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Frontiers in Pediatrics
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Association of cancer diagnosis and therapeutic stage with mortality in pediatric patients with COVID-19, prospective multicenter cohort study from Latin America / Alejandro Díaz Díaz ; Mónica Rosa Trujillo Honeysberg
Título : Association of cancer diagnosis and therapeutic stage with mortality in pediatric patients with COVID-19, prospective multicenter cohort study from Latin America Tipo de documento : documento electrónico Autores : Alejandro Díaz Díaz, ; Mónica Rosa Trujillo Honeysberg, Fecha de publicación : 2022 Títulos uniformes : Frontiers in Pediatrics Idioma : Inglés (eng) Palabras clave : pediatric cancer pediatric COVID-19 child development PICU (pediatric intensive care unit) Resumen : Background: Children with cancer are at risk of critical disease and mortality from COVID-19 infection. In this study, we describe the clinical characteristics of pediatric patients with cancer and COVID-19 from multiple Latin American centers and risk factors associated with mortality in this population. Methods: This study is a multicenter, prospective cohort study conducted at 12 hospitals from 6 Latin American countries (Argentina, Bolivia, Colombia, Ecuador, Honduras and Peru) from April to November 2021. Patients younger than 14 years of age that had an oncological diagnosis and COVID-19 or multisystemic inflammatory syndrome in children (MIS-C) who were treated in the inpatient setting were included. The primary exposure was the diagnosis and treatment status, and the primary outcome was mortality. We defined “new diagnosis” as patients with no previous diagnosis of cancer, “established diagnosis” as patients with cancer and ongoing treatment and “relapse” as patients with cancer and ongoing treatment that had a prior cancer-free period. A frequentist analysis was performed including a multivariate logistic regression for mortality. Results: Two hundred and ten patients were included in the study; 30 (14%) died during the study period and 67% of patients who died were admitted to critical care. Demographics were similar in survivors and non-survivors. Patients with low weight for age ( Mención de responsabilidad : Jesus Ángel Dominguez-Rojas, Pablo Vásquez-Hoyos, Rodrigo Pérez-Morales, Ana María Monsalve-Quintero, Lupe Mora-Robles, Alejandro Diaz-Diaz, Silvio Fabio Torres, Ángel Castro-Dajer, Lizeth Yuliana Cabanillas-Burgos, Vladimir Aguilera-Avendaño, Edwin Mauricio Cantillano-Quintero, Anna Camporesi, Asya Agulnik, Sheena Mukkada, Giancarlo Alvarado-Gamarra, Ninoska Rojas-Soto, Ana Luisa Mendieta-Zevallos, Mariela Violeta Tello-Pezo, Liliana Vásquez-Ponce, Rubén Eduardo Lasso-Palomino, María Camila Pérez-Arroyave, Mónica Trujillo-Honeysberg, Juan Gonzalo Mesa-Monsalve, Carlos Alberto Pardo González, Juan Francisco López Cubillos, Sebastián Gonzalez-Dambrauskas and Alvaro Coronado-Munoz Referencia : Front Pediatr. 2022 May 3;10:885633. DOI (Digital Object Identifier) : 10.3389/fped.2022.885633 PMID : 35592840 Derechos de uso : CC BY En línea : https://www.frontiersin.org/articles/10.3389/fped.2022.885633/full Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6022 Association of cancer diagnosis and therapeutic stage with mortality in pediatric patients with COVID-19, prospective multicenter cohort study from Latin America [documento electrónico] / Alejandro Díaz Díaz, ; Mónica Rosa Trujillo Honeysberg, . - 2022.
Obra : Frontiers in Pediatrics
Idioma : Inglés (eng)
Palabras clave : pediatric cancer pediatric COVID-19 child development PICU (pediatric intensive care unit) Resumen : Background: Children with cancer are at risk of critical disease and mortality from COVID-19 infection. In this study, we describe the clinical characteristics of pediatric patients with cancer and COVID-19 from multiple Latin American centers and risk factors associated with mortality in this population. Methods: This study is a multicenter, prospective cohort study conducted at 12 hospitals from 6 Latin American countries (Argentina, Bolivia, Colombia, Ecuador, Honduras and Peru) from April to November 2021. Patients younger than 14 years of age that had an oncological diagnosis and COVID-19 or multisystemic inflammatory syndrome in children (MIS-C) who were treated in the inpatient setting were included. The primary exposure was the diagnosis and treatment status, and the primary outcome was mortality. We defined “new diagnosis” as patients with no previous diagnosis of cancer, “established diagnosis” as patients with cancer and ongoing treatment and “relapse” as patients with cancer and ongoing treatment that had a prior cancer-free period. A frequentist analysis was performed including a multivariate logistic regression for mortality. Results: Two hundred and ten patients were included in the study; 30 (14%) died during the study period and 67% of patients who died were admitted to critical care. Demographics were similar in survivors and non-survivors. Patients with low weight for age ( Mención de responsabilidad : Jesus Ángel Dominguez-Rojas, Pablo Vásquez-Hoyos, Rodrigo Pérez-Morales, Ana María Monsalve-Quintero, Lupe Mora-Robles, Alejandro Diaz-Diaz, Silvio Fabio Torres, Ángel Castro-Dajer, Lizeth Yuliana Cabanillas-Burgos, Vladimir Aguilera-Avendaño, Edwin Mauricio Cantillano-Quintero, Anna Camporesi, Asya Agulnik, Sheena Mukkada, Giancarlo Alvarado-Gamarra, Ninoska Rojas-Soto, Ana Luisa Mendieta-Zevallos, Mariela Violeta Tello-Pezo, Liliana Vásquez-Ponce, Rubén Eduardo Lasso-Palomino, María Camila Pérez-Arroyave, Mónica Trujillo-Honeysberg, Juan Gonzalo Mesa-Monsalve, Carlos Alberto Pardo González, Juan Francisco López Cubillos, Sebastián Gonzalez-Dambrauskas and Alvaro Coronado-Munoz Referencia : Front Pediatr. 2022 May 3;10:885633. DOI (Digital Object Identifier) : 10.3389/fped.2022.885633 PMID : 35592840 Derechos de uso : CC BY En línea : https://www.frontiersin.org/articles/10.3389/fped.2022.885633/full Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6022 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001862 AC-2022-028 Archivo digital Producción Científica Artículos científicos Disponible Documentos electrónicos
AC-2022-028Adobe Acrobat PDF Changes in the incidence of acute bacterial meningitis caused by Streptococcus pneumoniae and the implications of serotype replacement in children in Colombia after mass vaccination with PCV10 / Mónica Rosa Trujillo Honeysberg
Título : Changes in the incidence of acute bacterial meningitis caused by Streptococcus pneumoniae and the implications of serotype replacement in children in Colombia after mass vaccination with PCV10 Tipo de documento : documento electrónico Autores : Mónica Rosa Trujillo Honeysberg, Fecha de publicación : 2022 Títulos uniformes : Frontiers in Pediatrics Idioma : Inglés (eng) Palabras clave : pneumococcal meningitis pediatrics infections vaccines microbiology serotype Resumen : Introduction: Acute bacterial meningitis (ABM) is a public health problem. The disease has reemerged after the introduction of pneumococcal conjugate vaccines (PCVs) due to an increase in serotypes that are not covered. The objective was to determine the changes in the disease incidence before and after the introduction of the 10-valent vaccine (PCV10) in Colombia. Methods: This multicenter study was conducted in 17 hospitals in Colombia. Data were collected from January 2008 to December 2019 in 10 hospitals in Bogotá and from January 2017 to December 2019 in seven hospitals in Cali, Medellín and Cartagena. The data were grouped into three periods: 2008–2011, 2012–2015, and 2016-2019. Results: Of the 706 cases of invasive pneumococcal disease, 81 (11.4%) corresponded to meningitis. The relative incidence in Bogotá in the first period was 0.6 per 100,000 patients ≤ 5 years, decreased to 0.4 per 100,000 patients ≤ 5 years in the second period and increased in the third period to 0.7 per 100,000 patients ≤ 5 years. Serotypes covered by PCV10 decreased from 75 to 9.1%, with Spn19A (31.8%) and Spn34 (13.6%) emerging in the third period. Increased resistance to penicillin (13 to 37%) and to ceftriaxone (5.9 to 16%) was due to the emergence of multidrug-resistant Spn19A. The total mortality rate was 23.5% and increased from 12 to 33%. Conclusions: ABM due to pneumococcus has high morbidity and mortality rates. Reemergence of the disease has been observed due to the inclusion of polymerase chain reaction (PCR) for diagnosis and replacement of circulating serotypes after the introduction of PCV10, with an increase in Spn19A, which causes death and exhibits antimicrobial resistance. Continued surveillance is needed. Mención de responsabilidad : Juan David Farfán-Albarracín, Germán Camacho-Moreno, Aura Lucia Leal, Jaime Patiño, Wilfrido Coronell, Iván Felipe Gutiérrez, Sandra Beltrán, Martha I Álvarez-Olmos, Cristina Mariño, Rocio Barrero, Juan Pablo Rojas, Fabio Espinosa, Catalina Arango-Ferreira, Maria Alejandra Suarez, Monica Trujillo, Eduardo López-Medina, Pio López, Hernando Pinzón, Nicolás Ramos, Vivian Marcela Moreno, Anita Montañez Referencia : Front Pediatr. 2022 Sep 23;10:1006887. DOI (Digital Object Identifier) : 10.3389/fped.2022.1006887 PMID : 36210950 En línea : https://www.frontiersin.org/articles/10.3389/fped.2022.1006887/full Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6088 Changes in the incidence of acute bacterial meningitis caused by Streptococcus pneumoniae and the implications of serotype replacement in children in Colombia after mass vaccination with PCV10 [documento electrónico] / Mónica Rosa Trujillo Honeysberg, . - 2022.
Obra : Frontiers in Pediatrics
Idioma : Inglés (eng)
Palabras clave : pneumococcal meningitis pediatrics infections vaccines microbiology serotype Resumen : Introduction: Acute bacterial meningitis (ABM) is a public health problem. The disease has reemerged after the introduction of pneumococcal conjugate vaccines (PCVs) due to an increase in serotypes that are not covered. The objective was to determine the changes in the disease incidence before and after the introduction of the 10-valent vaccine (PCV10) in Colombia. Methods: This multicenter study was conducted in 17 hospitals in Colombia. Data were collected from January 2008 to December 2019 in 10 hospitals in Bogotá and from January 2017 to December 2019 in seven hospitals in Cali, Medellín and Cartagena. The data were grouped into three periods: 2008–2011, 2012–2015, and 2016-2019. Results: Of the 706 cases of invasive pneumococcal disease, 81 (11.4%) corresponded to meningitis. The relative incidence in Bogotá in the first period was 0.6 per 100,000 patients ≤ 5 years, decreased to 0.4 per 100,000 patients ≤ 5 years in the second period and increased in the third period to 0.7 per 100,000 patients ≤ 5 years. Serotypes covered by PCV10 decreased from 75 to 9.1%, with Spn19A (31.8%) and Spn34 (13.6%) emerging in the third period. Increased resistance to penicillin (13 to 37%) and to ceftriaxone (5.9 to 16%) was due to the emergence of multidrug-resistant Spn19A. The total mortality rate was 23.5% and increased from 12 to 33%. Conclusions: ABM due to pneumococcus has high morbidity and mortality rates. Reemergence of the disease has been observed due to the inclusion of polymerase chain reaction (PCR) for diagnosis and replacement of circulating serotypes after the introduction of PCV10, with an increase in Spn19A, which causes death and exhibits antimicrobial resistance. Continued surveillance is needed. Mención de responsabilidad : Juan David Farfán-Albarracín, Germán Camacho-Moreno, Aura Lucia Leal, Jaime Patiño, Wilfrido Coronell, Iván Felipe Gutiérrez, Sandra Beltrán, Martha I Álvarez-Olmos, Cristina Mariño, Rocio Barrero, Juan Pablo Rojas, Fabio Espinosa, Catalina Arango-Ferreira, Maria Alejandra Suarez, Monica Trujillo, Eduardo López-Medina, Pio López, Hernando Pinzón, Nicolás Ramos, Vivian Marcela Moreno, Anita Montañez Referencia : Front Pediatr. 2022 Sep 23;10:1006887. DOI (Digital Object Identifier) : 10.3389/fped.2022.1006887 PMID : 36210950 En línea : https://www.frontiersin.org/articles/10.3389/fped.2022.1006887/full Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6088 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001935 AC-2022-096 Archivo digital Producción Científica Artículos científicos Disponible Clinical characteristics of children with SARS-CoV-2 infection in a hospital in Latin America / Laura Fernanda Niño Serna ; Eliana López Barón ; Isabel Cristina Maya Ángel ; Carolina Tamayo Múnera
Título : Clinical characteristics of children with SARS-CoV-2 infection in a hospital in Latin America Tipo de documento : documento electrónico Autores : Laura Fernanda Niño Serna, ; Eliana López Barón, ; Isabel Cristina Maya Ángel, ; Carolina Tamayo Múnera, Fecha de publicación : 2022 Títulos uniformes : Frontiers in Pediatrics Idioma : Inglés (eng) Palabras clave : pediatrics comorbidity inpatients pediatric intensive care unit Latin America COVID-19 Resumen : Objective: COVID-19 infections have shown a different behavior in children than in adults. The objective of this study was to describe the clinical characteristics and severity of SARS-CoV-2 infection in pediatric patients seen at a reference hospital in Colombia. Method: A descriptive, observational study in patients under the age of 18 years with a positive test for SARS-CoV-2 infection (RT-PCR or antigen) between April 2020 and March 2021. Multiple variables were studied, including demographic data, clinical characteristics, lab measurements, treatments administered, intensive care unit admission, and mortality. Results: A total of 361 patients were included of whom 196 (54%) were males. The median age was 3 years. Of all the patients, 65 (18%) were asymptomatic. The majority of patients had no comorbidities (n = 225, 76%). In those who were symptomatic (n = 296, 82%), the most frequent complaints were fever (n = 178, 60%), nasal congestion (n = 164, 55%) and cough (n = 149, 50%). Chest x-rays were normal in 73 patients (50%). When abnormalities were found, interstitial (29%) and alveolar (12%) patterns were the most prevalent. One hundred and fifty-seven children (53%) required general ward hospitalization, and 24 patients (8%) required pediatric intensive care admission. The global mortality was 0.8% (3 patients). Conclusions: The majority of cases were asymptomatic or mild. However, a significant percentage of patients required general ward admission, and some even required intensive care. The main symptom of COVID-19 infections in newborns was apnea. A second COVID-19 RT-PCR may be necessary to detect infections in critically ill patients with a high clinical suspicion of the disease if an initial test was negative. Mención de responsabilidad : Laura F. Niño-Serna, Eliana López-Barón, Isabel Cristina Maya Ángel and Carolina Tamayo-Múnera Referencia : Front Pediatr. 2022 Jun 9;10:921880. DOI (Digital Object Identifier) : 10.3389/fped.2022.921880 PMID : 35757135 Derechos de uso : CC BY En línea : https://www.frontiersin.org/articles/10.3389/fped.2022.921880/full Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6032 Clinical characteristics of children with SARS-CoV-2 infection in a hospital in Latin America [documento electrónico] / Laura Fernanda Niño Serna, ; Eliana López Barón, ; Isabel Cristina Maya Ángel, ; Carolina Tamayo Múnera, . - 2022.
Obra : Frontiers in Pediatrics
Idioma : Inglés (eng)
Palabras clave : pediatrics comorbidity inpatients pediatric intensive care unit Latin America COVID-19 Resumen : Objective: COVID-19 infections have shown a different behavior in children than in adults. The objective of this study was to describe the clinical characteristics and severity of SARS-CoV-2 infection in pediatric patients seen at a reference hospital in Colombia. Method: A descriptive, observational study in patients under the age of 18 years with a positive test for SARS-CoV-2 infection (RT-PCR or antigen) between April 2020 and March 2021. Multiple variables were studied, including demographic data, clinical characteristics, lab measurements, treatments administered, intensive care unit admission, and mortality. Results: A total of 361 patients were included of whom 196 (54%) were males. The median age was 3 years. Of all the patients, 65 (18%) were asymptomatic. The majority of patients had no comorbidities (n = 225, 76%). In those who were symptomatic (n = 296, 82%), the most frequent complaints were fever (n = 178, 60%), nasal congestion (n = 164, 55%) and cough (n = 149, 50%). Chest x-rays were normal in 73 patients (50%). When abnormalities were found, interstitial (29%) and alveolar (12%) patterns were the most prevalent. One hundred and fifty-seven children (53%) required general ward hospitalization, and 24 patients (8%) required pediatric intensive care admission. The global mortality was 0.8% (3 patients). Conclusions: The majority of cases were asymptomatic or mild. However, a significant percentage of patients required general ward admission, and some even required intensive care. The main symptom of COVID-19 infections in newborns was apnea. A second COVID-19 RT-PCR may be necessary to detect infections in critically ill patients with a high clinical suspicion of the disease if an initial test was negative. Mención de responsabilidad : Laura F. Niño-Serna, Eliana López-Barón, Isabel Cristina Maya Ángel and Carolina Tamayo-Múnera Referencia : Front Pediatr. 2022 Jun 9;10:921880. DOI (Digital Object Identifier) : 10.3389/fped.2022.921880 PMID : 35757135 Derechos de uso : CC BY En línea : https://www.frontiersin.org/articles/10.3389/fped.2022.921880/full Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6032 Reserva
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AC-2022-039Adobe Acrobat PDF Global PARITY: study design for a multi-centered, international point prevalence study to estimate the burden of pediatric acute critical illness in resource-limited settings / Eliana López Barón
Título : Global PARITY: study design for a multi-centered, international point prevalence study to estimate the burden of pediatric acute critical illness in resource-limited settings Tipo de documento : documento electrónico Autores : Eliana López Barón, Fecha de publicación : 2022 Títulos uniformes : Frontiers in Pediatrics Idioma : Inglés (eng) Palabras clave : pediatric critical illness acute pediatric care critical care outcome low-and lower-middle-income countries resource utilization low resource setting Resumen : Background: The burden of pediatric critical illness and resource utilization by children with critical illness in resource limited settings (RLS) are largely unknown. Without specific data that captures key aspects of critical illness, disease presentation, and resource utilization for pediatric populations in RLS, development of a contextual framework for appropriate, evidence-based interventions to guide allocation of limited but available resources is challenging. We present this methods paper which describes our efforts to determine the prevalence, etiology, hospital outcomes, and resource utilization associated with pediatric acute, critical illness in RLS globally. Methods: We will conduct a prospective, observational, multicenter, multinational point prevalence study in sixty-one participating RLS hospitals from North, Central and South America, Africa, Middle East and South Asia with four sampling time points over a 12-month period. Children aged 29 days to 14 years evaluated for acute illness or injury in an emergency department) or directly admitted to an inpatient unit will be enrolled and followed for hospital outcomes and resource utilization for the first seven days of hospitalization. The primary outcome will be prevalence of acute critical illness, which Global PARITY has defined as death within 48 hours of presentation to the hospital, including ED mortality; or admission/transfer to an HDU or ICU; or transfer to another institution for a higher level-of-care; or receiving critical care-level interventions (vasopressor infusion, invasive mechanical ventilation, non-invasive mechanical ventilation) regardless of location in the hospital, among children presenting to the hospital. Secondary outcomes include etiology of critical illness, in-hospital mortality, cause of death, resource utilization, length of hospital stay, and change in neurocognitive status. Data will be managed via REDCap, aggregated, and analyzed across sites. Discussion: This study is expected to address the current gap in understanding of the burden, etiology, resource utilization and outcomes associated with pediatric acute and critical illness in RLS. These data are crucial to inform future research and clinical management decisions and to improve global pediatric hospital outcomes. Mención de responsabilidad : Qalab Abbas, Adrian Holloway, Paula Caporal, Eliana López-Barón, Asya Agulnik, Kenneth E. Remy, John A. Appiah, Jonah Attebery, Ericka L. Fink, Jan Hau Lee, Shubhada Hooli, Niranjan Kissoon, Erika Mille, Srinivas Murthy, Fiona Muttalib, Katie Nielsen, Maria Puerto-Torres, Karla Rodrigues, Firas Sakaan, Adriana Teixeira Rodrigues, Erica A. Tabor, Amelie von Saint Andre-von Arnim, Matthew O. Wiens, William Blackwelder, David He, Teresa B. Kortz and Adnan T. Bhutta on behalf of the PALISI Global Health Subgroup the Global PARITY Investigators Referencia : Front Pediatr. 2022 Jan 28;9:793326. DOI (Digital Object Identifier) : 10.3389/fped.2021.793326 PMID : 35155314 Derechos de uso : CC BY En línea : https://www.frontiersin.org/articles/10.3389/fped.2021.793326/full Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6008 Global PARITY: study design for a multi-centered, international point prevalence study to estimate the burden of pediatric acute critical illness in resource-limited settings [documento electrónico] / Eliana López Barón, . - 2022.
Obra : Frontiers in Pediatrics
Idioma : Inglés (eng)
Palabras clave : pediatric critical illness acute pediatric care critical care outcome low-and lower-middle-income countries resource utilization low resource setting Resumen : Background: The burden of pediatric critical illness and resource utilization by children with critical illness in resource limited settings (RLS) are largely unknown. Without specific data that captures key aspects of critical illness, disease presentation, and resource utilization for pediatric populations in RLS, development of a contextual framework for appropriate, evidence-based interventions to guide allocation of limited but available resources is challenging. We present this methods paper which describes our efforts to determine the prevalence, etiology, hospital outcomes, and resource utilization associated with pediatric acute, critical illness in RLS globally. Methods: We will conduct a prospective, observational, multicenter, multinational point prevalence study in sixty-one participating RLS hospitals from North, Central and South America, Africa, Middle East and South Asia with four sampling time points over a 12-month period. Children aged 29 days to 14 years evaluated for acute illness or injury in an emergency department) or directly admitted to an inpatient unit will be enrolled and followed for hospital outcomes and resource utilization for the first seven days of hospitalization. The primary outcome will be prevalence of acute critical illness, which Global PARITY has defined as death within 48 hours of presentation to the hospital, including ED mortality; or admission/transfer to an HDU or ICU; or transfer to another institution for a higher level-of-care; or receiving critical care-level interventions (vasopressor infusion, invasive mechanical ventilation, non-invasive mechanical ventilation) regardless of location in the hospital, among children presenting to the hospital. Secondary outcomes include etiology of critical illness, in-hospital mortality, cause of death, resource utilization, length of hospital stay, and change in neurocognitive status. Data will be managed via REDCap, aggregated, and analyzed across sites. Discussion: This study is expected to address the current gap in understanding of the burden, etiology, resource utilization and outcomes associated with pediatric acute and critical illness in RLS. These data are crucial to inform future research and clinical management decisions and to improve global pediatric hospital outcomes. Mención de responsabilidad : Qalab Abbas, Adrian Holloway, Paula Caporal, Eliana López-Barón, Asya Agulnik, Kenneth E. Remy, John A. Appiah, Jonah Attebery, Ericka L. Fink, Jan Hau Lee, Shubhada Hooli, Niranjan Kissoon, Erika Mille, Srinivas Murthy, Fiona Muttalib, Katie Nielsen, Maria Puerto-Torres, Karla Rodrigues, Firas Sakaan, Adriana Teixeira Rodrigues, Erica A. Tabor, Amelie von Saint Andre-von Arnim, Matthew O. Wiens, William Blackwelder, David He, Teresa B. Kortz and Adnan T. Bhutta on behalf of the PALISI Global Health Subgroup the Global PARITY Investigators Referencia : Front Pediatr. 2022 Jan 28;9:793326. DOI (Digital Object Identifier) : 10.3389/fped.2021.793326 PMID : 35155314 Derechos de uso : CC BY En línea : https://www.frontiersin.org/articles/10.3389/fped.2021.793326/full Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6008 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001843 AC-2022-014 Archivo digital Producción Científica Artículos científicos Disponible Documentos electrónicos
AC-2022-014Adobe Acrobat PDF