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Dyspepsia in the community Older patients presenting for the first time and those with alarm symptoms or signs (weight loss, dysphagia, persistent vomiting, gastrointestinal bleeding, unexplained anemia, epigastric mass, previous gastric ulcer or gastric surgery) should be referred for upper gastrointestinal endoscopy and /or other investigations, both to exclude malignancy and to make a positive diagnosis

Everyday exposure to UV radiation, pollution and lifestyle factors can increase oxidative stress, which may influence how the skin looks over time

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