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Reference/s: [23] Overweight and Obesity E66 · Code first obesity complicating pregnancy arthritis in hips in dogs generic mobic 7.5 mg line, childbirth and the puerperium arthritis names discount 15mg mobic mastercard, if applicable (O99 arthritis fingers herbs cheap mobic 15 mg otc. Reference/s: [13-15] Percent Body Fat Advantages · More specific assessment of body fat · May be a reasonable longitudinal measure rheumatoid arthritis in my back order 7.5 mg mobic with mastercard, especially in patients who may not be losing weight, but engaged in resistance exercise training, and thus may be losing body fat, and increasing muscle Disadvantages · Some measurement techniques are not always accurate, nor easily reproducible. Reference/s: [1] Fat Mass Disease: Abnormal and Pathologic Physical Forces 41obesitymedicine. Clinical Manifestations: Fat Mass Disease Cardiovascular · · · · Congestive heart failure and cor pulmonale Varicose veins Thromboembolic events. Reference/s: [25-27] Clinical Manifestations: Fat Mass Disease Musculoskeletal · Immobility · · · · · Osteoarthritis. Reference/s: [25-27] Striae distensae (skin stretch marks) Stasis pigmentation Venous stasis ulcers Cellulitis Skin tags Intertrigo. Reference/s: [25-27] Sleep Disorders and Obesity: Obstructive Sleep Apnea* History · · · · · · · · · · · · Snoring (usually loudly) Insomnia Restless sleep Sudden wakening with choking or gasping Headaches Daytime sleepiness Fatigue Increased risk of motor vehicle accidents Forgetfulness Mood changes Lack of interest in sexual behavior Gastroesophageal reflux *Other sleep disorders associated with obesity include insomnia and restless leg syndrome. Reference/s: [28-29] Sleep Disorders and Obesity: Obstructive Sleep Apnea Physical Findings · Increased neck circumference Men > 17 inches Women > 16 inches Head abnormalities Modified Mallampati score of 3 or 4 Retrognathia Lateral peritonsillar narrowing Macroglossia Tonsillar hypertrophy Enlarged uvula High arched/narrow palate Nasal abnormalities Overbite Cardiopulmonary abnormalities Peripheral edema Cardiac dysrhythmia High blood pressure Obesity Algorithm. Reference/s: [28-30] Sleep Disorders and Obesity: Obstructive Sleep Apnea Treatment · · · Reduction of fat mass Behavior therapy to improve sleep patterns Oral appliances Mandibular reposition devices Tongue retaining devices Nasal expiratory positive airway Continuous positive airway pressure Adaptive servo-ventilation Surgery Laser-assisted uvulopalatoplasty Radiofrequency ablation Palatal implants Electrical stimulation of upper airway muscles · · · · 48 Obesity Algorithm. Reference/s: [31] Adiposopathy (Sick Fat Disease): Abnormal Endocrine and Immune Responses 49obesitymedicine. Reference/s: [32-33] Functional Changes · Increased adipocyte hypertrophy and adipose tissue accumulation may contribute to: Adipocyte and adipose tissue hypoxia Increased adipose tissue immune cell infiltration Increased adipocyte apoptosis Increased reactive oxygen species and oxidative stress Extracellular matrix abnormalities Intraorganelle dysfunction. Reference/s: [32-33] Adiposopathic Endocrinopathies · · · · · · · Angiogenesis Adipogenesis Extracellular matrix dissolution and reformation Lipogenesis Growth factor production Glucose metabolism Production of factors associated with the reninangiotensin system Lipid metabolism Enzyme production · · · · · · Hormone production Steroid metabolism Immune response Hemostasis Element binding. Reference/s: [33-37] Adiposopathic Immunopathies · Proinflammatory adipose tissue factors Factors with cytokine activity. Reference/s: [33-35,37] Obesity, Health, and Harmony of Function of Body Organs Adiposopathy most often results in metabolic disease when accompanied by: · · Dysfunction other body organs Limitations of the metabolic "flexibility" of other body organs to mitigate the pathogenic metabolic, endocrine, and immune responses promoted by obesity Metabolic health is dependent upon the interactions or crosstalk with adipose tissue and other body organs: · · · · · · · · · Liver Muscle Pancreas Immune system Heart and vasculature Brain Endocrine glands Intestine Other body organs 55 Obesity Algorithm. Reference/s: [33] Metabolic Manifestations of Adiposopathy · · · · High blood glucose (prediabetes mellitus, type 2 diabetes mellitus) High blood pressure Metabolic syndrome Adiposopathic dyslipidemia · · · · · · · · · Insulin resistance Hepatosteatosis (fatty liver) Hyperuricemia and gout Cholelithiasis Acanthosis Nigricans Nephrolithiasis Glomerulopathy Pro-thrombotic predisposition Neuropsychiatric diseases (such as worsening depression due to adiposopathic immune and endocrine responses) Asthma (due to adiposopathic immune and endocrine responses) Worsening of other inflammatory diseases (osteoarthritis, atherosclerosis, etc. Reference/s: [33-35,37] Gender-specific Manifestations of Adiposopathy Women · Hyperandrogenemia · Hirsutism · Acne · Polycystic ovarian syndrome · Menstrual disorders · Infertility · Gestational diabetes mellitus · Preeclampsia · Thrombosis Men · Hypoandrogenemia · Hyperestrogenemia · Erectile dysfunction · Low sperm count · Infertility 57 Obesity Algorithm. Reference/s: [38-40] Obesity and Adiposopathy Increases the Risk of Cancers · · · · · · · · · · · 58 Obesity Algorithm. Reference/s: [41-45] Bladder cancer Brain cancer Breast cancer (postmenopausal) Cervical cancer Colon cancer Endometrial/uterine cancer Esophageal cancer Gallbladder cancer Head and neck cancer Kidney/renal cancer Leukemia · · · · · · Liver cancer Multiple myeloma Non-Hodgkin lymphoma Ovarian cancer Pancreatic cancer Prostate cancer (prognosis is worse, not necessarily increased risk) · Stomach cancer · Thyroid cancer Adiposopathic and/or Fat Mass Pathologies: Genitourinary and Reproductive Manifestations Genitourinary · · · Urinary stress incontinence Pelvic prolapse. Reference/s: [46-48] Gestational diabetes mellitus Preeclampsia Increased risk of miscarriage and stillbirth Overdue pregnancy Increased need for induction Increased need and complications of cesarean section in women (delayed healing and wound infection) Large for gestational age offspring Thrombosis Obstructive sleep apnea Obesity Paradox 60obesitymedicine. Reference/s: [11,33,51] Obesity Paradox: General Concepts · · · · Obesity increases mortality Obesity increases morbidity More than one "obesity paradox" exists Obesity paradoxes are less paradoxical when viewed from the perspective of both fat mass and fat function 62 Obesity Algorithm. Reference/s: [52,53] Anatomic Obesity Paradox Are some fat depots protective while others are "paradoxically" pathogenic? Reference/s: [11,33,51] Anatomic Obesity Paradox Are some fat depots protective while others are "paradoxically" pathogenic? Benign Multiple Symmetrical Lipomatosis · Increased fat accumulation in the subcutaneous adipose tissue regions of the arms, legs, shoulders, and neck. Reference/s: [11,33,51] Physiologic Obesity Paradox Are some individuals who are overweight or with obesity "paradoxically" healthy? Do some individuals who are normal weight, or only mildly overweight "paradoxically" have metabolic disease? Are some races "paradoxically" at increased risk for metabolic diseases for the same amount of body weight? Reference/s: [11,33,51] Demographic (Gender and Race) Obesity Paradox Are women at a "paradoxically" lower age-adjusted cardiovascular disease risk than men? For the Same Increase in Body Fat, Individuals of Asian Descent Have an Increased Risk for Type 2 Diabetes Mellitus, Metabolic Syndrome, and Cardiovascular Disease Compared to Other Races · Greater adipocyte size; reduced number of adipocytes · Increased visceral adiposity · Increased free fatty acid and leptin levels · Increased pro-inflammatory factors. Reference/s: [11,33,51] Therapeutic Obesity Paradox Can adding body fat "paradoxically" treat metabolic diseases typically associated with too much body fat? Transplantation of Fat in Lipoatrophic Mice · Lipoatrophic mice have virtually no white adipose tissue · Severe hyperglycemia. An "Outside-to-in" Atherogenic Model Suggests That Adiposopathic Adipose Tissue Surrounding the Heart and Arteries Also Contributes to Atherosclerosis · Coronary calcium correlates to epicardial fat · Coronary calcium scoring is used to assess atherosclerosis · Adipose tissue surrounding the heart and arteries may serve as a local supplier of toxic, free fatty acids to the myocardium, and thus contribute to "fatty heart" · Pericoronary adipose tissue may serve as a supply site for oxidized low density lipoproteins in coronary plaques, possibly via transport through the interstitial space 79 Obesity Algorithm. Reference/s: [11,33,51] Atherosclerosis "Outside-to-In" Obesity Paradox What is the role of pericardiac and perivascular adipose tissue in promoting atherosclerosis?
Cooperation among policy makers rheumatoid arthritis medication not working order 7.5 mg mobic overnight delivery, local health agencies and the public to invest in disease prevention instead of spending our resources to treat diseases after they occur rheumatoid arthritis knee injections buy 7.5 mg mobic otc. This resource takes a population approach and states that prevention of obesity will require coordinated policy and environmental changes that affect large populations simultaneously arthritis joint pain medication buy 7.5mg mobic otc. This document uses a socio-ecological model for levels of influence associated with developing programs to promote healthy eating and physical activity arthritis pain predictor order 7.5mg mobic amex, which is reproduced on page 16. The guidelines lists the following goals for a comprehensive approach to nutrition and physical activity: · Promote healthy eating that follows national dietary guidance policy; · Maintain recommended levels of moderate and vigorous physical activity from childhood through adolescence into adulthood; · Eliminate disparities in diet, physical activity and overweight among disadvantaged population groups; · Increase access to healthy foods and opportunities to be active for every age and population group; and · Promote healthy weight among adults and children. Task Force on Community Preventive Services the Community Guide the Task Force on Community Preventive Services is in the process of working with a group of experts to conduct a systematic review of studies regarding population-based interventions focusing on the following areas of nutrition and community health: physical activity, school-based nutrition programs; community approaches to increase fruit and vegetable intake; food and beverage advertising to children; and food and beverage availability, price, portion size and labeling in restaurants. Department of Health and Human Services that advances the goal of helping Americans live longer, better and healthier lives. The Steps initiative is built upon the premise that small changes over time can yield dramatic results. The Steps initiative is committed to identifying and promoting programs that encourage small behavior changes. Steps promotes: · Health promotion programs to motivate and support responsible health choices. It provides information about nutrition and physical activity programs to prevent and control obesity 15 Developed by the Nutrition and Physical Activity Work Group of the Association of State and Territorial Nutrition Directors. The following goals are from this guide: Nutrition and Physical Activity Goals To prevent and control obesity and other chronic diseases, nutrition and physical activity program should include obesity prevention and control (including caloric intake and expenditure), increased physical activity, improved nutrition (including increased breastfeeding and increased consumption of fruits and vegetables), and reduced television time. Nutrition and physical activity goals of the program are to · Decrease levels of obesity or reduce the rate of growth of obesity in communities reached through interventions. Community-based nutrition and physical activity program development and implementation includes a collaborative approach with local public and private partners and state government partners to describe the obesity epidemic and other chronic diseases in the community; · describe the nutrition and physical activity risk factors associated with obesity and other chronic diseases; · describe the population subgroups affected by obesity; · set priorities with and for the subgroups; · identify the behaviors of the population subgroups which are priorities for intervention; · use the social-ecological model to guide planning to address obesity and other chronic diseases in these populations; and · select and implement interventions from proven resources (see Attachments 37) so that multiple levels of influence in the social-ecological model (Attachment 8) are addressed. It provides a brief overview of six state projects designed to improve physical activity and nutrition. In 17 20042005, 23 states are funded at $300,000 to $450,000 for capacity building. The March of Dimes87 report Nutrition Today Matters Tomorrow is found at. The report focuses on promoting healthy lifestyles, prevention and targeting the preconceptional female, as a way to achieve significant improvements in health. Interventions must now focus on strategies to promote healthful living by concentrating primarily on diet and physical activity. Interventions will need to build on past successes but go beyond a direct service model; it is not enough to provide a meal or a pill. Models of successful, sustainable interventions for healthy lifestyles will need to draw heavily on social marketing and the health communications fields to mount interventions that are effective in promoting behavior change. Most of the earlier successes in nutrition focused on an underlying therapeutic model. Stunted children or children with low weight for age were the targets for nutrition services. We now know from vast scientific literature summarized in this report that dramatic improvements in nutritional status worldwide will occur from preventive nutrition efforts. If policymakers and implementers are truly interested in preventive nutrition, the target of interventions needs to shift to a different part of the life cycle. Investment in the preconceptional female will yield enormous nutritional benefits in other parts of the life cycle. We know unequivocally that healthier females - before pregnancy - are more likely to produce healthier babies, who develop into healthier children. The Healthy Women Build Healthy Communities Toolkit is meant to be fun and useful. March of Dimes, Maternal Obesity and Pregnancy: Weight Matters, Medical Perspectives on Prematurity.
Adult mullerian duct or utricle cyst: clinical significance and therapeutic management of 65 cases arthritis nos definition discount 7.5mg mobic with amex. Transurethral hot-water balloon thermoablation for benign prostatic hyperplasia: patient tolerance and pathologic findings arthritis pain doctors discount 15 mg mobic with mastercard. Page 46 163830 115860 126720 161210 104340 112650 160350 152450 102570 153330 119010 112350 126610 155190 136360 121440 September 2010 Appendix 3: Master Bibliography American Urological Association rheumatoid arthritis joints locking up trusted 7.5mg mobic, Inc arthritis and weather generic mobic 7.5mg without prescription. Heat shock protein expression independently predicts clinical outcome in prostate cancer. Effect of heat exposure on viability and contractility of cultured prostatic stromal cells. Interstitial laser coagulation combined with minimal transurethral resection of the prostate for the treatment of benign prostatic hyperplasia. Automatic segmentation of bladder and prostate using coupled 3D deformable models. Med Image Comput Comput Assist Interv Int Conf Med Image Comput Comput Assist Interv. Volumetric density of elastic and reticular fibers in transition zone of controls and patients with benign prostatic hyperplasia. How can we best characterize the relationship between erectile dysfunction and benign prostatic hyperplasia. Evaluation of interstitial diode laser therapy for treatment of benign prostatic hyperplasia. Testosterone and prolactin regulation of metabolic genes and citrate metabolism of prostate epithelial cells. Reflux nephropathy in kidney transplants, demonstrated by dimercaptosuccinic acid scanning. Evaluation of urokinase plasminogen activator and its receptor in different grades of human prostate cancer. Palliative transurethral prostate resection for bladder outlet obstruction in patients with locally advanced prostate cancer. Amprenavir and didanosine are associated with declining kidney function among patients receiving tenofovir. Maintenance immunosuppression with mycophenolate mofetil and corticosteroids in pediatric kidney transplantation: temporary benefit but not without risk. Page 47 119550 122010 113640 156530 105530 123400 160400 139630 113810 165300 150560 139760 151150 165610 108670 154820 154130 September 2010 Appendix 3: Master Bibliography American Urological Association, Inc. Management of lower urinary tract symptoms suggestive of benign prostatic hyperplasia: the central role of the patient risk profile. The role of alpha-blockers in the management of lower urinary tract symptoms in prostate cancer patients treated with radiation therapy. Baseline factors as predictors of clinical progression of benign prostatic hyperplasia in men treated with placebo. Pre-surgical finasteride therapy in patients treated endoscopically for benign prostatic hyperplasia. Inhibition of spontaneous and androgen-induced prostate growth by a nonhypercalcemic calcitriol analog. Effect of a vitamin D3 analogue on keratinocyte growth factor-induced cell proliferation in benign prostate hyperplasia. Assessment of fiberoptic nearinfrared raman spectroscopy for diagnosis of bladder and prostate cancer. Botulinum toxin in the management of lower urinary tract dysfunction: contemporary update. Effect of human natural xenoantibody depletion and complement inactivation on early pig kidney function. The overactive bladder in childhood: longterm results with conservative management. Prioritizing patients for prostatectomy: balancing clinical and psychosocial factors. Single dose methodology to assess the influence of an alpha1-adrenoceptor antagonist on uroflowmetric parameters in patients with benign prostatic hyperplasia. Nursing care for raised intra-abdominal pressure and abdominal decompression in the critically ill. Postnatal renal function in preterm newborns: a role of diseases, drugs and therapeutic interventions.
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Relationship of prostate-specific antigen and prostate volume in patients with biopsy proven benign prostatic hyperplasia types of arthritis in feet order 7.5 mg mobic free shipping. Decreased suburethral prostatic microvessel density in finasteride treated prostates: a possible mechanism for reduced bleeding in benign prostatic hyperplasia arthritis in back causing leg pain buy mobic 15 mg overnight delivery. Lasers for lower urinary tract symptoms secondary to benign prostatic hyperplasia: when is the fuss worth it arthritis in neck and tmj purchase mobic 15mg mastercard. Evaluation of the cytokines interleukin 8 and epithelial neutrophil activating peptide 78 as indicators of inflammation in prostatic secretions arthritis gluten order mobic 7.5mg visa. Holmium laser enucleation of the prostate combined with electrocautery resection: the mushroom technique. Page 97 109310 134890 139500 102040 152750 110830 100360 165600 156740 119990 115550 123000 102580 122860 113460 131330 106560 September 2010 Appendix 3: Master Bibliography American Urological Association, Inc. Value of free prostate-specific antigen (Hybritech Tandem-R) in symptomatic patients consulting the urologist. Misclassifying the indications for prostate-specific antigen testing may bias case-control studies of the efficacy of prostate cancer screening. Transurethral microwave thermotherapy vs transurethral resection for treating benign prostatic hyperplasia: a systematic review. Laser prostatectomy versus transurethral resection for treating benign prostatic obstruction: a systematic review. Intraprostatic temperature monitoring during transurethral microwave thermotherapy: status and future developments. Quantification of prostate shrinkage after microwave thermotherapy: a comparison of calculated cell-kill versus 3D transrectal ultrasound planimetry. Safety and efficacy of tolterodine extended release in men with overactive bladder symptoms and presumed non-obstructive benign prostatic hyperplasia. Chronic sacral neuromodulation for treatment of neurogenic bladder dysfunction: long-term results with unilateral implants. Crystallization during volume reduction of solutions with a composition corresponding to that in the collecting duct: the influence of hydroxyapatite seed crystals and urinary macromolecules. Racial differences in pathogenetic mechanisms, prevalence, and progression of benign prostatic hyperplasia. Page 98 103750 121970 130650 105170 112920 108260 129790 120170 112300 155900 161050 140300 137130 164050 156050 152170 September 2010 Appendix 3: Master Bibliography American Urological Association, Inc. The detrusor muscle cell in bladder outlet obstruction-ultrastructural and morphometric findings. Mortality and prostate cancer risk in 19,598 men after surgery for benign prostatic hyperplasia. Infectious disease hospitalizations among older American Indian and Alaska Native adults. Is bladder dysfunction and incontinence associated with ureteroceles congenital or acquired. Classification of nocturia in the adult and elderly patient: a review of clinical criteria and selected literature. Pressure-flow studies in benign prostatic hyperplasia: to do or not to do for the patient. Nocturia in the adult: classification on the basis of largest voided volume and nocturnal urine production. Significance of nocturia in the International Prostate Symptom Score for benign prostatic hyperplasia. Symptom assessment tool for overactive bladder syndrome-overactive bladder symptom score. Comparative study of concentration of isoflavones and lignans in plasma and prostatic tissues of normal control and benign prostatic hyperplasia. Identification of baseline clinical factors which predict medical treatment failure of benign prostatic hyperplasia: an observational cohort study. The importance of patient perception in the clinical assessment of benign prostatic hyperplasia and its management. Cadmium-induced acute hepatic injury is exacerbated in human interleukin-8 transgenic mice. The short-term effects of tamsulosin in Japanese men with benign prostatic hyperplasia.
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