DR + E preserved lower extremity muscle size and function and reduced regional lower extremity adipose tissue. Although the magnitude of reduction in adipose tissue was greater in the thigh than the calf region, post hoc analyses demonstrated that reductions in calf SAT and IMAT were associated with positive adaptations in physical function.

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Timolol maleate is a non-selective beta-adrenergic receptor blocking agent with demonstrated efficacy in the treatment of open-angle glaucoma. A 76 year old female who presented with productive cough, progressive dyspnea and hypoxia after starting timolol maleate opthalamic drops following glaucoma surgery. The patient was diagnosed with interstitial lung disease secondary to timolol treatment and after cessation of the offending agent along with corticosteroid treatment, symptoms improved drastically. Elimination of other possible causes of disease along with evolution of radiological and functional signs left us with a diagnosis of timolol-induced interstitial lung disease. To our knowledge, this is the second reported case of timolol-induced interstitial lung disease.

Eisenmenger syndrome represents the extreme manifestation of pulmonary arterial hypertension associated with congenital heart defects (CHD). Adults with CHD represent an increasing population which will require management in the long term. We present a case of a 38 year old female who presented with progressive dyspnea along with cyanosis at rest. Echocardiography showed a dilated right ventricle and an ostium secundum ASD with bidirectional shunting. Catheterization revealed severe pulmonary hypertension and evidence of partial anomalous pulmonary venous return. Warden procedure for PAPVR repair was performed along with a fenestrated pericardial ASD patch to close the shunt. A Maze Cox III procedure was also performed to treat the atrial fibrillation. Both procedures were performed successfully with significant improvement in patient's clinical status. This article provides details regarding etiology, pathogenesis, clinical features, and diagnostic evaluation of Eisenmenger syndrome. It covers recent guidelines for screening and therapy as well as information regarding innovations in social and healthcare.

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