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Books > Medicine > Clinical & internal medicine > Geriatric medicine
Most of the DNA in the human genome does not encode proteins but is involved in regulatory functions. In addition, the human genome is characterized by an extensive array of structural DNA variants arising from de novo mutations plus accumulated structural variants transmitted through an individual's lineage. The result is that each person has a unique genome which is expressed as that person's unique phenotype. Ageing can be understood on both the species and individual level. Each species has a programmed ageing and mortality pattern, but within those broad species-specific boundaries there is considerable individual variation. At the individual level, ageing reflects the integrated effects of that individual's unique mix of DNA structural variants, unique experience-specific epigenetic marks and imperfectly repaired genomic and cellular damage. This book examines human "chronic degenerative" diseases which are not diseases, but rather variations of the ageing process across individuals.
Up-to-date information on pain managementincluding options to consider when conventional treatment is ineffective Providing effective treatment for pain-especially to elderly clients-can be a vexing problem for even the most knowledgeable clinician. In Clinical Management of the Elderly Patient in Pain, some of the world's leading authorities describe the unique difficulties that arise when trying to provide pain relief to elderly patients. They examine conventional treatment with opioid and non-steroidal anti-inflammatory drugs along with a broad range of alternatives to consider when frontline drugs fail. Non-drug options for pain relief from the fields of physical medicine and psychology are also explored. Essential topics addressed in Clinical Management of the Elderly Patient in Pain include: pain as an aspect of advancing age how pharmacology differs in elderly patients available therapeutic options, including opioids, non-steroidal anti-inflammatory drugs, anti-epileptic drugs, tricyclic antidepressants, membrane stabilizers, and topical agents physical medicine approaches psychological approaches to pain in the elderly Most publications on this subject focus on the use of opioids, non-steroidal drugs, and other commonly prescribed analgesics. Clinical Management of the Elderly Patient in Pain takes a different approach. Editor Gary McCleane, MD, says, Our need, with elderly patients, is to provide treatment that is both effective and easily tolerated. This is not a book devoted to opioids and non-steroidals, although they are addressed. Nor is it about those analgesics used in younger patients being used in smaller doses with the elderly. Rather, it contains practical options for treating pain when other simple remedies fail to help. At times this will involve using conventional analgesics in scaled-down doses, but at others it will involve using substances not yet fully recognized as possessing analgesic properties because they fit the bill in terms of possible analgesic actions, side-effect profiles, and lack of drug/drug interactionsand because practical experience suggests they may be useful in the scenario described. Clinical Management of the Elderly Patient in Pain is designed as a point of interface between the specialist pain practitioner and the clinician faced with all the problems of satisfactorily managing pain in elderly patients. It presents commonsense, practical, patient-oriented options that make it a useful resource for busy clinicians.
The first two volumes of Care-Giving in Dementia integrated
up-to-date neurobiological information about dementia with specific
developments in care-giving. Taking the same multidisciplinary
approach, and drawing contributions from leading practitioners,
this third volume will prove invaluable to health and mental health
professionals caring for people with dementia.
Explore pastoral strategies for dealing with mental health problems! Mental health is increasingly being recognized as an important issue in later life. This valuable book will help you examine this dimension of aging in the context of pastoral, spiritual, and cultural issues. It explores the relationship between mental health, spirituality, and religion in later life, including the search for meaning, cultural issues, spiritual issues, depression, dementia, and issues of suicide in older people. The first part of Mental Health and Spirituality in Later Life focuses on theology, ethics, and cultural issues in mental health and aging. The second part addresses issues of multidisciplinary practice, including a challenging chapter written by a woman with early onset dementia (Alzheimer's) and other chapters that present perspectives on the uses and meanings of ritual and symbolism in mental health and pastoral approaches to care. Part one of Mental Health and Spirituality in Later Life deals with issues of theology, culture, and mental health in later life, focusing on: the importance of a richly textured understanding of personhood as a prerequisite for constructing a picture of late-life mental health in the context of theology the relationship between culture, spirituality, and meaning for older immigrantsand their effects on mental health the adverse effects of a mental health system that reflects only the dominant culture of a society, leaving minority cultures vulnerable to misdiagnosis and inappropriate treatments that can do more harm than good a wholistic picture of aging that moves beyond the biomedical paradigm and demonstrates the power and potential of the human spirit in adjusting to and moving beyond suffering Part two of this valuable book addresses issues of concern to practitioners in mental health and spirituality for the aging, including: disruptive behavior among nursing home residents and common practices that fail to identify its causes or address the problem how some staff/resident interactions can produce suffering for all concernedwith case study outlines that illustrate the point memory loss and its effect on spirituality, self-worth, and the faith community pastoral care for people suffering with dementiawith practical information on helping them to make use of the power of prayer and to deal with loneliness, fear, and disempowerment an insightful look at a recent major study of residents in aged care facilities in Australia that explores the link between depression and spirituality risk and protective factors associated with suicide in later life and the treatment of depression pastoral interventions for depression and dementia
Explore pastoral strategies for dealing with mental health problems! Mental health is increasingly being recognized as an important issue in later life. This valuable book will help you examine this dimension of aging in the context of pastoral, spiritual, and cultural issues. It explores the relationship between mental health, spirituality, and religion in later life, including the search for meaning, cultural issues, spiritual issues, depression, dementia, and issues of suicide in older people. The first part of Mental Health and Spirituality in Later Life focuses on theology, ethics, and cultural issues in mental health and aging. The second part addresses issues of multidisciplinary practice, including a challenging chapter written by a woman with early onset dementia (Alzheimer's) and other chapters that present perspectives on the uses and meanings of ritual and symbolism in mental health and pastoral approaches to care. Part one of Mental Health and Spirituality in Later Life deals with issues of theology, culture, and mental health in later life, focusing on: the importance of a richly textured understanding of personhood as a prerequisite for constructing a picture of late-life mental health in the context of theology the relationship between culture, spirituality, and meaning for older immigrantsand their effects on mental health the adverse effects of a mental health system that reflects only the dominant culture of a society, leaving minority cultures vulnerable to misdiagnosis and inappropriate treatments that can do more harm than good a wholistic picture of aging that moves beyond the biomedical paradigm and demonstrates the power and potential of the human spirit in adjusting to and moving beyond suffering Part two of this valuable book addresses issues of concern to practitioners in mental health and spirituality for the aging, including: disruptive behavior among nursing home residents and common practices that fail to identify its causes or address the problem how some staff/resident interactions can produce suffering for all concernedwith case study outlines that illustrate the point memory loss and its effect on spirituality, self-worth, and the faith community pastoral care for people suffering with dementiawith practical information on helping them to make use of the power of prayer and to deal with loneliness, fear, and disempowerment an insightful look at a recent major study of residents in aged care facilities in Australia that explores the link between depression and spirituality risk and protective factors associated with suicide in later life and the treatment of depression pastoral interventions for depression and dementia
Get the vital clinical information you need with this comprehensive handbook In the decade since the first edition of this book, dramatic changes have taken place in the field of geriatric psychiatry. Psychiatry in the Nursing Home, Second Edition, presents timely information on the newest trends in law, culture, and medications, while still offering essential advice on the fundamental concerns of caring for elderly patients with mental illnesses. The new edition of this essential handbook presents up-to-date information on psychiatric issues involving nursing home patients. Featuring helpful case histories and diagnostic criteria, Psychiatry in the Nursing Home, Second Edition, helps you effectively treat such difficult problems as noisy patients, sexual acting out, and incontinence. In addition, it offers help with such administrative concerns as financial issues, absent or warring families, and staffing problems. Psychiatry in the Nursing Home, Second Edition, presents incisive discussions of the changes in the field since the publication of the first edition, including: the effects of the new Prospective Payment System the use of newly released psychotropic medications the altered nomenclature of the DSM-IV the rise in assisted-living facilities the rapid development of the specialty of geriatric psychiatry With its comprehensive scope and practical advice, Psychiatry in the Nursing Home, Second Edition, is a must-have for nursing-home administrators and staff. Policymakers, mental health professionals, and geriatricians will be fascinated by the book's wider considerations of the problems of housing and caring for the mentally ill and its provocative suggestions for future policy.
Over the past few years the world's population has continued on its remarkable transition from a state of high birth and death rates to one characterized by low birth and death rates. Consequently, primary care physicians and dermatologists will see more elderly patients presenting age-related dermatological conditions. There has never been a better time for a book devoted entirely to skin care in the elderly.
This volume dealing with the male body in the iconography of fascism reflects an ambition rather than an achievement. The supremacy of the global fascist superman never became a reality but was certainly an intention. This work explores the use of the image of the male body for this purpose in European, American and Asian fascism of varying degrees and various interpretations, and the differences and similarities involved. Among the similarities isthe fact that sport in all the cases in this volume was at the centre of the induction of the male body (and mind) into martial self-sacrifice. Sport was an important part of fascist socialization. The reasons are not hard to find. Sport develops muscle and muscle is equated with power - literally and metaphorically. War, the essence of fascism, demands physical fitness and sport helps promote this fitness. Competitive sport can help develop attitudes of aggression and aggression is essential in war.
This volume dealing with the male body in the iconography of fascism reflects an ambition rather than an achievement. The supremacy of the global fascist superman never became a reality but was certainly an intention. This work explores the use of the image of the male body for this purpose in European, American and Asian fascism of varying degrees and various interpretations, and the differences and similarities involved. Among the similarities isthe fact that sport in all the cases in this volume was at the centre of the induction of the male body (and mind) into martial self-sacrifice. Sport was an important part of fascist socialization. The reasons are not hard to find. Sport develops muscle and muscle is equated with power - literally and metaphorically. War, the essence of fascism, demands physical fitness and sport helps promote this fitness. Competitive sport can help develop attitudes of aggression and aggression is essential in war.
A dramatic shift in the average age of the U.S. population and the
increasing number of elderly Americans has introduced new and
challenging healthcare dilemmas. This book addresses these issues
with contributed chapters by the leading authorities in the field
of behavioral medicine. It deals with health and healthcare needs
of the elderly by considering basic changes that result from aging
and some of the more specific problems that accompany it.
This volume focuses on understanding the impact of age-related
decline in cognitive abilities on medical decisions and compliance
with medical instructions. It examines how medical information and
the medical environment can be restructured to accommodate the
decreased cognitive function associated with aging. Although the
issues discussed in this book are of critical importance in
providing effective health care, they have been largely neglected
in the national debate over provision of health care for the
increasingly aging population. It is essential that we begin to
understand how to present information so that informed choices are
made and patients comprehend well enough that they can follow their
treatment regimens and understand the importance of those regimens.
Gerontological research is currently of great interest due to
ever-increasing longevity of human life spans. Created to provide
researchers and scientists with the technical methods essential to
their work, Methods in Aging Research is a practical bench-top
guide for everyone who plans, designs, or conducts research in
aging. It highlights experimental procedures that are key to the
investigation of the biological aging phenomena.
Medication costs and common drug-related problems, such as misapplication of therapy, medication misuse, and adverse effects, can often be avoided or reduced. Geriatric Drug Therapy Interventions will help you get better outcomes with your patients as it points out pitfalls to avoid and provides you with logical principles for administering drug therapy. Offering guidelines, advice, and gentle reminders, this book shows you the importance of properly documenting patient problems and of considering the entire medical history of your patients. It also helps you perform fall and psychoactive drug risk assessments and address under-recognized and undertreated problems such as malnutrition, depression, sensory deficits, anemia, osteoporosis, and pressure ulcers.As Geriatric Drug Therapy Interventions clarifies, increased consultant pharmacist involvement in comprehensive pharmaceutical services results in the reduction of drug-related problems and medication-associated costs with long-term care patients. Using this book's helpful and substantive interventions, you can improve clinical, economic, and humanistic outcomes in your practice. For this purpose, Geriatric Drug Therapy Interventions discusses: a study designed to teach pharmacy students to identify, document, solve, and prevent medication-related problems providing patient-focused care and assuming responsibility for patient outcomes reimbursing pharmacists for performing cognitive service and cost-savings activities how the prevalence of drug-related problems that influence the need for hospital and nursing home admissions increases with age reasons for patient noncompliance NSAID-associated gastritis, gastrointestinal bleeding, drug-induced delirium, incontinence, and constipation why the advent of managed care does not bode well for the overall health outcomes of the elderlyPharmacists, physicians, and other health care providers can't control all aspects of drug use, but there are many practical steps you can take to help your patients use their prescriptions appropriately. Geriatric Drug Therapy Interventions will help you monitor the efficacy of drug therapy, guide patients who are exasperated with being poked, prodded, and barraged with medications, and work together to develop therapy patterns and schedules that are effective and comfortable.
Comprehensive health services cannot be planned on the basis of 7.000 people - the average list size of a fundholding practice. Services such as casualty and kidney transplantation must be planned on populations of hundreds of thousands. GP commissioning has developed from the spontaneous reaction against fundholding by some GPs ( both fundholding and non-fundholding) into a comprehensive, systematic approach towards the planning and monitoring of health services. This book is the first to explain GP commissioning in its own right. It documents the history, theory and practice of GP commissioning and places it within the current political situation faced by the NHS. It shows how commissioning goes beyond fundholding. Commissioning is a more cost-efficient alternative, is clinically effective and its spontaneous development implies it is more in keeping with the basic tenets of the National Health Service. The difficult areas of financing, commercialization and rationing of health care are all covered. The book also explores the relationship between GP commissioning and evidence-based medicine, both of which can contribute to a systematic approach towards the planning and provision of health care into the next century. With contributions from GP commissioners, health services managers, leading academics, the Secretary of State, and the former Shadow Secretary of State for Health, this book will inform the important debate on the structure of primary care. It is vital reading for all those with an interest in the future of the health service.
Part of a series of pocket-sized books that set out to provide easily assimilable information on diagnosis and treatment of common medical conditions. This volume looks at depression in the elderly, covering such topics as aetiology and risk factors, clinical presentation and prognosis.
As more of us live longer, the fear of an old age devastated by brain diseases like dementia is growing. Many people are already facing the challenges posed by these progressive and terminal conditions, whether in person or because they are caring for loved ones. Dementia is now the fifth most common cause of death across the world. It is small wonder that understanding, preventing, and finally curing these illnesses is now a global priority. Recent advances in brain research have given scientists a better chance than ever of finding ways to help patients, carers, and clinicians dealing with dementia. Yet there is still no effective treatment. Why has progress been so slow? And what can we all do to reduce our chances of getting the disease? In this Very Short Introduction Kathleen Taylor offers a guide to the science of dementia and brain ageing. Never forgetting the human costs of brain disorders - movingly illustrated throughout the book - she also discusses their costs to society. Clearly explaining the research, she sets out the main ideas which have driven dementia science, and the new contenders hoping to make a breakthrough. Taylor also looks at risk factors, and how to lower our chances of succumbing to dementia. Assessing current and potential treatments, including both drugs and other approaches, she explains, clearly and gently, what help is available for someone who is diagnosed with dementia, and how to boost the chances of living well with the condition. ABOUT THE SERIES: The Very Short Introductions series from Oxford University Press contains hundreds of titles in almost every subject area. These pocket-sized books are the perfect way to get ahead in a new subject quickly. Our expert authors combine facts, analysis, perspective, new ideas, and enthusiasm to make interesting and challenging topics highly readable.
Changing Seasons: A Language Arts Curriculum for Healthy Aging is a language-based, interdisciplinary program that increases interaction and communication skills among older adults. Featuring simple step-by-step lesson plans and interactive activities, Changing Seasons is a practical guide for caregivers and health care professionals to ensure individuals sustain their quality of life as they age. Each activity reveals new, creative, and fun ways to encourage individuals to speak, think, and write, sparking imagination and engagement with others. This new revised edition recognizes the growing importance of technology in communication, and incorporates many lessons learned during pandemic isolation, as communication was often limited to screens. Included is a new chapter that incorporates eight lessons on utilizing videoconferencing platforms. Though technology may evolve, communication will remain key to a sense of community and companionship-whether in person or online. Changing Seasons provides a roadmap to promoting meaningful interactions.
In our highly interconnected and globalized world, people often pursue their aspirations in multiple places. Yet in public and scholarly debates, aspirations are often seen as the realm of younger, mobile generations, since they are assumed to hold the greatest potential for shaping the future. This volume flips this perspective on its head by exploring how aspirations are constructed from the vantage point of later life, and shows how they are pursued across time, space, and generations. The aspirations of older people are diverse, and relate not only to aging itself but also to planning the next generation’s future, preparing an "ideal" retirement, searching for intimacy and self-realization, and confronting death and afterlives. Aspiring in Later Life brings together rich ethnographic cases from different regions of the world, offering original insights into how aspirations shift over the course of life and how they are pursued in contexts of translocal mobility. This book is also freely available online as an open-access digital edition.​
Practical, essential advice about making tough decisions for people with end-stage dementia. Each year, more than 500,000 people are diagnosed with dementia in the United States. As stunning as that figure is, countless family members and caregivers are also affected by each diagnosis. Families are faced with the need to make vital end-of-life decisions about medical treatment, legal and financial matters, and living situations for those who no longer can; no one is prepared for this process. And many caregivers grapple with sadness, confusion, guilt, anger, and physical and mental exhaustion as dementia enters its final stage. In Making Tough Decisions about End-of-Life Care in Dementia, Dr. Anne Kenny, a skilled palliative care physician, describes how to navigate the difficult journey of late-stage dementia with sensitivity, compassion, and common sense. Combining her personal experience caring for a mother with dementia with her medical expertise in both dementia and end-of-life care, Dr. Kenny helps the reader prepare for a family member's death while managing their own emotional health. Drawing on stories of families that Dr. Kenny has worked with to illustrate common issues, concerns, and situations that occurs in late-stage dementia, this book includes practical advice about * making life-altering decisions while preparing for a loved one's inevitable death * medical care, pain, insomnia, medication, and eating * caring for the caregiver * having conversations about difficult topics with other family members and with health care, legal, and financial professionals Concrete to-do lists and lists of important points provide information at a glance for busy caregivers. Each chapter concludes with a list of additional resources for more information and help. Making Tough Decisions about End-of-Life Care in Dementia is a lifeline, an invaluable guide to assist in the late stage of dementia.
The average life expectancy has increased worldwide in the recent decades. This has presented new challenges as old age brings the onset of diseases such as cancer, neurodegenerative disorders, cardiovascular disease, type 2 diabetes, arthritis, osteoporosis, stroke, and Alzheimer's disease. Studies and research have shown the potential preventive and therapeutic roles of antioxidants in aging and age-related diseases by inhibiting the formation or disrupting the propagation of free radicals and thus increasing healthy longevity, enhancing immune function, and decreasing oxidative stress. This has made an antioxidant rich diet of increasing importance in battling the detrimental effects of the aging process. "The Role of Antioxidants in Longevity and Age-Related Diseases" is the book that compiles research on antioxidants and their biological mechanisms that mediate age-related diseases. This book covers the major issues linked to antioxidants, aging, and age-related diseases, including changes in organ systems over the lifespan, age-related oxidative stress-induced redox imbalance, inflammaging, implications of inflammation in aging and age-related diseases, and the important role of antioxidant-rich foods in their prevention and treatment of various age-related diseases. For researchers seeking a comprehensive single source on antioxidants and their roles in aging and age-related diseases, this novel text provides an up-to-date overview.
Elderly Care Medicine Lecture Notes provides all the necessary information, within one short volume, for a sound introduction to the particular characteristics and needs of elderly patients. Presented in a user-friendly format, combining readability with high-quality illustrations, this eighth edition has been thoroughly revised to reflect advances in knowledge on how disease presents in elderly people, and changes in management practice, particularly regarding stroke, dementia, delirium, and cancer. New for this edition, Elderly Care Medicine Lecture Notes also features: * More treatment tables and boxes throughout for rapid access and revision * Expansion of material on polypharmacy and prescribing * Discussion of emotional support, counselling and spirituality * Advice for doctors on breaking bad news and end-of-life care * Consideration of ethical and legal issues A companion website at www.lecturenoteseries.com/elderlycaremed features appendices which can be used as guidelines in a clinical setting, key revision points for each chapter, further reading suggestions, and extended content for specialty training in geriatrics. Not only is this book a great starting point to support initial teaching on the topic, but it is also easy to dip in and out of for reference or revision at the end of a module, rotation or final exams. Whether you need to develop or refresh your knowledge of geriatrics, Elderly Care Medicine Lecture Notes presents 'need to know' information for all those involved in treating elderly people.
Forensic pathologists and clinicians are increasingly faced with challenges when it comes to geriatric cases, due to an aging population and increased comorbidities in the elderly. This text provides an up-to-date guide to all facets of geriatric forensic pathology, with contributions from experts from a variety of disciplines. Packed with color illustrations and case examples, chapters cover inflicted, self-inflicted, and accidental trauma, as well as natural conditions leading to unexpected death. In addition, specific chapters cover a wide range of difficult and topical areas, from elder abuse, dementias, and nutrition to pharmacology and toxicology issues, long-term care facilities, and scene investigation. Topics such as euthanasia are also explored to provide the reader with a rich, contemporary understanding of medicolegal issues. This is an invaluable resource not only for pathologists, but also for medical practitioners and lawyers dealing with geriatric cases. The book comes packaged with online access to the text and high-resolution images.
An indispensable, comprehensive reference for family caregivers. Caregivers hold the key to the health, well-being, and happiness of their aging relatives, partners, or friends. The Caregiver's Encyclopedia provides you with all of the information you need to take the best care of your loved one-from making major medical decisions to making sure you don't burn out. Written by Muriel R. Gillick, MD, a geriatrician with more than 30 years' experience caring for older people, this book highlights the importance of understanding your friend's or family member's overall health. With compassion and expertise, this book will help you "think like a doctor." The content * helps you navigate the health-care system * shares important information about treating basic geriatric syndromes, including delirium, dementia, and falls * teaches you about preventive care options * enables you to manage medical decisions related to both acute and chronic conditions * discusses what Medicare covers-and what it doesn't * guides you through different approaches to care * weighs the risks and benefits of hospital vs. home, nursing home, or hospice care * provides a detailed list of medical supplies that you might want to keep on hand * offers you additional resources and emotional support Throughout, Gillick provides helpful information and concrete concepts that caregivers can put into practice today. Authoritative, comprehensive, holistic, and highly illustrated, The Caregiver's Encyclopedia will help you figure out how to be the best caregiver you can be.
A leading expert answers your questions about how to live to your fullest with COPD. Significant lung damage from smoking, exposure in some jobs, or even diseases such as AIDS and tuberculosis can lead to COPD. Having chronic obstructive pulmonary disease can leave you feeling short of breath, sometimes reluctant to go shopping or for a walk because you are afraid of more difficulties. You may have wheezing, tightness in the chest, or frequent coughing. Although you see a doctor for your COPD, you often have questions and need answers. In this concise and practical guide, leading medical expert Donald A. Mahler answers some of the most pressing questions that he has been asked over 30 years of seeing patients with COPD, including * Why am I short of breath? * What medications can treat my COPD? * Can surgery improve COPD? * What are flare-ups-and how can I prevent them? * How can I stop smoking? * What should I do if my breathing isn't getting better? * Can exercise help? If so, which exercises are the most beneficial? * What's the best way to prevent lung infections? * How does COVID-19 affect COPD? * How can I travel with oxygen? * Can I be sexually active with COPD? and much more. Each chapter includes a patient vignette and key points. Tables and boxes offering helpful tips are included throughout. Providing up-to-date, evidence-based content that covers more than just medications, COPD gives you the tools you need to keep active-and thrive.
A quick yet comprehensive guide for anyone considering hip replacement surgery. Each year, more than 300,000 adults in the United States undergo hip replacement surgery. What can the many people experiencing hip pain in this country expect before, during, and after surgery? Hip Replacement-part of a new series of Johns Hopkins University Press books on specific surgical procedures-is designed to provide quick answers to all of the most common questions individuals have about hip surgery and the recovery process. Focusing on the patient experience, this frank and easy-to-use book highlights real patient experiences with hip pain, diagnosis, and treatment. The book * discusses basic hip anatomy * describes the symptoms of hip arthritis * explores alternative treatments, including lifestyle changes, medications, and surgical treatments other than hip replacement * reviews the entire recovery process, including preferred exercises to help speed your recovery and how quickly you can return to certain activities * features a glossary of key terms and a list of frequently asked questions * contains numerous sidebars touching on important points to consider, questions to ask your doctor, red flags, and risks * is supplemented with useful illustrations and photographs The book's concise format allows readers to peruse the content quickly in the days leading up to surgery and then refer to it during the recovery period. Written by experts in the field, Hip Replacement is destined to become the most trusted book on this topic. Contributors: Roy K. Aaron, MD, Valentin Antoci, Jr., MD, PhD, Travis Blood, MD, Eric Cohen, MD, Matthew E. Deren, MD, John Froehlich, MD, MBA, Derek R. Jenkins, MD, Dominic T. Kleinhenz, MD, Scott Ritterman, MD, Lee E. Rubin, MD |
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