Comprehensive therapy
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Comprehensive therapy · Jan 2009
ReviewBariatric surgery: important considerations for the primary care provider.
Bariatric surgery has become an acceptable therapy for the management of the patient with medically complicated obesity. This paper will review important considerations for the primary care provider as they identify, counsel and care for patients interested in these interventions.
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Women of childbearing age with depression present with a unique set of risks. This article will discuss the following topics: these specific risks, current literature on treating depression in the peripartum, and roles of physician and patient in peripartum treatment.
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Vasomotor symptoms affect the majority of postmenopausal women. Given the risks of hormone replacement therapy, alternative treatments for hot flashes have emerged over recent years. This article will review currently available treatments for hot flashes, including hormonal and non-hormonal therapies.
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Randomized, double-blind, placebo-controlled studies and observational studies have demonstrated that statins reduce mortality and major cardiovascular events in high-risk persons with hypercholesterolemia. The Heart Protection Study showed that statins reduced mortality and major cardiovascular events in high-risk persons, regardless of the initial level of serum lipids, age, or gender. Lipid-lowering therapy reduces cardiovascular morbidity and mortality in high-risk persons, forming the basis for the updated National Cholesterol Education Program (NCEP) III guidelines.
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Chronic obstructive pulmonary disease (COPD) is a major cause of mortality and morbidity throughout the world. It is the only cause of death among the top 10 causes that is increasing and is expected to become the third leading cause of death in the world by 2020. A diagnosis of COPD should be considered in any patient with previous exposure to risk factors for the disease and/or the presence of chronic cough, sputum production, or dyspnea. ⋯ Other adjunctive measures include vaccination, oxygen therapy, pulmonary rehabilitation, and certain surgical measures like bullectomy and lung transplantation. Management of acute exacerbations includes the use of systemic steroids, antibiotics, bronchodilators, and oxygen therapy. During very severe exacerbations, patients may need ventilatory support.