Association Between Periodontal Health and Quality of Life in Patients with Psoriasis: A Cross-Sectional Study
Abstract
1. Introduction
2. Materials and Methods
2.1. Patient Selection
2.2. Dermatological Assessment
2.3. Clinical Examination
2.4. Data Collection
2.5. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Gelfand, J.M.; Stern, R.S.; Nijsten, T.; Feldman, S.R.; Thomas, J.; Kist, J.; Rolstad, T.; Margolis, D.J. The prevalence of psoriasis in African Americans: Results from a population-based study. J. Am. Acad. Dermatol. 2005, 52, 23–26. [Google Scholar] [CrossRef] [PubMed]
- Langley, R.G.; Krueger, G.G.; Griffiths, C.E. Psoriasis: Epidemiology, clinical features, and quality of life. Ann. Rheum. Dis. 2005, 64 (Suppl. S2), ii18–ii23; discussion ii24–ii25. [Google Scholar] [CrossRef] [PubMed]
- Menter, A.; Gottlieb, A.; Feldman, S.R.; Van Voorhees, A.S.; Leonardi, C.L.; Gordon, K.B.; Lebwohl, M.; Koo, J.Y.; Elmets, C.A.; Korman, N.J.; et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 1. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics. J. Am. Acad. Dermatol. 2008, 58, 826–850. [Google Scholar] [CrossRef]
- Gudjonsson, J.E.; Elder, J.T. Psoriasis: Epidemiology. Clin. Dermatol. 2007, 25, 535–546. [Google Scholar] [CrossRef]
- Hepat, A.; Chakole, S.; Rannaware, A. Psychological Well-Being of Adult Psoriasis Patients: A Narrative Review. Cureus 2023, 15, e37702. [Google Scholar] [CrossRef]
- Zeng, J.; Luo, S.; Huang, Y.; Lu, Q. Critical role of environmental factors in the pathogenesis of psoriasis. J. Dermatol. 2017, 44, 863–872. [Google Scholar] [CrossRef]
- Menter, A.; Krueger, G.G.; Paek, S.Y.; Kivelevitch, D.; Adamopoulos, I.E.; Langley, R.G. Interleukin-17 and Interleukin-23: A Narrative Review of Mechanisms of Action in Psoriasis and Associated Comorbidities. Dermatol. Ther. 2021, 11, 385–400. [Google Scholar] [CrossRef]
- Page, R.C.; Kornman, K.S. The pathogenesis of human periodontitis: An introduction. Periodontology 2000 1997, 14, 9–11. [Google Scholar] [CrossRef]
- Sabine Elisabeth, G.; Yuxi, Z.; Jiawen, Y.; Lei, W.; Sabine, R.; Joerg, M. Systemic, Lifestyle and Environmental Modifying Factors in the Pathogenesis of Periodontitis. J. Periodontal Res. 2025; ahead of print. [Google Scholar] [CrossRef]
- Stoica, S.A.; Valentini, G.; Dolci, M.; D’Agostino, S. Diabetes and Non-Surgical Periodontal Therapy: What Can We Hope for? Hygiene 2022, 2, 85–93. [Google Scholar] [CrossRef]
- Preus, H.R.; Khanifam, P.; Kolltveit, K.; Mørk, C.; Gjermo, P. Periodontitis in psoriasis patients: A blinded, case-controlled study. Acta Odontol. Scand. 2010, 68, 165–170. [Google Scholar] [CrossRef] [PubMed]
- Sharma, A.; Raman, A.; Pradeep, A.R. Association of chronic periodontitis and psoriasis: Periodontal status with severity of psoriasis. Oral Dis. 2015, 21, 314–319. [Google Scholar] [CrossRef]
- Skudutyte-Rysstad, R.; Slevolden, E.M.; Hansen, B.F.; Sandvik, L.; Preus, H.R. Association between moderate to severe psoriasis and periodontitis in a Scandinavian population. BMC Oral Health 2014, 14, 139. [Google Scholar] [CrossRef] [PubMed]
- Barros, F.C.; Sampaio, J.N.; Figueredo, C.; Carneiro, S.; Fischer, R.G. Higher Prevalence of Periodontitis and Decayed, Missing and Filled Teeth in Patients with Psoriasis. Eur. J. Dent. 2020, 14, 366–370. [Google Scholar] [CrossRef] [PubMed]
- Dalmády, S.; Kemény, L.; Antal, M.; Gyulai, R. Periodontitis: A newly identified comorbidity in psoriasis and psoriatic arthritis. Expert Rev. Clin. Immunol. 2019, 16, 101–108. [Google Scholar] [CrossRef] [PubMed]
- de Arruda, L.H.; De Moraes, A.P. The impact of psoriasis on quality of life. Br. J. Dermatol. 2001, 144 (Suppl. S58), 33–36. [Google Scholar] [CrossRef]
- Kirby, B.; Richards, H.L.; Woo, P.; Hindle, E.; Main, C.J.; Griffiths, C.E. Physical and psychologic measures are necessary to assess overall psoriasis severity. J. Am. Acad. Dermatol. 2001, 45, 72–76. [Google Scholar] [CrossRef]
- Ramsay, B.; O’Reagan, M. A survey of the social and psychological effects of psoriasis. Br. J. Dermatol. 1988, 118, 195–201. [Google Scholar] [CrossRef]
- Fortune, D.G.; Main, C.J.; O’Sullivan, T.M.; Griffiths, C.E. Quality of life in patients with psoriasis: The contribution of clinical variables and psoriasis-specific stress. Br. J. Dermatol. 1997, 137, 755–760. [Google Scholar] [CrossRef]
- Gupta, M.A.; Gupta, A.K. The Psoriasis Life Stress Inventory: A preliminary index of psoriasis-related stress. Acta Derm.-Venereol. 1995, 75, 240–243. [Google Scholar] [CrossRef]
- Finlay, A.Y.; Khan, G.K.; Luscombe, D.K.; Salek, M.S. Validation of Sickness Impact Profile and Psoriasis Disability Index in Psoriasis. Br. J. Dermatol. 1990, 123, 751–756. [Google Scholar] [CrossRef]
- Wahl, A.; Loge, J.H.; Wiklund, I.; Hanestad, B.R. The burden of psoriasis: A study concerning health-related quality of life among Norwegian adult patients with psoriasis compared with general population norms. J. Am. Acad. Dermatol. 2000, 43, 803–808. [Google Scholar] [CrossRef]
- Badia, X.; Mascaró, J.M.; Lozano, R. Measuring health-related quality of life in patients with mild to moderate eczema and psoriasis: Clinical validity, reliability and sensitivity to change of the DLQI. The Cavide Research Group. Br. J. Dermatol. 1999, 141, 698–702. [Google Scholar] [CrossRef]
- Root, S.; Kent, G.; Al-Abadie, M.S. The relationship between disease severity, disability and psychological distress in patients undergoing PUVA treatment for psoriasis. Dermatology 1994, 189, 234–237. [Google Scholar] [CrossRef]
- Lundberg, L.; Johannesson, M.; Silverdahl, M.; Hermansson, C.; Lindberg, M. Quality of life, health-state utilities and willingness to pay in patients with psoriasis and atopic eczema. Br. J. Dermatol. 1999, 141, 1067–1075. [Google Scholar] [CrossRef]
- Mombers, F.; De Korte, J. A review of quality of life measurement in psoriasis. Br. J. Dermatol. 1999, 141, 996–997. [Google Scholar]
- Yavuz Daglioglu, E.B.; Cadirci, D.; Aksoy, M. Effects of disease severity on quality of life in patients with psoriasis. Dermatol. Ther. 2020, 33, e14422. [Google Scholar] [CrossRef]
- İnanır, I.; Aydemir, Ö.; Gündüz, K.; Danacı, A.E.; Ermertcan, A.T. Developing a quality of life questionnaire in patients with psoriasis. Turkderm-Turk. Arch. Dermatol. Venereol. 2003, 37, 189–195. [Google Scholar]
- Slade, G.D. Derivation and validation of a short-form oral health impact profile. Community Dent. Oral Epidemiol. 1997, 25, 284–290. [Google Scholar] [CrossRef]
- Schmitt, J.; Wozel, G. The psoriasis area and severity index is the adequate criterion to define severity in chronic plaque-type psoriasis. Dermatology 2005, 210, 194–199. [Google Scholar] [CrossRef] [PubMed]
- Inanir, I.; Aydemir, O.; Gündüz, K.; Danaci, A.E.; Türel, A. Developing a quality of life instrument in patients with psoriasis: The Psoriasis Quality of Life Questionnaire (PQLQ). Int. J. Dermatol. 2006, 45, 234–238. [Google Scholar] [CrossRef]
- Löe, H. The Gingival Index, the Plaque Index and the Retention Index Systems. J. Periodontol. 1967, 38, 610–616. [Google Scholar] [CrossRef] [PubMed]
- Silness, J.; Loe, H. Periodontal Disease in Pregnancy. II. Correlation Between Oral Hygiene and Periodontal Condtion. Acta Odontol. Scand. 1964, 22, 121–135. [Google Scholar] [CrossRef]
- Sönmez, S.; Top, M. Quality of Life and Oral Health Impact Profile in Turkish Dental Patients. Health Policy Technol. (SSCI) 2016, 5, 291–297. [Google Scholar] [CrossRef]
- Faul, F.; Erdfelder, E.; Buchner, A.; Lang, A.G. Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behav. Res. Methods 2009, 41, 1149–1160. [Google Scholar] [CrossRef]
- Mendes, V.S.; Cota, L.O.M.; Costa, A.A.; Oliveira, A.M.S.D.; Costa, F.O. Periodontitis as another comorbidity associated with psoriasis: A case-control study. J. Periodontol. 2019, 90, 358–366. [Google Scholar] [CrossRef]
- Zhang, X.; Gu, H.; Xie, S.; Su, Y. Periodontitis in patients with psoriasis: A systematic review and meta-analysis. Oral Dis. 2022, 28, 33–43. [Google Scholar] [CrossRef]
- Ungprasert, P.; Wijarnpreecha, K.; Wetter, D.A. Periodontitis and risk of psoriasis: A systematic review and meta-analysis. J. Eur. Acad. Dermatol. Venereol. JEADV 2017, 31, 857–862. [Google Scholar] [CrossRef] [PubMed]
- Marruganti, C.; Gaeta, C.; Falciani, C.; Cinotti, E.; Rubegni, P.; Alovisi, M.; Scotti, N.; Baldi, A.; Bellan, C.; Defraia, C.; et al. Are periodontitis and psoriasis associated? A pre-clinical murine model. J. Clin. Periodontol. 2024, 51, 1044–1053. [Google Scholar] [CrossRef]
- Han, J.H.; Park, J.W.; Han, K.D.; Park, J.B.; Kim, M.; Lee, J.H. Smoking and Periodontitis Can Play a Synergistic Role in the Development of Psoriasis: A Nationwide Cohort Study. Dermatology 2022, 238, 554–561. [Google Scholar] [CrossRef]
- Egeberg, A.; Mallbris, L.; Gislason, G.; Hansen, P.R.; Mrowietz, U. Risk of periodontitis in patients with psoriasis and psoriatic arthritis. J. Eur. Acad. Dermatol. Venereol. JEADV 2017, 31, 288–293. [Google Scholar] [CrossRef] [PubMed]
- Sachan, S.S.; Trivedi, S.; Sharma, S.K. Association of psoriasis and periodontitis in the north Indian population. J. Oral Biol. Craniofacial Res. 2024, 14, 507–511. [Google Scholar] [CrossRef]
- Christophers, E.; Metzler, G.; Röcken, M. Bimodal immune activation in psoriasis. Br. J. Dermatol. 2014, 170, 59–65. [Google Scholar] [CrossRef]
- Di Spirito, F.; Di Palo, M.P.; Rupe, A.; Piedepalumbo, F.; Sessa, A.; De Benedetto, G.; Russo Barone, S.; Contaldo, M. Periodontitis in Psoriatic Patients: Epidemiological Insights and Putative Etiopathogenic Links. Epidemiologia 2024, 5, 479–498. [Google Scholar] [CrossRef]
- Majchrzycka, M.; Andrzejewska, M.; Surdacka, A.; Surdacki, M.; Adamski, Z. Evaluation of the relationship between psoriasis, periodontitis, and markers of inflammation. Postep. Dermatol. Alergol. 2022, 39, 1123–1127. [Google Scholar] [CrossRef] [PubMed]
- Baurecht, H.; Freuer, D.; Welker, C.; Tsoi, L.C.; Elder, J.T.; Ehmke, B.; Leitzmann, M.F.; Holtfreter, B.; Baumeister, S.E. Relationship between periodontitis and psoriasis: A two-sample Mendelian randomization study. J. Clin. Periodontol. 2022, 49, 573–579. [Google Scholar] [CrossRef] [PubMed]
- Chen, G.; Zhou, D.; Zhang, Z.; Kan, M.; Zhang, D.; Hu, X.; Feng, G.; Liu, Y.; He, L. Genetic variants in IFIH1 play opposite roles in the pathogenesis of psoriasis and chronic periodontitis. Int. J. Immunogenet. 2012, 39, 137–143. [Google Scholar] [CrossRef]
- Dowlatshahi, E.A.; Wakkee, M.; Arends, L.R.; Nijsten, T. The prevalence and odds of depressive symptoms and clinical depression in psoriasis patients: A systematic review and meta-analysis. J. Investig. Dermatol. 2014, 134, 1542–1551. [Google Scholar] [CrossRef]
- Koo, J.; Marangell, L.B.; Nakamura, M.; Armstrong, A.; Jeon, C.; Bhutani, T.; Wu, J.J. Depression and suicidality in psoriasis: Review of the literature including the cytokine theory of depression. J. Eur. Acad. Dermatol. Venereol. JEADV 2017, 31, 1999–2009. [Google Scholar] [CrossRef] [PubMed]
- Kimball, A.B.; Jacobson, C.; Weiss, S.; Vreeland, M.G.; Wu, Y. The psychosocial burden of psoriasis. Am. J. Clin. Dermatol. 2005, 6, 383–392. [Google Scholar] [CrossRef]
- Ponikowska, M.; Vellone, E.; Czapla, M.; Uchmanowicz, I. Challenges Psoriasis and Its Impact on Quality of Life: Challenges in Treatment and Management. Psoriasis 2025, 15, 175–183. [Google Scholar] [CrossRef]
- Costa, A.A.; Cota, L.O.M.; Esteves Lima, R.P.; Oliveira, A.; Cortelli, S.C.; Cortelli, J.R.; Cyrino, R.M.; Mendes, V.S.; Silva, T.A.; Costa, F.O. The association between periodontitis and the impact of oral health on the quality of life of individuals with psoriasis and psoriatic arthritis. PLoS ONE 2024, 19, e0301158. [Google Scholar] [CrossRef]
- Mishra, S.; Johnson, L.; Kaushal, L.; Upadhyay, P. Impact of periodontitis on oral health-related quality of life of patients with psoriatic arthritis. Spec. Care Dent. 2024, 44, 893–902. [Google Scholar] [CrossRef] [PubMed]
- Costa, A.A.; Cota, L.O.M.; Mendes, V.S.; Oliveira, A.; Cyrino, R.M.; Costa, F.O. Periodontitis and the impact of oral health on the quality of life of psoriatic individuals: A case-control study. Clin. Oral Investig. 2021, 25, 2827–2836. [Google Scholar] [CrossRef] [PubMed]
- Woeste, S.; Graetz, C.; Gerdes, S.; Mrowietz, U. Oral Health in Patients with Psoriasis-A Prospective Study. J. Investig. Dermatol. 2019, 139, 1237–1244. [Google Scholar] [CrossRef] [PubMed]
- Polineni, S.; Gopinath, H.; Ramani, J.R.; Yadav, S.; Aravindakshan, R.; Yerragudi, N.; Prabhakaran, N.; Sreenivas, K.D.; Abraham, V.T. The association of psoriasis and psoriatic arthritis with periodontitis: A hospital-based case-control study. Indian J. Dermatol. Venereol. Leprol. 2023, 90, 291–295. [Google Scholar] [CrossRef]
- Kiernan, Y.; O’Connor, C.; Ryan, J.; Murphy, M. Oral health in patients with severe inflammatory dermatologic and rheumatologic disease. Ski. Health Dis. 2023, 3, e156. [Google Scholar] [CrossRef]
Control (n = 113) Mean ± Sd | Psoriasis (n = 113) Mean ± Sd | p | |
---|---|---|---|
Age at diagnosis | 29.14 ± 11.44 | ||
PASI | 2.16 ± 3.91 | ||
PQLQ score | 13.48 ± 9.01 | ||
Functional limitation | 1.85 ± 1.75 | 1.04 ± 1.57 | 0.001 * |
Physical pain | 1.68 ± 1.80 | 1.81 ± 1.90 | 0.590 |
Psychological discomfort | 1.17 ± 1.49 | 1.42 ± 1.77 | 0.240 |
Physical disability | 1.12 ± 1.56 | 1.04 ± 1.49 | 0.663 |
Psychological disability | 1.26 ± 1.63 | 1.37 ± 1.72 | 0.606 |
Social disability | 1.24 ± 1.70 | 1.06 ± 1.54 | 0.412 |
Handicap | 1.28 ± 1.53 | 0.96 ± 1.40 | 0.104 |
OHIP-14 score | 9.60 ± 9.72 | 8.72 ± 8.92 | 0.477 |
Control (n = 113) Mean ± Sd | Psoriasis (n = 113) Mean ± Sd | p | |
---|---|---|---|
GI | 1.35 ± 0.43 | 1.41 ± 0.43 | 0.331 |
PI | 1.48 ± 0.52 | 1.69 ± 0.62 | 0.006 * |
PD | 2.03 ± 0.68 | 2.37 ± 0.83 | 0.001 * |
CAL | 2.31 ± 0.91 | 2.56 ± 0.91 | 0.041 * |
Total teeth number | 28.92 ± 1.77 | 27.69 ± 3.45 | 0.027 * |
Control (n = 113) | Psoriasis (n = 113) | p | ||||
---|---|---|---|---|---|---|
Age (Mean ± Sd) | 42.94 ± 10.22 | 43.12 ± 11.48 | 0.908 | |||
Gender | Male | n | % | n | % | 0.894 |
58 | 50.4% | 57 | 49.6% | |||
Female | 55 | 49.5% | 56 | 50.5% | ||
Marital status | Unmarried | 34 | 54.8% | 28 | 45.2% | 0.371 |
Married | 79 | 48.2% | 85 | 51.8% | ||
Smoking | Yes | 78 | 52.7% | 70 | 47.3% | 0.263 |
No | 35 | 44.9% | 43 | 55.1% | ||
Alcohol consumption | Yes | 26 | 54.2% | 22 | 45.8% | 0.515 |
No | 87 | 48.9% | 91 | 51.1% | ||
Educational level | Primary | 17 | 30.4% | 39 | 69.6% | 0.001 * |
High school | 48 | 57.1% | 36 | 42.9% | ||
University | 45 | 60.0% | 30 | 40.0% | ||
Postgraduate | 3 | 27.3% | 8 | 72.7% | ||
Toothbrushing frequency | Once a day | 52 | 46.8% | 59 | 53.2% | 0.003 * |
2–3 times a day | 50 | 63.3% | 29 | 36.7% | ||
1–3 times a week | 11 | 30.6% | 25 | 69.4% | ||
Periodontal status | Healthy | 60 | 58.3% | 43 | 41.7% | 0.076 |
Gingivitis | 41 | 43.2% | 54 | 56.8% | ||
Periodontitis | 12 | 42.9% | 16 | 57.1% |
Functional Limitation | Physical Pain | Psychological Discomfort | Physical Disability | Psychological Disability | Social Disability | Handicap | ||
---|---|---|---|---|---|---|---|---|
Physical pain | r | 0.743 * | ||||||
p | 0.001 | |||||||
Psychological discomfort | r | 0.511 * | 0.735 * | |||||
p | 0.001 | 0.001 | ||||||
Physical disability | r | 0.503 * | 0.641 * | 0.812 * | ||||
p | 0.001 | 0.001 | 0.001 | |||||
Psychological disability | r | 0.538 * | 0.631 * | 0.771 * | 0.869 * | |||
p | 0.001 | 0.001 | 0.001 | 0.001 | ||||
Social disability | r | 0.492 * | 0.613 * | 0.724 * | 0.728 * | 0.752 * | ||
p | 0.001 | 0.001 | 0.001 | 0.001 | 0.001 | |||
Handicap | r | 0.598 * | 0.665 * | 0.713 * | 0.669 * | 0.714 * | 0.746 * | |
p | 0.001 | 0.001 | 0.001 | 0.001 | 0.001 | 0.001 | ||
OHIP-14 score | r | 0.748 * | 0.853 * | 0.880 * | 0.873 * | 0.884 * | 0.849 * | 0.856 * |
p | 0.001 | 0.001 | 0.001 | 0.001 | 0.001 | 0.001 | 0.001 |
PQLQ Score | Functional Limitation | Physical Pain | Psychological Discomfort | Physical Disability | Psychological Disability | Social Disability | Handicap | ||
---|---|---|---|---|---|---|---|---|---|
Functional limitation | r | 0.327 * | |||||||
p | 0.001 | ||||||||
Physical pain | r | 0.287 * | 0.503 * | ||||||
p | 0.002 | 0.001 | |||||||
Psychological discomfort | r | 0.411 * | 0.480 * | 0531 * | |||||
p | 0.001 | 0.001 | 0.001 | ||||||
Physical disability | r | 0.337 * | 0.541 * | 0.518 * | 0.733 * | ||||
p | 0.001 | 0.001 | 0.001 | 0.001 | |||||
Psychological disability | r | 0.299 * | 0.437 * | 0.506 * | 0.716 * | 0.652 * | |||
p | 0.001 | 0.001 | 0.001 | 0.001 | 0.001 | ||||
Social disability | r | 0.318 * | 0.453 * | 0.423 * | 0.613 * | 0.679 * | 0.617 * | ||
p | 0.001 | 0.001 | 0.001 | 0.001 | 0.001 | 0.001 | |||
Handicap | r | 0.251 * | 0.349 * | 0.468 * | 0.524 * | 0.596 * | 0.555 * | 0.669 * | |
p | 0.007 | 0.001 | 0.001 | 0.001 | 0.001 | 0.001 | 0.001 | ||
OHIP-14 score | r | 0.408 * | 0.686 * | 0.737 * | 0.844 * | 0.854 * | 0.821 * | 0.801 * | 0.743 * |
p | 0.001 | 0.001 | 0.001 | 0.001 | 0.001 | 0.001 | 0.001 | 0.001 |
n | PASI Score Mean ± Sd | p | |
---|---|---|---|
Healthy | 43 | 1.58 ± 3.40 | 0.257 |
Gingivitis | 54 | 2.36 ± 4.24 | |
Periodontitis | 16 | 3.05 ± 4.01 |
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Ustaoğlu, G.; Çardakcı Bahar, Ş.; Botsalı, A.; Saraç Atagün, Ö.; Ceylan Şen, S.; Su, A.T.; Yıldız, Z.H. Association Between Periodontal Health and Quality of Life in Patients with Psoriasis: A Cross-Sectional Study. Medicina 2025, 61, 1825. https://doi.org/10.3390/medicina61101825
Ustaoğlu G, Çardakcı Bahar Ş, Botsalı A, Saraç Atagün Ö, Ceylan Şen S, Su AT, Yıldız ZH. Association Between Periodontal Health and Quality of Life in Patients with Psoriasis: A Cross-Sectional Study. Medicina. 2025; 61(10):1825. https://doi.org/10.3390/medicina61101825
Chicago/Turabian StyleUstaoğlu, Gülbahar, Şeyma Çardakcı Bahar, Ayşenur Botsalı, Özlem Saraç Atagün, Seval Ceylan Şen, Ahmet Tuğrul Su, and Zeynep Hazan Yıldız. 2025. "Association Between Periodontal Health and Quality of Life in Patients with Psoriasis: A Cross-Sectional Study" Medicina 61, no. 10: 1825. https://doi.org/10.3390/medicina61101825
APA StyleUstaoğlu, G., Çardakcı Bahar, Ş., Botsalı, A., Saraç Atagün, Ö., Ceylan Şen, S., Su, A. T., & Yıldız, Z. H. (2025). Association Between Periodontal Health and Quality of Life in Patients with Psoriasis: A Cross-Sectional Study. Medicina, 61(10), 1825. https://doi.org/10.3390/medicina61101825