The Periodontitis and Vascular Events (PAVE) Pilot Study: Adverse Events

Background: During the last 15 years, a substantial number of population‐based, clinical, laboratory, and animal studies have been published that reported findings on the relationship between periodontal disease and cardiovascular disease. The Periodontitis and Vascular Events (PAVE) pilot study was...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Journal of periodontology (1970) 2008-01, Vol.79 (1), p.90-96
Hauptverfasser: Beck, James D., Couper, David J., Falkner, Karen L., Graham, Susan P., Grossi, Sara G., Gunsolley, John C., Madden, Theresa, Maupome, Gerardo, Offenbacher, Steven, Stewart, Dawn D., Trevisan, Maurizio, Van Dyke, Thomas E., Genco, Robert J.
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 96
container_issue 1
container_start_page 90
container_title Journal of periodontology (1970)
container_volume 79
creator Beck, James D.
Couper, David J.
Falkner, Karen L.
Graham, Susan P.
Grossi, Sara G.
Gunsolley, John C.
Madden, Theresa
Maupome, Gerardo
Offenbacher, Steven
Stewart, Dawn D.
Trevisan, Maurizio
Van Dyke, Thomas E.
Genco, Robert J.
description Background: During the last 15 years, a substantial number of population‐based, clinical, laboratory, and animal studies have been published that reported findings on the relationship between periodontal disease and cardiovascular disease. The Periodontitis and Vascular Events (PAVE) pilot study was conducted to investigate the feasibility of a randomized secondary prevention trial to test whether treatment of periodontal disease reduces the risk for cardiovascular disease. This article describes the occurrence of adverse events during the pilot study. Methods: The PAVE pilot study was a multicenter, randomized trial comparing periodontal therapy to community dental care. Baseline and follow‐up clinic visits included a periodontal examination; blood, subgingival plaque, and crevicular fluid specimen collection; and medical and dental histories. Telephone follow‐up contacts were scheduled to occur 3 months after randomization and every 6 months thereafter to assess adverse events or endpoints. Results: Cardiovascular adverse events occurred with similar frequency (23 versus 24 [P = 0.85] in the community control and the treatment groups, respectively). There were 15 serious adverse events (SAEs) with a non‐significantly higher percentage occurring in the community care group (6.6% versus 3.3%; P = 0.19). A time‐to‐event analysis of patterns of SAEs indicated that subjects in the periodontal therapy group tended to be less likely to experience an SAE over the entire 25 months of the study. Conclusion: For those individuals who remained in the study, it appears that provision of periodontal scaling and root planing treatment to individuals with heart disease resulted in a similar pattern of adverse events as seen in the community care group, which also received some treatment.
doi_str_mv 10.1902/jop.2008.070223
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_70171421</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>70171421</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4370-d2df421670a7d80e93890983e4479aa43e8e439fca9304bffe68d16ef58d12353</originalsourceid><addsrcrecordid>eNqFkE1Lw0AQhhdRtH6cvUkuih7Szn40m_VWpFqlYNHa67LNTjCSJnU3Ufrv3dKgR0_DDM-8MzyEnFPoUwVs8FGv-wwg7YMExvge6VEleMwTCfukB2EWc6HYETn2_iO0VHA4JEc0pUkCSvbIZP6O0QxdUdu6aoqm8JGpbLQwPmtL46LxF1aNj65no8X4JpoVZd1Er01rN7fRyH6h89ghp-QgN6XHs66ekLf78fxuEk-fHx7vRtM4E1xCbJnNBaPhPyNtCqh4qkClHIWQyhjBMUXBVZ4ZxUEs8xyT1NIE82EojA_5Cbna5a5d_dmib_Sq8BmWpamwbr2WQCUNFwI42IGZq713mOu1K1bGbTQFvZWngzy9lad38sLGRRfdLldo__jOVgAuOyDoMWXuTJUV_pcLWUPJ0i033HHfRYmb_-7qp9n4BUAB_wHNeoWo</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>70171421</pqid></control><display><type>article</type><title>The Periodontitis and Vascular Events (PAVE) Pilot Study: Adverse Events</title><source>MEDLINE</source><source>Wiley Online Library All Journals</source><creator>Beck, James D. ; Couper, David J. ; Falkner, Karen L. ; Graham, Susan P. ; Grossi, Sara G. ; Gunsolley, John C. ; Madden, Theresa ; Maupome, Gerardo ; Offenbacher, Steven ; Stewart, Dawn D. ; Trevisan, Maurizio ; Van Dyke, Thomas E. ; Genco, Robert J.</creator><creatorcontrib>Beck, James D. ; Couper, David J. ; Falkner, Karen L. ; Graham, Susan P. ; Grossi, Sara G. ; Gunsolley, John C. ; Madden, Theresa ; Maupome, Gerardo ; Offenbacher, Steven ; Stewart, Dawn D. ; Trevisan, Maurizio ; Van Dyke, Thomas E. ; Genco, Robert J.</creatorcontrib><description>Background: During the last 15 years, a substantial number of population‐based, clinical, laboratory, and animal studies have been published that reported findings on the relationship between periodontal disease and cardiovascular disease. The Periodontitis and Vascular Events (PAVE) pilot study was conducted to investigate the feasibility of a randomized secondary prevention trial to test whether treatment of periodontal disease reduces the risk for cardiovascular disease. This article describes the occurrence of adverse events during the pilot study. Methods: The PAVE pilot study was a multicenter, randomized trial comparing periodontal therapy to community dental care. Baseline and follow‐up clinic visits included a periodontal examination; blood, subgingival plaque, and crevicular fluid specimen collection; and medical and dental histories. Telephone follow‐up contacts were scheduled to occur 3 months after randomization and every 6 months thereafter to assess adverse events or endpoints. Results: Cardiovascular adverse events occurred with similar frequency (23 versus 24 [P = 0.85] in the community control and the treatment groups, respectively). There were 15 serious adverse events (SAEs) with a non‐significantly higher percentage occurring in the community care group (6.6% versus 3.3%; P = 0.19). A time‐to‐event analysis of patterns of SAEs indicated that subjects in the periodontal therapy group tended to be less likely to experience an SAE over the entire 25 months of the study. Conclusion: For those individuals who remained in the study, it appears that provision of periodontal scaling and root planing treatment to individuals with heart disease resulted in a similar pattern of adverse events as seen in the community care group, which also received some treatment.</description><identifier>ISSN: 0022-3492</identifier><identifier>EISSN: 1943-3670</identifier><identifier>DOI: 10.1902/jop.2008.070223</identifier><identifier>PMID: 18166097</identifier><language>eng</language><publisher>Chicago, IL: American Academy of Periodontology</publisher><subject>Abscess - etiology ; Biological and medical sciences ; Cardiovascular disease ; Community Health Services ; Community-Acquired Infections - etiology ; controlled clinical trial ; Coronary Artery Disease - blood ; Coronary Artery Disease - complications ; Coronary Artery Disease - prevention &amp; control ; Dental Care ; Dental Plaque Index ; Dental Scaling ; Dentistry ; Depression - etiology ; Facial bones, jaws, teeth, parodontium: diseases, semeiology ; Feasibility Studies ; Female ; Follow-Up Studies ; Gingival Crevicular Fluid - chemistry ; Humans ; Hypertension - etiology ; Male ; Medical sciences ; Middle Aged ; Non tumoral diseases ; Oral Hygiene ; Otorhinolaryngology. Stomatology ; periodontal disease ; Periodontitis - blood ; Periodontitis - complications ; Periodontitis - prevention &amp; control ; Pilot Projects ; pilot study ; Pneumonia - etiology ; Root Planing ; Subgingival Curettage ; subgingival scaling ; Tooth Diseases - etiology ; Treatment Outcome</subject><ispartof>Journal of periodontology (1970), 2008-01, Vol.79 (1), p.90-96</ispartof><rights>2008 American Academy of Periodontology</rights><rights>2008 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4370-d2df421670a7d80e93890983e4479aa43e8e439fca9304bffe68d16ef58d12353</citedby><cites>FETCH-LOGICAL-c4370-d2df421670a7d80e93890983e4479aa43e8e439fca9304bffe68d16ef58d12353</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1902%2Fjop.2008.070223$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1902%2Fjop.2008.070223$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,4022,27922,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=20057287$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18166097$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Beck, James D.</creatorcontrib><creatorcontrib>Couper, David J.</creatorcontrib><creatorcontrib>Falkner, Karen L.</creatorcontrib><creatorcontrib>Graham, Susan P.</creatorcontrib><creatorcontrib>Grossi, Sara G.</creatorcontrib><creatorcontrib>Gunsolley, John C.</creatorcontrib><creatorcontrib>Madden, Theresa</creatorcontrib><creatorcontrib>Maupome, Gerardo</creatorcontrib><creatorcontrib>Offenbacher, Steven</creatorcontrib><creatorcontrib>Stewart, Dawn D.</creatorcontrib><creatorcontrib>Trevisan, Maurizio</creatorcontrib><creatorcontrib>Van Dyke, Thomas E.</creatorcontrib><creatorcontrib>Genco, Robert J.</creatorcontrib><title>The Periodontitis and Vascular Events (PAVE) Pilot Study: Adverse Events</title><title>Journal of periodontology (1970)</title><addtitle>J Periodontol</addtitle><description>Background: During the last 15 years, a substantial number of population‐based, clinical, laboratory, and animal studies have been published that reported findings on the relationship between periodontal disease and cardiovascular disease. The Periodontitis and Vascular Events (PAVE) pilot study was conducted to investigate the feasibility of a randomized secondary prevention trial to test whether treatment of periodontal disease reduces the risk for cardiovascular disease. This article describes the occurrence of adverse events during the pilot study. Methods: The PAVE pilot study was a multicenter, randomized trial comparing periodontal therapy to community dental care. Baseline and follow‐up clinic visits included a periodontal examination; blood, subgingival plaque, and crevicular fluid specimen collection; and medical and dental histories. Telephone follow‐up contacts were scheduled to occur 3 months after randomization and every 6 months thereafter to assess adverse events or endpoints. Results: Cardiovascular adverse events occurred with similar frequency (23 versus 24 [P = 0.85] in the community control and the treatment groups, respectively). There were 15 serious adverse events (SAEs) with a non‐significantly higher percentage occurring in the community care group (6.6% versus 3.3%; P = 0.19). A time‐to‐event analysis of patterns of SAEs indicated that subjects in the periodontal therapy group tended to be less likely to experience an SAE over the entire 25 months of the study. Conclusion: For those individuals who remained in the study, it appears that provision of periodontal scaling and root planing treatment to individuals with heart disease resulted in a similar pattern of adverse events as seen in the community care group, which also received some treatment.</description><subject>Abscess - etiology</subject><subject>Biological and medical sciences</subject><subject>Cardiovascular disease</subject><subject>Community Health Services</subject><subject>Community-Acquired Infections - etiology</subject><subject>controlled clinical trial</subject><subject>Coronary Artery Disease - blood</subject><subject>Coronary Artery Disease - complications</subject><subject>Coronary Artery Disease - prevention &amp; control</subject><subject>Dental Care</subject><subject>Dental Plaque Index</subject><subject>Dental Scaling</subject><subject>Dentistry</subject><subject>Depression - etiology</subject><subject>Facial bones, jaws, teeth, parodontium: diseases, semeiology</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gingival Crevicular Fluid - chemistry</subject><subject>Humans</subject><subject>Hypertension - etiology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Non tumoral diseases</subject><subject>Oral Hygiene</subject><subject>Otorhinolaryngology. Stomatology</subject><subject>periodontal disease</subject><subject>Periodontitis - blood</subject><subject>Periodontitis - complications</subject><subject>Periodontitis - prevention &amp; control</subject><subject>Pilot Projects</subject><subject>pilot study</subject><subject>Pneumonia - etiology</subject><subject>Root Planing</subject><subject>Subgingival Curettage</subject><subject>subgingival scaling</subject><subject>Tooth Diseases - etiology</subject><subject>Treatment Outcome</subject><issn>0022-3492</issn><issn>1943-3670</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1Lw0AQhhdRtH6cvUkuih7Szn40m_VWpFqlYNHa67LNTjCSJnU3Ufrv3dKgR0_DDM-8MzyEnFPoUwVs8FGv-wwg7YMExvge6VEleMwTCfukB2EWc6HYETn2_iO0VHA4JEc0pUkCSvbIZP6O0QxdUdu6aoqm8JGpbLQwPmtL46LxF1aNj65no8X4JpoVZd1Er01rN7fRyH6h89ghp-QgN6XHs66ekLf78fxuEk-fHx7vRtM4E1xCbJnNBaPhPyNtCqh4qkClHIWQyhjBMUXBVZ4ZxUEs8xyT1NIE82EojA_5Cbna5a5d_dmib_Sq8BmWpamwbr2WQCUNFwI42IGZq713mOu1K1bGbTQFvZWngzy9lad38sLGRRfdLldo__jOVgAuOyDoMWXuTJUV_pcLWUPJ0i033HHfRYmb_-7qp9n4BUAB_wHNeoWo</recordid><startdate>200801</startdate><enddate>200801</enddate><creator>Beck, James D.</creator><creator>Couper, David J.</creator><creator>Falkner, Karen L.</creator><creator>Graham, Susan P.</creator><creator>Grossi, Sara G.</creator><creator>Gunsolley, John C.</creator><creator>Madden, Theresa</creator><creator>Maupome, Gerardo</creator><creator>Offenbacher, Steven</creator><creator>Stewart, Dawn D.</creator><creator>Trevisan, Maurizio</creator><creator>Van Dyke, Thomas E.</creator><creator>Genco, Robert J.</creator><general>American Academy of Periodontology</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>7X8</scope></search><sort><creationdate>200801</creationdate><title>The Periodontitis and Vascular Events (PAVE) Pilot Study: Adverse Events</title><author>Beck, James D. ; Couper, David J. ; Falkner, Karen L. ; Graham, Susan P. ; Grossi, Sara G. ; Gunsolley, John C. ; Madden, Theresa ; Maupome, Gerardo ; Offenbacher, Steven ; Stewart, Dawn D. ; Trevisan, Maurizio ; Van Dyke, Thomas E. ; Genco, Robert J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4370-d2df421670a7d80e93890983e4479aa43e8e439fca9304bffe68d16ef58d12353</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Abscess - etiology</topic><topic>Biological and medical sciences</topic><topic>Cardiovascular disease</topic><topic>Community Health Services</topic><topic>Community-Acquired Infections - etiology</topic><topic>controlled clinical trial</topic><topic>Coronary Artery Disease - blood</topic><topic>Coronary Artery Disease - complications</topic><topic>Coronary Artery Disease - prevention &amp; control</topic><topic>Dental Care</topic><topic>Dental Plaque Index</topic><topic>Dental Scaling</topic><topic>Dentistry</topic><topic>Depression - etiology</topic><topic>Facial bones, jaws, teeth, parodontium: diseases, semeiology</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gingival Crevicular Fluid - chemistry</topic><topic>Humans</topic><topic>Hypertension - etiology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Non tumoral diseases</topic><topic>Oral Hygiene</topic><topic>Otorhinolaryngology. Stomatology</topic><topic>periodontal disease</topic><topic>Periodontitis - blood</topic><topic>Periodontitis - complications</topic><topic>Periodontitis - prevention &amp; control</topic><topic>Pilot Projects</topic><topic>pilot study</topic><topic>Pneumonia - etiology</topic><topic>Root Planing</topic><topic>Subgingival Curettage</topic><topic>subgingival scaling</topic><topic>Tooth Diseases - etiology</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Beck, James D.</creatorcontrib><creatorcontrib>Couper, David J.</creatorcontrib><creatorcontrib>Falkner, Karen L.</creatorcontrib><creatorcontrib>Graham, Susan P.</creatorcontrib><creatorcontrib>Grossi, Sara G.</creatorcontrib><creatorcontrib>Gunsolley, John C.</creatorcontrib><creatorcontrib>Madden, Theresa</creatorcontrib><creatorcontrib>Maupome, Gerardo</creatorcontrib><creatorcontrib>Offenbacher, Steven</creatorcontrib><creatorcontrib>Stewart, Dawn D.</creatorcontrib><creatorcontrib>Trevisan, Maurizio</creatorcontrib><creatorcontrib>Van Dyke, Thomas E.</creatorcontrib><creatorcontrib>Genco, Robert 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>MEDLINE - Academic</collection><jtitle>Journal of periodontology (1970)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Beck, James D.</au><au>Couper, David J.</au><au>Falkner, Karen L.</au><au>Graham, Susan P.</au><au>Grossi, Sara G.</au><au>Gunsolley, John C.</au><au>Madden, Theresa</au><au>Maupome, Gerardo</au><au>Offenbacher, Steven</au><au>Stewart, Dawn D.</au><au>Trevisan, Maurizio</au><au>Van Dyke, Thomas E.</au><au>Genco, Robert J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Periodontitis and Vascular Events (PAVE) Pilot Study: Adverse Events</atitle><jtitle>Journal of periodontology (1970)</jtitle><addtitle>J Periodontol</addtitle><date>2008-01</date><risdate>2008</risdate><volume>79</volume><issue>1</issue><spage>90</spage><epage>96</epage><pages>90-96</pages><issn>0022-3492</issn><eissn>1943-3670</eissn><abstract>Background: During the last 15 years, a substantial number of population‐based, clinical, laboratory, and animal studies have been published that reported findings on the relationship between periodontal disease and cardiovascular disease. The Periodontitis and Vascular Events (PAVE) pilot study was conducted to investigate the feasibility of a randomized secondary prevention trial to test whether treatment of periodontal disease reduces the risk for cardiovascular disease. This article describes the occurrence of adverse events during the pilot study. Methods: The PAVE pilot study was a multicenter, randomized trial comparing periodontal therapy to community dental care. Baseline and follow‐up clinic visits included a periodontal examination; blood, subgingival plaque, and crevicular fluid specimen collection; and medical and dental histories. Telephone follow‐up contacts were scheduled to occur 3 months after randomization and every 6 months thereafter to assess adverse events or endpoints. Results: Cardiovascular adverse events occurred with similar frequency (23 versus 24 [P = 0.85] in the community control and the treatment groups, respectively). There were 15 serious adverse events (SAEs) with a non‐significantly higher percentage occurring in the community care group (6.6% versus 3.3%; P = 0.19). A time‐to‐event analysis of patterns of SAEs indicated that subjects in the periodontal therapy group tended to be less likely to experience an SAE over the entire 25 months of the study. Conclusion: For those individuals who remained in the study, it appears that provision of periodontal scaling and root planing treatment to individuals with heart disease resulted in a similar pattern of adverse events as seen in the community care group, which also received some treatment.</abstract><cop>Chicago, IL</cop><pub>American Academy of Periodontology</pub><pmid>18166097</pmid><doi>10.1902/jop.2008.070223</doi><tpages>7</tpages></addata></record>
fulltext fulltext
identifier ISSN: 0022-3492
ispartof Journal of periodontology (1970), 2008-01, Vol.79 (1), p.90-96
issn 0022-3492
1943-3670
language eng
recordid cdi_proquest_miscellaneous_70171421
source MEDLINE; Wiley Online Library All Journals
subjects Abscess - etiology
Biological and medical sciences
Cardiovascular disease
Community Health Services
Community-Acquired Infections - etiology
controlled clinical trial
Coronary Artery Disease - blood
Coronary Artery Disease - complications
Coronary Artery Disease - prevention & control
Dental Care
Dental Plaque Index
Dental Scaling
Dentistry
Depression - etiology
Facial bones, jaws, teeth, parodontium: diseases, semeiology
Feasibility Studies
Female
Follow-Up Studies
Gingival Crevicular Fluid - chemistry
Humans
Hypertension - etiology
Male
Medical sciences
Middle Aged
Non tumoral diseases
Oral Hygiene
Otorhinolaryngology. Stomatology
periodontal disease
Periodontitis - blood
Periodontitis - complications
Periodontitis - prevention & control
Pilot Projects
pilot study
Pneumonia - etiology
Root Planing
Subgingival Curettage
subgingival scaling
Tooth Diseases - etiology
Treatment Outcome
title The Periodontitis and Vascular Events (PAVE) Pilot Study: Adverse Events
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-12T22%3A25%3A52IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20Periodontitis%20and%20Vascular%20Events%20(PAVE)%20Pilot%20Study:%20Adverse%20Events&rft.jtitle=Journal%20of%20periodontology%20(1970)&rft.au=Beck,%20James%20D.&rft.date=2008-01&rft.volume=79&rft.issue=1&rft.spage=90&rft.epage=96&rft.pages=90-96&rft.issn=0022-3492&rft.eissn=1943-3670&rft_id=info:doi/10.1902/jop.2008.070223&rft_dat=%3Cproquest_cross%3E70171421%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=70171421&rft_id=info:pmid/18166097&rfr_iscdi=true