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Jeffrey A Brinker, M.D.

Jeffrey A Brinker, M.D.

  • Professor of Medicine
  • Joint Appointment in Radiology and Radiological Science


Key Features: cinnamon-brown cultures purchase procardia uk cardiovascular training definition, conidial heads biseriate with metulae as long as the phialides discount generic procardia canada capillaries kids. Descriptions of Medical Fungi 27 Aureobasidium pullulans (de Bary) Arnaud Aureobasidium pullulans has a worldwide distribution and is usually isolated as a saprophyte buy 30mg procardia otc coronary heart disease quality of life, occasionally from skin and nails. Morphological Description: colonies are fast growing, smooth, soon covered with slimy masses of conidia, cream or pink, later becoming brown or black. Hyphae are hyaline and septate, frequently becoming dark-brown with age and forming chains of one to two-celled, thick-walled, darkly pigmented arthroconidia. These arthroconidia actually represent the Scytalidium anamorph of Aureobasidium and are only of secondary importance in recognising members of this genus. Key Features: Hyphomycete (so-called black yeast) producing hyaline blastoconidia simultaneously from the vegetative hyphae, which may also form chains of darkly pigmented, thick-walled arthroconidia. Basidiobolus ranarum is commonly present in decaying fruit and vegetable matter, and as a commensal in the intestinal tract of frogs, toads and lizards. It has been reported from tropical regions of africa and asia including India, Indonesia and australia. Morphological Description: colonies are moderately fast growing at 30 c, fat,O yellowish-grey to creamy-grey, glabrous, becoming radially folded and covered by a fne, powdery, white surface mycelium. Satellite colonies are often formed by germinating conidia ejected from the primary colony. Microscopic examination usually shows the presence of large vegetative hyphae (8-20 ?m in diameter) forming numerous round (20 50 ?m in diameter), smooth, thick-walled zygospores that have two closely appressed beak-like appendages. Two types of asexual conidia are formed, although isolates often lose their ability to sporulate with subculture. Special media incorporating glucosamine hydrochloride and casein hydrolsate may be needed to stimulate sporulation (Shipton and Zahari, 1987). Primary conidia are globose, one-celled, solitary and are forcibly discharged from a sporophore. The sporophore has a distinct swollen area just below the conidium that actively participates in the discharge of the conidium. Secondary (replicative) conidia are clavate, one-celled and are passively released from a sporophore. References: Strinivasan and Thirumalachar (1965), greer and friedman (1966), Dworzack et al. Descriptions of Medical Fungi 29 Basidiobolus ranarum Eidem Basidiobolus ranarum culture showing satellite colonies formed by germinating conidia ejected from the primary colony. Beauvaria bassiana is the most common species and is best known as the causal agent of muscardine disease in silkworms. Beauveria species are occasionally isolated in the clinical laboratory as saprophytic contaminants. Morphological Description: colonies are usually slow growing, usually not exceeding 2 cm in ten days at 20 c, downy, at frst white, but later often becoming yellow toO pinkish. The genus Beauveria is characterised by the sympodial development of single celled conidia (ameroconidia) on a geniculate or zig-zag rachis. Key Features: Hyphomycete showing sympodial development of single-celled conidia on a geniculate or zig-zag rachis emanating from a fask-shaped conidiophore. Molecular Identifcation: Specifc primers were developed by Hegedus and Khachatourians (1996). Descriptions of Medical Fungi 31 Bipolaris Shoemaker the genus Bipolaris contains about 45 species, which are mostly subtropical and tropical plant parasites. However recent phylogenetic studies have transferred several well-documented human pathogens, notably B. Morphological Description: colonies are moderately fast growing, effuse, grey to blackish brown, suede-like to foccose with a black reverse. Microscopic morphology shows sympodial development of hyaline to deep olivaceous pigmented, pseudoseptate conidia on a geniculate or zig-zag rachis. Key Features: Dematiaceous hyphomycete producing sympodial, pseudoseptate, pale brown, long slender, gently curving conidia, which are rounded at both ends. Comment: the genera Drechslera, Bipolaris, Curvularia and Exserohilum are all closely related. In the past, morphological differentiation of the genera relied upon a combination of characters including conidial shape, the presence or absence of a protruding hilum, the contour of the basal portion of the conidium and its hilum, the point at which the germ tube originates from the basal cell and, to a lesser degree, the sequence and location of the frst three conidial septa. It is the causal agent of blastomycosis a chronic granulomatous and suppurative disease, having a primary pulmonary stage that is frequently followed by dissemination to other body sites, typically the skin and bone. Morphological Description: colonies at 25 c have variable morphology and growthO rate. They may grow rapidly, producing a fuffy white mycelium or slowly as glabrous, tan, nonsporulating colonies. Microscopically, hyaline, ovoid to pyriform, one-celled, smooth-walled conidia (2-10 ?m in diameter) of the Chrysosporium type, are borne on short lateral or terminal hyphal branches. O Microscopically, the organism produces the characteristic yeast phase seen in tissue pathology; ie. Comment: In the past, conversion from the mould form to the yeast form was necessary to positively identify this dimorphic pathogen from species of Chrysosporium or Sepedonium. However, culture identifcation by exoantigen test and/or molecular methods is now preferred to minimise manipulation of the fungus. Key Features: clinical history, tissue pathology, culture identifcation by positive exoantigen test and/or by molecular methods.

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Topical application of an Aloe compound resulted in healing patterns comparable to generic procardia 30 mg visa heart disease 20 the anti-thromboxane agents purchase procardia master card physioex 90 cardiovascular dynamics answers. Robson and his colleagues2 also showed that such an Aloe compound had anti-bacterial properties as well order generic procardia from india cardiovascular disease data. Therefore, topical application of anti-microbials and other chemo-therapeutic agents is essential in order to restore the normal healing process and prevent infection. Halsted has been quoted as saying, ?A wound which has been irrigated with solutions of carbolic acid, corrosive sublimate, or other disinfectant labors under the disadvantage of a more less extensive area of superficial necrosis?3. McCauley and his colleagues4 have show that both silver sulfadiazine and Sulfamylon are toxic to fibroblasts in tissue culture at concentrations of 0. Leitch, et al5 recently presented data that silver sulfadiazine, Sulfamylon and silver sulfadiazine with chlorohexadine significantly retarded wound healing in the acute wound model. The gel was stained by silver stain kit method, and the kit was purchased from Bio-Rad. Cell concentration and viability were determined by hemacytometer counts and dye exclusion with 0. Cells at 5x104 cell/well were plated into 96-well flat-bottom plates and maintained 24 hours at standard conditions in adherence studies. The formazan crystals, formed only in viable cells after four hours at 37o C, were dissolved by addition of 100ul of acid-isopropanol solution. The skin defects were treated three times a day for 14 days with Aloe vera gel (n=10), 2% mupirocin ointment (n=10), 1% clindamycin cream (n=10), 1% silver sulfadiazine alone (n=10), 1% silver sulfadiazine cream + Aloe (n=10). Wound half-lives and overall healing rates were calculated by regressing the log of the areas of all wounds over time. The rat adrenal cultured cells in the presence of Aloe vera gel #5 showed a 26% increase in growth activity when compared to the control (Fig. Acute Wound Healing Topical application of each therapeutic agent had a profound effect on the healing process. Overall healing rates of all the treated groups were significantly different as compared to the control group (p<0. The Aloe group had the shortest half-life, and healed faster than the control group (Table I). While silver sulfadiazine with Aloe significantly increased the breaking strength (2. Carney and his co-workers10 showed that exogenous delivery of synthetic Thrombin Receptor-activating peptides enhanced the healing process and neovascularization of an incisional wound. In a clinical trial Bishop, et al11 evaluated two potential wound healing agents in a blinded trial for the treatment of venous status ulcers. Contrary to previous in vitro and in vivo studies by McCauley, et al4 and Leitch, et al5 the Bishop study showed that silver sulfadiazine was significantly more therapeutic in healing the venous status ulcer when compared to a biologically active tripeptide copper complex or a placebo. These results suggest that a silver sulfadiazine cream may facilitate healing in wounds that heal by epitheliazation. Our previous studies have provided evidence that Aloe vera may contain a growth factor like substance. Therefore, with this foundation of knowledge regarding the exogenous administration of cytokines and Aloe substances in the process of wound healing, we closely examined Aloe vera gel 1:1 (#5) to provide further evidence of its wound-healing potential compared to other chemotherapeutic agents. McCauley, et al4 showed that silver sulfadiazine in tissue culture was toxic to fibroblasts and keratinocytes, and Leitch and his co-workers5 showed that it retarded wound healing in vivo. The silver sulfadiazine and Aloe group, while it healed significantly faster (p = <0. The Bactroban -clindamycin and silver sulfadiazine-treated wounds were apparently stronger than the controls, but the healing time was significantly (p<0. This study further substantiates the fact that Aloe contains a growth promoting factor that enhances the healing process and the breaking strength of these healed wounds. Aloe can also reverse the wound healing retardant effect of silver sulfadiazine, a topical antimicrobial used to treat and control burn wound sepsis. Vol 79, Number 11, Nov 1989, P559-62 Abstract the influence of Aloe vera, orally and topically, on wound healing was studied. For the oral study, experimental animals received Aloe vera in their drinking water for 2 months, whereas the control animals received only water. In the topical study, experimental animals were given 25% Aloe vera in Eucerin cream topically. These data suggest that Aloe vera is effective by both oral and topical routes of administration. Previous studies have amply demonstrated the wound-healing influence of Aloe vera. Decolorized Aloe vera (without anthraquinones) was more effective than colorized Aloe. Aloe vera is a natural substance containing enzymes, amino acids, and other active ingredients that contain important properties needed for wound healing. This response could be explained by the fact that Aloe dilated capillaries to increase blood flow to injured areas. Possibly, there are specific factors that Aloe vera overcomes to improve wound healing. In normal and diabetic animals, Aloe vera possesses anti-inflammatory, antiedemic, and improved healing properties. This study attempts to show the oral and topical activity of Aloe vera in improving wound healing.

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During a lumbar puncture cheap procardia 30mg otc cardiovascular jobs in san diego, a needle is carefully inserted into the spinal canal low in the back (lumbar area) purchase procardia 30 mg free shipping heart disease nails. Their mechanism of action in this disease is the suppression of ovarian estrogen production buy procardia online pills cardiovascular system sentence. B cells produce antibodies that are used to attack invading bacteria, viruses, and toxins. Median survival: the length of time from diagnosis until half of the patients are still alive. In a clinical trial, measuring the median survival is a method of determining how effective a treatment is. A medical oncologist often is the main health care provider for a patient who has cancer. Meninges: the three membranes (the dura mater, arachnoid, and pia mater) that line the skull and vertebral canal and enclose the brain and spinal cord. Meta-analysis: A systematic process in which similar data collected from multiple studies are re-analyzed to increase statistical power. For example, enzymes in the liver break down or metabolize drugs and other foreign substances so that they can be excreted from the body. Metastasis: the medical term for cancer that spreads to a different part of the body from where it started. Metronomic Therapy: this refers to the continuous or frequent administration of low-doses of anti-cancer drugs, often with other forms of therapy. The microenvironment consists of a variety of molecules, cells, and blood vessels, all of which may affect the survival of tumor cells and the response to therapy. Molecular Breast Cancer Sub-typing: Researchers are studying how molecular subtypes of breast cancer may be useful in planning treatment and developing new therapies. Molecule: An electrically neutral group of two or more atoms held together by chemical bonds. Monotherapy: Treatment with a single drug instead of using a combination of drugs. Mortality the number of people who die from a disease during a specified period of time within a specific population. The pathway regulates many major cellular processes and is implicated in an increasing number of pathological conditions, including cancer. Neuropathy: A condition where one or more parts of the nervous system are not working properly. Neuropathy generally involves ?peripheral nerves, which are those outside the brain and spinal cord. Neurotrophins: Neurotrophins are a family of proteins that induce the survival, development, and function of neurons. They belong to a class of growth factors that are capable of signaling particular cells to survive, differentiate, or grow. Neutrophils are a common type of white blood cell important to fighting off infections particularly those caused by bacteria. Oligometastatic disease: Characterized by solitary or few detectable metastatic lesions that are usually limited to a single organ. Some studies indicate that in such cases, a combination of localized and systemic treatment can potentially be curative in some cases. Ommaya Port (or reservoir): A device consisting of a small port (about the size of a quarter) that is placed underneath the skin on the head, which is attached to a catheter (tube) that is threaded into a ventricle (open space) in the brain. Patients can feel the port that sits under the skin, which will be elevated in that area. P-Value: P-values are used to express statistical significance and represent the probability that the effect observed in a study could be the result of chance alone. Palliative Care: A multidisciplinary approach to specialized medical and nursing care for people with life-limiting illnesses. It focuses on providing patients with relief from the symptoms, pain, physical stress, and mental stress of the terminal diagnosis. Palliative Care differs from Hospice Care in that the patient can continue with therapy for their disease while on Palliative Care. Pathology Report: A document that contains the diagnosis determined by examining cells and tissues under a microscope. This interaction tells the T cells to leave the other cells alone and not attack them. Perimenopause: Menopause is defined as the time when a woman has not had a menstrual period for 12 consecutive months, and the time that precedes preceding menopause has been referred to as the perimenopause, although there is no strict medical definition for this. Perimenopause usually begins for women in their 40s but may start as early as the late 30s. Perimenopausal women will have had one or more periods within 12 months, And typically begin experiencing menopausal symptoms such as mood swings, irregular periods, and/or hot flashes. Phenotype: the characteristics of a protein, cell, organ, or organism as determined by its genes. The placebo arm of a clinical trial is used as a control to compare how effective or safe the actual treatment drug is. Port: A small disc made of plastic or metal about the size of a quarter that sits just under the skin. The port is attached to a catheter (tube) that is threaded into a vein or specific area for purposes of extracting blood or delivering a drug(s) to a patient.

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We are only 10% mammalian and 90% microbiome generic procardia 30 mg amex cardiovascular health assessment, making us hosts to quality procardia 30mg arteries legs a bacterial banquet buy cheap procardia 30 mg on line cardiovascular effects xanax. We need to abandon the adheres to a products, practices, and antibiotics that are making surface our microbes mutate, mottling our teeth, and deforesting the flora of our oral ecology. As holobiont human hosts to these microbes, we have forged an elaborate evolutionary and ancient alliance. A good host provides a stable, loving home and nourishing food for their flora friends. In return, these microbes micro-manage our bodies by digesting food and secreting beneficial bio-chemicals. They are also sentient-sentinels that strengthen our immunity while preventing pathogenic periodontal party crashers from proliferating and from excreting endotoxins and colonizing the community. The key to oral health is maintaining an ecologically balanced and diverse microbiome. Contrary to this, we have been caught in the dross of carpet bombing the biome, practicing a scorched-earth policy of periodontal care. Chemicals in teeth bleaching, fillings, rinses, and fluoride, the sudsy surfactants; the antibiotic-atomic bombs on bacteria, masticating meals of glyphosates and pesticides, root canals festering focal infections, the metallic-mass of mercury, titanium, and nickel: these have all scorched the hive-intelligence of our oral habitat. This defoliation of our flora-nation has made extinct and mutated 11 microbes, resulting in complex ecological shifts of resident microbiota giving rise to gingivitis, halitosis, cavities, oral thrush, cankers, and bleeding and receding gums. And, our mouth, once a moist, microhabitat of homeostasis, becomes an oxygen-starved-oasis of anaerobic-activity eating away at our immunity and sending systemic disease throughout the body. Avoid Root Canals A root canal is a procedure for infected teeth that kills the tooth by removing its internal structure including the nerves, pulp-tissue, and blood vessels. The hollowed out tooth is rinsed, filled with latex and cement, and then topped with a crown. The purpose of a root canal is to hermetically seal the tooth and save the chewing surface. Theoretically, a root canal seems like a good idea, but, clinically, it is a bacterial horror story. A dead tooth remains in the mouth as an incubator of infection, a bacterial-breeding ground, and necrotic-nest for pathogens to grow and spread. The whole goal of a root canal is to have a non-infected, sterile tooth but the exact opposite is created; each tooth contains 3 miles of microscopic dentin tubules that are impossible to sterilize! With the blood vessels removed, neither antibiotics nor white blood cells can reach the location to fight infection. Every time a root-canaled tooth is used to chew, bacterial toxins are squirted into the bloodstream. To qualify, the teeth had to be symptom-free and show zero signs of pathology on an x-ray. There is much discussion in endodontics journals about the impossibility of sterility in root canal treated teeth the information is just not filtering down to all dentists and the public. Root canals become focal infections that feed anaerobic bacteria 100% of the time; however, not all root canals are causing systemic health issues because of epigenetics and because each person handles toxicity differently. Interrupt the Quorum Call Just as toxic-food and chemical irritants induce leaky guts by microscopically perforating the intestines, the scrubbing and rubbing of our gums with mutating medicants and caustic chemicals causes leaky gums. Bacteria from our mouth does not normally enter our bloodstream, but dental procedures and products can perforate the epithelium, the skin in our mouths, which is only one cell thick, providing a port of entry into the bloodstream. When the bacteria and plaque that cause tooth decay and gum disease enter our circulatory system, they cause a cascade of inflammation releasing cytokines and C-reactive proteins. For example, even healthy mouths are homes to the cavity causing Streptococcus mutans. But when they grow in ordinate group numbers, they are able to gain traction by behavior and regulate communicating through quorum sensing, gene expression enabling them to colonize into a biofilm. Quorum sensing is the way in which pathogens communicate to co-ordinate group behavior and regulate gene expression. A biofilm is a densely packed colony of microbes that adhere to surfaces and surround themselves with sticky secretions. A mucopolysaccharide plaque layer is produced around the biofilm colony, which forms a barrier that is not permeable to antibiotics. Dental plaque is a biofilm that can either entrap existing oral pathogens from flourishing or provide a refuge for pathogens to hide from alkalinizing salivary flow. Under healthy conditions, an oral-ecological balance of bacteria keeps biofilms healthy and stable. This blocks the teeth from breathing and prevents the saliva and dentinal-lymph-fluid from doing its job of cleansing the teeth with a protective coating. These essential oils indicate anti-infective activity that can co-exist with our flora 13 while cleaning up periodontal-pathogens. Now we have scientific studies confirming the ancient wisdom of using botanical-biotics to maintain oral ecology. The aromatic compounds of essential oils act as botanical biotics, microbiome regenerators, and biofilm disruptors. Neem, cardamom, tea tree, frankincense, and clove tidy up bacteria activity rather than indiscriminately bombing all bacteria, effectively reducing biofilm formation, specifically biofilms formed by S. Quorum Sensing Inhibitors of rose, thyme, peppermint, tea tree, clove, and cinnamon can be used to brush teeth and in a serum to massage into gums. We have gone from a seemingly Golden Age of Antibiotics to a very real Anarchy of Antibiotic Resistance.

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Saller r discount 30 mg procardia mastercard cardiovascular and respiratory system, Beschomer M and Hellenbrecht d: dose dependency of fitoterapia 75: 32-38 purchase procardia australia cardiovascular disease quiz, 2004 order 30 mg procardia fast delivery heart disease nutrition. Phytomedicine methode zur beurteilung der therapeutischen wirsamkeit kon 12: 25-27, 2005. Patzelt-Wenczler R and Ponce-Poschl E: Proof of effcacy of evaluation of aromatherapy massage in palliative care. Kroll U and Cordes C: Pharmaceutical prerequisites for a multi toilet paper in patients allergic to Compositae. Thornfeldt C: Cosmeceuticals containing herbs: fact, fction, and Kelber O and Weiser D: Mechanisms involved in the gastro future. Kato a, Minoshima y, yamamoto J, adachi i, Watson aa and favonoid fraction: a review of its use in chronic venous insuf nash rJ: Protective effects of dietary chamomile tea on diabetic fciency, venous ulcers, and haemorrhoids. Misra Mc and Parshad r: randomized clinical trial of micron hypoglycaemic activity of the aqueous extract of Chamaemelum ized favonoids in the early control of bleeding from acute nobile in normal and streptozotocin-induced diabetic rats. Charuluxananan S, Sumethawattana P, Kosawiboonpol R, Hypotensive effect of Chamaemelum nobile aqueous extract Somboonviboon W and Werawataganon T: Effectiveness of in spontaneously hypertensive rats. Clin Exp Hypertens 31: lubrication of endotracheal tube cuff with chamomile-extract for 440-450, 2009. Fugh-Berman A: Herbal supplements: indications, clinical analysis between Chamomilla recutita and corticosteroids on concerns, and safety. Wilcock a, Manderson c, Weller r, Walker G, carr d, carey aM, burn injury: report of a case. Dis Colon Rectum 41: 929-931, Broadhurst D, Mew J and Ernst E: Does aromatherapy massage 1998. Kassi E, Papoutsi Z, Fokialakis N, Messari I, Mitakou S and controlled double-blind randomized trial. J Clin Oncol 21: Moutsatsou P: Greek plant extracts exhibit selective estrogen 2372-2376, 2003. Shinomiya K, Inoue T, Utsu Y, Tokunaga S, Masuoka T, tion by selected commercial herbal extracts and tinctures. J Pharm of routine patch testing with the sesquiterpene lactone mix Pharmacol 51: 519-526, 1999. A randomized, double-blind, placebo-controlled trial of oral Matricaria recutita (Chamomile) extract therapy for generalized anxiety disorder. If you choose to use any remedies or follow the advice in these newsletters, you do so at your own risk. New young plants, called pups or First we completed a series of cooking saves lives suckers, develop near the base of the classes showing how to make tasty parent plant as it grows to a good size or vegan vegetarian recipes (with a to maturity, which may take 2-4 years, special thanks to Esther and Naomi an has used aloe for over 5000 depending on climate and growing Clarke for their assistance). Leaves of young pups tend to requested by some who tasted it and Mthe healing powers of the plant fan sideways and are pale green with loved it! This was followed by a class on their ancient papyrus texts calling it white spots. At maturity these flowers are bright some of the methods our great mentioned several times in the Bible. History when the leaf is cut, the sap has a strong this knowledge has almost been lost to smell. Many of Socotra in order to collect aloe plants Another class that we held showed how members of the aloe family can be found to use as medicine for his soldiers. Greek to make herbal ointments and oils and a in Australia, but accurate identification is writer Dioscorides made detailed very nice face cream. Arab traders scheduled class teaches simple water carried aloe from Spain to Asia around Socratine Aloe (aloe perryi) as aloe vera treatments that can be used for pain the sixth century and introduced it to barbadensis. They Details of coming classes are on page that Indians of both Central America and propagate profusely (called pups) when 5. If you have not already placed your name on my list, do not hesitate to Mexico were so amazed at this plants young, flowers are orange/apricot shade. These classes will be run ability to relieve so many ailments, that the properties of this species are not on demand. So if you are interested in they called the plant with its long leaves nearly as potent as aloe vera attending, or have a friend that you reaching toward heaven, ?the hand of barbadensis. Many herbalists believe that aloe Australia is the Tree Aloe (aloe invite them to attend. If you have vera is a most beneficial herb that offers arborescens), that with age can grow 1-2 already attended these classes, please many amazing healing benefits. These three species all can be used Aloe vera (aloe vera barbadensis) is a internally. Many other species can be the Back to Eden advertising budget is used, but be aware that there are several succulent perennial with a narrow, virtually non-existent. The success of species that contain very toxic alkaloids, prickly-edged, fleshy dagger shaped 30 any programs and classes we hold rely so correct identification is important. It produces a single leafless newsletter is the only way we have to When picking leaves, always start with stalk. A whole leaf can be Copy these, share them with your rosette formation being younger and sliced off at the base, or small pieces can friends, invite them to attend programs. Leaves on mature plants are a distinctive grey-green, due to the surface being There are two products derived from aloe From Kaye and the Back to Eden team covered by a greyish bloom, although leaves. The clear gel that forms naturally 1 in the hollow interior of the leaves is the International Immunopharmacology together to provide antimicrobial product that is used to relieve burns and (1995) showed that aloe vera protection. Then there is a specialized resin polysaccharides exhibited potent magnesium, are highly effective canal cells in the thick leaf skin that macrophage-activating activities including analgesics, which make a good pain produces a bitter yellow juice that is the producing increased volumes of nitric killer.


  • https://www.science.gov/topicpages/a/aethina+tumida+murray
  • https://www.rand.org/content/dam/rand/pubs/technical_reports/2006/RAND_TR303.pdf
  • https://digitalcommons.lsu.edu/authors.html
  • https://commed.vcu.edu/Chronic_Disease/Cancers/2014/CancerCare2013_IOM.pdf
  • https://apps.dtic.mil/dtic/tr/fulltext/u2/a528970.pdf

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