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1. Psychotic Disorders

Author

Chawla, Vanika, primary, Makowski, Maryam S., additional, Freeman, Heather, additional, and Noordsy, Douglas L., additional

Published
2023
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2. Psychosis in Sports

Author

Ho, Patrick A., Stull, Todd, Noordsy, Douglas L., Baron, David, editor, Wenzel, Thomas, editor, Ströhle, Andreas, editor, and Stull, Todd, editor

Published
2023
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3. Risperidone versus olanzapine among patients with schizophrenia participating in supported employment: Eighteen-month outcomes

Author

Noordsy, Douglas L, Glynn, Shirley M, Sugar, Catherine A, O'Keefe, Christopher D, and Marder, Stephen R

Subjects
Biological Psychology, Pharmacology and Pharmaceutical Sciences, Biomedical and Clinical Sciences, Psychology, Clinical Trials and Supportive Activities, Mental Health, Clinical Research, Brain Disorders, Schizophrenia, Serious Mental Illness, 6.1 Pharmaceuticals, Evaluation of treatments and therapeutic interventions, Mental health, Adult, Antipsychotic Agents, Benzodiazepines, Double-Blind Method, Employment, Supported, Female, Humans, Male, Middle Aged, Olanzapine, Outcome Assessment, Health Care, Risperidone, Weight Gain, Antipsychotic medication, Supported employment, BMI, Medical and Health Sciences, Psychology and Cognitive Sciences, Psychiatry, Clinical sciences, Clinical and health psychology
Abstract

This study compares the efficacy and tolerability of olanzapine versus risperidone among patients with schizophrenia who are established in outpatient psychiatric care and entering supported employment. A multicenter, randomized, double-blind trial was conducted among 107 outpatients with schizophrenia, who were cross-titrated to flexible dose risperidone or olanzapine over 2 weeks. Clinical endpoints included time to hospitalization and persistence on assigned medication. Weight, laboratory tests, psychopathology, neurologic side effects, social adjustment and role functioning were assessed at 3-6 month intervals. Data were analyzed first by randomized treatment, and then reassessed controlling for prior medication treatment. The proportion of patients on assigned medication at 18 months was 30.9% for risperidone and 37.3% for olanzapine. Mean doses were 6.4 ± 3.2 mg daily for risperidone, and 17.0 ± 5.0 mg daily for olanzapine. The groups did not differ significantly in time to medication discontinuation, first hospitalization or first employment. There were few differences in psychopathology, laboratory, or neurological assessments between groups at 18 months. Patients randomized to olanzapine gained modestly more weight. Controlling for pre-randomization medication suggested improvement in some aspects of psychopathology from switching medications; however, switching from olanzapine to risperidone was associated with more hospitalizations. Risperidone and olanzapine have similar efficacy and tolerability in patients with schizophrenia who are participating in supported employment. Randomization to olanzapine was associated with more weight gain, but randomization from olanzapine to risperidone appeared to be associated with a greater likelihood of hospitalization. Careful monitoring of metabolic effects and participation in supported employment may have contributed to minimal weight gain and metabolic effects.

Published
2017

4. The Role of Physical Exercise in Cognitive Preservation: A Systematic Review.

Author

Kaufman, Matt, Dyrek, Paige, Fredericson, Michael, Oppezzo, Marily, Roche, Megan, Frehlich, Levi, and Noordsy, Douglas

Subjects
BRAIN physiology, DEMENTIA prevention, CONTINUING education units, MEDICAL information storage & retrieval systems, MUSIC, PSYCHOTHERAPY, MENTAL health, MILD cognitive impairment, EXERCISE therapy, EXECUTIVE function, HIGH-intensity interval training, BRAIN, SOCIAL role, DESCRIPTIVE statistics, SYSTEMATIC reviews, MEDLINE, RESISTANCE training, COGNITION disorders, PHYSICAL fitness, AEROBIC exercises, DANCE, MEMORY, NEUROPSYCHOLOGICAL tests, ONLINE information services, QUALITY assurance, CEREBRAL circulation, BLOOD volume, PHYSICAL activity, COGNITION, OLD age
Abstract

Dementia, or major neurocognitive disorder, is one of the most common causes of disability and dependency in older adults with far-reaching social, physical, and economic impacts. In the absence of adequate treatment, much research has been directed towards prevention. Physical exercise has been shown to increase cerebral blood flow, amplify production of neurotrophic factors, and enhance brain volume. Whether these changes on a structural and cellular level result in cognitive preservation is less clear. This systematic review synthesizes findings from seventeen randomized controlled trials that examine the effects of physical activity on global cognition, memory, and executive function in older adults. Cognitive benefits of exercise are strongest for those who are cognitively intact or with mild cognitive impairment. In studies with long-term follow up, cognitive gains tended to decay after cessation of physical intervention suggesting that sustained physical exercise may be required to preserve cognitive function in older adults prior to onset of dementia. [ABSTRACT FROM AUTHOR]

Published
2024
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5. The Association Between Well-Being and Empathy in Medical Residents: A Cross-Sectional Survey.

Author

Swenson, Theodora L., Ehsanian, Reza, Tran, Richard T., Petersen, Timothy R., Kennedy, David J., Roche, Megan, Oppezzo, Marily, Noordsy, Douglas L., and Fredericson, Michael

Subjects
EMPATHY, PSYCHOLOGY of physicians, CROSS-sectional method, MEDICAL specialties & specialists, ACADEMIC medical centers, INTERNSHIP programs, MULTIPLE regression analysis, RESIDENTIAL patterns, QUESTIONNAIRES, SEX distribution, DESCRIPTIVE statistics, AGE distribution, CLINICAL competence, RESEARCH, CONFIDENCE intervals, WELL-being, TIME
Abstract

Objective: To evaluate the extent to which personal well-being may be associated with empathy, while controlling for potential confounders. Settings/Location: Residency programs throughout the United States. Subjects: A total of 407 medical residents from residencies including general medicine, surgery, specialized and diagnostic medicine participated in this study. Outcome Measures: Well-being was measured using the modified existential well-being subscale of the spiritual well-being scale. Empathy was measured using the Jefferson Scale of Empathy. Results: Well-being was found to be positively correlated with empathy when adjusted for possible confounders (p < 0.001). In addition to well-being, other factors noted to be statistically significant contributors to higher empathy scores while controlling for the others included age, gender, year in residency, specialty, and work-hours (p < 0.05 for each). After controlling for these factors, a resident's year in residency was not found to be a statistically significant contributor to empathy score. Conclusions: In this study, well-being was associated with empathy in medical and surgical residents. Empathy is a fundamental component of physician competency, and its development is an essential aspect of medical training. These findings suggest that efforts to increase well-being may promote empathy among medical residents. [ABSTRACT FROM AUTHOR]

Published
2024
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7. The Integration of Early Psychosis Services in a System of Care Framework: Opportunities, Issues, and Recommendations

Author

Portland State University, Research and Training Center for Pathways to Positive Futures, Sale, Tamara, Fetzer, Patrice, Humensky, Jennifer, Baker, Megan, Hardy, Kate, Noordsy, Douglas, and Adelsheim, Steven

Abstract

This monograph describes how an SOC approach, coupled with specialized early psychosis intervention, can create a sustainable infrastructure, significantly decrease the duration of untreated psychosis, and improve service delivery and outcomes for youth and young adults with early signs of psychosis. [This product was made possible, in part, with support from the National Technical Assistance Network for Children's Behavioral Health at the University of Maryland, funded by the Center for Mental Health Services (CMHS) at the U.S. Department of Health and Human Service (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA).]

Published
2018

12. Treatment of Schizophrenia

Author

Woo, Tsung-Ung, primary, Canuso, Carla, additional, Wojcik, Joanne, additional, Noordsy, Douglas, additional, Brunette, Mary, additional, and Green, Alan, additional

Published
2017
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16. The Future of Yoga for Mental Health Care.

Author

Chawla, Vanika, Brems, Christiane, Freeman, Heather, Ravindran, Arun, and Noordsy, Douglas L.

Abstract

Yoga is an integrated holistic system originating in India that provides a path to alleviate physical, mental, and emotional suffering. Interest in the application of yoga in health care to manage and treat psychiatric conditions has grown. While research and clinical interventions using yoga show promising results for improving mental and emotional well‑being, more data are needed. This perspective article summarizes the current evidence on yoga as a treatment for mental health conditions, potential mechanisms of action, future directions, and a call to action for proactive clinical and research agendas for yoga‑based interventions in mental health care. [ABSTRACT FROM AUTHOR]

Published
2023
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23. List of Contributors

Author

Abraham, Amanda J., primary, Ait-Daoud, Nassima, additional, Alessi, Sheila M., additional, Alexander, James F., additional, Ames, Susan L., additional, Anderson, Peter, additional, Bedi, Gillinder, additional, Belon, Katherine E., additional, Bendtsen, Preben, additional, Bhatti, Junaid, additional, Bickel, Warren K., additional, Bittinger, Joyce N., additional, Blanchette-Martin, Nadine, additional, Blume, Arthur W., additional, Borsari, Brian, additional, Bray, Robert M., additional, Brensilver, Matthew, additional, Brewer, Colin, additional, Brody, Janet L., additional, Brown, Barry S., additional, Brown, Janice M., additional, Brown, Thomas G., additional, Brown, Edson Sherwood, additional, Budney, Alan J., additional, Burgess, Douglas M., additional, Campbell, E. Cabrina, additional, Caroff, Stanley N., additional, Carroll, Kathleen M., additional, Carter, Adrian, additional, Casares López, María José, additional, Catalano, Richard F., additional, Chakravorty, Subhajit, additional, Cheatle, Martin D., additional, Clancy, Luke, additional, Cohen, Jason, additional, Collins, Rick, additional, Cooper, Ziva D., additional, Cornelius, Jack R., additional, Cronce, Jessica M., additional, D’Amico, Elizabeth J., additional, Dadich, Ann, additional, Darkes, Jack, additional, Dawe, Sharon, additional, de Jong, Menno D.T., additional, De Leon, George, additional, Deane, Frank P., additional, Dennis, Michael L., additional, Di Leo, Ivana, additional, Dingle, Genevieve, additional, Drake, Robert E., additional, Duffy, Sarah Q., additional, Dundon, William D., additional, Esposito, Alex Z., additional, Fagan, Abigail A., additional, Fareed, Ayman, additional, Fell, James C., additional, Ferland, Francine, additional, Flynn, Patrick M., additional, Ford, Julian D., additional, George, William H., additional, George, Tony P., additional, Godley, Susan H., additional, Godley, Mark D., additional, Gold, Mark S., additional, Gordon, Adam J., additional, Gosselt, Jordy F., additional, Gould, Michele, additional, Grabowski, John, additional, Granato, Hollie F., additional, Grant, Jon E., additional, Grella, Christine, additional, Grossbard, Joel R., additional, Guttman, Kelly, additional, Gwartney, Daniel, additional, Haighton, Catherine A., additional, Haji-Khamneh, Bahar, additional, Hall, Wayne, additional, Haney, Margaret, additional, Hawkins, J. David, additional, Heberlein, Annemarie, additional, Heinzerling, Keith, additional, Herin, David, additional, Herkov, Michael J., additional, Herman, Aryeh I., additional, Hides, Leanne, additional, Higley, Amanda E., additional, Hillemacher, Thomas, additional, Hoffman, Kim A., additional, Holmes, Jacqueline K., additional, Hopwood, Max, additional, Houston, Jaime L., additional, Hunt, Yvonne, additional, Hunter, Sarah B., additional, Hurford, Irene M., additional, Jardin, Bianca, additional, Johnsson, Kent, additional, Jones, Alexis M., additional, Kaner, Eileen F.S., additional, Kaufman, Annette, additional, Kavanagh, David J., additional, Kelly, Peter J., additional, Kerfoot, Karin E., additional, Kilmer, Jason R., additional, Kingree, Jeffrey B., additional, Kinsey, Berma M., additional, Koo, Kelly H., additional, Kosten, Thomas R., additional, Krumm, Margaret M., additional, Krupitsky, Evgeny, additional, Lane, Marian E., additional, Larimer, Mary E., additional, Larios, Sandra E., additional, Leal, Nerida L., additional, Ledgerwood, David M., additional, Lee, Jonathan C., additional, Lee, Christine M., additional, Lehman, Wayne E.K., additional, M. Lenk, Kathleen, additional, Liao, Yue, additional, Liddle, Howard A., additional, Litt, Mark D., additional, Logan, Diane, additional, Lostutter, Ty W., additional, Loxton, Natalie J., additional, Lucke, Jayne, additional, Lybrand, Janice, additional, Lyons, Geoffrey C.B., additional, Mallett, Kimberly, additional, Mann, Stephan C., additional, Manuel, Jennifer K., additional, Marlowe, Douglas B., additional, Marsch, Lisa A., additional, Martino, Steve, additional, Mason, Barbara J., additional, Mastroleo, Nadine R., additional, Mathers, Bradley, additional, McCarty, Dennis, additional, Mercer, Delinda, additional, Meyers, Robert J., additional, Miles, Jeremy N.V., additional, Mooney, Marc, additional, Morasco, Benjamin J., additional, Mueser, Kim T., additional, Muir, Joan A., additional, Nelson, Toben F., additional, Newbury-Birch, Dorothy, additional, Newville, Howard, additional, Nguyen, Hong V., additional, Nicholson, Lisa, additional, Noordsy, Douglas L., additional, O’Farrell, Timothy J., additional, Odlaug, Brian L., additional, Orson, Frank M., additional, Paddock, Susan M., additional, Pasch, Keryn E., additional, Patkar, Ashwin A., additional, Pedersen, Eric R., additional, Petrakis, Ismene L., additional, Pettinati, Helen M., additional, Ponce, Guillermo, additional, Ponicki, William R., additional, Ramakrishnan, Muthu, additional, Riper, Heleen, additional, Robbins, Michael S., additional, Rohsenow, Damaris J., additional, Roman, Paul M., additional, Rubio, Gabriel, additional, Santa Ana, Elizabeth J., additional, Schreiber, Liana R.N., additional, Schumm, Jeremiah A., additional, Schwartz, Seth J., additional, Scott, Christy K., additional, Serna, Brian, additional, Sheidow, Ashli J., additional, Shoptaw, Steven, additional, Smith, Jane Ellen, additional, Sofuoglu, Mehmet, additional, Soole, David W., additional, Sorensen, James L., additional, Soyka, Michael, additional, Stockwell, Tim, additional, Sussman, Steve, additional, Szapocznik, José, additional, Tait, Robert, additional, Toneatto, Tony, additional, Toomey, Traci L., additional, Treloar, Carla, additional, Turrisi, Rob, additional, van Hoof, Joris J., additional, Varvil-Weld, Lindsey, additional, Velazquez, Cayley E., additional, Waldron, Holly Barrett, additional, Walker, Denise D., additional, Watson, Barry C., additional, Whiteside, Ursula, additional, Willis, Belinda, additional, and Woods, Briana A., additional

Published
2013
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24. List of Contributors

Author

Adams, Jeremy, primary, Aivadyan, Christina, additional, Andrade, Jackie, additional, Andreassen, Cecilie Schou, additional, Attwood, Angela, additional, Aveyard, Paul, additional, Baker, Amanda, additional, Balsam, Kimberly F., additional, Bancroft, John, additional, Barth, Kelly S., additional, Bauld, Linda, additional, Beranuy, Marta, additional, Blume, Arthur W., additional, Bolton, James M., additional, Bonn-Miller, Marcel O., additional, Borsari, Brian, additional, Brady, Kathleen T., additional, Braun, Ashley R., additional, Britton, John, additional, Brown, Brian P., additional, Campbell, Justine, additional, Carbonell, Xavier, additional, Carvalho, Félix, additional, Caselli, Gabriele, additional, Castellanos-Ryan, Natalie, additional, Chan, Grace, additional, Chartier, Karen Grube, additional, Chen, Chuan-Yu, additional, Chen, Wei J., additional, Chung, Tammy, additional, Clemens, Kelly J., additional, Collado-Rodriguez, Anahi, additional, Conrad, Megan, additional, Conrod, Patricia J., additional, Copeland, Jan, additional, Correia, Christopher J., additional, Craft, Baine B., additional, Crosland, Ann, additional, Cunha-Oliveira, Teresa, additional, Davis, Kelly C., additional, Deady, Mark, additional, Degenhardt, Louisa, additional, Delfabbro, Paul H., additional, Dennhardt, Ashley A., additional, Dillon, Paul, additional, Drobes, David J., additional, Eaddy, Jessica L., additional, Echeburúa, Enrique, additional, Faden, Vivian B., additional, Fenton, Miriam C., additional, Ferguson, Stuart G., additional, Fernandez-Serrano, M.J., additional, Field, Matt, additional, Fossos, Nicole, additional, Foster, Dawn W., additional, Franken, Ingmar H.A., additional, Geisner, Irene M., additional, George, William H., additional, Ghandour, Lilian A., additional, Gil-Rivas, Virginia, additional, Gilmore, Amanda K., additional, Glantz, Meyer D., additional, Gold, Mark S., additional, Gonzalez, Vivian M., additional, Griffiths, Mark D., additional, Grov, Christian, additional, Grover, Kristin W., additional, Haighton, Catherine A., additional, Hajek, Peter, additional, Hall, Wayne, additional, Hanson, David J., additional, Harrell, Paul, additional, Hasin, Deborah, additional, Hasking, Penelope Anne, additional, Hastings, Gerard, additional, Heaton, Jennifer A., additional, Heinz, Adrienne J., additional, Hendricks, Shai, additional, Hermens, Daniel, additional, Hesselbrock, Michie N., additional, Hesselbrock, Victor M., additional, Hill, Elizabeth M., additional, Hingson, Ralph W., additional, Hogan, Julianna, additional, Horvath, Keith J., additional, Hsu, Sharon Hsin, additional, Huang, Xiuqin, additional, Hunter-Reel, Dorian, additional, Jiang, Qiaolei, additional, Johnson, Thomas J., additional, Kanayama, Gen, additional, Kaner, Eileen F.S., additional, Kassel, Jon D., additional, Kay-Lambkin, Frances, additional, Kaye, Sharlene S., additional, Kaysen, Debra, additional, Kemps, Eva, additional, Kilmer, Jason R., additional, King, Daniel L., additional, Klein, Axel, additional, Kosiba, Jesse, additional, Kristeller, Jean L., additional, Lee, Grace P., additional, Lehavot, Keren, additional, Lejoyeux, Michel, additional, Lejuez, Carl, additional, Leonard, Kenneth E., additional, Lewis, Melissa A., additional, Lindgren, Kristen P., additional, Ling, Jonathan, additional, Litt, Dana, additional, Littlefield, Andrew K., additional, Lustyk, M. Kathleen B., additional, MacPherson, Laura, additional, MacQueen, David A., additional, Maggs, Jennifer L., additional, Malcolm, Robert, additional, Marel, Christina, additional, Marlatt, G. Alan, additional, Martens, Matthew P., additional, Martins, Silvia S., additional, May, Jon, additional, Maziak, Wasim, additional, McKetin, Rebecca, additional, McNeill, Ann, additional, McWhorter, Linda, additional, Mills, Katherine L., additional, Mishra, Manish K., additional, Molina, Yamile, additional, Moselhy, Hamdy Fouad, additional, Mueser, Kim T., additional, Munafò, Marcus, additional, Murphy, James G., additional, Murray, Rachael, additional, Neighbors, Clayton, additional, Noel, Nora E., additional, Nolen-Hoeksema, Susan, additional, Noordsy, Douglas L., additional, O'Farrell, Timothy J., additional, Oberst, Ursula, additional, Odenwald, Michael, additional, Oliveira, Catarina R., additional, Oliver, Jason A., additional, Oei, Tian P.S., additional, Parsons, Jeffrey T., additional, Patrick, Megan E., additional, Paulus, Martin P., additional, Pope, Harrison G., additional, Powell, Patricia A., additional, Proctor, Dawn, additional, Quigley, Brian M., additional, Ramo, Danielle E., additional, Rego, Ana Cristina, additional, Rehm, Jürgen, additional, Reynolds, Elizabeth K., additional, Robinson, Jennifer A., additional, Rodriguez, Lindsey, additional, Roll, John M., additional, Rose, Abigail K., additional, Rosenberg, Harold, additional, Rudisill, Desiree M., additional, Samokhvalov, Andriy V., additional, Sanchez, Zila M., additional, Santoya, Natalia, additional, Schacht, Rebecca L., additional, Schraufnagel, Trevor J., additional, Schulenberg, John E., additional, Schumm, Jeremiah A., additional, Shahab, Lion, additional, Shiffman, Saul, additional, Shriner, Richard L., additional, Sinha, Rajita, additional, Skewes, Monica C., additional, Smith, Andrew Paul, additional, Smith, Karen E., additional, Spada, Marcantonio, additional, Stacy, Alan W., additional, Steckler, Gillian, additional, Stewart, Jennifer L., additional, Storr, Carla L., additional, Strodl, Esben, additional, Oei, Tian Po Sumantri, additional, Tao, Ran, additional, Teesson, Maree, additional, Thakker, Jo, additional, Tidwell, Judy, additional, Tiggemann, Marika, additional, Tirapu-Ustarroz, J., additional, Toneatto, Tony, additional, Veatch, Lynn M., additional, Veilleux, Jennifer C., additional, Verdejo-García, A., additional, Warfa, Nasir, additional, Weinstein, Aviv, additional, West, Robert, additional, Westermeyer, Joseph, additional, White, Aaron M., additional, Wiers, Reinout W., additional, Wilson, Graeme B., additional, Winograd, Rachel P., additional, Winstock, Adam R., additional, Witkiewitz, Katie, additional, Woody, George E., additional, Wray-Lake, Laura, additional, Wu, Li-Tzy, additional, Young, Ross Mc.D., additional, Zvolensky, Michael J., additional, and Zvorsky, Ivori, additional

Published
2013
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34. Antisocial personality disorder, conduct disorder, and substance abuse in schizophrenia

Author

Mueser, Kim T., Drake, Robert E., Ackerson, Theimann H., Alterman, Arthur I., Miles, Keith M., and Noordsy, Douglas L.

Subjects
Antisocial behavior -- Analysis, Behavior disorders in children -- Analysis, Substance abuse -- Psychological aspects, Schizophrenia -- Analysis, Psychology and mental health
Abstract

The validity of subtypes based on antisocial personality disorder (APD) or childhood conduct disorder without adult APD (CD only) in patients with schizophrenia (or schizoaffective disorder) and a substance use disorder (abuse or dependence) was examined. APD patients scored lower on personality measures related to socialization and higher on antisocial behavior, psychopathy, and aggression. APD patients also reported higher rates of aggression and legal problems. APD, and to a lesser extent CD only, was associated with more severe psychiatric symptoms, an earlier age of onset of substance abuse, more severe symptoms of substance abuse, and a stronger family history of substance abuse and psychiatric hospitalization. The findings suggest that schizophrenia patients with APD represent a high-risk subgroup vulnerable to more severe substance abuse, psychiatric impairment, aggression, and legal problems.

Published
1997

43. Subjective experiences related to alcohol use among schizophrenics

Author

Noordsy, Douglas L., Drake, Robert E., Teague, Gregory B., Osher, Fred C., Hurlbut, Stephanie C., Beaudett, Malcolm S., and Paskus, Thomas S.

Subjects
Schizophrenics -- Alcohol use, Schizophrenics -- Psychological aspects, Alcoholism -- Psychological aspects, Psychology and mental health
Abstract

Noninstitutionalized schizophrenics often use alcohol and other drugs, making proper treatment difficult. One study found that alcoholism and schizophrenia were associated four times more often than in the nonalcoholic population. Schizophrenics who abuse alcohol usually have poor outcomes and related complications including depression, delusions, disruptive behavior, assaultiveness, poor self-care, housing instability, and homelessness. Treatment noncompliance and increased rates of rehospitalization are problems in this group as well. Schizophrenics seem to be vulnerable to abusing alcohol and other drugs. Some investigators conclude that they use these substances to reduce depression or psychotic symptoms (hallucinations and delusions). Other say it is a way to alleviate the negative side effects of psychiatric medications. To learn more about the reasons schizophrenics themselves say they use alcohol, a study was undertaken of 75 outpatients. Subjects were interviewed regarding the relief they experienced with alcohol from nonpsychotic symptoms (social anxiety, tension, shyness) and from psychotic symptoms. More than two-thirds of the 66 subjects who used alcohol said the drug improved social anxiety and tension, and many also reported positive effects on mood, apathy, and sleep. Only 15 percent reported that alcohol helped psychotic symptoms, and about the same number said that alcohol actually made these symptoms worse. Subjects with alcohol disorders (as opposed to social drinkers) were more likely to report improvement in nonpsychotic symptoms. This may be due to the objective effects of alcohol but may also be a rationalization for its use. The use of alcohol by schizophrenics is a complex issue that warrants further study. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1991

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