Cleveland Clinic journal of medicine
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Obesity affects 42% of US adults and has a devastating impact on health. Although many patients initially lose weight with diet and exercise, long-term weight loss is difficult to achieve. ⋯ Choosing an antiobesity drug regimen should be an individualized, shared decision-making process that accounts for patient preferences, comorbidities, and out-of-pocket costs. We review antiobesity drugs and propose an individualized and comprehensive approach to obesity management.
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Antibody-mediated autoimmune encephalitis (AE) is a heterogeneous group of inflammatory central nervous system disorders. Symptoms typically include subacute, progressive neuropsychiatric symptoms with associated cognitive dysfunction, movement disorders, and autoimmune seizures. ⋯ Treatment with immunotherapies requires both short-term and long-term strategies depending on the specific syndrome and potential for relapse. In this paper, we review key features of AE, focusing on syndromes involving cell surface and synaptic proteins, and share a practical approach to the diagnosis and management, including common pitfalls associated with nonspecific antibody findings.
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The obesity paradox describes a survival benefit for higher body mass index in patients with heart failure. But other factors like cardiorespiratory fitness may play a role in heart failure development, severity, and survival. Although more research is needed to better understand the relationships between body mass index and fitness in patients with heart failure, evidence indicates that recommending weight loss and an exercise program is appropriate for most patients.