FitSugar

Penny For Your Thoughts: Copper in Your Diet

FitSugar — Mon, 04 Feb 2008 11:00:00 -0800

Did you know that copper isn't just for pennies and the bottom of pots? It is also an important mineral for your diet. Even though iron usually gets the nutritional spotlight, copper is necessary for the production of red blood cells. It also keeps your nervous and immune systems happy and your bones healthy. If you don't get enough copper in your diet, it could lead to conditions such as osteoporosis and anemia. If you get too much, it's poisonous.

So how much is enough? To find out read more

People ages 19 and over should focus on getting around .9 milligrams a day. If you're pregnant you should get 1 mg, and if you're breastfeeding, you need even more: 1.3 mg. Watch out, because if you get more than 10 mg, it could be toxic.

So where can you get this important mineral? Dark, leafy greens, dried fruit (prunes), cocoa (yay!), black pepper, and yeast contain copper. Oysters and other shellfish, whole grains, beans, nuts, taters, and organ meats (kidney and liver) are also great sources. Check the list below to make sure you're getting the right amount each day.

Food	Amount of Copper
6 oysters	3.7 mg
1/4 cup almonds	.4 mg
1/4 cup cashews	.76 mg
2 tbsp peanut butter	.18 mg
1 large baked potato	.33 mg
1 cup cooked oats	.12 mg
1/2 cup brown rice	.08 mg
1/2 cup quinoa	.7 mg
1 cup prune juice	.15 mg
1/2 cup kidney beans	.19 mg
1/2 cup garbanzo beans	.2 mg
1 tsp cocoa powder	.19 mg
1 cup kale	.19 mg
1 tbsp black pepper	.07 mg

Source

IUD: Long-Term Birth Control

FitSugar — Wed, 07 Mar 2007 03:30:00 -0800

IUD, also known as a coil, stands for intrauterine device. - "intra" meaning within, and "uterine" meaning of the uterus. An IUD is about 1.5 inches long and it's inserted into your uterus to prevent pregnancy. They are 99% effective.

There are 2 types of IUDs, ones made out of metal, and ones that release hormones similar to those found in oral contraceptives (the Pill.) Most of the metal IUDs have a plastic T-shaped frame that is wrapped with copper. The copper is believed to have spermicidal effects, which is one reason why it works. You can wear this one for up to 10 years.

IUD's that release hormones are also T-shaped, but they are made out of plastic. The hormones make your cervical fluid thick and tacky, making it difficult for sperm to swim in, so they never make it to the egg, so therefore they can't fertilize it. You can wear this one for up to 5 years.

Both kinds of IUDs have little plastic strings attached at the bottom that hangs down past the cervix. The string is not visible and it won't cause any problems during intercourse. The string is a safety check so you can check to make sure your IUD is still in place.

An IUD has to be fitted inside and removed from the uterus by a doctor or nurse practitioner. IUDs don't stop you from ovulating, so you still get your period, but your flow may become shorter or lighter, or may even stop altogether. Some women complain that their periods are irregular when using an IUD as birth control.

Want to know how they work? Then read more

When something foreign is inside your uterus, your body produces white blood cells, or leukocytes to defend itself. These white blood cells attack any sperm or eggs that may find their way into your uterus. Even if an egg does get fertilized, the white blood cells will attack it. For this reason, people who are against abortion, believing that life begins at conception, are against the IUD.

Fit's Tips: An IUD is great if you are looking for hassle-free birth control. In no way does it prevent against STDs, so that's why it's great to use if you are in a long-term relationship with someone you know is disease-free. That is why they are most often recommended for women who are married and done having children. Ask your doctor to discuss if an IUD may be right for you.

Papain/urea/chlorophyllin copper (On the skin)

admin — Thu, 04 Sep 2008 20:01:35 -0700

Overview

Introduction
Brand Name(s)
When This Medicine Should Not Be Used
How to Use This Medicine
How to Store and Dispose of This Medicine
Drugs and Foods to Avoid
Warnings While Using This Medicine
Possible Side Effects While Using This Medicine

HEALTH GUIDE REFERENCE FROM A.D.A.M

Introduction

Chlorophyllin Copper Complex (klor-oh-FIL-in KOP-per kom-plex), Papain (pa-PAY-in), Urea (yoor-EE-a)

Treats many kinds of skin sores and infections, including burns, bed sores, wounds from surgery, and skin ulcers caused by diabetes or varicose veins.

Brand Name(s)

Panafil, Allanfil 405 Ointment, Ziox 405, Gladase-C, Panafil SE, Allanfil

There may be other brand names for this medicine.

When This Medicine Should Not Be Used

You should not use this medicine if you have had an allergic reaction to papain, papaya fruit, urea, or chlorophyllin copper.

How to Use This Medicine

Spray, Ointment, Liquid Under Pressure

Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.
This medicine is for use on the skin only. Do not get it in your eyes, nose, or mouth. Do not use it on skin areas that have cuts or scrapes. If it does get on these areas, rinse it off right away.
Wash your hands with soap and water before and after using this medicine.
Clean the affected skin area just before using this medicine. A nurse or other health caregiver will show you what to use and how to clean your wound. Do not use hydrogen peroxide to clean your wound.
Apply a thin layer of ointment to the affected area. Cover the area as directed.
Before using a new spray bottle, prime the pump by holding the spray upright directly over the wound, and pumping 6 to 8 times.
Once the spray pump has been primed, hold the bottle about 2 to 3 inches from your wound to apply. Use even, firm, and equal pressure each time you pump the bottle. Completely cover your wound site with the medicine. You should not be able to see the wound under the medicine. Then, follow your doctor's directions for dressing (covering) the wound.

If a dose is missed:

If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine

Store this medicine at room temperature, away from heat and direct light. Keep the container opening covered and clean when you are not using it. Store the spray upright.
Ask your pharmacist, doctor, or health caregiver about the best way to dispose of the used medicine container and any leftover medicine after you have finished your treatment. You will also need to throw away old medicine after the expiration date has passed.
Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

Do not use any medicine that contains lead, silver, or mercury on your wound. Do not use cosmetics or other skin care products on the treated skin areas.

Warnings While Using This Medicine

Make sure your doctor knows if you are pregnant or breastfeeding.
Do not use this medicine for a skin problem that has not been checked by your doctor.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.

If you notice these less serious side effects, talk with your doctor:

Burning, redness, or irritation of the treated skin.

Review Date: 8/4/2008

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

A.D.A.M. Copyright

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997-2009 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

adam.com

Source Doc: 45_4727

Copper in diet

admin — Thu, 04 Sep 2008 18:56:10 -0700

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

Copper is an essential trace mineral present in all body tissues.

Alternative Names

Diet - copper

Function

Copper, along with iron, helps in the formation of red blood cells. It also helps in keeping the blood vessels, nerves, immune system, and bones healthy.

Food Sources

Oysters and other shellfish, whole grains, beans, nuts, potatoes, and organ meats (kidneys, liver) are good sources of copper. Dark leafy greens, dried fruits such as prunes, cocoa, black pepper, and yeast are also sources of copper in the diet.

Side Effects

Normally people have enough copper in the foods they eat. Menkes disease (kinky hair syndrome) is a very rare disorder of copper metabolism that is present before birth. It occurs in male infants.

Lack of copper may lead to anemia and osteoporosis.

In large amounts, copper is poisonous. A rare inherited disorder, Wilson's disease, causes deposits of copper in the liver, brain, and other organs. The increased copper in these tissues leads to hepatitis, kidney problems, brain disorders, and other problems.

Recommendations

The Food and Nutrition Center of the Institute of Medicine has established the following recommended dietary intakes for copper:

Infants

0 - 6 months: 200 micrograms a day (mcg/day)
7 - 12 months: 220 mcg/day

Children

1 - 3 years: 340 mcg/day
4 - 8 years: 440 mcg/day
9 - 13 years: 700 mcg/day

Adolescents and Adults

14 - 18 years: 890 mcg/day
19 and older: 900 mcg/day

Pregnant and lactating (milk-producing) women need slightly higher amounts (1000 mcg during pregnancy and 1300 mcg during lactation). Ask your health care provider which amount is best for you.

References

Trumbo P, Yates AA, Schlicker S, Poos M. Food and Nutrition Board, Institute of Medicine, The National Academies. Dietary reference intakes: vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. J Am Diet Assoc. 2001 Mar;101(3):294-301.

Review Date: 3/2/2007

Reviewed By: William McGee, M.D., M.H.A., Assistant Professor of Medicine and Surgery, Tufts University School of Medicine, Boston, MA, and Chairman, Nutrition Committee, Baystate Medical Center, Springfield, MA. and Alice O'Connor, MS, RD, LDN, CNSD, Clinical Dietitian, Baystate Medical Center, Springfield, MA. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

adam.com

Source Doc: 1_002419

24-hour urine copper test

admin — Thu, 04 Sep 2008 19:12:55 -0700

Overview

Definition
Alternative Names
How the test is performed
How to prepare for the test
How the test will feel
Why the test is performed
Normal Values
What abnormal results mean
What the risks are

Illustrations

Copper urine test

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

The 24-hour urine copper test measures the amount of copper in a urine sample.

Alternative Names

Quantitative urinary copper

How the test is performed

A 24-hour urine sample is needed.

On day 1, urinate into the toilet upon arising in the morning.
Collect all subsequent urine (in a special container provided by your doctor's office or lab) for the next 24 hours.
On day 2, urinate into the container in the morning upon arising.
Cap the container. Keep it in the refrigerator or a cool place during the collection period. Label the container with your name, the date, the time of completion, and return it as instructed.

For infants, thoroughly wash the area around the urethra. Open a urine collection bag (a plastic bag with an adhesive paper on one end), and place it on the infant. For males, the entire penis can be placed in the bag and the adhesive attached to the skin. For females, the bag is placed over the labia. Diaper as usual over the secured bag.

This procedure may take a couple of attempts -- lively infants can displace the bag, causing the specimen to be absorbed by the diaper. The infant should be checked frequently and the bag changed after the infant has urinated into the bag. The urine is drained into the container for transport to the laboratory.

Deliver it to the laboratory or your health care provider as soon as possible upon completion. A laboratory specialist will determine how much copper is in the sample.

How to prepare for the test

No special preparation is necessary for this test, but if the collection is being taken from an infant, a couple of extra collection bags may be necessary.

How the test will feel

The test involves only normal urination, and there is no discomfort.

Why the test is performed

Your doctor may order this test if you have signs of Wilson's disease, a genetic disorder that affects how the body processes copper.

Normal Values

The normal range is 10 to 30 micrograms per 24 hours.

Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

What abnormal results mean

An abnormal result means you have a higher than normal level of copper. This may be due to:

Biliary cirrhosis
Chronic active hepatitis
Wilson's disease

What the risks are

There are no risks associated with providing a urine sample.

Review Date: 7/25/2008

Reviewed By: A.D.A.M. Editorial Team: David Zieve, MD, MHA, Greg Juhn, MTPW, David R. Eltz. Previously reviewed by Frank A. Greco, MD, PhD, Director, Biophysical Laboratory, The Lahey Clinic, Burlington, MA. Review provided by VeriMed Healthcare Network (10/15/2007).

A.D.A.M. Copyright

adam.com

Source Doc: 1_003604

Copper poisoning

admin — Thu, 04 Sep 2008 18:57:24 -0700

Overview

Definition
Poisonous Ingredient
Where Found
Symptoms
Home Treatment
Before Calling Emergency
Poison Control, or a local emergency number
What to expect at the emergency room
Expectations (prognosis)

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

This article discusses poisoning from an overdose of copper.

Poisonous Ingredient

Copper

Where Found

Copper wire
Some aquarium products
Vitamin and mineral supplements
Certain insecticides and fungicides

Note: This list may not be all inclusive.

Symptoms

Swallowing large amounts of copper may cause vomiting, abdominal pain, diarrhea, and jaundice. Touching large amounts of copper can result in hair discoloration (green).

Anemia
Burning sensation
Chills
Convulsions
Diarrhea (often bloody and may be blue in color)
Fever
Liver failure
Metallic taste
Muscular aches
Nausea
No urine output
Pain
Shock
Vomiting
Weakness
Yellow eyes
Yellow skin

Home Treatment

Seek immediate medical help. DO NOT make a person throw up unless told to do so by Poison Control or a health care professional.

Before Calling Emergency

Determine the following information:

The patient's age, weight, and condition
The name of the product (and ingredients and strengths, if known)
The time it was swallowed
The amount swallowed

Poison Control, or a local emergency number

The National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the U.S. use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take the container with you to the hospital, if possible.

See National Poison Control center.

What to expect at the emergency room

The health care provider will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate, and blood pressure. The patient may receive:

Medicines to treat symptoms
Activated charcoal
A nasogastric (NG) tube thru the nose into the stomach to empty the stomach (gastric lavage)
Medicine (antidote) to reverse the effect of the poison
Dialysis

Expectations (prognosis)

Sudden (acute) copper poisoning is rarely seen. However, serious long-term health problems, including liver failure and death, can occur with significant poisonings.

If toxicity is due to long-time accumulation, the ultimate outcome depends how much damage there is to body organs.

Review Date: 10/23/2006

Reviewed By: Eric Perez, MD, Department of Emergency Medicine, St. Luke's-Roosevelt Hospital Center, New York, NY. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

adam.com

Source Doc: 1_002496

Copper urine test

admin — Thu, 04 Sep 2008 19:38:36 -0700

Back

HEALTH GUIDE REFERENCE FROM A.D.A.M

The copper urine test is performed by collecting urine at specific times for a 24-hour period. The urine is tested for the amount of copper present. The copper urine test is used to determine the presence of Wilson disease, a sometimes fatal condition in which the buildup of excess copper damages the liver, and eventually the kidneys, eyes and brain.

Review Date: 10/15/2007

Reviewed By: Frank A. Greco, M.D., Ph.D., Director, Biophysical Laboratory, The Lahey Clinic, Burlington, MA. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

adam.com

Source Doc: 2_9222

Health Benefits of Pears

FitSugar — Thu, 22 Oct 2009 09:00:13 -0700

Apples are in season in the Autumn, but pears are too. The soft, sweet, buttery flesh of the pear makes this Fall fruit one of my favorites. Plus there are so many varieties to choose from - Bartlett, Bosc, and Anjou - that they each seem like a different fruit. These juicy gems are pretty healthy for you, too.

Pears are high in fiber. One medium-sized pear contains six grams, so snacking on a pear can help you meet your daily requirement of 25 to 30 grams. They're a delicious way to keep you regular too, which can help prevent colon cancer. A diet high in fiber can also keep your cholesterol levels down, which is good news for your ticker. Getting your fill of fiber from fruit is also linked to a lower risk for breast cancer.
Pears contain a fair amount of vitamins A, C, K, B2, B3, and B6. For expecting or nursing moms, they also contain folate. Pears aren't too shabby in the mineral department either, containing calcium, magnesium, potassium, copper, and manganese. Vitamin C and copper are antioxidant nutrients, so eating pears is good for your immune system, and may help prevent cancer.
Pears also contain boron, which our bodies need in order to retain calcium, so this fruit can also be linked to osteoporosis prevention.

For the other health benefits, read more.

The hydroxycinnamic acid found in pears is also associated with preventing stomach and lung cancer.
It's a hypo-allergenic fruit. That means those with food sensitivities can usually eat pears with no adverse effects.
Eating three or more servings of fruits a day, such as pears, may also lower your risk of age-related macular degeneration (ARMD), the primary cause of vision loss in older adults.
Quercetin is another antioxidant found in the skin of pears. It helps prevent cancer and artery damage that can lead to heart problems. A recent study at Cornell University found it may also protect against Alzheimer’s disease. So don't peel your pears!

Tell me, what's your favorite type of pear?

Run Barefoot and Avoid Running Injuries?

FitSugar — Wed, 07 Oct 2009 10:00:04 -0700

The idea of running barefoot seems like some new age, hippie movement to get people to be free in their bare skin. Or some eco-friendly push to persuade people to forgo sneakers so they don't end up in landfills. Although the freedom and environmental arguments for barefoot running are valid, Christopher McDougall, author of the best-selling book Born to Run, believes running without sneakers could be the answer to preventing shin splints, knee pain, and other running injuries.

After suffering many an injury himself, he set out with the question, "Why does my foot hurt?" In his journey to answer that question, he discovered the Tarahumara Indians of Mexico’s Copper Canyons. They run hundreds of miles at a time with only thin, homemade sandals on their feet, and don't suffer any of the injuries that the rest of us runners do. After running with them, he realized the secret was ditching his sneaks, and since then, he's been injury-free. McDougall believes today's high-tech sneakers "warp our natural stride, encourage bad form, and lead to injuries."

To hear more about barefoot running, keep reading

Wilson's disease

admin — Wed, 03 Sep 2008 17:51:58 -0700

Overview

Definition
Alternative Names
Causes, incidence, and risk factors
Symptoms
Signs and tests
Treatment
Support Groups
Expectations (prognosis)
Complications
Calling your health care provider
Prevention

Illustrations

Central nervous system

Copper urine test

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

Wilson's disease is an inherited disorder where there is excessive amounts of copper in the body's tissues. This causes a variety of effects, including liver disease and damage to the nervous system.

Alternative Names

Hepatolenticular degeneration

Causes, incidence, and risk factors

Wilson's disease is a rare inherited disorder. If both parents carry an abnormal gene for Wilson's disease, there is a 25% chance in each pregnancy that the child will have the disorder (i.e., it is an autosomal recessive disease).

Wilson's disease causes the body to take in and keep too much copper. The copper deposits in the liver, brain, kidneys, and the eyes. The deposits of copper cause tissue damage, death of the tissues, and scarring, which causes the affected organs to stop working correctly. Liver failure and damage to the central nervous system (brain, spinal cord) are the most predominant, and the most dangerous, effects of the disorder. If not caught and treated early, Wilson's disease is fatal.

It is most common in eastern Europeans, Sicilians, and southern Italians, but may occur in any group. The disorder most commonly appears in people under 40 years old. In children, the symptoms begin to show by around 4 years of age.

Symptoms

Enlargement of the abdomen (abdominal distention)
Splenomegaly
Yellow skin (jaundice) or yellow color of the white of the eye (icterus)
Vomiting blood
Weakness
Tremors of the arms or hands
Difficulty moving arms and legs, stiffness
Abnormal arms and legs posture
Slow movements
Difficulty walking
Unpredictable and jerky movement
Uncontrollable movement
Weakness of the head, neck, face, or arms
Speech impairment
Slow or decreased facial movement and expressions
Emotional or behavioral changes
Confusion or delirium
Dementia (loss of many brain functions)

Signs and tests

An eye examination may show:

Kayser-Fleischer rings (rusty or brown-colored ring around the iris).
Eye movement may be restricted.

A physical examination may show signs of:

Liver or spleen disorders (including cirrhosis and liver necrosis)
Damage to the central nervous system including loss of coordination, loss of muscle control, muscle tremors, loss of cognitive and intellectual functions, loss of memory, confusion (delirium or dementia), and other damage.

Lab findings may include:

Serum ceruloplasmin - low (although it is normal in 5% of cases)
Serum copper - low in spite of the copper deposits in tissues
Urine copper - high
CBC - may show hemolytic anemia or decreased white blood cell count
Serum uric acid levels - low

If there are liver problems, lab abnormalities include:

PT and PTT - elevated
AST and ALT - elevated
Albumin - decreased
Bilirubin - elevated

Other tests findings may include:

Head MRI or head CT scan may be abnormal, especially in a region of the brain called the basal ganglia.
Abdominal x-ray, abdominal MRI, or CT scan of the abdomen may indicate liver disease or other abnormality.
Liver biopsy or biopsy of the kidneys or other suspect tissue shows deposits of copper, and shows tissue changes that indicate damage to the tissues. This disease may increase the protein and amino acid levels in a 24-hr. urine specimen.

The specific gene responsible for the abnormality that causes Wilson's disease has been identified. It is called ATP7B. However, a simple genetic test to screen for Wilson's disease has not yet been developed. Testing is complicated because there are many possible mutations in this gene.

Treatment

The goals of treatment are to reduce the amount of copper in the tissues and to manage the symptoms of the disorder. Treatment must be lifelong.

The following medications may be used:

Zinc acetate (Galzin), which blocks the absorption (taking in) of copper in the intestinal tract.
Trientine (Syprine), which binds (chelates) the copper and leads to increased release of the copper through the urine.
Penicillamine (Cuprimine, Depen), which also binds copper and leads to increased urinary release of copper.

Sometimes, medications that chelate copper, especially penicillamine, can worsen the person's neurological function. There are other medications under investigation which will, hopefully, bind copper without risking possible worsening of neurological function.

In addition, a low-copper diet may be recommended, including avoiding mushrooms, nuts, chocolate, dried fruit, liver, and shellfish. Distilled water may be suggested because most tap water flows through copper pipes. Patients are advised to avoid using copper cooking utensils.

Symptoms are treated as appropriate, including exercises or physical therapy, and protective measures for people who are confused or unable to care for themselves.

In cases where the liver is severely damaged by the disease, liver transplantation might be considered by healthcare providers.

Support Groups

Wilson disease support groups can be found at www.wilsonsdisease.org and www.geneticalliance.org.

Expectations (prognosis)

Lifelong treatment is required to control the disorder. The disorder may cause fatal effects, especially loss of liver function and toxic effects of copper on the nervous system. In cases where the disorder is not fatal, symptoms may be disabling.

Complications

Hepatitis
Cirrhosis
Death of liver tissues
Spleen dysfunction
Anemia
Increased number of infections
Injury caused by falls
Loss of ability to interact with other people
Loss of ability to function at work and home
Loss of ability to care for self
Loss of muscle mass (muscle atrophy)
Joint contractures or other deformity
Increased number of bone fractures
Side effects of penicillamine
Side effects of other medications used to treat the disorder

Calling your health care provider

Call your health care provider if symptoms indicate Wilson's disease may be present. Call a genetic counselor if Wilson's disease is present in your family and you are planning to have children.

Prevention

Genetic counseling is recommended for persons with a family history of Wilson's disease.

Review Date: 8/11/2006

Reviewed By: Brian Kirmse, MD, Mount Sinai School of Medicine, Department of Human Genetics, New York, NY. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

adam.com

Source Doc: 1_000785