Cleveland Clinic journal of medicine
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Hyperuricemia has long been known to be associated with cardiovascular disease, and it is particularly common in people with hypertension, metabolic syndrome, or kidney disease. Most authorities have viewed elevated uric acid as a secondary phenomenon that is either innocuous or perhaps even beneficial, since uric acid can be an antioxidant. ⋯ In this paper we argue that uric acid is a true risk factor for cardiovascular disease. Furthermore, we suggest that the recent increased intake in the American diet of fructose, which is a known cause of hyperuricemia, may be contributing to the current epidemic of obesity and diabetes.
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Patients typically lose more than 50% of their excess weight after bariatric surgery. Obesity-related diseases markedly improve, reducing cardiovascular risk and improving life expectancy. Obese patients lose more weight with bariatric surgery than with medical weight-loss treatment.
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If usual medical measures fail to control the pain of knee osteoarthritis and allow the patient to cope with its symptoms, intra-articular injections of a corticosteroid, a hyaluronan, or both can be tried.
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If a patient has frequent, severely debilitating migraine headaches, prophylactic treatment may help. Beta-blockers, tricyclic antidepressants, and anticonvulsants have the best evidence of efficacy; calcium channel blockers and nonsteroidal anti-inflammatory drugs are also popular because they are well tolerated and inexpensive. We review migraine treatment with emphasis on prophylaxis.