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Wood H, Kluk K, BinKhamis G. Association between vitamin D deficiency and benign paroxysmal positional vertigo (BPPV) incidence and recurrence: a systematic review and meta-analysis. BMJ Open 2024; 14:e077986. [PMID: 38653514 PMCID: PMC11043747 DOI: 10.1136/bmjopen-2023-077986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 02/27/2024] [Indexed: 04/25/2024] Open
Abstract
OBJECTIVES The objective of this study is to determine the relationship between serum vitamin D level and the risk of developing benign paroxysmal positional vertigo (BPPV) incidence and recurrence in countries in the Northern Hemisphere. DESIGN Systematic review and meta-analysis. DATA SOURCES PubMed, Scopus and Web of Science databases were searched for studies published between January 2000 and February 2023. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Participants located in the Northern Hemisphere aged 18 or over with at least one episode of BPPV, serum 25-hydroxyvitamin D levels measured and reported, no comorbidities or history of vitamin D supplementation. DATA EXTRACTION AND SYNTHESIS Data extraction and synthesis were performed by a single reviewer and checked by a second reviewer. Inclusion and exclusion criteria and risk of bias were assessed by two independent reviewers using the Newcastle Ottawa Tool for Cohort studies and Risk of Bias Assessment Tool for Nonrandomised Studies checklist for case-control studies. Meta-analysis was conducted using random effects models. Standard mean difference with a 95% CI was used to measure the relationship between vitamin D level and BPPV. RESULTS The 35 articles identified by the literature search reported data of 9843 individuals. 19 studies (7387 individuals) were included in the BPPV incidence meta-analysis while 7 studies (622 individuals) were included in the BPPV recurrence meta-analysis. Lower serum vitamin D levels were found in BPPV incidence compared with controls, but the relationship between vitamin D levels in recurrent BPPV compared with non-recurrent disease remained uncertain. CONCLUSION Results of this systematic review and meta-analysis demonstrated a negative correlation between serum vitamin D and BPPV incidence, while any relationship between serum vitamin D and BPPV recurrence remained uncertain. Risk of bias analysis revealed evidence of variable quality. There were insufficient data available to evaluate seasonal relationships between serum vitamin D and BPPV. Given the potential for this as a confounding factor, future research should aim to investigate this further. PROSPERO REGISTRATION NUMBER CRD42021271840.
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Affiliation(s)
- Heather Wood
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Karolina Kluk
- Manchester Centre for Audiology and Deafness, The University of Manchester, Manchester, UK
| | - Ghada BinKhamis
- Manchester Centre for Audiology and Deafness, The University of Manchester, Manchester, UK
- Cochlear Implant Center, King Fahad Medical City, Riyadh, Saudi Arabia
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Li J, Yu L, An P, Pang W, Yan X, Deng D, Song Y, Mao M, Qiu K, Rao Y, Cheng D, Zhang Y, Feng L, Wang X, Zhang Z, Zheng Y, Xu W, Ren J, Zhao Y. Low Bone Mineral Density and the Risk of Benign Paroxysmal Positional Vertigo. Otolaryngol Head Neck Surg 2024; 170:877-885. [PMID: 38044484 DOI: 10.1002/ohn.600] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 10/19/2023] [Accepted: 11/02/2023] [Indexed: 12/05/2023]
Abstract
OBJECTIVE This study aimed to comprehensively analyze the relationship between low bone mineral density (BMD) and the risk of benign paroxysmal positional vertigo (BPPV) based on the large prospective population-based UK Biobank (UKB) cohort. STUDY DESIGN Prospective population-based cohort study. SETTING The UKB. METHODS This prospective cohort study included UKB participants recruited between 2006 and 2010 who had information on BMD and did not have BPPV before being diagnosed with low BMD. Univariable and multivariable logistic regression models were constructed to assess the association between low BMD (overall low BMD, osteopenia, and osteoporosis) and BPPV. We further conducted sex and age subgroup analysis, respectively. Finally, the effects of antiosteoporosis and female sex hormone medications on BPPV in participants with osteoporosis were evaluated. RESULTS In total, 484,303 participants were included in the final analysis, and 985 developed BPPV after a maximum follow-up period of 15 years. Osteoporosis was associated with a higher risk of BPPV (odds ratio [OR] = 1.37, P = .0094), whereas osteopenia was not. Subgroup analyses suggested that the association between osteoporosis and BPPV was significant only in elderly females (≥60 years, OR = 1.51, P = .0007). However, no association was observed between antiosteoporosis or female sex hormone medications and BPPV in the participants with osteoporosis. CONCLUSION Osteoporosis was associated with a higher risk of developing general BPPV, especially in females aged ≥ 60 years old, whereas osteopenia was not associated with BPPV.
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Affiliation(s)
- Junhong Li
- Department of Otolaryngology-Head and Neck Surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Libo Yu
- Department of Otolaryngology-Head and Neck Surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Ping An
- Department of Otolaryngology-Head and Neck Surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Wendu Pang
- Department of Otolaryngology-Head and Neck Surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaohong Yan
- Department of Otolaryngology-Head and Neck Surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Di Deng
- Department of Otolaryngology-Head and Neck Surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Yao Song
- Department of Otolaryngology-Head and Neck Surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Minzi Mao
- Department of Otolaryngology-Head and Neck Surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Ke Qiu
- Department of Otolaryngology-Head and Neck Surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Yufang Rao
- Department of Otolaryngology-Head and Neck Surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Danni Cheng
- Department of Otolaryngology-Head and Neck Surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Yuyang Zhang
- Department of Otolaryngology-Head and Neck Surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Lan Feng
- Department of Otolaryngology-Head and Neck Surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoyu Wang
- Department of Otolaryngology-Head and Neck Surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Ziyan Zhang
- Department of Otolaryngology-Head and Neck Surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Yongbo Zheng
- Department of Otolaryngology-Head and Neck Surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Xu
- Department of Biostatistics, Princess Margaret Cancer Centre, Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - Jianjun Ren
- Department of Otolaryngology-Head and Neck Surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Yu Zhao
- Department of Otolaryngology-Head and Neck Surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
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Evaluation of a questionnaire as a screening tool for benign paroxysmal position vertigo. Eur Arch Otorhinolaryngol 2023; 280:1919-1926. [PMID: 36422670 DOI: 10.1007/s00405-022-07744-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 11/07/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine the value of a questionnaire as a screening tool for benign paroxysmal position vertigo (BPPV). STUDY DESIGN Retrospective chart review. SETTING Tertiary care centers. METHODS A total of 520 vertigo adults completed the questionnaire before the diagnosis was confirmed. After vestibular function examination and other diagnostic examination, the diagnosis of all participants was confirmed by experts. By validating valuable items from the questionnaire with 47 items, a new questionnaire of 5 items was formed to quickly diagnose BPPV. The internal consistency of the new questionnaire and validity were evaluated. The correlation between the score obtained from the new questionnaire and diagnosis was investigated. The mean score was also compared between groups with and without BPPV and diagnostic precision measures were calculated. RESULTS 520 vertigo participants answered all the question completely and BPPV was identified in 138 participants (26.5%). The responses to questionnaire revealed preferable reproducibility (r = 0.898, P < 0.05) and internal consistency (Cronbach's α = 0.702) as well as the validity (Kaiser-Meyer-Olkin, KMO = 0.731). The higher the individual score, the more likely to be BPPV (B = 2.082; P < 0.05). The mean score of answers was greater in the group with a clinical diagnosis of BPPV compared to those without BPPV (F = 58.459, P < 0.05). The sensitivity of the screening tool was 92.8% and specificity was 88.5%, with an area under the ROC curve of 0.946 (95% confidence interval 0.926-0.965; P < 0.05). CONCLUSION The questionnaire proved to be of great value to screen for individuals with possible BPPV.
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Deng W, Huang J, Kong S, Zhan Y, Lv J, Cui Y. Pupil trajectory tracing from video-oculography with a new definition of pupil location. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2022.104196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Nakata T, Okada M, Nishihara E, Ikedo A, Asoh S, Takagi T, Tokunaga N, Hato N, Imai Y. Effect of hormonal therapy on the otoconial changes caused by estrogen deficiency. Sci Rep 2022; 12:22596. [PMID: 36585504 PMCID: PMC9803649 DOI: 10.1038/s41598-022-27240-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/28/2022] [Indexed: 12/31/2022] Open
Abstract
Benign paroxysmal positional vertigo (BPPV) is associated with menopause and/or osteopenia. Morphological changes in the otoconial layer have been reported after ovariectomy (OVX). Moreover, hormone replacement therapy decreases BPPV risk. However, knowledge concerning the effect of hormonal therapy on the otoconial changes caused by estrogen deficiency is limited. We aimed to examine the effect of hormonal therapy on otoconial changes caused by estrogen deficiency. We hypothesized that hormonal therapy could reduce otoconial changes caused by OVX. Eight-week-old C57BL/6 mice were divided into four groups: sham operation with implantation of vehicle (sham + v), OVX with implantation of vehicle (OVX + v), OVX with implantation of estradiol (E2) (OVX + E2), and OVX with implantation of raloxifene (RAL) (OVX + RAL) groups. Otoconial layer volume was measured by micro-CT at 4 weeks after OVX or the sham operation. The otic bullae were removed; immunohistochemistry was performed for estrogen receptor alpha and 4-hydroxynonenal. Otoconial layer volume was significantly higher in the OVX + v than in the sham + v group. E2 and RAL significantly reduced these changes in the endometrial layer. The staining of estrogen receptor alpha and 4-hydroxynonenal were stronger in the OVX + v than in the sham + v group but equal in the sham + v, OVX + E2, and OVX + RAL groups. These results indicate that E2 and RAL are effective against morphological changes of the otoconial layer caused by estrogen deficiency via oxidative stress reduction.
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Affiliation(s)
- Takahiro Nakata
- grid.255464.40000 0001 1011 3808Department of Otolaryngology, Head and Neck Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan ,Department of Otolaryngology, Ehime Prefectural Niihama Hospital, Niihama, Japan
| | - Masahiro Okada
- grid.255464.40000 0001 1011 3808Department of Otolaryngology, Head and Neck Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| | - Eriko Nishihara
- grid.255464.40000 0001 1011 3808Department of Otolaryngology, Head and Neck Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| | - Aoi Ikedo
- grid.255464.40000 0001 1011 3808Division of Integrative Pathophysiology, Proteo-Science Center, Ehime University, Toon, Japan
| | - Sawa Asoh
- grid.255464.40000 0001 1011 3808Department of Otolaryngology, Head and Neck Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| | - Taro Takagi
- grid.255464.40000 0001 1011 3808Department of Otolaryngology, Head and Neck Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| | - Naohito Tokunaga
- grid.255464.40000 0001 1011 3808Division of Medical Research Support the Advanced Research Support Center, Ehime University, Toon, Japan
| | - Naohito Hato
- grid.255464.40000 0001 1011 3808Department of Otolaryngology, Head and Neck Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| | - Yuuki Imai
- grid.255464.40000 0001 1011 3808Division of Integrative Pathophysiology, Proteo-Science Center, Ehime University, Toon, Japan ,grid.255464.40000 0001 1011 3808Department of Pathophysiology, Ehime University Graduate School of Medicine, Toon, Japan ,grid.255464.40000 0001 1011 3808Division of Laboratory Animal Research, Advanced Research Support Center, Ehime University, Toon, Japan
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Zhong M. Effect of Core Muscle Strength Training Combined with Taijiquan on Bone Mineral Density Measured by Quantitative CT Scanning in the Elderly. SCANNING 2022; 2022:6942081. [PMID: 35795616 PMCID: PMC9152348 DOI: 10.1155/2022/6942081] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/08/2022] [Accepted: 05/13/2022] [Indexed: 06/15/2023]
Abstract
Learn about the benefits of muscle strength training combined with tai chi for adult skeletal muscle in multiple CT scanning. The study included 182 people over the age of 60 with no long-term history of physical activity and exercise. They were divided into the Taijiquan group (52 people), student muscle strength group (45 people), student muscle group combined with Taijiquan group (45 people), and control group (40 people). The board of directors did not attend. The other three groups received tai chi (more than 4 times a week), muscle strength training, and muscle training combined with tai chi for 6 months. Lumbar spine (L1-4) BMD and Berg scores were approximately the same as those measured in adults before exercise and at 3 and 6 months after exercise. The results showed that there were significant differences in the scores of lumbar spine BMD and Berg Balance Scale between the Taijiquan group and students before and after exercise combined with muscle strength training (P < 0.05 or <0.01). The difference was statistically significant (P < 0.05). The scores of lumbar BMD and Berg Balance Scale in the core muscle strength training combined with Taijiquan group after 6 months of exercise were higher than those after 3 months of exercise (P < 0.05), and the CT value of lumbar vertebral bone calcium was significantly positively correlated with BMD (Pearson correlation coefficients of L5 vertebral body were r = 0.704, 0.683, 0.728, 0.673, and 0.686, P < 0.01). Single or combined training of core muscle strength or Taijiquan can improve lumbar bone mineral density and balance function in the elderly.
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Affiliation(s)
- Mingliang Zhong
- Zhengzhou Preschool Education College, Zhengzhou, Henan 450000, China
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Libonati GA, Martellucci S, Castellucci A, Malara P. Minimum Stimulus Strategy: A step-by-step diagnostic approach to BPPV. J Neurol Sci 2022; 434:120158. [DOI: 10.1016/j.jns.2022.120158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/15/2021] [Accepted: 01/13/2022] [Indexed: 11/29/2022]
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Sun L, Li M. ANALYSIS AND RESEARCH ON THE KEY FACTORS OF SPORTS IN MAINTAINING HUMAN HEALTH. REV BRAS MED ESPORTE 2021. [DOI: 10.1590/1517-8692202127032021_0091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Introduction The research on the promotion of physical fitness of the human body by exercise has also attracted widespread attention in sports and rehabilitation medicine. Object This article uses ultrasound to study the bone density health of the human body, thereby establishing the relationship between sports and bone density health. We hope to use the research results of this article to improve people’s awareness of sports health. Method We used ultrasound to test the bone mineral density of two groups of students (exercise group and non-exercise group) to explore the relationship between different sports items and the students’ bone mineral density. Results There is a significant difference in bone density between the two groups of students. There is no gender difference in bone density. Conclusion Students need to strengthen physical exercise in the growth and development stage to improve bone density. Level of evidence II; Therapeutic studies - investigation of treatment results.
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Affiliation(s)
- Lina Sun
- North China Institute of Science and Technology, China
| | - Mingzhi Li
- North China Institute of Science and Technology, China
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Melis A, Rizzo D, Gallus R, Leo ME, Turra N, Masnaghetti D, De Luca LM, Piras A, Bussu F. Relationship between calcium metabolism and benign paroxysmal positional vertigo in north Sardinia population. J Vestib Res 2020; 30:375-382. [PMID: 33285658 DOI: 10.3233/ves-200025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Benign paroxysmal positional vertigo (BPPV) has a reported recurrence ranging from 26.8 to 50%. Osteoporosis and Vitamin D deficiency seems to have an impact on recurrence of BPPV. OBJECTIVE to evaluate the impact of osteoporosis and Vitamin D deficiency on recurrence of BPPV. METHODS 73 consecutive patients were divided in two groups according to the presence (group 1) or absence (group 0) of a recurrent episode. BMD, femoral and lumbar T-scores and Vitamin D levels were recorded. Statistical analysis was performed to investigate correlations. RESULTS patients in group 1 had statistically significant lower values of both femoral (-1,62±1,06 vs. -0,53±1,51; p = 0,001), lumbar T-score (-2,10±1,19 vs -0, 53±1.51, p = 0.001) and Vitamin D (19.53±15.33). The values of femoral T-score and Vitamin D could be combined in a model able to properly classify 65.8% of the cases (p = 0.002) as isolated or recurrent BPPV, with high accuracy (AUC 0.710 [0.590 -0.830]). CONCLUSION present data show a probable correlation between osteoporosis and Vitamin D with recurrent BPPV.
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Affiliation(s)
- Andrea Melis
- Azienda Ospedaliero Universitaria, Otolaryngology Division, Sassari, Italy
| | - Davide Rizzo
- Azienda Ospedaliero Universitaria, Otolaryngology Division, Sassari, Italy
| | | | - Maria Eleonora Leo
- Division of Otolaryngology, Department of Medical, Surgical and Experimental Science, University of Sassari, Sassari, Italy
| | - Nicola Turra
- Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
| | | | | | - Antonio Piras
- Azienda Ospedaliero Universitaria, Otolaryngology Division, Sassari, Italy
| | - Francesco Bussu
- Azienda Ospedaliero Universitaria, Otolaryngology Division, Sassari, Italy.,Division of Otolaryngology, Department of Medical, Surgical and Experimental Science, University of Sassari, Sassari, Italy
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Kelly RR, Sidles SJ, LaRue AC. Effects of Neurological Disorders on Bone Health. Front Psychol 2020; 11:612366. [PMID: 33424724 PMCID: PMC7793932 DOI: 10.3389/fpsyg.2020.612366] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 11/11/2020] [Indexed: 01/10/2023] Open
Abstract
Neurological diseases, particularly in the context of aging, have serious impacts on quality of life and can negatively affect bone health. The brain-bone axis is critically important for skeletal metabolism, sensory innervation, and endocrine cross-talk between these organs. This review discusses current evidence for the cellular and molecular mechanisms by which various neurological disease categories, including autoimmune, developmental, dementia-related, movement, neuromuscular, stroke, trauma, and psychological, impart changes in bone homeostasis and mass, as well as fracture risk. Likewise, how bone may affect neurological function is discussed. Gaining a better understanding of brain-bone interactions, particularly in patients with underlying neurological disorders, may lead to development of novel therapies and discovery of shared risk factors, as well as highlight the need for broad, whole-health clinical approaches toward treatment.
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Affiliation(s)
- Ryan R. Kelly
- Research Services, Ralph H. Johnson VA Medical Center, Charleston, SC, United States
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Sara J. Sidles
- Research Services, Ralph H. Johnson VA Medical Center, Charleston, SC, United States
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Amanda C. LaRue
- Research Services, Ralph H. Johnson VA Medical Center, Charleston, SC, United States
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, United States
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