Abnormal Cardiac Structure and Function in the Metabolic Syndrome: A Population-Based Study
OBJECTIVE To measure the association between cardiac structure and function abnormalities and isolated metabolic syndrome (metabolic syndrome excluding established hypertension or diabetes mellitus). PARTICIPANTS AND METHODS We collected data prospectively on a population-based random sample of 2042...
Gespeichert in:
| Veröffentlicht in: | Mayo Clinic proceedings 2008-12, Vol.83 (12), p.1350-1357 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1357 |
|---|---|
| container_issue | 12 |
| container_start_page | 1350 |
| container_title | Mayo Clinic proceedings |
| container_volume | 83 |
| creator | Aijaz, Bilal, MD Ammar, Khawaja A., MD Lopez-Jimenez, Francisco, MD Redfield, Margaret M., MD Jacobsen, Steven J., MD, PhD Rodeheffer, Richard J., MD |
| description | OBJECTIVE To measure the association between cardiac structure and function abnormalities and isolated metabolic syndrome (metabolic syndrome excluding established hypertension or diabetes mellitus). PARTICIPANTS AND METHODS We collected data prospectively on a population-based random sample of 2042 Olmsted County, Minnesota, residents aged 45 years or older who underwent echocardiography between January 1, 1997, and September 30, 2000. Metabolic syndrome was defined by National Cholesterol Education Program Adult Treatment Panel III criteria. RESULTS The prevalence of isolated metabolic syndrome was 21.7% (214/984) in men and 16.7% (177/1058) in women. Left ventricular (LV) mass index was greater (91.7 vs 87.9 g/m2 ; P =.04) and LV diastolic dysfunction more prevalent (28.2% [50/177] vs 14.9% [81/544]; P |
| doi_str_mv | 10.4065/83.12.1350 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2726751</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A190883874</galeid><els_id>1_s2_0_S0025619611607830</els_id><sourcerecordid>A190883874</sourcerecordid><originalsourceid>FETCH-LOGICAL-c624t-f66038d9b97ae453b300b54b50d1bd2aad5585edf7134386fd6a99c25d331eb83</originalsourceid><addsrcrecordid>eNpdkl9rFDEUxQdRbK2--AFkEPRBmDV_JpnEB2FdrAoVheqTDyGT3OmmZpM1mSnstzfjLttW8hBIfvdc7rmnqp5jtGgRZ28FXWCywJShB9Upli1pGGv5w-oUIcIajiU_qZ7kfI0Q6qRsH1cnWKKWF-i0-rXsQ0wb7euVTtZpU1-OaTLjlKDWwdbnUzCji6F2oR7XUH-FUffRu8Ltgk1xA-_qZf09bievZ675oDPYIjLZ3dPq0aB9hmeH-6z6ef7xx-pzc_Ht05fV8qIxnLRjM3COqLCyl52GltGeItSztmfI4t4SrS1jgoEdOkxbKvhguZbSEGYpxdALela93-tup34D1kAYk_Zqm9xGp52K2qn7P8Gt1VW8UaQjvGO4CLw-CKT4Z4I8qo3LBrzXAeKUFZeCSYFYAV_-B17HKYUynCKYi451WBZosYeutAflwhBLU1OOhY0zMcDgyvuy7EAIKrr2tv2_gjVoP65z9NPsZ74PvtmDJsWcEwzHGTFScxSUoAoTNUehwC_uunKLHnZfgFcHQGej_ZB0MC4fOYJkh3l3x14oO7xxkJTxLrhS8ht2kI8OYJWJQupyTt0cOow5KuWI_gUdzs6r</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>216875719</pqid></control><display><type>article</type><title>Abnormal Cardiac Structure and Function in the Metabolic Syndrome: A Population-Based Study</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Aijaz, Bilal, MD ; Ammar, Khawaja A., MD ; Lopez-Jimenez, Francisco, MD ; Redfield, Margaret M., MD ; Jacobsen, Steven J., MD, PhD ; Rodeheffer, Richard J., MD</creator><creatorcontrib>Aijaz, Bilal, MD ; Ammar, Khawaja A., MD ; Lopez-Jimenez, Francisco, MD ; Redfield, Margaret M., MD ; Jacobsen, Steven J., MD, PhD ; Rodeheffer, Richard J., MD</creatorcontrib><description>OBJECTIVE To measure the association between cardiac structure and function abnormalities and isolated metabolic syndrome (metabolic syndrome excluding established hypertension or diabetes mellitus). PARTICIPANTS AND METHODS We collected data prospectively on a population-based random sample of 2042 Olmsted County, Minnesota, residents aged 45 years or older who underwent echocardiography between January 1, 1997, and September 30, 2000. Metabolic syndrome was defined by National Cholesterol Education Program Adult Treatment Panel III criteria. RESULTS The prevalence of isolated metabolic syndrome was 21.7% (214/984) in men and 16.7% (177/1058) in women. Left ventricular (LV) mass index was greater (91.7 vs 87.9 g/m2 ; P =.04) and LV diastolic dysfunction more prevalent (28.2% [50/177] vs 14.9% [81/544]; P <.001) in women with isolated metabolic syndrome than in women without metabolic syndrome; no difference was found in men. When patients with hypertension or diabetes mellitus were included in the cohort, there was a stepwise increase in LV mass index and LV diastolic dysfunction from no metabolic syndrome to isolated metabolic syndrome to metabolic syndrome in women and men. CONCLUSION Isolated metabolic syndrome, which is associated with increased LV mass index and LV diastolic dysfunction in women, identifies women with evidence of early ventricular dysfunction.</description><identifier>ISSN: 0025-6196</identifier><identifier>ISSN: 1942-5546</identifier><identifier>EISSN: 1942-5546</identifier><identifier>DOI: 10.4065/83.12.1350</identifier><identifier>PMID: 19046554</identifier><identifier>CODEN: MACPAJ</identifier><language>eng</language><publisher>Rochester, MN: Mayo Foundation</publisher><subject>Abnormalities ; Aged ; Biological and medical sciences ; Diagnosis ; Early Diagnosis ; Echocardiography, Doppler ; Female ; General aspects ; Heart ventricle, Left ; Heart Ventricles - diagnostic imaging ; Heart Ventricles - pathology ; Humans ; Internal Medicine ; Logistic Models ; Male ; Medical sciences ; Metabolic diseases ; Metabolic Syndrome - diagnostic imaging ; Metabolic Syndrome - epidemiology ; Metabolic Syndrome - pathology ; Metabolic syndrome X ; Middle Aged ; Minnesota - epidemiology ; Miscellaneous ; Other metabolic disorders ; Prevalence ; Prospective Studies ; Sex Distribution ; Ventricular Dysfunction, Left - diagnostic imaging ; Ventricular Dysfunction, Left - epidemiology</subject><ispartof>Mayo Clinic proceedings, 2008-12, Vol.83 (12), p.1350-1357</ispartof><rights>Mayo Foundation for Medical Education and Research</rights><rights>2009 INIST-CNRS</rights><rights>COPYRIGHT 2008 Elsevier, Inc.</rights><rights>Copyright Mayo Foundation for Medical Education and Research Dec 2008</rights><rights>2008 Mayo Foundation for Medical Education and Research 2008</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c624t-f66038d9b97ae453b300b54b50d1bd2aad5585edf7134386fd6a99c25d331eb83</citedby><cites>FETCH-LOGICAL-c624t-f66038d9b97ae453b300b54b50d1bd2aad5585edf7134386fd6a99c25d331eb83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20971678$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19046554$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Aijaz, Bilal, MD</creatorcontrib><creatorcontrib>Ammar, Khawaja A., MD</creatorcontrib><creatorcontrib>Lopez-Jimenez, Francisco, MD</creatorcontrib><creatorcontrib>Redfield, Margaret M., MD</creatorcontrib><creatorcontrib>Jacobsen, Steven J., MD, PhD</creatorcontrib><creatorcontrib>Rodeheffer, Richard J., MD</creatorcontrib><title>Abnormal Cardiac Structure and Function in the Metabolic Syndrome: A Population-Based Study</title><title>Mayo Clinic proceedings</title><addtitle>Mayo Clin Proc</addtitle><description>OBJECTIVE To measure the association between cardiac structure and function abnormalities and isolated metabolic syndrome (metabolic syndrome excluding established hypertension or diabetes mellitus). PARTICIPANTS AND METHODS We collected data prospectively on a population-based random sample of 2042 Olmsted County, Minnesota, residents aged 45 years or older who underwent echocardiography between January 1, 1997, and September 30, 2000. Metabolic syndrome was defined by National Cholesterol Education Program Adult Treatment Panel III criteria. RESULTS The prevalence of isolated metabolic syndrome was 21.7% (214/984) in men and 16.7% (177/1058) in women. Left ventricular (LV) mass index was greater (91.7 vs 87.9 g/m2 ; P =.04) and LV diastolic dysfunction more prevalent (28.2% [50/177] vs 14.9% [81/544]; P <.001) in women with isolated metabolic syndrome than in women without metabolic syndrome; no difference was found in men. When patients with hypertension or diabetes mellitus were included in the cohort, there was a stepwise increase in LV mass index and LV diastolic dysfunction from no metabolic syndrome to isolated metabolic syndrome to metabolic syndrome in women and men. CONCLUSION Isolated metabolic syndrome, which is associated with increased LV mass index and LV diastolic dysfunction in women, identifies women with evidence of early ventricular dysfunction.</description><subject>Abnormalities</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Diagnosis</subject><subject>Early Diagnosis</subject><subject>Echocardiography, Doppler</subject><subject>Female</subject><subject>General aspects</subject><subject>Heart ventricle, Left</subject><subject>Heart Ventricles - diagnostic imaging</subject><subject>Heart Ventricles - pathology</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Metabolic diseases</subject><subject>Metabolic Syndrome - diagnostic imaging</subject><subject>Metabolic Syndrome - epidemiology</subject><subject>Metabolic Syndrome - pathology</subject><subject>Metabolic syndrome X</subject><subject>Middle Aged</subject><subject>Minnesota - epidemiology</subject><subject>Miscellaneous</subject><subject>Other metabolic disorders</subject><subject>Prevalence</subject><subject>Prospective Studies</subject><subject>Sex Distribution</subject><subject>Ventricular Dysfunction, Left - diagnostic imaging</subject><subject>Ventricular Dysfunction, Left - epidemiology</subject><issn>0025-6196</issn><issn>1942-5546</issn><issn>1942-5546</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><recordid>eNpdkl9rFDEUxQdRbK2--AFkEPRBmDV_JpnEB2FdrAoVheqTDyGT3OmmZpM1mSnstzfjLttW8hBIfvdc7rmnqp5jtGgRZ28FXWCywJShB9Upli1pGGv5w-oUIcIajiU_qZ7kfI0Q6qRsH1cnWKKWF-i0-rXsQ0wb7euVTtZpU1-OaTLjlKDWwdbnUzCji6F2oR7XUH-FUffRu8Ltgk1xA-_qZf09bievZ675oDPYIjLZ3dPq0aB9hmeH-6z6ef7xx-pzc_Ht05fV8qIxnLRjM3COqLCyl52GltGeItSztmfI4t4SrS1jgoEdOkxbKvhguZbSEGYpxdALela93-tup34D1kAYk_Zqm9xGp52K2qn7P8Gt1VW8UaQjvGO4CLw-CKT4Z4I8qo3LBrzXAeKUFZeCSYFYAV_-B17HKYUynCKYi451WBZosYeutAflwhBLU1OOhY0zMcDgyvuy7EAIKrr2tv2_gjVoP65z9NPsZ74PvtmDJsWcEwzHGTFScxSUoAoTNUehwC_uunKLHnZfgFcHQGej_ZB0MC4fOYJkh3l3x14oO7xxkJTxLrhS8ht2kI8OYJWJQupyTt0cOow5KuWI_gUdzs6r</recordid><startdate>20081201</startdate><enddate>20081201</enddate><creator>Aijaz, Bilal, MD</creator><creator>Ammar, Khawaja A., MD</creator><creator>Lopez-Jimenez, Francisco, MD</creator><creator>Redfield, Margaret M., MD</creator><creator>Jacobsen, Steven J., MD, PhD</creator><creator>Rodeheffer, Richard J., MD</creator><general>Mayo Foundation</general><general>Elsevier, Inc</general><general>Elsevier Limited</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>4U-</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20081201</creationdate><title>Abnormal Cardiac Structure and Function in the Metabolic Syndrome: A Population-Based Study</title><author>Aijaz, Bilal, MD ; Ammar, Khawaja A., MD ; Lopez-Jimenez, Francisco, MD ; Redfield, Margaret M., MD ; Jacobsen, Steven J., MD, PhD ; Rodeheffer, Richard J., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c624t-f66038d9b97ae453b300b54b50d1bd2aad5585edf7134386fd6a99c25d331eb83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Abnormalities</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Diagnosis</topic><topic>Early Diagnosis</topic><topic>Echocardiography, Doppler</topic><topic>Female</topic><topic>General aspects</topic><topic>Heart ventricle, Left</topic><topic>Heart Ventricles - diagnostic imaging</topic><topic>Heart Ventricles - pathology</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Metabolic diseases</topic><topic>Metabolic Syndrome - diagnostic imaging</topic><topic>Metabolic Syndrome - epidemiology</topic><topic>Metabolic Syndrome - pathology</topic><topic>Metabolic syndrome X</topic><topic>Middle Aged</topic><topic>Minnesota - epidemiology</topic><topic>Miscellaneous</topic><topic>Other metabolic disorders</topic><topic>Prevalence</topic><topic>Prospective Studies</topic><topic>Sex Distribution</topic><topic>Ventricular Dysfunction, Left - diagnostic imaging</topic><topic>Ventricular Dysfunction, Left - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Aijaz, Bilal, MD</creatorcontrib><creatorcontrib>Ammar, Khawaja A., MD</creatorcontrib><creatorcontrib>Lopez-Jimenez, Francisco, MD</creatorcontrib><creatorcontrib>Redfield, Margaret M., MD</creatorcontrib><creatorcontrib>Jacobsen, Steven J., MD, PhD</creatorcontrib><creatorcontrib>Rodeheffer, Richard J., MD</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>University Readers</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</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>Public Health Database</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>eLibrary</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>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Nursing & Allied Health Premium</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><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Mayo Clinic proceedings</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Aijaz, Bilal, MD</au><au>Ammar, Khawaja A., MD</au><au>Lopez-Jimenez, Francisco, MD</au><au>Redfield, Margaret M., MD</au><au>Jacobsen, Steven J., MD, PhD</au><au>Rodeheffer, Richard J., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Abnormal Cardiac Structure and Function in the Metabolic Syndrome: A Population-Based Study</atitle><jtitle>Mayo Clinic proceedings</jtitle><addtitle>Mayo Clin Proc</addtitle><date>2008-12-01</date><risdate>2008</risdate><volume>83</volume><issue>12</issue><spage>1350</spage><epage>1357</epage><pages>1350-1357</pages><issn>0025-6196</issn><issn>1942-5546</issn><eissn>1942-5546</eissn><coden>MACPAJ</coden><abstract>OBJECTIVE To measure the association between cardiac structure and function abnormalities and isolated metabolic syndrome (metabolic syndrome excluding established hypertension or diabetes mellitus). PARTICIPANTS AND METHODS We collected data prospectively on a population-based random sample of 2042 Olmsted County, Minnesota, residents aged 45 years or older who underwent echocardiography between January 1, 1997, and September 30, 2000. Metabolic syndrome was defined by National Cholesterol Education Program Adult Treatment Panel III criteria. RESULTS The prevalence of isolated metabolic syndrome was 21.7% (214/984) in men and 16.7% (177/1058) in women. Left ventricular (LV) mass index was greater (91.7 vs 87.9 g/m2 ; P =.04) and LV diastolic dysfunction more prevalent (28.2% [50/177] vs 14.9% [81/544]; P <.001) in women with isolated metabolic syndrome than in women without metabolic syndrome; no difference was found in men. When patients with hypertension or diabetes mellitus were included in the cohort, there was a stepwise increase in LV mass index and LV diastolic dysfunction from no metabolic syndrome to isolated metabolic syndrome to metabolic syndrome in women and men. CONCLUSION Isolated metabolic syndrome, which is associated with increased LV mass index and LV diastolic dysfunction in women, identifies women with evidence of early ventricular dysfunction.</abstract><cop>Rochester, MN</cop><pub>Mayo Foundation</pub><pmid>19046554</pmid><doi>10.4065/83.12.1350</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0025-6196 |
| ispartof | Mayo Clinic proceedings, 2008-12, Vol.83 (12), p.1350-1357 |
| issn | 0025-6196 1942-5546 1942-5546 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2726751 |
| source | MEDLINE; Alma/SFX Local Collection |
| subjects | Abnormalities Aged Biological and medical sciences Diagnosis Early Diagnosis Echocardiography, Doppler Female General aspects Heart ventricle, Left Heart Ventricles - diagnostic imaging Heart Ventricles - pathology Humans Internal Medicine Logistic Models Male Medical sciences Metabolic diseases Metabolic Syndrome - diagnostic imaging Metabolic Syndrome - epidemiology Metabolic Syndrome - pathology Metabolic syndrome X Middle Aged Minnesota - epidemiology Miscellaneous Other metabolic disorders Prevalence Prospective Studies Sex Distribution Ventricular Dysfunction, Left - diagnostic imaging Ventricular Dysfunction, Left - epidemiology |
| title | Abnormal Cardiac Structure and Function in the Metabolic Syndrome: A Population-Based Study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-03T22%3A39%3A18IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Abnormal%20Cardiac%20Structure%20and%20Function%20in%20the%20Metabolic%20Syndrome:%20A%20Population-Based%20Study&rft.jtitle=Mayo%20Clinic%20proceedings&rft.au=Aijaz,%20Bilal,%20MD&rft.date=2008-12-01&rft.volume=83&rft.issue=12&rft.spage=1350&rft.epage=1357&rft.pages=1350-1357&rft.issn=0025-6196&rft.eissn=1942-5546&rft.coden=MACPAJ&rft_id=info:doi/10.4065/83.12.1350&rft_dat=%3Cgale_pubme%3EA190883874%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=216875719&rft_id=info:pmid/19046554&rft_galeid=A190883874&rft_els_id=1_s2_0_S0025619611607830&rfr_iscdi=true |