Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Oncology Letters
      • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Biomedical Reports
      • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • Information for Authors
    • Information for Reviewers
    • Information for Librarians
    • Information for Advertisers
    • Conferences
  • Language Editing
Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • For Authors
    • For Reviewers
    • For Librarians
    • For Advertisers
    • Conferences
  • Language Editing
Login Register Submit
  • This site uses cookies
  • You can change your cookie settings at any time by following the instructions in our Cookie Policy. To find out more, you may read our Privacy Policy.

    I agree
Search articles by DOI, keyword, author or affiliation
Search
Advanced Search
presentation
Biomedical Reports
Join Editorial Board Propose a Special Issue
Print ISSN: 2049-9434 Online ISSN: 2049-9442
Journal Cover
September-2022 Volume 17 Issue 3

Full Size Image

Sign up for eToc alerts
Recommend to Library

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

Medicine International

An International Open Access Journal Devoted to General Medicine.

Journal Cover
September-2022 Volume 17 Issue 3

Full Size Image

Sign up for eToc alerts
Recommend to Library

  • Article
  • Citations
    • Cite This Article
    • Download Citation
    • Create Citation Alert
    • Remove Citation Alert
    • Cited By
  • Similar Articles
    • Related Articles (in Spandidos Publications)
    • Similar Articles (Google Scholar)
    • Similar Articles (PubMed)
  • Download PDF
  • Download XML
  • View XML
Case Report Open Access

Possible role of low dose dexamethasone administration in listeria monocytogenes meningoencephalitis: A case series

  • Authors:
    • Vittoria Moscatt
    • Andrea Marino
    • Manuela Ceccarelli
    • Federica Cosentino
    • Aldo Zagami
    • Benedetto Maurizio Celesia
    • Giuseppe Nunnari
    • Bruno Cacopardo
  • View Affiliations / Copyright

    Affiliations: Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Messina, I-98124 Messina, Sicily, Italy, Department of Biomedical and Biotechnological Sciences, University of Catania, I-95122 Catania, Italy, Department of Clinical and Experimental Medicine, ARNAS Garibaldi Hospital, University of Catania, I-95122 Catania, Italy
    Copyright: © Moscatt et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 73
    |
    Published online on: July 11, 2022
       https://doi.org/10.3892/br.2022.1556
  • Expand metrics +
Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )
Cited By (CrossRef): 0 citations Loading Articles...

This article is mentioned in:



Abstract

Listeria (L.) monocytogenes is a gram‑positive, non‑sporulating, facultatively anaerobic bacillus transmitted to humans through ingestion of contaminated foods. Listeriosis represents the third most common cause of death from foodborne illness, with a mortality rate of 20‑30%, especially for patients affected by an invasive disease, which typically affects immunocompromised patients, pregnant women, the elderly, and neonates. It causes several clinical syndromes, of which meningitis, meningoencephalitis, and sepsis are the most challenging to deal with. Here, five cases of L. monocytogenes meningitis/meningoencephalitis affecting two previously healthy immunocompetent and three immunocompromised adult patients treated with ampicillin plus gentamicin are reported. In addition, all the patients described in this report received a low dose of intravenous dexamethasone; four of them made a full recovery. Additionally, a literature search was performed to better explain the appropriate clinical and therapeutic management approaches for these patients, highlighting the value of dexamethasone administration as part of the therapy.
View Figures

Figure 1

View References

1 

Pagliano P, Ascione T, Boccia G, De Caro F and Esposito S: Listeria monocytogenes meningitis in the elderly: Epidemiological, clinical and therapeutic findings. Le Infez Med. 24:105–111. 2016.PubMed/NCBI

2 

Erdem H, Hargreaves S, Ankarali H, Caskurlu H, Ceviker SA, Bahar-Kacmaz A, Meric-Koc M, Altindis M, Yildiz-Kirazaldi Y, Kizilates F, et al: Managing adult patients with infectious diseases in emergency departments: International ID-IRI study. J Chemother. 33:302–318. 2021.PubMed/NCBI View Article : Google Scholar

3 

El-Sokkary R, Uysal S, Erdem H, Kullar R, Pekok AU, Amer F, Grgić S, Carevic B, El-Kholy A, Liskova A, et al: Profiles of multidrug-resistant organisms among patients with bacteremia in intensive care units: An international ID-IRI survey. Eur J Clin Microbiol Infect Dis. 40:2323–2334. 2021.PubMed/NCBI View Article : Google Scholar

4 

WHO. https://www.who.int/news-room/fact-sheets/detail/listeriosis.

5 

Adriani KS, Brouwer MC, van der Ende A and van de Beek D: Bacterial meningitis in pregnancy: Report of six cases and review of the literature. Clin Microbiol Infect. 18:345–351. 2012.PubMed/NCBI View Article : Google Scholar

6 

Skogberg K, Syrjanen J, Jahkola M, Renkonen OV, Paavonen J, Ahonen J, Kontiainen S, Ruutu P and Valtonen V: Clinical presentation and outcome of listeriosis in patients with and without immunosuppressive therapy. Clin Infect Dis. 14:815–821. 1992.PubMed/NCBI View Article : Google Scholar

7 

Bula CJ, Bille J and Glauser MP: An epidemic of food-borne listeriosis in Western Switzerland: Description of 57 cases involving adults. Clin Infect Dis. 20:66–72. 1995.PubMed/NCBI View Article : Google Scholar

8 

Chen SY, Lee JJ, Chien CC, Tsai WC, Lu CH, Chang WN and Lien CY: High incidence of severe neurological manifestations and high mortality rate for adult Listeria monocytogenes meningitis in Taiwan. J Clin Neurosci. 71:177–185. 2019.PubMed/NCBI View Article : Google Scholar

9 

van de Beek D, Cabellos C, Dzupova O, Esposito S, Klein M, Kloek AT, Leib SL, Mourvillier B, Ostergaard C, Pagliano P, et al: ESCMID guideline: Diagnosis and treatment of acute bacterial meningitis. Clin Microbiol Infect 22 Suppl. 3:S37–S62. 2016.PubMed/NCBI View Article : Google Scholar

10 

Lorber B: Listeria monocytogenes. In: Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 9th edition. Bennett J, Dolin R and Blaser M (eds). Elsevier/Saunders', Philadelphia, PA, 2020;.

11 

Thønnings S, Knudsen JD, Schønheyder HC, Søgaard M, Arpi M, Gradel KO and Østergaard C: Danish Collaborative Bacteraemia Network (DACOBAN). Antibiotic treatment and mortality in patients with Listeria monocytogenes meningitis or bacteraemia. Clin Microbiol Infect. 22:725–730. 2016.PubMed/NCBI View Article : Google Scholar

12 

Garcia-Carretero R: Clinical features and predictors for mortality in neurolisteriosis: An administrative data-based study. Bacteria. 1:3–11. 2022.

13 

Celesia BM, Marino A, Borracino S, Arcadipane AF, Pantò G, Gussio M, Coniglio S, Pennisi A, Cacopardo B and Panarello G: Successful extracorporeal membrane oxygenation treatment in an acquired immune deficiency syndrome (AIDS) patient with acute respiratory distress syndrome (ARDS) complicating pneumocystis jirovecii Pneumonia: A challenging case. Am J Case Rep. 21(e919570)2020.PubMed/NCBI View Article : Google Scholar

14 

Celesia BM, Marino A, Del Vecchio RF, Bruno R, Palermo F, Gussio M, Nunnari G and Cacopardo B: Is it safe and cost saving to defer the CD4+ cell count monitoring in stable patients on art with more than 350 or 500 cells/µl? Mediterr J Hematol Infect Dis. 11(e2019063)2019.PubMed/NCBI View Article : Google Scholar

15 

Marino A, Cosentino F, Ceccarelli M, Moscatt V, Pampaloni A, Scuderi D, D'Andrea F, Rullo EV, Nunnari G, Benanti F, et al: Entecavir resistance in a patient with treatment-naïve HBV: A case report. Mol Clin Oncol. 14(113)2021.PubMed/NCBI View Article : Google Scholar

16 

Marino A, Scuderi D, Locatelli ME, Gentile A, Pampaloni A, Cosentino F, Ceccarelli M, Celesia BM, Benanti F, Nunnar G, et al: Modification of serum brain-derived neurotrophic factor levels following Anti-HCV therapy with direct antiviral agents: A new marker of neurocognitive disorders. Hepat Mon. 20(e95101)2020.

17 

Marino A, Zafarana G, Ceccarelli M, Cosentino F, Moscatt V, Bruno G, Bruno R, Benanti F, Cacopardo B and Celesia BM: Immunological and clinical impact of DAA-Mediated HCV Eradication in a Cohort of HIV/HCV coinfected patients: Monocentric Italian experience. Diagnostics (Basel). 11(2336)2021.PubMed/NCBI View Article : Google Scholar

18 

Marino A, Munafò A, Zagami A, Ceccarelli M, Di Mauro R, Cantarella G, Bernardini R, Nunnari G and Cacopardo B: Ampicillin plus ceftriaxone regimen against enterococcus faecalis endocarditis: A literature review. J Clin Med. 10(4594)2021.PubMed/NCBI View Article : Google Scholar

19 

Pagliano P, Arslan F and Ascione T: Epidemiology and treatment of the commonest form of listeriosis: Meningitis and bacteraemia. Infez Med. 25:210–216. 2017.PubMed/NCBI

20 

Hernandez-Milian A and Payeras-Cifre A: What is new in listeriosis? Biomed Res Int. 2014(358051)2014.PubMed/NCBI View Article : Google Scholar

21 

Brouwer MC, van de Beek D, Heckenberg SG, Spanjaard L and de Gans J: Community-Acquired Listeria monocytogenes meningitis in adults. Clin Infect Dis. 43:1233–1238. 2006.PubMed/NCBI View Article : Google Scholar

22 

Mylonakis E, Hohmann EL and Calderwood SB: Central nervous system infection with listeria monocytogenes: 33 Yearsʼ experience at a general hospital and review of 776 episodes from the literature. Medicine (Baltimore). 77:313–336. 1998.PubMed/NCBI View Article : Google Scholar

23 

Temple ME and Nahata MC: Treatment of listeriosis. Ann Pharmacother. 34:656–661. 2000.PubMed/NCBI View Article : Google Scholar

24 

Lan ZW, Xiao MJ, Guan YL, Zhan YJ and Tang XQ: Detection of Listeria monocytogenes in a patient with meningoencephalitis using next-generation sequencing: A case report. BMC Infect Dis. 20(721)2020.PubMed/NCBI View Article : Google Scholar

25 

Arslan F, Meynet E, Sunbul M, Sipahi OR, Kurtaran B, Kaya S, Inkaya AC, Pagliano P, Sengoz G, Batirel A, et al: The clinical features, diagnosis, treatment, and prognosis of neuroinvasive listeriosis: A multinational study. Eur J Clin Microbiol Infect Dis. 34:1213–1221. 2015.PubMed/NCBI View Article : Google Scholar

26 

Koopmans MM, Brouwer MC, Bijlsma MW, Bovenkerk S, Keijzers W, van der Ende A and van de Beek D: Listeria monocytogenes sequence type 6 and increased rate of unfavorable outcome in meningitis: Epidemiologic cohort study. Clin Infect Dis. 57:247–253. 2013.PubMed/NCBI View Article : Google Scholar

27 

de Gans J and van de Beek D: European Dexamethasone in Adulthood Bacterial Meningitis Study Investigators. Dexamethasone in adults with bacterial meningitis. N Engl J Med. 347:1549–1556. 2002.PubMed/NCBI View Article : Google Scholar

28 

Brouwer MC, McIntyre P, Prasad K and van de Beek D: Corticosteroids for acute bacterial meningitis. Cochrane Database Syst Rev: Jun 13, 2013 (Epub ahead of print).

29 

Nau R, Djukic M, Spreer A and Eiffert H: Bacterial meningitis: New therapeutic approaches. Expert Rev Anti Infect Ther. 11:1079–1095. 2013.PubMed/NCBI View Article : Google Scholar

30 

Polkowska A, Toropainen M, Ollgren J, Lyytikäinen O and Nuorti JP: Bacterial meningitis in Finland, 1995-2014: A population-based observational study. BMJ Open. 7(e015080)2017.PubMed/NCBI View Article : Google Scholar

31 

Charlier C, Perrodeau É, Leclercq A, Cazenave B, Pilmis B, Henry B, Lopes A, Maury MM, Moura A, Goffinet F, et al: Clinical features and prognostic factors of listeriosis: The MONALISA national prospective cohort study. Lancet Infect Dis. 17:510–519. 2017.PubMed/NCBI View Article : Google Scholar

32 

Pelegrín I, Moragas M, Suárez C, Ribera A, Verdaguer R, Martínez-Yelamos S, Rubio-Borrego F, Ariza J, Viladrich PF and Cabellos C: Listeria monocytogenes meningoencephalitis in adults: Analysis of factors related to unfavourable outcome. Infection. 42:817–827. 2014.PubMed/NCBI View Article : Google Scholar

33 

Amaya-Villar R, García-Cabrera E, Sulleiro-Igual E, Fernández-Viladrich P, Fontanals-Aymerich D, Catalán-Alonso P, Rodrigo-Gonzalo de Liria C, Coloma-Conde A, Grill-Díaz F, Guerrero-Espejo A, et al: Three-year multicenter surveillance of community-acquired listeria monocytogenes meningitis in adults. BMC Infect Dis. 10(324)2010.PubMed/NCBI View Article : Google Scholar

34 

Chau TT, Campbell JI, Schultsz C, Chau NV, Diep TS, Baker S, Chinh NT, Farrar JJ and van Doorn HR: Three adult cases of Listeria monocytogenes meningitis in Vietnam. PLoS Med. 7(e1000306)2010.PubMed/NCBI View Article : Google Scholar

35 

Barocci S, Mancini A, Canovari B, Petrelli E, Sbriscia-Fioretti E, Licci A, D'Addesa S, Petrini G, Giacomini M, Renzi A, et al: Listeria monocytogenes meningitis in an immunocompromised patient. New Microbiol. 38:113–118. 2015.PubMed/NCBI

36 

Romero Gutiérrez J, Garcia Peña J, Rodrigo Casanova P and Aguilera Celorrio L: Listeria monocytogenes and Herpes simplex type 1, associated in a meningoencephalitis episode in an immunodepressed patient. Rev Esp Anestesiol Reanim. 59:227–228. 2012.PubMed/NCBI View Article : Google Scholar : (In Spanish).

Related Articles

  • Abstract
  • View
  • Download
  • Twitter
Copy and paste a formatted citation
Spandidos Publications style
Moscatt V, Marino A, Ceccarelli M, Cosentino F, Zagami A, Celesia BM, Nunnari G and Cacopardo B: Possible role of low dose dexamethasone administration in listeria monocytogenes meningoencephalitis: A case series. Biomed Rep 17: 73, 2022.
APA
Moscatt, V., Marino, A., Ceccarelli, M., Cosentino, F., Zagami, A., Celesia, B.M. ... Cacopardo, B. (2022). Possible role of low dose dexamethasone administration in listeria monocytogenes meningoencephalitis: A case series. Biomedical Reports, 17, 73. https://doi.org/10.3892/br.2022.1556
MLA
Moscatt, V., Marino, A., Ceccarelli, M., Cosentino, F., Zagami, A., Celesia, B. M., Nunnari, G., Cacopardo, B."Possible role of low dose dexamethasone administration in listeria monocytogenes meningoencephalitis: A case series". Biomedical Reports 17.3 (2022): 73.
Chicago
Moscatt, V., Marino, A., Ceccarelli, M., Cosentino, F., Zagami, A., Celesia, B. M., Nunnari, G., Cacopardo, B."Possible role of low dose dexamethasone administration in listeria monocytogenes meningoencephalitis: A case series". Biomedical Reports 17, no. 3 (2022): 73. https://doi.org/10.3892/br.2022.1556
Copy and paste a formatted citation
x
Spandidos Publications style
Moscatt V, Marino A, Ceccarelli M, Cosentino F, Zagami A, Celesia BM, Nunnari G and Cacopardo B: Possible role of low dose dexamethasone administration in listeria monocytogenes meningoencephalitis: A case series. Biomed Rep 17: 73, 2022.
APA
Moscatt, V., Marino, A., Ceccarelli, M., Cosentino, F., Zagami, A., Celesia, B.M. ... Cacopardo, B. (2022). Possible role of low dose dexamethasone administration in listeria monocytogenes meningoencephalitis: A case series. Biomedical Reports, 17, 73. https://doi.org/10.3892/br.2022.1556
MLA
Moscatt, V., Marino, A., Ceccarelli, M., Cosentino, F., Zagami, A., Celesia, B. M., Nunnari, G., Cacopardo, B."Possible role of low dose dexamethasone administration in listeria monocytogenes meningoencephalitis: A case series". Biomedical Reports 17.3 (2022): 73.
Chicago
Moscatt, V., Marino, A., Ceccarelli, M., Cosentino, F., Zagami, A., Celesia, B. M., Nunnari, G., Cacopardo, B."Possible role of low dose dexamethasone administration in listeria monocytogenes meningoencephalitis: A case series". Biomedical Reports 17, no. 3 (2022): 73. https://doi.org/10.3892/br.2022.1556
Follow us
  • Twitter
  • LinkedIn
  • Facebook
About
  • Spandidos Publications
  • Careers
  • Cookie Policy
  • Privacy Policy
How can we help?
  • Help
  • Live Chat
  • Contact
  • Email to our Support Team