Loading…

Incidence of respiratory and allergic symptoms in Italian and immigrant children

Summary Background Immigration usually implies a complete change of the environment where one lives. Hence, studies on immigrants may help to disentangle genetic and environmental determinants of disease. We investigated whether the incidence of allergic and respiratory symptoms differed for Italian...

Full description

Saved in:
Bibliographic Details
Published in:Respiratory medicine 2011-02, Vol.105 (2), p.204-210
Main Authors: Marcon, Alessandro, Cazzoletti, Lucia, Rava, Marta, Gisondi, Paolo, Pironi, Vanda, Ricci, Paolo, de Marco, Roberto
Format: Article
Language:English
Subjects:
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c512t-d160f6f6b5c662690029768609ba5cc09988ef6e231d39d37c13f6e65246c2e93
cites cdi_FETCH-LOGICAL-c512t-d160f6f6b5c662690029768609ba5cc09988ef6e231d39d37c13f6e65246c2e93
container_end_page 210
container_issue 2
container_start_page 204
container_title Respiratory medicine
container_volume 105
creator Marcon, Alessandro
Cazzoletti, Lucia
Rava, Marta
Gisondi, Paolo
Pironi, Vanda
Ricci, Paolo
de Marco, Roberto
description Summary Background Immigration usually implies a complete change of the environment where one lives. Hence, studies on immigrants may help to disentangle genetic and environmental determinants of disease. We investigated whether the incidence of allergic and respiratory symptoms differed for Italian and immigrant children living in one area of Northern Italy. Methods In December 2006, all the children (3–14 years) living in the Viadana district were surveyed through a parental questionnaire (response rate = 99%, n  = 3854). Retrospective incidences of several symptoms were compared across different ethnic groups. Results Parental asthma, allergic rhinitis and eczema were less frequent in immigrant children than in Italian children. Wheezing and eczema incidences were lower in children born to foreign parents (especially if born abroad, incidence rate ratio (IRR) = 0.47, 95% CI: 0.26–0.82 and IRR = 0.43, 95% CI: 0.23–0.83, respectively), with respect to Italian children, while the occurrence of nasal allergies was similar among the ethnic groups. The greatest incidence of persistent cough/phlegm was observed in children born in Italy to foreign parents (IRR = 1.98, 95% CI: 1.06–3.71) and in children whose parents had chronic bronchitis (IRR = 2.57, 95% CI: 1.52–4.33). Conclusions Considering the distribution of parental atopic diseases and the low disease prevalence in the immigrants’ countries of origin, we suggest that nasal allergies may be more sensitive than wheezing or eczema to the change in the environment related to migration. Genetic or environmental factors clustered into families seem to have a role on chronic bronchitis.
doi_str_mv 10.1016/j.rmed.2010.09.009
format article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_843413634</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0954611110003951</els_id><sourcerecordid>2745491041</sourcerecordid><originalsourceid>FETCH-LOGICAL-c512t-d160f6f6b5c662690029768609ba5cc09988ef6e231d39d37c13f6e65246c2e93</originalsourceid><addsrcrecordid>eNp9klGLEzEQgIMoXq_6B3yQBRGftk6S3ekGRJDD08KBgvoc0mT2TM1ma7IV-u_N2h4H9-BTSPLNZObLMPaCw4oDx7e7VRrIrQSUA1ArAPWILXgrRS0Bm8dsAaptauScX7DLnHdQiKaBp-xCgJKN5LhgXzfRekfRUjX2VaK898lMYzpWJrrKhEDp1tsqH4f9NA658rHaTCZ4E_8Bfhj8bTJxquxPH1yi-Iw96U3I9Py8LtmP64_frz7XN18-ba4-3NS25WKqHUfoscdtaxEFKgCh1tghqK1prQWluo56JCG5k8rJteWybLEVDVpBSi7Zm1PefRp_HyhPevDZUggm0njIumtkwyWWNpfs1QNyNx5SLMVpDrLlUmKLhRInyqYx50S93ic_mHQskJ51652edetZtwali8wS9PKc-rCd7-5C7vwW4PUZMNma0BdV1ud7Tq7XCrqucO9OHBVlfzwlna2ff8X5RHbSbvT_r-P9g3AbfPTlxV90pHzfr85Cg_42D8Y8F7yMhFRFwV-5-bDT</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1035133656</pqid></control><display><type>article</type><title>Incidence of respiratory and allergic symptoms in Italian and immigrant children</title><source>ScienceDirect Freedom Collection</source><creator>Marcon, Alessandro ; Cazzoletti, Lucia ; Rava, Marta ; Gisondi, Paolo ; Pironi, Vanda ; Ricci, Paolo ; de Marco, Roberto</creator><creatorcontrib>Marcon, Alessandro ; Cazzoletti, Lucia ; Rava, Marta ; Gisondi, Paolo ; Pironi, Vanda ; Ricci, Paolo ; de Marco, Roberto</creatorcontrib><description>Summary Background Immigration usually implies a complete change of the environment where one lives. Hence, studies on immigrants may help to disentangle genetic and environmental determinants of disease. We investigated whether the incidence of allergic and respiratory symptoms differed for Italian and immigrant children living in one area of Northern Italy. Methods In December 2006, all the children (3–14 years) living in the Viadana district were surveyed through a parental questionnaire (response rate = 99%, n  = 3854). Retrospective incidences of several symptoms were compared across different ethnic groups. Results Parental asthma, allergic rhinitis and eczema were less frequent in immigrant children than in Italian children. Wheezing and eczema incidences were lower in children born to foreign parents (especially if born abroad, incidence rate ratio (IRR) = 0.47, 95% CI: 0.26–0.82 and IRR = 0.43, 95% CI: 0.23–0.83, respectively), with respect to Italian children, while the occurrence of nasal allergies was similar among the ethnic groups. The greatest incidence of persistent cough/phlegm was observed in children born in Italy to foreign parents (IRR = 1.98, 95% CI: 1.06–3.71) and in children whose parents had chronic bronchitis (IRR = 2.57, 95% CI: 1.52–4.33). Conclusions Considering the distribution of parental atopic diseases and the low disease prevalence in the immigrants’ countries of origin, we suggest that nasal allergies may be more sensitive than wheezing or eczema to the change in the environment related to migration. Genetic or environmental factors clustered into families seem to have a role on chronic bronchitis.</description><identifier>ISSN: 0954-6111</identifier><identifier>EISSN: 1532-3064</identifier><identifier>DOI: 10.1016/j.rmed.2010.09.009</identifier><identifier>PMID: 20934316</identifier><language>eng</language><publisher>Kidlington: Elsevier Ltd</publisher><subject>Allergic diseases ; Asthma ; Asthma - epidemiology ; Asthma - ethnology ; Asthma - physiopathology ; Biological and medical sciences ; Bronchitis, Chronic - epidemiology ; Bronchitis, Chronic - physiopathology ; Child ; Child, Preschool ; Children &amp; youth ; Chronic illnesses ; Chronic obstructive pulmonary disease, asthma ; Confounding Factors (Epidemiology) ; Cough ; Cough - epidemiology ; Cough - ethnology ; Cough - physiopathology ; Eczema ; Eczema - epidemiology ; Eczema - ethnology ; Eczema - physiopathology ; Emigrants and Immigrants - statistics &amp; numerical data ; Epidemiology ; Factories ; Female ; Humans ; Immigration policy ; Immunopathology ; Incidence ; Italy - epidemiology ; Male ; Medical sciences ; Non tumoral diseases ; Noncitizens ; Otorhinolaryngology. Stomatology ; Phlegm ; Pneumology ; Pulmonary/Respiratory ; Questionnaires ; Respiratory system : syndromes and miscellaneous diseases ; Retrospective Studies ; Rhinitis ; Risk Factors ; Skin allergic diseases. Stinging insect allergies ; Studies ; Surveys and Questionnaires ; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology ; Wheezing</subject><ispartof>Respiratory medicine, 2011-02, Vol.105 (2), p.204-210</ispartof><rights>Elsevier Ltd</rights><rights>2010 Elsevier Ltd</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2010 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c512t-d160f6f6b5c662690029768609ba5cc09988ef6e231d39d37c13f6e65246c2e93</citedby><cites>FETCH-LOGICAL-c512t-d160f6f6b5c662690029768609ba5cc09988ef6e231d39d37c13f6e65246c2e93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=23779088$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20934316$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Marcon, Alessandro</creatorcontrib><creatorcontrib>Cazzoletti, Lucia</creatorcontrib><creatorcontrib>Rava, Marta</creatorcontrib><creatorcontrib>Gisondi, Paolo</creatorcontrib><creatorcontrib>Pironi, Vanda</creatorcontrib><creatorcontrib>Ricci, Paolo</creatorcontrib><creatorcontrib>de Marco, Roberto</creatorcontrib><title>Incidence of respiratory and allergic symptoms in Italian and immigrant children</title><title>Respiratory medicine</title><addtitle>Respir Med</addtitle><description>Summary Background Immigration usually implies a complete change of the environment where one lives. Hence, studies on immigrants may help to disentangle genetic and environmental determinants of disease. We investigated whether the incidence of allergic and respiratory symptoms differed for Italian and immigrant children living in one area of Northern Italy. Methods In December 2006, all the children (3–14 years) living in the Viadana district were surveyed through a parental questionnaire (response rate = 99%, n  = 3854). Retrospective incidences of several symptoms were compared across different ethnic groups. Results Parental asthma, allergic rhinitis and eczema were less frequent in immigrant children than in Italian children. Wheezing and eczema incidences were lower in children born to foreign parents (especially if born abroad, incidence rate ratio (IRR) = 0.47, 95% CI: 0.26–0.82 and IRR = 0.43, 95% CI: 0.23–0.83, respectively), with respect to Italian children, while the occurrence of nasal allergies was similar among the ethnic groups. The greatest incidence of persistent cough/phlegm was observed in children born in Italy to foreign parents (IRR = 1.98, 95% CI: 1.06–3.71) and in children whose parents had chronic bronchitis (IRR = 2.57, 95% CI: 1.52–4.33). Conclusions Considering the distribution of parental atopic diseases and the low disease prevalence in the immigrants’ countries of origin, we suggest that nasal allergies may be more sensitive than wheezing or eczema to the change in the environment related to migration. Genetic or environmental factors clustered into families seem to have a role on chronic bronchitis.</description><subject>Allergic diseases</subject><subject>Asthma</subject><subject>Asthma - epidemiology</subject><subject>Asthma - ethnology</subject><subject>Asthma - physiopathology</subject><subject>Biological and medical sciences</subject><subject>Bronchitis, Chronic - epidemiology</subject><subject>Bronchitis, Chronic - physiopathology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children &amp; youth</subject><subject>Chronic illnesses</subject><subject>Chronic obstructive pulmonary disease, asthma</subject><subject>Confounding Factors (Epidemiology)</subject><subject>Cough</subject><subject>Cough - epidemiology</subject><subject>Cough - ethnology</subject><subject>Cough - physiopathology</subject><subject>Eczema</subject><subject>Eczema - epidemiology</subject><subject>Eczema - ethnology</subject><subject>Eczema - physiopathology</subject><subject>Emigrants and Immigrants - statistics &amp; numerical data</subject><subject>Epidemiology</subject><subject>Factories</subject><subject>Female</subject><subject>Humans</subject><subject>Immigration policy</subject><subject>Immunopathology</subject><subject>Incidence</subject><subject>Italy - epidemiology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Non tumoral diseases</subject><subject>Noncitizens</subject><subject>Otorhinolaryngology. Stomatology</subject><subject>Phlegm</subject><subject>Pneumology</subject><subject>Pulmonary/Respiratory</subject><subject>Questionnaires</subject><subject>Respiratory system : syndromes and miscellaneous diseases</subject><subject>Retrospective Studies</subject><subject>Rhinitis</subject><subject>Risk Factors</subject><subject>Skin allergic diseases. Stinging insect allergies</subject><subject>Studies</subject><subject>Surveys and Questionnaires</subject><subject>Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology</subject><subject>Wheezing</subject><issn>0954-6111</issn><issn>1532-3064</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><recordid>eNp9klGLEzEQgIMoXq_6B3yQBRGftk6S3ekGRJDD08KBgvoc0mT2TM1ma7IV-u_N2h4H9-BTSPLNZObLMPaCw4oDx7e7VRrIrQSUA1ArAPWILXgrRS0Bm8dsAaptauScX7DLnHdQiKaBp-xCgJKN5LhgXzfRekfRUjX2VaK898lMYzpWJrrKhEDp1tsqH4f9NA658rHaTCZ4E_8Bfhj8bTJxquxPH1yi-Iw96U3I9Py8LtmP64_frz7XN18-ba4-3NS25WKqHUfoscdtaxEFKgCh1tghqK1prQWluo56JCG5k8rJteWybLEVDVpBSi7Zm1PefRp_HyhPevDZUggm0njIumtkwyWWNpfs1QNyNx5SLMVpDrLlUmKLhRInyqYx50S93ic_mHQskJ51652edetZtwali8wS9PKc-rCd7-5C7vwW4PUZMNma0BdV1ud7Tq7XCrqucO9OHBVlfzwlna2ff8X5RHbSbvT_r-P9g3AbfPTlxV90pHzfr85Cg_42D8Y8F7yMhFRFwV-5-bDT</recordid><startdate>20110201</startdate><enddate>20110201</enddate><creator>Marcon, Alessandro</creator><creator>Cazzoletti, Lucia</creator><creator>Rava, Marta</creator><creator>Gisondi, Paolo</creator><creator>Pironi, Vanda</creator><creator>Ricci, Paolo</creator><creator>de Marco, Roberto</creator><general>Elsevier Ltd</general><general>Elsevier</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><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>7U9</scope><scope>ASE</scope><scope>FPQ</scope><scope>H94</scope><scope>K6X</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20110201</creationdate><title>Incidence of respiratory and allergic symptoms in Italian and immigrant children</title><author>Marcon, Alessandro ; Cazzoletti, Lucia ; Rava, Marta ; Gisondi, Paolo ; Pironi, Vanda ; Ricci, Paolo ; de Marco, Roberto</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c512t-d160f6f6b5c662690029768609ba5cc09988ef6e231d39d37c13f6e65246c2e93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Allergic diseases</topic><topic>Asthma</topic><topic>Asthma - epidemiology</topic><topic>Asthma - ethnology</topic><topic>Asthma - physiopathology</topic><topic>Biological and medical sciences</topic><topic>Bronchitis, Chronic - epidemiology</topic><topic>Bronchitis, Chronic - physiopathology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children &amp; youth</topic><topic>Chronic illnesses</topic><topic>Chronic obstructive pulmonary disease, asthma</topic><topic>Confounding Factors (Epidemiology)</topic><topic>Cough</topic><topic>Cough - epidemiology</topic><topic>Cough - ethnology</topic><topic>Cough - physiopathology</topic><topic>Eczema</topic><topic>Eczema - epidemiology</topic><topic>Eczema - ethnology</topic><topic>Eczema - physiopathology</topic><topic>Emigrants and Immigrants - statistics &amp; numerical data</topic><topic>Epidemiology</topic><topic>Factories</topic><topic>Female</topic><topic>Humans</topic><topic>Immigration policy</topic><topic>Immunopathology</topic><topic>Incidence</topic><topic>Italy - epidemiology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Non tumoral diseases</topic><topic>Noncitizens</topic><topic>Otorhinolaryngology. Stomatology</topic><topic>Phlegm</topic><topic>Pneumology</topic><topic>Pulmonary/Respiratory</topic><topic>Questionnaires</topic><topic>Respiratory system : syndromes and miscellaneous diseases</topic><topic>Retrospective Studies</topic><topic>Rhinitis</topic><topic>Risk Factors</topic><topic>Skin allergic diseases. Stinging insect allergies</topic><topic>Studies</topic><topic>Surveys and Questionnaires</topic><topic>Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology</topic><topic>Wheezing</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Marcon, Alessandro</creatorcontrib><creatorcontrib>Cazzoletti, Lucia</creatorcontrib><creatorcontrib>Rava, Marta</creatorcontrib><creatorcontrib>Gisondi, Paolo</creatorcontrib><creatorcontrib>Pironi, Vanda</creatorcontrib><creatorcontrib>Ricci, Paolo</creatorcontrib><creatorcontrib>de Marco, Roberto</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><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>Virology and AIDS Abstracts</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>British Nursing Index</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Respiratory medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Marcon, Alessandro</au><au>Cazzoletti, Lucia</au><au>Rava, Marta</au><au>Gisondi, Paolo</au><au>Pironi, Vanda</au><au>Ricci, Paolo</au><au>de Marco, Roberto</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidence of respiratory and allergic symptoms in Italian and immigrant children</atitle><jtitle>Respiratory medicine</jtitle><addtitle>Respir Med</addtitle><date>2011-02-01</date><risdate>2011</risdate><volume>105</volume><issue>2</issue><spage>204</spage><epage>210</epage><pages>204-210</pages><issn>0954-6111</issn><eissn>1532-3064</eissn><abstract>Summary Background Immigration usually implies a complete change of the environment where one lives. Hence, studies on immigrants may help to disentangle genetic and environmental determinants of disease. We investigated whether the incidence of allergic and respiratory symptoms differed for Italian and immigrant children living in one area of Northern Italy. Methods In December 2006, all the children (3–14 years) living in the Viadana district were surveyed through a parental questionnaire (response rate = 99%, n  = 3854). Retrospective incidences of several symptoms were compared across different ethnic groups. Results Parental asthma, allergic rhinitis and eczema were less frequent in immigrant children than in Italian children. Wheezing and eczema incidences were lower in children born to foreign parents (especially if born abroad, incidence rate ratio (IRR) = 0.47, 95% CI: 0.26–0.82 and IRR = 0.43, 95% CI: 0.23–0.83, respectively), with respect to Italian children, while the occurrence of nasal allergies was similar among the ethnic groups. The greatest incidence of persistent cough/phlegm was observed in children born in Italy to foreign parents (IRR = 1.98, 95% CI: 1.06–3.71) and in children whose parents had chronic bronchitis (IRR = 2.57, 95% CI: 1.52–4.33). Conclusions Considering the distribution of parental atopic diseases and the low disease prevalence in the immigrants’ countries of origin, we suggest that nasal allergies may be more sensitive than wheezing or eczema to the change in the environment related to migration. Genetic or environmental factors clustered into families seem to have a role on chronic bronchitis.</abstract><cop>Kidlington</cop><pub>Elsevier Ltd</pub><pmid>20934316</pmid><doi>10.1016/j.rmed.2010.09.009</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0954-6111
ispartof Respiratory medicine, 2011-02, Vol.105 (2), p.204-210
issn 0954-6111
1532-3064
language eng
recordid cdi_proquest_miscellaneous_843413634
source ScienceDirect Freedom Collection
subjects Allergic diseases
Asthma
Asthma - epidemiology
Asthma - ethnology
Asthma - physiopathology
Biological and medical sciences
Bronchitis, Chronic - epidemiology
Bronchitis, Chronic - physiopathology
Child
Child, Preschool
Children & youth
Chronic illnesses
Chronic obstructive pulmonary disease, asthma
Confounding Factors (Epidemiology)
Cough
Cough - epidemiology
Cough - ethnology
Cough - physiopathology
Eczema
Eczema - epidemiology
Eczema - ethnology
Eczema - physiopathology
Emigrants and Immigrants - statistics & numerical data
Epidemiology
Factories
Female
Humans
Immigration policy
Immunopathology
Incidence
Italy - epidemiology
Male
Medical sciences
Non tumoral diseases
Noncitizens
Otorhinolaryngology. Stomatology
Phlegm
Pneumology
Pulmonary/Respiratory
Questionnaires
Respiratory system : syndromes and miscellaneous diseases
Retrospective Studies
Rhinitis
Risk Factors
Skin allergic diseases. Stinging insect allergies
Studies
Surveys and Questionnaires
Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
Wheezing
title Incidence of respiratory and allergic symptoms in Italian and immigrant children
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-20T10%3A20%3A20IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Incidence%20of%20respiratory%20and%20allergic%20symptoms%20in%20Italian%20and%20immigrant%20children&rft.jtitle=Respiratory%20medicine&rft.au=Marcon,%20Alessandro&rft.date=2011-02-01&rft.volume=105&rft.issue=2&rft.spage=204&rft.epage=210&rft.pages=204-210&rft.issn=0954-6111&rft.eissn=1532-3064&rft_id=info:doi/10.1016/j.rmed.2010.09.009&rft_dat=%3Cproquest_cross%3E2745491041%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c512t-d160f6f6b5c662690029768609ba5cc09988ef6e231d39d37c13f6e65246c2e93%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=1035133656&rft_id=info:pmid/20934316&rfr_iscdi=true