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Advanced Radiology

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b2ap3_thumbnail_heart.jpgTwo drugs known to reduce cholesterol to all-time lows were found recently to have a different effect than hoped by their manufacturers. The drugs, evolocumab and alirocumab, were approved by the Food and Drug Administration in 2015 after being shown to significantly lower cholesterol, but without having been put through major clinical trials to test their effect on patient’s overall risk of heart disease or death.

The drugs, marketed as Repatha and Praulent, did, in fact reduce cholesterol in patients, sometimes to levels as low as 30 mg/dl. These lows have never been seen before with other cholesterol-lowering drugs or other medical interventions. Many medical professionals were excited about the ability for these medications to reduce cholesterol so significantly because naturally this reduction would then reduce the risk of heart attack and improve health outcomes.

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b2ap3_thumbnail_basketball.jpgMeniscus tears are very common among athletes, especially basketball players. New York Knick’s point guard Derrick Rose underwent arthroscopic knee surgery to repair a torn meniscus in his right knee in April. Rose is no stranger to knee injuries, having torn his meniscus twice before, as well as his ACL. Fortunately for Rose- and the Knicks- he is expected to make a full recovery and get back on the court in the next four to six weeks.

Meniscus tears are not the only knee injury plaguing the pros, however. Another common injury basketball players face is the condition known as jumper’s knee, or patella’s tendonitis. Patients with jumper’s knee experience inflammation of the patellar tendon. The patellar tendon connects the kneecap to the shin in the lower leg.

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b2ap3_thumbnail_office-stretch.jpgDid you know that strengthening your core help prevent back pain and problems like compression fractures? It's true- your body's core is the center of the body, and helps to support your weight as you walk, stand and even sit. When your core is weak, your body is unable to support itself. This causes your spine to compress, which leads to bulging and slipped discs, and painful compression fractures. In this blog, Advanced Radiology gives you a few tips to keep your core strong and save your back. 

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b2ap3_thumbnail_golf-ball.jpgGolfer’s elbow is a condition that is often confused with tennis elbow, but this lesser known condition doesn’t just happen from playing 18 holes. Golfer’s elbow can impact anyone as a result of repetitive motions of the hands, wrists, or forearms. These repetitive motions include things like swinging a tennis racket or a hammer, turning a screwdriver, or even painting. Dr. Budler treats patients with golfer’s elbow in order to get them back on the green or doing the other activities they love.

Golfer’s elbow is a form of tendinitis. The repetitive motions behind the condition inflame the tendon that connects the forearm muscles to the elbow. This tendon gives you the ability to move your forearm- and rotate it, grip, or swing objects. These motions, when done over and over, wear down the tendon and cause microtears to form.

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b2ap3_thumbnail_cholesterol.jpgHigh LDL cholesterol is damaging to the heart and puts patients at risk for developing serious health conditions such as peripheral artery disease, heart attack and stroke. 73.5 million adults suffer from high LDL cholesterol, according to the Centers for Disease Control. High LDL cholesterol happens as a result of genetics in some individuals, but for many people, their high cholesterol number is a direct result of diet and behavioral habits. While many patients reduce their cholesterol with medication, there is lifestyle and dietary changes patients with high LDL cholesterol should consider lowering their cholesterol to protect their health.

Overwhelmingly, patients with high cholesterol see the biggest impact on their cholesterol number and health by changing their diet. Patients should select healthier fats like those found in lean meats and nuts. It is also recommended patients avoid trans fats all together, for the greatest impact on cholesterol levels. Trans fats are often found in fried and processed food, and not only raise bad cholesterol, they often lower good, or HDL, cholesterol.

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b2ap3_thumbnail_health-screening.jpgPatients with peripheral artery disease have a serious condition that puts them at risk for a variety of health complications. These complications range from numbness or loss of feeling in the extremities to a heightened risk of blood clots and a dangerous condition known as Critical limb ischemia.Critical limb ischemia, or CLI, happens in patients with peripheral artery disease when an artery becomes obstructed as a result of severe atherosclerosis, or arterial plaque buildup.

Arterial plaque buildup often occurs in patients with high cholesterol, high blood pressure and diabetes. It also occurs in patients who smoke, abuse alcohol and lead sedentary lifestyles. Arterial plaque reduces blood flow and impacts the ability of the blood to circulate through the body to the hands, legs and feet. CLI is so dangerous for PAD patients that it could result in amputation of the feet or legs.

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b2ap3_thumbnail_Varicose-vein-anim.jpgVaricose veins are dark, swollen, and twisted. They are often seen through the skin. They develop mostly in the legs and feet, and for some people, they’re simply a cosmetic concern. But for many others, they are very painful and represent a significant health risk. Varicose veins occur when the veins swell with blood as a result of increased pressure in the veins of the lower body.Pressure that increases with standing or walking for extended periods of time, day in and day out, as a result of some jobs or activities. Learn more about varicose veins and if you are at risk for developing this condition, and read up on some varicose vein prevention tips.

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b2ap3_thumbnail_headacheAAW_20170220-152309_1.jpgFor many migraine sufferers, likening a migraine to a headache is like comparing an iceberg to an ice cube. A migraine is more than a headache, and like an iceberg, when one starts moving in things get serious quickly. Find out how to tell the difference between a migraine and a headache, what treatments are available for each condition and ways to head off future occurrences of head pain.

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b2ap3_thumbnail_pregnantbelly.jpgVaricose veins are often thought of as something that happens as a result of standing or sitting for long periods of time, but the condition frequently arises or worsens in women during pregnancy. For most women, varicose veins are simply annoying, but they present a risk for significant health complications in others. Women who are pregnant or planning on becoming pregnant should understand their risk for varicose veins and interventions necessary to prevent them.

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b2ap3_thumbnail_bloodflow_20170208-230717_1.jpgIf you’ve been diagnosed with peripheral artery disease also known as PAD, you know that keeping your blood circulating properly is critical for your health. Poor circulation is uncomfortable, causes numbness in your extremities, makes your feet feel cold, and leads serious medical complications. Advanced Radiology offers PAD patients some tips on how to improve their circulation to protect their health.

Quit Smoking If you are a PAD patient and still smoking, the first thing we advise you to do is quit your habit immediately. Nicotine causes the blood vessels to constrict, further reducing your already restricted blood flow. As PAD patient, your body is already straining to deliver the oxygen-rich blood your lower extremities need. Smoking impacts not only your blood vessels but also your heart, lungs and other organs. Quitting smoking lowers your risk of developing cancer and other medical complications. Many PAD patients developed their artery disease as a result of smoking.

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b2ap3_thumbnail_blue-spine_20170118-141922_1.jpgMany factors cause brittle bones – osteoporosis, the use of some medications, certain lifestyle habits, and some health conditions. One such condition is multiple myeloma, a rare form of blood cancer caused by malignant plasma cells. Around 30,000 people each year are diagnosed with the disease, according to the American Cancer Society, and approximately one-third of those diagnosed will die from their condition. Plasma cells are a key art of the body's immune defense system, and when they become cancerous, they both attack the body and also suppress the immune. Another consequence experienced by patients with multiple myeloma is the development of brittle bones and spinal compression fractures.

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b2ap3_thumbnail_bloodcell.jpgBlood clots are minuscule, but their ability for damage should not be underestimated. Blood clots are, in fact, a dangerous health condition capable of causing major health events such as heart attack, stroke, and even death. These tiny wrecking balls develop as a result of illness, disease or injury, but some develop seemingly out of nowhere or without a clear reason. Patients with peripheral artery disease, or PAD, have a greater chance of developing complications from blood clots and should understand their risks for developing this life-threatening condition. PAD patients should also become aware of the signs they may be experiencing a blood clot.

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Posted by on in Osteoporosis

b2ap3_thumbnail_man-drinking-milk.jpgOsteoporosis is a disease that causes the bones to weaken, become brittle, and break. It is a disease commonly thought to only impact women, but in reality, the condition impacts millions of men in the United States each year. Advanced Radiology explains the causes of osteoporosis in men.

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b2ap3_thumbnail_chocolate2.jpgAn October study by scientists at the University of San Diego has discovered a possible link between oral bacteria and migraines. The study explores the connection between the rates of bacteria in the mouths of migraine sufferers to the rates of bacteria in the mouths of individuals who do not suffer from migraines. Specifically, the kind of bacteria in question is the types of bacteria that have the ability to modify nitrates found in food.

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Tendonitis is one of the most commonly diagnosed orthopedic conditions. It occurs when there is inflammation of the tendon tissue, most commonly as a result of overuse or injury. Symptoms of tendonitis include pain, weakness in the muscle, limited range of movement and stiffness. The symptoms are similar to another commonly diagnosed orthopedic condition, bursitis. The two terms are often used interchangeably – which can be confusing for some patients.

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b2ap3_thumbnail_desk-brick-wall.jpgDesk jobs can be stressful for many. Deadlines, meetings, and projects contribute to mental stress, but did you know that sitting behind a desk can also stress you physically? Sitting can cause physical wear and tear on your body, just like jobs that involve physical labor. Things like carpal tunnel syndrome, computer eye strain, and "tech neck" are all physical ailments that can develop as a result of the office workplace. Sitting all day causes lower back problems and worsens existing back problems. Advanced Radiology treats many patients for back pain as a result of being stuck behind a desk all day.

Sitting for long periods of time causes low back pain and worsens your existing back problems because sitting causes a significant amount of pressure on your back muscles and spine. The pressure of sitting is actually forty percent greater than the pressure of standing. Your back bears the brunt of this pressure. The pressure of sitting eventually causes the discs of your back to bulge, muscles to strain, and in some patients, will cause compression fractures in the vertebrae, or bones that make up the spine. Shoulders, arms, and legs also feel the stress of sitting.

Sitting also causes bad posture. It encourages people to slouch forward over their desks to use their keyboards, or look at their computer screens. It can also cause people to slouch down in their chairs. This slouching stretches the ligaments and muscles in your back, causing further strain on back's discs, vertebrae, and muscles.

You can limit the strain of sitting by making sure you are using a desk chair that is ergonomic. You can also make sure you are practicing correct posture while you sit. Occupational health experts recommend that when you sit, your back should be in line with the back of your chair. Arms should be able to rest at a seventy-five to ninety-degree angle when placed on your desk, and your knees should align with your hips. If these criteria aren’t met, it’s time to adjust the height of your chair.

Some people who have back problems or are concerned about back problems as a result of too much sitting have switched to using stand up desks. Standing desks allow users to work on a surface that is at a more natural height, relieving pressure on the spine.

Whether you decide to sit or stand while you are working, it is also a good idea to move around the office. A walk down the hall or a quick walk at lunch helps to prevent back problems. Even five minutes of light to moderate stretching and exercise several times a day can help ward off back problems. Abdominal exercises, like sit-ups or planks, strengthen your core and help support your back.

The strain of sitting can be serious. Back problems impact your quality of life and may limit your participation in your favorite activities. Serious back problems may require surgery or other interventions for relief. One such intervention is kyphoplasty, an implant that used to treat vertebral compression fractures or VCFs. Advanced Radiology offers Kyphoplasty for patients with pain from VCFs. Call our office for a consultation today at 822.201.1519.

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b2ap3_thumbnail_Osteoporosis.jpgOsteoporosis, a common bone disease, accounts for 2 million broken bones each year, according to the National Osteoporosis Foundation. Patients with osteoporosis often have fractures in their hips or wrists, but many patients experience spinal fractures caused by the disease, too. Spinal fractures caused by osteoporosis are extremely painful, and can negatively impact a patient's quality of life and mobility. Osteoporosis-related spinal fractures are treated with kyphoplasty, a specialized spinal therapy that gives patients relief and helps to regain mobility.

Osteoporosis happens when the body stops making bone. Like all cells in the body, bone cells are always being renewed. New cells form as old cells break down. When more old cells are breaking down in comparison to new cells being formed, bone loss occurs. As a result of bone loss, bones weaken and become brittle.

Osteoporosis typically strikes post-menopausal Caucasian and Asian women but can impact both men and women of all races. Patients younger than the age of 60 with osteoporosis usually have a family history of osteoporosis, and may also have lifestyle factors that contribute to an early onset of the disease. Lifestyle factors that contribute to osteoporosis include smoking and a sedentary lifestyle. Other causes of the disease include poor diet and hormonal conditions, such as thyroid disorders, and the use of some medications, like steroids, which interrupt bone cell regeneration.

When the bones of the spine, called vertebrae, become soft, weakened and brittle, they are at risk of fracturing. Spinal fractures can occur as a result of trauma or fall, but the majority of spinal fractures in osteoporosis patients happens as a result of compression. Vertebral bones are no longer able to support the weight of the body as the patient moves. These fractures can happen during normal activities such as walking, climbing stairs, bending over and even coughing if the patient’s osteoporosis is severe.

Spinal compression fractures caused by osteoporosis are wedge shaped fractures. The wedge shape is a result of the front of the vertebra disintegrating while the back of the bone is unaffected. The fracture occurs in this manner because the back of the vertebrae is harder than the front. The wedge shape of the fracture tips forces the spine to lean forward and curve. This curve is called a kyphotic curve, and if severe, can result in stooped postures.

The standard procedure to correct the kyphotic curve, called a balloon kyphoplasty, treats the painful fracture by inserting a small balloon into the area of fracture to lift up the front that has collapsed. During the kyphoplasty, one or two small incisions are made in the back, and two needles are inserted into the area of the fracture. The needles deliver balloons which will then be inflated, clearing space in the center of the vertebrae. A special bone cement compound will be inserted into the cleared space, which will harden to strengthen the bone. This returns the spine back to its natural shape reduces forward stooping and allows patients to live pain-free.

Dr. Michael Budler, M.D., is an interventional radiologist performing the kyphoplasty procedure for osteoporosis patients with spinal compression fractures in Grand Island, Nebraska. "The kyphoplasty procedure is very beneficial for osteoporosis patients," he says. "As it fills in the space damaged by the compression fracture, it forces the spine back to its normal position, allowing the patient to stand upright." It also relieves stress on the rest of the spine, says Budler. "Because spinal compression factors cause forward stooping, the body is constantly under tension as the top half of the patient is thrust forward. Kyphoplasty can relieve the pull on the muscles caused by osteoporosis-related spinal compression fractures," says Budler. The procedure has an additional benefit of reducing the stress exerted on the back, and can also eliminate or reduce the risk of fracture of adjacent vertebrae. Kyphoplasty can stop the downward spiral brought on by compression fractures," says Budler.

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b2ap3_thumbnail_Plaque.jpgMedical professionals have known for years that the buildup of arterial plaque can wreak havoc on the heart and health of a patient. Plaque narrows the arteries and reduces the ability of blood to flow, which eventually leads to strain on the heart as it overworks to pump blood out to the body’s extremities. Plaque can even block the heart completely. Arterial plaque can cause high blood pressure, heart disease and heart attack. Heart attacks that occur as a result of atherosclerosis account for 30 percent of the total number of heart attacks in Americans each year, according to the Texas Heart Institute at Baylor St. Luke’s Medical Center in Houston, Texas.

While heart attacks that stem from clogged arteries make up a third of all heart attack cases, a specific type of plaque has also been found to be the source of a large percentage of the other two-thirds of heart attacks. This type of plaque is called vulnerable plaque, and it is a type of arterial plaque that made up of lipids, cholesterol, and white blood cells. Like other forms of plaque, vulnerable plaque is found in the walls of the arteries. What makes it different from other types of plaque is that it is covered with a very thin fibrous layer that makes it vulnerable to disruption or movement. Vulnerable plaque may even be more serious than types of arterial plaque, according to some researchers.

The thin, fibrous layer or cap that covers vulnerable plaque in the artery can be easily disrupted. One trigger that causes vulnerable plaque cap disruption is strenuous forms of exercise, particularly those high in intensity. Infrequent or irregular exercise can also strain the patient’s heart and disrupt the cap of vulnerable plaque.

While strenuous exercise can be one cause of cap disruption, researchers have found inflammation of the arteries is likely to be the biggest reason that the cap covering vulnerable plaque is disrupted. Vulnerable plaque is typically very soft in comparison to other types of arterial plaque, and when arteries become inflamed, the cap over the vulnerable plaque begins to crack or split, allowing the soft, fatty substance to leak out. Once the plaque has leaked out, it is picked up by the blood and is carried to other parts of the body where it can cause blockages that may lead to heart attack or ischemic stroke.

Like regular arterial plaque, vulnerable plaque can be prevented. Prevention steps include eating a healthy diet starting an exercise routine under the advisement of your physician. Patients with vulnerable plaque should also quit smoking, as smoking can cause inflammation.

Individuals with vulnerable plaque should look to lower their risk of cap disruption by discussing with their doctor ways to reduce or eliminate inflammation. Patients can be tested to check their C-reactive protein levels. C-reactive protein a protein found in the body, and is an indicator of inflammation and may indicate a future heart attack. If a patient has a high level of C-reactive protein, prophylactic steps can be taken to reduce inflammation in order to lower risk of a heart attack, such as establishing a daily aspirin regimen or using medications to lower C-reactive levels.

Any kind of arterial plaque buildup is a cause for concern, says Dr. Michael Budler, M.D. Budler, an interventional radiologist in Grand Island, Nebraska, treats patients that have an arterial plaque buildup, including the vulnerable plaque. Arterial plaque causes a range of health conditions, like heart disease and peripheral artery disease. Peripheral artery disease, or PAD, is a condition in which plaque builds up in the arteries located in the extremities, like the legs. The condition can cause numbness, pain, and even thinning of the skin. "Plaque buildup in the arteries has a significant impact on the rest of the body," says Budler. "The biggest impact is the reduction of blood flow. This impacts everything – the heart, circulation and even the skin," he explains.

Budler uses vascular stenting to treat patients with arterial plaque buildup. Vascular stenting involves the insertion of a wire mesh tube into the artery to compress plaque and holds the artery open. Another therapy offered by Budler is angioplasty, in which a small balloon is pushed into the artery to push back plaque buildup and increase blood flow. Both the vascular stenting and angioplasty procedures are safe, routine therapies that can yield great results for patients, and decrease their chance of heart attack," says Budler.

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For most people living with migraines really doesn’t mean living as much as it means managing your migraines and the pain they bring. Many migraine sufferers adopt strategies or develop coping mechanisms to handle their head pain in order to get some relief. You may be able to stop migraines before they start with these prevention strategies from Dr. Budler.


Recognize your triggers. Migraines happen when the trigeminal nerve is stimulated. The trigeminal nerve is the main nerve of the face and head and helps to control actions like chewing and blinking. When this nerve is stimulated, it sends messages to other facial nerves to start a pain response. Because the triggers that kick off migraines vary widely from person to person, it is important to understand your specific triggers so you can avoid them. Some examples of common migraine triggers include different foods, food preservatives, perfumes, fluorescent lighting, and stress. Some patients keep a journal of their diets, behaviors, and environmental experience as a way to track and find out their triggers so they can help reduce exposure and possibly reduce migraines.

 


Stop Smoking. Smoking can also be a trigger for migraines. It can cause the trigeminal nerve and other nerves to activate, which can kick off a pain response. Also, smoking is just really bad for you and can increase your risk of stroke and other cardiovascular diseases.

 


Get moving. Increasing the frequency in which you exercise may help head off your next headache. Physical activity has been found to be beneficial in reducing tension, which can cause severe headaches. Migraine patients are cautioned to first discuss their plans for exercise with their doctors and to ease into their new activity routine slowly. This is because exercise that is high intensity can actually bring on a migraine. Also, adding in exercise to your routine at random is also discouraged, because it can also trigger headaches. Establish a walk, jog, or swim routine that you can stick to b2ap3_thumbnail_headacheAAW.jpghelp reduce tension and headache pain.

 

These strategies for prevention may not work for all the time and may not work for all migraine sufferers. Prevention strategies, in combination with self-care treatments, may only provide temporary relief from pain. Dr. Budler offers SPG block therapy for migraine patients for long lasting benefits.

 

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b2ap3_thumbnail_bloodflow.jpgOne in every 20 Americans has peripheral artery disease, according to the National Institute of Health’s Heart, Blood and Lung Institute. This disease increases the risk of heart attack and stroke for many, but can be especially dangerous diabetics. Interventional medical treatments are now helping people with diabetes lower their risks of complications from peripheral artery disease and improve health outcomes.

Peripheral Artery Disease, also known as PAD, is a disease caused by the buildup of plaque in the arteries of the legs, abdomen, and pelvic area. Arterial plaque is caused by fat, cholesterol, mineral deposits and other substances that build up along the wall of arteries. Arteries carry oxygen-rich blood from the heart to the rest of the body. Plaque hardens in the artery over time, a condition known as atherosclerosis. As plaque hardens, it narrows the available space in the vessel and reduces blood flow. This reduction in blood flow means oxygen is not being carried to the extremities and can result in claudication, painful cramping in the legs caused by reduced oxygen due to obstructed arteries. Additionally, PAD patients also have difficulty walking, numbness in the lower extremities and may have sores on the legs or feet that do not heal.

The American Diabetes Association estimates that one in three diabetes over the age of 50 has PAD, but peripheral artery disease can be found in diabetics at any age. PAD is especially common in patients that have Type 2 diabetes. This is because many Type 2 diabetics have uncontrolled blood sugar, which increases the production of artery-clogging LDL cholesterol. Diabetics with additional risk factors like being overweight or obese, smoking or living a sedentary lifestyle also have an increased risk of developing peripheral artery disease.

Many diabetics with peripheral artery disease are not aware they have the disease, because the symptoms of PAD can be similar to the symptoms of their diabetes, or are simply the signs of getting older. Many people go undiagnosed and untreated. If left untreated, PAD can lead to blood clots, amputations, kidney failure and even death.

Peripheral artery disease can be diagnosed successfully in most diabetics by measuring the patient’s ankle-brachial pressure index, ABI. This test is not invasive and is performed by interventional radiologists like Dr. Michael Budler, M.D., of Grande Island, Nebraska. Budler explains the importance of the ABI test, "The ABI test is the fastest and most accurate way to diagnose if a patient has peripheral artery disease."

During the test, blood pressure readings taken using Doppler technology on the patient’s arms and legs to measure the blood flow through the extremities. " If blood pressure is lower in the legs PAD may be present," says Budler. The test is painless and takes approximately an hour.

Once diagnosed, patients can work with their physicians to develop a treatment plan. Treatments for PAD include the use of statins to reduce cholesterol, vasodilation medications to widen the blood vessels and blood thinners to reduce or dissolve blood clots. Interventional radiologists like Budler also perform treatments like angioplasty and vascular stenting.

Angioplasty uses a small catheter inserted into the artery to deliver a balloon that inflates to push any plaque out of the way and increase blood flow. Vascular stenting involves inserting a mesh tube to keep the artery open and blood flowing.

Diabetics are encouraged to talk to their doctor about their symptoms. Patients can reduce their risk of developing PAD by keeping their A1C levels below 7 percent, lowering their LDL cholesterol and lowering their blood pressure. Also, increasing activity and managing weight through exercise as well as eating a healthy diet can help lower the risk of developing peripheral artery disease.

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