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It may occur because of blood turbulence near areasof arterial narrowing (such as carotid bruits), near areasof abnormal blood flow (such as arteriovenous malforma-tions, carotid-cavernous fistulas, or vascular tumors), byincreased blood flow (such as anemia, thyrotoxicosis, orhypertension treated with agents that lower peripheralvascular resistance), by transmission of heart sounds (suchas aortic stenosis or mechanical heart valves), or as a resultof intracranial hypertension (Sismanis, 1998, Jun et al.,2003; Sismanis, 2003).

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I may not be able to give thrillingscenes of sex and car chases, but I do include historical background, curi-ous folklore, and patients’ anecdotal accounts, which will provide someentertainment as you become increasingly familiarized and comfortablewith the language and methods of science. Due tothe increasing age of the population,in addition to those areas of comor-bidity already mentioned for ODD,youth with CD also have high comor-bid associations with substance abuseand depression. When expression of NFATc1 is inhibited T cell proliferationceases.

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