La Ataxia es una enfermedad de alteración genética que consiste en la disminución de la frataxina en las mitocondrias (pulmones de la célula). Esto trae como consecuencia un exceso de hierro que al oxidarse produce radicales libres, que son tóxicos para la célula generando daños irreversibles en ella. La ataxia hereditaria es la más frecuente que existe, se da en menores de 20 años  con diversos signos que nos podrían hacer sospechar de la existencia de esta enfermedad.

Consecuencia

Entre las consecuencias más palpables podemos mencionar la inestabilidad y falta de coordinación al caminar, inestabilidad postural progresiva. Puede ser simétrica y sensorial lo cual se propaga hacia los brazos (apendicular) y luego al tronco. También presenta disartria que es la dificultad para articular palabra.

Muchos sistemas son afectados debido a la ataxia, entre ellos podemos mencionar: 

  • Neurológico: Se presenta una disminución de masa muscular en zonas distales, disminución de reflejos rotulianos (en el tendón de la rodilla) y aquilianos (en el tendón del talón). El signo de Romberg será positivo (consiste en quedarse parado primero con ojos abiertos y luego cerrados, la idea es ver si pierde el equilibrio). Signo de Babinski positivo que es una reacción al rozar la planta del pie y que el primer dedo vaya en dirección hacia la cabeza. Pérdida a la sensibilidad vibratoria y de posición de las articulaciones en el espacio; en algunos casos presentan atrofia óptica, nistagmo y sordera,
  • Cardiacas: pueden presentar una miocardiopatía con alteraciones de las ondas normales del corazón, arritmias son fibrilación auricular cuando ya está muy avanzada la enfermedad.
  • Musculares: por la falta de estabilidad van a adoptar posturas cifóticas (encorvadas) y por tanto van a disminuir su amplitud torácica y volúmenes respiratorios. Algunos adoptan pie cavo o equino por el tipo de marcha que realizan.
  • Endocrinas: pueden padecer diabetes, por lo que se debe cuidar su alimentación.

Es importante saber que es un enfermedad de progreso lento y su principal inconveniente es la pérdida de la capacidad para caminar por sí solo, muchas veces puede pasar hasta 15 años luego del diagnóstico, la mortalidad generalmente se debe a infecciones recurrentes o a la miocardiopatía; es por ello, que la intervención de un equipo multidisciplinario de manera precoz es vital para mantener la independencia y calidad de vida del paciente.

Si está interesado en encontrar la forma de menguar el proceso de deterioro y encontrar una forma de tratar esta enfermedad, no dude en comunicarse con Hogar Salud.

Contáctenos al:
Celular: 973040749
Central: (01) 7951224
Corre: consultas@hogarsalud.com.pe

This Post Has 856 Comments

  1. buy cialis pills

    Hi my loved one! I wish to say that this post is amazing, nice written and include approximately all significant infos.
    I’d like to look extra posts like this .

  2. israelnightclub.com

    Can I just say what a comfort to find somebody who really knows what theyre talking about on the web. You definitely understand how to bring an issue to light and make it important. More people have to read this and understand this side of your story. I was surprised that you arent more popular because you surely possess the gift.

  3. Defincese

    where to buy cialis cheap persantine motilium urup niin kullanlr MUNICH, Sept 15 Reuters Bavarians cast their ballots onSunday in an election that is expected to hand Angela Merkel sallies nearly 50 percent of the vote, giving the Germanchancellor and her conservatives momentum a week before afederal election

  4. Nuplida

    Strategies to Prevent OHSS cialis 10mg If you have a history of the polycystic ovarian syndrome, you should mention this to your doctor as starting hormone therapy can exacerbate its symptoms

  5. clewabs

    We estimated the average daily caffeine intake by computing the consumption of all food sources of caffeine and the caffeine content found in the literature for these foods; in our study, the caffeine contents were 72 8 mg 125 ml coffee, 13 8 mg 125 ml tea, 16 1 mg 125 ml chicory beverage, 17 6 mg 330 ml cola, 2 1 mg 30 g chocolate candy and 17 8 mg 30 g plain chocolate how do i get a prescription for viagra Students are expected to come to the HPS simulations with some background knowledge and experience

  6. vorbelutr ioperbir

    An interesting discussion is worth comment. I think that you should write more on this topic, it might not be a taboo subject but generally people are not enough to speak on such topics. To the next. Cheers

  7. bem

    Wenn Sie mit einer vorgeschlagenen Joker-Zahl nicht einverstanden sind, dann klicken Sie einfach auf das Symbol neben der Joker-Zahl. Das System schlägt Ihnen dann eine andere Zahl vor. Christina Pichlmaier Nächste Ziehung Nächste Ziehung Jackpot beim Joker – 450.000 Euro im Pot. Bei LottoPlus endete die Oster-Runde ohne Sechser. Dafür gab es gleich 130 Fünfer, auf die die Gewinnsumme aufgeteilt wurde. Jeder Spieler kann sich somit über jeweils mehr als 3.700 Euro freuen. Beim LottoPlus-Sechser der nächsten Runde geht es um rund 200.000 Euro. „Das Glück ist ein Vogerl“ – so sagt man in Österreich. Es gibt wohl kaum eine treffendere Beschreibung für das Glücksspiel Lotto, welches seit 1986 viele Österreicher in seinen Bann gezogen hat und mittlerweile zweimal pro Woche zu den Lottoannahmestellen treibt. Seit der Einführung des Spiels Lotto 6 aus 45 durch die staatlichen Lotterien in Österreich konnten sich 825 Personen über einen Millionengewinn freuen und sich von da an als Lotto-Millionär bezeichnen. Mittlerweile können die „hoffentlich“ 6 Richtigen aber auch online getippt werden, Lottospieler müssen also nicht mehr den Weg zur Lottoannahmestelle ums Eck antreten.
    https://www.tsgfoundation.org/community/profile/lamarburkett081/
    Wir entwickeln unsere App laufend weiter! Diesmal haben wir einige kleinere Fehler im Hintergrund behoben, und die App auf den neuesten Stand gebracht. Die Lotterien Welt im Newsletter-Format: Jetzt kostenlos Glückspost abonnieren und keine Gewinnspiele, Promotions und Aktionen mehr verpassen! Wir aktualisieren Daten für 6 verschiedene Lotterien in Österreich. Diese Lotterien und ihre Gewinnzahlen sind unten aufgeführt Das französische Energieunternehmen EDF will 2024 in Penly am Ärmelkanal mit den Bauarbeiten für neue Atomreaktoren beginnen. Konkret gehe es um zunächst zwei von bis zu 14 neuen Druckwasserreaktoren (EPR), sagte der zuständige Direktor Gabriel Oblin heute. „Wenn die politischen Entscheidungen zügig fallen, können wir Mitte 2024 dort mit den vorbereitenden Bauarbeiten beginnen.“

  8. trern

    Once the bonus round is triggered, you will receive 10 free rounds, which are played automatically. There is a new set of symbols during this feature, which consists of various sleepy, dark-colored energoonz. You want to have anywhere from five to ten of them to receive a win. Once they become a part of a winning combination, the energoonz get an electric charge and wake up. © 2022 Palomar Spine & Pain. All Rights Reserved. Design and Development by Advice Media Energoonz includes a wild symbol (the plasma ball). The wild symbol substitutes for any other symbol to help comprise winning combinations. Winning combinations are removed after collected and remaining symbols drop down to possibly form new winning combinations. The wild symbol appears at the middle symbol when a winning combination of 3 symbols is removed from the grid. A win multiplier is increased at each new drop. If all symbols are removed from the grid, a special full clear win is awarded.
    https://saskkartclub.com/community/profile/florenceu848909/
    And, as in most Novomatic casinos, RTP is much higher when you play with your first deposit than on consecutive desposits. At least, it feels like that. Kedai69 merupakan salah satu situs judi slot online gacor terlengkap yang menyediakan berbagai macam metode deposit, contohnya adalah judi slot deposit via dana. Dengan rtp live terbaik di indonesia dengan berbagai jenis permainan ternama dan bonus melimpah disetiap harinya. Banyak para member setia kedai69 mendapatkan maxwin di bet receh maupun di bet tinggi. Mengapa bisa begitu? karna kedai 69 selalu memberikan pelayanan dan winrate tertinggi kepada setiap member yang bergabung di situs slot online gacor terpercaya ini. Spadegaming adalah penyedia game terkenal di Asia. Saat ini spadegaming adalah salah satu penyedia paling populer. Pada tahun 2022 yaitu tahun in tingkat popularitas mereka meningkat dan tahun ini mereka merilis lebih dari 6 permainan slot baru. Keunggulan dari provider ini adalah merupakan salah satu provider yang paling mudah menang dan memiliki RTP yang tinggi yaitu 96,33%. Selanjutnya yang perlu diketahui juga saat ini provider ini juga merupakan salah satu situs slot gacor Bdslot88 terpopuler di Indonesia. Sangat menguntungkan untuk bermain spadegaming karena hanya dengan taruhan kecil bisa mendapatkan hasil yang besar.

  9. MichaelLiC

    The 9 Best Case Management Software For Law Firms in 2022
    AUG 23, 2022

    Law firms can sometimes be endlessly chaotic. Lawyers, paralegals, and staff members must organize, analyze, and manage every aspect of multiple cases. They must track and monitor:

    Deadlines,
    Statutes of limitations,
    Filing requirements,
    Client records,
    Billing,
    Expert witnesses,
    Evidence,
    and much more.

    Even a smaller case can require a great deal of time organizing documents and tracking details.

    Effective case management is crucial in every law office.

    Regardless of the size of the case or the size of the law firm, failing to have an efficient case management system makes your job much more difficult, at the very least.

    Even worse, failing to manage your cases could result in a costly error or a mistake with irreversible consequences.

    Your law practice doesn’t have to be ruled by chaos. The best case management software available today allows you to incorporate all aspects of managing a case into one platform.

    Table of Contents
    What Should You Look for When Choosing Case Management Software?
    There are many options for case management software. You need to choose software that meets your specific needs.

    Each law firm is unique, and lawyers may have different preferences.

    Fortunately, there are options that allow you to customize a case management program to fit your needs.

    Things you may want to consider include:

    The ease of transferring, storing, and retrieving information
    The ability of the software to work with other programs to gather information and data
    Make minor adjustments and modifications to the system without going through the provider
    The provider offers ongoing, quality support
    Ability to configure the system to adapt it to your needs and current systems
    Ease of retrieving data and create reports, forms, and other documents
    The ability to track time, expenses, and generate invoices and billing documents
    Accept online and credit card payments
    Prepare documents for trial and monitor litigation deadlines
    Many software companies offer free demos or free trial periods. You might need to try several case management software systems before finding the best system for you.

    What Are Some Popular Case Management Software Systems for Law Firms?
    Some of the popular case management software systems available today include:

    CASEpeer,
    FileVine,
    SmartAdvocate,
    Litify,
    MyCase,
    Clio,
    Thomson Reuter’s Legal Tracker,
    Trialworks, and
    LawRuler.
    Here’s a brief overview of each of these top-rated attorney case management systems:

    CASEPeer Logo
    CASEPeer is designed specifically for personal injury law firms. This cloud-based system offers time-saving and organizational features such as:

    Settlement tools to track demands, offers, liens, fees, and costs
    Dedicated tracking of discovery requests and responses
    Integrated calendar
    Automated notifications for statute of limitations
    From the company: “CASEpeer’s powerful built-in tools allow you to constantly evaluate your organization’s workflow, identify opportunities to further develop employees, more effectively communicate on client’s cases, and maximize productivity and results.” -Lucero Smith, COO, CASEPeer

    Demo: Interested in seeing how CASEPeer can help to transform your law firm into a well-oiled machine? Contact CASEPeer today to get started with a free demo.

    Filevine Logo
    FileVine is highly customizable and allows you to keep notes, documents, client communication, and calendar in one place.

    Additional features include:

    Allows multiple users
    Ability to text and email clients
    Task and deadline management
    Integrates with more than 2,000 programs
    Good choice for document management
    Demo: Want to see how FileVine can help you transform your law firm operations? Book a free demo that’s customized to your firm’s particular needs.

    Smart Advocate Logo
    SmartAdvocate is a fully integrated legal case management system. Initially designed for personal injury and mass tort litigation practices, it is now used by a large range of litigation firms.

    Features include:

    Specific tool for tracking insurance information
    Automated workflows
    Medical records tracker
    Fee calculator lets you enter the settlement amount and break out your firm’s fee, any referral fees or other costs for each client
    From the company: “We take pride with each annual release,” Igor Selizhuk, CTO at SmartAdvocate states, “because with each release, we fulfill our promise to our clients to continually provide them with a system that matches their evolving needs.”

    Demo: Interested in learning more about Smart Advocate? Check out their story and discover how this top-rated case management system can be a catalyst for success.

    Litify Logo
    Litify is an integrated solution designed for mid-size and large law firms. It is built on the popular Salesforce platform used by many businesses for automation and analytics.

    It features:

    Robust security
    Automated tasks
    Customizable dashboard to track key performance indicators
    Testimonial: “Working with Litify is like having the best developers in the world as my software guys,” said Johnson. “They understand the legal industry, know what works for the big firms, and bake the best practices right into the platform.

    As the owner of a younger firm, I don’t have to reinvent the wheel.” Anthony Johnson Owner, Attorney at Law Johnson Firm

    Visit www litify com to learn more about how you, your team, and your clients could all benefit from a partnership with Litify.

    Mycase Logo
    MyCase offers an all-in-one case management software solution to document management, time tracking, invoicing, payment collection, and calendaring.

    Some of its key features are:

    Simple user-friendly interface
    Simple pricing structure includes all features instead of having to add options
    Unlimited e-signatures included
    MyCase offers a free 10-day trial, so you can test the software and see if it’s a good fit for your practice.

    Clio Manage Logo
    Clio Manage offers a variety of features, including billing, contact management, document management, calendaring, accounting, task management, online payments, and time tracking.

    A few highlights of Clio include:

    Secure client portal for document sharing
    Matter timelines display who made changes and when updates were made
    Separate module available for client intake/client relationship management
    Clio is versatile and has customizable solutions for everything from solo to large firms.

    Thomson Reuters >ogo
    Legal Tracker has features such as eBilling, matter management, reporting, analytics, cloud integrations, data services, and legal operations.

    It offers such features as:

    Legal analytics to track budgets and compare performance of outside legal counsel
    Robust reporting system
    Excellent collaboration tools
    This Thomson Reuters system is geared towards helping corporate in-house legal departments track and organize their legal teams.

    Trialworks Logo
    Trialworks is a cloud-based solution created by trial lawyers with options for mobile case intake, document management, calendaring, and trial management.

    Some distinct features include:

    Litigation-centered tools
    Based on familiar Microsoft Office platform
    Available as software to be used on local network or cloud-based
    Offers database conversion (as a separate service)
    Check out their website to learn more and schedule a free demo.

    Law Ruler Logo
    Law Ruler has customized solutions for litigation firms and is integrated with Office 365 for convenient workflow. Its detailed dashboard analytics help you keep track of case status, leads, and marketing performance.

    Other features include:

    Built-in settlement calculators
    Automated text and email reminders
    Integrated click-to-call dialer powered by artificial intelligence
    Managing your cases effectively improves customer service, as well as your legal services. You have more time to devote to your clients and work on their cases when you do not need to worry about the day-to-day logistics of case management.

    FAQs About Law Firm Case Management Software
    If you are not familiar with case management software, these frequently asked questions may help you understand why your law firm needs to invest in high-quality case management software.

    WHAT IS CASE MANAGEMENT SOFTWARE?
    Managing legal cases requires a system for keeping up with detailed information about each case. Case management begins before your client hires your law firm. You need an effective way to perform conflict checks before your client signs a retainer agreement.

    Throughout the case, there could be hundreds or thousands of documents to organize, deadlines to monitor, statements to process, and other details that must be analyzed and organized into categories that are easy to search.

    You also have billing, client communications, contact information, appointment scheduling, court information, and case notes to organize and manage.

    After closing the case, you need a system for storing and archiving the case that allows for continued conflict checks. You may also need to access information in one case to assist with a matter in a related case or similar case.

    Today, digital files must be stored, organized, and cataloged. The days of managing legal cases by hand are over.

    WHAT CAN CASE MANAGEMENT SOFTWARE DO FOR MY PRACTICE?
    Gathering, analyzing, and organizing large amounts of information, data, and documents is a significant element of case management. Many lawyers, paralegals, and case managers have multiple cases they handle. As a result, the volume of data can be overwhelming.

    Case management software provides an efficient way to collect and organize data.

    Many software programs link to email, telephone, and other systems to create calls and message logs. The information is stored in the client’s file immediately.

    Tracking contacts with clients, including calls and emails, through the software help to ensure that you do not miss anything.

    Having all the information in one place makes it easy to:

    create reports,
    visualize evidence, and
    collaborate with other staff members.
    In addition, everyone within the law firm can access the case files and all information stored in the files from their desktop or tablet.

    WHAT ARE OTHER BENEFITS OF CASE MANAGEMENT SOFTWARE?
    In addition to managing the data, documents, and other information associated with a client’s case, there are other benefits of using case management software.

    REDUCE THE RISK OF MISTAKES
    Case management software can reduce the risk of human error. Mistakes happen when you are handling multiple cases and thousands of documents. Case management software completes many of the tasks automatically, which reduces the risk of errors and mistakes.

    For example, errors in transferring data to forms could be costly and time-consuming.

    When the data is contained in case management software, the software transfers the data ensuring there are no errors.

    ENHANCE SECURITY
    Lawyers have a fiduciary duty to protect confidential information. A data breach could result in the theft or exposure of sensitive information. Case management software can add another layer of security for data.

    The software also automatically backs up entire files to ensure that nothing is lost in case of a data breach or natural disaster.

    FACILITATE REMOTE WORK
    Lawyers and staff members can access client files and data from work, home, and other locations. In addition, case management software that is cloud-based allows employees to access data even when telecommuting.

    TRACK LEADS
    In addition to managing your current cases, case management software can help you track leads. An efficient, easy-to-use system to track and follow up with leads increases retention rates for the law firm.

    A lead can be entered into the system, forwarded to the correct person to respond, and scheduled for a follow-up. All information about the lead is in one location that is accessible to everyone.

    IMPROVE EFFICIENCY
    Case management software increases efficiency. Everyone working on a case can access and update information. Having data in a system that permits easy retrieval reduces the time it takes to locate information.

    Get More Insight Into Case Management For Your Law Firm
    At LawRank, we specialize in SEO for lawyers: getting law firms like yours to rank for competitive, high-volume keywords in competitive markets.

    We know that your business operations have to be set up for success when you begin to see an influx of calls and clients.

    That’s why we’re ready to help you discuss your case management needs and provide some insight into popular systems. We can even connect with you with leading case management software providers.

    Get in touch with our law firm SEO specialists to learn more today.

    Updated 2022

  10. Map

    Free versions are available to play for most popular slot games from trusted software developers. We keep thousands of great free slots here at VegasSlotsOnline.com for you to choose from. The Bank is always open to spin for free and go for 10 total Jackpots! Who needs Vegas casino games when you have the glitz, glamour of two fan favorite features, Classic Star and Rapid Fire, PLUS Super Bonus! You’ve just discovered the biggest online free slots library. Like thousands of slots players who use VegasSlotsOnline.com every day, you now have instant access to over 7780 free online slots that you can play right here. With no downloading required, you can now play your favorite slot machine game for free from any device! Simply login with your email address or Facebook account and play! Discover the thrill without the hassle! You no longer have to pay to be entertained! Play for free today to win the ultimate Jackpot!
    https://medvacancy.ru/user/profile/464291
    Judi slot online adalah pilihan game judi online slot tergacor di indonesia yang sudah sangat populer dan memiliki peminat terbanyak dalam hal judi online dan pemakaiannya. Beberapa pemain slot online gacor harus tahu bagaimanakah cara bermain slot terbaru paling gacor dengan mekanisme main yang mudah dan terkini juga termasuk bermain game slot online dengan mekanisme mumpuni. Kalian juga dapat bermain game slot gacor jackpot terbesar hari ini di beberapa pilihan provider slot gacor dengan syarat &ketentuan main yang gampang dengan winrate rtp slot tertinggi di indonesia dihadirkan oleh link slot gacor gampang menang 2023 AIRBET88. Sudah bukan rahasia lagi kalau GADUNSLOT disebut sebagai situs judi online terlengkap, lantaran menghadirkan berbagai permainan judi online yang lengkap. GADUNSLOT menghadirkan berbagai jenis taruhan online seperti Slot, Sportsbook, Casino, Arcade, Poker, Togel dan yang terbaru adalah E-Sports. Berikut adalah Daftar Permainan Judi Online Terlengkap yang ada di Situs Judi Online Terlengkap:

  11. Juinc

    Уже через 28 дней регулярного использования Xlash вы заметите, что ваши ресницы окрепли и стали длиннее, длина ресницы увеличится на 72%, густота – на 33%, цвет станет на один тон темнее. Объем флакона – 3 мл, этого хватит на 3 месяца регулярного применения. Нет, использовать сыворотку XLASH чаще одного раза в день нет необходимости – это не ускорит рост ресниц. Средство рассчитано на использование один раз в сутки и мы не рекомендуем использовать его чаще. Xlash является активатором естественных сил организма, направленных на рост ресниц. Он считается космецевтическим средством и действует очень быстро и эффективно. Первые результаты заметны уже через 4 недели использования, а через 2-3 месяца ресницы становятся значительно длиннее, объемнее и темнее. Продукты В итоге, через несколько месяцев мои родные ресницы невероятно длинные. Теперь я настоятельно советую всем девушкам не наращивать ресницы в салонах. Во-первых, это травматично для родных волосков. Во-вторых, выглядит не естественно и даже как-то вульгарно. С помощью Хлаш вы можете вырастить свои красивые реснички и поражать всех натуральной красотой. В моде сегодня естественность!
    http://www.ogcil.or.kr/bbs/board.php?bo_table=free&wr_id=64857
    – Эффект укладки бровей на 100% Воск для бровей – это популярное косметическое средство, которое используется как для их моделирования, так и для укладки. Если правильно применять этот простой продукт, можно очень быстро исправить все свои маленькие недостатки. Фиксирующий воск, как правило, имеет легкую прозрачную структуру. Восковой карандаш прост в использовании. Он отлично подходит для быстрого и эффективного создания нужной укладки в домашних условиях. Существует несколько видов моделирующего воска для бровей. Добро пожаловать в наш магазин! Состав: воск пчелиный, экстракт целебной тамбуканской грязи, масло репейное, масло касторовое, масло кокосовое, масло фисташковое, экстракт корня аира. Эпиляция бровей воском с каждым днем становится все популярнее. Даже начинающие бровисты сейчас начинают использовать воск вместо привычной нити или пинцета при коррекции формы.

  12. gralion torile

    I cherished up to you will receive performed proper here. The caricature is attractive, your authored material stylish. nevertheless, you command get got an impatience over that you want be handing over the following. ill indisputably come further beforehand again as exactly the similar just about very continuously within case you defend this hike.

  13. lup

    Agora você tem acesso a todo o conteúdo do nosso portal! Na noite desta quarta-feira (26) aconteceu mais uma Prova do Fazendeiro na Fazenda 14 «Já que você não negociam, não liberar o Jair, a gente (São Paulo) vai fazer jogo duro para liberar o Patrick. Eu ainda acho que essa negociação do Patrick vai sair porque ainda pesa muito o desejo do jogador. Jair que foi procurado pelo Inter, pelo Grêmio, pelo São Paulo, mas vai para o Vasco», revelou o jornalista.  De 0 a 10, qual a sua satisfação com o conteúdo especialmente selecionado para você? Necessary cookies are absolutely essential for the website to function properly. This category only includes cookies that ensures basic functionalities and security features of the website. These cookies do not store any personal information.
    http://koreaht2.motionblue.org/bbs/board.php?bo_table=free&wr_id=91209#.ZEe_1na9thE
    Resumo do pedido O Santos era grande, mas não invencível, pois nenhum time de futebol é imbatível e não existem gênios infalíveis. Para comprovar, três dias antes, o Santos havia sido goleado por 5 a 1 pelo Guarani, no Brinco de Ouro da Princesa, em Campinas. Ainda por cima, Pelé havia perdido um pênalti. Então veio o jogo contra o Botafogo de Ribeirão Preto, na Vila. O desejo da torcida, e do time, era vingar-se da derrota do primeiro turno, em Ribeirão, quando o Botafogo havia vencido por 2 a 0. O Internacional foi superior durante toda primeira etapa. Logo aos dois minutos de jogo, o Inter abriu placar com o zagueiro Rodrigo Moledo, em bola levantada na área. Porém, o VAR revisou o lance e assinalou impedimento. O Roger Guedes jogou com raça e coração!, jogou muito!

  14. bafAppank

    Primary data collected to obtain estimates of out of pocket expenditure OOPE and utility weights real propecia from canadian pharmacy Careful selection of healthy normotensive individuals may reduce confounding, but inclusion of these individuals may introduce other biases and reduce the generalizability of the findings