(HealthDay News) -- Men who were short at birth are more likely to attempt suicide and more than twice as likely to attempt violent suicide than men who were normal-length newborns, a new study says.
Violent suicide includes hanging, the use of a gun or a knife, jumping from a height or in front of a vehicle, or drowning.
The increased risk of suicide among men who were short at birth (less than 47 centimeters) persisted no matter what height they reached in adulthood, said the study authors, who looked at almost 320,000 Swedish men born between 1973 and 1980.
Short height in adulthood also boosted suicide risk. Men who were normal-length babies, but were short adults, were 56 percent more likely than taller men to attempt suicide. The taller a man was, the less likely he was to attempt suicide.
The researchers also found that men who were born underweight (less than 2,500 grams), but who reached normal height as adults, were more than 2.5 times as likely to attempt violent suicide. Men born prematurely (therefore short and underweight) were more than four times as likely to attempt violent suicide as men born between 38 and 40 weeks' gestation.
The brain chemical serotonin may be a factor in these findings, the study authors said. Serotonin is crucial to brain development and low levels are factors in impulsivity, aggression and suicidal behavior. Premature birth and other factors that restrict growth in the womb may affect serotonin levels.
The study was published recently in the Journal of Epidemiology and Community Health.
More information
Mental Health America has more about suicide.
Selasa, 29 Januari 2008
Kamis, 24 Januari 2008
Driving Skills Decline Among People With Early Alzheimer's
(HealthDay News) -- People with early Alzheimer's disease were involved in more traffic crashes and performed worse on road tests than drivers without cognitive impairment, a new study finds.
The findings, by researchers at Rhode Island Hospital and Brown University, confirm previous reports of potentially hazardous driving by people with early Alzheimer's disease (AD). But the study also shows that some people with mild dementia are able to continue driving safely for extended periods of time.
The study included 84 people with early Alzheimer's and a control group of 44 age-matched people without cognitive impairment. Over two to three years, the participants' driving abilities were assessed through self-reports, family reports and a standardized road test.
People with Alzheimer's disease were involved in more crashes and had worse results on road tests than those in the control group. The study also found that people with mild dementia were much more likely to fail a road test than those with very mild dementia.
"Our findings showed that people with mild dementia were almost four times more likely to fail a road test than those with very mild dementia, indicating that people with very mild dementia may be able to drive safely for longer periods of time," principal investigator Dr. Brian Ott, director of the Alzheimer's Disease and Memory Disorders Center at Rhode Island Hospital, said in a prepared statement.
"It is clear, however, that driving ability declines fairly rapidly among patients with dementia, and therefore, regular follow-up assessments are warranted in these people with very mild dementia," added Ott, a professor at Brown University Medical School.
The findings were published in the Jan. 23 issue of the journal Neurology.
People with very mild dementia who continue to drive should be re-assessed every six months, the American Academy of Neurology Guideline on Risk of Driving and Alzheimer's Disease recommends.
Interestingly, the frequency of crashes involving those with Alzheimer's declined during the study.
Overall, the study results "suggest that a regular driving assessment program may actually reduce the frequency of motor vehicle accidents in drivers with mild dementia by increasing awareness among drivers and caregivers. This, however, may also result in premature termination of driving privileges for some persons with dementia," Ott said.
Ott and his colleagues also found that driving abilities could be affected by age as well as education levels. For each year after age 75, the odds of failing a road test increased by about 6 percent. And the risk of failing a road test increased 10 percent for each year a person lagged behind the average 14 years of education.
More information
The Alzheimer's Association has more about Alzheimer's and driving.
The findings, by researchers at Rhode Island Hospital and Brown University, confirm previous reports of potentially hazardous driving by people with early Alzheimer's disease (AD). But the study also shows that some people with mild dementia are able to continue driving safely for extended periods of time.
The study included 84 people with early Alzheimer's and a control group of 44 age-matched people without cognitive impairment. Over two to three years, the participants' driving abilities were assessed through self-reports, family reports and a standardized road test.
People with Alzheimer's disease were involved in more crashes and had worse results on road tests than those in the control group. The study also found that people with mild dementia were much more likely to fail a road test than those with very mild dementia.
"Our findings showed that people with mild dementia were almost four times more likely to fail a road test than those with very mild dementia, indicating that people with very mild dementia may be able to drive safely for longer periods of time," principal investigator Dr. Brian Ott, director of the Alzheimer's Disease and Memory Disorders Center at Rhode Island Hospital, said in a prepared statement.
"It is clear, however, that driving ability declines fairly rapidly among patients with dementia, and therefore, regular follow-up assessments are warranted in these people with very mild dementia," added Ott, a professor at Brown University Medical School.
The findings were published in the Jan. 23 issue of the journal Neurology.
People with very mild dementia who continue to drive should be re-assessed every six months, the American Academy of Neurology Guideline on Risk of Driving and Alzheimer's Disease recommends.
Interestingly, the frequency of crashes involving those with Alzheimer's declined during the study.
Overall, the study results "suggest that a regular driving assessment program may actually reduce the frequency of motor vehicle accidents in drivers with mild dementia by increasing awareness among drivers and caregivers. This, however, may also result in premature termination of driving privileges for some persons with dementia," Ott said.
Ott and his colleagues also found that driving abilities could be affected by age as well as education levels. For each year after age 75, the odds of failing a road test increased by about 6 percent. And the risk of failing a road test increased 10 percent for each year a person lagged behind the average 14 years of education.
More information
The Alzheimer's Association has more about Alzheimer's and driving.
Selasa, 22 Januari 2008
Smoking Worsens Prognosis for IPF Patients
(HealthDay News) -- Current and former smokers with the lung disease idiopathic pulmonary fibrosis (IPF) have a worse prognosis than nonsmokers, says a British study.
IPF is untreatable, and patients usually die within five years of diagnosis. Previous research had suggested that current smokers with IPF may live longer than former smokers, but the authors of this new study said that was likely due to a "healthy smoker effect."
"Smoking is associated with a higher degree of mortality in IPF, and an earlier finding, suggesting the contrary, was almost certainly due to the fact that smokers tend to stop smoking when disease becomes more severe -- and so current smoking is linked to milder disease," research leader Dr. Athol U. Wells, of the Interstitial Lung Disease Unit at the Royal Brompton Hospital in London, said in a prepared statement.
Publishing in the second issue for January of the American Journal of Respiratory and Critical Care Medicine, Wells and his colleagues analyzed the medical records of 249 IPF patients and found nonsmokers survived longer than current or former smokers.
"We speculate as to whether this reflects disease co-morbidity -- that is, excess mortality from non-pulmonary disease ascribable to smoking -- or an effect of smoking in driving progression of lung disease," Wells said.
The team is doing further research in this area.
"The next step is to pursue the idea that mechanisms linked to smoking cause progression of pulmonary fibrosis. If we can then understand these mechanisms better, this may give us new treatment options," Wells said.
More information
The U.S. National Heart, Lung, and Blood Institute has more about idiopathic pulmonary fibrosis.
IPF is untreatable, and patients usually die within five years of diagnosis. Previous research had suggested that current smokers with IPF may live longer than former smokers, but the authors of this new study said that was likely due to a "healthy smoker effect."
"Smoking is associated with a higher degree of mortality in IPF, and an earlier finding, suggesting the contrary, was almost certainly due to the fact that smokers tend to stop smoking when disease becomes more severe -- and so current smoking is linked to milder disease," research leader Dr. Athol U. Wells, of the Interstitial Lung Disease Unit at the Royal Brompton Hospital in London, said in a prepared statement.
Publishing in the second issue for January of the American Journal of Respiratory and Critical Care Medicine, Wells and his colleagues analyzed the medical records of 249 IPF patients and found nonsmokers survived longer than current or former smokers.
"We speculate as to whether this reflects disease co-morbidity -- that is, excess mortality from non-pulmonary disease ascribable to smoking -- or an effect of smoking in driving progression of lung disease," Wells said.
The team is doing further research in this area.
"The next step is to pursue the idea that mechanisms linked to smoking cause progression of pulmonary fibrosis. If we can then understand these mechanisms better, this may give us new treatment options," Wells said.
More information
The U.S. National Heart, Lung, and Blood Institute has more about idiopathic pulmonary fibrosis.
Kamis, 17 Januari 2008
Genetic Breast Cancer Test Approved
(HealthDay News) -- A new genetic test that helps assess the risk of tumor recurrence and long-term survival for patients with relatively high-risk breast cancer has been approved by the U.S. Food and Drug Administration.
The TOP2A/FISH pharmDx is the first approved device to test for the TOP2A (topoisomerase 2 alpha) gene in cancer patients. The gene plays a role in DNA replication. Changes in the TOP2A gene in breast cancer cells indicate increased risk that a tumor will recur or decreased survival.
The new test, made by Dako Denmark A/S, uses fluorescently-labeled DNA probes to detect or confirm gene or chromosome abnormalities, a process called fluorescent in situ hybridization (FISH).
The FDA approval was based on a study of 767 high-risk patients in Denmark who had been treated with chemotherapy after removal of a breast tumor. The findings indicated the test was useful in estimating cancer recurrence and overall survival.
"When used with other clinical information and laboratory tests, this test can provide health care professionals with additional insights on the likely clinical course for breast cancer patients," Dr. Daniel Schultz, director of the FDA's Center for Clinical Devices and Radiological Health, said in a prepared statement.
More information
This FDA announcement has more about the approval.
The TOP2A/FISH pharmDx is the first approved device to test for the TOP2A (topoisomerase 2 alpha) gene in cancer patients. The gene plays a role in DNA replication. Changes in the TOP2A gene in breast cancer cells indicate increased risk that a tumor will recur or decreased survival.
The new test, made by Dako Denmark A/S, uses fluorescently-labeled DNA probes to detect or confirm gene or chromosome abnormalities, a process called fluorescent in situ hybridization (FISH).
The FDA approval was based on a study of 767 high-risk patients in Denmark who had been treated with chemotherapy after removal of a breast tumor. The findings indicated the test was useful in estimating cancer recurrence and overall survival.
"When used with other clinical information and laboratory tests, this test can provide health care professionals with additional insights on the likely clinical course for breast cancer patients," Dr. Daniel Schultz, director of the FDA's Center for Clinical Devices and Radiological Health, said in a prepared statement.
More information
This FDA announcement has more about the approval.
Senin, 14 Januari 2008
Depression, Obesity Coexist in Many Middle-Aged Women
(HealthDay News) -- Obesity and depression often go hand-in-hand in middle-aged women, a new U.S. study found.
The research collected information on the height, weight, dietary and exercise habits, and body image of 4,641 women, ages 40 to 65, enrolled in a health plan. The women also completed a questionnaire used to measure depression symptoms.
Women with clinical depression were more than twice as likely to be obese (a body mass index of 30 or more), and obese women were more than twice as likely to be depressed, the study found.
It also found that women with BMIs of 30 or higher exercised the least, had the poorest body image, and consumed 20 percent more calories than women with lower BMIs.
The link between obesity and depression remained intact even when the researchers factored in marital status, education, tobacco use and antidepressant use.
The study was published in the January/February issue of the journal General Hospital Psychiatry.
It's likely that depression and obesity fuel one another, said lead author Dr. Gregory Simon, a psychiatrist and researcher at Group Health Cooperative in Seattle.
"When people gain weight, they're more likely to become depressed, and when they get depressed, they have more trouble losing weight," he said in a prepared statement.
The stigma of being overweight can damage self-esteem and efforts to lose weight.
"It's not that these women are clueless. It's that they're hopeless," said Simon, who suggested that if obese women focus on rebuilding their self esteem, it may help them lose weight.
More information
The American Academy of Family Physicians has more about women and depression.
The research collected information on the height, weight, dietary and exercise habits, and body image of 4,641 women, ages 40 to 65, enrolled in a health plan. The women also completed a questionnaire used to measure depression symptoms.
Women with clinical depression were more than twice as likely to be obese (a body mass index of 30 or more), and obese women were more than twice as likely to be depressed, the study found.
It also found that women with BMIs of 30 or higher exercised the least, had the poorest body image, and consumed 20 percent more calories than women with lower BMIs.
The link between obesity and depression remained intact even when the researchers factored in marital status, education, tobacco use and antidepressant use.
The study was published in the January/February issue of the journal General Hospital Psychiatry.
It's likely that depression and obesity fuel one another, said lead author Dr. Gregory Simon, a psychiatrist and researcher at Group Health Cooperative in Seattle.
"When people gain weight, they're more likely to become depressed, and when they get depressed, they have more trouble losing weight," he said in a prepared statement.
The stigma of being overweight can damage self-esteem and efforts to lose weight.
"It's not that these women are clueless. It's that they're hopeless," said Simon, who suggested that if obese women focus on rebuilding their self esteem, it may help them lose weight.
More information
The American Academy of Family Physicians has more about women and depression.
Selasa, 08 Januari 2008
Breast-Feeding Seems to Protect Against Some Allergies
(HealthDay News) -- Atopic disease -- which includes eczema, asthma and food allergies -- may be delayed or even prevented in high-risk infants if they are exclusively breast-fed for at least four months or fed infant formula without cow milk protein.
That's the conclusion of a new clinical report from the American Academy of Pediatrics (AAP) that's published in the January issue of Pediatrics. The report replaces an earlier policy statement from the AAP.
"Basically, it probably does not matter what pregnant or lactating women eat," said Dr. Frank Greer, an author of the report, professor of pediatrics at the University of Wisconsin and chairman of the AAP Committee on Nutrition.
"The best prevention for atopic [allergic] disease is exclusive breast-feeding for four months," he added. "And if your infant comes from a family with significant atopic disease, then weaning from breast milk to a partially or extensively hydrolyzed [hypoallergenic] formula [without cow milk protein] may delay or prevent the onset of atopic disease, especially atopic dermatitis [eczema]."
Greer added that this recommendation would also apply to formula-fed infants who are at risk for atopic disease.
The timing and introduction of solid foods has no protective effect on the prevention of atopic disease, according to the new report.
"With the increase in asthma and food allergies that we've seen recently, we had hoped that maternal diet, breast-feeding and early childhood diet might all have some factor in decreasing incidence," said Dr. Jennifer Wu, an obstetrician/gynecologist at Lenox Hill Hospital in New York City. "Unfortunately, it doesn't seem to significantly impact, according to studies already done. The only one that seems to be impacted is the atopic dermatitis, which is decreased by about one third by breast-feeding. But the studies that have been done so far have not proven that breast-feeding will significantly impact childhood asthma or food allergies."
The incidence of allergic diseases such as asthma, food allergies and various skin conditions has exploded during the past few decades. In children 4 years of age and younger, the incidence of asthma has risen 160 percent, while the incidence of atopic dermatitis has almost tripled. And the incidence of peanut allergy has doubled just during the past decade, according to the report.
While genetics certainly plays a role in the development of these diseases, environmental factors such as diet are also strongly related.
The new report reviewed different evidence on nutrition during pregnancy, breast-feeding and the first year of life that might affect the development of allergic disease. Its major findings are as follows:
That's the conclusion of a new clinical report from the American Academy of Pediatrics (AAP) that's published in the January issue of Pediatrics. The report replaces an earlier policy statement from the AAP.
"Basically, it probably does not matter what pregnant or lactating women eat," said Dr. Frank Greer, an author of the report, professor of pediatrics at the University of Wisconsin and chairman of the AAP Committee on Nutrition.
"The best prevention for atopic [allergic] disease is exclusive breast-feeding for four months," he added. "And if your infant comes from a family with significant atopic disease, then weaning from breast milk to a partially or extensively hydrolyzed [hypoallergenic] formula [without cow milk protein] may delay or prevent the onset of atopic disease, especially atopic dermatitis [eczema]."
Greer added that this recommendation would also apply to formula-fed infants who are at risk for atopic disease.
The timing and introduction of solid foods has no protective effect on the prevention of atopic disease, according to the new report.
"With the increase in asthma and food allergies that we've seen recently, we had hoped that maternal diet, breast-feeding and early childhood diet might all have some factor in decreasing incidence," said Dr. Jennifer Wu, an obstetrician/gynecologist at Lenox Hill Hospital in New York City. "Unfortunately, it doesn't seem to significantly impact, according to studies already done. The only one that seems to be impacted is the atopic dermatitis, which is decreased by about one third by breast-feeding. But the studies that have been done so far have not proven that breast-feeding will significantly impact childhood asthma or food allergies."
The incidence of allergic diseases such as asthma, food allergies and various skin conditions has exploded during the past few decades. In children 4 years of age and younger, the incidence of asthma has risen 160 percent, while the incidence of atopic dermatitis has almost tripled. And the incidence of peanut allergy has doubled just during the past decade, according to the report.
While genetics certainly plays a role in the development of these diseases, environmental factors such as diet are also strongly related.
The new report reviewed different evidence on nutrition during pregnancy, breast-feeding and the first year of life that might affect the development of allergic disease. Its major findings are as follows:
- Currently, there is no evidence that what a mother eats during pregnancy or breast-feeding plays a major role in preventing atopic disease in infants. There is some evidence, however, that avoiding certain foods during breast-feeding may help prevent atopic eczema.
- Exclusive breast-feeding for at least four months for infants at high-risk of developing atopic disease decreases the risk of developing eczema and cow milk allergy during the first two years of life.
- In high-risk infants who aren't breast-fed exclusively for four to six months, the use of hydrolyzed infant formula (as opposed to formula containing cow milk) may delay or prevent the onset of atopic dermatitis.
- Exclusive breast-feeding for at least three months protects an infant against wheezing in early life.
- There is no good evidence to support the use of soy-based infant formula to prevent allergies.
- There is no evidence to suggest that delaying the introduction of solid foods before the recommended 4 to 6 months of age will have an effect on the development of atopic disease.
- There is no convincing evidence to suggest that any dietary intervention will prevent atopic disease after 4 to 6 months of age.
- "It's a mixed picture," Wu said. "We don't have proven efficacy for breast-feeding. It may mean that we need more robust studies and a longer-term follow-up for kids."
The new report is titled "Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Timing of Introduction of Complementary Foods, and Hydrolyzed Formulas."
More information
There's more on infant nutrition at the National Institutes of Health.
Kamis, 03 Januari 2008
Body Abnormalities, Childhood Cancer May Share Genes
(HealthDay News) -- Dutch scientists have discovered that children who have cancer also have more body anomalies, such as asymmetric limbs and curvature of the spine.
This suggests that the same genetic defect underlies both the cancer and the anomaly, raising hopes that genetic information may help identify individuals predisposed to develop cancer.
"This is an excellent study, with very large numbers of patients, and it shows that we're beginning to understand that there are certain genetic changes that predispose individuals to developing various cancers," said Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in Baton Rouge, La.
"The good news in childhood cancer is that many of them are highly curable," said Brooks. Hopefully we'll be able to use the information in this study to better follow patients who have a genetic predisposition and be able to diagnose cancers sooner."
Another expert agreed.
"The authors have identified many anomalies that are more likely to be found in a group of children with cancer. Any child with cancer and an anomaly deserves a complete genetic evaluation," said Dr. Stephanie Sacharow, a medical geneticist at the University of Miami Miller School of Medicine.
The study, led by Dr. Johannes Merks of the Academic Medical Center in Amsterdam, was published in the Jan. 2 issue of the Journal of the American Medical Association.
Certain genetic syndromes have already been linked with an increased risk for developing childhood cancer.
For instance, Gorlin syndrome (characterized by a broad face and possibly organ deformities) is linked with an increased risk for basal cell carcinoma. Rubinstein-Taybi syndrome (associated with certain physical features and developmental abnormalities) is linked with meningioma, or benign brain tumors.
This study involved nearly 1,100 patients: 898 long-term survivors of childhood cancers and 175 children newly diagnosed with cancer. These children were compared with more than 1,000 children who did not have cancer but who were examined for 683 physical abnormalities in the same way.
Children who had cancer also had more major and minor abnormalities, such as uneven limbs, broad hands or feet, prominent ears and curvature of the spine.
Just under 27 percent of cancer patients had one or more major abnormalities, compared with 15.5 percent of controls. There were two or more abnormalities present in 5.1 percent of patients versus 1.6 percent of controls; while three or more abnormalities were found in 0.9 percent of patients and no controls.
One or more minor anomalies were present in 65.1 percent of patients versus 56.2 percent of controls; two or more minor abnormalities were present in 32.8 percent of patients versus 22.1 percent of controls; while three or more such abnormalities were found in 15.2 percent of patients compared with 8.3 percent of controls.
Almost 4 percent of cancer patients had a clinical genetic syndrome and 14 different abnormalities were significantly linked with childhood cancer.
The mean ages of the two groups of participants were widely divergent, with cancer patients at 21.2 years and controls at 10.4 years, but the authors stated that they only looked at abnormalities that were not associated with a particular age.
All participants were white, eliminating the possibility that ethnicity influenced the prevalence of different cancers or different abnormalities.
"The importance of this is not necessarily in the clinical practice but rather in the fact that as we put this information together, you can then eventually link the actual genes that are involved in producing a particular abnormality and that -- in the long run, not in the short run -- may be quite significant in looking at the potential for explanation and eventually cure," noted Dr. Ludovico Guarini, director of pediatric hematology/oncology at Maimonides Cancer Center in New York City.
The subject of diagnosis and identification of high-risk individuals is trickier, he added.
"Gene mutations which are associated with cancer can give you a hint and sometimes even a solid lead, but they by no means identify the individuals who will develop cancer. They will identify individuals who are somewhat at increased risk," Guarini said.
More information
There's more on childhood cancer at the U.S. National Cancer Institute.
This suggests that the same genetic defect underlies both the cancer and the anomaly, raising hopes that genetic information may help identify individuals predisposed to develop cancer.
"This is an excellent study, with very large numbers of patients, and it shows that we're beginning to understand that there are certain genetic changes that predispose individuals to developing various cancers," said Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in Baton Rouge, La.
"The good news in childhood cancer is that many of them are highly curable," said Brooks. Hopefully we'll be able to use the information in this study to better follow patients who have a genetic predisposition and be able to diagnose cancers sooner."
Another expert agreed.
"The authors have identified many anomalies that are more likely to be found in a group of children with cancer. Any child with cancer and an anomaly deserves a complete genetic evaluation," said Dr. Stephanie Sacharow, a medical geneticist at the University of Miami Miller School of Medicine.
The study, led by Dr. Johannes Merks of the Academic Medical Center in Amsterdam, was published in the Jan. 2 issue of the Journal of the American Medical Association.
Certain genetic syndromes have already been linked with an increased risk for developing childhood cancer.
For instance, Gorlin syndrome (characterized by a broad face and possibly organ deformities) is linked with an increased risk for basal cell carcinoma. Rubinstein-Taybi syndrome (associated with certain physical features and developmental abnormalities) is linked with meningioma, or benign brain tumors.
This study involved nearly 1,100 patients: 898 long-term survivors of childhood cancers and 175 children newly diagnosed with cancer. These children were compared with more than 1,000 children who did not have cancer but who were examined for 683 physical abnormalities in the same way.
Children who had cancer also had more major and minor abnormalities, such as uneven limbs, broad hands or feet, prominent ears and curvature of the spine.
Just under 27 percent of cancer patients had one or more major abnormalities, compared with 15.5 percent of controls. There were two or more abnormalities present in 5.1 percent of patients versus 1.6 percent of controls; while three or more abnormalities were found in 0.9 percent of patients and no controls.
One or more minor anomalies were present in 65.1 percent of patients versus 56.2 percent of controls; two or more minor abnormalities were present in 32.8 percent of patients versus 22.1 percent of controls; while three or more such abnormalities were found in 15.2 percent of patients compared with 8.3 percent of controls.
Almost 4 percent of cancer patients had a clinical genetic syndrome and 14 different abnormalities were significantly linked with childhood cancer.
The mean ages of the two groups of participants were widely divergent, with cancer patients at 21.2 years and controls at 10.4 years, but the authors stated that they only looked at abnormalities that were not associated with a particular age.
All participants were white, eliminating the possibility that ethnicity influenced the prevalence of different cancers or different abnormalities.
"The importance of this is not necessarily in the clinical practice but rather in the fact that as we put this information together, you can then eventually link the actual genes that are involved in producing a particular abnormality and that -- in the long run, not in the short run -- may be quite significant in looking at the potential for explanation and eventually cure," noted Dr. Ludovico Guarini, director of pediatric hematology/oncology at Maimonides Cancer Center in New York City.
The subject of diagnosis and identification of high-risk individuals is trickier, he added.
"Gene mutations which are associated with cancer can give you a hint and sometimes even a solid lead, but they by no means identify the individuals who will develop cancer. They will identify individuals who are somewhat at increased risk," Guarini said.
More information
There's more on childhood cancer at the U.S. National Cancer Institute.
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