A study published in the Archives of Internal Medicine, finds that when physicians in hospitals use health information technology (health IT) to its full potential there are fewer deaths, fewer complications, and lower health care costs. The study, supported by The Commonwealth Fund and led by Ruben Amarasingham M.D., M.B.A., Associate Chief of Medicine at Parkland Health & Hospital System and Assistant Professor of Medicine at UT Southwestern Medical School and Neil Powe, M.D., M.P.H., M.B.A., Professor of Medicine at the Johns Hopkins University School of Medicine, surveyed physicians from 41 hospitals in Texas treating a diverse group of patients across a variety of conditions including heart attack, heart failure, and pneumonia.

The survey directly measures physicians using health IT in a hospital setting. Respondents were asked about their use of several different types of health IT including electronic notes and records, order entry, and clinical decision support. Researchers found that relatively modest increases in technology use had dramatic results – a 10 point increase in the use of electronic notes and medical records was associated with a 15 percent reduction in the likelihood of patient death. And, when physicians electronically entered their instructions for patient care, there was a 55 percent reduction in the likelihood of death for some procedures. Increased use of health IT was also linked to lower costs: hospitals with automated test results, order entry, and decision support experienced lower costs for all hospital admissions (-$110, -$132, and -$538, respectively per admission).

“These findings tell us, straight from the physicians using it, that this technology works to improve quality of care for patients – the first priority of health information technology,” said Commonwealth Fund Vice President for Quality Improvement and Efficiency Anne-Marie Audet, M.D. “But, in order to save lives and keep costs downs, health information technology has to be used to its fullest extent. As President Obama and his health care team consider investing in this technology for the nation, it would make sense to factor in on-going support and training for health care providers so that the technology can live up to its potential.”

Two additional Commonwealth Fund publications, also released today and available at commonwealthfund, expand on how health IT can be successfully integrated to help the U.S. create a truly high performing health care system:
In her new column, Commonwealth Fund President Karen Davis calls health IT a critical component of efforts to reform the U.S. health care system, when implemented alongside other key strategies such as payment reform and an overall commitment to performance improvement. “Just as investment in railroads, air traffic control, and interstate highways facilitated economic development and national prosperity in the 20th century, so too will the spread of health IT and the development of a national health information network bring long-run benefits and gains to the nation in the 21st century,” writes Davis. “It is crucial that our federal leadership move now to harness the power of information technology and put the nation on a path to high performance.”

In a new “Perspectives on Health Reform” brief also published today on The Commonwealth Fund Web site, David Blumenthal, M.D., director of the Institute for Health Policy at Massachusetts General Hospital/Partners HealthCare System and professor of medicine at Harvard Medical School, outlines federal policy options for overcoming the financial, technical, and logistical obstacles to getting hospitals and doctors to adopt health IT. “The Federal Role in Promoting Health Information Technology,” recommends offering assistance for purchase and implementation of health IT to providers that lack financial means; financial support for information exchange in local communities; support for research to improve health IT capabilities; payment reform to hasten use of health IT; and creating national regulations and standards for data security and patient privacy.

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The Commonwealth Fund is a private foundation supporting independent research on health policy reform and a high performance health system.

Source: Mary Mahon

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AstraZeneca today announced that the European Patent Office (EPO) has ruled that the European patent for Symbicort(R) in
the treatment of Chronic Obstructive Pulmonary Disease (COPD) is still valid, despite a challenge by generic manufacturers.

This positive decision means that this patent for Symbicort is still valid, covering its use in Austria, Belgium, Cyprus,
Denmark, Finland, France, Germany, Greece, Ireland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Monaco, the
Netherlands, Portugal, Romania, Slovenia, Spain, Sweden, Switzerland, the United Kingdom and former Yugoslav Republic of
Macedonia, in COPD. The patent, which expires in 2018, was challenged by generic manufacturers, Chiesi Farmaceutici S.p.A.,
Norton Healthcare Ltd and Generics [UK] Limited.

AstraZeneca has a comprehensive intellectual property portfolio for Symbicort including patents and data exclusivity.

In March, the EPO ruled that another European patent covering the combination of formoterol and budesonide in Symbicort(R) was
still valid, despite a separate challenge by several generic manufacturers.

Symbicort is a treatment for asthma and Chronic Obstructive Pulmonary Disease (COPD). The worldwide sales reached $797
million in 2004. Europe accounted for $701 million.

Media Enquiries:
Steve Brown, +44 207 304 5033
Edel McCaffrey, +44 207 304 5034

Investor Enquiries:
Jonathan Hunt, +44 207 304 5087
Mina Blair, +44 20 7304 5084

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The lack of a fall in the maternal death rate in the latest report by the Confidential Enquiry into Maternal and Child Health (CEMACH) has been partly attributed to the increasing percentage of births from immigrant women.

Women from ethnic minority groups (defined as those other than white British women), immigrants, refugees, asylum seekers and those from the gypsy population have been identified as being significantly more at risk of maternal mortality. Many of these women experience a range of complex medical and personal problems. A new paper to be published in The Obstetrician & Gynaecologist (TOG) examines why the maternal death rate is higher in these sections of UK society.

Researchers looked at the evidence from previous CEMACH reports and 34 relevant published papers. They examined the particular obstetric risks which such women are prone to, their access to care, the quality of care received and their perceptions of the maternity care received.

Several organisational issues were detected as risk factors:

- Communication problems – there are inadequate translation services for non-English speaking women and the written information provided to them is usually poor.

- Poor access to care – many were unlikely to attend antenatal classes or were more likely to present late when compared to white British women.

- Substandard care provision – the expectations of many of these women were not met. This was a result of systemic failures within maternity services to cater to these women’s special needs and also down to the women themselves and their poor understanding of the services available to them.

Levels of healthcare for these women vary from trust to trust. The authors of the paper suggest better monitoring and evaluation of the strategies implemented and for more research to be conducted into the healthcare needs of this particular group of women.

Nynke van den Broek, Senior Clinical Lecturer in Sexual and Reproductive Health at the Liverpool School of Tropical Medicine who co-authored the paper said, “Women belonging to an ethnic minority group, in particular asylum seekers and refugees, have an increased risk of maternal mortality. The women most affected are those who are newly arrived in the UK.

“There is evidence to suggest that care received by these women is substandard and that these women experience barriers to accessing maternal health care.”

Professor Neil McClure, TOG editor-in-chief said, “Caring for women from ethnic backgrounds is a complex issue facing all NHS staff working in maternity services. Although we would seek to individualise care for all patients, we must be particularly aware of the need to be sensitive to different cultural attitudes towards pregnancy and childbirth and to the often frightening experience of attending hospital. Many new immigrants see hospitals as a place of last resort and not for routine obstetric care.
“Ultimately, we must offer high quality safe care, for all mothers, regardless of their nationality and circumstances.”

Notes

The Obstetrician & Gynaecologist (TOG) is published quarterly and is the Royal College of Obstetricans and Gynaecologists’ (RCOG) medical journal for continuing professional development. TOG is an editorially independent, peer reviewed journal aimed at providing health professions with updated information about scientific, medical and clinical developments in the specialty of obstetrics and gynaecology.

Reference

Increased risk of maternal death among ethnic minority women in the UK.
Ameh CA, van den Broek N.
The Obstetrician & Gynaecologist 2008;10:177-182.

Royal College of Obstetricans and Gynaecologists Continue reading →

It has been a long debate in the United States as to whether or not vaccines used to battle the H1N1 outbreaks of recent lead to the development of Guillain-Barre syndrome, a rare disorder that causes the body’s immune system to turn against itself, resulting in muscle weakness and even paralysis. A new study says no such chance.

In 1976, a vaccine used during a U.S. flu outbreak was linked to the disease, and the government halted vaccination, but in a study published July 13 in the British Medical Journal, a renowned group of researchers reported that the H1N1 vaccine posed little, if any, increased risk for the disease.

The researchers state:

“This study provides reassurance that adjuvanted pandemic influenza A (H1N1) 2009 vaccines did not increase the risk of Guillain-Barre syndrome substantially, if at all.”

Guillain-Barr?© syndrome is a disorder in which the body’s immune system attacks part of the peripheral nervous system. The first symptoms of this disorder include varying degrees of weakness or tingling sensations in the legs. In many instances, the weakness and abnormal sensations spread to the arms and upper body. These symptoms can increase in intensity until the muscles cannot be used at all and the patient is almost totally paralyzed. In these cases, the disorder is life-threatening and is considered a medical emergency.

The patient is often put on a ventilator to assist with breathing. Most patients, however, recover from even the most severe cases of Guillain-Barr?© syndrome GBS), although some continue to have some degree of weakness.

Usually Guillain-Barr?© occurs a few days or weeks after the patient has had symptoms of a respiratory or gastrointestinal viral infection. Occasionally, surgery will trigger the syndrome. In rare instances, vaccinations may increase the risk of GBS. The disorder can develop over the course of hours or days, or it may take up to 3 to 4 weeks.

No one yet knows why Guillain-Barr?© strikes some people and not others or what sets the disease in motion. What scientists do know is that the body’s immune system begins to attack the body itself, causing what is known as an autoimmune disease.

The research was spawned from an analysis of 50 million people in five European countries that vaccinated people against H1N1 in 2009. The researchers compared 104 people with Guillain-Barre syndrome or a related condition to other people without the diseases.

The researchers adjusted their statistics to account for other risk factors for the diseases and found no link between flu vaccination and Guillain-Barre syndrome. Still, noting that it’s possible a small risk might remain, they estimated there may be less than three extra cases of Guillain-Barre syndrome for each one million people who get protected by a flu vaccination.

Larger studies already in progress should provide even more definitive information, the study authors added.

The flu is a serious disease, and while most cases are mild, some can be deadly. So far this flu season, most flu activity has been caused by the 2009 H1N1 virus, which was first identified in April 2009 and caused the first flu pandemic in 40 years.

Because many people with influenza illness are not tested for flu or are tested late in their illness, methods have been developed to estimate the numbers of people with influenza illness and with influenza-related complications, including hospitalizations and deaths. CDC estimates that from April to January 16, 2010, approximately 57 million cases of 2009 H1N1 occurred in the United States, including 257,000 H1N1-related hospitalizations and about 11,690 deaths.

Sources: The British Medical Journal and The U.S. Centers for Disease Control and Prevention

Sy Kraft

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The American Academy of Pediatric Dentistry (AAPD), the recognized leader in children’s dental and oral health, is one of only 21 organizations nationally to receive an Award of Excellence in the second round of the 2010 Associations Advance America (AAA) Awards program, a national competition sponsored by the American Society of Association Executives (ASAE) and The Center for Association Leadership, Washington, D.C.

AAPD received the award for its AAPD Head Start Dental Home Initiative. This program is now in the running to receive a Summit Award, ASAE & The Center’s top recognition for association programs, to be presented in ceremonies at ASAE’s 11th Annual Summit Awards Dinner at the National Building Museum in Washington, D.C., on September 29, 2010.

AAPD and Head Start (HS) are partnering at national, regional, state and local levels to develop a national network of dentists to link Head Start children with dental homes. A dental home means that each child’s oral health care is delivered in a comprehensive, ongoing, accessible, coordinated, family-centered way by a dentist.

This partnership also provides parents, caregivers and HS staff with the latest evidence-based information on how they can help prevent tooth decay and establish a foundation for a lifetime of oral health.

The AAPD Head Start Dental Home Initiative, which is in its third year of a five-year contract, will establish dental homes for the approximately 1 million children enrolled annually in Head Start across the United States. The five-year plan relies on five key components:

- Providing project leadership, administration and organizational support;
- Providing oral health expertise and technical assistance;
- Developing networks of dentists to provide access to dental homes;
- Training dentists to enhance their capability to meet the oral health needs of young children and their understanding of HS programs; and
- Enhancing HS oral health staff training and parent education programs.

Now in its 20th year, the prestigious Associations Advance America Awards program recognizes associations that propel America forward – with innovative projects in education, skills training, standards-setting, business and social innovation, knowledge creation,

citizenship and community service. Although association activities have been a powerful impact on everyday life, they often go unnoticed by the general public.

“AAPD’s program truly embodies the spirit of the Associations Advance America campaign. It is an honor and an inspiration to showcase this activity as an example of the many contributions associations are making to advance American society,” said the 2009-2010 Associations Advance America (AAA) Committee Chair Ping Wei, director of educational opportunities for the American Society of Civil Engineers.

“AAPD is deeply honored to receive this award on behalf of our members, professional partners and Head Start programs throughout America. Through this initiative we are combining their professional and creative talents, and developing the infrastructure necessary to provide Head Start children with the foundation for a lifetime of optimal oral health,” noted Project Director Dr. Jim Crall.

Source:
American Academy of Pediatric Dentistry Continue reading →

Researchers at The University of Manchester (UK) are testing our genetic disposition to depression with a unique Internet test.

The team, based at the Neuroscience and Psychiatry Unit (NPU), in the Faculty of Medical and Human Sciences, has set up a website (www.newmood) where would-be volunteers can see how prone they may be to depression by identifying the emotions on people’s faces and taking a gambling test.

The team aims to recruit more than 1000 UK volunteers for further tests as part of the five-year, EU-funded project called NewMood – New Molecules in Mood Disorders. They have already discovered how anti-depressants such as Prozac can affect how the brain reacts to fearful faces and which parts of the brain react to fear.

Professor Bill Deakin explains: “Anxiety is a contagious emotion. When you see other people who are anxious, as a primate you feel anxious as well. Our brains are wired to see anxiety – it makes sure we are safe. This is a fascinating test and, during further testing, we will be able to see which parts of the brain light up, or work harder, when you see a fearful face. Depressed people are more likely to see sadness or fear in a neutral face.

“The gambling test, where volunteers choose from pairs of spinners to ‘win’ money, will show us which parts of the brain light up when you are working for a reward. Depressed people are less affected by reward and more likely to give up easily as the test goes on.”

Volunteers for this research study will be asked to fill in a confidential questionnaire and provide a mouth swab for genetic analysis. The team will then compare the DNA with the questionnaire group data.

In the other EU NewMood centres, rats and mice are also being tested for their predisposition to depression using similar reward and anxiety measures. When offered sweet-tasting drinks, depressed animals show no preference, much as humans lose pleasure in eating and often lose weight when they are depressed. And when given the opportunity to explore a new location depressed animals are more wary and take longer to emerge from dark corners, much as depressed humans avoid social situations.

“All humans have the same genes and they are very similar to those in all mammals – we turn out differently from each other because we inherit different versions of the same genes which can vary in their activity” Professor Deakin says. “We can see what genetic traits towards depression these animals have, then compare them with the same genes in the human DNA.

“Depression is a common trait like height or body build and, just like those, we suspect there are lots of genes involved. By measuring the important possible factors that can lead to a tendency to depression across a large number of individual people, we hope to find which ones act together to cause depression. Ultimately, this will help us to develop new ways of preventing and treating this illness.”

Depression is common illness affecting 10-20% of the population at some time in their life and is twice as common in women as in men. Treatment can be very effective, but may not help everyone. The causes of depression are a mixture of genetic tendency, personality factors, difficult circumstances and life experiences, and the big challenge is trying to understand how these work together to lead to depression.

Professor Deakin adds: “We have already made two discoveries through our work so far. We have found that anti-depressants such as Prozac affect how the brain reacts to fearful faces, and also which parts of the brain react directly to antidepressants.”

The University of Manchester is leading 13 institutions in ten countries in the NewMood project. Four institutions are testing humans and each need 1000 volunteers. Those who take part in this study could win ?100 in a prize draw.

For more information or to take part in the project, visit the website at: newmood

This study has been approved by the North Manchester Local Research Ethics Committee (reference: 05/Q1406/26), the University of Manchester’s Ethics Committee (ref. 05056), the Manchester Mental Health and Social Care Trust (ref. 115-04-NEU-DEAK) and by Stockport PCT (ref RD/9047/2).

The Neuroscience and Psychiatry Unit (NPU) was established to bring together a group of psychiatrists, psychologists and laboratory scientists to identify the abnormal brain mechanisms which underlie common mental illnesses such as schizophrenia and depression. Understanding brain mechanisms of mental illness requires a multidisciplinary approach and its collaborating departments are Radiology (MR scanning); Imaging Science (image analysis); Arthritis and Rheumatism Council Research Unit (genetic epidemiology); and, Neuroscience (post-mortem brain neurochemistry). It has strong links with local NHS trusts most notably the Bolton Salford and Trafford NHS Trust – its general adult services and specialist units such as drug dependency and forensic in the Mental Health Services of Salford NHS Trust (bstmht.nhs). See npu.man.ac

For more information or to arrange an interview with Professor Bill Deakin contact Media Relations Officers Mikaela Sitford on 0161 275 2111/07768 980942 or Jo Nightingale on 0161 275 8156.

Mikaela Sitford or Jo Nightingale
44-161-275-2111
University of Manchester
manchester.ac

View drug information on Prozac Weekly. Continue reading →

A new approach to analyzing social networks, reported in the current issue of the International Journal of Services Sciences, could help homeland security find the covert connections between the people behind terrorist attacks. The approach involves revealing the nodes that act as hubs in a terrorist network and tracing back to individual planners and perpetrators.

Dr Yoshiharu Maeno, Founder Management Consultant of the Social Design Group and Dr Yukio Ohsawa, Associate Professor at the School of Engineering, University of Tokyo, Japan, explain that their analytical approach to understanding terrorist networks could ultimately help prevent future attacks.

Terrorist attacks can cause significant loss of life, have intense social and environmental impacts, and large economic losses. Maeno and Ohsawa explain that responding to a terrorist attack is akin to dealing with a natural disaster, with one important difference. Disaster recovery management is required with both, but in the case of a terrorist attack there is the added pressure of short-term responses to the terrorists themselves and in the long-term the need to identify and weaken the covert foundation underpinning an organized attack.

The team explains that by combining the prior understanding of expert investigators with graph theory and computational data processing, it should be possible to analyze a terrorist network and reveal latent connections and patterns. The researchers have carried out such an analysis of the network responsible for the 9/11 attacks in 2001 in order to evaluate the performance of their approach.

Fundamentally, their technique is a mathematical one involving “node” discovery. The nodes of a network are the hubs at which different members of the network are connected. Usually, ordinary members have one or two connections, nodes can have several and the critical nodes, the hubs, have many more.

The scheme is analogous to the structure of the world-wide web where individual web pages may have one or two connections, small organizations may have a few more. Major hubs, such as the big search engine companies, such as Google and Yahoo, news sources like CNN and the BBC, and social media networks such as Facebook and MySpace have many, many more. These big nodes act as the hubs through which individual and smaller sites are interconnected.

The team’s computational analysis of the terrorist network associated with the 9/11 attacks revealed nodes that were not apparent to security experts in advance of the attacks. Such latent nodes appear to have been critical to the attacks but superficially do not appear to be particularly important individuals acting as hubs.

The analysis revealed a connection not known in advance of 9/11 between Waleed Alshehri and Mohand Alshehri, who share a name but are unrelated, which indicated the existence of Mustafa Ahmed Al-Hisawi as an important individual in the network.

In retrospect the connections seem obvious, but they were not seen initially, but the Japanese team’s analysis could have unearthed them much sooner. Mohand Alshehri helped Mohammed Atta hijack the AA11 and fly it into the North Tower of the World Trade Center. Mohand Alshehri hijacked the AA175 and flew it into the South Tower of the World Trade Center. Waleed Alshehri had six links and is, the researchers demonstrate, the keystone person.

Having such network insights sooner rather than later would allow investigators to gather information on associates, friends, and relatives of a suspect terrorist and so bring the perpetrators to justice that much sooner or perhaps even unravel a network plotting future attacks.

“If the investigators had had a warning information on the 19 hijack planners (including WA and MA) before 9/11, our analysis could have aided the investigators in quickly understanding the complete picture of the organized attack including the covert foundation (like MAAH),” Yoshiharu says, “I am not sure, however, whether even a very quick investigators’ understanding and action could have prevented the attack. Our analysis seems more suitable to satisfying the long-term need than the short-term need.”

“Analyzing covert social network foundation behind terrorism disaster” in Int. J. Services Sciences, 2009, 2, 125-141

Source:
Yoshiharu Maeno

Inderscience Publishers Continue reading →

Baxter received Food
and Drug Administration approval to transfer ARALAST processing from a
third party to Baxter. ARALAST NP is a brand name referring to the therapy
completely processed by Baxter. It is biologically equivalent to currently
marketed ARALAST.

ARALAST is a human alpha1 — proteinase inhibitor (A1PI) indicated for
chronic augmentation therapy in patients with hereditary emphysema, which
is a genetic condition caused by a deficiency of A1PI in the lungs. People
with this deficiency have reduced serum levels of A1PI, an important blood
protein processed in the liver that can protect lung tissue from damage
caused by enzymes that are released by white blood cells.

Alpha1-Antitrypsin deficiency affects an estimated 60,000 to 100,000 people
in the United States. It is estimated more than 95 percent of those with
AAT deficiency are undiagnosed. Without sufficient quantities of A1PI,
patients develop lung damage. If untreated, A1PI deficiency can result in
emphysema and premature death.

Important Safety Information

ARALAST is contraindicated in individuals with selective IgA
deficiencies (IgA level less than 15mg/dL) who have known antibody against
IgA, since they may experience severe reactions, including a severe,
potentially life-threatening allergic reaction to IgA, which may be
present. The most common symptoms during the clinical study were headache
(0.3%) and sleepiness (0.3%). Post-market adverse event data have indicated
reports of infusion site pain associated with the administration of
ARALAST. Pregnancy Category C, reproduction studies have not been conducted
with ARALAST. As with all plasma-derived therapeutics, the potential to
transmit infectious agents cannot be totally eliminated. Please see
accompanying ARALAST Prescribing Information for full prescribing details.

For more information on ARALAST, including full prescribing
information, please visit aralast.

About Baxter

Baxter Healthcare Corporation is the principal U.S. operating
subsidiary of Baxter International Inc. (NYSE: BAX). Baxter International
Inc., through its subsidiaries, assists healthcare professionals and their
patients with the treatment of complex medical conditions, including
cancer, hemophilia, immune disorders, kidney disease and trauma. The
company applies its expertise in medical devices, pharmaceuticals and
biotechnology to make a meaningful difference in patients’ lives.

Baxter International Inc.
baxter Continue reading →

In what is seen as a serious setback for Abbott Laboratories, the Oncology Drug Advisory Committee (ODAC) to the US Food and Drug Administration (FDA) advised against the approval of Xinlay (atrasentan), an experimental drug for prostate cancer. Abbott was hoping Xinlay would become a blockbuster (big-selling drug). The panel were concerned about lack of clear efficacy evidence, they also wondered about its cardiovascular safety.

The panel, in its report, mentioned some protocol violations.

Abbot disagreed, saying the benefits are great while the safety profile is manageable.

Abbott says it is hopeful the FDA’s final decision may be different. Historically, the agency tends to go by what the panel has recommended.

In a statement, Abbott said “Abbott respects the committee’s vote on Xinlay today; however, we continue to believe that Xinlay represents an important option for patients with advanced prostate cancer who currently have limited options,” said Eugene Sun, M.D., vice president, Global Pharmaceutical Clinical Development, Abbott. “The company is encouraged by committee member statements regarding the activity of Xinlay and the value of continuing development of the drug. We await FDA’s decision on Xinlay.”

Dr. Joel Nelson, professor and chairman of urology, University of Pittsburgh School of Medicine said, “Eighty-five percent of the men with hormone-refractory prostate cancer have disease that spreads to the bone. Debilitating bone pain is the cardinal symptom of this stage of the disease and there are currently limited choices to delay this in men.”

Christian
Editor – blog

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Tuomas Jartti (University of Wisconsin, Madison, USA) and his team
examined detailed viral aetiologies of recurrent moderate-to-severe
respiratory illnesses in 27 infants from families with allergies or
asthma.

The demographic and clinical data of these recurrently ill infants
were compared with 258 children with fewer illnesses.

This is the first long-term prospective study using virus strain
specific diagnostics for rhinoviruses, and it reveals several
interesting findings.

First, frequently ill infants had higher exposure to other children
and more wheezing illnesses than less symptomatic children.
In addition, rhinoviruses were the most common virus detected, and
could be associated with wheezing illnesses, as well as milder common
colds.

Mixed viral infections were fairly common in these frequently ill
infants, and were associated with more severe symptoms.
Finally, detection of the same virus strain for more than two weeks
was unusual (only 5% of all 244 positive findings) and most prolonged
illnesses were caused by consecutive infections with different viruses.

In conclusion, this study demonstrates that rhinovirus infections
occur early, pervasively, and repetitively in these high-risk infants
and that prolonged illnesses in this age group are usually caused by
a series of infections, rather than extending infection with a single
virus.

Title of Original Article
Serial viral infections in infants with recurrent respiratory illnesses
European Respiratory Journal (Erj), Vol. 32, No 2

The European Respiratory Journal is the peer-reviewed scientific
publication of the European Respiratory Society (more than 8,000
specialists in lung diseases and respiratory medicine in Europe, the
United States and Australia).

European Respiratory Journal Continue reading →