scholarly journals REHABILITASI MEDIK PADA ANAK DENGAN LEUKEMIA LIMFOBLASTIK AKUT

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
. Yenni
Keyword(s):  
Lymphoblastic Leukemia ◽  
Clinical Manifestations ◽  
Medical Rehabilitation ◽  
Functional Improvement ◽  
Toxic Substances ◽  
Ionization Radiation ◽  
The Face ◽  
Easy Bleeding ◽  
Loss Of Appetite ◽  
Social Support Systems

Abstract: Acute lymphoblastic leukemia (ALL) is oftenly found in children as well as in adolescents. ALL occurs in 3-4 cases of 100,000 children. The specific etiology of ALL is still unknown, but it is related to a multifactorial process associated with genetic, immunology, environment, toxic substances, viral exposures, and ionization radiation. Clinical manifestations of ALL may include fatigue and weakness, palor, infections and febris that are not improved with antibiotics, easy bleeding or bruising, joint or bone pain, loss of appetite, weight loss, enlarged lymph nodes, cough, or difficulty of breathing, enlargement of the liver or spleen, swelling of the face and hands, headaches, and vomiting. Functional improvement is a goal for medical rehabilitation in patient with LLA. In general, cancer rehabilitation management aims to maintain body functions including mobilization and activity, nutrition, social support systems, and pain control. Moreover, the program is implemented in conjunction with specific interventions based on the affected organ systems.Keywords: ALL, medical rehabilitationAbstrak: Leukemia limfoblastik akut (LLA) merupakan kanker yang sering terjadi pada anak-anak dan remaja. LLA terjadi pada 3-4 kasus dari 100.000 anak. Etiologi spesifik LLA belum diketahui, tetapi berhubungan dengan proses multifaktorial yang berkaitan dengan genetik, imunologi, lingkungan, toksik, paparan virus, ionization radiation. Manifestasi klinik leukemia dapat berupa kelelahan dan kelemahan, kulit pucat, infeksi dan demam yang tidak sembuh dengan antibiotik, mudah berdarah atau memar, nyeri sendi atau tulang, hilangnya nafsu makan dan turunnya berat badan, pembesaran kelenjar limfe, batuk atau kesulitan pernafasan, pembesaran hati atau limpa, pembengkakan muka dan tangan, sakit kepala, dan muntah Perbaikan status fungsional merupakan tujuan utama rehabilitasi medik pasien LLA. Penanganan rehabilitasi kanker secara umum ialah untuk memelihara fungsi meliputi mobilisasi, aktivitas, nutrisi, sistem pendukung sosial dan pengendalian rasa nyeri. Keseluruhan program ini diterapkan bersamaan dengan intervensi spesifik berdasarkan sistem organ yang terkena.Kata kunci: LLA, rehabilitasi medik

Trismus in a 6 year old child: a manifestation of leukemia?

2002 ◽  
Vol 26 (4) ◽  
pp. 337-339 ◽  
Author(s):  
Joseph Katz ◽  
Benjamin Peretz
Keyword(s):  
Complete Blood Count ◽  
Lymphoblastic Leukemia ◽  
Panoramic Radiograph ◽  
Clinical Findings ◽  
Leukemic Cells ◽  
Motor Branch ◽  
Jaw Opening ◽  
The Face ◽  
Loss Of Appetite ◽  
Muscles Of Mastication

Trismus is a firm closing of the jaw due to tonic spasm of the muscles of mastication from disease or the motor branch of the trigeminal nerve. Trismus may be produced by a variety of reasons such as dental abscess, trauma, following mandibular block with local anesthesia, as a result of radiation to the facial muscles, and patients after chemotherapy. A case of a referral of a six-year-old boy to a dentist from an ENT due to severe limitation in jaw opening is presented. Intraoral examination and panoramic radiograph demonstrated no signs of infection and/or other pathology. After a diagnosis of trismus was made, due to his icteric appearance, the general fatigue and loss of appetite in the last few days, palpated and sensitive lymph nodes in the submandibular and cervical regions, the child was referred for a complete blood count and sedimentation rate. The laboratory and clinical findings resulted in the diagnosis of acute lymphoblastic leukemia (ALL). Dental and oral manifestations of ALL are discussed, and the trismus may be explained by an intensive infiltration of leukemic cells into the deep portion of the contracting muscles of the face. This case emphasizes the importance of physical examination and independent judgement made by dentists, even when patients are referred to them by other members of the medical communities.

KEJANG SEBAGAI MANIFESTASI NEUROLOGI DARI LEUKOSTASIS

2020 ◽  
Vol 3 (3) ◽  
pp. 127-131
Author(s):  
Eric Hartono Tedyanto ◽  
Ni Komang Sri Dewi Untari
Keyword(s):  
Lymphoblastic Leukemia ◽  
Clinical Manifestations ◽  
Emergency Situation ◽  
Early Mortality ◽  
Brain Cells ◽  
Trigger Factors ◽  
Medicine Department ◽  
Adult Age ◽  
Patient Morbidity ◽  
Laboratory Results

ABSTRAK Latar Belakang: Secara klinis, leukostasis didiagnosa pada pasien leukemia dengan hasil laboratorium hiperleukositosis (>100.000 u/L) disertai manifestasi respiratorik, neurologis, atau renal. Insidensi hiperleukositosis pada Leukemia Limfoblastik Akut (LLA) usia dewasa 10-30%, jarang pada wanita, dan jarang menyebabkan leukostasis. Laporan Kasus: Seorang wanita berusia 20 tahun dikonsulkan dari bagian penyakit dalam dengan kejang umum tonik-klonik. Hasil laboratorium menunjukkan leukosit 134.500 u/L, hasil EKG menunjukkan iskemik miokardium. Diskusi: Leukostasis jarang terjadi pada pasien leukemia. Leukostasis menyebabkan aliran oksigen dalam darah menuju sel menjadi inadekuat, termasuk salah satunya aliran darah yang menuju sel otak. Hipoksia jaringan otak merupakan salah satu faktor pemicu terjadinya kejang. Kesimpulan: Leukostasis merupakan suatu keadaan emergensi yang dapat meningkatkan morbiditas dan mortalitas pasien. Tujuan tatalaksana penyakit adalah mengurangi mortalitas dini, termasuk tatalaksana kejang, yang merupakan salah satu menifestasi klinis leukostasis. Kata kunci: kejang, leukostasis, leukemia.   ABSTRACT Background: Clinically, leukostasis is diagnosed in patients with leukemia with laboratory results of hyperleukocytosis (> 100,000 u / L) followed by respiratory, neurological, or renal manifestations. The incidence of hyperleukocytosis in Acute Lymphoblastic Leukemia (LLA) is 10-30% of adult age, rare in women, and rarely causes leukostasis. Case Report: A 20th-years-old woman was consulted from an Internal Medicine Department with a tonic-clonic general seizure. Laboratory results showed that leukocytes were 134,500 U / L and ECG results showed an ischemic myocardium. Discussion: Leukostasis rarely occurs in leukemic patients. Leukostasis causes the flow of oxygen in the blood to the cells to be inadequate, including the blood flow to brain cells. Brain tissue hypoxia is one of the trigger factors for seizures. Conclussion: Leukostasis is an emergency situation that can increase patient morbidity and mortality. The aim of disease management is to reduce early mortality, including management of seizures, which is one of the clinical manifestations of leukostasis. Keywords: seizure, leukostasis, leukemia.

Generalized eruptive keratoacanthomas of Grzybowski (case report)

2021 ◽  
Author(s):  
И.А. Куклин ◽  
Н.П. Малишевская ◽  
М.М. Кохан ◽  
Г.Д. Сафонова ◽  
О.Г. Римар ◽  
...  
Keyword(s):  
Clinical Care ◽  
Clinical Manifestations ◽  
Review Of The Literature ◽  
Trunk Limbs ◽  
The Face ◽  
Spontaneous Involution ◽  
Atrophic Scars ◽  
Short Time ◽  
First Time ◽  
Aromatic Retinoids

В статье представлен краткий обзор литературы о клинических проявлениях, современных методах диагностики и лечения чрезвычайно редкого заболевания – множественной эруптивной кератоакантомы типа Гржебовски. Заболевание характеризуется возникновением сотен или тысяч генерализованных зудящих узелков на коже лица, туловища, конечностей, половых органов, слизистой полости рта и гортани в течение короткого времени. Заболевание развивается в возрасте старше 40 лет, имеет рецидивирующее течение, возможна спонтанная инволюция отдельных элементов с формированием участков депигментации или атрофических рубцов. Авторы приводят случай собственного клинического наблюдения множественной эруптивной кератоакантомы типа Гржебовски у пациента 50 лет, который обратился на консультацию к дерматовенерологу в клинику Уральского НИИ дерматовенерологии и иммунопатологии. Длительность болезни на момент обращения составляла 2,5 года, ее возникновению предшествовало неоднократное посещение больным стран с избыточной инсоляцией, что может рассматриваться в качестве этиологического фактора развития заболевания. Диагноз впервые был заподозрен на консилиуме дерматовенерологов на основании клинической картины заболевания и в дальнейшем верифицирован данными патоморфологического исследования биоптата пораженной кожи. Показана эффективность применения ароматических ретиноидов в лечении множественной эруптивной кератоакантомы типа Гржебовски и приведены побочные эффекты, которые развились у больного при самостоятельном увеличении дозы ацитретина до 70 мг/сутки. В статье констатируется чрезвычайно редкая встречаемость данного заболевания, о чем свидетельствует приведенный клинический случай, диагностируемый впервые более чем за 90-летнюю историю существования института. Подчеркивается важность консолидации клинического опыта нескольких ведущих дерматовенерологов для диагностики множественной эруптивной кератоакантомы типа Гржебовски. The article presents a brief review of the literature about clinical manifestations, modern methods of diagnosticsand treatment of an extremely rare disease – generalized eruptive keratoacanthomas of Grzybowski. The disease is characterized by the appearance of hundreds or thousands of generalized itchy nodules on the skin of the face, trunk, limbs, genitals, oral mucosa and larynx within a short time. The disease develops at the age of over 40, has a recurrent course, spontaneous involution of individual elements with the formation of areas of depigmentation or atrophic scars is possible. The authors describe a case of their own clinical care of generalized eruptive keratoacanthomas of Grzybowski in a 50-year-old patient who consulted a dermatovenerologist at the clinic of the Ural Research Institute of Dermatovenerology and Immunopathology.The duration of the disease at the time of visit to a doctor was 2,5 years, its occurrence was preceded by repeated visits to countries with excessive insolation, which can be considered as an etiological factor in the development of the disease. The diagnosis was first suspected at a boarddermatovenerologists based on the clinical picture of the disease and subsequently verified by the data of a pathomorphological examination of the biopsy of the affected skin.The effectiveness of the use of aromatic retinoids in the treatment of generalized eruptive keratoacanthomas of Grzybowski is shown and the side effects that developed in the patient with an independent increase in the dose of acitretin to 70 mg/day are given. The article states the extremely rare occurrence of this disease, as evidenced by the above clinical case, diagnosed for the first time in more than 90 years of the institute's existence. The importance of consolidating the clinical experience of several leading dermatovenerologists for the diagnostics of generalized eruptive keratoacanthomas of Grzybowski is emphasized.

Strengthening the pharmacological potential of drug therapy in treatment of patients with chronic pancreatitis by using therapeutic physical factors

2020 ◽  
pp. 8-14
Author(s):  
R. M. Mallaeva ◽  
A. N. Makhinko ◽  
M. B. Uzdenov
Keyword(s):  
Quality Of Life ◽  
Chronic Pancreatitis ◽  
Drug Therapy ◽  
Clinical Manifestations ◽  
Medical Rehabilitation ◽  
Control Group ◽  
Physical Factors ◽  
Standard Drug ◽  
Pharmacological Potential

The purpose of the study is to improve rehabilitation treatment of patients with chronic pancreatitis (CP) at inpatient stage by strengthening pharmacological potential of drug therapy due to inclusion of therapeutic physical factors (TPF) in therapeutic programs. Materials and methods. 159 patients with acute CP were observed. By simple randomization, 4 groups were formed: the control group (MG, 39 people) received standard drug therapy; 1st comparison group (GC1; 38 people) additionally received TPF; GC2 (40 people) in addition to treatment in GC1 had drinking mineral water «Slavyanovskaya»; in main group (42 people) in addition to the treatment in GC2 got preformed peloidotherapy on the cervical-collar zone. All the patients underwent the evaluation of clinical score and quality of life before and after medical rehabilitation. Results. In MG, clinical symptomatology leveling was by 78,2% (p<0,01), in GC1 — by 71,5% (p<0,01), GC2 — by 62,3% (p<0,01), CG — by 57,2% (p<0,01) on average immediately after the treatment, which was in a clear correlation with indicators of quality of life. In the long term (in 6 and 12 months), the advantage of combination therapy was noted with the same validity, the preservation of the achieved positive result was mostly noted in the MG: after 6 months the improvement in physical health compared to the initial values was noted by 34,4% (p<0,01), after 12 months — by 24,0% (p<0,05); mental — by 32,3% (p<0,01) and 22,5% (p<0,05), respectively. In both comparison groups, positive dynamics was 10–12% lower, and in the control group, after 6 months, there was only a tendency to improve quality of life indicators. Conclusion. The inclusion of TPF in the programs of the inpatient stage of medical rehabilitation of patients with chronic pancreatitis by strengthening the pharmacological potential of drug therapy contributes to the leveling of clinical manifestations (abdominal pain, dyspepsia and diarrhea), the result of which is an improvement in the quality of life of this category of patients.

scholarly journals CLINICAL MANIFESTATIONS OF SARCOIDOSIS ON THE PROLABIUM AND ORAL MUCOSA: MANAGEMENT

2018 ◽  
pp. 34-36
Author(s):  
P.M. Skrypnikov ◽  
T.P. Skrypnikova ◽  
Yu.M. Vitko
Keyword(s):  
Oral Cavity ◽  
Oral Mucosa ◽  
Correct Diagnosis ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Morbidity Rate ◽  
Unknown Etiology ◽  
Toxic Substances ◽  
Male Population ◽  
Female Population

The statistics indicates on the tendency of morbidity rate of sarcoidosis to increase. The pathology affects young and older people notably. Sarcoidosis becomes a common chronic disease, which is often difficult to diagnose. Insufficient experience in recognition of this disease leads to misdiagnosis and ineffective treatment. All mentioned above highlights the extreme relevance of this issue. Sarcoidosis is a multisystem inflammatory nature disease of unknown etiology. The hereditary predisposition is taken to be but the whole family cases are also known. An abnormal immune response is also considered among the theories of the development of the disease. The infectious factor is also regarded as the cause of the disease. The increasing activity of lymphocytes, which start to produce substances promoting the formation of the granulomas, which are considered to be the basis for the pathological process, can initiate the onset of the disease. The maximum morbidity rate of sarcoidosis is observed between the ages of 35 to 55 years. Two age periods of the peak in male population are 35-40 years and about 55 years. The rate of sarcoidosis morbidity among female population is 65%. Up to 700 new cases of sarcoidosis are registered in Ukraine annually. The clinical signs of sarcoidosis vary. This pathology is more often manifested by the bilateral lymphadenopathy of lung roots, eyes and skin lesions. The liver, spleen, lymph nodes, heart, nervous system, muscles, bones and other organs can also be affected. In dental practice sarcoidosis can be manifested on the prolabium, oral mucosa and salivary glands. Blood laboratory indices (the increased level of calcium) are changed in sarcoidosis. Chest X-ray, MRI and CT also demonstrate changes in the lungs. The test for detection of granulomas shows positive Kveim reaction (the formation of purple-red nodules due to administration of antigen). Biopsy and bronchoscopy facilitate detection of both direct and indirect signs of sarcoidosis of the lungs. A general treatment of sarcoidosis is provided by a pulmonologist, who can assess the severity of the lesion and provide appropriate treatment. The core of treatment is based on corticosteroids. In severe cases immunosuppressors, anti-inflammatory drugs, antioxidants are prescribed. A dentist performs oral cavity sanation, professional hygiene. Mouth rinses with Dekasan solution, sublingual Lisobakt pills are prescribed to prevent inflammatory lesions. Patients with sarcoidosis are recommended to avoid solar radiation and contact with chemical and toxic substances harmful to the liver, reduction of the consumption of foods rich in calcium. Healthy life-style is crucial in prevention of exacerbations of sarcoidosis. In the remission period regular medical check-ups and oral cavity sanation are recommended. The correct diagnosis in rare diseases requires highly qualified dental professionals, the interdisciplinary approach in the diagnosing and management of patients with this pathology.

scholarly journals A novel nano-sulphur and essential oil-based room freshener

2021 ◽  
pp. 75-82
Author(s):  
Ashwini S. Kaware ◽  
Pramod U Ingle ◽  
Aniket K. Gade ◽  
Mahendra Rai
Keyword(s):  
Fungal Pathogens ◽  
Indoor Environment ◽  
Toxic Substances ◽  
Significant Activity ◽  
Face Centered Cubic ◽  
Candida Spp ◽  
Indoor Fungi ◽  
The Face ◽  
Average Size

Introduction: Alternaria spp. and Candida spp. are the main fungal pathogen of indoor environment like house, office, classroom, etc. These may cause various diseases and infections like systemic infections, or chronic asthma in immunocompromised individuals through secretion of various toxic substances. Chemical-based commercially available room fresheners used to control the fungal load of indoor environment are not beneficial to human health. Objective: was to provide viable alternative in the form of nanoparticle-based approach for the management of air-borne fungi. Methodology: The present study primarily focuses on the isolation, microscopic and biochemical identification of indoor fungi; Azadirachta indica-mediated sulphur nanoparticles (SNPs) synthesis, their detection and characterization; and in vitro assessment of SNPs against isolated fungi present in indoor environment. Result: The isolated fungi were identified as Alternaria spp and Candida spp. The SNPs showed absorbance maxima at 291 nm. NTA analysis showed average size of 188.4 nm, and zeta potential of -4.94 mV which represented synthesis of stable SNPs. XRD pattern confirmed the face centered cubic, crystalline nature of SNPs. FTIR spectrum depicted the presence of polyhydroxyl, nitrile, keto, aromatic and carboxylic compounds which stabilized the SNPs. The antifungal assays demonstrated the significant activity of the formulated SNPs and eucalyptus oil infused air freshener. Conclusion: It can be concluded that A. indica-mediated SNPs can be applied in the formulation and manufacture of an ecofriendly air freshener for the management of indoor fungal pathogens like Alternaria spp. and Candida spp.

scholarly journals Emerging Pharmacotherapies for Adult Patients with Acute Lymphoblastic Leukemia

2012 ◽  
Vol 6 ◽  
pp. CMO.S7262 ◽  
Author(s):  
Lydia Lee ◽  
Adele K. Fielding
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Lymphoblastic Leukemia ◽  
Sustained Remission ◽  
The Novel ◽  
Durable Response ◽  
Treatment Regimes ◽  
The Face ◽  
Pediatric All ◽  
Relapsed Disease ◽  
Failure Of Induction

Acute lymphoblastic leukemia (ALL) treatment regimes are amongst the longest, most intensive and complex used in hemato-oncology. Despite this, while treatment of pediatric ALL is a success story, we are far from being able to ensure a durable response in adult ALL. This is not due to failure of induction therapy as a complete remission (CR) is achieved in over 90% of patients. However the challenge remains in ensuring a sustained remission. Furthermore in the face of relapsed disease, salvage therapies currently offer a poor chance of a good outcome. This article reviews the novel agents which show the most promise in the treatment of adult ALL.

THE FIRST DESCRIPTION OF CHICKENPOX AS A DISEASE, BY WILLIAM HEBERDEN THE ELDER (1710-1801) IN 1767

PEDIATRICS ◽  
1970 ◽  
Vol 45 (4) ◽  
pp. 588-588
Author(s):  
T. E. C.
Keyword(s):  
The Body ◽  
The Third ◽  
Millet Seed ◽  
The Face ◽  
The Common ◽  
Loss Of Appetite ◽  
Full Maturity

Both Rosén von Rosenstein (1706-1773)1 and François Boissier de Sauvages (1706-1767)2 came close to differentiating varicella from variola. But, it was left to William Heberden3 to give the first detailed description of chickenpox as a disease sui generis in 1767 as follows: These pocks break out on many without any illness or previous sign: in others they are preceded by a little degree of chillness, lassitude, cough, broken sleep, wandering pains, loss of appetite and feverishness for three days. In some patients I have observed them to make their first appearance on the back, but this perhaps is not constant. Most of them are of the common size of the smallpox but some are less. I never saw them confluent nor very numerous. The greatest number which I ever observed was about twelve in the face, and two hundred over the rest of the body. On the first day of the eruption they are reddish: on the second day there is at the top of most of them a very small bladder about the size of a millet seed. This is sometimes full of a watery and colourless, sometimes of a yellowish, liquor contained between the cuticle and the skin. On the second or at the farthest on the third day from the beginning of the eruption as many of the pocks as are not broken seem arrived at their full maturity, and those which are fullest of that yellow liquor very much resemble what the genuine smallpox are on the fifth or sixth day especially where there happens to be a larger space than ordinary occupied by the extravasated serum.

scholarly journals Rare Presentation of Self-Limiting Kikuchi–Fujimoto Disease in Relapsing Nature

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Karo Servatyari ◽  
Hero Yazdanpanah ◽  
Chamara Dalugama
Keyword(s):  
Lymph Nodes ◽  
Wide Spectrum ◽  
Clinical Manifestations ◽  
Cervical Lymphadenopathy ◽  
Excision Biopsy ◽  
Presentation Of Self ◽  
Rare Presentation ◽  
Cervical Lymph Nodes ◽  
One Year ◽  
Loss Of Appetite

Background. Kikuchi–Fujimoto disease (KFD) is a rare, benign, and self-limiting disease that is commonly associated with cervical lymphadenopathy and fever. The disease has a wide spectrum of clinical manifestations, and definitive diagnosis is based on the histological appearance in the excision biopsy of the lymph nodes. Recurrence of KFD is reported rarely. Case Presentation. A 56-year-old Iranian woman with a background history of thrombocytopenia presented with fever, malaise, loss of appetite, and weight loss with cervical lymphadenopathy. The excision biopsy of the cervical lymph nodes confirmed the diagnosis of KFD, and she made a full recovery with improvement of symptoms, regression of cervical lymph nodes, and normalization inflammatory markers. One year after remission, she presented with similar clinico-biochemical profile, and repeat biopsy confirmed KFD. Conclusion. Although the rate of recurrence of the disease is very low, the treating physician should consider the possibility and confirm it histologically.

scholarly journals DNA methylation and copy number variation profiling of T-cell lymphoblastic leukemia and lymphoma

2020 ◽  
Vol 10 (4) ◽  
Author(s):  
Zahra Haider ◽  
Mattias Landfors ◽  
Irina Golovleva ◽  
Martin Erlanson ◽  
Kjeld Schmiegelow ◽  
...  
Keyword(s):  
Dna Methylation ◽  
T Cell ◽  
Copy Number Variation ◽  
Copy Number ◽  
Cpg Island ◽  
Lymphoblastic Leukemia ◽  
Clinical Manifestations ◽  
Cpg Island Methylator Phenotype ◽  
Genetic Landscape ◽  
Number Variation

AbstractDespite having common overlapping immunophenotypic and morphological features, T-cell lymphoblastic leukemia (T-ALL) and lymphoma (T-LBL) have distinct clinical manifestations, which may represent separate diseases. We investigated and compared the epigenetic and genetic landscape of adult and pediatric T-ALL (n = 77) and T-LBL (n = 15) patient samples by high-resolution genome-wide DNA methylation and Copy Number Variation (CNV) BeadChip arrays. DNA methylation profiling identified the presence of CpG island methylator phenotype (CIMP) subgroups within both pediatric and adult T-LBL and T-ALL. An epigenetic signature of 128 differentially methylated CpG sites was identified, that clustered T-LBL and T-ALL separately. The most significant differentially methylated gene loci included the SGCE/PEG10 shared promoter region, previously implicated in lymphoid malignancies. CNV analysis confirmed overlapping recurrent aberrations between T-ALL and T-LBL, including 9p21.3 (CDKN2A/CDKN2B) deletions. A significantly higher frequency of chromosome 13q14.2 deletions was identified in T-LBL samples (36% in T-LBL vs. 0% in T-ALL). This deletion, encompassing the RB1, MIR15A and MIR16-1 gene loci, has been reported as a recurrent deletion in B-cell malignancies. Our study reveals epigenetic and genetic markers that can distinguish between T-LBL and T-ALL, and deepen the understanding of the biology underlying the diverse disease localization.

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