Skip to main content
SpringerLink
Log in

Treatment of Risk Factors and Antiplatelet Therapy

  • Chapter
Peripheral Arterial Disease

Part of the book series: Contemporary Cardiology ((CONCARD))

  • 190 Accesses

Abstract

The factors that predispose to atherosclerotic disease of the lower extremity arteries have been evaluated in numerous case-control and prospective studies. Data continue to accumulate that modification of these risk factors is essential to prevent progression of disease, not only in the lower extremities, but also in the coronary and cerebrovascular systems. The following sections detail these risk factors and medical strategies for modification of atherosclerotic disease risk.

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

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Erb W. Beiträge zur Pathologic des intermittierenden Hinkens. Munch Med Wschr 1911; 2: 2487.

    Google Scholar 

  2. Schroll M, Munck O. Estimation of peripheral arteriosclerotic disease by ankle blood pressure measurements in a population study of 60-year-old men and women. J Chronic Dis 1981; 34: 261–269.

    Article  PubMed  CAS  Google Scholar 

  3. Hughson WG, Mann JI, Garrod A. Intermittent claudication: prevalence and risk factors. Br Med J 1978; 1: 1379–1381.

    Article  PubMed  CAS  Google Scholar 

  4. Reunanen A, Takkunen H, Aromaa A. Prevalence of intermittent claudication and its effect on mortality. Acta Med Scand 1982; 211: 249–256.

    Article  PubMed  CAS  Google Scholar 

  5. Kannel WB, McGee DL. Update on some epidemiologic features of intermittent claudication: the Framingham Study. J Am Geriatr Soc 1985; 33: 13–18.

    PubMed  CAS  Google Scholar 

  6. Gofin R, Kark JD, Friedlander Y, et al. Peripheral vascular disease in a middle-aged population sample: the Jerusalem Lipid Research Clinic Prevalence Study. Isr J Med Sci 1987; 23: 157–167.

    PubMed  CAS  Google Scholar 

  7. Kannel WB, McGee DL. Diabetes and cardiovascular disease: the Framingham study. JAMA 1979; 241: 2035–2038.

    Article  PubMed  CAS  Google Scholar 

  8. Murabito JM, D’Agostino RB, Silbershatz H, Wilson WE Intermittent claudication: a risk profile from the Framingham Heart Study. Circulation 1997; 96: 44–49.

    Article  PubMed  CAS  Google Scholar 

  9. Kannel WB. Risk factors for atherosclerotic cardiovascular outcomes in different arterial territories. J Cardiovasc Risk 1994; 1: 333–339.

    Article  PubMed  CAS  Google Scholar 

  10. Criqui MH, Browner D, Fronek A, et al. Peripheral arterial disease in large vessels is epidemiologically distinct from small vessel disease: an analysis of risk factors. Am J Epidemiol 1989; 129: 1110–1119.

    PubMed  CAS  Google Scholar 

  11. Gordon T, Kannel WB. Predisposition to atherosclerosis in the head, heart, and legs: the Framingham study. JAMA 1972; 221: 661–666.

    Article  PubMed  CAS  Google Scholar 

  12. Freund KM, Belanger AJ, D’Agostino RB, Kannel WB. The health risks of smoking: the Framingham Study: 34 years of follow-up. Ann Epidemiol 1993; 3: 417–424.

    Article  PubMed  CAS  Google Scholar 

  13. Ingolfsson IO, Sigurdsson G, Sigvaldason H, Thorgeirsson G, Sigfusson N. A marked decline in the prevalence and incidence of intermittent claudication in Icelandic men 1968–1986: a strong relationship to smoking and serum cholesterol-the Reykjavik Study. J Clin Epidemiol 1994; 47: 1237–1243.

    Article  PubMed  CAS  Google Scholar 

  14. Hirsch AT, Criqui MH, Treat-Jacobson D, et al. Peripheral arterial disease detection, awareness, and treatment in primary care. JAMA 2001; 286: 1317–1324.

    Article  PubMed  CAS  Google Scholar 

  15. Weiss NS. Cigarette smoking and arteriosclerosis obliterans: an epidemiologic approach. Am J Epidemiol 1972; 95: 17–25.

    PubMed  CAS  Google Scholar 

  16. Lepantalo M, Lassila R. Smoking and occlusive peripheral arterial disease. Clinical review. Eur J Surg 1991; 15783–15787.

    Google Scholar 

  17. Jonason T, Bergstrom R. Cessation of smoking in patients with intermittent claudication: effects on the risk of peripheral vascular complications, myocardial infarction and mortality. Acta Med Scand 1987; 221: 253–260.

    Article  PubMed  CAS  Google Scholar 

  18. Powell JT, Edwards RJ, Worrell PC, Franks PJ, Greenhalgh RM, Poulter NR. Risk factors associated with the development of peripheral arterial disease in smokers: a case-control study. Atherosclerosis 1997; 129: 41–48.

    Article  PubMed  CAS  Google Scholar 

  19. Smith GD, Shipley MJ, Rose G. Intermittent claudication, heart disease risk factors, and mortality: the Whitehall Study. Circulation 1990; 82: 1925–1931.

    Article  PubMed  CAS  Google Scholar 

  20. Bowlin SJ, Medalie JH, Flocke SA, Zyzanski SJ, Goldbourt U. Epidemiology of intermittent claudication in middle-aged men. Am J Epidemiol 1994; 140: 418–430.

    PubMed  CAS  Google Scholar 

  21. Gardner AW. The effect of cigarette smoking on exercise capacity in patients with intermittent claudication. Vasc Med 1996; 1: 181–186.

    PubMed  CAS  Google Scholar 

  22. Ameli FM, Stein M, Provan JL, Prosser R. The effect of postoperative smoking on femoropopliteal bypass grafts. Ann Vasc Surg 1989; 3: 20–25.

    Article  PubMed  CAS  Google Scholar 

  23. Girolami B, Bernardi E, Prins MH, et al. Treatment of intermittent claudication with physical training, smoking cessation, pentoxifylline, or nafronyl: a meta-analysis. Arch Intern Med 1999; 159: 337–345.

    Article  PubMed  CAS  Google Scholar 

  24. Quick CR, Cotton LT. The measured effect of stopping smoking on intermittent claudication. Br J Surg 1982; 69 (Suppl): S24 - S26.

    Article  PubMed  Google Scholar 

  25. Hirsch AT, Treat-Jacobson D, Lando HA, Hatsukami DK. The role of tobacco cessation, antiplatelet and lipid-lowering therapies in the treatment of peripheral arterial disease. Vasc Med 1997; 2: 243–251.

    PubMed  CAS  Google Scholar 

  26. Faulkner KW, House AK, Castleden WM. The effect of cessation of smoking on the accumulative survival rates of patients with symptomatic peripheral vascular disease. Med J Aust 1983; 1: 217–219.

    PubMed  CAS  Google Scholar 

  27. Heeschen C, Jang JJ, Weis M, et al. Nicotine stimulates angiogenesis and promotes tumor growth and atherosclerosis. Nat Med 2001; 7: 833–839.

    Article  PubMed  CAS  Google Scholar 

  28. Hurt RD, Sachs DP, Glover ED, et al. A comparison of sustained-release bupropion and placebo for smoking cessation. N Engl J Med 1997; 337: 1195–1202.

    Article  PubMed  CAS  Google Scholar 

  29. Anonymous. American Diabetes Association Website. www.diabetes.org/ada/facts.asp, editor. 2001.

    Google Scholar 

  30. Fowkes FG, Housley E, Riemersma RA, et al. Smoking, lipids, glucose intolerance, and blood pressure as risk factors for peripheral atherosclerosis compared with ischemic heart disease in the Edinburgh Artery Study. Am J Epidemiol 1992; 135: 331–340.

    PubMed  CAS  Google Scholar 

  31. Brand FN, Abbott RD, Kannel WB. Diabetes, intermittent claudication, and risk of cardiovascular events: the Framingham Study. Diabetes 1989; 38: 504–509.

    Article  PubMed  CAS  Google Scholar 

  32. Nathan DM. Long-term complications of diabetes mellitus. N Engl J Med 1993; 328: 1676–1685.

    Article  PubMed  CAS  Google Scholar 

  33. Everhart JE, Pettitt DJ, Knowler WC, Rose FA, Bennett PH. Medial arterial calcification and its association with mortality and complications of diabetes. Diabetologia 1988; 31: 16–23.

    PubMed  CAS  Google Scholar 

  34. Mozes G, Keresztury G, Kadar A, et al. Atherosclerosis in amputated legs of patients with and without diabetes mellitus. Int Angiol 1998; 17: 282–286.

    PubMed  CAS  Google Scholar 

  35. Edmonds ME. Medial arterial calcification and diabetes mellitus. Z Kardiol 2000; 89 (Suppl 2): 101–104.

    Article  PubMed  Google Scholar 

  36. Goldenberg S, Alex M, Joshi RA, Blumenthal HT. Nonatheromatous peripheral vascular disease of the lower extremity in diabetes mellitus. Diabetes 1959; 8: 261–273.

    PubMed  CAS  Google Scholar 

  37. Strandness DE, Priest RE, Gibbons GE. A combined clinical and pathologic study of diabetic and non-diabetic peripheral arterial disease. Diabetes 1964; 13: 366–372.

    PubMed  Google Scholar 

  38. Conrad MC. Large and small artery occlusion in diabetics and nondiabetics with severe vascular disease. Circulation 1967; 36: 83–91.

    Article  PubMed  CAS  Google Scholar 

  39. Barner HB, Kaiser GC, Willman VL. Blood flow in the diabetic leg. Circulation 1971; 43: 391–394.

    Article  PubMed  CAS  Google Scholar 

  40. Beach KW, Brunzell JD, Strandness DE Jr. Prevalence of severe arteriosclerosis obliterans in patients with diabetes mellitus: relation to smoking and form of therapy. Arteriosclerosis 1982; 2: 275–280.

    Article  PubMed  CAS  Google Scholar 

  41. McDaniel MD, Cronenwett JL. Basic data related to the natural history of intermittent claudication. Ann Vasac Surg 1989; 3: 273–277.

    Article  CAS  Google Scholar 

  42. Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes 1988; 37: 1595–1607.

    Google Scholar 

  43. Juhan-Vague I, Alessi MC, Vague P. Increased plasma plasminogen activator inhibitor 1 levels: a possible link between insulin resistance and atherothrombosis. Diabetologia 1991; 34: 457–462.

    Article  PubMed  CAS  Google Scholar 

  44. Juhan-Vague I, Roul C, Alessi MC, Ardissone JP, Heim M, Vague P. Increased plasminogen activator inhibitor activity in non insulin dependent diabetic patients-relationship with plasma insulin. Thromb Haemost 1989; 61: 370–373.

    PubMed  CAS  Google Scholar 

  45. UK Prospective Diabetes Study Group. The UK Prospective Diabetes Study. Lancet 1998; 352: 837–853.

    Article  Google Scholar 

  46. Fegan G, Ward D, Clarke L, MacLeod K, Hattersley A. The HOPE study and diabetes: Heart Outcomes Prevention Evaluation. Lancet 2000; 355: 1182–1183.

    Article  PubMed  CAS  Google Scholar 

  47. Heart Outcomes Prevention Evaluation Study Investigators. Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes mellitus: results of the HOPE study and MICRO-HOPE substudy. Lancet 2000; 355: 253–259.

    Google Scholar 

  48. Jelnes R, Gaardsting O, Hougaard JK, Baekgaard N, Tonnesen KH, Schroeder T. Fate in intermittent claudication: outcome and risk factors. Br Med J (Clin Res Ed) 1986; 293: 1137–1140.

    Article  CAS  Google Scholar 

  49. Dormandy JA, Rutherford RB for the TransAtlantic Inter-Society Concensus (TASC) Working Group. Management of peripheral arterial disease (PAD). J Vasc Surg 2000; 31: S1 - S296.

    Google Scholar 

  50. UK Prospective Diabetes Study Group. UKPDS Blood Pressure Study. Br Med J 1998; 317: 703–713.

    Google Scholar 

  51. The sixth report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Arch Intern Med 1997; 157: 2413–2446.

    Google Scholar 

  52. O’Brien E, Staessen JA. Critical appraisal of the JNC VI, WHO/ISH and BHS guidelines for essential hypertension. Expert Opin Pharmacother 2000; 1: 675–682.

    Article  PubMed  Google Scholar 

  53. Cantin B, Moorjani S, Dagenais GR, Lupien PJ. Lipoprotein(a) distribution in a French Canadian population and its relation to intermittent claudication (the Quebec Cardiovascular Study). Am J Cardiol 1995; 75: 1224–1228.

    Article  PubMed  CAS  Google Scholar 

  54. Johansson J, Egberg N, Johnsson H, Carlson LA. Serum lipoproteins and hemostatic function in intermittent claudication. Arterioscler Thromb 1993; 13: 1441–1448.

    Article  PubMed  CAS  Google Scholar 

  55. Hiatt WR, Hoag S, Hamman RE Effect of diagnostic criteria on the prevalence of peripheral arterial disease: the San Luis Valley Diabetes Study. Circulation 1995; 91: 1472–1479.

    Article  PubMed  CAS  Google Scholar 

  56. Mowat BF, Skinner ER, Wilson HM, Leng GC, Fowkes FG, Horrobin D. Alterations in plasma lipids, lipoproteins and high density lipoprotein subfractions in peripheral arterial disease. Atherosclerosis 1997; 131: 161–166.

    Article  PubMed  CAS  Google Scholar 

  57. Brewer HB, Jr., Zech LA, Gregg RE, Schwartz D, Schaefer EJ. NIH conference. Type III hyperlipoproteinemia: diagnosis, molecular defects, pathology, and treatment. Ann Intern Med 1983; 98: 623–640.

    PubMed  Google Scholar 

  58. Blankenhorn DH, Azen SP, Crawford DW, et al. Effects of colestipol-niacin therapy on human femoral atherosclerosis. Circulation 1991; 83: 438–447.

    Article  PubMed  CAS  Google Scholar 

  59. Walldius G, Erikson U, Olsson AG, et al. The effect of probucol on femoral atherosclerosis: the Probucol Quantitative Regression Swedish Trial (PQRST). Am J Cardiol 1994; 74: 875–883.

    Article  PubMed  CAS  Google Scholar 

  60. Buchwald H, Bourdages HR, Campos CT, Nguyen P, Williams SE, Boen JR. Impact of cholesterol reduction on peripheral arterial disease in the Program on the Surgical Control of the Hyperlipidemias (POSCH). Surgery 1996; 120: 672–679.

    Article  PubMed  CAS  Google Scholar 

  61. Scandinavian Simvistatin Survival Study Group. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet 1994; 344: 1383–1389.

    Google Scholar 

  62. Pedersen TR, Kjekshus J, Pyorala K, et al. Effect of simvastatin on ischemic signs and symptoms in the Scandinavian simvastatin survival study (4S). Am J Cardiol 1998; 81: 333–335.

    Article  PubMed  CAS  Google Scholar 

  63. Kroon AA, van Asten WN, Stalenhoef AE Effect of apheresis of low-density lipoprotein on peripheral vascular disease in hypercholesterolemic patients with coronary artery disease. Ann Intern Med 1996; 125: 945–954.

    PubMed  CAS  Google Scholar 

  64. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001; 285: 2486–2497.

    Google Scholar 

  65. Malinow MR, Kang SS, Taylor LM, et al. Prevalence of hyperhomocyst(e)inemia in patients with peripheral arterial occlusive disease. Circulation 1989; 79: 1180–1188.

    Article  PubMed  CAS  Google Scholar 

  66. Kang SS, Wong PW, Malinow MR. Hyperhomocyst(e)inemia as a risk factor for occlusive vascular disease. Annu Rev Nutr 1992; 12: 279–298.

    Article  PubMed  CAS  Google Scholar 

  67. Fermo I, Vigano’ DS, Paroni R, Mazzola G, Calori G, D’Angelo A. Prevalence of moderate hyperhomocysteinemia in patients with early-onset venous and arterial occlusive disease. Ann Intern Med 1995; 123: 747–753.

    PubMed  CAS  Google Scholar 

  68. Ridker PM, Cushman M, Stampfer MJ, Tracy RP, Hennekens CH. Plasma concentration of C-reactive protein and risk of developing peripheral vascular disease. Circulation 1998; 97: 425–428.

    Article  PubMed  CAS  Google Scholar 

  69. Blann AD, Gurney D, Hughes E, Buggins P, Silverman SH, Lip GY. Influence of pravastatin on lipoproteins, and on endothelial, platelet, and inflammatory markers in subjects with peripheral artery disease. Am J Cardiol 2001; 88: 89–92.

    Article  CAS  Google Scholar 

  70. Virchow R. Cellular Pathology: As Based upon Physiological and Pathological Histology. New York: Dover, 1863.

    Google Scholar 

  71. Elkind MS, Lin IF, Grayston JT, Sacco RL. Chlamydia pneumoniae and the risk of first ischemic stroke: the Northern Manhattan Stroke Study. Stroke 2000; 31: 1521–1525.

    Article  PubMed  CAS  Google Scholar 

  72. Siscovick DS, Schwartz SM, Corey L, et al. Chlamydia pneumoniae, herpes simplex virus type 1, and cytomegalovirus and incident myocardial infarction and coronary heart disease death in older adults: the Cardiovascular Health Study. Circulation 2000; 102: 2335–2340.

    Article  PubMed  CAS  Google Scholar 

  73. Muhlestein JB. Chronic infection and coronary artery disease. Med Clin North Am 2000; 84: 123–148.

    Article  PubMed  CAS  Google Scholar 

  74. Bachmaier K, Neu N, de la Maza LM, Pal S, Hessel A, Penninger JM. Chlamydia infections and heart disease linked through antigenic mimicry. Science 1999; 283: 1335–1339.

    Article  PubMed  CAS  Google Scholar 

  75. Benitez RM. Atherosclerosis: an infectious disease? Hosp Pract (Off Ed) 1999;34: 79–6, 89.

    Google Scholar 

  76. Muhlestein JB, Anderson JL, Hammond EH, Zhao L, Trehan S, Schwobe EP, Carlquist JE. Infection with Chlamydia pneumoniae accelerates the development of atherosclerosis and treatment with azithromycin prevents it in a rabbit model. Circulation 1998; 97: 633–636.

    Article  PubMed  CAS  Google Scholar 

  77. Grayston JT. Secondary prevention antibiotic treatment trials for coronary artery disease. Circulation 2000; 102: 1742–1743.

    Article  PubMed  CAS  Google Scholar 

  78. Gupta S, Leatham EW, Carrington D, Mendall MA, Kaski JC, Camm AJ. Elevated Chlamydia pneumoniae antibodies, cardiovascular events, and azithromycin in male survivors of myocardial infarction. Circulation 1997; 96: 404–407.

    Article  PubMed  CAS  Google Scholar 

  79. Gurfinkel E, Bozovich G, Daroca A, Beck E, Mautner B. Randomised trial of roxithromycin in nonQ-wave coronary syndromes: ROXIS Pilot Study. ROXIS Study Group. Lancet 1997; 350: 404–407.

    CAS  Google Scholar 

  80. Muhlestein JB, Anderson JL, Carlquist JF, et al. Randomized secondary prevention trial of azithromycin in patients with coronary artery disease: primary clinical results of the ACADEMIC study. Circulation 2000; 102: 1755–1760.

    Article  PubMed  CAS  Google Scholar 

  81. Dunne M. WIZARD and the design of trials for secondary prevention of atherosclerosis with antibiotics. Am Heart J 1999; 138 (5 Pt 2): S542 - S544.

    Article  PubMed  CAS  Google Scholar 

  82. Kannel WB, Wolf PA, Castelli WP, D’Agostino RB. Fibrinogen and risk of cardiovascular disease: the Framingham Study. JAMA 1987; 258: 1183–1186.

    Article  PubMed  CAS  Google Scholar 

  83. Smith FB, Lee AJ, Hau CM, Rumley A, Lowe GD, Fowkes FG. Plasma fibrinogen, haemostatic factors and prediction of peripheral arterial disease in the Edinburgh Artery Study. Blood Coagul Fibrinolysis 2000; 11: 43–50.

    PubMed  CAS  Google Scholar 

  84. Lee AJ, Fowkes FG, Lowe GD, Connor JM, Rumley A. Fibrinogen, factor VII and PAI-1 genotypes and the risk of coronary and peripheral atherosclerosis: Edinburgh Artery Study. Thromb Haemost 1999; 81: 553–560.

    CAS  Google Scholar 

  85. Smith FB, Lee AJ, Rumley A, Fowkes FG, Lowe GD. Tissue-plasminogen activator, plasminogen activator inhibitor and risk of peripheral arterial disease. Atherosclerosis 1995; 115: 35–43.

    Article  PubMed  CAS  Google Scholar 

  86. Vaughan DE. Angiotensin, fibrinolysis, and vascular homeostasis. Am J Cardiol 2001; 87 (8A): 18C - 24C.

    Article  Google Scholar 

  87. Smith FB, Rumley A, Lee AJ, Leng GC, Fowkes FG, Lowe GD. Haemostatic factors and prediction of ischaemic heart disease and stroke in claudicants. Br J Haematol 1998; 100: 758–763.

    Article  PubMed  CAS  Google Scholar 

  88. Blann AD, Seigneur M, Steiner M, Boisseau MR, McCollum CN. Circulating endothelial cell markers in peripheral vascular disease: relationship to the location and extent of atherosclerotic disease. Eur J Clin Invest 1997; 27: 916–921.

    Article  PubMed  CAS  Google Scholar 

  89. Antiplatelet Trialists’ Collaboration. Collaborative overview of randomised trials of antiplatelet therapy. I. Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. Br Med J 1994; 308: 81–106.

    Google Scholar 

  90. Diener HC, Cunha L, Forbes C, Sivenius J, Smets P, Lowenthal A. European Stroke Prevention Study. 2. Dipyridamole and acetylsalicylic acid in the secondary prevention of stroke. J Neurol Sci 1996; 143: 1–13.

    Article  PubMed  CAS  Google Scholar 

  91. CAPRIE Steering Committee. A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). Lancet 1996; 348: 1329–1339.

    Article  Google Scholar 

  92. Bennett CL, Connors JM, Carwile JM, et al. Thrombotic thrombocytopenic purpura associated with clopidogrel. N Engl J Med 2000; 342: 1773–1777.

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. Emile R. Mohler III MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Medicine, Boston University Medical Center, Boston, MA, USA

    Jay D. Coffman MD  & Robert T. Eberhardt MD  & 

Rights and permissions

Reprints and permissions

Copyright information

© 2003 Springer Science+Business Media New York

About this chapter

Cite this chapter

Mohler, E.R. (2003). Treatment of Risk Factors and Antiplatelet Therapy. In: Coffman, J.D., Eberhardt, R.T. (eds) Peripheral Arterial Disease. Contemporary Cardiology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-331-6_9

Download citation

  • DOI: https://doi.org/10.1007/978-1-59259-331-6_9

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-61737-326-8

  • Online ISBN: 978-1-59259-331-6

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation