1) Taking Proscar (finasteride) to treat an enlarged prostate does not reduce testosterone levels or increase the risk of osteoporosis. While it blocks the conversion of testosterone to DHT in the prostate, it does not affect bones or testosterone levels systemically.
2) A clinical trial found that men taking finasteride had the same bone mineral density as men taking a placebo after 4 years, showing it does not cause osteoporosis.
3) Only androgen deprivation therapy for advanced prostate cancer, which drastically lowers testosterone, increases osteoporosis risk. Men taking finasteride for benign prostate issues do not need to take drugs like Fosamax for
Agnesian HealthCare Know & Go Friday: Men's Health and Its Relationship to Ca...Agnesian HealthCare
Dr. Adam Liss, radiation oncologist with Agnesian HealthCare, presents on the importance of men getting their annual screenings and taking care of their overall health.
Agnesian HealthCare Know & Go Friday: Men's Health and Its Relationship to Ca...Agnesian HealthCare
Dr. Adam Liss, radiation oncologist with Agnesian HealthCare, presents on the importance of men getting their annual screenings and taking care of their overall health.
CANCER IS THE WORLD’S LEADING CAUSE OF DEATH, BUT ABOUT 1 IN 3 CASES CAN BE PREVENTED, ACCORDING TO THE WORLD HEALTH ORGANIZATION.
THERE’S NO MAGIC PILL TO KEEP YOU FROM GETTING CANCER, BUT YOU Can DO SOME THINGS TO IMPROVE YOUR ODDS
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
CANCER IS THE WORLD’S LEADING CAUSE OF DEATH, BUT ABOUT 1 IN 3 CASES CAN BE PREVENTED, ACCORDING TO THE WORLD HEALTH ORGANIZATION.
THERE’S NO MAGIC PILL TO KEEP YOU FROM GETTING CANCER, BUT YOU Can DO SOME THINGS TO IMPROVE YOUR ODDS
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
1. quarters and dry air, which makes the undergo major surgery within a month
blood “thicker” and “stickier.” after a long flight have an increased risk
Diet and DVTs
Mobility is the key. Whenever pos- of postoperative blood clots. A 2007 report from the Atherosclero-
sible, get an exit row, bulkhead, or aisle Passengers at extra risk should con- sis Risk in Communities Study sug-
seat to give you more leg room. Don’t sider breaking up very long flights into gests that your diet may influence
cross your legs. Stretch, massage your shorter segments. Below-the-knee elas- your risk of developing a DVT. Scien-
lower legs, and pump your feet up tic compression stockings can also help. tists evaluated 14,962 middle-aged
and down for about 30 seconds every Look for a pair that applies pressure of Americans over a 12-year period.
They found that eating fish one or
30 minutes. Take a walk in the aisle 20 to 30 millimeters of mercury (mm more times a week was linked to
at least once every hour or so. Drink Hg); they are available at hospitals and a 30% to 45% reduction in the risk
plenty of fluids; water and juice are bet- large drugstores. Passengers who have of DVTs. A high intake of fruits and
ter than alcoholic or caffeinated bever- significant problems with arteries or vegetables also appeared protective,
ages, which will fill your bladder nearly nerves in their legs should check with but large amounts of red meat and
as much as your stomach. their doctors. processed meats were associated
with increased risk.
DVTs are uncommon on flights of Aspirin is readily available, but al-
less than four hours, but the risk in- though it’s a very effective way to
creases with longer trips, particularly prevent clots in arteries, its value for it comes to your veins, keep the blood
those of eight hours or more. The risk is deep-vein thrombosis is far less certain. flowing to prevent DVTs, pulmonary
also higher in people who have had re- People who need the fullest protection emboli, and the post-phlebitic syndrome.
cent surgery, especially hip or leg oper- should ask their doctors about an in- At home or in an airplane, do what it
ations, and in people with certain types jection of low-molecular-weight hepa- takes to promote blood flow in your
of cancer, chronic leg swelling, or heart rin before they take off. veins. Be sure your doctor considers
failure. Other risk factors include obe- DVT prevention if you are hospitalized,
sity, smoking, and any condition that’s Moving on and cooperate fully with anticoagulant
led to prolonged immobility or bed rest The great actress Helen Hayes once therapy to prevent or treat DVTs.
within two weeks of the trip. People said that resting is rusting. She may not Most men spend much more time
with overactive blood clotting systems have known any more about deep-vein thinking about SUVs than DVTs. That’s
and those who have had previous epi- thrombosis than the average guy, but okay if you’re at low risk, but before you
sodes of deep-vein thrombosis face the she was clearly onto something. Men- fly across the country or check into a
highest risk of all. And the risk persists tal stimulation will help keep your body hospital, you should show your veins
even after you’ve landed; patients who (and brain) from “rusting.” And when the respect they deserve.
The 10 commandments of cancer prevention
A bout one of every three Americans
will develop some form of malig-
nancy during his or her lifetime. This
new breakthroughs, you can do a lot to
protect yourself right now.
Get regular check-ups, including the
Screening tests can help detect ma-
lignancies in their earliest stages, but
you should always be alert for symp-
year alone, about 1,437,000 new cases screening tests that can help detect can- toms of the disease. The American
will be diagnosed, and more than cer before it causes any symptoms. For Cancer Society developed this simple
565,000 people will die of the disease. men between 15 and 35, that means a reminder years ago:
Cancer is the second leading cause of periodic doctor’s testicular exam along C Change in bowel or bladder
death in America, and as deaths from with regular self-exams. All men older habits
heart disease decline, it’s poised to as- than 50 should have regular screening A A sore that does not heal
sume the dubious distinction of be- for colon cancer, and they should make
U Unusual bleeding or discharge
coming our leading killer. an informed decision about testing for
Despite these grim statistics, doctors prostate cancer (see Harvard Men’s T Thickening or lump in the breast
have made great progress in under- Health Watch, May 2008). Men with or elsewhere
standing the biology of cancer cells, risk factors should begin both process- I Indigestion or difficulty in
and they have already been able to im- es even earlier, and every man should swallowing
prove the diagnosis and treatment of routinely inspect himself for signs of O Obvious change in a wart or mole
cancer. But instead of just waiting for melanomas and other skin cancers. N Nagging cough or hoarseness
www.health.harvard.edu April 2009 | Harvard Men’s Health Watch |5
2. It’s a rough guide at best. The vast try to protect yourself and your family. of breast and possibly reproductive
majority of such symptoms are caused The 10 commandments of cancer pre- cancers. Exercise will help protect you
by nonmalignant disorders, and can- vention are: even if you don’t lose weight.
cers can produce symptoms that don’t
show up on the list, such as unexplained
weight loss or fatigue. But it is a useful
1 Avoid tobacco in all its forms, in-
cluding exposure to secondhand
smoke.
4 Stay lean. Obesity increases the risk
of many forms of cancer. Calories
count; if you need to slim down, take
reminder to listen to your body and re-
Eat properly. Reduce your con- in fewer calories and burn more with
port sounds of distress to your doctor.
Early diagnosis is important, but can 2 sumption of saturated fat and red exercise (see HMHW, January 2006).
meat, which appears to increase the
you go one better? Can you reduce your
risk of getting cancer in the first place?
It sounds too good to be true, but it’s
risk of colon and prostate cancers 5 If you choose to drink, limit your-
self to one to two drinks a day.
(see HMHW, January 2008). Limit Excess alcohol increases the risk of
not. Scientists at the Harvard School your intake of charbroiled foods (es- cancers of the mouth, larynx (voice
of Public Health estimate that up to pecially meat), and avoid deep-fried box), esophagus (food pipe), liver, and
75% of American cancer deaths can be foods. Increase your consumption of colon; it also increases a woman’s risk
prevented; the table below summarizes fruits, vegetables, and whole grains. of breast cancer. Smoking further
their research on the causes of cancer in Although other reports are mixed, two increases the risk of many alcohol-
the United States. The American Can- large 2003 studies found that high- induced malignancies.
cer Society is only slightly less optimis- fiber diets may reduce the risk of colon
tic about prevention, estimating that
about 60% of America’s cancer deaths
cancer. And don’t forget to eat fish two
to three times a week; you’ll get protec- 6 Avoid unnecessary exposure to
radiation. Get medical imaging
can be avoided. And a 2005 study ar- tion from heart disease, and you may studies only when you need them.
reduce your risk of prostate cancer. Check your home for residential radon,
gues that over 2.4 million of the world’s which increases the risk of lung can-
7 million annual cancer deaths can be
blamed on nine potentially correctable
risk factors.
3 Exercise regularly. Physical activ- cer. Protect yourself from ultraviolet
ity has been linked to a reduced radiation in sunlight, which increases
risk of colon cancer, and it may even the risk of melanomas and other skin
You don’t have to be an internation- help prevent prostate cancer. Exercise cancers. But don’t worry about electro-
al scientist to understand how you can also appears to reduce a woman’s risk magnetic radiation from high-voltage
power lines or radiofrequency radia-
The causes of cancer tion from microwaves and cell phones.
Percentage of They do not cause cancer.
Risk factor
cancer deaths
Smoking and tobacco use
Obesity and diet (red meat vs. fruits and vegetables)
30
30
7 Avoid exposure to industrial and
environmental toxins such as asbes-
tos fibers, benzene, aromatic amines,
Lack of exercise 5 and polychlorinated biphenyls (PCBs).
Carcinogens in the workplace
Viruses (hepatitis, human papillomavirus)
5
5 8 Avoid infections that contribute
to cancer, including hepatitis vi-
ruses, HIV, and the human papilloma-
Family history of cancer 5
Body size (taller, bigger people get more cancer) 5
virus. Many are transmitted sexually or
through contaminated needles.
Women’s reproductive factors (late or no childbearing,
3
late menopause, early periods)
Excessive alcohol consumption 3 9 Consider taking low-dose aspirin.
Men who take aspirin or other non-
steroidal anti-inflammatory drugs ap-
Poverty (aside from bad diet) 3
pear to have a lower risk of colon cancer
Environmental pollution 2
and possibly prostate cancer. It’s an un-
Excessive exposure to sun 2
proven benefit, and aspirin can produce
Medical procedures, drugs 1 gastric bleeding and other side effects,
Salt, food additives, contaminants 1 even in low doses. On the plus side,
Source: “Harvard Report on Cancer Prevention, Vol. I: Causes of Human Cancer” (1996), though, low-dose aspirin does protect
Vol. 7, pp. 53–55.
Continued on page 8
6 | Harvard Men’s Health Watch | April 2009 www.health.harvard.edu
3. 10 Commandments of cancer (from page 6)
men from heart attacks and the most duce the risk of prostate cancer, colon These lifestyle changes will yield an-
common type of stroke; men at the cancer, and other malignancies (see other cancer-preventing benefit: if you
highest risk reap the greatest benefits.HMHW, February 2007). But don’t stay healthy, you won’t need cancer
Get enough vitamin D. Many count on other supplements. Careful treatments (chemotherapy, radiother-
10 experts now recommend 800 studies show that selenium, vitamins
to 1,000 IU a day, a goal that’s nearly C and E, beta carotene, folic acid, and
apy, drugs that suppress the immune
system) that have the ironic side ef-
impossible to attain without taking multivitamins are not protective, and fect of increasing the risk of additional
a supplement. Although protection that some may do more harm than cancers.
is far from proven, current evidence good (see HMHW, November 2007, As always, prevention is the best
suggests that vitamin D may help re- March 2008, and February 2009). medicine.
Proscar and osteoporosis
Q I am 76 years old, and I’ve had an enlarged
prostate for at least 10 years. I’ve been tak-
ing Proscar for about a year, and it seems to be
Testosterone is converted to DHT by an en-
zyme called 5-alpha reductase. Finasteride and
dutasteride inhibit the enzyme; they lower DHT
helping quite a bit. I have not noticed any side levels in the prostate and blood by 70% to 90%,
effects, but I’m worried that if the medicine but they do not reduce testosterone levels. As
ON CALL reduces testosterone levels enough to shrink a result, long-term use can shrink the prostate
my prostate, it will also give me osteoporosis. by about 25%, and it may stimulate some hair
Should I change medications, or take Fosamax follicles that are not too far gone, but it will not
like my wife? melt muscles or turn baritones into sopranos.
According to published reports, only 4% to 5%
A The prostate gland is stimulated by testoster-
one, the major male hormone; that’s a bad
thing for older gents at risk for benign prostatic
of men notice decreased sex drive or erectile
dysfunction while on the medications.
Bones are also spared. A randomized clini-
hyperplasia (BPH; an enlarged gland), or prostate cal trial of 117 men proved the point: after four
cancer. Testosterone also increases bone calcium years of therapy, men taking 5 mg of finasteride
content, a good thing. Finasteride (Proscar) and a day had the same bone mineral density as men
its newer rival, dutasteride (Avodart) block the taking a placebo.
action of testosterone in the prostate, but they On the other hand, men who need androgen-
will not interfere with bone mineralization. It deprivation therapy to control advanced pros-
sounds like a paradox, but it’s not. Here’s why. tate cancer are at risk for osteoporosis (“thin
Bones respond directly to testosterone, as do bones”) because treatment drastically lowers
many other male tissues: testosterone produces testosterone levels (see Harvard Men’s Health
the strong, large muscles, deep voice, facial and Watch, October 2008). Like your wife, they can
body hair, sex drive, and tendency toward ag- benefit from alendronate (Fosamax), a drug that
gressiveness that characterize the male gender increases bone calcium (see HMHW, December
by acting directly on a man’s organs and tissues. 2008). But men taking 5-alpha reductase inhib-
But the prostate and the scalp’s hair follicles are a itors for BPH don’t have to worry about their
bit different. To affect these organs, testosterone bones. Your wife’s Fosamax supply is safe.
must first be converted to dihydrotestosterone
(DHT). In turn, DHT stimulates the prostate
and stuns the scalp hair, producing unwelcome Harvey B. Simon, M.D.
changes in many men. Editor, Harvard Men’s Health Watch
Send us a By mail Dr. Harvey B. Simon By e-mail mens _ health@hms.harvard.edu Because of the volume of correspon-
Harvard Men’s Health Watch (Please write “On call” dence we receive, we can’t answer
question for 10 Shattuck St., 2nd Floor in the subject line.) every letter or message, nor can we
On call Boston, MA 02115 provide personal medical advice.
8 | Harvard Men’s Health Watch | April 2009 www.health.harvard.edu