Sunday, March 16, 2008

Positive Phase II Clinical Trial Results For Insomnia Drug

Neurogen Corporation (Nasdaq: NRGN) today announced top-line grades of Phase II human trialling within transient restlessness in cavort of the Company's internally discovered remedy adversary for insomnia, NG2-73. The earliest endpoint of the examination measured the efficacy of NG2-73 in reducing occurrence to beginning of unyielding sleep insubstantially behind schedule a resourcefully confirmed clinical ideal of transient insomnia in subsequent to form adults. In this multi-center, 369 branch of learning study, NG2-73 be shown to prominently take uphill up time to onset of persistent sleep versus placebo by any means dose tested.

"We admit the results of this pharmacokinetic study explain the resources of the BEMA drug delivery system to swiftly and trimly deliver fentanyl through the buccal mucosa and verify the potential of the technology for transmucosal delivery of other agents," said Dr. Andrew Finn, Executive Vice President of Product Development at BioDelivery Sciences.

Commenting on the study results, principal investigator Gary Zammit, Ph.D., President & CEO of CliniLabs, Inc. and Clinical Associate Professor of Psychology (in Psychiatry), Columbia University College of Physicians and Surgeons, said, "In study to date, NG2-73 hold be shown to be a protected and potent sleep agent that reduce sleep latency and photocopy inclusive sleep time and sleep worth. The in haste onset of endeavour of this merged may spoon out to tell concerning it from other sleep agents, providing an impressive rehabilitation probability for patients difficulty from insomnia." William H. Koster, President and CEO, said, "We be vehement to have gather round our primary endpoint here Phase II study in such a conclusive deportment. We have admission of the efficacy of NG2-73 and have narrowed our focus on the counteractive dose inventory which we'll be taking into subsequent studies. As in our abovementioned Phase I studies, NG2-73 was well-tolerated, an primary trait for therapeutic agents for the treatment of patients near insomnia.

"Over 20 million race in the United States are implicit to suffer from fairly a bundle of rundown of insomnia and the carnival be programmed to germinate dramatically over the next several years. The requests of insomnia patients alter greatly and the emerging treatment, such in pop of NG2-73, should relieve to much in good provision serve this lax population." Study Design The Phase II clinical tribulation was a randomized, double-blind, placebo- controlled study, designed to bring into being the efficacy of four dose level (1, 3, 10 and 20 mg) of NG2-73 compare to placebo in reducing the time it take to decline unresponsive to the world as defined with LPS. Dose screening was made on the spring of a prior Phase I pharmacokinetic/pharmacodynamic (PK/PD) trial which studied a range of doses of NG2-73 antagonistic placebo and an stirring comparator.

In this Phase II study, LPS was measured in a single-night, validate model of transient insomnia. The telling answer affinity for NG2-73 is self explore using PK/PD modeling. The study was conduct at 11 spot in the United States. Healthy full-size subject be enrol in five treatment military hardware totaling 369 subjects.

NG2-73 is a partial agonist, preferential for the alpha-3 receptor subtype of the gamma-aminobutyric sharp (GABAA) neurotransmitter freeze of law. NG2-73 and associated compound are a bit of Neurogen's wholly-owned insomnia program. During 2005, Neurogen announced results from a first-in-human, at large ascending dose study and a multiple ascending dose study for NG2-73. In both of these Phase I trial, the compound was safe and well-tolerated with no serious adverse events.

Webcast Neurogen will host a seminar call upon and webcast to question this announcement at 8:30 a.m. EDT today, May 11, 2006. The webcast will be untaken in the Investor Relations slot of and will be archived on the website until December 31, 2006.

About Neurogen Neurogen Corporation is a drug uncovering and start enterprise focus on petty molecule drugs to restructure the live of patients suffering from revolution with significant unmet medical obligation, plus insomnia, backache, depreciation, tubbiness, and inflammation. Neurogen has generate a portfolio of compelling exotic drug candidate through its Accelerated Intelligent Drug Discovery (AIDD(TM)) system, its competence in cellular functional assay, and its reserve downwards in medicinal chemistry. Neurogen conduct its research and development one by one and, when advantageous, collaborate with world-class pharmaceutical company.

Neurogen Safe Harbor Statemen The hearsay in this grip let loose enclose guaranteed forward-looking admission that amalgam up with risk and uncertainties as detailed at times in Neurogen's SEC filings, including its maximum recent 10-K. Actual results may baulk materially from the statements made fittingly of an choice of factor, including, but not constrained to, risks associated with the original ambiguity of drug research and development, difficulties or rearrangement in development, testing, regulatory agreement, productivity and marketing of any of the Company's drug candidates, adverse haunch effects or unacceptable therapeutic efficacy or pharmacokinetic property of the Company's drug candidates or other properties of drug candidates which could label them insalubrious for commercialization, advancement of ruthless products, need on corporate partner, capability of dosh to fund the Company's intended operation and exclusive rights, service liability and third jamboree payback risks associated with the pharmaceutical industry. Future results may also differ from previously report results. For model, practical results or safekeeping and tolerability in one clinical study provide no self-possession that this will be true in projected studies.

Neurogen Corporation


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Saturday, March 15, 2008

ROZEREM (Ramelteon) Does Not Affect Body Sway, Demonstrated By Study

Two research delight in demonstrated that ROZEREM succeed not affect article sway at culmination plasma height, nor did it impair middle-of-the-night symmetry, mobility or remembrance acting out inwardly patients who suffer from hardened wakefulness. The grades of the studies be presented at the 21st Annual Meeting of the Associated Professional Sleep Societies (APSS).

"These resume be key because they show signs of that ROZEREM may be a cosy have forty winks medication in support of the several elder adults who disconcert supply or clutch a few their balance when they obligation to appropriation in the air in the intermediate of the hours of shadow. These studies also show that the patients' recollections were not false near ROZEREM the subsequent morning," said Gary Zammit, PhD, manager, Sleep Disorders Institute, New York.

ROZEREM works differently from other prescription sleep medication. It particularly target an constituency of the mentality believed to be mixed up in the statute of the body's hackneyed sleep-wake cycle. It be the original prescription sleep medication that is to say not a controlled things, and have shown no attestation of ill-treat or assurance in clinical studies.

Managing other Medical Problems: Treatment of blood coercion that is as economically full-size or too at a low rank may be essential in treating a stroke. Currently, subjugate an elevated blood pressure into the common inventory is no longer recommended during the first few days later a stroke. Doing so may maybe compromise the blood motion through narrowed or nearly closed artery, which could physique the stroke worse or lessen the unplanned of recovery. In patients essential diabetes, the blood sugar (glucose) level is regularly a little high after a stroke. Controlling the glucose level in these patients may minimize the magnitude of a stroke. Finally, oxygen may administered to stroke patients when necessary.

Results showed that at the juncture of predict near-peak plasma levels, the effect of ROZEREM on body sway was no not resembling from placebo. However, the positive control, zopiclone, did show a statistically glamorous discrimination versus placebo at near-peak plasma levels, indicating impairment in body sway. Specific findings showed that the be set to log of COP post-dose for placebo was 1.617 cm2 and for ROZEREM 1.497 cm2, (P0.532). For zopiclone the mean log of COP after dosage was 3.539 cm2, (P0.001) compare to placebo.

ROZEREM Study Design 2: Middle-of-the-Night Balance, Mobility or Memory Performance This study evaluate the effects of ROZEREM versus placebo on middle-of-the-night balance, mobility and memory performance in older adults with chronic insomnia, with zolpidem as a positive control. A total of 33 adults age 65 or older with chronic insomnia received ROZEREM 8 mg, zolpidem 10 mg or placebo 30 records before bedtime for one night all here double-blind, placebo-controlled study. Patients were awakened two hours after they were given medication to weigh in opposition undeviating balance, ramp helpfulness and stability, memory and adverse measures. The primary endpoint was balance as estimate by NeuroCom EquiTest Sensory Organization Test (SOT) rack up two hours after dosage. An SOT objectively identify abnormality in patients' burn up of the three sensory system that partake to postural control.

Results found that compared to placebo, ROZEREM did not impair middle-of-the-night balance, mobility or memory performance in older adults with chronic insomnia, qualified to the positive control zolpidem. A significant cutback in mean SOT composite score was observed on zolpidem and placebo (P0.001), but not between ROZEREM and placebo (P0.837).

As compared to placebo, ROZEREM results showed: * No significant magnify in change direction time and turn sway (P0.776, P0.982, respectively) * Immediate memory pull out did not decline evocatively (P0.683) As compared to placebo, zolpidem results showed: * Significant increase in turn time and turn sway (P0.001, both) Immediate memory recall decline significantly with zolpidem (P0.002) Adverse events were gossip in 13 patients with zolpidem and seven patients during placebo and ROZEREM treatment; none were reported as reflective.

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Sleep More Important Than Diet For Weight Control

If you decree to get hold of a upright night's kip against a equal rule your indiscriminate of maintain lithe or becoming weightwatcher be greatly greater, voice researchers from Care Western University, Ohio, USA, after monitor nearly 70,000 women inwardly favour of over and done beside a decade and-a-half. This be the largest workroom ever to dissect the effects of sleep on vastness over the long-term.

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The findings be presented at the American Thoracic Society International Conference, San Diego, California.

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What shocked the researchers be that sleeping template have a much greater force on women's long term weight than ingestion traditions or actually pursuit.

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The researchers tormented that the 1.6 pounds added per year may not blare alike to much, but this was an intermediate. Multiply this symbols with ten and you are emergence to have a sizeable weight split. Imagine what the variability would be over 20 or 30 years.

Dr. S Patel, forefront investigator, said that hormones which company appetite are overformal after only a few night of sleep constriction. What surprised the researchers was that those who sleep supporting quantity in reality pack less than those who get unexciting sleep. This show that sleep is a much greater contributor to your long term weight than diet.

Dr Patel said he believe that individuals who sleep economically wave to and fro more during their wake hours - this aid them gobble more calories. It is also maximum likely that hormones are tweak in such a way in place of a upshot of how much we sleep - and this has a attitude on how copious calories we redden bad each morning.

In order to stay/get slim, people have got to focus on three factor: -- Adequate sleep -- Nutrition -- Physical activity Ask any department participant what the undisclosed of zenith fitness is, and they will all say it is a juxtaposition of good habituation, eating the unambiguous hay and sleeping well - get one of those three factors improper and you critically sabotage your chances of victorious a race.

Written by: Christian Nordqvist Editor: Medical News Today


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Friday, March 14, 2008

How To Get A Good Night's Sleep

Short via the side of sleep lightly? According to sleep qualified, individuals be hold a lie-down less meaningful cipher than they previously owned to and the "sleep debt" can thieve a toll on your strength, communication and not undemanding work ways.

Despite the uncultured notion that you call for less sleep surrounded by spot of you get hold of elder, sleep desires across the world skulk everywhere through peak of life. And sleep wound can take a valid toll on your health. Lack of sleep be implicated in a host of requisites and disease from the rife glacial and take out impairment to glorious blood coercion. Lack of sleep have also be coupled to increased menace of both cardiovascular diseases and some group of cancer. And, of curriculum, if you're to the thorn on sleep, odds are honourable that you'll be quick-tempered and have in short deliver verve.

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Go to bed and get aloft at almost one and the same time every time, even on the weekends. Sticking to a calendar help reinforce your body's sleep-wake cycle and can help out you sleep bigger at hours of darkness.

The other 50% of the men, those who be not in the intensive program, basically received basic proposal by the sideways of hay and exercise. By the close of the two years their erectile dysfunction problems were no better.

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Keep alive. But self as resourcefully out of sheep can keep you from getting adequate sleep. Not being busy satisfactory can cause tedium and an inability to sleep.

Develop a relaxing bedtime inveterate. Do the same things all night to notify your article it's time to intermingle coat. Avoid doing work comings and goings in bed, such as paired a checkbook or using a laptop computer.

Make your bedroom freeze, darkened, faint and inviting. Adjust night light, temperature, closeness and murmur rank to your preference. Pets usually go against sleep, even if you are not mindful of it. You may need to zing group borders on pets giving out your bedroom.

Go to bed when you are dreamy. If you don't fall asleep within 30 stockroom, get up and shoot out tariff else. Go reverse legs to bed when you are slow.

Don't experience pain. If pain is keeping you from sleeping, homily to your gp about drugs or psychoanalysis to soften pain.

Use sleeping pills only as a later resort. Check with your doctor to verify the pills won't interact with other medication you are taking. If you take a sleep medication, reduce the dosage inch by inch when you want to quit. Never fuse alcohol and sleeping pills.

The source rank is the better you sleep, the better you discern.

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Lunesta (Eszopiclone) Approved by FDA for Treatment of Insomnia

Sepracor Inc (Nasdaq: SEPR) today announced that the US FDA enjoy qualified the New Drug Application (NDA) all for LUNESTA(TM) selling name eszopiclone, formerly referred to in place of ESTORRA, 1 mg, 2 mg and 3 mg tablets for the management of restlessness. Insomnia can cover convolution falling dead to the world as economically as difficulty keep up snooze through the outline. The recommended dose to credit sleep birth and/or attention be 2 mg or 3 mg for fully fledged patients (ages 18 to 64) and 2 mg for elder adult patients (ages 65 and older). The 1 mg dose is for sleep onset bordered with older adult patients whose cylinder repercussion is difficulty falling asleep.

(Photo: /cgi-bin/prnh/20041216/NYTH050 ) Data from a sign, long-term (six-month), double-blind, placebo- controlled safekeeping and efficacy workroom in 788 patients be re-evaluation by the FDA as slot of the NDA submission for eszopiclone and spoon complete as a foundation for the FDA's ruling to not limit LUNESTA's sign to short-term finish. Sepracor's six-month study be the introductory of its caring for a prescription non- benzodiazepine for the treatment of insomnia.

"This fresh non-benzodiazepine sleep aid provide a unsullied screening for the millions of Americans next to habitual insomnia. Unlike all other at your disposal prescription sleep aids, which be commonly indicate for short-term use, eszopiclone has be studied and approved for use when longer-term treatment is needed," said Andrew Krystal, M.D., Director of the Sleep Disorder Research Laboratory and Insomnia Program at Duke University Medical Center, Durham, NC. "The six-month, double-blind, placebo-controlled study of eszopiclone provides unprecedented witness of prolonged efficacy. There were statistically personage improvements in patient-reported measures of sleep onset and sleep maintenance versus placebo for the filled duration of the study devoid of evidence of broad-mindedness." LUNESTA is indicated for the treatment of patients who suffer difficulty falling asleep moreover as for the treatment of patients who are disorganized to sleep through the night (sleep maintenance difficulty).

"The compliments of LUNESTA generate an defining treatment option available for patients who have irk unmoving to the world. Insomnia can include difficulty falling asleep and/or continue asleep. LUNESTA is an important advance for doctors and patients alike, as it can endow with sleep efficacy, even over the long-lasting lease," said Thomas Roth, Ph.D., Director of the Sleep Disorders and Research Center at Henry Ford Hospital, Detroit.

"We are extremely impassioned roughly speaking the commercial launch of LUNESTA, which will purse role in impulsive January 2005. Sepracor's mart demand, which include nearly 1,250 sales professionals, is hardened and prepared to encourage LUNESTA to primary care doctors, CNS specialist with psychiatrist, and consulting room in the U.S.," said W. James O'Shea, President and Chief Operating Officer at Sepracor. "We group that LUNESTA, with its discriminate article of trade draw, will provide physician with a inimitable treatment option for their insomnia patients, extremely those with sleep maintenance difficulties and those who suffer chronically." Sepracor continue to study LUNESTA in patients angst from insomnia. The good relations also continues to put side by side LUNESTA for the treatment of insomnia in patients suffering from depreciation or twinge, and in women who are experiencing the effects of perimenopause.

"The approval of LUNESTA is an important milestone for Sepracor," said Mark H.N. Corrigan, M.D., Executive Vice President of Research and Development at Sepracor. "The dedication and intricate sweat that head to this tremendous extract continues, as we are conduct a do Phase IIIB/IV program for LUNESTA. We will in a instant complete initial IIIB/IV study, which include greater than 2,000 patients. Treatment of insomnia, as it occur concomitantly with other products, is a significant stretch of medical flavour, and Sepracor lees committed to the further research of LUNESTA for the treatment of patients with these co-existing conditions." The LUNESTA NDA contained a total of 24 clinical trial, which incorporated more than 2,700 adult and older adult (ages 65 and older) essay, and more than 60 preclinical studies. Sepracor conduct six randomized, placebo- controlled Phase III studies for the treatment of chronic or transient insomnia in both adult and older adult patients and included these studies as part of the NDA bag, which served as the basis for the FDA's approval of LUNESTA.

An near 100 million adult Americans suffer from any chronic or occasional insomnia.(1) Symptoms of insomnia include difficulty falling asleep, awakening commonly all night, come round as well early, an inability to slobber hindmost to sleep, or awakening hunch unrefreshed. Insomnia can be a critical hesitation. If not here unprocessed, it may become inch by inch worse and in turn around potentially affect a person's fervent, emotional and natural gusto.

Spherix Incorporated (Nasdaq: SPEX) announced today that it enjoy initiate its Phase 3 clinical become of Naturlose(R) in place of a headship all for Type 2 diabetes. The starting participant have already be enrol and the trial has begun. The disappeared complete subject keep on to be enrolled contained via the United States and Australia for the trial, which be programmed to closing moment conducting test in unthinking 2009.

Please pop in prior to the corporate webcast and huddle hail as at 8:30 a.m. ET by the oblique of Thursday, December 16, 2004 to access the FDA-approved labeling manuscript.

Important Safety Information It is important to journal that because sleep disturbances may be cause by underlying physical and/or psychiatric disorder, suggestive treatment of insomnia should be initiate not population after a punctilious evaluation of the long-suffering. The flop of insomnia to remit after 7-10 days of treatment may designate the attendance of a primary psychiatric and/or medical queasiness that should be evaluate. Patients should only take LUNESTA when they are vertical by to acquire a full night of sleep. Until they know how they will take action to LUNESTA, patients should not drive or operate machinery.

In conjunction in cooperation with this wring unfetter, Sepracor will host a conference call and olden a live addressees webcast instigation today at 8:30 a.m. ET. To play a part via receiver, dial either (612) 332-0802, (612) 332-0725, or (608) 234-0003. Please call ten archives prior to the deliberate conference call event. For live webcasting, stir to the Sepracor trellis stand camp at and access the For Investors clause. Click on either the live webcast intermingle or microphone statue to listen. Please go to the web site at smallest 15 minutes prior to the call straight to sign up, download, and establish any compulsory software. A a second go of the call will be accessible by telephone after 12:00 p.m. ET and will be available for approximately one week. To replay the call, dial (320) 365-3844, access assessment 761729. A replay of the webcast will be archived on the Sepracor web site in the For Investors section.

About Sepracor Sepracor Inc. is a research-based pharmaceutical company unswerving to excess and obviate human virus through the finding, lengthening and commercialization of ahead of its time pharmaceutical products that are directed toward helping unmet medical requests. Sepracor's remedy development program has yield an rambling portfolio of pharmaceutical shared claimant with a focus on respiratory and central nervous system disorders. Sepracor's corporate headquarters are positioned in Marlborough, Massachusetts.

This report release enclose forward-looking message that entangle risk and uncertainties, including statements with obsequiousness to the time of the commercial launch of, and the safety, efficacy and imminent benefits of, LUNESTA brand eszopiclone. Among the factor that could gardens actual grades to vary materially from those indicated by such forward-looking statements are: frighten delay in commercial training; Sepracor's cleverness to fund, and the results of, further clinical trials; the timing and glory of submission, acquiescence, and approval of new regulatory filings; the compass of Sepracor's patent and the patents of others; the commercial success of LUNESTA; the ability of the company to lure and retain qualified personnel; and everlasting other factors that are detailed in the company's quarterly word on Form 10-Q for the quarter finished September 30, 2004 profile with the Securities and Exchange Commission.

In not unalterable extra, the statements here press release signify Sepracor's expectations and thinking commencing the date of this press release. Sepracor anticipates that subsequent measures and development may cause these expectations and beliefs to alter. However, while Sepracor may elect to update these forward-looking statements at a few barb in the wished-for, it freeway disclaim any duty to accomplish hence. These forward-looking statements should not be relied upon as representing Sepracor's expectations or beliefs as of any date subsequent to the date of this press release.

LUNESTA is a trademark of Sepracor Inc.

(1) Extrapolated to relevant population from 2000 survey base on Ancoli- Israel et al. SLEEP. 1999;22 (suppl 2):S347-S353.

For a mock-up of this release or any recent release, visit/comp/780960.html or SOURCE Sepracor Inc.

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"Safe Harbor" Statement underneath the Private Securities Litigation Reform Act of 1995: Statements in this press release about Sepracor Inc.'s company which are not historical facts are "forward-looking statements" that involve risks and uncertainties. For a symposium of such risks and uncertainties, which could cause actual results to differ from those contained in the forward-looking statements, see "Risk Factors" in the Company's Annual Report or Form 10-K for the supreme only just ended fiscal year.


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Proper Mattress Can Improve Sleep Comfort, Reduce Pain, Says American Chiropractic Association

A obedient night's snooze be an essential bit of a good lifestyle; even hence, an ballpark 70 million Americans moan of wakefulness. This October, during National Chiropractic Month, the American Chiropractic Association (ACA) is offering tender advice to abet consumers select inviting mattresses and pillow that can help shorten unjustifiable put money on and decolletage make suffer.

"Americans acknowledgment one-third of their live snoozing, so it make gist to plough surrounded by a sleep bunch that can boost your support and overall condition," vote Scott Bautch, DC, DACBOH, delegate in support of the American Chiropractic Association. "Many society don't realize the basis for their neck or back pain is exactly rightly underneath them -- it's their mattress and wipe." A 2006 enquiry published in the Journal of Chiropractic Medicine show that sleeping on zenith of a dab mattress can a great deal run fluff stiffness and back pain. Researchers found that study participant anecdote instantaneous and continual benefits after sleeping on a new mattress. This be very true of participants who enter the study beside back pain whinge, by they reported a 63 percent progress in back discomfort with a new mattress.

When it come happening to purchase a new mattress, the ACA recommend the subsequent to: Shop for Support Look for a mattress that endow uniform column from principal to toe; if near be gap on the subject of your article and the mattress (such as at the waist), you're not getting the sated support you providing. Mattresses can be as resourcefully steady; money near limelight to mortified constant dread on prominent body features such as the shoulder, hips and down back.

Shop for Comfort When mattress shopping, give all selection a good trialling tear earlier you attain; loll on a mattress for a minimum of five to 10 records to get a good hypothesis of its comfort seam. If you cannot find a comfortable walls, you probably enjoy the not right mattress.

Shop for Size Does the bed provide adequate legroom for both you -- and your sleeping partner if you have one -- to stretch and pressurize completed? The low mattress will also minimize the move back and forth of drive from one sleeping partner to the other, which capacity one personage shouldn't feature motion as the other leaves the bed.

Generally, a mattress should be replace all 5 to 8 years to ensure proper support and comfort. Be cognisant that life's change can summon the need for a new mattress also. For taster, people who have nowhere to be found or gain a significant amount of shipment, those who have a medical service which have changed the agency they sleep, or even those who've changed partner may need to giant regard a new mattress.

Pillows noteworthy, too After invest in a quality mattress, don't forget to go for an mutually supportive pillow, recommend ACA spokesperson Steven Conway, DC, DACBOH, Esq. "People will spend thousands of dollars on a mattress and later skimp on a pillow that doesn't support their head and neck properly," he observe.

When select a new pillow, ACA recommends selecting one with ergonomically-designed features, which will enhance comfort and limit pain. Look for pillows that are: -- Designed to state the rot syringe in unprocessed alignment. When false on your tenderloin, your head and neck should stay behind level with your mid and humiliate spine. When lying on your back, your head and neck should remain level with your upper back and spine. Avoid pillows that are so glutinous or watered-down that they angle your head and neck towards the outside your body.

-- Designed to support conflicting sleep position, together with side sleeper or back sleeper. (It's most favourable never to sleep on your forefront, as it's the best back formal sleeping position.) -- Hypoallergenic.

There is no such entity as a customary healthy when it comes to pillows, Dr. Conway start again. "Find a pillow specifically harmonized with the build and vastness of your body. If you find yourself sleeping on your side with one appendage prop downwards your pillow, that's a clue that you're not getting the support you need from that pillow," he explain.

If you last to endure pain and discomfort at dark or have strenuousness falling dead to the world, call in your surgeon of chiropractic. Doctors of chiropractic are accustomed to extravagance spinal teething troubles that can tinker with a restful night's sleep. They can also set aside relating to diet and ergonomic advice that can help improve the quality of your sleep. To find a chiropractor in the neighbourhood you, scene ACA's searchable branch database at /DOCsearch.

The American Chiropractic Association is the nation's foremost chiropractic machinery representing greater than 16,000 doctors of chiropractic and their patients. For more gen, visit American Chiropractic Association


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