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This review of the literature provides an update on the scientific biological and psychosocial bases for Canada's Physical Activity Guide for Health Active Living, with particular reference to the effect of physical activity on the health of adults aged 20-55 years. Existing physical activity guidelines for adults from around the world are summarized briefly and compared to the Canadian guidelines. The descriptive epidemiology of physical activity and inactivity in Canada is presented, and the strength of the relationship between physical activity and specific health outcomes is evaluated, with particular emphasis on minimal and optimal physical activity requirements. Finally, areas requiring further investigation are highlighted. Summarizing the findings, Canadian and most international physical activity guidelines advocate moderate-intensity physical activity on most days of the week. Physical activity appears to reduce the risk for over 25 chronic conditions, in particular coronary heart disease, stroke, hypertension, breast cancer, colon cancer, type 2 diabetes, and osteoporosis. Current literature suggests that if the entire Canadian population followed current physical activity guidelines, approximately one-third of deaths related to coronary heart disease, one quarter of deaths related to stroke and osteoporosis, 20% of deaths related to colon cancer, hypertension, and type 2 diabetes, and 14% of deaths related to breast cancer could be prevented. It also appears that the prevention of weight gain and the maintenance of weight loss require greater physical activity levels than current recommendations.
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PMID:[Evidence-based guidelines for physical activity of adult Canadians]. 1937 40

This special issue of AJP is focused on research using nonhuman primates as models to further the understanding of women's health. Nonhuman primates play a unique role in translational science by bridging the gap between basic and clinical investigations. The use of nonhuman primates in biomedical research challenges our resolve to treat all life as sacred. The scientific community has responded by developing ethical guidelines for the care and the use of primates and clarifying the responsibility of investigators to insure the physical and psychological well-being of nonhuman primates used in research. Preclinical investigations often involve the use of animal models. Rodent models have been the mainstay of biomedical science and have provided enormous insight into the workings of many mammalian systems that have proved applicable to human biological systems. Rodent models are dissimilar to primates in numerous ways, which may limit the generalizability to human biological systems. These limitations are much less likely in nonhuman primates and in Old World primates, in particular, Macaques are useful models for investigations involving the reproductive system, bioenergetics, obesity and diabetes, cardiovascular health, central nervous system function, cognitive and social behavior, the musculoskeletal system, and diseases of aging. This issue considers primate models of polycystic ovary syndrome; diet effects on glycemic control, breast and endometrium; estrogen, reproductive life stage and atherosclerosis; estrogen and diet effects on inflammation in atherogenesis; the neuroprotective effects of estrogen therapy; social stress and visceral obesity; and sex differences in the role of social status in atherogenesis. Unmet research needs in women's health include the use of diets in nonhuman primate studies that are similar to those consumed by human beings, primate models of natural menopause, dementia, hypertension, colon cancer, and frailty in old age, and dedicated colonies for the study of breast cancer.
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PMID:The unique value of primate models in translational research. Nonhuman primate models of women's health: introduction and overview. 1950 47

Obesity is currently reaching epidemic levels worldwide and is a major predisposing factor for a variety of life-threatening diseases including diabetes, hypertension and cardiovascular diseases. Recently, it has also been suggested to be linked with cancer. Epidemiological studies have shown that obesity increases the risk of colon cancer by 1.5-2 fold with obesity-associated colon cancer accounting for 14-35% of total incidence. Several factors, altered in obesity, may be important in cancer development including increased levels of blood insulin, insulin-like growth factor I, leptin, TNF-alpha, IL-6 as well as decreased adiponectin. A unifying characteristic of all these factors is that they increase the activity of the PI3K/Akt signal pathway. The PI3K/Akt signal pathway in turn activates signals for cell survival, cell growth and cell cycle leading to carcinogenesis. Here we review the evidence that PI3K/Akt and its downstream targets are important in obesity-associated colon cancer and thus, that targeted inhibition of this pathway could be employed for the prevention of obesity-associated colon cancer and incorporated into the therapy regime for those with irremovable colon cancers.
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PMID:Obesity, the PI3K/Akt signal pathway and colon cancer. 1952 47

Subjects that do physical exercise regularly have a reduced risk of developing diabetes, obesity, hypertension, osteoporosis, cardiovascular disease and stroke, colon cancer, depression and complications related to these morbid events. Here we present a series of articles on specific topics linked with diabetes focusing on physical exercise and cardiorespiratory fitness, their role in fuel metabolism and insulin resistance and the relationship with health care and the quality of life of diabetic patients.
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PMID:Physical exercise, public health and quality of life in diabetes. 1966 14

Overexpression of vascular endothelial growth factor (VEGF) by tumor cells promotes angiogenesis, which correlates with progressive tumor growth and poor outcomes in many types of cancer. Bevacizumab inhibits VEGF to promote regression of tumor vessels by limiting blood supply and tumor growth, enhancing delivery of chemotherapy, and inhibiting formation of new vessels. Combined with chemotherapy, bevacizumab prolongs progression-free and overall survival over chemotherapy alone in patients with metastatic carcinoma of the colon and rectum; unresectable, locally advanced, recurrent or metastatic non-squamous, non-small cell lung cancer (NSCLC); and metastatic HER2-negative breast cancers (mBC). Side effects, including hypertension, proteinuria, bleeding, arterial thrombotic events, and impaired wound healing, can be clinically significant, particularly in patients with risk factors. To optimize patient outcomes, nurses should understand bevacizumab's role in cancer therapy, recognize symptoms of toxicity, and manage its side effects. This article describes the rationale for bevacizumab in the treatment of metastatic colorectal cancer, NSCLC, and mBC and discusses patient selection, treatment duration, and side-effect management to support the role of oncology nurses in caring for, educating, and enhancing treatment adherence among patients with cancer receiving bevacizumab. Two case studies are presented as examples of the complex scenarios nurses may encounter regarding these issues.
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PMID:Oncology nursing in a new era: optimizing treatment with bevacizumab. 1979 13

We report a rare case of subarachnoid hemorrhage (SAH) in a man who acquired factor VIII inhibitor and suffered coagulopathy a month after disease onset. Acquired factor VIII inhibitors in patients without hemophilia is a rare disease characterized by severe bleeding as a result of antibody against factor VIII. A 61-year-old male, who had a past history of hypertension, underwent resection for colon cancer at the local hospital. Ten days after surgery he suffered septic shock that required intensive use of antibiotics. Two days after this episode, he had a sudden loss-of-consciousness attack, and was referred to our hospital with the diagnosis of SAH. Emergency angiography revealed a dissecting aneurysm at the right intracranial vertebral artery distal to the origin of the posterior inferior cerebellar artery. The aneurysm was successfully treated with endovascular parent artery occlusion. However, after a placing ventriculo-peritoneal shunt a month later, he developed severe coagulopathy due to acquired factor VIII inhibitor.
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PMID:[A case of subarachnoid hemorrhage complicated by acquired hemophilia]. 1999 54

This systematic review examines critically the scientific basis for Canada's Physical Activity Guide for Healthy Active Living for adults. Particular reference is given to the dose-response relationship between physical activity and premature all-cause mortality and seven chronic diseases (cardiovascular disease, stroke, hypertension, colon cancer, breast cancer, type 2 diabetes (diabetes mellitus) and osteoporosis). The strength of the relationship between physical activity and specific health outcomes is evaluated critically. Literature was obtained through searching electronic databases (e.g., MEDLINE, EMBASE), cross-referencing, and through the authors' knowledge of the area. For inclusion in our systematic review articles must have at least 3 levels of physical activity and the concomitant risk for each chronic disease. The quality of included studies was appraised using a modified Downs and Black tool. Through this search we identified a total of 254 articles that met the eligibility criteria related to premature all-cause mortality (N = 70), cardiovascular disease (N = 49), stroke (N = 25), hypertension (N = 12), colon cancer (N = 33), breast cancer (N = 43), type 2 diabetes (N = 20), and osteoporosis (N = 2). Overall, the current literature supports clearly the dose-response relationship between physical activity and the seven chronic conditions identified. Moreover, higher levels of physical activity reduce the risk for premature all-cause mortality. The current Canadian guidelines appear to be appropriate to reduce the risk for the seven chronic conditions identified above and all-cause mortality.
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PMID:A systematic review of the evidence for Canada's Physical Activity Guidelines for Adults. 2045 83

Colorectal cancer continues to be an important public health concern, despite improvements in screening and better systemic chemotherapy. The integration of targeted therapies in the treatment of colon cancer has resulted in significant improvements in efficacy outcomes. Angiogenesis is important for tumor growth and metastasis and is an important target for new biological agents. Bevacizumab is a humanized recombinant antibody that prevents vascular endothelial growth factor (VEGF) receptor binding, and inhibits angiogenesis and tumor growth. The addition of bevacizumab to fluoropyrimidine-based chemotherapy, with or without irinotecan or oxaliplatin, in both the first- and second-line treatment of metastatic colorectal cancer, significantly increased median progression-free survival and overall survival in select randomized phase III studies. Ongoing studies are evaluating the role of bevacizumab in the adjuvant treatment of colon cancer. Common toxicities associated with bevacizumab include hypertension, bleeding episodes, and thrombotic events. This review will focus on the integration of bevacizumab in the treatment paradigm of colon cancer and the management of its side effects.
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PMID:Targeted therapies in the management of colorectal carcinoma: role of bevacizumab. 2061 90

The current treatment of pulmonary arterial hypertension (PAH) uses vasodilator drugs. Although they improve symptoms associated with PAH, their chronic effects on the pulmonary vasculature and the right ventricle (RV) in humans remain unknown. We report the autopsy findings from a patient with idiopathic PAH treated with epoprostenol successfully for 18 years. The patient died of colon cancer. The pulmonary vasculature surprisingly showed extensive changes of a proliferative vasculopathy. Immunohistochemical studies confirmed ongoing cellular proliferation. Studies of the RV demonstrated concentric hypertrophy with seemingly preserved contractility. The myocardium shifted to glycolytic metabolism. Although the long-term use of epoprostenol contributed to the patient's increased survival, it did not prevent progression of the underlying vascular disease. Remarkably, the RV was able to sustain a normal cardiac output in the face of advanced vascular pathology. The mechanisms by which the RV adapts to chronic PAH need further study.
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PMID:Long-term effects of epoprostenol on the pulmonary vasculature in idiopathic pulmonary arterial hypertension. 2105 99

This study was conducted to estimate the socioeconomic costs of overweight and obesity in a sample of Korean adults aged 20 yr and older in 2005. The socioeconomic costs of overweight and obesity include direct costs (inpatient care, outpatient care and medication) and indirect costs (loss of productivity due to premature deaths and inpatient care, time costs, traffic costs and nursing fees). Hypertension, diabetes mellitus, dyslipidemia, ischemic heart disease, stroke, colon cancer and osteoarthritis were selected as obesity-related diseases. The population attributable fraction (PAF) of obesity was calculated from national representative data of Korea such as the National Health Insurance Corporation (NHIC) cohort data and the 2005 Korea National Health and Nutrition Examination Survey (KNHANES) data. Direct costs of overweight and obesity were estimated at approximately U$1,081 million equivalent (men: U$497 million, women: U$584 million) and indirect costs were estimated at approximately U$706 million (men: U$527 million, women: U$178 million). The estimated total socioeconomic costs of overweight and obesity were approximately U$1,787 million (men: U$1,081 million, women: U$706 million). These total costs represented about 0.22% of the gross domestic product (GDP) and 3.7% of the national health care expenditures in 2005. We found the socioeconomic costs of overweight and obesity in Korean adults aged 20 yr and older are substantial. In order to control the socioeconomic burden attributable to overweight and obesity, effective national strategies for prevention and management of obesity should be established and implemented.
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PMID:Socioeconomic costs of overweight and obesity in Korean adults. 2214 88


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