Posts Tagged ‘heart disease’

New study shows Transcendental Meditation prevents abnormal enlargement of the heart, reduces chronic heart failure risk

December 26, 2019

A randomized controlled study recently published in the Hypertension issue of Ethnicity & Disease found the Transcendental Meditation (TM) technique helps prevent abnormal enlargement of the heart compared to health education (HE) controls. Also known as left ventricular hypertrophy (LVH), it can lead to chronic heart failure and death. It is twice as prevalent among African Americans. LVH and CVD death rates are double in African Americans compared to whites, possibly due to psychosocial stress. EurekAlert! Press Release

Changes in Left Ventricle Mass Index (LVMI) between the TM and HE Groups after 6 Months

After six months, the control group showed nearly 10% progression of abnormal heart enlargement (LVMI) while the TM group maintained their baseline level of heart size.

Transcendental Meditation prevents abnormal enlargement of the heart, reduces chronic heart failure risk

A randomized controlled study recently published in Ethnicity & Disease in their Autumn 2019 Hypertension issue found that the Transcendental Meditation (TM) technique helps to prevent abnormal enlargement of the heart compared to health education (HE) controls. Also known as left ventricular hypertrophy (LVH), it can lead to chronic heart failure and death, and is especially prevalent among African Americans.

Risk factor for cardiovascular disease

Despite advances in medical care, cardiovascular disease (CVD) is the leading cause of death in the USA. Abnormal enlargement of heart, medically known as left ventricular hypertrophy (LVH), is an important risk factor for CVD. It doubles the risk of heart attacks, arrhythmias, stroke, heart failure, and death from CVD.

Heart disease death rates are significantly higher in African Americans than in whites, in part because the rate of LVH is double in African Americans compared to whites.

The disproportionately high rates are suggested to be associated with the burden of psychosocial stress.

A recent scientific statement from the American Heart Association emphasized the potential for stress-reduction methods to prevent heart disease and premature mortality in African Americans.

Prevented further heart enlargement

The trial included 85 African Americans with high blood pressure who were randomly assigned to Transcendental Meditation or to a health education (HE) control group, in addition to usual medical care.

This trial tested the effects of stress-reducing meditation to prevent LVH in this high-risk population. It found that stress reduction with TM practice prevented heart enlargement in hypertensive African American patients.

After six months, the control group showed nearly 10% progression of abnormal heart enlargement while the TM group maintained their baseline level of heart size.

The findings of this study suggest that TM practice is an effective nondrug method for preventing heart enlargement in African American hypertensives who are especially at high risk of developing associated CVD.

“This is a form of heart disease where nondrug treatments are relatively understudied,” said Professor Robert Schneider, MD, FACC, first author. “Since the physiology of stress contributes to cardiac enlargement, we hypothesized that managing one’s mind-body connection with Transcendental Meditation might prevent the disease process.”

Use of echocardiography to detect hypertrophy

Echocardiography is a noninvasive diagnostic test that uses ultrasound waves to create an image of the heart muscle. Ultrasound waves that rebound or echo off the heart can show the size, shape, and movement of the heart’s valves and chambers as well as the flow of blood through the heart. It can therefore be used to detect heart chamber or wall enlargement known as hypertrophy.

Echocardiography was issued at the start of the study to both TM and HE groups. After six months of practice, repeat testing with echocardiography found that the HE control group progressed on cardiac enlargement while the TM group prevented further enlargement. There was a significant change in left ventricle mass index (LVMI) between the groups after the six-month intervention.

11% reduced risk of cardiovascular mortality

Komal Marwaha, M.D., Ph.D., coauthor of the study and an associate professor in the Department of Physiology and Health at MIU, Maharishi International University (formerly Maharishi University of Management) worked on this research as part of her doctoral thesis.

“By preventing left ventricle mass index progression in the present study, TM may reduce the likelihood of cardiovascular morbidity and mortality associated with LVH,” she said. “Patients randomized to practicing the TM technique in the current study had an estimated 11 percent reduced risk of cardiovascular mortality and an 8 percent reduced risk of all-cause mortality compared with the control group.”

Dr. Schneider, dean of MIU’s College of Integrative Medicine, said these reductions are significant. “These results suggest that an effective technique for stress reduction may prevent the progression of left ventricular hypertrophy and thereby help to prevent premature heart disease and cardiac mortality.”

Keith Norris, MD, PhD, Professor of Medicine at UCLA, and one of the study’s co-authors, added: “We hope these findings will lead to more investigations into nondrug interventions for the prevention and early intervention of heart disease that are sorely needed given the high cost of health care in our nation and the impact of health care cost on low income and disproportionately minority communities.”

The research was conducted in conjunction with Martin Luther King Hospital and Charles R. Drew University of Medicine and Science in Los Angeles, and was funded by a grant from the National Institutes of Health.

Possible study limitations

Of the 85 original subjects, roughly 50% in each group were available for the final echocardiograph tests after the 6-month study period. The high attrition might have reduced power for some of the findings.

However, the attrition was not significantly different between the TM and the HE groups, thus reducing potential subject bias in the final sample. Moreover, the attritors and completers were not significantly different in demographic or physiological characteristics at baseline that prevented the occurrence of systematically biased treatment outcomes. No record of compliance for home TM practice was collected. However, the record of meeting attendance was significantly higher in the TM (80.6%) as compared with HE (50.2%) group (P=.001).

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Ethnicity & Disease: Original Reports: Cardiovascular Disease and Risk Factors Vol 29, No 4 (2019): Stress Reduction in the Prevention of Left Ventricular Hypertrophy: A Randomized Controlled Trial of Transcendental Meditation and Health Education in Hypertensive African Americans, Robert H. Schneider, Hector F. Myers, Komal Marwaha, Maxwell A. Rainforth, John W. Salerno, Sanford I. Nidich, Carolyn Gaylord-King, Charles N. Alexander, Keith C. Norris Ethn Dis. 2019;29(4):577-586; doi:10.18865/ed.29.4.577. Also listed on PubMed.

Related: PET scans show Transcendental Meditation with cardiac rehabilitation increases blood flow to the heart | Transcendental Meditation may reduce death, heart attack and stroke in heart patients—AHA

News coverage has been positive. The press release has been posted on medical news sites around the world. Johny Fernandez at CBS News in New York puts out a MedDay report on the top health stories in the news and included ours. It was picked up by KOLR 10 CBS News in Springfield, MO, on MedDay – December 27, 2019, and included in their Health and Medical segment. I cued up the video from their YouTube site. It’s also on their OzarksFirst site. It starts at 40 seconds in.

The January 4, 2020 issue of Enjoy TM News published: New Study: TM Technique Effective in Preventing Abnormal Heart Enlargement and Reducing Heart Failure. Risk factor for cardiovascular disease reduced.

Jan 7, 2020, Medical Research published a Q&A with Dr. Schneider: Transcendental Meditation To Reduce LVH in African Americans.

Excellent article by Tom Jacobs on Meditation: Strong Preventative Medicine for Heart Patients

November 14, 2012

Meditation: Strong Preventative Medicine for Heart Patients

New research finds major health benefits of meditation for African Americans with heart disease.

November 13, 2012 • By for Pacific Standard

Meditation is usually thought of as a practice of healthy, well-off white people and Asians. But newly published research suggests it can produce hugely significant health benefits in a very different demographic group: African Americans with heart disease.

A study of that followed 201 African Americans for an average of five years found those who meditated regularly were far more likely to avoid three extremely unwelcome outcomes. Compared to peers participating in a health-education program, meditators were, in that period, 48 percent less likely to die, have a heart attack, or suffer a stroke.

“It appears that Transcendental Meditation is a technique that turns on the body’s own pharmacy—to repair and maintain itself,” said Dr. Robert Schneider, the paper’s lead author and director of the Institute for National Medicine and Prevention at the Maharishi University of Management in Fairfield, Iowa. His research is published in the American Heart Association journal Circulation: Cardiovascular Quality and Outcomes.

The paper was originally scheduled to be published in 2011 in the journal Archives of Internal Medicine, but was withdrawn just before being posted “to allow time for review and statistical analysis of additional data.” The AHA’s Maggie Francis reports that the paper “went through peer review, statistical review, editorial discussions, and the authors of the article were responsive to the review process.”

While, two decades ago, research from Maharishi University was often regarded with skepticism, the institution is now well-regarded for its scholarly work.

Schneider and his co-authors undertook this research in part because African Americans “suffer from disproportionately high rates” of mortality due to cardiovascular disease. As we have reported, this may in part reflect high stress levels, the result of living in a society where racial prejudice continues to linger.

The study was conducted at the Medical College of Wisconsin in two phases: From 1998 to 2003, and from 2004 to 2007. Participants were African Americans whose blood flow to the heart was seriously obstructed. Specifically, at least one of their coronary arteries had been narrowed by at least 50 percent.

The patients’ mean age was 59; almost half reported an income of under $10,000. Males slightly outnumbered females. Around 40 percent were cigarette smokers; their mean body mass index was just over 32, making them, on average, clinically obese.

They were randomly divided into two groups. Half took part in a cardiovascular health education program, in which they “were advised to spent at least 20 minutes a day at home practicing heart-healthy behaviors,” including exercise and eating healthy food.

The others were taught the technique of Transcendental Meditation, and encouraged to engage in this activity for 20 minutes each day. “Follow-up and maintenance meetings were held weekly for the first month, biweekly for the next two months, and monthly thereafter,” the researchers write.

The researchers followed up on the participants an average of 5.4 years after they initially joined the experiment. They found those in the meditation group were 48 percent less likely than their peers to have suffered one of three negative outcomes: a heart attack, a stroke, or death from any cause.

“There was a significant association between regularity of home (meditation) practice and survival,” the researchers report. “The subgroup of subjects who were regular in their TM practice had a 66 percent risk reduction, compared with the overall sample risk reduction of 48 percent.”

Regular meditators also reduced their blood pressure, on average, and reported feeling less anger than they did before beginning the experiment.

“This trial did not address the effects of other mind-body, meditation-type interventions on clinical events,” the researchers note. So it’s not clear if these apparent health benefits were the result of some specific aspect of Transcendental Meditation, or would apply to any regimen involving deep breathing and clearing one’s mind.

Nevertheless, as the researchers note, this appears to be the first randomized, controlled trial to find the risk of mortality, heart attack and stroke declined “with the individual practice of a relatively simple mind-body intervention.”

It’s some of the clearest evidence yet that reducing stress through regular meditation can have a positive effect on one’s physical health.

About Tom Jacobs
Staff writer Tom Jacobs is a veteran journalist with more than 20 years experience at daily newspapers. He has served as a staff writer for The Los Angeles Daily News and the Santa Barbara News-Press. His work has also appeared in The Los Angeles Times, Chicago Tribune and Ventura County Star.
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Transcendental Meditation May Lower Heart Risk: WebMD Heart Disease Health Center

November 13, 2012

Heart Disease Health Center

Transcendental Meditation May Lower Heart Risk

By 
WebMD Health News
Reviewed by Louise Chang, MD

Nov. 13, 2012 — Transcendental Meditation is good for the heart, according to a new study.

The study was funded by the National Institutes of Health. It found that African-Americans with heart disease who regularly practiced TM reduced their risk of death, heart attack, and stroke by 48%.

Researcher Robert Schneider, MD, says those results should apply to the general population. Schneider is director of the Institute for Natural Medicine and Prevention at the Maharishi University of Management (MUM) in Fairfield, Iowa.

“This taps into a universal physical phenomenon that is not related to race, age, culture, etc.,” Schneider says. “This state of restful alertness has restorative benefits for everyone. It’s a way to utilize the body’s own internal pharmacy.”

TM is a trademarked form of meditation. It requires training by a certified teacher to “settle inward” to a place called “transcendental consciousness.” The technique is one of the two pillars underlying education at the Maharishi University of Management, according to the school’s web site.

Health Benefits of TM

The study was a collaboration between MUM and the Medical College of Wisconsin in Milwaukee. Researchers recruited 201 African-American men and women whose average age was 59 and who were generally considered obese.

All of the participants previously had been diagnosed with heart disease. Many of them were current smokers. African-Americans, says Schneider, have a 35% higher risk of dying from heart disease than the general population.

The people in the study were divided into two groups. While both groups continued to receive standard care and medication for heart disease, the study group attended a seven-step course in TM. The people in that group were then instructed to meditate twice a day for 20 minutes for the duration of the study.

Schneider says that the program was standard for TM practitioners and had not been modified for the study.

The comparison group received conventional health education. The people in that group were told to spend at least 20 minutes a day on heart-healthy activities.

Members of both groups were followed for as long as nine years.

In addition to reducing the risk of death, heart attack, and stroke by nearly half, TM also significantly lowered systolic blood pressure, the top number in a blood pressure reading.

Anger control and overall anger also improved. Those who entered the study with either high blood pressure or high stress benefited the most from meditation.

“What this is saying is that mind-body interventions can have an effect as big as conventional medications, such as statins,” says Schneider.

The TM group was expected to meditate 14 times per week. But the researchers found that on average participants only practiced the technique 8.5 times.

They would have done well to stick to their instructions. Those who followed the study guidelines more strictly, Schneider says, had even greater benefits. Their risk reduction was 66%.

Second Opinion

“In cardiology, we are always impressed when we see any effective intervention,” says cardiologist Michael Shapiro, DO, of Oregon Health and Science University in Portland. “But to actually show a reduction in overall mortality — that is really impressive.”

Shapiro, who reviewed the study for WebMD, says that its design appears scientifically rigorous and that its results are likely valid. But he says the study was too small to draw any definite conclusions.

“I am enthusiastic and cautiously optimistic,” says Shapiro. “Overall, I like the study, and it provides justification for a much larger study.”

Shapiro, who practices a different form of meditation, also says that more needs to be learned about what drives these results. He says the reduction in blood pressure, while significant, is likely not enough to account for all of the study’s positive outcomes.

“Meditation can do a whole host of positive things: reduce anger and stress, encourage happiness,” he says. “Who is to say that these are not the most important factors? This study can’t get at the mechanism involved. We don’t know how it works.”

A Cost-Effective Means of Prevention

Transcendental Meditation, says Schneider, is “a simple, effortless, and natural way to settle down to a quiet state of mind.”

But it is not free. According to the Maharishi Foundation USA’s web site, the seven-part introductory TM course that the study participants attended costs $1,500. Financial aid and sliding scale fees are available to those who can’t afford the full amount.

To Schneider, this study shows that TM is a cost-effective means of prevention.

“This is the strongest study ever done on meditation or any mind-body intervention for cardiovascular disease,” he says.

In July 2011, the study was pulled from publication in Archives of Internal Medicine, a last-minute decision made when one of the journal’s reviewers raised questions about the data. Schneider says that in the intervening time, the data was re-analyzed. Also, new data was added and the study underwent an independent review.

“This is the new and improved version,” Schneider says. It appears in the current issue of Circulation: Cardiovascular Quality and Outcomes.

Note: Check November 20 when the next issue comes out in print: http://circoutcomes.ahajournals.org.

Also see: Transcendental Meditation may reduce death, heart attack and stroke in heart patients—AHA

Science Codex: Meditation may reduce death, heart attack and stroke in heart patients

Meditation could slash the risk of heart attack and stroke (and make you less angry) — Daily Mail

Transcendental Meditation may reduce death, heart attack and stroke in heart patients—AHA

November 13, 2012

Meditation may reduce death, heart attack and stroke in heart patients

November 13, 2012

Study Highlights:

  • Twice-a-day Transcendental Meditation helped African Americans with heart disease reduce risk of death, heart attack and stroke.
  • Meditation helped patients lower their blood pressure, stress and anger compared with patients who attended a health education class.
  • Regular Transcendental Meditation may improve long-term heart health.

DALLAS, Nov. 13, 2012 — African Americans with heart disease who practiced Transcendental Meditation regularly were 48 percent less likely to have a heart attack, stroke or die from all causes compared with African Americans who attended a health education class over more than five years, according to new research published in the American Heart Association journal Circulation: Cardiovascular Quality and Outcomes.

Those practicing meditation also lowered their blood pressure and reported less stress and anger. And the more regularly patients meditated, the greater their survival, said researchers who conducted the study at the Medical College of Wisconsin in Milwaukee.

Robert Schneider, M.D., director of the Institute for Natural Medicine and Prevention and dean of Maharishi College of Perfect Health in Fairfield, Iowa. Courtesy MAPI

“We hypothesized that reducing stress by managing the mind-body connection would help improve rates of this epidemic disease,” said Robert Schneider, M.D., lead researcher and director of the Institute for Natural Medicine and Prevention in Fairfield, Iowa. “It appears that Transcendental Meditation is a technique that turns on the body’s own pharmacy — to repair and maintain itself.”

For the study, researchers randomly assigned 201 people to participate in a Transcendental Meditation stress-reducing program or a health education class about lifestyle modification for diet and exercise.

  • Forty-two percent of the participants were women, average age 59, and half reported earning less than $10,000 per year.
  • Average body mass index was about 32, which is clinically obese.
  • Nearly 60 percent in both treatment groups took cholesterol-lowering drugs; 41 percent of the meditation group and 31 percent of the health education group took aspirin; and 38 percent of the meditation group and 43 percent of the health education group smoked.

Those in the meditation program sat with eyes closed for about 20 minutes twice a day practicing the technique, allowing their minds and bodies to rest deeply while remaining alert.

 Participants in the health education group were advised, under the instruction of professional health educators, to spend at least 20 minutes a day at home practicing heart-healthy behaviors such as exercise, healthy meal preparation and nonspecific relaxation.
Researchers evaluated participants at the start of the study, at three months and every six months thereafter for body mass index, diet, program adherence, blood pressure and cardiovascular hospitalizations. They found:
  • There were 52 primary end point events, which included death, heart attack or stroke. Of these, 20 events occurred in the meditation group and 32 in the health education group.
  • Blood pressure was reduced by 5 mm Hg and anger decreased significantly among Transcendental Meditation participants compared to controls.
  • Both groups showed beneficial changes in exercise and alcohol consumption, and the meditation group showed a trend towards reduced smoking. Although, there were no significant differences between the groups in weight, exercise or diet.
  • Regular meditation was correlated with reduced death, heart attack and stroke.

Cardiovascular disease is the leading cause of death worldwide. Death from heart disease is about 50 percent higher in black adults compared to whites in the United States. Researchers focused on African Americans because of health disparities in America.

“Transcendental Meditation may reduce heart disease risks for both healthy people and those with diagnosed heart conditions,” said Schneider, who is also dean of Maharishi College of Perfect Health in Fairfield, Iowa.

“The research on Transcendental Meditation and cardiovascular disease is established well enough that physicians may safely and routinely prescribe stress reduction for their patients with this easy to implement, standardized and practical program,” he said.

Co-authors are: Theodore Kotchen, M.D.; John W. Salerno, Ph.D.; Clarence E. Grim, M.D.; Sanford I. Nidich, Ed.D.; Jane Morley Kotchen, M.D., M.P.H.; Maxwell V. Rainforth, Ph.D.; Carolyn Gaylord-King, Ph.D.; and Charles N. Alexander, Ph.D. Author disclosures are available on the manuscript.

The National Heart, Lung and Blood Institute funded the study.

Follow @HeartNews on Twitter for the latest heart and stroke news.

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Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at www.heart.org/corporatefunding .

Circulation: Cardiovascular Quality and Outcomes. 2012; 5: 750-758. Published online before print November 13, 2012, doi: 10.1161/ CIRCOUTCOMES.112.967406. November 2012 issue. Stress Reduction in the Secondary Prevention of Cardiovascular Disease: Randomized, Controlled Trial of Transcendental Meditation and Health Education in Blacks. Abstract | Full Text | PDF

Also posted on EurekAlert! http://www.eurekalert.org/pub_releases/2012-11/aha-mmr110812.php

Also see: Transcendental Meditation May Lower Heart Risk: WebMD Heart Disease Health Center

Science Codex: Meditation may reduce death, heart attack and stroke in heart patients

Meditation could slash the risk of heart attack and stroke (and make you less angry) — Daily Mail

TIME Strongest Study Yet Shows Meditation Can Lower Risk of Heart Attack and Stroke

Excellent article by Tom Jacobs on Meditation: Strong Preventative Medicine for Heart Patients

AHA Newsletter: News from the Heart: Update from CEO Nancy Brown for AHA Volunteers (11/15/12) features Dr. Schneider’s study, “meditation reduces cardiovascular risk”

And many major articles around the world, including reports by CNN, CBS, ABC, and NBC.

I also included a review of some of the global news coverage and the report in our university paper the Review: New Study Shows Reduced Mortality, Heart Attack, Stroke (Vol. 28, #6, November 28, 2012). You can also read it in this news post: Results of American Heart Association publishing landmark TM study.

South Asian Heart Center uses Transcendental Meditation to prevent and manage heart disease

May 12, 2012

South Asians are becoming painfully aware of the high incidence of heart attacks, often fatal, frequently among seemingly healthy, trim, and physically active close family & friends.

The South Asian Heart Center (SAHC) at El Camino Hospital in Mountain View, California has developed a four-pronged approach to prevent and successfully manage heart disease among men and women of South Asian descent living and working in America. Here is an introduction to their work presented by Executive Director Ashish Mathur, and SAHC Medical Director Cesar Molina, MD, FACC: South Asian Heart Center Helps South Asians Fight Heart Disease.

In this fourth of a four-part series on Therapeutic Lifestyle Changes Dr. Molina focuses on the importance of deep rest and its effect on heart-health and diabetes. He specifically covers the importance of meditation (or restful alertness) on longevity and health, and the science behind the effective technique of Transcendental Meditation (TM), which produces a “hypo-metabolic state of restful alertness.” Learn the evidence on the profound impact of this unique form of meditation on a whole class of chronic ailments. This is a very clear and comprehensive presentation!

South Asian Heart Center Webinar: TLC – Restful Sleep & Restful Alertness April 25, 2012, published on Apr 26, 2012 by sahcsathi.

At 26:26 of Part 4, Dr. César Molina begins talking about resting while awake with Transcendental Meditation and how it impacts our health, especially for South Asians and their propensity toward heart disease. One of the therapeutic modalities from the South Asian Heart Center is Transcendental Meditation as a stress-reduction technique. Dr. Molina reviews his talk starting at 56:18. He summarizes the lifestyle methodology to prevent heart disease and enhance longevity at the South Asian Heart Center: nutrition, physical activity, the importance of restful sleep, and the importance and benefit for stress reduction through Transcendental Meditation decreasing cardiovascular risk factors, decreasing hospital expenditures and admissions, and enhancing longevity.

Dr. César Molina presents Wednesday Lunch-hour Webinar Series TLC: Therapeutic Lifestyle Changes. Here are the 4 topics where you can download the video and a PDF of the main points and graphs for each talk. The recommendations can be applied to all Americans regardless of ethnicity or geographical location.

1. TLC: Therapeutic Lifestyle Changes Overview: May 2, noon
2. TLC: Exercise as Medicine: May 9, noon
3. TLC: The Dinner vs. the Diner: May 30, noon
4. TLC: Restful Sleep and Restful Alertness: June 20, noon

For more information: www.southasianheartcenter.org and www.tm.org.

KTVO 3: M.U.M. Gets $1 Million Research Grant

September 26, 2009

MUM gets $1 million research grant

Friday, September 25, 2009 at 6:37 p.m.

FAIRFIELD, IOWA — University Receives $1 Million NIH Grant for Mind-Body Medicine Research

The National Institutes of Health recently awarded a grant of $500,000 per year for two years for research on the Transcendental Meditation® technique in the treatment of coronary heart disease in African Americans.

The research is a collaboration between Maharishi University of Management Research Institute’s Center for Natural Medicine and Prevention and Columbia University Medical School in New York.

The funding comes from the American Recovery and Investment Act, via the NIH-National Heart, Lung and Blood Institute.

About 21,000 applications were submitted to NIH for these specific funds, with just 3% receiving grants.

“This recent achievement continues to place MUM Research Institute and its research on the Transcendental Meditation technique and Maharishi Vedic MedicineSM programs in an elite category in academic medicine,” said project director Robert Schneider, M.D., F.A.C.C., and dean of the Maharishi College of Perfect Health.

The research will compare the effectiveness of cardiac rehabilitation with and without the Transcendental Meditation program, especially after a heart attack. The study will utilize positron emission tomography (PET) to image and quantify changes in heart disease in the patients.

The Center for Natural Medicine and Prevention team includes Sanford Nidich, EdD, Carolyn King, PhD, Maxwell Rainforth, PhD, John Salerno, PhD, Marilyn Ungaro, Laura Alcorn, and Linda Heaton.

See video: http://bit.ly/13D7d4

KTVO Medical News


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