Anticholinergic withdrawal and benzhexol treatment in Parkinson's disease

The effects of slow withdrawal of anticholinergic medication and addition of benzhexol (8 mg/day) have been studied in patients with Parkinson's disease on stable levodopa therapy. Withdrawal of anticholinergic drugs led to measurable and often severe deterioration in about two-thirds of patien...

Full description

Saved in:
Bibliographic Details
Published inJournal of neurology, neurosurgery and psychiatry Vol. 36; no. 6; pp. 936 - 941
Main Authors Horrocks, P. M., Vicary, D. J., Rees, J. E., Parkes, J. D., Marsden, C. D.
Format Journal Article
LanguageEnglish
Published England BMJ Publishing Group Ltd 01.12.1973
BMJ Publishing Group LTD
Subjects
Adult
Aged
Dihydroxyphenylalanine - therapeutic use
Disability Evaluation
Drug Synergism
Evaluation Studies as Topic
Female
Humans
Male
Middle Aged
Parasympatholytics - adverse effects
Parasympatholytics - therapeutic use
Parkinson Disease - drug therapy
Placebos
Trihexyphenidyl - therapeutic use
Online AccessGet full text

Cover

Abstract The effects of slow withdrawal of anticholinergic medication and addition of benzhexol (8 mg/day) have been studied in patients with Parkinson's disease on stable levodopa therapy. Withdrawal of anticholinergic drugs led to measurable and often severe deterioration in about two-thirds of patients. Addition of benzhexol produced a slight but definite additional improvement in those patients in whom anticholinergics were withdrawn before the trial. Anticholinergic drugs thus still have a part to play in the treatment of Parkinson's disease, for they produce benefit in addition to that provided by levodopa.
AbstractList The effects of slow withdrawal of anticholinergic medication and addition of benzhexol (8 mg/day) have been studied in patients with Parkinson's disease on stable levodopa therapy. Withdrawal of anticholinergic drugs led to measurable and often severe deterioration in about two-thirds of patients. Addition of benzhexol produced a slight but definite additional improvement in those patients in whom anticholinergics were withdrawn before the trial. Anticholinergic drugs thus still have a part to play in the treatment of Parkinson's disease, for they produce benefit in addition to that provided by levodopa.
Author Vicary, D. J.
Marsden, C. D.
Horrocks, P. M.
Parkes, J. D.
Rees, J. E.
AuthorAffiliation University Department of Neurology, Institute of Psychiatry, King's College Hospital, Denmark Hill, London
AuthorAffiliation_xml – name: University Department of Neurology, Institute of Psychiatry, King's College Hospital, Denmark Hill, London
Author_xml – sequence: 1
  givenname: P. M.
  surname: Horrocks
  fullname: Horrocks, P. M.
– sequence: 2
  givenname: D. J.
  surname: Vicary
  fullname: Vicary, D. J.
– sequence: 3
  givenname: J. E.
  surname: Rees
  fullname: Rees, J. E.
– sequence: 4
  givenname: J. D.
  surname: Parkes
  fullname: Parkes, J. D.
– sequence: 5
  givenname: C. D.
  surname: Marsden
  fullname: Marsden, C. D.
BackLink https://www.ncbi.nlm.nih.gov/pubmed/4772727$$D View this record in MEDLINE/PubMed
BookMark eNqFkMFP2zAUhy3ExArjuOOkSDuwS8pznNjJZRJUozBVbIdtQlwsJ36h7lK72Cmw_fU4alW2E_bhHd6n3_vpOyT71lkk5D2FMaWMny6sXY0ZH_NxxfgeGdGclyljcLNPRgBZljIo4C05DGEBwyurA3KQC5HFPyJXZ7Y3zdx1xqK_M03yaPq59upRdYmyOqnR_p3jk-uS3qPql2j7xNjku_K_jQ3OnoREm4Aq4DvyplVdwOPtPCI_L778mFyms2_Tq8nZLK3zkvZppXLIhC4V1Q1A27AKoc2w5aIA4HWDNWrasqKIdC5oBbooG9qKWkNbAzJ2RD5vclfreom6iY286uTKm6Xyf6RTRv6_sWYu79yDpFCyohoCPm4DvLtfY-jlwq29jZ0lHbSUnIkqUumGarwLwWO7u0BBDuLlIF7GyWUUH_kP_9ba0VvTL3km9Pi0W0ePkgsmCnn9ayJnfDo5n369lRD5Txu-Xi5eOf0M_mqfEA
CODEN JNNPAU
CitedBy_id crossref_primary_10_1016_S1353_8020_95_00044_5
crossref_primary_10_1111_j_1600_0404_1975_tb05769_x
crossref_primary_10_1002_ana_410220415
crossref_primary_10_1212_WNL_56_suppl_5_S1
crossref_primary_10_1517_14740338_2014_931369
crossref_primary_10_1017_S0317167100046436
crossref_primary_10_1212_WNL_0b013e3181a1d44c
crossref_primary_10_1016_S0733_8619_18_30223_8
crossref_primary_10_1517_14656566_4_10_1747
crossref_primary_10_1136_pgmj_51_599_619
crossref_primary_10_1177_003693307602100317
crossref_primary_10_1111_j_1468_1331_2006_01547_x
crossref_primary_10_1002_14651858_CD003735
crossref_primary_10_1007_s00702_024_02799_7
crossref_primary_10_1002_1531_8257_199903_14_2_252__AID_MDS1009_3_0_CO_2_N
Cites_doi 10.1136/jnnp.36.1.10
10.1126/science.166.3907.899
10.1136/bmj.2.5760.487
ContentType Journal Article
Copyright Copyright BMJ Publishing Group LTD Dec 1973
Copyright_xml – notice: Copyright BMJ Publishing Group LTD Dec 1973
DBID BSCLL
CGR
CUY
CVF
ECM
EIF
NPM
AAYXX
CITATION
3V.
7RV
7X7
7XB
88E
88G
88I
8AF
8FI
8FJ
8FK
ABUWG
AFKRA
AZQEC
BENPR
BTHHO
CCPQU
DWQXO
FYUFA
GHDGH
GNUQQ
HCIFZ
K9.
KB0
M0S
M1P
M2M
M2P
NAPCQ
PQEST
PQQKQ
PQUKI
PRINS
PSYQQ
Q9U
5PM
DOI 10.1136/jnnp.36.6.936
DatabaseName Istex
Medline
MEDLINE
MEDLINE (Ovid)
MEDLINE
MEDLINE
PubMed
CrossRef
ProQuest Central (Corporate)
Nursing & Allied Health Database
Health & Medical Collection
ProQuest Central (purchase pre-March 2016)
Medical Database (Alumni Edition)
Psychology Database (Alumni)
Science Database (Alumni Edition)
STEM Database
Hospital Premium Collection
Hospital Premium Collection (Alumni Edition)
ProQuest Central (Alumni) (purchase pre-March 2016)
ProQuest Central (Alumni)
ProQuest Central UK/Ireland
ProQuest Central Essentials
ProQuest Central
BMJ Journals
ProQuest One Community College
ProQuest Central Korea
Health Research Premium Collection
Health Research Premium Collection (Alumni)
ProQuest Central Student
SciTech Premium Collection
ProQuest Health & Medical Complete (Alumni)
Nursing & Allied Health Database (Alumni Edition)
Health & Medical Collection (Alumni Edition)
Medical Database
Psychology Database
Science Database (ProQuest)
Nursing & Allied Health Premium
ProQuest One Academic Eastern Edition (DO NOT USE)
ProQuest One Academic
ProQuest One Academic UKI Edition
ProQuest Central China
ProQuest One Psychology
ProQuest Central Basic
PubMed Central (Full Participant titles)
DatabaseTitle MEDLINE
Medline Complete
MEDLINE with Full Text
PubMed
MEDLINE (Ovid)
CrossRef
ProQuest One Psychology
ProQuest Central Student
ProQuest Central Essentials
ProQuest Health & Medical Complete (Alumni)
ProQuest AP Science
ProQuest Central (Alumni Edition)
SciTech Premium Collection
ProQuest One Community College
ProQuest Central China
ProQuest Central
Health Research Premium Collection
Health and Medicine Complete (Alumni Edition)
ProQuest Central Korea
ProQuest Medical Library (Alumni)
ProQuest Science Journals (Alumni Edition)
ProQuest Central Basic
ProQuest Science Journals
ProQuest One Academic Eastern Edition
ProQuest Nursing & Allied Health Source
ProQuest Hospital Collection
Health Research Premium Collection (Alumni)
ProQuest Psychology Journals (Alumni)
ProQuest Hospital Collection (Alumni)
Nursing & Allied Health Premium
ProQuest Health & Medical Complete
ProQuest Medical Library
ProQuest Psychology Journals
ProQuest One Academic UKI Edition
BMJ Journals
ProQuest Nursing & Allied Health Source (Alumni)
ProQuest One Academic
ProQuest Central (Alumni)
DatabaseTitleList ProQuest One Psychology
MEDLINE
Database_xml – sequence: 1
  dbid: NPM
  name: PubMed
  url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
  sourceTypes: Index Database
– sequence: 2
  dbid: EIF
  name: MEDLINE
  url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search
  sourceTypes: Index Database
– sequence: 3
  dbid: BENPR
  name: ProQuest Central
  url: https://www.proquest.com/central
  sourceTypes: Aggregation Database
DeliveryMethod fulltext_linktorsrc
Discipline Medicine
EISSN 1468-330X
EndPage 941
ExternalDocumentID 3983541201
10_1136_jnnp_36_6_936
4772727
ark_67375_NVC_L6GCBGJZ_0
Genre Clinical Trial
Controlled Clinical Trial
Journal Article
GroupedDBID ---
.55
.GJ
.VT
0R~
18M
29L
2WC
354
39C
3O-
3V.
4.4
40O
41~
53G
5GY
5RE
5VS
7RV
7X7
7~S
88E
88I
8AF
8FI
8FJ
8R4
8R5
AAHLL
AAKAS
AAOJX
AAUVZ
AAWJN
AAWTL
ABAAH
ABIVO
ABJNI
ABKDF
ABMQD
ABOCM
ABUWG
ABVAJ
ACGFO
ACGFS
ACGOD
ACGTL
ACHTP
ACMFJ
ACOFX
ACTZY
ADBBV
ADCEG
ADFRT
ADUGQ
ADZCM
AEKJL
AENEX
AFKRA
AFWFF
AHMBA
AHNKE
AHQMW
AI.
AJYBZ
AKKEP
ALIPV
ALMA_UNASSIGNED_HOLDINGS
AZFZN
AZQEC
BAWUL
BENPR
BLJBA
BOMFT
BPHCQ
BTFSW
BTHHO
BVXVI
C45
CAG
CCPQU
COF
CS3
CXRWF
DIK
DU5
DWQXO
E3Z
EBS
EJD
EX3
F20
F5P
FEDTE
FYUFA
GNUQQ
GX1
H13
HAJ
HCIFZ
HMCUK
HVGLF
HYE
HZ~
IAO
IEA
IHR
INH
INR
IOF
IPO
IPY
ITC
J5H
KQ8
L7B
M1P
M2M
M2P
N9A
NAPCQ
NTWIH
NXWIF
O9-
OK1
OMB
OMG
OVD
P2P
PCD
PQQKQ
PROAC
PSQYO
PSYQQ
Q2X
R53
RHF
RHI
RMJ
RPM
RV8
SJN
TEORI
TR2
UKHRP
UPT
UYXKK
V24
VH1
VM9
VVN
W8F
WH7
WOW
X7M
YCJ
YFH
YQT
YQY
ZGI
8RD
ABPTK
AEQTP
BHJZB
BJGMD
BSCLL
ZA5
CGR
CUY
CVF
ECM
EIF
NPM
AAYXX
CITATION
7XB
8FK
K9.
PQEST
PQUKI
PRINS
Q9U
5PM
ID FETCH-LOGICAL-b481t-9a4027d8a1dc00fc39e0f2ef675006bcebed1f35548147190d58c1f7bd0fb0e33
IEDL.DBID RPM
ISSN 0022-3050
IngestDate Tue Sep 17 21:16:28 EDT 2024
Thu Oct 10 19:11:52 EDT 2024
Fri Aug 23 00:43:07 EDT 2024
Sat Sep 28 08:40:47 EDT 2024
Wed Jan 17 04:50:47 EST 2024
Wed Aug 21 03:34:18 EDT 2024
IsDoiOpenAccess false
IsOpenAccess true
IsPeerReviewed true
IsScholarly true
Issue 6
Language English
LinkModel DirectLink
MergedId FETCHMERGED-LOGICAL-b481t-9a4027d8a1dc00fc39e0f2ef675006bcebed1f35548147190d58c1f7bd0fb0e33
Notes href:jnnp-36-936.pdf
PMID:4772727
ark:/67375/NVC-L6GCBGJZ-0
local:jnnp;36/6/936
istex:514F404F9FCEF7B364CC226DE149546AE61D0E67
OpenAccessLink https://jnnp.bmj.com/content/jnnp/36/6/936.full.pdf
PMID 4772727
PQID 1772786379
PQPubID 2041879
PageCount 6
ParticipantIDs pubmedcentral_primary_oai_pubmedcentral_nih_gov_1083593
proquest_journals_1772786379
crossref_primary_10_1136_jnnp_36_6_936
pubmed_primary_4772727
istex_primary_ark_67375_NVC_L6GCBGJZ_0
bmj_primary_10_1136_jnnp_36_6_936
PublicationCentury 1900
PublicationDate 19731201
PublicationDateYYYYMMDD 1973-12-01
PublicationDate_xml – month: 12
  year: 1973
  text: 19731201
  day: 1
PublicationDecade 1970
PublicationPlace England
PublicationPlace_xml – name: England
– name: London
PublicationTitle Journal of neurology, neurosurgery and psychiatry
PublicationTitleAlternate J Neurol Neurosurg Psychiatry
PublicationYear 1973
Publisher BMJ Publishing Group Ltd
BMJ Publishing Group LTD
Publisher_xml – name: BMJ Publishing Group Ltd
– name: BMJ Publishing Group LTD
References Yahr, M.D. (ref_4) 1971
Marsden, C.D.; Barry, P.E.; Parkes, J.D.; Zilkha, K.J. (ref_3) 1973; 36
Hughes, R.C.; Polgar, J.G.; Weightman, D.; Walton, J.N. (ref_2) 1971; 2
Coyle, J.T.; Snyder, S.H. (ref_1) 1969; 166
References_xml – volume: 36
  start-page: 10
  year: 1973
  ident: ref_3
  article-title: Treatment of Parkinson's disease with levodopa combined with L-alpha-methyl-dopahydrazine, an inhibitor of extracerebral dopa decarboxylase
  publication-title: Journal of Neurology, Neurosurgery, and Psychiatry
  doi: 10.1136/jnnp.36.1.10
  contributor:
    fullname: Marsden, C.D.; Barry, P.E.; Parkes, J.D.; Zilkha, K.J.
– start-page: 403
  volume-title: Results of long-term administration of L-dopa. In Monoamines Noyaux Gris Centraux et Syndrome de Parkinson
  year: 1971
  ident: ref_4
  contributor:
    fullname: Yahr, M.D.
– volume: 166
  start-page: 899
  year: 1969
  ident: ref_1
  article-title: Antiparkinsonian drugs: inhibition of dopamine uptake in the corpus striatum as a possible mechanism of action
  publication-title: Science
  doi: 10.1126/science.166.3907.899
  contributor:
    fullname: Coyle, J.T.; Snyder, S.H.
– volume: 2
  start-page: 487
  year: 1971
  ident: ref_2
  article-title: Levodopa in Parkinsonism: the effects of withdrawal of anticholinergic drugs
  publication-title: British Medical Journal
  doi: 10.1136/bmj.2.5760.487
  contributor:
    fullname: Hughes, R.C.; Polgar, J.G.; Weightman, D.; Walton, J.N.
SSID ssj0000089
Score 1.2695801
Snippet The effects of slow withdrawal of anticholinergic medication and addition of benzhexol (8 mg/day) have been studied in patients with Parkinson's disease on...
SourceID pubmedcentral
proquest
crossref
pubmed
istex
bmj
SourceType Open Access Repository
Aggregation Database
Index Database
Publisher
StartPage 936
SubjectTerms Adult
Aged
Dihydroxyphenylalanine - therapeutic use
Disability Evaluation
Drug Synergism
Evaluation Studies as Topic
Female
Humans
Male
Middle Aged
Parasympatholytics - adverse effects
Parasympatholytics - therapeutic use
Parkinson Disease - drug therapy
Placebos
Trihexyphenidyl - therapeutic use
SummonAdditionalLinks – databaseName: ProQuest Central
  dbid: BENPR
  link: http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwhV1Lb9QwELZoV0JcEK-K0IKChOCU1o4TP05Vu-qDiq4QoqjiYsWPqK3A2-4uasWvZybrDd2qglMOthNlxp75xvMi5J0DyMGcK4sutLHyrC5UrdBwbbljvHVMY6Lw8UgcnlRHp_VpunCbprDKhUzsBLUfO7wj32IAA6USXOrty6sCu0ahdzW10Fghg5JV6KYd7O6NPn-5BYCV7uuF05ouqmxysXURI1j8YlNsaqzPvGJ_XizppgGS-eY-4Hk3fvKWQtp_Qh4nJJnvzFn_lDwI8Rl5eJx85c_Jx52ISVXYlCdMQL7leOXqJ801LGqiz22Iv8_CzfhH3geb5-cxxzToLiPswzRP3psX5GR_7-vwsEiNEwpbKTYrdANWofSqYd5R2jquA23L0IJxAIfMOmCcB14AklAMlJOmvlaOtdJ62loaOF8jq3Ecw0uSq6bhQejaYwqqAOusdLZ2nnNplahYyMhbIJy5nJfGMJ1JwYVB4hp4CgPEzcj7BVn_O7Ejej8L_hgDz2RtRt-G5pM4GO4eHH03NCMbC66YdOam5u8OycjanEH9iyocK2VG5BLn-nEssr08Es_PumLbDDGq5q_-_cV18ohpyedxLhtkdTb5FV4DWpnZN2lL_gHL1uj1
  priority: 102
  providerName: ProQuest
Title Anticholinergic withdrawal and benzhexol treatment in Parkinson's disease
URI http://dx.doi.org/10.1136/jnnp.36.6.936
https://api.istex.fr/ark:/67375/NVC-L6GCBGJZ-0/fulltext.pdf
https://www.ncbi.nlm.nih.gov/pubmed/4772727
https://www.proquest.com/docview/1772786379
https://pubmed.ncbi.nlm.nih.gov/PMC1083593
Volume 36
hasFullText 1
inHoldings 1
isFullTextHit
isPrint
link http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV3ra9swED_6YKNfxl5l3rrgwdg-OZEiW4-PbdbnllDGOsK-COthmtKoJc1Y2V-_k2ObZQwG-2SMJGPfnXy_k353AnhrEXJQa4dZTW3MHS0yWcgYuFbMUlZZqmKi8HjCTy7ys2kx3YCizYWpSfvWzPrhet4Ps8uaW3k7t4OWJzY4H49oxA2KDTZhUzDWhugd5pWqKxFOCtIW1mR8cBUCBvm8z_uK8R14kIu4DRkdk5lfrTmm7Sjj-7-hzj_Jk795o6PH8KiBken-6nWfwIYPT-HhuNkofwan-yFmVMUTefwCf25pXG91i_IHDiqDS40PPy_9_c112jHN01lIYw50nQ72_i5ttm6ew8XR4ZfRSdacmpCZXNJlpkoMCYWTJXWWkMoy5Uk19BVGBjjDjEWtOVQEwghJ0TMp4gppaSWMI5UhnrFd2Ao3wb-AVJYl81wVLuafcgzNhtYU1jEmjOQ59Qm8QcHp21VdDF3HE4zrKGaNV65RzAm8a8X6z4610Lte-MWRdSYKPfk60p_48ejg-OybJgnstVrRzYS70zSqUnImVAK7KwV1D2rUnIBY01zXHitsr7eg4dWVthtDe_nfI1_BDlWCrfgve7C1XHz3rxHFLE0PbXcqerB9cDg5_4x3H04_9mpL_gVfN_Oz
link.rule.ids 230,315,733,786,790,891,12083,21416,27955,27956,31752,33777,43343,43838,53825,53827,74100,74657
linkProvider National Library of Medicine
linkToHtml http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwhV3db9MwED-xTQJeEF8TGQOChOApm10n_nhCo2LrRtunDVW8WIntaJvA3doiJv567tI0rAjBUx7OTpQ7-_y7830AvHEIObhzvawJbcw9LzJdaDJca-G4qB03lCg8GsvBWX4yKSatw23ehlWudGKjqP3UkY98nyMMVFoKZd5fXWfUNYpuV9sWGhuwlQuR0zpXE3UL_mrTVQtnBVvV2BRy_zJGtPflntwzVJ15o_p2uXYybRGTb_4GO_-Mnrx1HB0-hActjkwPloJ_BHdCfAx3R-1N-RM4PoiUUkUtecIMtVtKDlc_K3_gpDL6tArx53m4mX5Nu1Dz9CKmlATd5IO9m6ft3c1TODv8eNofZG3bhKzKNV9kpkSbUHldcu8Yq50wgdW9UKNpgFuscig2j5JAHKE5Hk2G-UI7XqvKs7piQYht2IzTGJ5BqstSBGkKTwmoEm2znqsK54VQlZY5Dwm8RsbZq2VhDNsYFEJaYq7Fp7TI3ATertj634EN07tR-McUdqYKO_7ct0N51P9wdPLFsgR2V1Kx7Y6b29_rI4HtpYC6F-VE66kE1JrkOjqV2F6nxIvzptQ2J4RqxM6_v_gK7g1OR0M7PB5_eg73uVFiGfGyC5uL2ffwAnHLonrZLM5f6aXqfA
linkToPdf http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwhV1LbxMxEB7RVqq4IF4V2xZYJASnbex4148TKoH0QRtxoCjiYq0fq7aiTkmCqPj1jDfO0iAEpz14H9qZsecb-5sZgJcWIQe1tl-01MbS0aqQlYyBa8MsZY2lKiYKn4744Vl5PK7Gif80S7TK5ZrYLtRuYuMeeY8iDBSSM6F6TaJFfHw3fHP9rYgdpOJJa2qnsQYb6CVJbOMgxuIWFJaqqxxOKrKst8l47zIEjP35Ht9TsVLzmrm6XPFSG1HgN3-DoH8yKW-5puF9uJcwZb6_MIIHcMeHh7B5mk7NH8HRfojpVbE9j5_iSpfHzVc3rX_gQ3VwufHh57m_mXzNO9p5fhHymBDd5oa9nuXpHOcxnA3ffxocFqmFQmFKSeeFqjE-FE7W1FlCGsuUJ03fNxgm4HQzFlXoUCuIKSRFN6WIq6SljTCONIZ4xrZgPUyCfwK5rGvmuapcTEblGKf1ramsY0wYyUvqM3iBgtPXiyIZug0uGNdRuBqvXKNwM3i1FOt_b2yF3t2FfxwpaKLSo88DfcIPBm8Pjr9oksHuUis6zb6Z_m0rGWwtFNS9qIxjfZGBWNFcNx7Lba-OhIvztuw2jWhVse1_f_E5bKJd6pOj0YcduEuVYAvyyy6sz6ff_VOEMHPzrLXNX8Yg7qg
openUrl ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Anticholinergic+withdrawal+and+benzhexol+treatment+in+Parkinson%27s+disease&rft.jtitle=Journal+of+neurology%2C+neurosurgery+and+psychiatry&rft.au=Horrocks%2C+P+M&rft.au=Vicary%2C+D+J&rft.au=Rees%2C+J+E&rft.au=Parkes%2C+J+D&rft.date=1973-12-01&rft.pub=BMJ+Publishing+Group+LTD&rft.issn=0022-3050&rft.eissn=1468-330X&rft.volume=36&rft.issue=6&rft.spage=936&rft_id=info:doi/10.1136%2Fjnnp.36.6.936&rft.externalDBID=HAS_PDF_LINK&rft.externalDocID=3983541201
thumbnail_l http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0022-3050&client=summon
thumbnail_m http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0022-3050&client=summon
thumbnail_s http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0022-3050&client=summon