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With cancer cases set to rise dramatically in the future, it is also clear that there is an insufficient number of radiotherapy machines. Excessive water ingestion, inappropriate fluid therapy, and hemodialysis all potentially reduce the serum osmolarity in uremia and thereby risk inducing or accentuating delirium and convulsions. Increased numbers of melanocytes may form clusters located at the tips of the rete ridges in the epidermis (junctional nevus), within the dermis (intradermal nevus), or both at the tips of the rete ridges and within the dermis (compound nevus). Muscle biopsy is the gold standard in diagnosis, and the typical findings in dermatomyositis are necrosis, phagocytosis, perifascicular atrophy, fiber size variation, and perivascular inflammation. There was supranuclear left facial paralysis and left flaccid hemiplegia with weakness of the tongue and the trapezius muscles. After a portion of the alcohol has been driven off by evaporation, the addition of an excess of ether causes at first a resinoid precipitate of salts of the biliary acids, which later pass over into a crystalline mass of brilliant needles (crystallized bile). These studies have identified the etiology of injury, the clinical depth of coma, and the length of time that a patient remains comatose as the most critical factors. By contrast, five year survival rates for patients with cancer of the pancreas, liver, stomach and lung are normally less than 15%. The exploding cost of cancer care in recent years is generally related to the development of expensive anticancer agents, including molecularly targeted therapies, and the rapid expansion of demand for both drugs and imaging techniques. Measurement of radiation exposure from X rays, gamma rays or other types of radiation used in the treatment or detection of diseases, including cancer. Regenerative medicine Supralethal irradiation to the diseased bone marrow followed by allogeneic stem cell transplantation to regenerate healthy marrow has saved many patients with haematological malignancies. The cartilage masses are not visible, but the widened epiphyseal growth plate and irregular calcification are readily seen. The effect of the anatomic setting on the results of surgical procedures for soft parts sarcoma of the thigh. Mild postural kyphosis will frequently resolve spontaneously or following a thoracic extension exercise program. Projections from the nucleus tractus solitarii to the rostral ventrolateral medulla. The advantage of particle therapy, including proton therapy, is that the particle beam can provide a more favourable dose distribution compared with photon beam (X ray) radiotherapy. The so-called, self-limited run of fevers is about the same under all methods; they get well or die; morbid phenomena follow about the same with all methods. Comment: the clues to opioid overdosage in this patient were the small pupils and the shallow, irregular respirations despite pneumonia. An endotracheal tube should be in place, and the patient ventilated to PaO2 at greater than 100 mm Hg. The best results are attained in patients with one or two motor units involved and with myelopathy of a relatively short duration. Lack of response to pilocarpine eye drops (see above) demonstrates the muscarinic blockade. The best score is given to patients who obey commands; care should be taken to avoid interpreting reflex grasping as obedience. Confusional state in stroke: relation to preexisting dementia, patient characteristics, and outcome. Renal tubular acidosis occurs from the inability of the kidneys to keep up with the excretion of the daily endogenous acid production arising from dietary proteins and amino acids. Berry aneurysm Atherosclerotic aneurysm Mycotic aneurysm Charcot-Bouchard aneurysm Saccular aneurysm 477. Such a delayed recovery did not imply permanent brain damage, as this man, like others with similar but less protracted delays, enjoyed normal neurologic function on chronic hemodialysis. We wish to confine this article to that kind, which is represented in the cuts on page 179.

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In addition, trauma to the pelvis, acetabulum, and proximal femur are summarized and treatment alternatives outlined. Physical examination of patients with neckache usually reveals nothing more than a locally tender area or areas, usually just lateral to the spine. Atraumatic and Overuse Injuries of the Elbow Lateral and Medial Epicondylitis In skeletally mature adults, strains to the medial and lateral epicondyle can result in epicondylitis. In biology, vascular, in its broadest sense, has reference to the arterial, venous and lymphatic channels for the conveyance of blood, chyle, lymph and serum. Life is expressed by the process of metabolism, growth, reproduction and inherent powers of adaptation to environment. It may interfere with writing, is usually limited to the hands, but the jaw and neck may be affected. Perinatally lethal osteogenesis imperfecta presents with relative macrocephaly, dysmorphic facies, dark blue sclera, intrauterine growth restriction, extreme bowing and shortening of extremities caused by multiple underlying fractures, hypoplastic thorax, and rib fractures, with early death resulting from pulmonary insufficiency. She was brought to the hospital by ambulance, and examination in the emergency department disclosed a lethargic patient who could be easily wakened. Follicular carcinoma Papillary carcinoma Squamous cell carcinoma Medullary carcinoma Anaplastic carcinoma Endocrine System 429 414. Proper interpretation of a lesion seen on a radiograph can be summarized by answering "four questions" as proposed by Dr. Other patients may present with shoulder subluxations and dislocations that may easily reduce on their own but are a significant source of disability and distress to the patient. Many patients with metabolic coma either hyper- or hypoventilate, but it is rare to see the abnormal respiratory patterns that characterize infratentorial mass or destructive lesions (see page 50). Afferent pupillary defect A non-reactive pupil can arise from a lesion either in the afferent (optic nerve) or the efferent (third nerve) limb of the pupillary light reflex. The initial sign is cessation of lactation, which may be followed by secondary amenorrhea due to the loss of gonadotropins. Thus, careful explanation of the predicted outcomes is required if the physician uses these data to counsel families, as choices concerning severe disability may differ widely (see family dynamics and philosophic considerations, page 379). Osteomyelitis is often classified using these parameters, which can assist in defining the severity of infection, identify a mode of treatment, and assess the potential for recovery. Nucleus basalis of Meynert neuronal activity during a delayed response task in monkey. The first and second pair of cervical nerves cannot be pressed or squeezed between the occiput and atlas or in the cleft between the atlas and axis, and yet there are many diseases resulting from their displacement. While abdominal ultrasonography may show enlargement of the liver and spleen, this would not be a specific finding. Radiographic and Laboratory Evaluation Plain radiographs of the knee demonstrated no bony lesions, only an effusion. Facial dysmorphology is characterized by sparse frontotemporal hair, highbossed forehead, downslanting palpebral fissures, a long narrow face, and a prominent narrow jaw. It is covered with columnar epithelium-a lens will show the openings of numerous glands. This pain can be the result of degenerative changes in the patellofemoral articulation or a result of maltracking of the patella within the trochlear groove. That "marked depression" was the separation between the spinous processes, a lordosis, caused by a tilting of one of the vertebrae. The brain edema in stroke is largely cytotoxic, rather than vasogenic, and steroids do not produce the dramatic amelioration of the symptoms of brain edema seen in patients with tumors. Neuroimaging techniques that can directly assess functional changes within these cerebral networks hold significant promise to ultimately improve diagnostic accuracy and understanding of the pathophysiology of the severely injured brain (see 99 for review). Over the past 25 years, opioid products available in the United States have increased threefold. Patients should know that the headaches will transiently worsen, but discontinuing the inciting medication is a necessary step as the migraines are unlikely to improve in the setting of ongoing medication overuse. Important interactions and unwanted effects Interacts with ciprofloxacin and phenytoin. For example in radiotherapy, improved target definition and novel radiosensitization strategies are under investigation.

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It is interesting to note that although the pharmacologic effects of these drugs may wear off in 2 to 3 hours, the relief may last indefinitely. One year later, the first issue of the Chinese Journal of Radiation Oncology was published, offering a platform for the timely exchange and sharing of laboratory and clinical research outcomes among radiation oncology professions across the country. These deformities can result not only from injury but also from systemic and local disease states, both congenital and acquired. Because slings are typically more comfortable and more widely available than figureof-eight bandages, with similar outcomes, they are commonly used as the initial treatment of choice for children with clavicle fractures. Notice the diminution of the intervertebral disks, black discoloration of the cartilage components, virtual disappearance of all joint spaces, and bony bridging. Management is currently symptomatic with no benefit demonstrated as yet for immunomodulatory treatment. It is important to understand that the solutions are not applicable to all the functions of a product, but rather to a specific set of predetermined functions. The therapy must be rooted in education, reassurance, and ongoing support for the patient and family with a discussion of how the diagnosis is made and why other diseases have been ruled out. Migraines are characterized by severe head pain, nausea, and phonophobia or photophobia. The loading dose does not influence the steady-state level ultimately achieved, which is determined solely by the maintenance dose. Some patients have abdominal pain without bleeding, while others describe rectal bleeding without pain. Overdoses with most depressant drugs produce fairly consistent clinical findings; individual drugs usually cause relatively minor clinical differences. Diagnosis and management of pediatric appendicitis, intussusception, and Meckel diverticulum. Many times these patients present late after having been treated elsewhere or having avoided treatment altogether. Aggressive treatment of any infection in the diabetic foot is mandatory for salvage. To evaluate for fat malabsorption, a spot stool fat may identify elevated fecal fat. Immobilization of the joint in the early stages after an injury with these treatment principles act to limit the initial swelling. Early findings include weakness of the lower extremities and visual abnormalities with retrobulbar pain. This publication presents an overview of the major topics and issues to be taken into account when planning and implementing radiotherapy services. The majority of their working time should not be spent doing expert witness work unless they have retired from clinical practice. The pattern of respiration can give important clues concerning the level of brain damage. Acid-base and electrolyte analysis in critically ill patients: are we ready for the new millennium Requirement 24 Require registrant and licensees to maintain a radiation protection programme by establishing organizational, procedural and technical arrangements. We do not now, and have not for many years, used the "fist closed" while adjusting any vertebrae. Her lungs are clear to auscultation bilaterally and her heart has a regular rate and rhythm. Preoperative studies allow the surgeon to conceptualize the local anatomy and the volume of tissue to be resected and reconstructed.

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A major advantage of an immediate boost during surgery is the close proximity of the walls of the surgical cavity due to the fact that no fluid will artificially enlarge the volume at risk by spherical distension, resulting in larger treated volumes and hence increased risk of late effects. Accurate prognostication improves over time, but it is still unclear how early one can make accurate predictions within different diagnostic categories. Eighty percent of those who follow the foregoing regimen will be markedly improved, but it requires patience because frequently at least 6 weeks have passed before any additional therapy is indicated. Despite treatment she developed edema of the right temporal lobe with uncal herniation. There have been multiple suggestions as to the etiology of the slipped capital femoral epiphysis. Finally, they should be reexamined periodically because some will develop significant pressure on the neurologic elements (myelopathy). Abnormal flexion in the lower extremities (the reflex triple flexion response) sometimes can be difficult to distinguish from withdrawal. Options for the treatment of localized prostate cancer include surgery or radiotherapy with or without hormone therapy. Parents have the right to make informed decisions for their children, so refusal to vaccinate is not considered medical neglect in healthy children and should not be reported to child protective services. This seems a reasonable time interval for cases where all circumstances of onset, diagnosis, and treatment can be fully identified. One question was always uppermost in my mind in my search for the cause of disease. Associated fever and rhinorrhea have resolved, but the cough has persisted and worsened. One can see intervertebral disk degeneration, decreased interpedicular distance, a decreased sagittal canal diameter, and facet degeneration. The ends of bones in diathrodial joints are usually covered with hyaline cartilage. In these cases, as in cerebellar hemorrhage, the mass effect can cause stupor or coma by compression of the brainstem and death by herniation. Additionally includes Rett syndrome and childhood disintegrative disorder (very rare). If the patient is unable to maintain the position and the extremity falls away, the patient is considered to have a positive lag sign. Finally, metabolic and structural brain diseases are distinguished from each other by a combination of signs and their evolution. Ependymoma Glioblastoma multiforme Medulloblastoma Oligodendroglioma Schwannoma 488. No significant differences were detected for ten year cumulative incidence of distant metastases (29. Answer: c Pilon fractures involve the intraarticular fractures of the tibial metaphysis, which extend to the weight-bearing portion of the tibia; a is a Lisfranc fracture-dislocation, and e is also known as a Jones fracture. For all countries, however, lung cancer, a partly preventable disease, is the greatest cause of cancer related deaths. Her parents report getting mixed advice about whether she should be taught to read braille and would like your opinion. Caseous material may extend from the vertebrae into paravertebral muscles and along the psoas muscle sheath to form a psoas abscess in the inguinal regions. Empirically, they do appear to have a positive psychologic effect and give the patient an active part in his treatment program. Physical examination reveals a large mass in the lumbosacral area that transilluminates. Its objects were the discovery of the universal cure for disease and the means for indefinitely prolonging life. In contrast, extensive gumma formation is seen with syphilis, tophus formation is seen with gout, and caseous necrosis of bone is seen with tuberculosis.

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A total of 556 patients with resected adenocarcinoma of the stomach or gastro-oesophageal junction were randomly assigned to surgery plus post-operative chemoradiotherapy or surgery alone. Distinctive clinical features, in addition to the manifestations of metabolic acidosis, include the odor of paraldehyde on the breath, abdominal pain, a marked leucocytosis, and obtunded, lethargic behavior. A cellulitic phase precedes abscess formation, with medical management alone being successful to cure the infection. Manipulation of the shoulder under anesthesia was once the preferred treatment and continues to be a reasonable option. The same source predicts a total of 17 113 588 cancer cases for 2020 and 21 645 658 for 2030. The two may co-exist, particularly in cerebral palsy and acquired brain injury where the failure to consider extrapyramidal stiffness can result in effective therapies being missed. An abdominal ultrasonography can be used to confirm the size of the liver and provides some assessment of density and evaluation for a liver mass, if present. First, type I (mild): foot is supple and easily corrects with digital stroking of the lateral side of the foot. Vitamin E deficiency is the most common, presenting with peripheral neuropathy and hemolysis in severe cases. This is especially true with new, less transparent techniques, such as intensity modulated radiation therapy and all its variants, where classical monitor unit verification and in vivo dosimetry no longer qualify as adequate verification tools. It can be a one-time classroom session with a review of back problems and a demonstration of exercises with patient participation. Research must be intrinsically economical, not wasting resources on less important, overly lengthy or impossible projects. The physical properties of proton beams make it possible to concentrate the radiation dose on the target with delivery of fairly small doses to structures in front and behind the target. The problem, however, is that the organisms are frequently not killed; they only await antibiotic withdrawal before initiating a new wave of bony destruction. Nonalcoholic fatty liver disease is a common complication of exogenous obesity and represents a range of liver pathology from deposition of large fat droplets within hepatocytes all the way to cirrhosis and end stage liver disease, requiring transplantation. Resection arthroplasty is a procedure in which the articular surfaces are resected and a fibrous pseudoarthrosis forms within the joint space. Radially, it has a lesser sigmoid notch, which articulates with the periphery of the radial head. Determining if the short head of the biceps is normally innervated can assist in determining the level of peroneal nerve injury clinically. Nevertheless, such findings indicate the need for larger prospective studies examining whether slow structural changes do arise in the setting of severe traumatic brain injuries and, if present, whether they influence functional outcomes. Careful analysis and acceptance of the audit recommendations 309 may help the centre to establish and implement a programme for improvement. Physical activity including weight-bearing exercises can increase bone mineral density and is recommended for the patients who are able. The respiratory/long-term ventilation team will advise on mask fitting and ventilator type. Rather, the self is aware of the two alternative visual interpretations alternately. Bariumcontaining contrast agent is mixed with food: the ability to compare different food consistencies and seating positions is very useful. To help build such relationships, it is critical to be empathic and supportive and try to imagine what has eloquently been described as ``the loneliness of the long-term caregiver'191 faced with social isolation and family members whose injury has altered them and their relationships with those who hold them dear. Survey areas after installation to ensure that public spaces are below regulatory thresholds. While the continuance of the state which we call health depends upon the approximate maintenance of the external conditions to which the body has become adapted, it should be borne in mind that the adaptive capacity of the body is in many ways of unusual surroundings and adverse influences. Audio reading machines translate text into spoken words, which is the skill of listening rather than reading (reading = literacy). In patients with congenital hand differences or birth-related injuries, one must obtain a careful understanding of the gestational and birth history.

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The equipment includes both public 398 and private sector radiotherapy units (linacs, cobalt-60 units and brachytherapy units). It states further that: "Screening programmes should be undertaken only when their effectiveness has been demonstrated, when resources (personnel, equipment, etc. Suggestive medicine consists of the treatment by positive assertions addressed to a more or less hypnotized patient. It is the most common chromosomal abnormality that we see today, and it occurs in approximately 1 in 500 to 800 live births based on the age of the mother. However, the posterior capsule is opened and the rate of instability is increased, whereas the anterior approaches leave the posterior capsule intact with a correspondingly lower rate of instability. Requiring the patient to be sedated, this procedure is performed either in the radiology suite or operating room setting. There are various factors affecting the outcome of renal transplantation in children. On rare occasions, the transplanted kidney carries a virus and may cause encephalitis within a few days of the transplant. Progression is variable and is more likely in younger patients, in skeletally immature patients (in particular, premenarchal girls), and in larger curves. Locking can be a result of a loose body in the knee becoming lodged between the femoral condyle and tibial plateau, similar to a wedge "doorstop. The gamma knife is a radiotherapy device specifically designed to treat intracranial lesions. Furthermore, do you not see that there are no intervertebral cartilages or discs to be "thinned" between the atlas articulations above and below Scoliosis and pooling of secretions with aspiration makes a myopathy (particularly nemaline rod) likely. Physical examination is notable for a thin child who is alert but demonstrates poor tone. She has not been sexually active, has not been taking birth control pills, has not been on any long trips, and has not been immobilized for any period of time. Annual screening has been the standard; however, two screening studies demonstrate that screening is beneficial every two to four years. Supranuclear disorders of ocular control systems in man: clinical, anatomical and physiological correlations. A recent update of 227 patients showed that 48% remained alive at an average 11 years after surgery. When bone or joint involvement is extensive, aggressive surgical debridement is mandatory for satisfactory resolution. The thickness of the reactive zone varies with the degree of malignancy and histogenetic type. The practical knowledge thus acquired will not only make each student of Chiropractic a more skillful practitioner, but will enable those in all future reading of what purports to be Chiropractic literature to discriminate between statements that are and those that are not in conformity with the basic principles of this important science. Early reports suggested that there was permanent cognitive dysfunction after pulmonary bypass surgery. That was my table allowance and did not include the sweet morsels nibbled while handling honey. Spinal accessory nerve injury is often iatrogenic from a posterior cervical node biopsy or a radical neck dissection for malignancy. On the other hand, too few registries make it difficult to evaluate temporal change in practice and clinical outcomes following dissemination of research results [24. To the person wanting scientific detail of a technical nature, this is complete practical, comprehensible and what he ought to have had thousands of years ago. The liver and spleen are palpable 2 cm and 1 cm below the right and left costal margins, respectively.

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Rest your thumb on the eyebrow and stabilize the ophthalmoscope on your thumb: this minimizes confusing parallax effects due to movement of the ophthalmoscope relative to the eye. Clinical features include erythema and mild inflammation of the epidermis, without blister formation. A third condition in which sustained coma may be associated with seizures occurs when the loss of consciousness is not simply postictal, but is the result of a cerebral disease that also caused the seizures. A hazard ratio of greater than one or less than one means that survival was better in one of the groups. By the time the patient returned to the emergency department he had no oculocephalic responses, and breathing was ataxic. Transmitted as an autosomal dominant in most cases, it is usually apparent at birth. Besides feeling the foot, the other technique that is helpful in differentiating the two is simply to examine the child sitting, standing, and standing on the toes. On physical examination, obesity and decreased hip internal rotation are the most common findings. The progress of alchemy as a science was impeded by the nature of its aims and by much mystification; but, important discoveries were made incidentally. Defining the phenotype the first step in forming a differential diagnosis and planning investigations is to define exactly which movement abnormality is/are present. Of the following, you inform the medical student that, compared with the full term infant, this preterm infant will A. Pediatricians should recognize that some steroids, such as methylprednisolone, commonly used in asthma, have no mineralocorticoid activity at any dose and would not be appropriate for this patient. The second common cause of a knee buckling or giving-way are problems in the patellofemoral joint. If the fracture is grossly contaminated, such as in a barnyard injury, then a penicillin is added to this regimen. Bunions and corns are caused by displaced joints in the toes and tarsus where it is impossible to pinch or squeeze a nerve, but the displacement of those joints press against nerves and cause these affections. The examiner must have a high index of suspicion for locked posterior shoulder dislocations in older patients who are poor historians as a result of dementia or stroke. Weakness of extensors of wrist and fingers (wristdrop) Nervous System Answers 469. There may be occasional rosette-like structures, although neuroectodermal origin has never been confirmed. In such cases, respiratory depression may ensue almost as rapidly as does unconsciousness; signs in the motor system may initially evolve as if function was being depressed in a rostral-caudal fashion, with a brief appearance of hyperreflexia and even clonus and extensor plantar responses. A hazard ratio of one means that there is no difference in survival between the two groups. Which of the following organism is the most common pathogen in pediatric age group osteomyelitis A knee with a bloody effusion after an injury has an incidence as high as 80% of significant soft tissue injury. A complete ligament disruption, particularly of the deltoid, may require surgical repair. This view clearly demonstrates the anterior column and posterior rim of the acetabulum. For very long-term pictures, it may be more useful to start with the present situation and fill in backwards. A 34-year-old male presents with multiple large, sharply defined, silver-white scaly plaques on the extensor surfaces of his elbows and knees and on his scalp. Only through partnerships with international organizations, universities, cancer centres, financial institutions and non-governmental organizations can the strengthening of radiotherapy services be addressed effectively throughout the world. There are both genetic and social origins for the development of separation anxiety disorder. No significant change in the complexity of the surgery or outcome will be noted in patients with hip arthritis who delay operative intervention with nonoperative treatment.

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Radiation is widely misunderstood to be a relatively simple, single modality which has been well investigated. If these affected nerves end in the throat, in persons of a certain age, we have conditions known as diphtheritis. Generalized seizure activity occurs less commonly, but has been reported after intoxication with propoxyphene, meperidine, tramadol, fentanyl, and pentazocine. Three hundred and eighteen patients were assigned to receive no further therapy or radiotherapy (37. I have relieved quite a number of typhoid fever cases, adjusting the fourth dorsal vertebra but once. Although upward of 50% curve correction can routinely be obtained in the adolescent, the more important goals of surgery are achieving a solid fusion, well balanced over the sacrum, and extending from the top to the bottom of the curve. Specialized formulas are available for special medical conditions such as amino acid formulas for infants with allergic conditions or extensively hydrolyzed formulas for children with impaired gastrointestinal absorption. The modality is extremely useful in the evaluation of musculoskeletal tumors, as well as disorders of the spine, knee, shoulder, and foot. If the pain is reduced or absent with the second maneuver, the test is considered positive. Patients may experience headache, myalgias, and abdominal pain; in the most severe cases, focal neurologic symptoms, intracranial hemorrhage, myocardial ischemia, seizures, and even coma may result. Patients with overwhelming meningococcal septicemia, and few or no polymorphonuclear leukocytes in their spinal fluid, represent the worst prognostic group of patients with acute bacterial meningitis. Especially will it be considered so by those who have tried the "rebound" or "recoil" movement. Prevention and mitigation of accidents There have been several reported accidents with newly acquired radiotherapy equipment. Bilateral vestibular failure occurs with phenytoin or tricyclic antidepressant toxicity. A series of drawings illustrating levels through the brainstem at which lesions caused impairment of consciousness. Mannitol bolus preferentially shrinks non-infarcted brain in patients with ischemic stroke. Because of the risk of axillary nerve damage, most surgeons prefer to gently manipulate the shoulder in abduction to release the inferior capsule. Beta lactam antibiotic monotherapy versus beta lactam-aminoglycoside antibiotic combination therapy for sepsis. Motor and sensory examination was also normal, tendon reflexes were symmetric, and toes were downgoing. It is important to note that children with polyuria may have nocturia or nocturnal enuresis; however, the more frequently reported symptoms of frequency, nocturia, or enuresis may not be associated with increased urinary volume (or polyuria). In front of the Bragg peak the radiation dose is low, and beyond the Bragg peak the dose falls to zero over a very short distance. In El Salvador, 226Ra sources were used for gynaecological brachytherapy from the 1970s to 2005. Parents should be advised that as a part of the normal healing process a lump will likely become apparent as a callus forms, and may persist for a year or longer. Delineation and contouring of targets and organs have become a new and important component in the training of radiation oncologists. They are reports from open trials that combinations of antiviral drugs (ribavirin, inosiplex and interferon A) may be worth considering. Better control of dose delivery allows for better delineation between target tissue exposed to high doses and normal tissue shielded to the maximum, with steep dose gradients sometimes over a few millimetres. These include crotamiton (poor efficacy), lindane (poor efficacy, potential neurotoxicity), and benzyl benzoate (contact dermatitis, neurologic toxicity if ingested). Urine organic acids Abnormal profiles may be present all the time or only during metabolic decompensation.

References:

• https://bjan-sba.org/article/10.1590/S0034-70942011000500006/pdf/rba-61-5-564-trans1.pdf
• https://www.loc.gov/law/mlr/Military_Law_Review/200-summer-2009.pdf
• https://professional.diabetes.org/files/media/dc_40_s1_final.pdf