Redefining medical treatment in the management of unstable angina
In 1994, the Agency for Health Care Policy and Research sponsored the development of guidelines for diagnosing and managing patients with unstable angina. Since their publication, several important developments have occurred. The prognostic value of biochemical assays for cardiac-specific troponins...
Gespeichert in:
| Veröffentlicht in: | The American journal of medicine 2000, Vol.108 (1), p.41-53 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 53 |
|---|---|
| container_issue | 1 |
| container_start_page | 41 |
| container_title | The American journal of medicine |
| container_volume | 108 |
| creator | Braunwald, Eugene Califf, Robert M Cannon, Christopher P Fox, Keith A.A Fuster, Valentin Gibler, W.Brian Harrington, Richard A King, Spencer B Kleiman, Neil S Theroux, Pierre Topol, Eric J Van de Werf, Frans White, Harvey D Willerson, James T |
| description | In 1994, the Agency for Health Care Policy and Research sponsored the development of guidelines for diagnosing and managing patients with unstable angina. Since their publication, several important developments have occurred. The prognostic value of biochemical assays for cardiac-specific troponins T and I have been shown in many studies. The possible role for C-reactive protein in determining prognosis deserves further investigation. Substantial clinical benefits have been obtained with intravenous inhibitors of the platelet glycoprotein (GP) IIb-IIIa receptor (abciximab, eptifibatide, tirofiban) and with one of the low-molecular-weight heparins (enoxaparin). The therapeutic potential of other low-molecular-weight heparins, direct thrombin inhibitors, and oral GP IIb-IIIa inhibitors remains to be clarified. On the basis of this evidence, consideration should be given to measuring serum levels of a cardiac troponin (either T or I) and using intravenous GP IIb-IIIa inhibitors and low-molecular-weight heparin in the standard management of patients with unstable angina. |
| doi_str_mv | 10.1016/S0002-9343(99)00416-7 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_72366522</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0002934399004167</els_id><sourcerecordid>52571142</sourcerecordid><originalsourceid>FETCH-LOGICAL-c417t-95197cbdc58e5aee59cda2d8fde6617dc5ffbd04cae3a65f6a5a6fe35f7d27433</originalsourceid><addsrcrecordid>eNqFkVuLFDEQRoMozuzqT1AaEVkfWnPpJJOnZVh2VRgQvDyHmqQyZulOj0m34L83c8EFX3wqqjhfUZwi5AWj7xhl6v1XSilvjejElTFvKe2YavUjsmRSylYzxR-T5V9kQS5Kua8tNVI9JQvGqDRdR5dk_QU9hphi2jUD-uigb6aMMA2YpiamZvqBzQAJdnicjKGZU5lg22MDaRcTPCNPAvQFn5_rJfl-d_vt5mO7-fzh081607qO6ak1khnttt7JFUpAlMZ54H4VPCrFdJ2HsPW0c4AClAwKJKiAQgbtue6EuCRvTnv3efw5Y5nsEIvDvoeE41ys5kIpyXkFX_0D3o9zTvU2ywUXQmkjKyRPkMtjKRmD3ec4QP5tGbUHwfYo2B7sWWPsUbDVNffyvHzeVl8PqbPRCrw-A1CqzJAhuVgeON5xLVjFrk8YVmW_ImZbXMTk6gsyusn6Mf7nkj-3yJc3</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>232336795</pqid></control><display><type>article</type><title>Redefining medical treatment in the management of unstable angina</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><creator>Braunwald, Eugene ; Califf, Robert M ; Cannon, Christopher P ; Fox, Keith A.A ; Fuster, Valentin ; Gibler, W.Brian ; Harrington, Richard A ; King, Spencer B ; Kleiman, Neil S ; Theroux, Pierre ; Topol, Eric J ; Van de Werf, Frans ; White, Harvey D ; Willerson, James T</creator><creatorcontrib>Braunwald, Eugene ; Califf, Robert M ; Cannon, Christopher P ; Fox, Keith A.A ; Fuster, Valentin ; Gibler, W.Brian ; Harrington, Richard A ; King, Spencer B ; Kleiman, Neil S ; Theroux, Pierre ; Topol, Eric J ; Van de Werf, Frans ; White, Harvey D ; Willerson, James T</creatorcontrib><description>In 1994, the Agency for Health Care Policy and Research sponsored the development of guidelines for diagnosing and managing patients with unstable angina. Since their publication, several important developments have occurred. The prognostic value of biochemical assays for cardiac-specific troponins T and I have been shown in many studies. The possible role for C-reactive protein in determining prognosis deserves further investigation. Substantial clinical benefits have been obtained with intravenous inhibitors of the platelet glycoprotein (GP) IIb-IIIa receptor (abciximab, eptifibatide, tirofiban) and with one of the low-molecular-weight heparins (enoxaparin). The therapeutic potential of other low-molecular-weight heparins, direct thrombin inhibitors, and oral GP IIb-IIIa inhibitors remains to be clarified. On the basis of this evidence, consideration should be given to measuring serum levels of a cardiac troponin (either T or I) and using intravenous GP IIb-IIIa inhibitors and low-molecular-weight heparin in the standard management of patients with unstable angina.</description><identifier>ISSN: 0002-9343</identifier><identifier>EISSN: 1555-7162</identifier><identifier>DOI: 10.1016/S0002-9343(99)00416-7</identifier><identifier>PMID: 11059440</identifier><identifier>CODEN: AJMEAZ</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject><![CDATA[Abciximab ; Administration, Oral ; Angina pectoris ; Angina, Unstable - blood ; Angina, Unstable - complications ; Angina, Unstable - drug therapy ; Antibodies, Monoclonal - therapeutic use ; Biological and medical sciences ; C-Reactive Protein - metabolism ; Cardiology. Vascular system ; Coronary heart disease ; Diagnosis, Differential ; Enoxaparin - therapeutic use ; Eptifibatide ; Government Agencies ; Health care ; Heart ; Heparin, Low-Molecular-Weight - administration & dosage ; Heparin, Low-Molecular-Weight - therapeutic use ; Humans ; Immunoglobulin Fab Fragments - therapeutic use ; Infusions, Intravenous ; Medical disorders ; Medical sciences ; Myocardial Infarction - blood ; Myocardial Infarction - etiology ; Myocardial Infarction - prevention & control ; National Institutes of Health (U.S.) ; Peptides - therapeutic use ; Platelet Aggregation Inhibitors - administration & dosage ; Platelet Aggregation Inhibitors - therapeutic use ; Platelet Glycoprotein GPIIb-IIIa Complex - administration & dosage ; Platelet Glycoprotein GPIIb-IIIa Complex - antagonists & inhibitors ; Practice Guidelines as Topic ; Risk ; Time Factors ; Tirofiban ; Troponin I - blood ; Troponin T - blood ; Tyrosine - analogs & derivatives ; Tyrosine - therapeutic use ; United States]]></subject><ispartof>The American journal of medicine, 2000, Vol.108 (1), p.41-53</ispartof><rights>2000 Excerpta Medica Inc.</rights><rights>2000 INIST-CNRS</rights><rights>Copyright Elsevier Sequoia S.A. Jan 2000</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c417t-95197cbdc58e5aee59cda2d8fde6617dc5ffbd04cae3a65f6a5a6fe35f7d27433</citedby><cites>FETCH-LOGICAL-c417t-95197cbdc58e5aee59cda2d8fde6617dc5ffbd04cae3a65f6a5a6fe35f7d27433</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002934399004167$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,4010,27900,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1242731$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11059440$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Braunwald, Eugene</creatorcontrib><creatorcontrib>Califf, Robert M</creatorcontrib><creatorcontrib>Cannon, Christopher P</creatorcontrib><creatorcontrib>Fox, Keith A.A</creatorcontrib><creatorcontrib>Fuster, Valentin</creatorcontrib><creatorcontrib>Gibler, W.Brian</creatorcontrib><creatorcontrib>Harrington, Richard A</creatorcontrib><creatorcontrib>King, Spencer B</creatorcontrib><creatorcontrib>Kleiman, Neil S</creatorcontrib><creatorcontrib>Theroux, Pierre</creatorcontrib><creatorcontrib>Topol, Eric J</creatorcontrib><creatorcontrib>Van de Werf, Frans</creatorcontrib><creatorcontrib>White, Harvey D</creatorcontrib><creatorcontrib>Willerson, James T</creatorcontrib><title>Redefining medical treatment in the management of unstable angina</title><title>The American journal of medicine</title><addtitle>Am J Med</addtitle><description>In 1994, the Agency for Health Care Policy and Research sponsored the development of guidelines for diagnosing and managing patients with unstable angina. Since their publication, several important developments have occurred. The prognostic value of biochemical assays for cardiac-specific troponins T and I have been shown in many studies. The possible role for C-reactive protein in determining prognosis deserves further investigation. Substantial clinical benefits have been obtained with intravenous inhibitors of the platelet glycoprotein (GP) IIb-IIIa receptor (abciximab, eptifibatide, tirofiban) and with one of the low-molecular-weight heparins (enoxaparin). The therapeutic potential of other low-molecular-weight heparins, direct thrombin inhibitors, and oral GP IIb-IIIa inhibitors remains to be clarified. On the basis of this evidence, consideration should be given to measuring serum levels of a cardiac troponin (either T or I) and using intravenous GP IIb-IIIa inhibitors and low-molecular-weight heparin in the standard management of patients with unstable angina.</description><subject>Abciximab</subject><subject>Administration, Oral</subject><subject>Angina pectoris</subject><subject>Angina, Unstable - blood</subject><subject>Angina, Unstable - complications</subject><subject>Angina, Unstable - drug therapy</subject><subject>Antibodies, Monoclonal - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>C-Reactive Protein - metabolism</subject><subject>Cardiology. Vascular system</subject><subject>Coronary heart disease</subject><subject>Diagnosis, Differential</subject><subject>Enoxaparin - therapeutic use</subject><subject>Eptifibatide</subject><subject>Government Agencies</subject><subject>Health care</subject><subject>Heart</subject><subject>Heparin, Low-Molecular-Weight - administration & dosage</subject><subject>Heparin, Low-Molecular-Weight - therapeutic use</subject><subject>Humans</subject><subject>Immunoglobulin Fab Fragments - therapeutic use</subject><subject>Infusions, Intravenous</subject><subject>Medical disorders</subject><subject>Medical sciences</subject><subject>Myocardial Infarction - blood</subject><subject>Myocardial Infarction - etiology</subject><subject>Myocardial Infarction - prevention & control</subject><subject>National Institutes of Health (U.S.)</subject><subject>Peptides - therapeutic use</subject><subject>Platelet Aggregation Inhibitors - administration & dosage</subject><subject>Platelet Aggregation Inhibitors - therapeutic use</subject><subject>Platelet Glycoprotein GPIIb-IIIa Complex - administration & dosage</subject><subject>Platelet Glycoprotein GPIIb-IIIa Complex - antagonists & inhibitors</subject><subject>Practice Guidelines as Topic</subject><subject>Risk</subject><subject>Time Factors</subject><subject>Tirofiban</subject><subject>Troponin I - blood</subject><subject>Troponin T - blood</subject><subject>Tyrosine - analogs & derivatives</subject><subject>Tyrosine - therapeutic use</subject><subject>United States</subject><issn>0002-9343</issn><issn>1555-7162</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkVuLFDEQRoMozuzqT1AaEVkfWnPpJJOnZVh2VRgQvDyHmqQyZulOj0m34L83c8EFX3wqqjhfUZwi5AWj7xhl6v1XSilvjejElTFvKe2YavUjsmRSylYzxR-T5V9kQS5Kua8tNVI9JQvGqDRdR5dk_QU9hphi2jUD-uigb6aMMA2YpiamZvqBzQAJdnicjKGZU5lg22MDaRcTPCNPAvQFn5_rJfl-d_vt5mO7-fzh081607qO6ak1khnttt7JFUpAlMZ54H4VPCrFdJ2HsPW0c4AClAwKJKiAQgbtue6EuCRvTnv3efw5Y5nsEIvDvoeE41ys5kIpyXkFX_0D3o9zTvU2ywUXQmkjKyRPkMtjKRmD3ec4QP5tGbUHwfYo2B7sWWPsUbDVNffyvHzeVl8PqbPRCrw-A1CqzJAhuVgeON5xLVjFrk8YVmW_ImZbXMTk6gsyusn6Mf7nkj-3yJc3</recordid><startdate>2000</startdate><enddate>2000</enddate><creator>Braunwald, Eugene</creator><creator>Califf, Robert M</creator><creator>Cannon, Christopher P</creator><creator>Fox, Keith A.A</creator><creator>Fuster, Valentin</creator><creator>Gibler, W.Brian</creator><creator>Harrington, Richard A</creator><creator>King, Spencer B</creator><creator>Kleiman, Neil S</creator><creator>Theroux, Pierre</creator><creator>Topol, Eric J</creator><creator>Van de Werf, Frans</creator><creator>White, Harvey D</creator><creator>Willerson, James T</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Sequoia S.A</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>7T5</scope><scope>7TK</scope><scope>7TO</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>2000</creationdate><title>Redefining medical treatment in the management of unstable angina</title><author>Braunwald, Eugene ; Califf, Robert M ; Cannon, Christopher P ; Fox, Keith A.A ; Fuster, Valentin ; Gibler, W.Brian ; Harrington, Richard A ; King, Spencer B ; Kleiman, Neil S ; Theroux, Pierre ; Topol, Eric J ; Van de Werf, Frans ; White, Harvey D ; Willerson, James T</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c417t-95197cbdc58e5aee59cda2d8fde6617dc5ffbd04cae3a65f6a5a6fe35f7d27433</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Abciximab</topic><topic>Administration, Oral</topic><topic>Angina pectoris</topic><topic>Angina, Unstable - blood</topic><topic>Angina, Unstable - complications</topic><topic>Angina, Unstable - drug therapy</topic><topic>Antibodies, Monoclonal - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>C-Reactive Protein - metabolism</topic><topic>Cardiology. Vascular system</topic><topic>Coronary heart disease</topic><topic>Diagnosis, Differential</topic><topic>Enoxaparin - therapeutic use</topic><topic>Eptifibatide</topic><topic>Government Agencies</topic><topic>Health care</topic><topic>Heart</topic><topic>Heparin, Low-Molecular-Weight - administration & dosage</topic><topic>Heparin, Low-Molecular-Weight - therapeutic use</topic><topic>Humans</topic><topic>Immunoglobulin Fab Fragments - therapeutic use</topic><topic>Infusions, Intravenous</topic><topic>Medical disorders</topic><topic>Medical sciences</topic><topic>Myocardial Infarction - blood</topic><topic>Myocardial Infarction - etiology</topic><topic>Myocardial Infarction - prevention & control</topic><topic>National Institutes of Health (U.S.)</topic><topic>Peptides - therapeutic use</topic><topic>Platelet Aggregation Inhibitors - administration & dosage</topic><topic>Platelet Aggregation Inhibitors - therapeutic use</topic><topic>Platelet Glycoprotein GPIIb-IIIa Complex - administration & dosage</topic><topic>Platelet Glycoprotein GPIIb-IIIa Complex - antagonists & inhibitors</topic><topic>Practice Guidelines as Topic</topic><topic>Risk</topic><topic>Time Factors</topic><topic>Tirofiban</topic><topic>Troponin I - blood</topic><topic>Troponin T - blood</topic><topic>Tyrosine - analogs & derivatives</topic><topic>Tyrosine - therapeutic use</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Braunwald, Eugene</creatorcontrib><creatorcontrib>Califf, Robert M</creatorcontrib><creatorcontrib>Cannon, Christopher P</creatorcontrib><creatorcontrib>Fox, Keith A.A</creatorcontrib><creatorcontrib>Fuster, Valentin</creatorcontrib><creatorcontrib>Gibler, W.Brian</creatorcontrib><creatorcontrib>Harrington, Richard A</creatorcontrib><creatorcontrib>King, Spencer B</creatorcontrib><creatorcontrib>Kleiman, Neil S</creatorcontrib><creatorcontrib>Theroux, Pierre</creatorcontrib><creatorcontrib>Topol, Eric J</creatorcontrib><creatorcontrib>Van de Werf, Frans</creatorcontrib><creatorcontrib>White, Harvey D</creatorcontrib><creatorcontrib>Willerson, James T</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>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Braunwald, Eugene</au><au>Califf, Robert M</au><au>Cannon, Christopher P</au><au>Fox, Keith A.A</au><au>Fuster, Valentin</au><au>Gibler, W.Brian</au><au>Harrington, Richard A</au><au>King, Spencer B</au><au>Kleiman, Neil S</au><au>Theroux, Pierre</au><au>Topol, Eric J</au><au>Van de Werf, Frans</au><au>White, Harvey D</au><au>Willerson, James T</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Redefining medical treatment in the management of unstable angina</atitle><jtitle>The American journal of medicine</jtitle><addtitle>Am J Med</addtitle><date>2000</date><risdate>2000</risdate><volume>108</volume><issue>1</issue><spage>41</spage><epage>53</epage><pages>41-53</pages><issn>0002-9343</issn><eissn>1555-7162</eissn><coden>AJMEAZ</coden><abstract>In 1994, the Agency for Health Care Policy and Research sponsored the development of guidelines for diagnosing and managing patients with unstable angina. Since their publication, several important developments have occurred. The prognostic value of biochemical assays for cardiac-specific troponins T and I have been shown in many studies. The possible role for C-reactive protein in determining prognosis deserves further investigation. Substantial clinical benefits have been obtained with intravenous inhibitors of the platelet glycoprotein (GP) IIb-IIIa receptor (abciximab, eptifibatide, tirofiban) and with one of the low-molecular-weight heparins (enoxaparin). The therapeutic potential of other low-molecular-weight heparins, direct thrombin inhibitors, and oral GP IIb-IIIa inhibitors remains to be clarified. On the basis of this evidence, consideration should be given to measuring serum levels of a cardiac troponin (either T or I) and using intravenous GP IIb-IIIa inhibitors and low-molecular-weight heparin in the standard management of patients with unstable angina.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>11059440</pmid><doi>10.1016/S0002-9343(99)00416-7</doi><tpages>13</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0002-9343 |
| ispartof | The American journal of medicine, 2000, Vol.108 (1), p.41-53 |
| issn | 0002-9343 1555-7162 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_72366522 |
| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Abciximab Administration, Oral Angina pectoris Angina, Unstable - blood Angina, Unstable - complications Angina, Unstable - drug therapy Antibodies, Monoclonal - therapeutic use Biological and medical sciences C-Reactive Protein - metabolism Cardiology. Vascular system Coronary heart disease Diagnosis, Differential Enoxaparin - therapeutic use Eptifibatide Government Agencies Health care Heart Heparin, Low-Molecular-Weight - administration & dosage Heparin, Low-Molecular-Weight - therapeutic use Humans Immunoglobulin Fab Fragments - therapeutic use Infusions, Intravenous Medical disorders Medical sciences Myocardial Infarction - blood Myocardial Infarction - etiology Myocardial Infarction - prevention & control National Institutes of Health (U.S.) Peptides - therapeutic use Platelet Aggregation Inhibitors - administration & dosage Platelet Aggregation Inhibitors - therapeutic use Platelet Glycoprotein GPIIb-IIIa Complex - administration & dosage Platelet Glycoprotein GPIIb-IIIa Complex - antagonists & inhibitors Practice Guidelines as Topic Risk Time Factors Tirofiban Troponin I - blood Troponin T - blood Tyrosine - analogs & derivatives Tyrosine - therapeutic use United States |
| title | Redefining medical treatment in the management of unstable angina |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-13T06%3A21%3A20IST&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=Redefining%20medical%20treatment%20in%20the%20management%20of%20unstable%20angina&rft.jtitle=The%20American%20journal%20of%20medicine&rft.au=Braunwald,%20Eugene&rft.date=2000&rft.volume=108&rft.issue=1&rft.spage=41&rft.epage=53&rft.pages=41-53&rft.issn=0002-9343&rft.eissn=1555-7162&rft.coden=AJMEAZ&rft_id=info:doi/10.1016/S0002-9343(99)00416-7&rft_dat=%3Cproquest_cross%3E52571142%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=232336795&rft_id=info:pmid/11059440&rft_els_id=S0002934399004167&rfr_iscdi=true |