INTRODUCCION
El sistema nervioso es el rector y coordinador de todas las funciones, funciones, conscientes e inconsc inconscient ientes es del organism organismo, o, consta consta del sistema sistema cerebro cerebroespi espinal nal (encéfa (encéfalo lo y medula espinal), los nervios y el sistema vegetativo o autónomo. A menu menudo, do, se comp compara ara el sistem sistema a nerv nervios ioso o con con un compu computa tador dor:: porqu porque e las unidades periféricas (órganos internos u órganos de los sentidos) aportan gran cantidad de información a través de los cables de transmisión (nervios) para que la unida unidad d de proces procesam amien iento to centr central al (cere (cerebro bro), ), provi provista sta de su banc banco o de datos datos (memoria), la ordene, la analice, muestre y ejecute. Sin embargo, la comparación termina aquí, en la mera descripción descripción de los distintos elementos. La informática avanza a enormes pasos, pero aun esta lejos el día que se disponga de un ordenador compacto, de componentes baratos y sin mantenimiento, capaz de igualar la rapidez, la sutileza y precisión del cerebro humano. El sistema nervioso central realiza las más altas funciones, ya que atiende y satisface las necesidades vitales y da respuesta a los estímulos. Ejecuta tres accion acciones es esenc esencia iales les,, que que son son la detec detecció ción n de estím estímulo ulos, s, la trans transmis misión ión de informaciones y la coordinación general.
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Fisiología El sistema nervioso y hormonal ha sido desarrollado para que todos los sistemas realicen una actividad conjunta efectiva. Ambos sistemas difieren en la rapidez para desencadenar una respuesta, el sistema nervioso lo hace rápidamente, y las hormonas con más lentitud. El sistema nervioso central se halla protegido por el cráneo y la columna vertebral. Respecto a su origen debemos decir que es ectodérmico. Está formado por tres partes: Encéfalo, dividido en:
Prosencéfalo. Telencéfalo: hemisferios cerebrales, lóbulos olfatorios, cuerpo estriado y corteza cerebral. Diencéfalo: epitálamo, tálamo, hipotálamo y apéndices. Mesencéfalo: techo, tubérculos cuadrigéminos, tegmentum y pedúnculos cerebrales.
Rombencéfalo. Metencéfalo: parte del bulbo, cerebelo y protuberancias.
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Nervios: aferentes y eferentes del sistema nervioso central; constituyen el sistema nervioso periférico.
Respecto a su organización se divide en dos partes. Sistema nervioso central: protegido por las meninges y todo él encerrado en el hueso. Muchas células se especializan en funciones de sostén, que forman la neuro neurogli glia. a. Pose Posee e más más neuro neurotra transm nsmiso isore res s que el perif periféri érico co,, como como dopa dopami mina, na, serotonina, ácido gamma-amino butírico, acetilcolina y noradrenalina. Sistema nervioso periférico: periférico: se encuentra encuentra libre de estructuras protectoras. Son los nervios que llegan a todo el cuerpo.
SISTEMA NERVIOSO CENTRAL EL CEREBRO Tiene tres regiones básicas: el Prosencéfalo, relacionado con el olfato; el mesencéfalo, con el ojo; y el rombencéfalo, con el oído.
EL BULBO Zona semejante semejante a la canal central muy
médula pero ensanchado. ensanchado.
con
el
Comunica los troncos nerviosos con las regiones superiores del cerebro. En su interior se alojan núcleos relacionados con la recepción de sensaciones auditivas e impulsos de los hemisferios cerebrales y del cerebelo.
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EL CEREBELO Se desarrolla en la parte anterior al bulbo y constituye el centro más importante para la regulación y coordinación de los movimientos. Recibe sensaciones de las estructuras estructuras sensitivas musculares y del órgano del equilibrio; equilibrio; desarrolla desarrolla la corteza cerebelosa.
EL MESENCÉFALO Los centros que posee coordinan algunos reflejos visuales y auditivos como la contracción pupilar a la luz y los movimientos auriculares de los perros al sonido.
EL DIENCÉFALO Zona de relevo de las vías aferentes y eferentes de los hemisferios, es el centro donde se integran los sistemas nervioso y endocrino.
El tálamo es el centro de enlace de los impulsos sensitivos, recula y coordina las manifestaciones manifestaciones externas de las emociones. El hipotálamo, hipotálamo, regula la temperatura, temperatura, el apetito, el equilibrio del agua.
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Cada Cada hemi hemisf sfer erio io está está unid unido o al otro otro por por el cuer cuerpo po call callos oso, o, form formad ados os por por el hipocampo, el cuerpo estriado, la paleocorteza y la neocorteza que forma las circunvoluciones separadas por las cisuras. La cisura de Rolando separa una zona frontal motora y otra posterior sensitiva, hay una zona específica para el oído y el ojo. La corteza de asociación es donde se plantean y organizan las ideas.
LA MÉDULA Encerrada en la columna vertebral, recorre longitudinalmente el cuerpo. En ella se distingue la sustancia gris que contiene los cuerpos neuronales de las neuronas de las vías sensitiv sensitivas as y motora; motora; y la sustancia blanca que son las fibr fibras as asc ascende endent ntes es y desc descen ende dent ntes es.. Es eficiente para los actos reflejos.
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SISTEMA NERVIOSO PERIFÉRICO Está compuesto por nervios y ganglios, éstos parten del encéfalo y de la médula, se diferencian en que son fibras aferentes y eferentes.
NERVIOS SENSITIVOS Craneales: Olfatorio: proviene del epitelio olfatorio Óptico: proviene del ojo Trigémino: es mixto y recibe sensaciones de la cabeza Facial: es mixto y recibe sensaciones de la cara Auditivo: proviene del oído Glosofaríngeo: es mixto y recibe sensaciones de la lengua y la faringe Vago: es mixto y recibe sensaciones de la cabeza y las vísceras
Espinales:
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NERVIOS MOTORES
Craneales: Motor ocular común: inerva parte de los músculos del ojo Patético: inerva el músculo oblicuo del ojo Trigémino: inerva los músculos mandibulares. Motor ocular externo: inerva el músculo que le da nombre Facial: inerva los músculos de la cara Glosofaríngeo: inerva la lengua y la faringe Vago: inerva la cabeza y las vísceras Espinal: accesorio del vago Hipogloso: inerva la lengua
Espinales: Motores somáticos: inervan los músculos esqueléticos, entran en la médula junto a los motor motores es viscer viscerale ales. s. Estos Estos nervi nervios os estimu estimula lan n o no al músc músculo ulo,, pero pero no lo
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ESTÍMULOS Y RECEPTORES
NATURALEZA DE LOS ESTÍMULOS Un estímulo estímulo es un cambio cambio ambient ambiental al capaz capaz de desenca desencadena denarr una respues respuesta ta determinada determinada por parte de un organismo. organismo. La diferencia estriba estriba en la capacidad de percibir diferentes intensidades del estímulo, y el nivel mínimo para desencadenar la respuesta es el umbral del estímulo. El estímulo hace reaccionar al receptor provocando una alteración.
Las enfermedades que más comúnmente afectan al sistema nervioso son:
Mal de Parkinson Alzheimer Esquizofrenia Epilepsia Depresión bipolar Estrés
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La Enfer Enferme medad dad de Alzhe Alzheime imer, r, la causa causa más más frecu frecuen ente te de demen demencia cia en los los ancianos, es un trastorno grave, degenerativo, producido por la pérdida gradual de neuro neurona nas s cere cerebra brales les,, cuya cuya caus causa a no es del del todo todo conoc conocida ida.. Se trata trata de una una enfermedad muy rara en los pacientes jóvenes, ocasional en los de mediana edad y cada vez más frecuente a medida que se cumplen años.
Diagnóstico Actua Actualm lment ente e la única única maner manera a defin definiti itiva va para para diagno diagnosti stica carr la enferm enfermed edad ad de Alzheimer es investigar sobre la existencia de placas y ovillos en el tejido cerebral. Pero Pero para para obse observa rvarr el tejid tejido o cereb cerebra rall se debe debe esper esperar ar hasta hasta que se haga haga la autopsia (examen del cuerpo que se hace después que la persona muere). Por consiguiente, los médicos hacen un “posible” o” probable” diagnóstico de enfermedad de alzheimer en la vida del paciente. Para esto se utilizan unos criterios clínicos, bien los establecidos por la tercera edición revisada o la cuarta edición del manual de diagnóstico y estadístico de la Socieda Sociedad d America Americana na de Psiquiat Psiquiatría ría (DSM-II (DSM-III-R) I-R) o por el Institut Instituto o Naciona Nacionall de Trastornos Neurológicos, Alteraciones de la Comunicación, Ictus y Enfermedad de Alzheimer y Enfermedades Asociadas (NINCDS-ADRDA). Estos criterios clínicos pueden pueden complet completars arse e con los resultad resultados os obtenido obtenidos s de las pruebas pruebas de imagen imagen cerebral (la resonancia o el scanner): las pruebas de imagen pueden ayudar al diagnóstico pero no son imprescindibles. Para hacer el diagnóstico lo mas importante es la historia clínica del paciente, pero existen otras pruebas que pueden ayudar al medico a descartar otras enfermedades y determinar Alzheimer. •Una historia médica completa que incluya información sobre la salud general de
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demencia. Su principal problema es que los resultados pueden estar condicionados por el nivel cultural o de estudios y no por el nivel cognitivo del entrevistado (por ejemplo algunas preguntas implican que el paciente tiene que restar, si el paciente no sabe hacerlo puntuará como negativo). Con todo resulta un test muy rentable en cuanto al tiempo que se necesita para hacerlo y la información que aporta, aunque no se debe olvidar que no se puede utilizar para hacer el diagnóstico definitivo de demencia, ya que sólo vale para cribar pacientes. Es neces necesar ario io ampli ampliar ar la infor informa mació ción n con con otras otras prueb pruebas as para para poder poder hacer hacer el diagnóstico final. •Debe descartarse la existencia de una depresión, que a veces puede simular un cuadro de demencia. Lo más frecuente, sin embargo, es que las dos enfermedades coexistan, es decir, muchos enfermos de Alzheimer tiene además depresión. •Exámenes del cerebro con escáner (TAC) o con resonancia magnética nuclear (RMN) para permitir al médico mirar fotografías del cerebro para ver si hay algo que no parezca normal. En general los pacientes con Enfermedad de Alzheimer no suelen tener grandes grandes alteraciones en estas pruebas, como mucho la presencia presencia de atrofia cerebral (un cerebro disminuído de tamaño). Con estos datos se pueden descartar otras causas de demencia, algunas de las cuales pueden recibir tratamiento, como por ejemplo la falta de hormonas del tiroides, la depresión, efectos de fármacos sedantes, o algunas enfermedades cerebrovasculares.
Características Los Los síntom síntomas as de la deme demenc ncia ia incluy incluyen en la incapa incapacid cidad ad para para apren aprender der nueva nueva
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Causas No se sabe que es lo que causa exactamente la enfermedad de Alzheimer. El envej envejeci ecimi mien ento to del del cere cerebro bro no se prod produce uce igua iguall en todos todos los enfer enfermo mos. s. Hay Hay factores genéticos, ambientales y sociales que parecen influir en el desarrollo de alzheimer, pero no actúan por igual en todas las personas. Los dos factores de riesgo más importantes son la edad y los antecedentes familiares, familiares, aunque se han estudiado muchos otros. La edad es un factor de riesgo evidente: los pacientes pacientes mayores de 65 años tienen un 10% de riesgo de tener la enfermedad, mientras que el riesgo se eleva a casi el 50% en los pacientes mayores de 85 años. En principio se consideró que el sexo femenino estaba más expuesto a desarrollar desarrollar la enfermedad, enfermedad, sin embargo embargo algunos estudios han relacionado esto con el hecho de que las mujeres viven más años que que los los varo varone nes, s, por por lo que que hay más más anci ancian anas as en ries riesgo go de padec adecer er la enfermedad. Es probable, por lo tanto que las mujeres no tengan más riesgo que los hombres. Los antecedentes familiares también son un factor de riesgo, de forma que los individuos cuyos padres o abuelos han tenido demencia tienen más riesgo de desarrollarla. Exist Existen en algun algunos os genes genes que que se han han asoci asociad ado o a mayo mayorr riesgo riesgo de pres present entar ar la enfermedad. Sin embargo la enfermedad se considera hereditaria en menos de un 1% de los casos.
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Tratamiento Hoy por hoy no existe ningún tratamiento que pueda curar la enfermedad de Alzheim Alzheimer. er. La enferm enfermedad edad progresa progresa de forma forma más o menos menos rápida, rápida, hacia un deterioro severo que precisa de ayuda para todas las actividades básicas. Sin embargo en algunas personas, en las fases temprana y media de la enfermedad, medic medicam ament entos os como como los inhib inhibido idore res s de la colin colinest estera erasa sa puede pueden n prev preveni enirr el empeoramiento de algunos síntomas durante un tiempo limitado. Dentro de los inhibidores inhibidores de la colinesterasa están la tacrina (Cognex), donepezilo (Aricept), rivastigmine (Exelon) o galantamine (Reminyl). También se ha usado como como tratami tratamiento ento específico específico la memanti memantina na (Axura, (Axura, Ebixa) Ebixa) o la selegilin selegilina a entre entre otros.
Prevención El alzheimer va de menos a mas y no se sabe aun su causa exacta por lo tanto no hay hay una una forma forma de preve prevenc nción ión exact exacta. a. Solo Solo en alguna algunas s perso personas nas en la fase fase temprana y media de la enfermedad, algunos medicamentes pueden prevenir el
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y es uno de los trastornos neurológicos más comunes en las personas de edad avanzada. En algunos casos, la enfermedad se presenta en familias, en especial cuando afecta a los jóvenes. La mayoría de los casos que ocurren a una edad avanzada no tienen una causa conocida.
Sus principales Síntomas son:
• Rigidez Rigidez muscular ◦rigidez o tensión ◦dificultad para flexionar los brazos o las piernas •Postura inestable, encorvada o desplomada •Pérdida del equilibrio •Cambios en la marcha (patrón de caminar) •Marcha arrastrada
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◦pueden empeorar cuando la persona está cansada, excitada o estresada
◦puede presentarse frotamiento del pulgar y dedos de la mano (rodamiento de píldora) •Cambios en la expresión facial: ◦reducción de la capacidad para manifestar expresiones faciales ◦cara con aspecto de "máscara" ◦mirada fija ◦posible incapacidad para cerrar la boca ◦reducción del ritmo de parpadeo •Cambios en el habla y en la voz: ◦habla lenta ◦bajo volumen de voz
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Algunos síntomas asociados a esta enfermedad son: •Depresión •Confusión •Demencia •Seborrea (piel grasosa) •Pérdida de la función o sensibilidad muscular •Atrofia muscular •Pérdida de la memoria •Babeo
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ésta, las células nerviosas no pueden enviar mensajes en una forma adecuada, ocasionando la pérdida de la función muscular.
Tratamiento No se conoce ninguna cura para el mal de Parkinson y el objetivo del tratamiento es solo controlar los síntomas. Los medicamentos controlan los síntomas principalmente mediante el incremento de los niveles de dopamina en el cerebro. A medida que cambian los síntomas, es posible que sea necesario ajustar el tipo de medicamento, la dosis, la cantidad de tiempo entre las dosis o la combinación
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•La entacapona es un medicamento utilizado para prevenir la descomposición de la levodopa.
•El pramipexol y el ropinirol son medicamentos dopaminérgicos que se utilizan antes o junto con la levodopa.
•La rasagilina es un medicamento recientemente aprobado para pacientes con mal de Parkinson en sus etapas iniciales y se puede combinar con levodopa en pacientes pacientes con casos más avanzados de la enfermedad. enfermedad. Este medicamento ayuda a bloquear la descomposición de la dopamina.
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Prevención Al presentar de manera leve los síntomas tomar precauciones del caso. Si esta enfermedad se deja sin tratamiento, progresa hasta provocar incapacidad total, acompañada frecuentemente de deterioro general de todas las funciones cerebrales y puede llevar a una muerte prematura. Recurrir a medico.
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manos o de otra parte del cuerpo. En otras oportunidades las crisis parciales pueden presentarse con sacudidas de una extremidad o de la mitad de la cara, sin pérdida de conocimiento. Si bien bien hemos hemos menc mencion ionad ado o los tipos tipos de crisi crisis s más más habit habitual uales es,, exist existen en otras otras manifestaciones menos frecuentes que deben ser evaluadas por el especialista. Además, una persona puede presentar más de un tipo de crisis.
Los distintos signos de alarma que advierten que se está produciendo un ataque epiléptico pueden ser los siguientes: *Períodos de confusión mental.
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Las crisis epilépticas son más frecuentes de lo que comúnmente se piensa y afectan al 1 % de la población. Pueden comenzar a cualquier edad, si bien se inici inician an más más frecu frecuent entem emen ente te dura durante nte la niñez niñez y la adoles adolesce cenci ncia, a, en todos todos los grupos humanos sin distinción de edad, sexo, raza ni condición económica. Los cuadros cuadros epilépt epilépticos icos no son contagi contagiosos osos,, no constit constituyen uyen una enferm enfermedad edad mental, no afectan la inteligencia y las personas que las presentan pueden llevar una vida prácticamente normal, una vez que logran controlar sus crisis con el tratamiento apropiado.
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La esquiz esquizof ofren renia ia es una de las las enferm enfermeda edade des s ment mentale ales s más más debil debilita itante ntes s y desconcertante. Define un grupo de trastornos que producen distorsión en los pensamientos y en la percepción. Los pensamientos parecieran estar mezclados o cambian bruscamente de un tema o otro. La percepción puede distorsionarse más allá de la realidad, haciendo que las personas oigan o vean cosas que no están allí. Las personas con esquizofrenia pasan por períodos en los cuales están mejor y peor: Remisión y recaída. Pueden vivir por largos períodos sin ningún síntoma, pero pero como como la esquiz esquizofr ofreni enia a es a menu menudo do una una enferm enfermed edad ad cróni crónica ca,, requ requier iere e atención médica continua, como la hipertensión y la diabetes. La esqui esquizo zofre frenia nia no es un trast trastorn orno o de perso personal nalid idad ad "dobl "doble" e" o múlti múltipl ples, es, un
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exhiben uno o más de los siguientes síntomas, durante las primeras etapas de la enfermedad:
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◦La falta de motivación y emoción, así como también la apatía, son síntomas muy difíciles de aceptar por los miembros de las familias de los enfermos. Muy pocas personas experimentan todos estos síntomas a la vez. Algunos pueden manifestarse durante la fase de remisión y pueden agravarse durante la etapa
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somnolencia y estreñimiento. Otros efectos son agitación, temblores, espasmos musculares, calambres y rigidez. Un efecto secundario irreversible es la diskinesia, que causa movimientos anormales en la boca, cara y luego en los brazos y piernas.
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La manía consiste en buscar desesperadamente vivir la vida en su nivel más apasionado; apasionado; repetir dos veces e incluso tres en las comidas, alcohol, alcohol, drogas, sexo y dinero; Intentar vivir toda una vida en un día. Todo el mundo tiene altibajos en su estado de ánimo y es normal sentirse a veces
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•Autoestima •Autoestima elevada (delirios de grandeza, grandeza, creencias falsas en habilidades especiales) •Compromiso exagerado en las actividades
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The world’s largest digital library
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The world’s largest digital library
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The world’s largest digital library
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The world’s largest digital library
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The world’s largest digital library
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The world’s largest digital library
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The world’s largest digital library
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The world’s largest digital library
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The world’s largest digital library
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The world’s largest digital library
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The world’s largest digital library
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The world’s largest digital library
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The world’s largest digital library
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The world’s largest digital library
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The world’s largest digital library
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The world’s largest digital library
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The world’s largest digital library
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The world’s largest digital library
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The world’s largest digital library
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The world’s largest digital library
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The world’s largest digital library
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The world’s largest digital library
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The world’s largest digital library
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The world’s largest digital library
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The world’s largest digital library
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The world’s largest digital library
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The world’s largest digital library
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The world’s largest digital library
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The world’s largest digital library
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