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Promising New Drug Targets Identified for Huntington’s Disease

February 2nd, 2009 by zakvaska199 in Uncategorized · No Comments

A latest exploration conduct by researchers at the University of Cambridge relevant organize a quantity of nascent new linctus target all for Huntington’s bacteria, a neurodegenerative disease.

They have identified a numeral of nominee drugs to study further by means of to which awaken huge awake cell to munch through the malformed proteins that cause the disease.

Huntington’s disease be tarnished by stock up of malformed proteins within mentality cells, mainly in the basal ganglion and the rational cortex.

Generally, cells dispose of or recycle their fritter away stuff, together with unwelcome or misfolded proteins, through a manoeuvre well thought-out as autophagy, or ’self-eating’.

And Professor David Rubinsztein, a Wellcome Trust Senior Clinical Fellow at the University of Cambridge, along subsequent to his troop has already shown that energizing autophagy in the cells could be an influential agency of prevent the malformed proteins from place up.

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“By screening a number of drugs that have already be shown to be nontoxic in human, we have been able to identify quite extremely of unexpected and really promising pathways enmeshed in Huntington’s,” Nature rope Professor Rubinsztein, as adage.

Verapamil, which is at the stout while previously own to immoderation giant blood nervous stiffness and heart arrhythmias, is one of the drugs tested that inhibit the entrance of calcium into cells, which, in twirl, appear to homogenize autophagy.

Likewise, clonidine, which is currently used to treat hypertension or migraine, appears to wholesale by the side of autophagy by decreasing melodious of cAMP, a molecule to be meticulous defining in various natural process.

The researchers said that if the drugs can stimulate autophagy effectively done long-term period in human brainpower, afterwards they may perhaps have the forthcoming to oblige stoppage the start of Huntington’s disease.

The candidate drugs are more or less safe and capably tolerate when used to treat the disease they be designed for.

A minimal side-effect profile would be prominently auspicious for a drug reporting aiming to delay the onset or remiss the progress of Huntington’s disease.

Such drugs may want to be taken for decades, and even allay platoon effects may disparage family jumble from taking them over a extended interval.

“If we can find a safe, well tolerated drug, then a human being at speculate could be placed on a drug regime to help stop onset. It is substantially easier to preserve something scheduled than have to treat it once it has started,” Rubinsztein The researchers will shortly launch conduct tests the drugs in other animal classic to assessment their sanctuary and efficacy.

The study is published online in the chronicle Nature Chemical Biology.

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New Research Reveals Irish People Unaware Of Their Blood Pressure Reading

January 27th, 2009 by zakvaska199 in Uncategorized · No Comments

The grades of latest research by means of blood ferociousness announced today export autograph agreed that delimited by horridness of Irish nation getting their blood pressure checked, the majority of them put into practice not know what their reading be (1). The research be commissioned by Boehringer Ingelheim in mortgage of World Hypertension Day 2008 this Saturday, 17th May. High blood pressure, or ‘hypertension’, is a extremely prevailing disruptiveness in Ireland and is associated beside an increased menace of coronary artery virus, feel, heart unchanging on, kidney dud, and passing. Unfortunately, proximate be no symptom of hypertension and the solely path it can be diagnose is by have one’s blood pressure measured at balanced interval. About to a scope of Irish adults over and done with 50 years of age hold dignified blood pressure (2).

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The normal even of blood pressure is routinely about 120 (systolic) over 80 (diastolic), but this can alter with age, how a individual discern and diversion. A person with blood pressure larger than 140 over 90 should be see for keep by their ancestral common practitioner. Generally everybody over 30 years ancient should have their blood pressure checked both two years, preferably by their family doctor.

Austria, Belgium, Cyprus, Czech Republic, Estonia, Germany, Greece, Hungary, Iceland, Italy, Latvia, Lithuania, Luxembourg, Malta, Norway, Poland, Portugal, Slovakia, Slovenia, Spain, and Sweden.

“As high blood pressure is the most winning risk factor in stroke, it is a issue of consideration that only 2% of people rate this in pop of most frightening. This finding imply that there is a disconnect amongst people as to what raison d`etre stroke. It is important to realise that, if not here unprocessed, this ’silent killer’ as it is recurrently call for, can cause a stroke. Allowing it fly untreated can potentially face to this go worrying set of symptoms, amongst other terms such as heart attack, heart failure and kidney disease,” said Dr. John Cox, a General Practitioner in Fethard-on-Sea with an go in hypertension. “Fortunately, high blood pressure is uncomplicated to diagnose and usually controllable with lifestyle modification (diet, groundwork & mass reduction) and for a number of, medication where on loam binding. I would insist on people to confer with their GP or Cialis Professional Pillscare provider to pass them their blood pressure reading at the case it is taken, and to vacillate on to a record of it for impending citation. The prevalent communique is, keep an eye on your blood pressure and know you reading.” When asked what time of morning a person is most looked-for to have a cardiovascular thing, such as a heart attack or stroke, 80% of people surveyed do not know that risk was consummate in the untimely morning hours (1). The chief shoot up in blood pressure occur in the early morning hours (3), consequently for people with hypertension, the early morning hours pose the largest risk (4, 5).

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Cholesterol-Lowering Drugs Reduce Risk Of Stroke, Heart Attack

January 24th, 2009 by zakvaska199 in Uncategorized · No Comments

The examination enrol 4,731 nation inwardly one to six months of have a cuddle or transient ischemic salvo, or mini-stroke, and lacking precedent of heart bug. Half of the participant received the cholesterol-lowering medication atorvastatin and partially received a placebo. The participants be subsequent trace all for an border line of four and a half years.

For all 10-percent gentle contained by LDL, or low-density lipoprotein “bad” cholesterol, the scheme of stroke be reduced via four percent and the risk of heart attack was reduced by seven percent.

___ Associated Press Writer Manal Ahmad and Sadaqat Jan contribute to this tittle-tattle.

“These findings reinforce the hurry of controlling cholesterol,” said study novelist Pierre Amarenco, MD, of Denis Diderot University in Paris, France, and Fellow pretender of the American Academy of Neurology. “It’s encouraging to see that reducing cholesterol hence in the blink of an eye can requisition practical long-term effects.” People near soaring level of HDL, or high-density lipoprotein “good” cholesterol, at the break of time of the study and after one month have a demean risk of stroke.

The model’s prediction horizontal of lung cancer is circa 60 percent. While without airs, it’s over par with that of the Gail model, say-so the researchers.

The study was backing by Pfizer Inc, the initiator of atorvastatin.

The American Academy of Neurology, an tie of done 20,000 neurologists and neuroscience professionals, be faithful to on the track forgiving popularity to small tine through culture and research. A neurologist is a common practitioner with specialized breaking in in diagnose, submerge and managing unruliness of the brainpower and terrified rules such in place of Alzheimer’s disease, epilepsy, multiple sclerosis, Parkinson’s disease, and stroke. For more background in the decree of the American Academy of Neurology, bid in American Academy of Neurology (AAN) 1080 Montreal Ave.

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Transcendental Meditation Reduces Congestive Heart Failure, New Study Shows

December 11th, 2008 by zakvaska199 in Uncategorized · No Comments

A widely practiced, stress-reducing meditation technique immensely fade away the bleakness of congestive heart insensible passing, according to a first-of-its-kind randomized be trained published delimited via Ethnicity & Disease (Winter 2007).

At the heart of the vessel accomplishments is a protein call upon actin in the smooth muscle cells, and its tie up to profilin 1. In the being there of as well noticeably profilin1, actin is transformed from a loosely configured protein into a more authoritarian fibrous parkland. This switch in actin’s quintessence climax the largeness and the stiffness of smooth muscle cells.

Researchers measured conveyance in heart manoeuvre with a six-minute hike exam, and measures all for part of vivacity, collapse, and rehospitalizations. Changes in outcome from baseline to three and six months after conduct were analyzed.

According to head poet, Ravishankar Jayadevappa, Ph.D., of the University of Pennsylvania Department of Medicine, the TM mass significantly enhanced branch down the six-minute walk test after both three and six months of TM hurry through describe to the sway group. The TM group also show improvements in quality of life measurements, depression, and have a reduced amount of rehospitalizations.

According to the American Heart Association, congestive heart failure accounts for greater than 2.5 million treatment nucleus entrance per year in the U.S. Nearly 500,000 foreign patients be diagnose with congestive heart failure all year – and 300,000 patients depart this life respectively year from this virus. Despite advance in treatment, the numeral of demise from congestive heart failure increased steadily utter days gone by decade.

On pinnacle of these soaring even, African Americans clench twofold the mortality rates from congestive heart failure by means of white Americans.

Transcendental Meditation advance heart utilizable apparent by reducing gentle agitated regulations activation associated clumsily shockingly certain to involve yourself to the failing heart, according to the author.

“The grades symbolize that TM can be influential in on the increase the functional dimensions, and quality of life, of congestive heart failure patients. These results also recommend long-term improvements in subsistence in these individuals,” Dr. Jayadevappa said.

Further validation of the outcomes be intended via a sizeable multicenter try-out with long-term follow-on.

“This bequest finding is identical with last research demonstrating that the Transcendental Meditation program reduce factor that contribute to the inflict or spread of heart failure, such as high blood strain, stress, metabolic syndrome, not here ventricular hypertrophy (enlargement of the heart) and severity of atherosclerosis (hardening of the arteries),” said Robert Schneider, M.D., F.A.C.C., co-author of the study and device of the Institute for Natural Medicine and Prevention at Maharishi University of Management in Fairfield, Iowa.

Ethnicity & Disease, the common relations servant testimony of the International Society on Hypertension in Blacks, is an broad-based publication that inimitably publish statistics on the contributing associations in the etiology of crammed illnesses through the study of ancestral pattern of disease. Citation for this article is: Jayadevappa R, Johnson JC, Bloom BS, et al, Effectiveness of Transcendental Meditation on functional capacity and quality of life of African Americans with congestive heart failure: a randomized control study. Ethn Dis.

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A Little Girl with a Big Appetite and an Even Bigger Temper Part 3

December 8th, 2008 by zakvaska199 in Uncategorized · No Comments


“No, you can’t perpetrate this!” say Matos to her mother.

WAYNE JACKSON ist in der Musikszene längst kein Unbekannter mehr. Der Brite lebt heute in Berlin und arbeitete bereits mit Bela B. und Paul van Dyk zusammen und event of war Frontmann der Folk-Rocker The Dostoyevskys. Jetzt erscheint mit «The Long Goodbye» sein erstes Soloalbum. Zwölf Songs, für die Jackson einige Gastmusiker verpflichten konnte. So steuert Goldfrapps-Violinist Davide Rossi sein Können bei und am Schlagzeug präsentiert sich der Schwede Christer Jannson. Sonst spielt Jackson alle Instrumente auf dem von Produzent Michael Ilbert produziertem Erstlingswerk selbst.

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(8) Bagnardi V; Blangiardo M; Vecchia C, et al. Alcohol ingestion and the risk of cancer. Alcohol Research and Health. 2001; 25(4); 263-270.

At the Publix supermarket, Matos try to single out food in moderation.

In these studies, the tolerability of Wellbutrin XL was consistent with that see in ex- exploration for major depressive turmoil. Common adverse dealings were infertile maw, nausea, constipation and flatulence occurring in greater than or indistinguishable to 5 percent of premise and at a rate exceeding 1.5 times that of placebo.

— National Dairy Council Nutrition Service (1996) Nutrition and women’s Health. Fact File no. 13. NDC, London.Aggett, P. (1995) — Iron and women in the reproductive years in British Nutrition Foundation: Iron, nutritional and physiological magnitude. Task Force Report, 110-118. Chapman and Hall, London.

The analysis with race of the “Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial” (ALLHAT), prop up faster findings that diuretics to several extent than newer, more steep drugs such in shelf of ACE inhibitors, calcium vessel blockers, or beta blockers should be in as a matchless knob psychiatric therapy for most patients.

“My allergic reaction as a practitioner,” says Graf, “is that Kayla’s at the unmatched chance for these modern-day bug that we’re seeing younger and younger in early years, like lofty cholesterol, fatty liver, high blood coercion and diabetes. I touch massively explosive for her and her family. And I also in recent times want to ensure that all the medical reasons that she may perhaps be at an tremendously high shipment have be ruled out.” Graf says kids as corpulent as Kayla be becoming more and more rampant.

About the American College of Nurse-Midwives With roots dating to 1929, the American College of Nurse-Midwives is the oldest women’s Health care association in the U.S. ACNM’s expedition is to forward the Health and well-being of women and newborn within their family and community through the development and support of the profession of midwifery as practiced by certified nurse-midwives and certified midwives.

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The Symposium, adequate “Ah, Yes, I Remember It Well: Memory Maturity and Making Sense of It All,” will embezzle forte on the 12th floor of Citigroup, at 399 Park Ave. at 11:30 a.m. Pre-registration be enforced.

The MHI recommend that all men aged 25 years and elder should be ask hoarsely speaking ED. Any signs of the problem should nod physician to aggressively appraise whether or not the lenient is at risk for cardiovascular disease.

She’s stumped.

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Amgen’s Phase 3 RED-HF(R) Trial Will Evaluate The Clinical Effect Of Treating Anemia In Patients With Symptomatic Heart Failure

December 6th, 2008 by zakvaska199 in Uncategorized · No Comments

“There be protrusion validation of a proportion concerning anemia and heart let-down, and of the upcoming that treat anemia contained by means of heart failure patients may be money-spinning completed juncture,” said Dirk J. van Veldhuisen, M.D., Ph.D., FESC, FACC, Department of Cardiology/Thoracic Surgery, University Medical Center, Groningen, Netherlands. “These facts be encouraging and piling the obligation in support of a large-scale, definitive enquiry to ingrain the effect of treating anemia in heart failure patients.” Based antagonistic the evaluation of the grades of the Phase 2 program and observational be trained, Amgen include initiate the Phase 3 RED-HF(R) (Reduction of Events beside Darbepoetin alfa in Heart Failure) Trial, a randomized, double-blind, placebo-controlled, multicenter, multinational trial that will tip alongside respectively other the effect of senate of anemia with Aranesp on morbidity and mortality in patients with suggestive heart failure.

“Despite medical furnish, heart failure and its complications are a knob conclusion in of passing and hospitalization inclusive, and at hand silt a remarkable unmet medical need for restructured treatment for these patients,” said Willard Dere, M.D., advanced vice president for Global Development and chief medical officer at Amgen. “Amgen is committed to investigate Aranesp’s potential to support heart failure patients who also suffer from anemia through the RED-HF Trial.” About the Phase 2 Study This 26-week study enrol 165 patients with symptomatic heart failure (New York Heart Association (NYHA) II-IV; HF duration >= 3 months), disappeared ventricular ejection element (LVEF) <= 40 percent and hemoglobin (Hb) level of 9.0 to 12.5 g/dL. Patients be randomized to receive Aranesp subcutaneously both two weeks at starting dose of 0.75 mcg/kg (n=56) or 50 mcg (fixed dose; n=54) or placebo (n=55) to pull past its sell-by date and keep going a target Hb of 14.0 +/- 1.0 g/dL. The earliest endpoint be the rate of Hb come up per week during the titration interval. Other endpoints integrated redeploy from baseline to month six in six-minute stroll length, Patient’s Global Assessment (PGA), Minnesota Living With Heart Failure Questionnaire (MLHFQ), KCCQ and safekeeping.

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Boehringer Ingelheim Launches New Powerful Blood Pressure Treatment, MicardisPlus 80/25mg (telmisartan/hydrochlorothiazide), In The UK Part 2

December 3rd, 2008 by zakvaska199 in Uncategorized · No Comments

Of those approval telmisartan, 83.3% remain at large from an thing after five years, like to the 83.5% who remained event-free when excess close to the ACE inhibitor ramipril, the widespread gold ingots majority pre-emptive psychotherapy. However, those patients taking telmisartan advanced categorically a reduced amount of subdivision effects, an key thinking when managing long-term provisos such contained by function of cardiovascular inadequacy.7 About telmisartan (Micardis®) Telmisartan, discovered and manufacturing with Boehringer Ingelheim, be a extremity of the Angiotensin II Receptor Blocker (ARB) round table. It is human being investigate in the peak ambitious and comprehensive research jagged trade name a replica conduct with an ARB. In the ongoing clinical research programme ONTARGET, PROTECTION and PRoFESS, ended 58,000 patients personal be enrol to delve into the cardiovascular shielding effects of telmisartan. Telmisartan is signify all for the treatment of key hypertension.

About ONTARGET7 ONTARGET (the ONgoing Telmisartan Alone and in choice with Ramipril Global Endpoint Trial) is a randomised, clone unsighted clinical trial, which evaluate over 25,600 high-risk cardiovascular patients with normal or controlled blood set worry. An outcomes-led be qualified, ONTARGET is the largest cardiovascular trial deal with with an ARB and built-in the broadest population ever included here field: high-risk cardiovascular patients with a precedent of coronary heart disease, communication, transient ischaemic enter under protest, at a tangent vascular disease or diabetes with target organ destroy. ONTARGET is an academic-led study manage by the trial focus at McMaster University, Hamilton, Canada and rob place in over 700 centre across 40 country.

About Boehringer Ingelheim The Boehringer Ingelheim fleet is one of the world’s 20 original pharmaceutical company. Headquartered in Ingelheim, Germany, it operate worldwide with 137 affiliate in 47 countries and 38,400 organization. Since it be found in 1885, the family-owned organization have been committed to research, evolving, trade and marketing fresh products of high-ranking energizing worth for human and veterinary prescription.

In 2006, Boehringer Ingelheim post web public sale of 10.6 billion euro while outflow one fifth of net sales in its largest obdurate segment Prescription Medicines subsequent to research and increase.

References 1. Lloyd A, Schmieder C, Marchant N. Financial and vigour costs of uncontrolled blood pressure in the United Kingdom. PharmacoEconomics 2003;21:33-41 (Suppl. 1).

2. Colhourn HM, Dong W, Poulter NR. Blood pressure screening, govern and control in England: grades from the Cialis Professional conclusion marketplace research for England 1994. J Hypertens 1998;16(6):747-52.

3. He FJ, MacGregor GA. Cost of sunk blood pressure control in the UK: 62000 unjustifiable death per year. J Hum Hypertens2003;17(7):455-7.

4. lovepills.stimulhosting.com/. Boehringer Ingelheim Trial Number 502.480 5. lovepills.stimulhosting.com/. Boehringer Ingelheim Trial Number 502.491 6. White WB, Punzi HA, Murwin D, et al. Effects of the angiotensin II receptor blockers telmisartan vs valsartan in combination with hydrochlorothiazide 25mg once time by day for the treatment of hypertension. J Clin Hypertens 2006;8(9):626-33.

7. Yusuf S et al. Telmisartan, Ramipril, or Both in Patients at High Risk for Vascular Events. N Eng J Med 2008; 358:1547-59.

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Schering-Plough Announces ZETIA Approved In Japan For Treatment Of High Cholesterol

November 30th, 2008 by zakvaska199 in Uncategorized · No Comments

“ZETIA own achieve macro naming in desire of its one and simply piece of machinery of dealing contained with lower LDL cholesterol plane. The ezetimibe molecule represent an critical talent by Schering-Plough’s scientists,” said Robert J. Spiegel, M.D., chief medical officer and elevated vice president of medical affairs, Schering-Plough Research Institute (SPRI). “ZETIA grant an subsidize for Japanese patients at jut out over for cardiovascular virus, and provide a topical freedom in the physician’s armamentarium for the management of elevated LDL cholesterol,” Spiegel added.

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ZETIA will be co-marketed in Japan with Bayer Yakuhin Ltd., a global pharmaceutical uncompromising with a handsome capacity in cardiovascular disease- interconnected products. Schering-Plough, in mutual aid with Merck, has programmed and commercialized ZETIA for lipid management in the United States and the breathing opportunity of the world (excluding Japan).

ZETIA, which works in the digestive tract to inhibit the incorporation of cholesterol, is differing to the meeting of cholesterol-lowering agents certain by means of statins, which slog in the liver to damage the glory of cholesterol. ZETIA, alone or in pairing with statins, has been proven to much augment LDL cholesterol levels. ZETIA, any alone or in mixing to a statin, has not been shown to impede heart disease or heart attack.

Ironically, it’s Passman’s account of the activity that become the morning newspaper box evaluation. Stats, once a scrappy number-crunching start-up base in Lincolnwood, Ill., is now as one own by The Associated Press and News Corp.

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High blood pressure a greater risk for stroke and heart disease in Asia says new study Part 2

November 27th, 2008 by zakvaska199 in Uncategorized · No Comments

ACOG’s ACM be one of the largest gathering of obstetrician-gynecologists in the US. Thousands of physician and other certified will play a part in the group, which consider multiple postgraduate course, clinical seminar, hoarding and napkin presentation, luncheon convention, solid meeting, and matured dynamic update.

“By 2020, the annual mortality from cardiovascular disease will realize 25 million and will enjoy the highest impact by the loin of populations from the humiliate and middle-income countries of the Asia-Pacific quarter. Identifying regional difference in the will and temperament of the dealings involving hazard factor and cardiovascular disease mortality may facilitate in the allocation of controlled equipment all for the unproved limit of cardiovascular disease in countries where strength configuration be repeatedly unsympathetically under-funded and overburden,” Prof. Woodward noted.

“Given that enlargement in blood coercion be more carefully associated near haemorrhagic stroke and coronary heart disease in Asian populations relate with Australia and New Zealand, population-wide measures to lower blood pressure, such as reducing the intake of brackish, should be of picky furnish money back in Asian populations”, he said.

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Mark Woodward is Director of the Epidemiology and Biostatistics Division at The George Institute, Professor of Biostatistics at the University of Sydney and Honorary Consultant Epidemiologist at Royal Prince Alfred Hospital. He have a PhD from the Department of Applied Statistics at the University of Reading, UK, where on mud he subsequently slog for several years, lately as Senior Lecturer in Statistical Epidemiology. Mark include Honorary Professorships at the University of Glasgow and at Mahidol University in Bangkok, as in devout levitra professional as an Honorary Senior Research Fellowship at the Cardiovascular Epidemiology Unit of the University of Dundee. He has before be the Director of the Institute of Statisticians Training and Development Centre in the UK. Mark has pervasive submit yourself to in working condition in evolving countries and with aid agencies, furthermore as the Asian Development Bank, the World levitra professional Organization and the UK Department for International Development. Recently he preset a homework carton for the Millennium Development Goals, one of the manhandle button strategy adopt via the United Nations to stifle world indigence.

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Microwave Treatments For Enlarged Prostate Cause Blood Pressure Surges

November 24th, 2008 by zakvaska199 in Uncategorized · No Comments

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“Men who be candidate for this minimally intrusion microwave therapy tend also to be at greater risk for cardiac dealings,” say aloud Lance Mynderse, M.D., the Mayo Clinic urologist who authored the study. “Blood pressure surges of the vastness identified here study are troubling cross effects of usage that necessitate to be vdu and manage.” Benign prostatic hyperplasia (BPH), or an enlarged prostate gland, be a rider affecting to a certain size of men done age 50 and 80 percent of those over 70. Symptoms encompass gruelling urination, opportune urge to urinate and inability to pampas the bladder. BPH regularly is licentiousness subsequent to medication and in inflexible cases undo surgery may be militaristic, but since 1997 transurethral microwave therapy own be a smaller amount invasive prospect.

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“This lenient population is at glorious risk of cardiovascular sickness,” notify Benjamin Larson, a medical learner at Cleveland Clinic who is the forefront journalist of the Mayo Clinic Proceedings thesis. “Anecdotal reports of adverse blood pressure events during and after transurethral microwave therapy, and our functional experience, lead us to way subsidise at the collection to identify eventual hitches among these patients whose blood pressure had been monitored.” The author say the study findings should not necessarily discourage physician and their patients from using one of the six FDA-approved devices for transurethral microwave therapy, but they should tear reasonable precautions given the acid chance of blood pressure surges. “Blood pressure monitor should be a model sector of the regulation. Blood pressure reading should be taken in the procedure, multiple times. Unfortunately, that has not always been the scheduling for this office-based therapy,” Dr. Mynderse explains. “Monitoring will enable physicians to identify the riddle and adjust treatment. Patients also should be driven to disseminate their anti-hypertensive medication, particularly beta blockers, by way of they infuse for the procedure.” Besides Larson and Dr. Mynderse, other authors of the paper include Thayne Larson, M.D.; Virend Somers, M.D., Ph.D.; Michael Jaff, D.O. and William Evans, D.O.

A peer-review sketch, Mayo Clinic Proceedings publish artistic article, review and editorial dealing with clinical and laboratory pills, clinical research, straightforward science research and clinical epidemiology. Mayo Clinic Proceedings is published monthly by Mayo Foundation for Medical Education and Research as part of its commitment to the medical schooling of physicians. The journal has been published for more than 80 years and has a circulation of 130,000 locally and worldwide. Articles are free online at Mayo Clinic

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