Medical Principles and Practice Journal Impact Factor & Information

Publisher: Karger

Journal description

Medical Principles and Practiceí is a general medical journal that focuses on recent advances made in basic medical sciences and clinical practice. It reflects the broad spectrum of work conducted by scientists and physicians from around the world at the Kuwait University faculty of medicine since its foundation in 1976. The international character of their contributions has resulted in the journal attracting original papers, reviews, reports and short communications not only from Kuwait and the Middle East, but also from the international scientific and medical communities as a whole.

Current impact factor: 1.11

Impact Factor Rankings

2015 Impact Factor Available summer 2015
2013 / 2014 Impact Factor 1.113
2012 Impact Factor 0.963
2011 Impact Factor 0.887
2010 Impact Factor 1.069
2009 Impact Factor 0.824
2008 Impact Factor 0.583
2007 Impact Factor 0.542
2006 Impact Factor 0.442
2005 Impact Factor 0.566
2004 Impact Factor 0.319
2003 Impact Factor 0.194
2002 Impact Factor 0.141
2001 Impact Factor 0.106
2000 Impact Factor 0.097
1999 Impact Factor 0.263
1998 Impact Factor 0.125

Impact factor over time

Impact factor

Additional details

5-year impact 0.97
Cited half-life 5.00
Immediacy index 0.18
Eigenfactor 0.00
Article influence 0.23
Website Medical Principles and Practice website
ISSN 1423-0151
OCLC 164576043
Material type Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details


  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author can archive a post-print version
  • Conditions
    • On author's personal website or institutional website
    • Server must be non-commercial
    • Publisher's version/PDF may be used
    • Published source must be acknowledged
    • Must link to publisher version
    • Creative Commons Attribution Non-Commercial License 3.0
    • All titles are open access journals
    • This policy is an exception to the default policies of 'Karger'
  • Classification
    ​ green

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: To investigate the possible correlation between serum 25-hydroxyvitamin D levels and resistant hypertension (RH). Patients who had undergone ambulatory blood pressure measurements (ABPM) during outpatient controls were enrolled. Fifty subjects with RH, 50 with controlled hypertension (CHT) and 50 normotensive subjects (NT) were included in the study. RH was defined as 'suboptimal blood pressure control despite using 3 antihypertensive agents including a diuretic or need for 4 or more drugs to control blood pressure'. The 25-hydroxyvitamin D and parathormone levels were compared between the groups. Pearson's correlation coefficient test was applied to assess the correlation between 25-hydroxyvitamin D levels and office blood pressure (BP) and ABPM. Logistic regression analysis was used to determine the independent correlates of RH. The 25-hydroxyvitamin D level was significantly lower in the RH group (17.02 ± 5.4 ng/ml) compared to the CHT (24.9 ± 4.8 ng/ml) and NT groups (28.0 ± 5.7 ng/ml, p < 0.001). In univariate correlation analysis, 25-hydroxyvitamin D levels had a significant negative correlation with office systolic BP (r = -0.329, p < 0.001), office diastolic BP (r = -0.395, p < 0.001), systolic ambulatory BP (r = -0.844, p = 0.004), and diastolic ambulatory BP (r = -0.567, p = 0.005). ROC analysis revealed that 25-hydroxyvitamin D levels <21.50 ng/ml predicted the presence of RH with a sensitivity of 78% and a specificity of 79% (AUC = 0.89, 95% CI 0.83-0.94). In the multivariate logistic regression analysis, 25-hydroxyvitamin D level was independently correlated with the presence of RH (β 0.660, 95% CI 0.572-0.760, p < 0.001). There was an independent correlation between lower 25-hydroxyvitamin D levels and presence of RH. © 2015 S. Karger AG, Basel.
    Medical Principles and Practice 08/2015; DOI:10.1159/000437227
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    ABSTRACT: To evaluate the prescription of potentially inappropriate medications (PIM), using the Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) and Beers criteria, to disabled older people. One hundred and forty-one patients aged ≥65 years with Barthel scale scores ≤60 and a regular intake of medication for chronic diseases at Chung Shan Medical University Hospital from July to December 2012 were included, and their medical records were reviewed. Comprehensive patient information was extracted from the patients' medical notes. The STOPP and Beers 2012 criteria were used separately to identify PIM, and logistic regression analyses were performed to identify risk factors for PIM. The optimal cutoff for the number of medications prescribed for predicting PIM was estimated using the Youden index. Of the 141 patients, 94 (66.7%) and 94 (66.7%) had at least one PIM identified by the STOPP and Beers criteria, respectively. In multivariate analysis, PIM identified by the Beers criteria were associated with the prescription of multiple medications (p = 0.013) and the presence of psychiatric diseases (p < 0.001), whereas PIM identified by the STOPP criteria were only associated with the prescription of multiple medications (p = 0.008). The optimal cutoff for the number of medications prescribed for predicting PIM by using the STOPP or Beers criteria was 6. After adjustment for covariates, patients prescribed ≥6 medications had a significantly higher risk of PIM, identified using the STOPP or Beers criteria, compared to patients prescribed <6 medications (both p < 0.05). This study revealed a high frequency of PIM in disabled older patients with chronic diseases, particularly those prescribed ≥6 medications. © 2015 S. Karger AG, Basel.
    Medical Principles and Practice 08/2015; DOI:10.1159/000435955
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    ABSTRACT: Gastrointestinal (GI) cancers, such as of the colon and pancreas, are highly resistant to both standard and targeted therapeutics. Therapy-resistant and heterogeneous GI cancers harbor highly complex signaling networks (the resistome) that resist apoptotic programming. Commonly used gemcitabine or platinum-based regimens fail to induce meaningful (i.e. disease-reversing) perturbations in the resistome, resulting in high rates of treatment failure. The GI cancer resistance networks are, in part, due to interactions between parallel signaling and aberrantly expressed microRNAs (miRNAs) that collectively promote the development and survival of drug-resistant cancer stem cells with epithelial-to-mesenchymal transition (EMT) characteristics. The lack of understanding of the resistance networks associated with this subpopulation of cells as well as reductionist, single protein-/pathway-targeted approaches have made 'effective drug design' a difficult task. We propose that the successful design of novel therapeutic regimens to target drug-resistant GI tumors is only possible if network-based drug avenues and agents, in particular 'natural agents' with no known toxicity, are correctly identified. Natural agents (dietary agents or their synthetic derivatives) can individually alter miRNA profiles, suppress EMT pathways and eliminate cancer stem-like cells that derive from pancreatic cancer and colon cancer, by partially targeting multiple yet meaningful networks within the GI cancer resistome. However, the efficacy of these agents as combinations (e.g. consumed in the diet) against this resistome has never been studied. This short review article provides an overview of the different challenges involved in the understanding of the GI resistome, and how novel computational biology can help in the design of effective therapies to overcome resistance. © 2015 S. Karger AG, Basel.
    Medical Principles and Practice 07/2015; DOI:10.1159/000435814
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    ABSTRACT: The purpose of this study was to evaluate the frequency and attitude of medical students towards cleaning their stethoscopes. A cross-sectional study was carried out in the first week of December 2013. The study included 771 students (397 in their fourth and 374 in their sixth year) from the Faculty of Medicine, University of Belgrade, Serbia. An anonymous questionnaire was distributed to students before the start of compulsory lessons in classrooms. 317 of the 397 fourth-year students (79.8%) and 306 of the 374 sixth-year students (81.9%) cleaned their stethoscope. The stethoscope diaphragm was most commonly cleaned, while the flexible tubing was the least commonly cleaned area, mainly using ethyl alcohol-based agents. The strongest positive attitude was observed for the statement 'It is important that my stethoscope is clean' (4.3 out of 5.0). A positive correlation (Spearman's ρ = 0.105) was observed between a higher frequency of cleaning and the stronger positive notion that a stethoscope should be cleaned. A considerably high proportion of the students studied had ever cleaned their stethoscopes. Based on the students' responses, it would be useful to implement instructions on stethoscope hygiene in the regular practical curriculum with the aim of applying stethoscope disinfection in daily work. © 2015 S. Karger AG, Basel.
    Medical Principles and Practice 07/2015; DOI:10.1159/000434753
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    ABSTRACT: To examine the effectiveness of apparent diffusion coefficient (ADC) values and to compare the reliability of different b-values in detecting and identifying significant liver fibrosis. There were 44 patients with chronic viral hepatitis (CVH) in the study group and 30 healthy participants in the control group. Diffusion-weighted magnetic resonance imaging (DWI) was performed before the liver biopsy in patients with CVH. The values of ADC were measured with 3 different b-values (100, 600, 1,000 s/mm(2)). In addition, liver fibrosis was classified using the modified Ishak scoring system. Liver fibrosis stages and ADC values were compared using areas under the receiver-operating characteristic (ROC) curve. The study group's mean ADC value was not statistically significantly different from the control group's mean ADC value at b = 100 s/mm(2) (3.69 ± 0.5 × 10(-3) vs. 3.7 ± 0.3 × 10(-3) mm(2)/s) and b = 600 s/mm(2) (2.40 ± 0.3 × 10(-3) vs. 2.5 ± 0.5 × 10(-3) mm(2)/s). However, the study group's mean ADC value (0.99 ± 0.3 × 10(-3) mm(2)/s) was significantly lower than that of the control group (1.2 ± 0.1 × 10(-3) mm(2)/s) at b = 1,000 s/mm(2). With b = 1,000 s/mm(2) and the cutoff ADC value of 0.0011 mm(2)/s for the diagnosis of liver fibrosis, the mean area under the ROC curve was 0.702 ± 0.07 (p = 0.0015). For b = 1,000 s/mm(2) and the cutoff ADC value of 0.0011 mm(2)/s to diagnose significant liver fibrosis (Ishak score = 3), the mean area under the ROC curve was 0.759 ± 0.07 (p = 0.0001). Measurement of ADC values by DWI was effective in detecting liver fibrosis and accurately identifying significant liver fibrosis when a b-value of 1,000 s/mm(2) was used. © 2015 S. Karger AG, Basel.
    Medical Principles and Practice 07/2015; DOI:10.1159/000434682
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    ABSTRACT: The aim of the present study was to investigate the association between nitrate-induced headache (NIH) and the complexity of coronary artery lesions in patients with stable coronary artery disease (CAD). Two hundred and seventy-five patients with anginal chest pain who underwent coronary angiography were enrolled in the present study. NIH was defined as the presence of headache due to nitrate treatment (isosorbide mononitrate 40 mg) after excluding confounding factors. Coronary artery lesion complexity was assessed by the SYNTAX score (SXscore) using a dedicated computer software system. The mean SXscore was lower in the patients with NIH than in patients without NIH (7.3 ± 5.2 vs. 14.4 ± 8.5, respectively; p < 0.001). Additionally, patients with NIH had a lower rate of multivessel disease compared with those without NIH (the mean number of diseased vessels was 1.5 ± 0.7 and 2.0 ± 07, respectively; p < 0.001). In multivariate analysis, increasing age (p = 0.02) and headache (p = 0.001) were found to be independent determinants of SXscore. The present study demonstrated an independent inverse association between NIH and SXscore. The NIH could provide important predictive information about coronary artery lesion complexity in patients with stable CAD. © 2015 S. Karger AG, Basel.
    Medical Principles and Practice 07/2015; DOI:10.1159/000434754
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    ABSTRACT: Our investigation was designed to examine the signaling pathway involved in the enhancement of vascular endothelial growth factor (VEGF) release by β-adrenoceptor agonists. Human U937 cells differentiated into macrophages were primed with lipopolysaccharide (LPS) in the absence or presence of β-adrenoceptor agonists and antagonists. The VEGF released and the intracellular cyclic adenosine monophosphate (cAMP) generated were assayed by ELISA. Where necessary, differences between mean values were tested for significance using Student's t test. Isoprenaline, procaterol and salbutamol concentration-dependently enhanced the release of VEGF induced by LPS in U937 cells. R*,R*-(±)-4-[2-[(2-(3-chlorophenyl)-2-hydroxyethyl)amino]propyl]phenoxyacetic acid (BRL 37344), a selective β3-adrenoceptor agonist, did not enhance VEGF release. Using isoprenaline as an agonist, propranolol, ICI 118551 and atenolol produced a parallel rightward shift of the concentration-response curve with no reduction in the maximum response. The -logKB values were 8.12 ± 0.17, 8.03 ± 0.05 and 7.23 ± 0.05 for propranolol, ICI 118551 and atenolol, respectively, indicating the possible involvement of both β1- and β2-adrenoceptor subtypes. Isoprenaline and prostaglandin E2 concentration-dependently increased cAMP generation in U937 cells. Isoprenaline, db-cAMP and 6-Bnz-cAMP, a protein kinase A (PKA) activator, all enhanced VEGF release induced by LPS, and this effect was abolished by KT 5720 and Rp-cAMPS, which are both selective PKA inhibitors, suggesting that PKA is the downstream effector of cAMP activity. 8-CPT-cAMP, a selective activator of the Epac system, had no effect on VEGF release induced by LPS, indicating that the Epac pathway played no role in the release process. In this study, we established that β1- and β2- but not β3-adrenoceptors mediated cAMP-dependent enhancement of VEGF release induced by LPS in differentiated U937 cells, and that PKA was the downstream effector of cAMP activity. © 2015 S. Karger AG, Basel.
    Medical Principles and Practice 07/2015; DOI:10.1159/000433540
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    ABSTRACT: The aim of this study was to investigate the impact of overlapping functional gastrointestinal disorder (FGID) on the quality of life of patients with nonerosive reflux disease (NERD) and erosive esophagitis (EE). Data from patients with NERD and EE were collected between January 2009 and March 2010. These cases were further stratified into the subgroups of overlapping NERD-functional dyspepsia (FD), NERD-irritable bowel syndrome (IBS), EE-FD, EE-IBS, and NERD or EE alone according to the symptoms. All patients completed the modified Chinese GERDQ and the SF-36 questionnaires. Of the 222 enrolled patients, 96 (43.2%) had NERD and 126 (56.8%) had EE. Overlap of FGID occurred in 43.8-45.8% of the NERD patients, and in 41.3-44.4% of EE cases. The impact of overlapping FGID on patient quality of life was greater in the patients with overlapping NERD-FD compared to those with NERD alone (mean SF-36 total scores 59 vs. 72, adjusted p = 0.025) and the cases with overlapping EE-FD compared to those with EE alone (mean SF-36 total scores 53.19 vs. 73.11, adjusted p = 0.047). There were no significant differences between the individuals with overlapping NERD/EE-IBS and those with NERD/EE alone. There was a high prevalence of overlapping FGID, with both FD and IBS, among the GERD patients. The individuals with overlapping GERD and FD had lower quality of life scores than those with GERD alone. © 2015 S. Karger AG, Basel.
    Medical Principles and Practice 06/2015; DOI:10.1159/000431370
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    ABSTRACT: To compare the changes in anti-malondialdehyde-modified low-density lipoprotein (MDA-LDL) IgG levels among patients undergoing off-pump and on-pump coronary artery bypass grafting (CABG) or valvuloplasty. A total of 38, 39 and 34 patients who underwent off-pump CABG, on-pump CABG and valvuloplasty, respectively, were enrolled in this study. Serum anti-MDA-LDL IgG values were measured 24 h before and after the operative procedures and at discharge. Echocardiography was also done before surgery and before discharge. The results were compared with values from 50 healthy controls. In all patients, a reduction in antibody titers was observed post-operatively. However, the decrease was significant only in the off-pump CABG - before surgery: 42.33 (25.83-58.51), after surgery: 30.86 (16.36-51.33) and at discharge: 10.96 (6.82-23.57; p = 0.027). There was a significant positive association between anti-MDA-LDL IgG levels and ejection fraction (r = 0.248, p = 0.036) and a negative association with E/E', a marker of pulmonary capillary wedge pressure, in the coronary patients (r = -0.345, p = 0.012), but no significant associations were found in patients with valvular heart disease. Serum anti-MDA-LDL IgG levels were associated with cardiac function indices in coronary patients undergoing CABG. © 2015 S. Karger AG, Basel.
    Medical Principles and Practice 06/2015; DOI:10.1159/000431178
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    ABSTRACT: To evaluate the effect of luminous intensity on contrast vision under different ocular conditions. Ninety eyes of 45 persons were included in this study as follows: 30 healthy eyes, 30 eyes with cataract simulation (using translucent glasses), and 30 myopic eyes. Contrast sensitivity was examined using 5 spatial frequencies (1.5, 3.0, 6.0, 12.0, and 18.0 cycles per degree) of sine wave contrast test optotypes for 4 light intensities (34, 68, 154, and 240 cd/m(2)). The mean linear contrast sensitivities averaged over the frequencies for each of the 4 light intensities were: healthy eyes: 59 ± 11, 72 ± 16, 79 ± 23, and 80 ± 19; myopic eyes: 52 ± 13, 67 ± 15, 73 ± 21, and 75 ± 18, and cataract simulation eyes: 15 ± 7, 21 ± 8.6, 28.7 ± 13, and 28.6 ± 13, respectively. The linear contrast sensitivities averaged over the light intensities for each of the 5 spatial frequencies were: healthy eyes: 78, 87, 117, 59, and 21; myopic eyes: 65, 84, 109, 54, and 29, and cataract simulation eyes: 37, 41, 28, 8, and 2. The light intensity level had a positive effect on the contrast sensitivity of the examined eyes, except for eyes with cataract simulation, where even the maximum light intensity did not improve the contrast vision. This indicates that patients with cataracts require increased contrast of text rather than brighter illumination to improve the quality of their vision. © 2015 S. Karger AG, Basel.
    Medical Principles and Practice 06/2015; DOI:10.1159/000433489
  • Medical Principles and Practice 06/2015; 24(5). DOI:10.1159/000431369
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    ABSTRACT: This study was carried out in order to ascertain whether or not Hurricane Katrina and related factors (i.e. the amount of rainfall) influenced the male-to-female birth ratio (M/F). Monthly births by gender for the affected states (Alabama, Florida, Louisiana and Mississippi) for January 2003 to December 2012 were obtained from the Centers for Disease Control and Prevention (CDC Wonder, Atlanta, Ga., USA). Precipitation data was obtained from the US National Weather Service. Ordinary linear logistic regression was used for trend analysis. A p value ≤0.05 was taken to represent a statistically significant result. Of the total of 3,903,660 live births, 1,996,966 (51.16%) were male and 1,906,694 (48.84%) were female. Significant seasonal variation was noted (the maximum M/F in May was 1.055, the minimum M/F in September was 1.041, p = 0.0073). There was also a separate and significant rise in M/F 8-10 months after the storm (April to June 2006, peak M/F 1.078, p = 0.0074), which translated to an approximate deficit of 800 girls compared to 46,072 girls born in that period if the M/F increase was theoretically only due to a girls' deficit in the denominator of the ratio. This spike was only present in Alabama, Louisiana and Mississippi, all of which received heavy rainfall. Florida did not receive heavy rainfall and experienced no such M/F spike. In this study there was a dose-response relation between the amount of rainfall after Hurricane Katrina and the monthly sex ratio of live births in the US states of Alabama, Louisiana and Mississippi 8-10 months later. The well-known yet unexplained distinct sex ratio seasonality may be due to natural or man-made radiation contained in the rain. © 2015 S. Karger AG, Basel.
    Medical Principles and Practice 06/2015; DOI:10.1159/000431363
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    ABSTRACT: We aimed to investigate the effect of smoking on the osmotic pressure (OP) of human dental pulp tissue. Sixty male dental patients (smokers and nonsmokers) scheduled for root canal treatment for prosthodontics were included in the study. Fifteen patients (1 premolar tooth/patient) were allocated to each of the following groups according to their smoking habits, i.e. group 1: ≤10 cigarettes/day, group 2: 11-20 cigarettes/day, group 3: >20 cigarettes/day and group 4: nonsmoking controls. Apical pulp tissues were removed via coronal access. Pulp tissue supernatants were obtained to measure the pulpal OP by means of a semimicro digital osmometer. One-way analysis of variance and the post hoc Duncan test were used to analyze the differences in OP between groups. Regression analysis was used to determine the relationship between the number of cigarettes smoked daily and the pulpal OP. The mean (± SD) OP value decreased as cigarette consumption increased: group 4 (268.00 ± 10.09 mosm/kg) > group 1 (259.20 ± 7.16 mosm/kg) > group 2 (248.90 ± 2.23 mosm/kg) > group 3 (239.90 ± 7.40 mosm/kg). The OP differed significantly between groups (p < 0.01), and a significant negative correlation was found between cigarette consumption and pulpal OP (r = -0.809, p < 0.01). In this study, the OP decreased as the number of cigarettes smoked increased. In clinical examination, there may be misdiagnosis of pulpal conditions in smokers (even in healthy pulp tissue) due to the effect of altered OP on pulpal tissue reactions. © 2015 S. Karger AG, Basel.
    Medical Principles and Practice 06/2015; 24(5). DOI:10.1159/000431325
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    ABSTRACT: We aimed to investigate the expression of interleukin 12 (IL-12) family cytokines (IL-12, IL-23, IL-27 and IL-35) and their relevant cytokines (IFN-γ, IL-4, IL-17A and IL-10) in patients with chronic immune thrombocytopenia (cITP) as well as the effect of high-dose dexamethasone (HD-DXM) treatment on this expression. DXM was administered orally at a dose of 40 mg per day for 4 consecutive days to 38 patients with cITP. We measured the plasma levels of IL-12p70, IL-23, IL-27, IFN-γ, IL-4 and IL-17A before and after treatment and also in 36 matched healthy controls, by means of FlowCytomix™ technology. The plasma levels of IL-10 and IL-35 were measured by enzyme-linked immunosorbent assay. Significantly higher plasma levels of IL-12p70, IL-23, IL-27, IFN-γ and IL-17A were observed in cITP patients than in controls (p < 0.01), and after HD-DXM treatment, these levels decreased significantly (p < 0.01). However, significantly lower plasma levels of IL-4, IL-10 and IL-35 were observed in cITP patients than in controls (p < 0.01); after the HD-DXM treatment, these levels had increased significantly in the cITP patients (p < 0.01). Moreover, the cytokine levels of patients who attained a complete response returned to the levels of normal controls (p > 0.05) but were not corrected in the patients who had no response (p < 0.01). The patients with cITP had abnormal expression of the IL-12 family cytokines and their relevant cytokines levels, and HD-DXM treatment corrected the derangement of plasma cytokines. Measuring cytokine levels may help in the clinical assessment of cITP. © 2015 S. Karger AG, Basel.
    Medical Principles and Practice 06/2015; DOI:10.1159/000433472
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    ABSTRACT: This study was designed to identify the effect of rivaroxaban, a direct factor Xa inhibitor, on trinitrobenzene sulfonic acid (TNBS)-induced colitis in rats. Twenty-four female Wistar rats were divided into 4 groups of 6 each. Group 1 received TNBS + rivaroxaban, group 2 received TNBS + methylprednisolone, group 3 received TNBS and group 4 received a saline enema. Colitis was induced in the rats by the intracolonic administration of TNBS. Rivaroxaban and methylprednisolone were given by oral gavage daily for 7 days. The rats were killed 7 days after the induction of colitis. Rivaroxaban and methylprednisolone significantly reduced gross damage and histopathological scores. Rivaroxaban was more effective than methylprednisolone in terms of microscopic mucosal healing. Rivaroxaban attenuated the accumulation of malonyldialdehyde (MDA) and transforming growth-factor β1 (TGF-β1) and the activites of myeloperoxidase (MPO), matrix metalloproteinase-3 and tissue inhibitor of metalloproteinases-1. Methylprednisolone reduced only the activity of MPO and the accumulation of MDA and TGF-β1. Superoxide dismutase activity showed a restoration to normal levels after rivaroxaban and methylprednisolone administration. Rivaroxaban showed a therapeutic effect in the TNBS model of experimental colitis, and it seemed to be at least as effective as methylprednisolone. This effect may be brought about by the inhibition of oxidative stress and metalloproteinase activity associated with tissue injury and remodeling. © 2015 S. Karger AG, Basel.
    Medical Principles and Practice 06/2015; DOI:10.1159/000431361