Bmc Med
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Obesity and metabolic syndrome are healthcare problems that continue to rise in frequency worldwide. Both phenotypes are a strong predictor for development of liver steatosis in the context of non-alcoholic fatty liver disease or non-alcoholic steatohepatitis. Ultrasound may detect steatosis, but its sensitivity is limited and liver biopsy is still considered to be the gold standard. ⋯ Their results show that this innovative technique measures the grade of steatosis in different clinical situations. Therefore, multi-echo magnetic resonance imaging might be considered for monitoring liver steatosis as an intermediate endpoint. Wide clinical applicability is limited though, as it does not allow differentiation between non-alcoholic fatty liver disease and non-alcoholic steatohepatitis.
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Much research is underway on the links between diet and obesity. So too are long-running disputes among nutritionists on core questions about the relationship. ⋯ The practical consequence is that, at present, frontline health professionals will not find in nutrition science agreed, actionable solutions to assist overweight patients. But research and debate continues actively.
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Government and societal efforts to combat obesity are aimed at prevention, although there is a generation for whom excess weight is the rule rather than the exception. Although measures to prevent a worsening of the current epidemic are important, management of obesity must also be prioritised. Obesity management is beset with problems ranging from attitudinal to clinical and pharmacological, and the individualisation of therapy.
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In this podcast we talk to Professor John Wass, co-author of the 'Action on obesity: Comprehensive care for all' report, and Chair of the Working Party for Action on Obesity in the UK. In this interview Prof Wass discusses the gaps in care for obese patients in current UK healthcare services, and outlines his recommendations on what actions should be taken to tackle these issues, including how education about nutrition and obesity should be offered to the public as well as within the formal medical education system. The podcast for this interview is available at: http://media.biomedcentral.com/content/movies/supplementary/johnwass-audio-v1.mp3.
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Meta Analysis
Predictors and correlates of adherence to combination antiretroviral therapy (ART) for chronic HIV infection: a meta-analysis.
Adherence to combination antiretroviral therapy (ART) is a key predictor of the success of human immunodeficiency virus (HIV) treatment, and is potentially amenable to intervention. Insight into predictors or correlates of non-adherence to ART may help guide targets for the development of adherence-enhancing interventions. Our objective was to review evidence on predictors/correlates of adherence to ART, and to aggregate findings into quantitative estimates of their impact on adherence. ⋯ These findings suggest that adherence-enhancing interventions should particularly target psychological factors such as self-efficacy and concerns/beliefs about the efficacy and safety of ART. Moreover, these findings suggest that simplification of regimens might have smaller but significant effects.