7f11ef0550d842a6274a800d6d0d17c980051f5b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.tandfonline.com/doi/pdf/10.1185/030079903125002108$$EPDF$$P50$$Ginformahealthcare$$H</linktopdf><linktohtml>$$Uhttps://www.tandfonline.com/doi/full/10.1185/030079903125002108$$EHTML$$P50$$Ginformahealthcare$$H</linktohtml><link.rule.ids>314,776,780,4010,27900,27901,27902,59620,59726,60409,60515,61194,61229,61375,61410</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15113925$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14594518$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Karagianis, James L.</creatorcontrib><creatorcontrib>LeDrew, Kellie K.</creatorcontrib><creatorcontrib>Walker, Daniel J.</creatorcontrib><title>Switching treatment-resistant patients with schizophrenia or schizoaffective disorder to olanzapine: a one-year open-label study with five-year follow-up</title><title>Current medical research and opinion</title><addtitle>Curr Med Res Opin</addtitle><description>Objective: To determine whether patients with treatment-resistant schizophrenia or schizoaffective disorder would respond when switched to olanzapine and whether they could maintain their response on this atypical anti psychotic.
Research design and methods: In this single-center, observational, 1-year open-label study, a cohort of patients was switched to olanzapine due to failure on previous treatment. The patients were followed up (retrospectively) for an additional 5 years. Patients had schizophrenia or schizoaffective disorder and all but one were treatment-resistant. The starting dose was 10 mg/day, with dosage adjustments based on physician judgment.
Main outcome measures: The CGI-S and CGI-I scales were the primary outcome measures. During the observation period, positive and negative symptoms, hospital readmission rates and duration of hospitalization were measured, and treatment-emergent adverse events recorded.
Results: Mean age of patients (n = 25) was 39.7 years; 19 were male, and all were Caucasian. The mean number of antipsychotics used prior to olanzapine was 4.6 with risperidone (76%) being the most common. The mean duration of olanzapine therapy was 8.6 months. The average number of hospital admissions per patient dropped from 1.32 during the year prior to olanzapine therapy to 0.39 after starting olanzapine. Total number of hospital days was 1042 the year before and 258 the year after olanzapine treatment. The mean CGI-S score improved from markedly ill at baseline to borderline/mildly ill at study end. The mean CGI-I score was rated much improved at study end. Few adverse events occurred during the study. Twelve patients remained on olanzapine monotherapy after 5 years of treatment (mean duration of 62 months).
Conclusions: Olanzapine may be a treatment option for patients who fail to respond to treatment with other antipsychotics. Importantly, this is one of the first reports showing that patients with schizophrenia can be maintained on atypical antipsychotic monotherapy for at least 5 years.</description><subject>Adult</subject><subject>Antipsychotic Agents - adverse effects</subject><subject>Antipsychotic Agents - therapeutic use</subject><subject>Atypical antipsychotics</subject><subject>Benzodiazepines</subject><subject>Biological and medical sciences</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Long-term therapy</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Neuropharmacology</subject><subject>Olanzapine</subject><subject>Pharmacology. Drug treatments</subject><subject>Pirenzepine - adverse effects</subject><subject>Pirenzepine - analogs & derivatives</subject><subject>Pirenzepine - therapeutic use</subject><subject>Psycholeptics: tranquillizer, neuroleptic</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopharmacology</subject><subject>Psychotic Disorders - drug therapy</subject><subject>Schizoaffective disorder</subject><subject>Schizophrenia</subject><subject>Schizophrenia - drug therapy</subject><subject>Severity of Illness Index</subject><subject>Treatment Outcome</subject><subject>Treatment-resistant patients</subject><issn>0300-7995</issn><issn>1473-4877</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kd2K1TAQgIMo7nH1BbyQIHhZTZqmSUUvZPEPFrxQr8u0SWyWnKQmqYezb-LbmkMrBxH2KmHyfTOTGYSeUvKSUslfEUaI6DrCaM0JqSmR99CONoJVjRTiPtqdgKoQ_AI9SumGEFrLrnuILmjDu4ZTuUO_vx5sHifrf-AcNeS99rmKOtmUwWc8Q7YlknChJpwKeBvmKWpvAYe4BcAYPWb7S2NlU4hKR5wDDg78LczW69e4wF5XRw0Rh1n7ysGgHU55Ucc1syn2-m6Cc-FQLfNj9MCAS_rJdl6i7x_ef7v6VF1_-fj56t11NTYty1XdGmGGQYzAJDBtBBDZKTYIQ6k2hHOiZFNDW4sGJCGqVURRMXblzqnhA7tEz9e8cww_F51yfxOW6EvJvi7jbVtJeIHqFRpjSClq08_R7iEee0r60zL6_5dRpGdb5mXYa3VWtukX4MUGQBrBmQh-tOnMcUpZV5-qv105602IeziE6FSf4ehC_CuxOxt5848_aXB5GiHq81_v0P8Atme6vw</recordid><startdate>2003</startdate><enddate>2003</enddate><creator>Karagianis, James L.</creator><creator>LeDrew, Kellie K.</creator><creator>Walker, Daniel J.</creator><general>Informa UK Ltd</general><general>Taylor & Francis</general><general>Librapharm</general><general>Informa Healthcare</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope></search><sort><creationdate>2003</creationdate><title>Switching treatment-resistant patients with schizophrenia or schizoaffective disorder to olanzapine: a one-year open-label study with five-year follow-up</title><author>Karagianis, James L. ; LeDrew, Kellie K. ; Walker, Daniel J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c463t-26f7fbb7ca38a3ef7a089d3b7f11ef0550d842a6274a800d6d0d17c980051f5b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Adult</topic><topic>Antipsychotic Agents - adverse effects</topic><topic>Antipsychotic Agents - therapeutic use</topic><topic>Atypical antipsychotics</topic><topic>Benzodiazepines</topic><topic>Biological and medical sciences</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Long-term therapy</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Neuropharmacology</topic><topic>Olanzapine</topic><topic>Pharmacology. Drug treatments</topic><topic>Pirenzepine - adverse effects</topic><topic>Pirenzepine - analogs & derivatives</topic><topic>Pirenzepine - therapeutic use</topic><topic>Psycholeptics: tranquillizer, neuroleptic</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopharmacology</topic><topic>Psychotic Disorders - drug therapy</topic><topic>Schizoaffective disorder</topic><topic>Schizophrenia</topic><topic>Schizophrenia - drug therapy</topic><topic>Severity of Illness Index</topic><topic>Treatment Outcome</topic><topic>Treatment-resistant patients</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Karagianis, James L.</creatorcontrib><creatorcontrib>LeDrew, Kellie K.</creatorcontrib><creatorcontrib>Walker, Daniel J.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><jtitle>Current medical research and opinion</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Karagianis, James L.</au><au>LeDrew, Kellie K.</au><au>Walker, Daniel J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Switching treatment-resistant patients with schizophrenia or schizoaffective disorder to olanzapine: a one-year open-label study with five-year follow-up</atitle><jtitle>Current medical research and opinion</jtitle><addtitle>Curr Med Res Opin</addtitle><date>2003</date><risdate>2003</risdate><volume>19</volume><issue>6</issue><spage>473</spage><epage>480</epage><pages>473-480</pages><issn>0300-7995</issn><eissn>1473-4877</eissn><coden>CMROCX</coden><abstract>Objective: To determine whether patients with treatment-resistant schizophrenia or schizoaffective disorder would respond when switched to olanzapine and whether they could maintain their response on this atypical anti psychotic.
Research design and methods: In this single-center, observational, 1-year open-label study, a cohort of patients was switched to olanzapine due to failure on previous treatment. The patients were followed up (retrospectively) for an additional 5 years. Patients had schizophrenia or schizoaffective disorder and all but one were treatment-resistant. The starting dose was 10 mg/day, with dosage adjustments based on physician judgment.
Main outcome measures: The CGI-S and CGI-I scales were the primary outcome measures. During the observation period, positive and negative symptoms, hospital readmission rates and duration of hospitalization were measured, and treatment-emergent adverse events recorded.
Results: Mean age of patients (n = 25) was 39.7 years; 19 were male, and all were Caucasian. The mean number of antipsychotics used prior to olanzapine was 4.6 with risperidone (76%) being the most common. The mean duration of olanzapine therapy was 8.6 months. The average number of hospital admissions per patient dropped from 1.32 during the year prior to olanzapine therapy to 0.39 after starting olanzapine. Total number of hospital days was 1042 the year before and 258 the year after olanzapine treatment. The mean CGI-S score improved from markedly ill at baseline to borderline/mildly ill at study end. The mean CGI-I score was rated much improved at study end. Few adverse events occurred during the study. Twelve patients remained on olanzapine monotherapy after 5 years of treatment (mean duration of 62 months).
Conclusions: Olanzapine may be a treatment option for patients who fail to respond to treatment with other antipsychotics. Importantly, this is one of the first reports showing that patients with schizophrenia can be maintained on atypical antipsychotic monotherapy for at least 5 years.</abstract><cop>Reading</cop><pub>Informa UK Ltd</pub><pmid>14594518</pmid><doi>10.1185/030079903125002108</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Current medical research and opinion, 2003, Vol.19 (6), p.473-480 |
| issn | 0300-7995 1473-4877 |
| language | eng |
| recordid | cdi_crossref_primary_10_1185_030079903125002108 |
| source | MEDLINE; Taylor & Francis Medical Library - CRKN; Taylor & Francis Journals Complete |
| subjects | Adult Antipsychotic Agents - adverse effects Antipsychotic Agents - therapeutic use Atypical antipsychotics Benzodiazepines Biological and medical sciences Female Follow-Up Studies Hospitalization Humans Long-term therapy Male Medical sciences Neuropharmacology Olanzapine Pharmacology. Drug treatments Pirenzepine - adverse effects Pirenzepine - analogs & derivatives Pirenzepine - therapeutic use Psycholeptics: tranquillizer, neuroleptic Psychology. Psychoanalysis. Psychiatry Psychopharmacology Psychotic Disorders - drug therapy Schizoaffective disorder Schizophrenia Schizophrenia - drug therapy Severity of Illness Index Treatment Outcome Treatment-resistant patients |
| title | Switching treatment-resistant patients with schizophrenia or schizoaffective disorder to olanzapine: a one-year open-label study with five-year follow-up |
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