The Journal of family practice
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YES. For both normal-weight and obese men with low testosterone levels and hypogonadal symptoms, selective estrogen receptor modulators (SERMs), such as clomiphene citrate (CC) and enclomiphene citrate (EC), appear to be effective and safe for improving serum testosterone levels (strength of recommendation [SOR]: C, disease-oriented outcomes from randomized controlled trials [RCTs] and cohort studies). Studies also show that symptom improvement is comparable to that with exogenous testosterone replacement and similar to eugonadal men (SOR: B, patient-oriented outcomes from retrospective cohort studies).
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A Pink, elevated, granulomatous, indurated plaques on the face, including the nasal alae, of a 52-year-old woman with a darker skin tone. B Orange and pink, elevated, granulomatous, indurated plaques on the face of a 55-year-old woman with a lighter skin tone.
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Often mistaken for a cyst or acneiform lesion, this lesion is actually quite aggressive-and worrisome.
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Caring for aggressive patients with dementia can lead to exhaustion, fear, and burnout. These strategies can help improve the welfare of both caregivers and patients.
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A full biopsychosocial interview is key, including use of an efficient tool such as the S2BI questionnaire to quickly stratify risk level and to guide follow-up decisions.