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Sedentary Lifestyle (sedentary + lifestyle)
Selected AbstractsPrevalence of Sedentary Lifestyle in Individuals With High Blood PressureINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2 2010Nirla Gomes Guedes RN OBJECTIVE., To identify the prevalence of a sedentary lifestyle in individuals with high blood pressure. METHODS., This cross-sectional study was conducted among 310 individuals with high blood pressure. RESULTS., The prevalence of the diagnosis of sedentary lifestyle was 60%. The more common defining characteristics were "lack of physical conditioning" and "lack of practice for physical exercises." The nursing diagnosis was associated with age and presence of diabetes. Individuals who presented with a sedentary lifestyle related to lack of motivation were significantly younger. CONCLUSIONS., This study showed a high prevalence of "sedentary lifestyle" and its associations with age and the presence of diabetes. IMPLICATIONS TO NURSING PRACTICE., The acknowledgement of "sedentary lifestyle" contributes to the choice for nursing interventions that promote physical activity centered on the subject and the surroundings. [source] The Expert Nurse Profile and Diagnostic Content Validity of Sedentary Lifestyle: The Spanish ValidationINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 3 2007Josep Adolf Guirao-Goris MSN First page of article [source] Physical activity and exercise performance predict long-term prognosis in middle-aged women surviving acute coronary syndromeJOURNAL OF INTERNAL MEDICINE, Issue 2 2007F. Al-Khalili Abstract. Aim., To evaluate the importance of exercise testing (ET) parameters and leisure time physical activity in predicting long-term prognosis in middle-aged women hospitalized for acute coronary syndrome (ACS). Methods and results., Women aged <66 years recently hospitalized for ACS in the Greater Stockholm area in Sweden were recruited. All underwent baseline clinical examinations including ET and then were followed up for 9 years. Nonparticipation in ET had a hazard ratio of 4.26 (95% confidence interval 2.02,8.95) for total mortality and 3.03 (1.03,8.91) for cardiovascular mortality. All ET parameters were significantly different between survivors than nonsurvivors, except for chest pain and ST-segment depression during ET. Sedentary lifestyle and ET parameters were related to total mortality and cardiovascular mortality in a multivariate analysis adjusting for potential confounders. Predictors of total mortality were sedentary lifestyle 2.94 (1.31,6.62), exercise time 1.75 (1.07,2.87) and inadequate haemodynamic responses: low increase in pulse rate 2.04 (1.16,3.60) and systolic blood pressure (SBP) 1.88 (1.19,2.95) from rest to peak exercise. Parameters that predicted cardiovascular mortality were sedentary lifestyle 3.15 (1.13,8.74) and poor increase in SBP 2.76 (1.30,5.86) from rest to peak exercise. The relation of sedentary lifestyle to survival was substantially weakened when exercise parameters were added to the multivariate analysis model. Conclusion., In female patients <66 years surviving ACS, important independent predictors of long-term all-cause mortality were sedentary lifestyle, low physical fitness and inadequate pulse rate and SBP increase during exercise. Predictors of cardiovascular mortality were sedentary lifestyle and inadequate blood pressure response during exercise. [source] Can we predict future improvement in glycaemic control?DIABETIC MEDICINE, Issue 2 2008R. Singh Abstract Aims To determine the factors responsible for poor glycaemic control in diabetes and whether any such factors are associated with likely improvement in glycaemic control. Methods A prospective cohort study of 130 diabetic patients with poor glycaemic control (HbA1c , 10.0%) with 1-year follow-up in a teaching hospital Diabetes Clinic. Changes in HbA1c were measured after 1 year. Results Poor glycaemic control was attributed to one of 15 possible causes. Those cases due to recent diagnosis of diabetes, inadequate treatment with diet, oral glucose-lowering agents or insulin, exacerbation of co-existent medical problems, recent stressful life-events and missed clinic appointments were all associated with significant improvement in HbA1c at 12 months. Patients with low mood or alcohol excess, inadequate blood glucose monitoring, poor exercise/sedentary lifestyle, refusal to take tablets or underdosing and refusal to take insulin at all or to increase the dose were all associated with continuing poor glycaemic control at 12 months. The patients were divided almost equally between the two groups. Conclusions In patients with poor glycaemic control, it is possible by simple features identified at clinic to predict which individuals are likely to show improvement in control and which will not. These findings have not been reported previously and suggest that about half of individuals with poor control will improve within our current diabetes clinic practice. Additional strategies will be required to address those individuals who are not likely to respond. [source] The Role of Natriuretic Peptides in Patients With Chronic Complex (Mixed or Multiple) Heart Valve DiseaseCONGESTIVE HEART FAILURE, Issue 2 2010FRACP, Naylin Bissessor MBChB N-terminal prohormone B-type natriuretic peptide (NT-proBNP) is an important biomarker of prognosis in heart failure and single valve disease. There are limited studies of complex valve disease. Patients with complex valve disease adopt a sedentary lifestyle, so symptoms may be difficult to detect. The authors aimed to determine whether NT-proBNP correlates with the severity of the valve lesion and underlying cardiac function and whether resting NT-proBNP predicts impaired peak VO2 in patients with complex valve disease. Forty-five patients with complex moderate to severe stenosis or regurgitation of the heart valves underwent a clinical assessment, echocardiography, resting NT-proBNP assessment, and formal cardiopulmonary exercise testing. In a multivariate analysis, the log NT-proBNP (,=,9.3, SE=1.9, P<.0001) and lean body weight (,=0.59, SE=0.22, P=.01) were dominant independent predictors of peak VO2. An NT-proBNP value of 84 pmol/L had 77% sensitivity and 70% specificity to predict impaired functional capacity, peak VO2 <60% (predicted), area under the curve=0.80. Resting NT-proBNP was the best predictor of peak VO2 in patients with complex valve disease, while symptoms and ejection fraction are a less reliable guide. Congest Heart Fail. 2010;16:50,54. © 2009 Wiley Periodicals, Inc. [source] Oesophageal adenocarcinoma: A paradigm of mechanical carcinogenesis?INTERNATIONAL JOURNAL OF CANCER, Issue 3 2002Carlo La Vecchia Abstract Incidence of adenocarcinoma of the oesophagus and gastric cardia is increasing in most developed countries and strongly associated with obesity and male gender. An underlying increase in the prevalence of gastro-oesophageal reflux has generally been postulated. We suggest that the increase in frequency of reflux and the 2 associated forms of cancer can be explained by growing abdominal pressure brought about by increasing central obesity, most common among men, and sedentary lifestyle, including car use. Abdominal pressure is further accentuated mainly in men by the shift in Western male dressing towards the general use of belts. © 2002 Wiley-Liss, Inc. [source] Prevalence of Sedentary Lifestyle in Individuals With High Blood PressureINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2 2010Nirla Gomes Guedes RN OBJECTIVE., To identify the prevalence of a sedentary lifestyle in individuals with high blood pressure. METHODS., This cross-sectional study was conducted among 310 individuals with high blood pressure. RESULTS., The prevalence of the diagnosis of sedentary lifestyle was 60%. The more common defining characteristics were "lack of physical conditioning" and "lack of practice for physical exercises." The nursing diagnosis was associated with age and presence of diabetes. Individuals who presented with a sedentary lifestyle related to lack of motivation were significantly younger. CONCLUSIONS., This study showed a high prevalence of "sedentary lifestyle" and its associations with age and the presence of diabetes. IMPLICATIONS TO NURSING PRACTICE., The acknowledgement of "sedentary lifestyle" contributes to the choice for nursing interventions that promote physical activity centered on the subject and the surroundings. [source] The French longitudinal study of growth and nutrition: data in adolescent males and femalesJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 6 2002M. Deheeger Abstract Objectives To assess nutritional intake, growth parameters, physical activity and television viewing in French adolescents. Method A longitudinal study of dietary intake and anthropometric data recorded in the same children (n = 94) from 10 to 16 years of age is presented here. Results Energy intake increased from age 10,16 years in boys, whereas it decreased in girls from the age of 14. Height and weight increased in both males and females over the same period of time. Energy intake was positively associated with age at menarche. Nutritional intake, such as fat and calcium, did not meet recommendations for French adolescents. Height was higher than reference values, but the difference was not significant for girls between 14 and 16 years. Overweight (BMI > 97th percentile of the French reference) was found to be 13,14% between age 10 and 16 years. Time watching TV/computer increased with age from 1.4 to 2.2 h day,1 from 10 to 16 years. Active children had nutritional intake closer to recommendations. Conclusion In conclusion, this study shows that during adolescence, some nutritional variations can be explained by normal individual growth processes. Low intake of calcium in girls and sedentary lifestyle are of particular concern. [source] Physical activity and exercise performance predict long-term prognosis in middle-aged women surviving acute coronary syndromeJOURNAL OF INTERNAL MEDICINE, Issue 2 2007F. Al-Khalili Abstract. Aim., To evaluate the importance of exercise testing (ET) parameters and leisure time physical activity in predicting long-term prognosis in middle-aged women hospitalized for acute coronary syndrome (ACS). Methods and results., Women aged <66 years recently hospitalized for ACS in the Greater Stockholm area in Sweden were recruited. All underwent baseline clinical examinations including ET and then were followed up for 9 years. Nonparticipation in ET had a hazard ratio of 4.26 (95% confidence interval 2.02,8.95) for total mortality and 3.03 (1.03,8.91) for cardiovascular mortality. All ET parameters were significantly different between survivors than nonsurvivors, except for chest pain and ST-segment depression during ET. Sedentary lifestyle and ET parameters were related to total mortality and cardiovascular mortality in a multivariate analysis adjusting for potential confounders. Predictors of total mortality were sedentary lifestyle 2.94 (1.31,6.62), exercise time 1.75 (1.07,2.87) and inadequate haemodynamic responses: low increase in pulse rate 2.04 (1.16,3.60) and systolic blood pressure (SBP) 1.88 (1.19,2.95) from rest to peak exercise. Parameters that predicted cardiovascular mortality were sedentary lifestyle 3.15 (1.13,8.74) and poor increase in SBP 2.76 (1.30,5.86) from rest to peak exercise. The relation of sedentary lifestyle to survival was substantially weakened when exercise parameters were added to the multivariate analysis model. Conclusion., In female patients <66 years surviving ACS, important independent predictors of long-term all-cause mortality were sedentary lifestyle, low physical fitness and inadequate pulse rate and SBP increase during exercise. Predictors of cardiovascular mortality were sedentary lifestyle and inadequate blood pressure response during exercise. [source] Comparative morphology of the foot structure of four genera of Loxosomatidae (Entoprocta): Implications for foot functions and taxonomyJOURNAL OF MORPHOLOGY, Issue 10 2010Tohru Iseto Abstract Entoprocta is a group of mostly cryptic, benthic invertebrates with a sedentary lifestyle. Here, we investigate the morphology of the entoproct foot, which is an important structure in attachment and locomotion. We describe the foot structure of four solitary entoprocts, Loxosoma monilis, Loxosomella stomatophora, Loxocorone allax, and Loxomitra mizugamaensis, by means of light and transmission electron microscopy. Gland cells containing secretory granules were found in the foot of all the four species. In L. monilis, the gland cells densely paved the underside of the disc-shaped foot, but no duct or groove was found. In L. stomatophora and L. allax, a foot gland was present at the frontal end of a foot groove. The foot gland was a solid cell mass in the former species but a sac-like structure in the latter. Two types of groove accessory cells were recognized in both species; groove bulge cells (GBCs) showed large cytoplasmic bulges extending into the groove lumen, while groove microvillus cells have microvillus mats in the lateral wall of the groove. The bulges of GBCs in L. stomatophora are slender and attached to one another with desmosomes, forming appendages that extend down to the substratum, hinting at their contribution to attachment and locomotion. The bulges in L. allax form large swellings that fill the groove lumen and are connected to the surrounding cells with hemidesmosomes. In the liberated buds of L. mizugamaensis, tripartite gland cell masses were found at the basal end of the stalk, but no groove was found. A small invagination, which may be the opening of the gland, was found at the center of the foot tip, where the liberated buds attach themselves to the substratum and then metamorphose into adults. No openings were found at the lateral terminal wings, which support locomotion in Loxomitra species. J. Morphol. 271:1185,1196, 2010. © 2010 Wiley-Liss, Inc. [source] Using Technology to Teach Health: A Collaborative Pilot Project in AlabamaJOURNAL OF SCHOOL HEALTH, Issue 10 2002Brian F. Geiger ABSTRACT: The Centers for Disease Control and Prevention (CDC) identified six adolescent risk behaviors that contribute to chronic diseases and disorders, including poor dietary habits, sedentary lifestyle, and abuse of alcohol, tobacco, and other drugs. This project pilot-tested a "train-the-trainer" model to diffuse an interactive health education software program into Alabama middle schools during a school year. Developmentally appropriate content included nutrition, physical activity, and prevention of substance use. Twenty-four site facilitators selected from 18 public school systems trained 364 colleagues and 2,249 students to use the software. During a school year, facilitators created 150 student assignments; they reported increased interest among students in health instruction. An essential feature of the project involved an active partnership among the funder, state department of education, university, and public schools. Planners provided technical assistance through face-to-face interaction, distance learning, telephone and e-mail communications, and a Web site. Planners and facilitators worked together to overcome barriers to the use of technology for health instruction. [source] Exercise tolerance and daily life in McArdle's diseaseMUSCLE AND NERVE, Issue 5 2005Karen Ollivier MSc Abstract McArdle's disease is a common disorder of muscle metabolism and is due to myophosphorylase deficiency. The major complaint of patients with this disease is effort intolerance. Although the clinical features of affected patients are well known, their daily lifestyle is not well documented. The main objective of this work was to assess their mean daily energy expenditure (DEE) and compare it with control subjects. Thirty patients and 87 control subjects completed a questionnaire. A 3-day self-record of daily physical activities was used to estimate the mean DEE for patients and control subjects. A separate section of the questionnaire was used to assess patients' clinical features and daily lifestyle. The DEE of patients (44.1 ± 6.9 kcal/kg) was not significantly different from control subjects (44.5 ± 5.6 kcal/kg). Half of the patients with McArdle's disease performed a daily physical leisure activity as sport, sometimes at a high level (17%). Despite large individual variation, physical abilities and patients' symptoms were negatively correlated. Physical leisure activity significantly decreased the sensation of muscle pain (P < 0.03). These findings show that patients with McArdle's disease do not have a strictly sedentary lifestyle. Moreover, physical exercise appears to have positive effects on the main clinical features, such as effort intolerance. Thus, regular, moderate physical activity may be beneficial in McArdle's disease. Muscle Nerve, 2005 [source] Gene-environment interaction and obesityNUTRITION REVIEWS, Issue 12 2008Lu Qi The epidemic of obesity has become a major public health problem. Common-form obesity is underpinned by both environmental and genetic factors. Epidemiological studies have documented that increased intakes of energy and reduced consumption of high-fiber foods, as well as sedentary lifestyle, were among the major driving forces for the epidemic of obesity. Recent genome-wide association studies have identified several genes convincingly related to obesity risk, including the fat mass and obesity associated gene and the melanocortin-4 receptor gene. Testing gene-environment interaction is a relatively new field. This article reviews recent advances in identifying the genetic and environmental risk factors (lifestyle and diet) for obesity. The evidence for gene-environment interaction, especially from observational studies and randomized intervention trials, is examined specifically. Knowledge about the interplay between genetic and environmental components may facilitate the choice of more effective and specific measures for obesity prevention based on the personalized genetic make-up. [source] Men's Sexual Health: Evaluating the Effectiveness of Print- and PDA-based CMETHE JOURNAL OF SEXUAL MEDICINE, Issue 9 2009Gregory A. Broderick MD ABSTRACT Introduction., Personal digital assistant (PDA)-based continuing medical education (CME) activities have become widely available. Aims., To evaluate the effectiveness of print- and PDA-based CME materials in erectile dysfunction (ED). Methods., CME materials describing links between ED and comorbid medical conditions, effects of certain lifestyle modifications on ED, and treatment of ED with phosphodiesterase 5 (PDE5) inhibitors were distributed as a print supplement and as electronic modules, viewed with PDAs. We evaluated how effectively these materials improved evidence-based clinical choices, using survey questions about case vignettes and comparing responses of CME participants (N = 85) and matched nonparticipants (N = 94). Main Outcome Measures., Effect size, measuring the difference in evidence-based clinical scores between participants and nonparticipants. Results., CME certificates were awarded to 3,557 participants (459 print, 3,098 PDA). Among survey respondents, significantly more CME participants recognized that ED was associated with greater risk for myocardial infarction (61% participants; 34% nonparticipants; P , 0.001) and was a strong marker for diabetes mellitus (37% participants; 9% nonparticipants; P , 0.001). In contrast, participants and nonparticipants both displayed a good understanding of the relationships of smoking, obesity, and sedentary lifestyle with ED and of using PDE5 inhibitors to treat ED in patients with prostate cancer or benign prostatic hyperplasia; this likely reflects a good baseline understanding of these topics. Participants and nonparticipants each displayed a poor understanding of the recommendations regarding nonarteritic anterior ischemic optic neuropathy and PDE5 inhibitor use. Patient reluctance to discuss sexual concerns was perceived as the most significant barrier to optimal ED management. Conclusions., Given patient reluctance to discuss sexual concerns, future CME activities should focus on educating health-care providers and patients that ED is a risk factor for cardiovascular disease and diabetes. Both print- and PDA-based CME on ED were effective; the large number of lesson completers suggests a trend toward on-demand, self-selected CME is positive. Broderick GA, and Abdolrasulnia M. Men's sexual health: Evaluating the effectiveness of print- and PDA-based CME. J Sex Med 2009;6:2417,2424. [source] Evaluation of the Association between Lower Urinary Tract Symptoms and Erectile Dysfunction, Considering its Multiple Risk FactorsTHE JOURNAL OF SEXUAL MEDICINE, Issue 11 2008Ernani Luis Rhoden MD ABSTRACT Aim., To investigate the relationship between lower urinary tract symptoms (LUTS) and erectile dysfunction (ED), while considering multiple risk factors for ED, including an anthropometric evaluation of central obesity. Methods., A cross-sectional study was carried out with 192 consecutive male subjects (,40 years old). Conditions clearly associated with ED, other than obesity and age, were considered exclusion criteria. Men were evaluated routinely for clinical history, received a physical examination, and were subjected to blood analysis for fasting serum glucose, lipid profile, and serum testosterone. Patients with previous known history of diabetes mellitus or hypertension were excluded. Anthropometric measures taken included body mass index (general obesity) and waist circumference, waist-hip index, and sagittal abdominal diameter (visceral obesity). Analyses were performed using bivariate and multivariate models (multiple logistic regression). Age, education, alcohol consumption, smoking, sedentary lifestyle, fasting blood glucose level, dyslipidemia, hypogonadism, general obesity, and visceral obesity were taken into account as potential confounding factors. Main Outcome Measures., All men completed the International Index of Erectile Function and International Prostate Symptom Score (IPSS). Results., IPSS scores were low, intermediate, and high in 89 (46.4%), 76 (39.6%), and 27 (14.1%) men, respectively. Overall IPSS scores were significantly associated with ED (P = 0.002). In addition, an association between the severity of ED and LUTS was observed (P = 0.008). The mean quality of life assessment in the IPSS revealed a statistically significant difference between individuals with varying degrees of ED (P = 0.008). The logistic regression analyses showed that IPSS scores and ED remained independently associated even after the control for confounding factors (odds ratio = 1.07, 95% CI = 1.02,1.13, P = 0.01). Conclusion., This study suggests that LUTS are independently associated with ED, taking into account various risk factors for ED, including visceral obesity. Rhoden EL, Riedner CE, Fornari A, Fuchs SC, and Ribeiro EP. Evaluation of the association between lower urinary tract symptoms and erectile dysfunction, considering its multiple risk factors. J Sex Med 2008;5:2662,2668. [source] A Validation Study of Type 2 Diabetes-related Variants of the TCF7L2, HHEX, KCNJ11, and ADIPOQ Genes in one Endogamous Ethnic Group of North IndiaANNALS OF HUMAN GENETICS, Issue 4 2010Vipin Gupta Summary The aim of this study was to validate the single nucleotide polymorphisms (SNPs) of four candidate genes (TCF7L2, HHEX, KCNJ11, and ADIPOQ) related to type 2 diabetes (T2D) in an endogamous population of north India; the Aggarwal population, having 18-clans. This endogamous population model was heavily supported by recent land mark work and we also verified the homogeneity of this population by clan-based stratification analysis. Two SNPs (rs4506565; rs7903146) in TCF7L2 were found to be significant (p-value = 0.00191; p-value = 0.00179, respectively), and odds ratios of 2.1 (dominant-model) and 2.0 (recessive-model) respectively, were obtained for this population. The TTT haplotype in the TCF7L2 gene was significantly associated with T2D. Waist-Hip ratio (WHR), systolic blood pressure (SBP), and age were significant covariates for increasing risk of T2D. Single-SNP, combined-SNPs and haplotype analysis provides clear evidence that the causal mutation is near to or within the significant haplotype (TTT) of the TCF7L2 gene. In spite of a culturally-learned sedentary lifestyle and fat-enriched dietary habits, WHR rather than body-mass-index emerged as a robust predictor of risk for T2D in this population. [source] Original Article: Maternal sleep deprivation, sedentary lifestyle and cooking smoke: Risk factors for miscarriage: A case control studyAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 4 2010Yasindu SAMARAWEERA Aims:, To determine risk factors for miscarriage. Methods:, A case control study was carried out at the gynaecological wards and antenatal clinics of the De Soysa Maternity Hospital in Sri Lanka. A case was defined as that of mothers with a confirmed diagnosis of partial or full expulsion of the fetus during the first 28 weeks of gestation. Controls comprised ante-natal clinic attendees whose period of gestation was <28 weeks and carrying a viable fetus. Two hundred and thirty cases and 504 controls were selected. A pre-tested interviewer-administered questionnaire and modified life events inventory were used to gather data. Multivariate logistic regression was applied separately for first and second trimester miscarriages and the results were expressed as odds ratios (OR) and as 95% confidence intervals (95%CI). Results:, Sleeping ,8 h/day (OR:3.80, 95%CI:1.01,14.3) was found to be a risk factor for first trimester miscarriage controlling for the effect of period of gestation. Sleeping ,8 h/day (OR:2.04, 95%CI:1.24,3.37), standing ,3 h/day (OR:1.83, 95%CI:1.08,3.10), exposure to cooking smoke (OR:3.83, 95%CI:1.50,9.90) and physical trauma during the pregnancy (OR:43.2, 95%CI:4.55,411.4) were found to be risk factors for second trimester miscarriage controlling for the effect of period of gestation. Conclusions:, Sleep deprivation, a sedentary lifestyle, exposure to cooking smoke and physical trauma during pregnancy were risk factors for miscarriage. Most of the risk factors are therefore modifiable. [source] Polymorphism of matrix metalloproteinase genes (MMP1 and MMP3) in patients with varicose veinsCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 5 2009M. Kurzawski Summary Background., Several risk factors for varicose veins have been identified: female gender, combined with obesity and pregnancy, occupations requiring standing for long periods, sedentary lifestyle, history of deep-vein thrombosis and family history. However, no specific gene variants related to a wide prevalence of varicosities in general population have been identified. Extracellular matrix composition, predominantly maintained by matrix metalloproteinases (MMPs), may affect the vein-wall structure, which may lead to dilation of vessels and cause varicosities. Aims., MMP-1 (tissue collagenase I) and MMP-3 (stromelysin I) expression was found to be raised in varicose veins compared with normal vessels. Therefore, a study was conducted to evaluate a potential association between MMP1 and MMP3 promoter polymorphisms and a risk of varicose veins. Methods., Genotyping for the presence of the polymorphisms ,1607dupG (rs1799750) in MMP1 and ,1171dupA (rs3025058) in the MMP3 promoter region was performed using PCR and restriction-fragment length polymorphism assays in a group of 109 patients diagnosed with varicose veins and 112 healthy controls. Results., The frequencies of the MMP1 and MMP3 alleles (minor allele frequency 0.440 in patients vs. 0.451 in the controls for MMP1,1607*G and 0.514 vs. 0.469 for MMP3,1171*dupA, respectively) and of genotypes did not differ significantly between patients and controls. Conclusions., The MMP1,1607dupG and MMP3,1171dupA promoter polymorphisms are not valuable markers of susceptibility for varicose veins. [source] Peroxisome proliferator-activated receptor-, coactivator-1, in muscle links metabolism to inflammationCLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY, Issue 12 2009Christoph Handschin Summary 1. In higher eukaryotes, metabolism and immunity are tightly coupled. However, whereas in evolutionary terms a compromised immune response due to undernourishment has been the predominant problem, the inflammatory response to obesity and other lifestyle-associated diseases has increased in relevance in Western societies in the past 100 years. 2. Traditionally, fat tissue has been considered as the major source of pro-inflammatory secreted factors in these pathologies. However, in recent years the contribution of other tissues to disease-causing chronic inflammation has been increasingly appreciated. 3. Peroxisome proliferator-activated receptor-, coactivator-1, (PGC-1,) is one of the key regulatory factors in active skeletal muscle. Aberrant expression of PGC-1, in inactive muscle fibres could be linked to a sedentary lifestyle, persistent systemic inflammation and a higher risk for many chronic diseases. Accordingly, modulation of PGC-1, activity in skeletal muscle may have a broad range of therapeutic effects. Here, recent advances in the understanding of the role of muscle PGC-1, in health and disease are reviewed. [source] Nonalcoholic fatty liver disease: is all the fat bad?INTERNAL MEDICINE JOURNAL, Issue 4 2004A. D. Clouston Abstract Nonalcoholic fatty liver disease is now a major cause of liver disease in developed countries, largely as a result of an epidemic of obesity, diabetes and sedentary lifestyles. This has resulted in raised clinical awareness and diagnostic refinement. The entity encompasses several histologic patterns from benign steatosis to nonalcoholic steatohepatitis, the latter having a significant risk of progressive fibrosis and the development of cirrhosis. Laboratory tests and imaging are not able to distinguish steatosis from steatohepatitis, which requires liver biopsy. However following an assessment of several risk factors, patients can be stratified for the potential risk of fibrosis, allowing the rational use of liver biopsy. This review will describe the various patterns of nonalcoholic fatty liver disease and relate this to disease pathogenesis and progression. Strategies for management, including experimental interventions, will be discussed. (Intern Med J 2004; 34: 187,191) [source] An integrative literature review of lifestyle interventions for the prevention of type II diabetes mellitusJOURNAL OF CLINICAL NURSING, Issue 17 2008Suzanne G Madden Aims and objectives., An integrative literature review was undertaken to determine what type II diabetes prevention programmes have been evaluated, what type of programme is the most effective and how adherent to lifestyle changes adults are after participating in a prevention programme. Background., Type II diabetes is important because the disease is affecting millions of people worldwide. Obesity and sedentary lifestyles are preventable risk factors for type II diabetes, leading many researchers from around the world to examine different programmes that are focussed on prevention of the disease. Design., Integrative literature review. Method., Search of electronic databases. Results., Diet, exercise, counselling and diet plus exercise were the types of prevention programmes, with the diet plus exercise being the most efficacious. Although many studies demonstrated excellent results initially, maintaining the effects of the lifestyle behaviour change proved to be difficult for participants, with only one study demonstrating the persistence of results after six years. Conclusion., Future research should focus on long-term maintenance programmes, rather than just short-term prevention programmes to determine the need for booster interventions or other means to ultimately decrease the incidence of type II diabetes. Relevance to clinical practice., As front-line healthcare providers working across a broad array of settings, nurses are particularly well-suited to play an integral part in future applications of diabetes prevention programmes. Lifestyle interventions are being delivered in a variety of settings and venues such as the workplace, the Internet and places of worship. In addition, at-risk populations also can be targeted, particularly overweight and obese persons, with at least one parent having type II diabetes or persons with gestational diabetes. [source] Clinical use of physical activity measuresJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 2 2009CRNP (Associate Professor), Lorraine M Reiser PhD Abstract Purpose:, To provide a review of physical activity measures and subjective and objective methods of its measurement. Considerations for the use of these measurements in research and practice will be discussed. Data sources:, The PubMed, CINAHL, and Health and Psychosocial Instruments databases, and the Centers for Disease Control Web site were searched using the search term "Physical Activity Measurement." Conclusions:, Physical activity is a lifestyle factor that is a key focus in chronic disease,related research, prevention, and interventions. Healthy People 2010 set goals of decreasing the prevalence of preventable diseases by encouraging healthier lifestyle patterns. Shifts toward more sedentary lifestyles have resulted in increases in life-limiting disease states, including obesity, diabetes, heart disease, cancer, and osteoporosis. Physical activity measurements have been used widely in research studies but are less commonly used in primary care. Measuring individuals' physical activity levels as part of the health assessment will enhance the provider's ability to engage in health promotion and suggest health protection interventions. The strengths, weaknesses, and potential applications to practice of physical activity measures are summarized in an effort to familiarize nurse practitioners (NPs) with commonly used tools and encourage integration of physical activity assessment into their current practice. Implications for practice:, NPs are in an ideal position to promote health by encouraging appropriate amounts of physical activity. Screening, health promotion, and disease prevention are part of the core competencies of NP practice established by the National Organization of Nurse Practitioner Faculties. Increased knowledge of physical activity measures will enhance the NP's ability to evaluate relevant physical activity research for use in evidence-based practice. Incorporation of simple yet appropriate physical activity measurements into practice will expand the NP's ability to identify and thus address sedentary lifestyles in their clientele. [source] Emerging Concepts in the Pathophysiology of Type 2 Diabetes MellitusMOUNT SINAI JOURNAL OF MEDICINE: A JOURNAL OF PERSONALIZED AND TRANSLATIONAL MEDICINE, Issue 3 2009Prasanth N. Surampudi MD Abstract Type 2 diabetes mellitus is a multifactorial metabolic disorder. It is characterized by chronic hyperglycemia, insulin resistance, and a relative insulin secretion defect. The prevalence of type 2 diabetes mellitus has risen worldwide in large part because of an increase in obesity and sedentary lifestyles. The underlying pathophysiology and complications of type 2 diabetes mellitus are still being elucidated. Recent advances in diabetes research have helped us to gain a better understanding about insulin resistance and insulin secretion defects. The evolving understanding about the influence of the incretin effect, insulin signal transduction, adipose tissue, intra,islet cell communication, and inflammation is changing the way in which we view type 2 diabetes mellitus. This new understanding will eventually provide us with new treatment approaches to help patients who have type 2 diabetes mellitus. This article gives a review of the current and emerging concepts of the pathophysiology of type 2 diabetes mellitus. Mt Sinai J Med 76: 216,226, 2009. © 2009 Mount Sinai School of Medicine [source] Understanding risk in hypercholesterolemiaCLINICAL CARDIOLOGY, Issue S1 2003John C. Larosa M.D. President Abstract Atherosclerosis was relatively uncommon 100 years ago, when researchers first established its link to elevated cholesterol. As the twentieth century progressed, however, factors such as high-fat diets, sedentary lifestyles, cigarette smoking, and urbanization combined to increase the prevalence of both hypercholesterolemia and coronary heart disease (CHD) throughout the developed world. Atherogenesis begins at an early age and progresses throughout life, and cholesterol levels during young adulthood strongly predict the risk of CHD and related mortality during the ensuing decades. The total cholesterol level in youth also determines the actual age at which a critical level of atherosclerosis will be reached. Early studies on the primary and secondary prevention of CHD failed to identify a linear relationship between lipid lowering and risk reduction, primarily because older lipid-lowering agents lacked the potency to reduce cholesterol levels significantly enough to achieve lower cardiovascular event and mortality rates. The introduction of the statins, with their powerful lipid-lowering activity, overcame this limitation. Several large-scale trials of statins firmly established the efficacy of these agents in both primary and secondary CHD prevention. With the availability of statin therapy, we are now able to reduce the risk of major adverse CHD events by an average of 30%, regardless of patient age or gender. [source] |