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[PMID]:29340678
[Au] Autor:Ikramuddin S; Korner J; Lee WJ; Thomas AJ; Connett JE; Bantle JP; Leslie DB; Wang Q; Inabnet WB; Jeffery RW; Chong K; Chuang LM; Jensen MD; Vella A; Ahmed L; Belani K; Billington CJ
[Ad] Endereço:Department of Surgery, University of Minnesota, Minneapolis.
[Ti] Título:Lifestyle Intervention and Medical Management With vs Without Roux-en-Y Gastric Bypass and Control of Hemoglobin A1c, LDL Cholesterol, and Systolic Blood Pressure at 5 Years in the Diabetes Surgery Study.
[So] Source:JAMA;319(3):266-278, 2018 01 16.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: The Roux-en-Y gastric bypass is effective in achieving established diabetes treatment targets, but durability is unknown. Objective: To compare durability of Roux-en-Y gastric bypass added to intensive lifestyle and medical management in achieving diabetes control targets. Design, Setting, and Participants: Observational follow-up of a randomized clinical trial at 4 sites in the United States and Taiwan, involving 120 participants who had a hemoglobin A1c (HbA1c) level of 8.0% or higher and a body mass index between 30.0 and 39.9 (enrolled between April 2008 and December 2011) were followed up for 5 years, ending in November 2016. Interventions: Lifestyle-intensive medical management intervention based on the Diabetes Prevention Program and LookAHEAD trials for 2 years, with and without (60 participants each) Roux-en-Y gastric bypass surgery followed by observation to year 5. Main Outcomes and Measures: The American Diabetes Association composite triple end point of hemoglobin A1c less than 7.0%, low-density lipoprotein cholesterol less than 100 mg/dL, and systolic blood pressure less than 130 mm Hg at 5 years. Results: Of 120 participants who were initially randomized (mean age, 49 years [SD, 8 years], 72 women [60%]), 98 (82%) completed 5 years of follow-up. Baseline characteristics were similar between groups: mean (SD) body mass index 34.4 (3.2) for the lifestyle-medical management group and 34.9 (3.0) for the gastric bypass group and had hemoglobin A1c levels of 9.6% (1.2) and 9.6% (1.0), respectively. At 5 years, 13 participants (23%) in the gastric bypass group and 2 (4%) in the lifestyle-intensive medical management group had achieved the composite triple end point (difference, 19%; 95% CI, 4%-34%; P = .01). In the fifth year, 31 patients (55%) in the gastric bypass group vs 8 (14%) in the lifestyle-medical management group achieved an HbA1c level of less than 7.0% (difference, 41%; 95% CI, 19%-63%; P = .002). Gastric bypass had more serious adverse events than did the lifestyle-medical management intervention, 66 events vs 38 events, most frequently gastrointestinal events and surgical complications such as strictures, small bowel obstructions, and leaks. Gastric bypass had more parathyroid hormone elevation but no difference in B12 deficiency. Conclusions and Relevance: In extended follow-up of obese adults with type 2 diabetes randomized to adding gastric bypass compared with lifestyle and intensive medical management alone, there remained a significantly better composite triple end point in the surgical group at 5 years. However, because the effect size diminished over 5 years, further follow-up is needed to understand the durability of the improvement. Trial Registration: clinicaltrials.gov Identifier: NCT00641251.
[Mh] Termos MeSH primário: Derivação Gástrica
Hemoglobina A Glicada/análise
[Mh] Termos MeSH secundário: LDL-Colesterol/sangue
Diabetes Mellitus Tipo 2/sangue
Feminino
Seres Humanos
Hipoglicemiantes
Estilo de Vida
Meia-Idade
Taiwan
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; COMMENT
[Nm] Nome de substância:
0 (Cholesterol, LDL); 0 (Glycated Hemoglobin A); 0 (Hypoglycemic Agents)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180311
[Lr] Data última revisão:
180311
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180118
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.20813


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[PMID]:29505512
[Au] Autor:Acosta T; Barengo NC; Arrieta A; Ricaurte C; Tuomilehto JO
[Ad] Endereço:Department of Public Health, Universidad del Norte, Barranquilla, Colombia.
[Ti] Título:A demonstration area for type 2 diabetes prevention in Barranquilla and Juan Mina (Colombia): Baseline characteristics of the study participants.
[So] Source:Medicine (Baltimore);97(1):e9285, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Type 2 diabetes (T2D) imposes a heavy public health burden in both developed and developing countries. It is necessary to understand the effect of T2D in different settings and population groups. This report aimed to present baseline characteristics of study participants in the demonstration area for the "Type 2 Diabetes Prevention in Barranquilla and Juan Mina" (DEMOJUAN) project after randomization and to compare their fasting and 2-hour glucose levels according to lifestyle and T2D risk factor levels.The DEMOJUAN project is a randomized controlled field trial. Study participants were recruited from study sites using population-wide screening using the Finnish Diabetes Risk Score (FINDRISC) questionnaire. All volunteers with FINDRISC of ≥13 points were invited to undergo an oral glucose tolerance test (OGTT). Participant inclusion criteria for the upcoming field trial were either FINDRISC of ≥13 points and 2-hour post-challenge glucose level of 7.0 to 11.0 mmol/L or FINDRISC of ≥13 points and fasting plasma glucose level of 6.1 to 6.9 mmol/L. Lifestyle habits and risk factors for T2D were assessed by trained interviewers using a validated questionnaire.Among the 14,193 participants who completed the FINDRISC questionnaire, 35% (n = 4915) had a FINDRISC score of ≥13 points and 47% (n = 2306) agreed to undergo the OGTT. Approximately, 33% (n = 772) of participants underwent the OGTT and met the entry criteria; these participants were randomized into 3 groups. There were no statistically significant differences found in anthropometric or lifestyle risk factors, distribution of the glucose metabolism categories, or other diabetes risk factors between the 3 groups (P > .05). Women with a past history of hyperglycaemia had significantly higher fasting glucose levels than those without previous hyperglycaemia (103 vs 99 mg/dL; P < .05).Lifestyle habits and risk factors were evenly distributed among the 3 study groups. No differences were found in fasting or 2-hour glucose levels among different lifestyle or risk factor categories with the exception of body mass index, past history of hyperglycaemia, and age of ≥64 years in women. TRIAL REGISTRATION: NCT01296100 (2/12/2011; Clinical trials.gov).
[Mh] Termos MeSH primário: Diabetes Mellitus Tipo 2/prevenção & controle
[Mh] Termos MeSH secundário: Adulto
Idoso
Glicemia
Colômbia
Feminino
Seres Humanos
Estilo de Vida
Masculino
Meia-Idade
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Blood Glucose)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180306
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009285


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[PMID]:29431940
[Au] Autor:Novichkova NI; Kallistov DY; Romanova EA; Sobolevskaya OV; Romanov AI
[Ti] Título:[Hygienic analysis of factors affecting of the occurrence of sleep disorders prevalence rate].
[So] Source:Gig Sanit;95(11):1037-40, 2016.
[Is] ISSN:0016-9900
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:Aim: To evaluate the prevalence rate of sleep disorders in various age and professional groups of the population - residents of different regions of Russia and to estimate the relative role of environmental, work-related and life style factors in their progression. Materials and Methods: 6 groups of the population including more than 2500 adults and children - residents of areas with various levels of environmental pollution were examined with the use of the structured questionnaire. Working conditions of state employees and health care professionals were examined. Statistical analysis including the calculation of odds ratios for sleep disorders was performed Results: Disorders of the sleep maintenance among adults were found in 49% of men and 51% of women in Moscow; 49.3% of men and 26.7% of women in Voronezh. Air pollution and noise levels increased risks of insomnia by 10% and 20% respectively. In the city of Serpukhov (the Moscow Region) 78.7% of girls and 94.1% of boys estimated their sleep as deep and sound; in the Great Novgorod so did 69.2% girls and 66.0% boys. A trend (R=0.97) for the increasing of the prevalence rate of insomnia symptoms among children with the age was revealed. In working populations there was shown the positive correlation between the prevalence rate of sleep disorders and job environment, hardness of the work (r=0.28) and work-related stress (odds ratio = 1.8). Conclusion: Harmful environmental factors, life style, hardness of the work and work related stress are independent risk factors of chronic insomnia.
[Mh] Termos MeSH primário: Exposição Ambiental
Estilo de Vida
Estresse Ocupacional
Transtornos do Sono-Vigília
[Mh] Termos MeSH secundário: Adulto
Criança
Exposição Ambiental/efeitos adversos
Exposição Ambiental/análise
Exposição Ambiental/prevenção & controle
Feminino
Seres Humanos
Masculino
Estresse Ocupacional/complicações
Estresse Ocupacional/epidemiologia
Estresse Ocupacional/prevenção & controle
Prevalência
Saúde Pública/métodos
Saúde Pública/estatística & dados numéricos
Federação Russa/epidemiologia
Transtornos do Sono-Vigília/epidemiologia
Transtornos do Sono-Vigília/etiologia
Transtornos do Sono-Vigília/prevenção & controle
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180213
[St] Status:MEDLINE


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[PMID]:28467207
[Au] Autor:Moon S
[Ad] Endereço:a Department of Nursing , College of Medicine, University of Ulsan , Ulsan , South Korea.
[Ti] Título:Unhealthy Lifestyle Behaviors in Korean People with Metabolic Syndrome.
[So] Source:J Community Health Nurs;34(2):69-79, 2017 Apr-Jun.
[Is] ISSN:1532-7655
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This study identified factors associated with unhealthy lifestyle behaviors in people with metabolic syndrome in South Korea. The sample consisted of 1,207 subjects with metabolic syndrome from the Sixth Korea National Health and Nutrition Examination Survey conducted in 2014. High-risk alcohol consumption, smoking, aerobic physical activity, leisure physical activity, excessive carbohydrate intake, and fat intake were measured. A secondary data analysis was performed using chi-square tests and logistic regression. Gender was associated with all unhealthy behaviors. The number of metabolic syndrome components, a poor perceived health status, and attempts to control weight were associated with physical inactivity. Those findings may be helpful to develop a tailored lifestyle modification programs for people with metabolic syndrome.
[Mh] Termos MeSH primário: Comportamentos Relacionados com a Saúde
Síndrome Metabólica/psicologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Consumo de Bebidas Alcoólicas/efeitos adversos
Consumo de Bebidas Alcoólicas/epidemiologia
Distribuição de Qui-Quadrado
Estudos Transversais
Carboidratos da Dieta/administração & dosagem
Carboidratos da Dieta/efeitos adversos
Gorduras na Dieta/administração & dosagem
Gorduras na Dieta/efeitos adversos
Exercício
Feminino
Seres Humanos
Estilo de Vida
Modelos Logísticos
Masculino
Meia-Idade
Inquéritos Nutricionais
República da Coreia/epidemiologia
Fatores Sexuais
Fumar/efeitos adversos
Fumar/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Dietary Carbohydrates); 0 (Dietary Fats)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM; N
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1080/07370016.2017.1304145


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[PMID]:29186634
[Au] Autor:Lein DH; Clark D; Graham C; Perez P; Morris D
[Ad] Endereço:Department of Physical Therapy, University of Alabama at Birmingham, SHPB 376, 1720 2nd Avenue South, Birmingham, AL, 35294-1212.
[Ti] Título:A Model to Integrate Health Promotion and Wellness in Physical Therapist Practice: Development and Validation.
[So] Source:Phys Ther;97(12):1169-1181, 2017 Dec 01.
[Is] ISSN:1538-6724
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Background: Globally, physical therapy professional organizations have called for physical therapists to perform lifestyle behavior management during customary care, or health-focused care, due to increasing morbidity and mortality related to noncommunicable diseases. Given the potential for health-focused care to improve health outcomes, physical therapists should integrate health promotion into their daily clinical practice. A clinical model that illustrates necessary steps to deliver health-focused care would be helpful to educate present and future physical therapists. Objective: The purpose of the study was to develop and validate the Health-Focused Physical Therapy Model (HFPTM) for physical inactivity and smoking. Methods: The authors used a mixed method approach. The preliminary model was informed by previous research and the investigators' shared experience in health promotion and physical therapy. An interdisciplinary group of health professionals provided input into the preliminary model by way of a World Café format. Eight physical therapists with health promotion and education expertise then engaged in a Delphi process to establish content validity. Results: World Café participants indicated that: (1) physical therapists are well positioned to engage in health promotion and wellness, and (2) the model facilitates interdisciplinary collaboration and consultation. Delphi process participants reached majority consensus in 1 round. The average model content validity index (CVI) was .915 for physical inactivity and .899 for smoking. Agreement concerning the model schematic was 88% for either behavior. Investigators made few editorial changes after the Delphi process. Limitations: Limitations of this study include using only 2 unhealthy lifestyle behaviors for testing, and performing the testing in a nonclinical setting. Conclusions: An interdisciplinary group of health professionals believes that physical therapists should practice health-focused care and that the HFPTM is a valid model. This model could help physical therapist educators when educating physical therapist students and clinicians to practice health-focused care.
[Mh] Termos MeSH primário: Comportamentos Relacionados com a Saúde
Promoção da Saúde
Modalidades de Fisioterapia
[Mh] Termos MeSH secundário: Protocolos Clínicos
Exercício
Seres Humanos
Estilo de Vida
Educação de Pacientes como Assunto
Reprodutibilidade dos Testes
Fumar
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171130
[St] Status:MEDLINE
[do] DOI:10.1093/ptj/pzx090


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[PMID]:28463859
[Au] Autor:Katsiki N; Mantzoros C; Mikhailidis DP
[Ad] Endereço:aSecond Department of Propaedeutic Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece bDivision of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA cDepartment of Clinical Biochemistry, Royal Free Hospital Campus, University College London Medical School, University College London (UCL), London, UK.
[Ti] Título:Adiponectin, lipids and atherosclerosis.
[So] Source:Curr Opin Lipidol;28(4):347-354, 2017 Aug.
[Is] ISSN:1473-6535
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:PURPOSE OF REVIEW: Adiponectin is an adipokine with anti-inflammatory, antioxidant, antiatherogenic, pro-angiogenic, vasoprotective and insulin-sensitizing properties. Several factors may influence adiponectin levels, such as genetic polymorphisms, obesity / body fat distribution, diet and exercise as well as cardiovascular risk factors such as sleep deprivation and smoking as well as medications. Adiponectin has been proposed as a potential prognostic biomarker and a therapeutic target in patients with cardiometabolic diseases. RECENT FINDINGS: This narrative review discusses the associations of adiponectin with obesity-related metabolic disorders (metabolic syndrome, nonalcoholic fatty liver disease, hyperuricaemia and type 2 diabetes mellitus). We also focus on the links between adiponectin and lipid disorders and with coronary heart disease and noncardiac vascular diseases (i.e. stroke, peripheral artery disease, carotid artery disease, atherosclerotic renal artery stenosis, abdominal aortic aneurysms and chronic kidney disease). Further, the effects of lifestyle interventions and drug therapy on adiponectin levels are briefly reviewed. SUMMARY: Based on available data, adiponectin represents a multifaceted biomarker that may beneficially affect atherosclerosis, inflammation and insulin resistance pathways. However, there are conflicting results with regard to the associations between adiponectin levels and the prevalence and outcomes of cardiometabolic diseases. Further research on the potential clinical implications of adiponectin in the diagnosis and treatment of such diseases is needed.
[Mh] Termos MeSH primário: Adiponectina/metabolismo
Aterosclerose/metabolismo
Metabolismo dos Lipídeos
[Mh] Termos MeSH secundário: Aterosclerose/complicações
Aterosclerose/cirurgia
Cirurgia Bariátrica
Seres Humanos
Estilo de Vida
Obesidade/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Adiponectin)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1097/MOL.0000000000000431


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[PMID]:28452689
[Au] Autor:An R; Khan N; Loehmer E; McCaffrey J
[Ad] Endereço:Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, USA.
[Ti] Título:Assessing the Network of Agencies in Local Communities that Promote Healthy Eating and Lifestyles among Populations with Limited Resources.
[So] Source:Am J Health Behav;41(2):127-138, 2017 Mar 01.
[Is] ISSN:1945-7359
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: We assessed the network of agencies in local communities that promote healthy eating and lifestyles among populations with limited resources. METHODS: Network surveys were administered among 159 Illinois agencies identified as serving limited-resource audiences categorized into 8 types: K-12 schools, early childhood centers, emergency food providers, health-related agencies, social resource centers, low-income/subsidized housing complexes, continuing education organizations, and others. Network analysis was conducted to examine 4 network structures - communications, funding, cooperation, and collaboration networks between agencies within each county/county cluster. RESULTS: Agencies in a network were found to be loosely connected, indicated by low network density. Reporting accuracy might be of concern, indicated by low reciprocity. Agencies in a network are decentralized rather than centralized around a few influential agencies, indicated by low betweenness centrality. There is suggestive evidence regarding homophily in a network, indicated by some significant correlations within agencies of the same type. Agencies connected in one network are significantly more likely to be connected in all the other networks as well. CONCLUSIONS: Promoting healthy eating and lifestyles among populations with limited resources warrants strong partnership across agencies in communities. Network analysis serves as a useful tool to evaluate community partnerships and facilitate coalition building..
[Mh] Termos MeSH primário: Órgãos Governamentais
Promoção da Saúde
Dieta Saudável
Colaboração Intersetorial
Estilo de Vida
Populações Vulneráveis
[Mh] Termos MeSH secundário: Seres Humanos
Illinois
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.5993/AJHB.41.2.3


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[PMID]:29480874
[Au] Autor:Recio-Rodriguez JI; Gómez-Marcos MA; Agudo-Conde C; Ramirez I; Gonzalez-Viejo N; Gomez-Arranz A; Salcedo-Aguilar F; Rodriguez-Sanchez E; Alonso-Domínguez R; Sánchez-Aguadero N; Gonzalez-Sanchez J; Garcia-Ortiz L; EVIDENT 3 investigators
[Ad] Endereço:Primary Health Care Research Unit, La Alamedilla Health Center, Health Service of Castilla y León (SACYL), Biomedical Research Institute of Salamanca (IBSAL), Spanish Network for Preventive Activities and Health Promotion (REDIAPP).
[Ti] Título:EVIDENT 3 Study: A randomized, controlled clinical trial to reduce inactivity and caloric intake in sedentary and overweight or obese people using a smartphone application: Study protocol.
[So] Source:Medicine (Baltimore);97(2):e9633, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Mobile technology, when included within multicomponent interventions, could contribute to more effective weight loss. The objective of this project is to assess the impact of adding the use of the EVIDENT 3 application, designed to promote healthy living habits, to traditional modification strategies employed for weight loss. Other targeted behaviors (walking, caloric-intake, sitting time) and outcomes (quality of life, inflammatory markers, measurements of arterial aging) will also be evaluated. METHODS: Randomized, multicentre clinical trial with 2 parallel groups. The study will be conducted in the primary care setting and will include 700 subjects 20 to 65 years, with a body mass index (27.5-40 kg/m), who are clinically classified as sedentary. The primary outcome will be weight loss. Secondary outcomes will include change in walking (steps/d), sitting time (min/wk), caloric intake (kcal/d), quality of life, arterial aging (augmentation index), and pro-inflammatory marker levels. Outcomes will be measured at baseline, after 3 months, and after 1 year. Participants will be randomly assigned to either the intervention group (IG) or the control group (CG). Both groups will receive the traditional primary care lifestyle counseling prior to randomization. The subjects in the IG will be lent a smartphone and a smartband for a 3-month period, corresponding to the length of the intervention. The EVIDENT 3 application integrates the information collected by the smartband on physical activity and the self-reported information by participants on daily food intake. Using this information, the application generates recommendations and personalized goals for weight loss. DISCUSSION: There is a great diversity in the applications used obtaining different results on lifestyle improvement and weight loss. The populations studied are not homogeneous and generate different results. The results of this study will help our understanding of the efficacy of new technologies, combined with traditional counseling, towards reducing obesity and enabling healthier lifestyles. ETHICS AND DISSEMINATION: The study was approved by the Clinical Research Ethics Committee of the Health Area of Salamanca ("CREC of Health Area of Salamanca") on April 2016. A SPIRIT checklist is available for this protocol. The trial was registered in ClinicalTrials.gov provided by the US National Library of Medicine-number NCT03175614.
[Mh] Termos MeSH primário: Restrição Calórica
Exercício
Aplicativos Móveis
Sobrepeso/terapia
Smartphone
Perda de Peso
[Mh] Termos MeSH secundário: Adulto
Idoso
Restrição Calórica/métodos
Aconselhamento
Comportamentos Relacionados com a Saúde
Seres Humanos
Estilo de Vida
Meia-Idade
Sobrepeso/fisiopatologia
Qualidade de Vida
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180227
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009633


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[PMID]:29386192
[Au] Autor:Tu H; Wen CP; Tsai SP; Chow WH; Wen C; Ye Y; Zhao H; Tsai MK; Huang M; Dinney CP; Tsao CK; Wu X
[Ad] Endereço:Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
[Ti] Título:Cancer risk associated with chronic diseases and disease markers: prospective cohort study.
[So] Source:BMJ;360:k134, 2018 01 31.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To assess the independent and joint associations of major chronic diseases and disease markers with cancer risk and to explore the benefit of physical activity in reducing the cancer risk associated with chronic diseases and disease markers. DESIGN: Prospective cohort study. SETTING: Standard medical screening program in Taiwan. PARTICIPANTS: 405 878 participants, for whom cardiovascular disease markers (blood pressure, total cholesterol, and heart rate), diabetes, chronic kidney disease markers (proteinuria and glomerular filtration rate), pulmonary disease, and gouty arthritis marker (uric acid) were measured or diagnosed according to standard methods, were followed for an average of 8.7 years. MAIN OUTCOME MEASURES: Cancer incidence and cancer mortality. RESULTS: A statistically significantly increased risk of incident cancer was observed for the eight diseases and markers individually (except blood pressure and pulmonary disease), with adjusted hazard ratios ranging from 1.07 to 1.44. All eight diseases and markers were statistically significantly associated with risk of cancer death, with adjusted hazard ratios ranging from 1.12 to 1.70. Chronic disease risk scores summarizing the eight diseases and markers were positively associated with cancer risk in a dose-response manner, with the highest scores associated with a 2.21-fold (95% confidence interval 1.77-fold to 2.75-fold) and 4.00-fold (2.84-fold to 5.63-fold) higher cancer incidence and cancer mortality, respectively. High chronic disease risk scores were associated with substantial years of life lost, and the highest scores were associated with 13.3 years of life lost in men and 15.9 years of life lost in women. The population attributable fractions of cancer incidence or cancer mortality from the eight chronic diseases and markers together were comparable to those from five major lifestyle factors combined (cancer incidence: 20.5% 24.8%; cancer mortality: 38.9% 39.7%). Among physically active (versus inactive) participants, the increased cancer risk associated with chronic diseases and markers was attenuated by 48% for cancer incidence and 27% for cancer mortality. CONCLUSIONS: Chronic disease is an overlooked risk factor for cancer, as important as five major lifestyle factors combined. In this study, chronic diseases contributed to more than one fifth of the risk for incident cancer and more than one third of the risk for cancer death. Physical activity is associated with a nearly 40% reduction in the cancer risk associated with chronic diseases.
[Mh] Termos MeSH primário: Biomarcadores/sangue
Doença Crônica/epidemiologia
Neoplasias/complicações
[Mh] Termos MeSH secundário: Adulto
Artrite Gotosa/epidemiologia
Artrite Gotosa/metabolismo
Doenças Cardiovasculares/complicações
Doenças Cardiovasculares/epidemiologia
Doença Crônica/mortalidade
Complicações do Diabetes
Diabetes Mellitus/epidemiologia
Detecção Precoce de Câncer/métodos
Exercício/fisiologia
Feminino
Seres Humanos
Incidência
Estilo de Vida
Pneumopatias/epidemiologia
Pneumopatias/metabolismo
Pneumopatias/fisiopatologia
Masculino
Meia-Idade
Neoplasias/epidemiologia
Neoplasias/mortalidade
Avaliação de Resultados (Cuidados de Saúde)
Estudos Prospectivos
Insuficiência Renal Crônica/complicações
Insuficiência Renal Crônica/epidemiologia
Fatores de Risco
Taiwan/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Biomarkers)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180202
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.k134


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[PMID]:29179828
[Au] Autor:Hjorth P; Juel A; Hansen MV; Madsen NJ; Viuff AG; Munk-Jørgensen P
[Ad] Endereço:Mental Health Center, Psychiatric Hospital, Randers, Denmark. Electronic address: Peter.Hjorth@rsyd.dk.
[Ti] Título:Reducing the Risk of Cardiovascular Diseases in Non-selected Outpatients With Schizophrenia: A 30-Month Program Conducted in a Real-life Setting.
[So] Source:Arch Psychiatr Nurs;31(6):602-609, 2017 12.
[Is] ISSN:1532-8228
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The most common cause of premature death in people with schizophrenia is cardiovascular disease, partially explained by an unhealthy lifestyle, smoking, poor diet and sedentary behavior. We aimed to reduce cardiovascular risk factors. METHOD: Naturalistic follow-up study with 54 long-term-treated non-selected outpatients with schizophrenia. The 30-month program consisted of individual guidance, group sessions and normal treatment and care offered in our clinic. RESULTS: On average, the participating women reduced their waist circumference by 11.4cm (P=0.037), whereas the participating men increased their waist circumference by 3.3cm (P=0.590). Patients' consumption of fast food was reduced from 1.2 to 0.8 times/week (P=0.016), just as their consumption of soft drinks was reduced from 0.7 to 0.1l/day (P=0.006). Their consumption of coffee increased from 1.6 to 2.5 cups/day (P=0.086). The time women spent on light physical activity increased from 134 to 469min/week (P=0.055). The number of daily cigarettes smoked was reduced by 25.7% for all smokers. CONCLUSIONS: Our program showed that it is possible for women but not for men to reduce their risk factors for developing cardiovascular disease. The program is manageable in most outpatient clinics and can be performed by nursing staff interested in physical health with support from and in cooperation with medical doctors, psychiatrist and leaders/managers.
[Mh] Termos MeSH primário: Doenças Cardiovasculares/prevenção & controle
Promoção da Saúde
Pacientes Ambulatoriais/psicologia
Esquizofrenia/terapia
[Mh] Termos MeSH secundário: Adulto
Doenças Cardiovasculares/mortalidade
Doenças Cardiovasculares/terapia
Exercício/fisiologia
Feminino
Seguimentos
Seres Humanos
Estilo de Vida
Masculino
Fatores de Risco
Esquizofrenia/complicações
Fumar/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM; N
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE



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