Abstract
Background: Few studies evaluated the clinical outcomes of Community Acquired Pneumonia (CAP), Hospital-Acquired Pneumonia (HAP) and Health Care-Associated Pneumonia (HCAP) in relation to the adherence of antibiotic treatment to the guidelines of the Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS) in hospitalized elderly people (65 years or older). Methods: Data were obtained from REPOSI, a prospective registry held in 87 Italian internal medicine and geriatric wards. Patients with a diagnosis of pneumonia (ICD-9 480-487) or prescribed with an antibiotic for pneumonia as indication were selected. The empirical antibiotic regimen was defined to be adherent to guidelines if concordant with the treatment regimens recommended by IDSA/ATS for CAP, HAP, and HCAP. Outcomes were assessed by logistic regression models. Results: A diagnosis of pneumonia was made in 317 patients. Only 38.8% of them received an empirical antibiotic regimen that was adherent to guidelines. However, no significant association was found between adherence to guidelines and outcomes. Having HAP, older age, and higher CIRS severity index were the main factors associated with in-hospital mortality. Conclusions: The adherence to antibiotic treatment guidelines was poor, particularly for HAP and HCAP, suggesting the need for more adherence to the optimal management of antibiotics in the elderly with pneumonia.
| Original language | English |
|---|---|
| Pages (from-to) | 330-337 |
| Number of pages | 8 |
| Journal | European Journal of Internal Medicine |
| Volume | 26 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - Jun 1 2015 |
Keywords
- Antibiotics
- Elderly
- Guidelines adherence
- Mortality
- Pneumonia
- Re-hospitalization
ASJC Scopus subject areas
- Internal Medicine
- Medicine(all)
Fingerprint
Dive into the research topics of 'Adherence to antibiotic treatment guidelines and outcomes in the hospitalized elderly with different types of pneumonia'. Together they form a unique fingerprint.Cite this
- APA
- Standard
- Harvard
- Vancouver
- Author
- BIBTEX
- RIS
Adherence to antibiotic treatment guidelines and outcomes in the hospitalized elderly with different types of pneumonia. / Rossio, Raffaella; Franchi, Carlotta; Ardoino, Ilaria; Djade, Codjo D.; Tettamanti, Mauro; Pasina, Luca; Salerno, Francesco; Marengoni, Alessandra; Corrao, Salvatore; Marcucci, Maura; Peyvandi, Flora; Biganzoli, Elia M.; Nobili, Alessandro; Mannucci, Pier Mannuccio; Sparacio, Eleonora; Alborghetti, Stefania; Di Costanzo, Rosa; Prisco, Domenico; Silvestri, Elena; Cenci, Caterina; Barnini, Tommaso; Delitala, Giuseppe; Carta, Stefano; Atzori, Sebastiana; Guarnieri, Gianfranco; Zanetti, Michela; Spalluti, Annalisa; Serra, Maria Grazia; Bleve, Maria Antonietta; Vanoli, Massimo; Grignani, Giulia; Casella, Gianluca; Gasbarrone, Laura; Maniscalco, Giorgio; Gunelli, Massimo; Tirotta, Daniela; Brucato, Antonio; Ghidoni, Silvia; Di Corato, Paola; Bernardi, Mauro; Li Bassi, Silvia; Santi, Luca; Agnelli, Giancarlo; Iorio, Alfonso; Marchesini, Emanuela; Mannarino, Elmo; Lupattelli, Graziana; Rondelli, Pamela; Paciullo, Francesco; Fabris, Fabrizio; Carlon, Michela; Turatto, Francesca; Baroni, Maria Cristina; Zardo, Marianna; Manfredini, Roberto; Molino, Christian; Pala, Marco; Fabbian, Fabio; Nuti, Ranuccio; Valenti, Roberto; Ruvio, Martina; Cappelli, Silvia; Paolisso, Giuseppe; Rizzo, Maria Rosaria; Laieta, Maria Teresa; Salvatore, Teresa; Sasso, Ferdinando Carlo; Utili, Riccardo; Mangoni, Emanuele Durante; Pinto, Daniela; Olivieri, Oliviero; Stanzial, Anna Maria; Fellin, Renato; Volpato, Stefano; Fotini, Sioulis; Barbagallo, Mario; Dominguez, Ligia; Plances, Lidia; D'Angelo, Daniela; Rini, Giovanbattista; Mansueto, Pasquale; Pepe, Ilenia; Licata, Giuseppe; Calvo, Luigi; Valenti, Maria; Borghi, Claudio; Strocchi, Enrico; Rinaldi, Elisa Rebecca; Zoli, Marco; Fabbri, Elisa; Magalotti, Donatella; Auteri, Alberto; Pasqui, Anna Laura; Puccetti, Luca; Pasini, Franco Laghi; Capecchi, Pier Leopoldo; Bicchi, Maurizio; Sabbà, Carlo; Vella, Francesco Saverio; Marseglia, Alessandro; Luglio, Chiara Valentina; Palasciano, Giuseppe; Modeo, Maria Ester; Aquilino, Annamaria; Raffaele, Pallante; Pugliese, Stefania; Capobianco, Caterina; Postiglione, Alfredo; Barbella, Maria Rosaria; De Stefano, Francesco; Fenoglio, Luigi; Brignone, Chiara; Bracco, Christian; Giraudo, Alessia; Musca, Giuseppe; Cuccurullo, Olga; Cricco, Luigi; Fiorentini, Alessandra; Cappellini, Maria Domenica; Fabio, Giovanna; Seghezzi, Sonia; De Amicis, Margherita Migone; Fargion, Silvia; Bonara, Paola; Bulgheroni, Mara; Lombardi, Rosa; Magrini, Fabio; Massari, Ferdinando; Tonella, Tatiana; Tedeschi, Alberto; Moreo, Guido; Ferrari, Barbara; Roncari, Luisa; Monzani, Valter; Savojardo, Valeria; Folli, Christian; Magnini, Maria; Mari, Daniela; Rossi, Paolo Dionigi; Damanti, Sarah; Prolo, Silvia; Lilleri, Maria Sole; Micale, Giuliana; Podda, Mauro; Selmi, Carlo; Meda, Francesca; Accordino, Silvia; Conca, Alessio; Monti, Valentina; Corazza, Gino Roberto; Miceli, Emanuela; Lenti, Marco Vincenzo; Padula, Donatella; Balduini, Carlo L.; Bertolino, Giampiera; Provini, Stella; Quaglia, Federica; Murialdo, Giovanni; Bovio, Marta; Dallegri, Franco; Ottonello, Luciano; Quercioli, Alessandra; Barreca, Alessandra; Secchi, Maria Beatrice; Ghelfi, Davide; Chin, Wu Sheng; Carassale, Laura; Caporotundo, Silvia; Anastasio, Luigi; Sofia, Lucia; Carbone, Maria; Traisci, Giancarlo; De Feudis, Lucrezia; Di Carlo, Silvia; Davì, Giovanni; Guagnano, Maria Teresa; Sestili, Simona; Bergami, Elisabetta; Rizzioli, Emanuela; Cagnoni, Carlo; Bertone, Luca; Manucra, Antonio; Buratti, Alberto; Tognin, Tiziana; Liberato, Nicola Lucio; Bernasconi, Giordano; Nardo, Barbara; Bianchi, Giovanni Battista; Benetti, Giampiero; Quagliolo, Michela; Centenaro, Giuseppe Riccardo; Purrello, Francesco; Di Pino, Antonino; Piro, Salvatore; Mancuso, Gerardo; Calipari, Daniela; Bartone, Mosè; Gullo, Francesco; Cortellaro, Michele; Magenta, Marina; Perego, Francesca; Meroni, Maria Rachele; Cicardi, Marco; Magenta, Antonio Gidaro Marina; Sacco, Andrea; Bonelli, Antonio; Dentamaro, Gaetano; Rozzini, Renzo; Falanga, Lina; Giordano, Alessandro; Perin, Paolo Cavallo; Lorenzati, Bartolomeo; Gruden, Gabriella; Bruno, Graziella; Montrucchio, Giuseppe; Greco, Elisabetta; Tizzani, Pietro; Fera, Giacomo; Di Luca, Maria Loreta; Renna, Donatella; Perciccante, Antonio; Coralli, Alessia; Tassara, Rodolfo; Melis, Deborah; Rebella, Lara; Menardo, Giorgio; Bottone, Stefania; Sferrazzo, Elsa; Ferri, Claudio; Striuli, Rinaldo; Scipioni, Rosa; Salmi, Raffaella; Gaudenzi, Piergiorgio; Gamberini, Susanna; Ricci, Franco; Morabito, Cosimo; Fava, Roberto; Semplicini, Andrea; Gottardo, Lucia; Vendemiale, Gianluigi; Serviddio, Gaetano; Forlano, Roberta; Bolondi, Luigi; Rasciti, Leonardo; Serio, Ilaria; Masala, Cesare; Mammarella, Antonio; Raparelli, Valeria; Fanelli, Filippo Rossi; Delfino, Massimo; Amoroso, Antonio; Violi, Francesco; Basili, Stefania; Perri, Ludovica; Serra, Pietro; Fontana, Vincenzo; Falcone, Marco; Landolfi, Raffaele; Grieco, Antonio; Gallo, Antonella; Zuccalà, Giuseppe; Franceschi, Francesco; De Marco, Guido; Chiara, Cordischi; Marta, Sabbatini; Bellusci, Martino; Setti, Donatella; Pedrazzoli, Filippo; Romanelli, Giuseppe; Pirali, Caterina; Amolini, Claudia; Rosei, Enrico Agabiti; Rizzoni, Damiano; Castoldi, Luana; Picardi, Antonio; Gentilucci, Umberto Vespasiani; Mazzarelli, Chiara; Gallo, Paolo; Guasti, Luigina; Castiglioni, Luana; Maresca, Andrea; Squizzato, Alessandro; Contini, Sara; Molaro, Marta; Annoni, Giorgio; Corsi, Maurizio; Zazzetta, Sara; Bertolotti, Marco; Mussi, Chiara; Scotto, Roberto; Ferri, Maria Alice; Veltri, Francesca; Arturi, Franco; Succurro, Elena; Sesti, Giorgio; Gualtieri, Umberto; Perticone, Francesco; Sciacqua, Angela; Quero, Michele; Bagnato, Chiara; Loria, Paola; Becchi, Maria Angela; Martucci, Gianfranco; Fantuzzi, Alessandra; Maurantonio, Mauro; Corinaldesi, Roberto; De Giorgio, Roberto; Serra, Mauro; Grasso, Valentina; Ruggeri, Eugenio; Carozza, Lorenzo Mauro; Pignatti, Fabio.
In: European Journal of Internal Medicine, Vol. 26, No. 5, 01.06.2015, p. 330-337.Research output: Contribution to journal › Article › peer-review
}
TY - JOUR
T1 - Adherence to antibiotic treatment guidelines and outcomes in the hospitalized elderly with different types of pneumonia
AU - Rossio, Raffaella
AU - Franchi, Carlotta
AU - Ardoino, Ilaria
AU - Djade, Codjo D.
AU - Tettamanti, Mauro
AU - Pasina, Luca
AU - Salerno, Francesco
AU - Marengoni, Alessandra
AU - Corrao, Salvatore
AU - Marcucci, Maura
AU - Peyvandi, Flora
AU - Biganzoli, Elia M.
AU - Nobili, Alessandro
AU - Mannucci, Pier Mannuccio
AU - Sparacio, Eleonora
AU - Alborghetti, Stefania
AU - Di Costanzo, Rosa
AU - Prisco, Domenico
AU - Silvestri, Elena
AU - Cenci, Caterina
AU - Barnini, Tommaso
AU - Delitala, Giuseppe
AU - Carta, Stefano
AU - Atzori, Sebastiana
AU - Guarnieri, Gianfranco
AU - Zanetti, Michela
AU - Spalluti, Annalisa
AU - Serra, Maria Grazia
AU - Bleve, Maria Antonietta
AU - Vanoli, Massimo
AU - Grignani, Giulia
AU - Casella, Gianluca
AU - Gasbarrone, Laura
AU - Maniscalco, Giorgio
AU - Gunelli, Massimo
AU - Tirotta, Daniela
AU - Brucato, Antonio
AU - Ghidoni, Silvia
AU - Di Corato, Paola
AU - Bernardi, Mauro
AU - Li Bassi, Silvia
AU - Santi, Luca
AU - Agnelli, Giancarlo
AU - Iorio, Alfonso
AU - Marchesini, Emanuela
AU - Mannarino, Elmo
AU - Lupattelli, Graziana
AU - Rondelli, Pamela
AU - Paciullo, Francesco
AU - Fabris, Fabrizio
AU - Carlon, Michela
AU - Turatto, Francesca
AU - Baroni, Maria Cristina
AU - Zardo, Marianna
AU - Manfredini, Roberto
AU - Molino, Christian
AU - Pala, Marco
AU - Fabbian, Fabio
AU - Nuti, Ranuccio
AU - Valenti, Roberto
AU - Ruvio, Martina
AU - Cappelli, Silvia
AU - Paolisso, Giuseppe
AU - Rizzo, Maria Rosaria
AU - Laieta, Maria Teresa
AU - Salvatore, Teresa
AU - Sasso, Ferdinando Carlo
AU - Utili, Riccardo
AU - Mangoni, Emanuele Durante
AU - Pinto, Daniela
AU - Olivieri, Oliviero
AU - Stanzial, Anna Maria
AU - Fellin, Renato
AU - Volpato, Stefano
AU - Fotini, Sioulis
AU - Barbagallo, Mario
AU - Dominguez, Ligia
AU - Plances, Lidia
AU - D'Angelo, Daniela
AU - Rini, Giovanbattista
AU - Mansueto, Pasquale
AU - Pepe, Ilenia
AU - Licata, Giuseppe
AU - Calvo, Luigi
AU - Valenti, Maria
AU - Borghi, Claudio
AU - Strocchi, Enrico
AU - Rinaldi, Elisa Rebecca
AU - Zoli, Marco
AU - Fabbri, Elisa
AU - Magalotti, Donatella
AU - Auteri, Alberto
AU - Pasqui, Anna Laura
AU - Puccetti, Luca
AU - Pasini, Franco Laghi
AU - Capecchi, Pier Leopoldo
AU - Bicchi, Maurizio
AU - Sabbà, Carlo
AU - Vella, Francesco Saverio
AU - Marseglia, Alessandro
AU - Luglio, Chiara Valentina
AU - Palasciano, Giuseppe
AU - Modeo, Maria Ester
AU - Aquilino, Annamaria
AU - Raffaele, Pallante
AU - Pugliese, Stefania
AU - Capobianco, Caterina
AU - Postiglione, Alfredo
AU - Barbella, Maria Rosaria
AU - De Stefano, Francesco
AU - Fenoglio, Luigi
AU - Brignone, Chiara
AU - Bracco, Christian
AU - Giraudo, Alessia
AU - Musca, Giuseppe
AU - Cuccurullo, Olga
AU - Cricco, Luigi
AU - Fiorentini, Alessandra
AU - Cappellini, Maria Domenica
AU - Fabio, Giovanna
AU - Seghezzi, Sonia
AU - De Amicis, Margherita Migone
AU - Fargion, Silvia
AU - Bonara, Paola
AU - Bulgheroni, Mara
AU - Lombardi, Rosa
AU - Magrini, Fabio
AU - Massari, Ferdinando
AU - Tonella, Tatiana
AU - Tedeschi, Alberto
AU - Moreo, Guido
AU - Ferrari, Barbara
AU - Roncari, Luisa
AU - Monzani, Valter
AU - Savojardo, Valeria
AU - Folli, Christian
AU - Magnini, Maria
AU - Mari, Daniela
AU - Rossi, Paolo Dionigi
AU - Damanti, Sarah
AU - Prolo, Silvia
AU - Lilleri, Maria Sole
AU - Micale, Giuliana
AU - Podda, Mauro
AU - Selmi, Carlo
AU - Meda, Francesca
AU - Accordino, Silvia
AU - Conca, Alessio
AU - Monti, Valentina
AU - Corazza, Gino Roberto
AU - Miceli, Emanuela
AU - Lenti, Marco Vincenzo
AU - Padula, Donatella
AU - Balduini, Carlo L.
AU - Bertolino, Giampiera
AU - Provini, Stella
AU - Quaglia, Federica
AU - Murialdo, Giovanni
AU - Bovio, Marta
AU - Dallegri, Franco
AU - Ottonello, Luciano
AU - Quercioli, Alessandra
AU - Barreca, Alessandra
AU - Secchi, Maria Beatrice
AU - Ghelfi, Davide
AU - Chin, Wu Sheng
AU - Carassale, Laura
AU - Caporotundo, Silvia
AU - Anastasio, Luigi
AU - Sofia, Lucia
AU - Carbone, Maria
AU - Traisci, Giancarlo
AU - De Feudis, Lucrezia
AU - Di Carlo, Silvia
AU - Davì, Giovanni
AU - Guagnano, Maria Teresa
AU - Sestili, Simona
AU - Bergami, Elisabetta
AU - Rizzioli, Emanuela
AU - Cagnoni, Carlo
AU - Bertone, Luca
AU - Manucra, Antonio
AU - Buratti, Alberto
AU - Tognin, Tiziana
AU - Liberato, Nicola Lucio
AU - Bernasconi, Giordano
AU - Nardo, Barbara
AU - Bianchi, Giovanni Battista
AU - Benetti, Giampiero
AU - Quagliolo, Michela
AU - Centenaro, Giuseppe Riccardo
AU - Purrello, Francesco
AU - Di Pino, Antonino
AU - Piro, Salvatore
AU - Mancuso, Gerardo
AU - Calipari, Daniela
AU - Bartone, Mosè
AU - Gullo, Francesco
AU - Cortellaro, Michele
AU - Magenta, Marina
AU - Perego, Francesca
AU - Meroni, Maria Rachele
AU - Cicardi, Marco
AU - Magenta, Antonio Gidaro Marina
AU - Sacco, Andrea
AU - Bonelli, Antonio
AU - Dentamaro, Gaetano
AU - Rozzini, Renzo
AU - Falanga, Lina
AU - Giordano, Alessandro
AU - Perin, Paolo Cavallo
AU - Lorenzati, Bartolomeo
AU - Gruden, Gabriella
AU - Bruno, Graziella
AU - Montrucchio, Giuseppe
AU - Greco, Elisabetta
AU - Tizzani, Pietro
AU - Fera, Giacomo
AU - Di Luca, Maria Loreta
AU - Renna, Donatella
AU - Perciccante, Antonio
AU - Coralli, Alessia
AU - Tassara, Rodolfo
AU - Melis, Deborah
AU - Rebella, Lara
AU - Menardo, Giorgio
AU - Bottone, Stefania
AU - Sferrazzo, Elsa
AU - Ferri, Claudio
AU - Striuli, Rinaldo
AU - Scipioni, Rosa
AU - Salmi, Raffaella
AU - Gaudenzi, Piergiorgio
AU - Gamberini, Susanna
AU - Ricci, Franco
AU - Morabito, Cosimo
AU - Fava, Roberto
AU - Semplicini, Andrea
AU - Gottardo, Lucia
AU - Vendemiale, Gianluigi
AU - Serviddio, Gaetano
AU - Forlano, Roberta
AU - Bolondi, Luigi
AU - Rasciti, Leonardo
AU - Serio, Ilaria
AU - Masala, Cesare
AU - Mammarella, Antonio
AU - Raparelli, Valeria
AU - Fanelli, Filippo Rossi
AU - Delfino, Massimo
AU - Amoroso, Antonio
AU - Violi, Francesco
AU - Basili, Stefania
AU - Perri, Ludovica
AU - Serra, Pietro
AU - Fontana, Vincenzo
AU - Falcone, Marco
AU - Landolfi, Raffaele
AU - Grieco, Antonio
AU - Gallo, Antonella
AU - Zuccalà, Giuseppe
AU - Franceschi, Francesco
AU - De Marco, Guido
AU - Chiara, Cordischi
AU - Marta, Sabbatini
AU - Bellusci, Martino
AU - Setti, Donatella
AU - Pedrazzoli, Filippo
AU - Romanelli, Giuseppe
AU - Pirali, Caterina
AU - Amolini, Claudia
AU - Rosei, Enrico Agabiti
AU - Rizzoni, Damiano
AU - Castoldi, Luana
AU - Picardi, Antonio
AU - Gentilucci, Umberto Vespasiani
AU - Mazzarelli, Chiara
AU - Gallo, Paolo
AU - Guasti, Luigina
AU - Castiglioni, Luana
AU - Maresca, Andrea
AU - Squizzato, Alessandro
AU - Contini, Sara
AU - Molaro, Marta
AU - Annoni, Giorgio
AU - Corsi, Maurizio
AU - Zazzetta, Sara
AU - Bertolotti, Marco
AU - Mussi, Chiara
AU - Scotto, Roberto
AU - Ferri, Maria Alice
AU - Veltri, Francesca
AU - Arturi, Franco
AU - Succurro, Elena
AU - Sesti, Giorgio
AU - Gualtieri, Umberto
AU - Perticone, Francesco
AU - Sciacqua, Angela
AU - Quero, Michele
AU - Bagnato, Chiara
AU - Loria, Paola
AU - Becchi, Maria Angela
AU - Martucci, Gianfranco
AU - Fantuzzi, Alessandra
AU - Maurantonio, Mauro
AU - Corinaldesi, Roberto
AU - De Giorgio, Roberto
AU - Serra, Mauro
AU - Grasso, Valentina
AU - Ruggeri, Eugenio
AU - Carozza, Lorenzo Mauro
AU - Pignatti, Fabio
PY - 2015/6/1
Y1 - 2015/6/1
N2 - Background: Few studies evaluated the clinical outcomes of Community Acquired Pneumonia (CAP), Hospital-Acquired Pneumonia (HAP) and Health Care-Associated Pneumonia (HCAP) in relation to the adherence of antibiotic treatment to the guidelines of the Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS) in hospitalized elderly people (65 years or older). Methods: Data were obtained from REPOSI, a prospective registry held in 87 Italian internal medicine and geriatric wards. Patients with a diagnosis of pneumonia (ICD-9 480-487) or prescribed with an antibiotic for pneumonia as indication were selected. The empirical antibiotic regimen was defined to be adherent to guidelines if concordant with the treatment regimens recommended by IDSA/ATS for CAP, HAP, and HCAP. Outcomes were assessed by logistic regression models. Results: A diagnosis of pneumonia was made in 317 patients. Only 38.8% of them received an empirical antibiotic regimen that was adherent to guidelines. However, no significant association was found between adherence to guidelines and outcomes. Having HAP, older age, and higher CIRS severity index were the main factors associated with in-hospital mortality. Conclusions: The adherence to antibiotic treatment guidelines was poor, particularly for HAP and HCAP, suggesting the need for more adherence to the optimal management of antibiotics in the elderly with pneumonia.
AB - Background: Few studies evaluated the clinical outcomes of Community Acquired Pneumonia (CAP), Hospital-Acquired Pneumonia (HAP) and Health Care-Associated Pneumonia (HCAP) in relation to the adherence of antibiotic treatment to the guidelines of the Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS) in hospitalized elderly people (65 years or older). Methods: Data were obtained from REPOSI, a prospective registry held in 87 Italian internal medicine and geriatric wards. Patients with a diagnosis of pneumonia (ICD-9 480-487) or prescribed with an antibiotic for pneumonia as indication were selected. The empirical antibiotic regimen was defined to be adherent to guidelines if concordant with the treatment regimens recommended by IDSA/ATS for CAP, HAP, and HCAP. Outcomes were assessed by logistic regression models. Results: A diagnosis of pneumonia was made in 317 patients. Only 38.8% of them received an empirical antibiotic regimen that was adherent to guidelines. However, no significant association was found between adherence to guidelines and outcomes. Having HAP, older age, and higher CIRS severity index were the main factors associated with in-hospital mortality. Conclusions: The adherence to antibiotic treatment guidelines was poor, particularly for HAP and HCAP, suggesting the need for more adherence to the optimal management of antibiotics in the elderly with pneumonia.
KW - Antibiotics
KW - Elderly
KW - Guidelines adherence
KW - Mortality
KW - Pneumonia
KW - Re-hospitalization
UR - http://www.scopus.com/inward/record.url?scp=84981276310&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84981276310&partnerID=8YFLogxK
U2 - 10.1016/j.ejim.2015.04.002
DO - 10.1016/j.ejim.2015.04.002
M3 - Article
C2 - 25898778
AN - SCOPUS:84981276310
VL - 26
SP - 330
EP - 337
JO - European Journal of Internal Medicine
JF - European Journal of Internal Medicine
SN - 0953-6205
IS - 5
ER -