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409 Sexual Dysfunction Kevin T. McVary Sexual Dysfunction Male sexual dysfunction affects up to 31% of middle-aged and elderly men, whereas female sexual dysfunction, although studied less intensely, has a higher prevalence (43%) than male sexual dysfunction. ...

410 Women’s Health treatments due to health concerns or are unable to use them due to a history of breast cancer or endometrial cancer. Hyaluronic acid vaginal gel has been found to be efficacious in treating atrophic vaginitis. ORAL AGENTS Flibanserin, origin...

411 Men’s Health ■ ■SUBSTANCE ABUSE AND TOBACCO (See also Chaps. 464 and 465) Substance abuse is more common in men than in women. However, nearly one-third of Americans who suf­ fer from alcoholism are women. Women are less likely to be diagnosed with alcohol...

SECTION 3 Obesity, Diabetes Mellitus, and Metabolic Syndrome Fenway Health: Glossary of LGBT terms for health care teams. February 2024. Available at https://www.lgbtqiahealtheducation.org/ publication/lgbtqia-glossary-of-terms-for-health-care-teams/. Institut...

413 Pathobiology of Obesity Fenway Health: Glossary of LGBT terms for health care teams. February 2024. Available at https://www.lgbtqiahealtheducation.org/ publication/lgbtqia-glossary-of-terms-for-health-care-teams/. Institute of Medicine: The health of lesb...

414 Evaluation and Management of Obesity FATTY LIVER DISEASE  Obesity is strongly associated with the pres­ ence of ectopic fat in hepatocytes. In a subset of patients, this can progress to nonalcoholic steatohepatitis (NASH), which can progress to fibrosis, w...

416 Diabetes Mellitus: Management and Therapies Diabetes Mellitus: Management and Therapies Alvin C. Powers, Kevin D. Niswender, Michael R. Rickels OVERALL GOALS The goals of therapy for all forms of diabetes mellitus (DM) are to (1) eliminate symptoms related...

417 Diabetes Mellitus: Complications comorbidities and risk factors (e.g., hypertension, CVD), neurocogni­ tive and physical functional status, living arrangements, social sup­ port, and other medications. For example, the HbA1c goal for a highly functional 80...

418 Hypoglycemia Pneumonia, urinary tract infections, and skin and soft tissue infec­ tions are all more common in the diabetic population. In general, the organisms that cause pulmonary infections are similar to those found in the nondiabetic population; howe...

419 Disorders of Lipoprotein Metabolism Acknowledgment The author acknowledges contributions of the late Phil E. Cryer to this chapter in prior editions of Harrison’s. ■ ■FURTHER READING Black JE et al: Real-world effects of second-generation versus earlier in...

420 The Metabolic Syndrome of choice in children and in women who are pregnant, lactating, or actively trying to conceive. However, they are otherwise fourth- or fifth-line drugs for LDL-C reduction in other settings. Specialized Drugs for HoFH  Three “orphan”...

SECTION 4 Disorders of Bone and Mineral Metabolism Section 4 Disorders of Bone and Mineral Metabolism Bone and Mineral Metabolism in Health and Disease F. Richard Bringhurst, Henry M. Kronenberg, Eva S. Liu, Marc N. Wein BONE STRUCTURE AND METABOLISM Bone is ...

421 Bone and Mineral Metabolism in Health and Disease Section 4 Disorders of Bone and Mineral Metabolism Bone and Mineral Metabolism in Health and Disease F. Richard Bringhurst, Henry M. Kronenberg, Eva S. Liu, Marc N. Wein BONE STRUCTURE AND METABOLISM Bone ...

422 Disorders of the Parathyroid Gland and Calcium Homeostasis relatively inaccessible, since osteoclasts cannot resorb unmineralized osteoid, and frank hypocalcemia ensues. Since PTH is a major stimulus for the renal 25(OH)D 1α-hydroxylase, there is increased...

423 Osteoporosis supplementation is sometimes needed for weeks to a month or two until bone defects are filled (which, of course, is of therapeutic benefit in the skeleton), making it possible to discontinue parenteral calcium and/or reduce the amount. Differe...

424 Paget’s Disease and Other Dysplasias of Bone Osteoporosis and related fractures are serious side effects of chronic glucocorticoid therapy. Because the effects of glucocorticoids on the skeleton are often superimposed on the consequences of aging and menop...

SECTION 5 Disorders of Intermediary Metabolism by short bulbous roots, pulp calcification, and radicular dentin depos­ ited in swirls. The disorder is caused by gene mutations in GALNT3, FGF23, or α-Klotho, leading to FGF23 deficiency or resistance. The reduce...

425 Heritable Disorders of Connective Tissue by short bulbous roots, pulp calcification, and radicular dentin depos­ ited in swirls. The disorder is caused by gene mutations in GALNT3, FGF23, or α-Klotho, leading to FGF23 deficiency or resistance. The reduced ...