MKSAP: 49-year-old woman with obesity, hypertension, and type 2 diabetes mellitus
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 49-year-old woman is evaluated during a follow-up visit. She is overweight and has hypertension and type 2 diabetes mellitus, both of which are well controlled. For several years, she has attempted to lose weight through various commercial diets; dietician-monitored, calorie-restricted diets; and physical activity. She has worked with a behavioral therapist, and although she has not achieved weight loss, her weight has remained stable. She exercises 30 minutes daily. Medical history is also remarkable for glaucoma, generalized anxiety disorder, and chronic constipation. Medications are lisinopril, metformin, timolol eye drops, and sertraline. On physical examination, temperature is normal, blood pressure is 128/74 mm Hg, pulse rate is 70/min, and respiration rate is 12/min. BMI is 29. Waist circumference is 92 cm (36 in). Head, neck, lung, and heart examinations are normal. The abdomen is obese without striae. In addition to continuing calorie restriction and exercise, which of the following is the most appropriate management to help this patient achieve weight loss? A. Lorcaserin B. Orlistat C. Phentermine-topiramate D. Roux-en-Y gastric bypass Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Authors: Bergland OU, Søraas CL, Larstorp ACK, Halvorsen LV, Hjørnholm U, Hoffman P, Høieggen A, Fadl Elmula FEM Abstract PURPOSE: The blood pressure (BP) lowering effect of renal sympathetic denervation (RDN) in treatment-resistant hypertension shows variation amongst the existing randomised studies. The long-term efficacy and safety of RDN require further investigation. For the first time, we report BP changes and safety up to 7 years after RDN, compared to drug adjustment in the randomised Oslo RDN study. MATERIALS AND METHODS: Patients with treatment-resistant hypertension, defined...
Authors: Zhang W, Xu JZ, Lu XH, Li H, Wang D, Wang JG Abstract PURPOSE: We hypothesise that dietary sodium intake interacts with serum uric acid to influence blood pressure (BP) in children and adolescents. In the present study, we investigated ambulatory BP in relation to hyperuricaemia, dietary sodium intake and their interaction in children and adolescents with hypertension. MATERIALS AND METHODS: A total of 616 study participants were 10-24 years old and had primary hypertension diagnosed after admission in a specialised inpatient ward. Ambulatory BP monitoring was performed during hospitalisat...
Conclusion: These findings suggest that consumption of peanuts high in oleic acid (D7) may have the potential to delay primary fatty liver symptoms. PMID: 33033472 [PubMed]
CONCLUSION: The proposed PHARMAC criteria will give access to these important drugs to those people with T2DM who will likely benefit the most. PMID: 33032305 [PubMed - in process]
This study investigated the factors associated with the nutritional status of school children in a rural municipality in Cebu, Philippines. Children aged 6-12 years (n = 327) and their parents were asked to participate. Children's anthropometric measurements were taken in schools, while interviews and measurements of parents were conducted at home. Children's nutritional status was assessed using height-for-age (HAZ) and weight-for-age (WAZ) z scores, while body mass index (BMI) was used for parents. Children's dietary patterns and physical activity, and household characteristics, such as food insecurity, eating ...
Authors: Siamashvili M, Davis S Abstract INTRODUCTION: Bromocriptine mesylate quick release (QR) is a dopamine D2 receptor agonist and is the only oral, primarily centrally acting drug that can be used for the treatment of adults with type 2 diabetes. AREAS COVERED: The authors describe current recommendations on the use of bromocriptine mesylate QR. Major efficacy and safety parameters of the late phase trials, including The Cycloset Safety Trial, have been identified and presented. EXPERT OPINION: Efficacy of bromocriptine mesylate QR monotherapy appears to be low but is compensated by favorable safety pr...
Acceptance of trauma can also help to reduce its damaging effects. → Support PsyBlog for just $5 per month. Enables access to articles marked (M) and removes ads. → Explore PsyBlog's ebooks, all written by Dr Jeremy Dean: Accept Yourself: How to feel a profound sense of warmth and self-compassion The Anxiety Plan: 42 Strategies For Worry, Phobias, OCD and Panic Spark: 17 Steps That Will Boost Your Motivation For Anything Activate: How To Find Joy Again By Changing What You Do
Publication date: Available online 9 October 2020Source: Nutrition, Metabolism and Cardiovascular DiseasesAuthor(s): Vanda Craveiro, Elisabete Ramos, Joana Araújo
Publication date: Available online 9 October 2020Source: Nutrition, Metabolism and Cardiovascular DiseasesAuthor(s): Elizabeth Sahagun, Brent B. Bachman, Kimberly P. Kinzig
Publication date: December 2020Source: Journal of Functional Foods, Volume 75Author(s): Tingting Wang, Lin Zheng, Tiantian Zhao, Qi Zhang, Zhitong Liu, Xiaoling Liu, Mouming Zhao
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