The Medical clinics of North America
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The behavioral treatment of obesity consists of a set of principles and techniques to help overweight individuals modify inappropriate eating and activity habits. As provided in University and hospital clinics, this approach produces an average loss of 8.5 kg (9% of initial weight) in approximately 20 weeks. ⋯ The most promising results are likely to be obtained when behavioral and pharmacologic approaches are combined. The article concludes with a discussion of the importance of treating obese individuals with respect and compassion.
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Frailty is a wasting syndrome of advanced age that leaves a person vulnerable to falls, functional decline, morbidity, and mortality. The cause of this syndrome is complex but likely has a biologic basis. Studies by the authors' research group have validated a phenotype of frailty [table: see text] and have established a gender difference in prevalence with women twice as likely to develop the syndrome as men. ⋯ There is also evidence of immune system dimorphism that is, in part, responsive to sex steroids, perhaps making men more vulnerable to sepsis and infection and women more vulnerable to chronic inflammatory conditions and muscle mass loss. The net effect of the hormonal dysregulation and immune system dysfunction is an accelerated loss of muscle mass. There is also evidence that lower levels of activity and lower caloric intake in women as compared to men may also influence the phenotype of frailty and make women more vulnerable then men to the syndrome.
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The authors cover many topics, including hypothalamic-pituitary-testicular axis and aging, sexuality, muscle strength, Leptin, osteoporosis, etc. They examine the ADAM Questionnaire and develop six conclusions regarding older men and testosterone.
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Med. Clin. North Am. · Sep 1999
ReviewOlder men's health. Sociocultural and ecological perspectives.
This article identifies a set of conditions that renders the morbidities and earlier deaths of men as the outcome. The article also discusses four factors that affect older men's health and longevity: culture, class, race and ethnicity, and social organization and participation.
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The differential diagnosis of a febrile illness in the returned traveler is extensive. The most commonly encountered tropical infections are malaria, dysentery, hepatitis, and dengue fever; a substantial number of febrile illnesses are never diagnosed. ⋯ The ability to recognize and manage tropical diseases in travelers is essential because the morbidity and mortality of these infections are often preventable with prompt therapy. When expertise in this area is lacking, febrile returned travelers should be referred to a tropical disease unit or an infectious disease consultant for urgent assessment.