Skip to main content

Sarcopenia

  • Chapter
  • First Online:
Handbook of Clinical Nutrition and Aging

Part of the book series: Nutrition and Health ((NH))

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 199.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Rosenberg IR. Summary comments. Am J Clin Nutr 1989;50:1231–3.

    Google Scholar 

  2. Janssen I, Heymsfield SB, Wang ZM, Ross R. Skeletal muscle mass and distribution in 468 men and women aged 18–88 yr. J Appl Physiol 2000;89(1):81–8.

    PubMed  CAS  Google Scholar 

  3. Frontera WR, Hughes VA, Lutz KJ, Evans WJ. A cross-sectional study of muscle strength and mass in 45- to 78-yr-old men and women. J Appl Physiol 1991;71(2):644–50.

    PubMed  CAS  Google Scholar 

  4. Ellis KJ, Shukla KK, Cohn SH, Pierson RN. A predictor for total body potassium in man based on height, weight, sex and age: applications in metabolic disorders. J Lab Clin Med 1974;83(5):716–27.

    PubMed  CAS  Google Scholar 

  5. Novak LP. Aging, total body potassium, fat-free mass, and cell mass in males and females between ages 18 and 85 years. J Gerontol 1972;27(4):438–43.

    Article  PubMed  CAS  Google Scholar 

  6. Tzankoff SP, Norris AH. Effect of muscle mass decrease on age-related BMR changes. J Appl Physiol 1977;43(6):1001–6.

    PubMed  CAS  Google Scholar 

  7. Larsson L, Sjodin B, Karlsson J. Histochemical and biochemical changes in human skeletal muscle with age in sedentary males, age 22–65 years. Acta Physiol Scand 1978;103(1):31–9.

    Article  PubMed  CAS  Google Scholar 

  8. Lexell J. Human aging, muscle mass, and fiber type composition. J Gerontol A Biol Sci Med Sci 1995;50 Spec No:11–6.

    Google Scholar 

  9. Lynch NA, Metter EJ, Lindle RS, et al. Muscle quality. I. Age-associated differences between arm and leg muscle groups. J Appl Physiol 1999;86(1):188–94.

    PubMed  CAS  Google Scholar 

  10. Gallagher D, Visser M, De Meersman RE, et al. Appendicular skeletal muscle mass: effects of age, gender, and ethnicity. J Appl Physiol 1997;83(1):229–39.

    PubMed  CAS  Google Scholar 

  11. Greig CA, Botella J, Young A. The quadriceps strength of healthy elderly people remeasured after eight years. Muscle Nerve 1993;16(1):6–10.

    Article  PubMed  CAS  Google Scholar 

  12. Frontera WR, Hughes VA, Fielding RA, Fiatarone MA, Evans WJ, Roubenoff R. Aging of skeletal muscle: a 12-yr longitudinal study. J Appl Physiol 2000;88(4):1321–6.

    PubMed  CAS  Google Scholar 

  13. Aniansson A, Hedberg M, Henning GB, Grimby G. Muscle morphology, enzymatic activity, and muscle strength in elderly men: a follow-up study. Muscle Nerve 1986;9(7):585–91.

    Article  PubMed  CAS  Google Scholar 

  14. Forbes GB, Reina JC. Adult lean body mass declines with age: some longitudinal observations. Metabolism 1970;19(9):653–63.

    Article  PubMed  CAS  Google Scholar 

  15. Flynn MA, Nolph GB, Baker AS, Martin WM, Krause G. Total body potassium in aging humans: a longitudinal study. Am J Clin Nutr 1989;50(4):713–7.

    PubMed  CAS  Google Scholar 

  16. Janssen I, Ross R. Linking age-related changes in skeletal muscle mass and composition with metabolism and disease. J Nutr Health Aging 2005;9:408–19.

    PubMed  CAS  Google Scholar 

  17. Grimby G. Muscle performance and structure in the elderly as studied cross-sectionally and longitudinally. J Gerontol A Biol Sci Med Sci 1995;50 Spec No:17–22.

    PubMed  Google Scholar 

  18. Bemben MG, Massey BH, Bemben DA, Misner JE, Boileau RA. Isometric muscle force production as a function of age in healthy 20- to 74-yr-old men. Med Sci Sports Exerc 1991;23(11):1302–10.

    PubMed  CAS  Google Scholar 

  19. Bemben MG, Massey BH, Bemben DA, Misner JE, Boileau RA. Isometric intermittent endurance of four muscle groups in men aged 20–74 yr. Med Sci Sports Exerc 1996;28(1):145–54.

    Article  PubMed  CAS  Google Scholar 

  20. Bennett KM. Gender and longitudinal changes in physical activities in later life. Age Ageing 1998;27 Suppl 3:24–8.

    Article  PubMed  Google Scholar 

  21. Westerterp KR. Daily physical activity and ageing. Curr Opin Clin Nutr Metab Care 2000;3(6):485–8.

    Article  PubMed  CAS  Google Scholar 

  22. Baumgartner RN, Koehler KM, Gallagher D, et al. Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol 1998;147(8):755–63.

    Article  PubMed  CAS  Google Scholar 

  23. Janssen I, Heymsfield SB, Ross R. Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. J Am Geriatr Soc 2002;50(5):889–96.

    Article  PubMed  Google Scholar 

  24. Melton LJ, 3rd, Khosla S, Crowson CS, O'Connor MK, O'Fallon WM, Riggs BL. Epidemiology of sarcopenia. J Am Geriatr Soc 2000;48(6):625–30.

    PubMed  Google Scholar 

  25. Tanko LB, Movsesyan L, Mouritzen U, Christiansen C, Svendsen OL. Appendicular lean tissue mass and the prevalence of sarcopenia among healthy women. Metabolism 2002;51(1): 69–74.

    Article  PubMed  CAS  Google Scholar 

  26. Janssen I, Baumgartner RN, Ross R, Rosenberg IR, Roubenoff R. Skeletal muscle cutpoints associated with elevated physical disability risk in older men and women. Am J Epidemiol 2004;159(4):413–21.

    Article  PubMed  Google Scholar 

  27. Harries UJ, Bassey EJ. Torque-velocity relationships for the knee extensors in women in their 3rd and 7th decades. Eur J Appl Physiol Occup Physiol 1990;60(3):187–90.

    Article  PubMed  CAS  Google Scholar 

  28. Brooks SV, Faulkner JA. Skeletal muscle weakness in old age: underlying mechanisms. Med Sci Sports Exerc 1994;26(4):432–9.

    PubMed  CAS  Google Scholar 

  29. Metter EJ, Lynch N, Conwit R, Lindle R, Tobin J, Hurley B. Muscle quality and age: cross-sectional and longitudinal comparisons. J Gerontol A Biol Sci Med Sci 1999;54(5):B207–18.

    Article  PubMed  CAS  Google Scholar 

  30. Frontera WR, Suh D, Krivickas LS, Hughes VA, Goldstein R, Roubenoff R. Skeletal muscle fiber quality in older men and women. Am J Physiol Cell Physiol 2000;279(3):C611–8.

    PubMed  CAS  Google Scholar 

  31. Doherty TJ, Vandervoort AA, Brown WF. Effects of ageing on the motor unit: a brief review. Can J Appl Physiol 1993;18(4):331–58.

    Article  PubMed  CAS  Google Scholar 

  32. Tomlinson BE, Irving D. The numbers of limb motor neurons in the human lumbosacral cord throughout life. J Neurol Sci 1977;34(2):213–9.

    Article  PubMed  CAS  Google Scholar 

  33. Roos MR, Rice CL, Connelly DM, Vandervoort AA. Quadriceps muscle strength, contractile properties, and motor unit firing rates in young and old men. Muscle Nerve 1999;22(8):1094–103.

    Article  PubMed  CAS  Google Scholar 

  34. Rosow I, Breslau N. A Guttman health scale for the aged. J Gerontol 1966;21(4):556–9.

    Article  PubMed  CAS  Google Scholar 

  35. Nagi SZ. An epidemiology of disability among adults in the United States. Milbank Mem Fund Q Health Soc 1976;54(4):439–67.

    Article  PubMed  CAS  Google Scholar 

  36. Newman AB, Kupelian V, Visser M, et al. Sarcopenia: alternative definitions and associations with lower extremity function. J Am Geriatr Soc 2003;51(11):1602–9.

    Article  PubMed  Google Scholar 

  37. Visser M, Goodpaster BH, Kritchevsky SB, et al. Muscle mass, muscle strength, and muscle fat infiltration as predictors of incident mobility limitations in well-functioning older persons. J Gerontol A Biol Sci Med Sci 2005;60(3):324–33.

    Article  PubMed  Google Scholar 

  38. Goodpaster BH, Park SW, Harris TB, et al. The loss of skeletal muscle strength, mass, and quality in older adults: the health, aging and body composition study. J Gerontol A Biol Sci Med Sci 2006;61(10):1059–64.

    Article  PubMed  Google Scholar 

  39. Janssen I. Influence of sarcopenia on the development of physical disability: the Cardiovascular Health Study. J Am Geriatr Soc 2006;54(1):56–62.

    Article  PubMed  Google Scholar 

  40. Lammes E, Akner G. Resting metabolic rate in elderly nursing home patients with multiple diagnoses. J Nutr Health Aging 2006;10(4):263–70.

    PubMed  CAS  Google Scholar 

  41. Karakelides H, Sreekumaran Nair K. Sarcopenia of aging and its metabolic impact. Curr Top Dev Biol 2005;68:123–48.

    Article  PubMed  CAS  Google Scholar 

  42. Aubertin-Leheudre M, Lord C, Goulet ED, Khalil A, Dionne IJ. Effect of sarcopenia on cardiovascular disease risk factors in obese postmenopausal women. Obesity (Silver Spring) 2006;14(12):2277–83.

    Article  Google Scholar 

  43. Visser M, Harris TB, Langlois J, et al. Body fat and skeletal muscle mass in relation to physical disability in very old men and women of the Framingham Heart Study. J Gerontol A Biol Sci Med Sci 1998;53(3):M214–21.

    Article  PubMed  CAS  Google Scholar 

  44. Blain H, Vuillemin A, Teissier A, Hanesse B, Guillemin F, Jeandel C. Influence of muscle strength and body weight and composition on regional bone mineral density in healthy women aged 60 years and over. Gerontology 2001;47(4):207–12.

    Article  PubMed  CAS  Google Scholar 

  45. Gillette-Guyonnet S, Nourhashemi F, Lauque S, Grandjean H, Vellas B. Body composition and osteoporosis in elderly women. Gerontology 2000;46(4):189–93.

    Article  PubMed  CAS  Google Scholar 

  46. Walsh MC, Hunter GR, Livingstone MB. Sarcopenia in premenopausal and postmenopausal women with osteopenia, osteoporosis and normal bone mineral density. Osteoporos Int 2006;17(1):61–7.

    Article  PubMed  Google Scholar 

  47. Friedman J, Campbell AJ, Caradoc-Davies TH. Prospective trial of new diagnostic criteria for severe wasting malnutrition in the elderly. Age Ageing 1985;14:149–54.

    Article  PubMed  CAS  Google Scholar 

  48. Miller MD, Crotty M, Giles LC, et al. Corrected arm muscle area: an independent predictor of long-term mortality in community-dwelling older adults? J Am Geriatr Soc 2002;50(7):1272–7.

    Article  PubMed  Google Scholar 

  49. Prothro JW, Rosenbloom CA. Body measurements of black and white elderly persons with emphasis on body composition. Gerontology 1995;41(1):22–38.

    Article  PubMed  CAS  Google Scholar 

  50. Muhlethaler R, Stuck AE, Minder CE, Frey BM. The prognostic significance of protein-energy malnutrition in geriatric patients. Age Ageing 1995;24(3):193–7.

    Article  PubMed  CAS  Google Scholar 

  51. Cosqueric G, Sebag A, Ducolombier C, Thomas C, Piette F, Weill-Engerer S. Sarcopenia is predictive of nosocomial infection in care of the elderly. Br J Nutr 2006;96(5):895–901.

    Article  PubMed  CAS  Google Scholar 

  52. Chandra RK. Protein-energy malnutrition and immunological responses. J Nutr 1992;122 (3 Suppl):597–600.

    PubMed  CAS  Google Scholar 

  53. Levin K, Daa Schroeder H, Alford FP, Beck-Nielsen H. Morphometric documentation of abnormal intramyocellular fat storage and reduced glycogen in obese patients with Type II diabetes. Diabetologia 2001;44(7):824–33.

    Article  PubMed  CAS  Google Scholar 

  54. Vock R, Hoppeler H, Claassen H, et al. Design of the oxygen and substrate pathways. VI. structural basis of intracellular substrate supply to mitochondria in muscle cells. J Exp Biol 1996;199 (Pt 8):1689–97.

    PubMed  CAS  Google Scholar 

  55. Tsubahara A, Chino N, Akaboshi K, Okajima Y, Takahashi H. Age-related changes of water and fat content in muscles estimated by magnetic resonance (MR) imaging. Disabil Rehabil 1995;17(6):298–304.

    Article  PubMed  CAS  Google Scholar 

  56. Forsberg AM, Nilsson E, Werneman J, Bergstrom J, Hultman E. Muscle composition in relation to age and sex. Clin Sci (Lond) 1991;81(2):249–56.

    CAS  Google Scholar 

  57. Rice CL, Cunningham DA, Paterson DH, Lefcoe MS. Arm and leg composition determined by computed tomography in young and elderly men. Clin Physiol 1989;9(3):207–20.

    Article  PubMed  CAS  Google Scholar 

  58. Overend TJ, Cunningham DA, Paterson DH, Lefcoe MS. Thigh composition in young and elderly men determined by computed tomography. Clin Physiol 1992;12(6):629–40.

    Article  PubMed  CAS  Google Scholar 

  59. Goodpaster BH, Kelley DE, Thaete FL, He J, Ross R. Skeletal muscle attenuation determined by computed tomography is associated with skeletal muscle lipid content. J Appl Physiol 2000;89(1):104–10.

    PubMed  CAS  Google Scholar 

  60. Visser M, Kritchevsky SB, Goodpaster BH, et al. Leg muscle mass and composition in relation to lower extremity performance in men and women aged 70–79: the health, aging and body composition study. J Am Geriatr Soc 2002;50(5):897–904.

    Article  PubMed  Google Scholar 

  61. Askanas V, Engel WK. Distinct subtypes of type I fibers of human skeletal muscle. Neurology 1975;25(9):879–87.

    Article  PubMed  CAS  Google Scholar 

  62. Malenfant P, Joanisse DR, Theriault R, Goodpaster BH, Kelley DE, Simoneau JA. Fat content in individual muscle fibers of lean and obese subjects. Int J Obes Relat Metab Disord 2001;25(9):1316–21.

    Article  PubMed  CAS  Google Scholar 

  63. Rousset S, Patureau Mirand P, Brandolini M, Martin JF, Boirie Y. Daily protein intakes and eating patterns in young and elderly French. Br J Nutr 2003;90(6):1107–15.

    Article  PubMed  CAS  Google Scholar 

  64. Morley JE. Anorexia of aging: physiologic and pathologic. Am J Clin Nutr 1997;66(4):760–73.

    PubMed  CAS  Google Scholar 

  65. Campbell WW, Trappe TA, Wolfe RR, Evans WJ. The recommended dietary allowance for protein may not be adequate for older people to maintain skeletal muscle. J Gerontol A Biol Sci Med Sci 2001;56(6):M373–80.

    Article  PubMed  CAS  Google Scholar 

  66. Morse MH, Haub MD, Evans WJ, Campbell WW. Protein requirement of elderly women: nitrogen balance responses to three levels of protein intake. J Gerontol A Biol Sci Med Sci 2001;56(11):M724–30.

    Article  PubMed  CAS  Google Scholar 

  67. Lauque S, Arnaud-Battandier F, Mansourian R, et al. Protein-energy oral supplementation in malnourished nursing-home residents. A controlled trial. Age Ageing 2000;29(1):51–6.

    Article  PubMed  CAS  Google Scholar 

  68. Fiatarone-Singh MA, Bernstein MA, Ryan AD, O'Neill EF, Clements KM, Evans WJ. The effect of oral nutritional supplements on habitual dietary quality and quantity in frail elders. J Nutr Health Aging 2000;4(1):5–12.

    PubMed  CAS  Google Scholar 

  69. Walrand S, Boirie Y. Optimizing protein intake in aging. Curr Opin Clin Nutr Metab Care 2005;8(1):89–94.

    Article  PubMed  CAS  Google Scholar 

  70. Fujita S, Volpi E. Amino acids and muscle loss with aging. J Nutr 2006;136(1 Suppl):277S–80S.

    PubMed  CAS  Google Scholar 

  71. Paddon-Jones D, Sheffield-Moore M, Katsanos CS, Zhang XJ, Wolfe RR. Differential stimulation of muscle protein synthesis in elderly humans following isocaloric ingestion of amino acids or whey protein. Exp Gerontol 2006;41(2):215–9.

    Article  PubMed  CAS  Google Scholar 

  72. Ferrucci L, Harris TB, Guralnik JM, et al. Serum IL-6 level and the development of disability in older persons. J Am Geriatr Soc 1999;47(6):639–46.

    PubMed  CAS  Google Scholar 

  73. Semba RD, Lauretani F, Ferrucci L. Carotenoids as protection against sarcopenia in older adults. Arch Biochem Biophys 2007;458(2):141–5.

    Article  PubMed  CAS  Google Scholar 

  74. Klitgaard H, Mantoni M, Schiaffino S, et al. Function, morphology and protein expression of ageing skeletal muscle: a cross-sectional study of elderly men with different training backgrounds. Acta Physiol Scand 1990;140(1):41–54.

    Article  PubMed  CAS  Google Scholar 

  75. Melichna J, Zauner CW, Havlickova L, Novak J, Hill DW, Colman RJ. Morphologic differences in skeletal muscle with age in normally active human males and their well-trained counterparts. Hum Biol 1990;62(2):205–20.

    PubMed  CAS  Google Scholar 

  76. Hurley BF, Redmond RA, Pratley RE, Treuth MS, Rogers MA, Goldberg AP. Effects of strength training on muscle hypertrophy and muscle cell disruption in older men. Int J Sports Med 1995;16(6):378–84.

    Article  PubMed  CAS  Google Scholar 

  77. Fiatarone MA, O'Neill EF, Ryan ND, et al. Exercise training and nutritional supplementation for physical frailty in very elderly people. N Engl J Med 1994;330(25):1769–75.

    Article  PubMed  CAS  Google Scholar 

  78. Brown AB, McCartney N, Sale DG. Positive adaptations to weight-lifting training in the elderly. J Appl Physiol 1990;69(5):1725–33.

    PubMed  CAS  Google Scholar 

  79. Grimby G, Aniansson A, Hedberg M, Henning GB, Grangard U, Kvist H. Training can improve muscle strength and endurance in 78- to 84-yr-old men. J Appl Physiol 1992;73(6):2517–23.

    PubMed  CAS  Google Scholar 

  80. Roman WJ, Fleckenstein J, Stray-Gundersen J, Alway SE, Peshock R, Gonyea WJ. Adaptations in the elbow flexors of elderly males after heavy-resistance training. J Appl Physiol 1993;74(2):750–4.

    PubMed  CAS  Google Scholar 

  81. Fiatarone MA, Marks EC, Ryan ND, Meredith CN, Lipsitz LA, Evans WJ. High-intensity strength training in nonagenarians. Effects on skeletal muscle. JAMA 1990;263(22):3029–34.

    Article  PubMed  CAS  Google Scholar 

  82. Frontera WR, Meredith CN, O'Reilly KP, Knuttgen HG, Evans WJ. Strength conditioning in older men: skeletal muscle hypertrophy and improved function. J Appl Physiol 1988;64(3):1038–44.

    PubMed  CAS  Google Scholar 

  83. Tracy BL, Ivey FM, Hurlbut D, et al. Muscle quality. II. Effects Of strength training in 65- to 75-yr-old men and women. J Appl Physiol 1999;86(1):195–201.

    PubMed  CAS  Google Scholar 

  84. Treuth MS, Hunter GR, Kekes-Szabo T, Weinsier RL, Goran MI, Berland L. Reduction in intra-abdominal adipose tissue after strength training in older women. J Appl Physiol 1995;78(4):1425–31.

    PubMed  CAS  Google Scholar 

  85. Nelson ME, Rejeski WJ, Blair SN, et al. Physical Activity and Public Health in Older Adults. Recommendation From the American College of Sports Medicine and the American Heart Association. Circulation 2007.

    Google Scholar 

  86. Esmarck B, Andersen JL, Olsen S, Richter EA, Mizuno M, Kjaer M. Timing of postexercise protein intake is important for muscle hypertrophy with resistance training in elderly humans. J Physiol 2001;535(Pt 1):301–11.

    Article  PubMed  CAS  Google Scholar 

  87. Meredith CN, Frontera WR, O'Reilly KP, Evans WJ. Body composition in elderly men: effect of dietary modification during strength training. J Am Geriatr Soc 1992;40(2):155–62.

    PubMed  CAS  Google Scholar 

  88. Roubenoff R. Origins and clinical relevance of sarcopenia. Can J Appl Physiol 2001;26(1):78–89.

    Article  PubMed  CAS  Google Scholar 

  89. Borst SE. Interventions for sarcopenia and muscle weakness in older people. Age Ageing 2004;33(6):548–55.

    Article  PubMed  Google Scholar 

  90. Brodsky IG, Balagopal P, Nair KS. Effects of testosterone replacement on muscle mass and muscle protein synthesis in hypogonadal men – a clinical research center study. J Clin Endocrinol Metab 1996;81(10):3469–75.

    Article  PubMed  CAS  Google Scholar 

  91. Urban RJ, Bodenburg YH, Gilkison C, et al. Testosterone administration to elderly men increases skeletal muscle strength and protein synthesis. Am J Physiol 1995;269(5 Pt 1):E820–6.

    PubMed  CAS  Google Scholar 

  92. Ottenbacher KJ, Ottenbacher ME, Ottenbacher AJ, Acha AA, Ostir GV. Androgen treatment and muscle strength in elderly men: A meta-analysis. J Am Geriatr Soc 2006;54(11):1666–73.

    Article  PubMed  Google Scholar 

  93. Dionne IJ, Kinaman KA, Poehlman ET. Sarcopenia and muscle function during menopause and hormone-replacement therapy. J Nutr Health Aging 2000;4(3):156–61.

    PubMed  CAS  Google Scholar 

  94. Yen SS, Morales AJ, Khorram O. Replacement of DHEA in aging men and women. Potential remedial effects. Ann N Y Acad Sci 1995;774:128–42.

    Article  PubMed  CAS  Google Scholar 

  95. Balagopal P, Proctor D, Nair KS. Sarcopenia and hormonal changes. Endocrine 1997;7(1):57–60.

    Article  PubMed  CAS  Google Scholar 

  96. Williams MJ, Hunter GR, Kekes-Szabo T, et al. Intra-abdominal adipose tissue cut-points related to elevated cardiovascular risk in women. Int J Obes Relat Metab Disord 1996;20(7):613–7.

    PubMed  CAS  Google Scholar 

  97. Zoico E, Di Francesco V, Guralnik JM, et al. Physical disability and muscular strength in relation to obesity and different body composition indexes in a sample of healthy elderly women. Int J Obes Relat Metab Disord 2004;28(2):234–41.

    PubMed  CAS  Google Scholar 

  98. Davison KK, Ford ES, Cogswell ME, Dietz WH. Percentage of body fat and body mass index are associated with mobility limitations in people aged 70 and older from NHANES III. J Am Geriatr Soc 2002;50(11):1802–9.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2009 Humana Press, a part of Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Janssen, I. (2009). Sarcopenia. In: Bales, C., Ritchie, C. (eds) Handbook of Clinical Nutrition and Aging. Nutrition and Health. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60327-385-5_10

Download citation

  • DOI: https://doi.org/10.1007/978-1-60327-385-5_10

  • Published:

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-60327-384-8

  • Online ISBN: 978-1-60327-385-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics