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The association of fitness and body mass index (BMI) on all-cause mortality in cancer survivors: The Henry Ford Exercise Testing Project (The FIT Project). J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.7060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7060 Background: The obesity paradox –i.e. inverse associations between body mass index (BMI) and mortality – has been reported in patients with cancer, heart failure, and diabetes. However, the influence of cardiorespiratory fitness (CRF) on this relationship is not well established. This study assesses the association of BMI and CRF with all-cause mortality among cancer patients. Methods: The Henry Ford (HF) FIT Project is a retrospective cohort study of 69,885 consecutive patients who underwent physician-referred exercise stress testing from 1991 through 2009. Cancer diagnosis was identified through linkage to the HF tumor registry. We included patients 40-70 years old, with BMI recorded, at time of exercise test, with a history of cancer > 6 months prior. BMI was categorized as normal (18.5-24.9kg/m2), overweight (25-29.9kg/m2), or obese ( > = 30kg/m2). All-cause mortality was obtained from the National Death Index. Because of a significant interaction between BMI and cancer type, patients with breast or prostate cancer were excluded. Multivariable adjusted Cox proportional hazard models were used to evaluate the association of CRF andBMI with all-cause mortality; adjusted for age at exercise test, sex, diabetes, smoking, cancer stage, and time from cancer diagnosis to exercise test. Results: Included were 676 patients with a mean age of 58 years (SD 7.5), 51% female, 70% White, 25% Black, with a median of 4.8 years from diagnosis to exercise test and median follow up time of 10.3 years. Among patients achieving < 10 METs, those who are overweight and obese had a lower risk of mortality HR 0.47 (95% CI 0.25,0.86) and HR 0.44 (95% CI 0.26, 0.74, respectively), compared to those with normal BMI. Among patients with METs > = 10, those who were overweight had the lowest risk of all-cause mortality (HR 0.23, 95% CI 0.09-0.62) compared to normal weight, while no statistically significant different risk of mortality was observed when comparing those who are obese to normal weight (HR 0.37, 95% CI 0.13-1.06). In an analysis combining BMI and fitness groups (four categories), those with BMI > = 25 and METs > = 10 had the lowest risk of all-cause mortality (Table). Conclusions: In non-breast/non-prostate cancer patients, increased BMI is associated with improved overall survival in those with METs < 10, while a U-shaped relationship between BMI and all-cause mortality exists among those with METs > = 10. [Table: see text]
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A112 Estimated Exercise Workload is a Predictor for Emergency Department Visits Following Bariatric Surgery. Surg Obes Relat Dis 2019. [DOI: 10.1016/j.soard.2019.08.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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FITNESS AND 10-YEAR RISK OF MORTALITY AMONG ADULTS ≥70 YEARS OLD AT THE EXTREMES OF CARDIOVASCULAR DISEASE RISK FACTOR BURDEN: THE FIT PROJECT. J Am Coll Cardiol 2019. [DOI: 10.1016/s0735-1097(19)33770-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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CARDIORESPIRATORY FITNESS AND INCIDENT STROKE TYPES: THE FIT (HENRY FORD EXERCISE TESTING) PROJECT. J Am Coll Cardiol 2019. [DOI: 10.1016/s0735-1097(19)32303-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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BODY MASS INDEX, FITNESS, AND MORTALITY IN PATIENTS WITH DIABETES: EVALUATING THE FAT BUT FIT PARADOX IN THE FIT PROJECT COHORT. J Am Coll Cardiol 2019. [DOI: 10.1016/s0735-1097(19)32092-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Shear stress induces noncanonical autophagy in intestinal epithelial monolayers. Mol Biol Cell 2017; 28:3043-3056. [PMID: 28855375 PMCID: PMC5662261 DOI: 10.1091/mbc.e17-01-0021] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 08/04/2017] [Accepted: 08/22/2017] [Indexed: 12/19/2022] Open
Abstract
Shear stress applied on the apical side of polarizing intestinal cells induces vacuole formation via the autophagy machinery. This response is relayed through apical microvilli that act as mechanosensors linking the physical environment to the intracellular trafficking pathways. Flow of fluids through the gut, such as milk from a neonatal diet, generates a shear stress on the unilaminar epithelium lining the lumen. We report that exposure to physiological levels of fluid shear stress leads to the formation of large vacuoles, containing extracellular contents within polarizing intestinal epithelial cell monolayers. These observations lead to two questions: how can cells lacking primary cilia transduce shear stress, and what molecular pathways support the formation of vacuoles that can exceed 80% of the cell volume? We find that shear forces are sensed by actin-rich microvilli that eventually generate the apical brush border, providing evidence that these structures possess mechanosensing ability. Importantly, we identified the molecular pathway that regulates large vacuole formation downstream from mechanostimulation to involve central components of the autophagy pathway, including ATG5 and LC3, but not Beclin. Together our results establish a novel link between the actin-rich microvilli, the macroscopic transport of fluids across cells, and the noncanonical autophagy pathway in organized epithelial monolayers.
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CHRONOTROPIC INCOMPETENCE AND LONG-TERM RISK OF HEART FAILURE: THE HENRY FORD EXERCISE TESTING PROJECT. J Am Coll Cardiol 2017. [DOI: 10.1016/s0735-1097(17)34080-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Supervised exercise versus primary stenting for claudication resulting from aortoiliac peripheral artery disease: six-month outcomes from the claudication: exercise versus endoluminal revascularization (CLEVER) study. Circulation 2011; 125:130-9. [PMID: 22090168 DOI: 10.1161/circulationaha.111.075770] [Citation(s) in RCA: 305] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Claudication is a common and disabling symptom of peripheral artery disease that can be treated with medication, supervised exercise (SE), or stent revascularization (ST). METHODS AND RESULTS We randomly assigned 111 patients with aortoiliac peripheral artery disease to receive 1 of 3 treatments: optimal medical care (OMC), OMC plus SE, or OMC plus ST. The primary end point was the change in peak walking time on a graded treadmill test at 6 months compared with baseline. Secondary end points included free-living step activity, quality of life with the Walking Impairment Questionnaire, Peripheral Artery Questionnaire, Medical Outcomes Study 12-Item Short Form, and cardiovascular risk factors. At the 6-month follow-up, change in peak walking time (the primary end point) was greatest for SE, intermediate for ST, and least with OMC (mean change versus baseline, 5.8±4.6, 3.7±4.9, and 1.2±2.6 minutes, respectively; P<0.001 for the comparison of SE versus OMC, P=0.02 for ST versus OMC, and P=0.04 for SE versus ST). Although disease-specific quality of life as assessed by the Walking Impairment Questionnaire and Peripheral Artery Questionnaire also improved with both SE and ST compared with OMC, for most scales, the extent of improvement was greater with ST than SE. Free-living step activity increased more with ST than with either SE or OMC alone (114±274 versus 73±139 versus -6±109 steps per hour), but these differences were not statistically significant. CONCLUSIONS SE results in superior treadmill walking performance than ST, even for those with aortoiliac peripheral artery disease. The contrast between better walking performance for SE and better patient-reported quality of life for ST warrants further study. CLINICAL TRIAL REGISTRATION URL: http://clinicaltrials.gov/ct/show/NCT00132743?order=1. Unique identifier: NCT00132743.
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Aquatic hyphomycetes in polluted groundwater habitats of central Germany. MICROBIAL ECOLOGY 2003; 45:329-339. [PMID: 12704555 DOI: 10.1007/s00248-003-0001-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2003] [Accepted: 01/25/2003] [Indexed: 05/24/2023]
Abstract
Polluted groundwater wells located in a former copper shale mining district (11 sites; Mansfelder Land, Central Germany) and in meadows of the Mulde and Elbe rivers (2 sites) were assessed for occurrence and species richness of aquatic hyphomycetes. Water temperatures at all sites were relatively low and fluctuated less than in surface waters. Oxygen concentrations were always below saturation, whereas sulfate, nitrate, and phosphate levels reached extremely high values in several of the wells. Relatively high levels of Pb, Mn, and Fe were found in some of the wells, but overall few concentrations of individual metals and metalloids exceeded European guidelines for drinking water. Pollen tube growth inhibition, used to assess cytotoxicity of the water, ranged between 4 and 50%. Between 1 and 10 distinct species of aquatic hyphomycetes colonized sterile Alnus glutinosa leaves exposed at the Mansfelder Land sites; for the meadow sites, 8-20 species were found. Heliscus lugdunensis and Anguillospora sp. were the two most widespread species. Fungal colonization occurred much more slowly than in surface water, as demonstrated by scanning electron microscopy and the release of conidia from recovered leaves. The conidial output from exposed alder leaves ranged from 0.2 to 95 conidia mg (-1) dry mass, corresponding to 10% of the values for contaminated surface waters in the same region. Overall, groundwater appears to be a marginal habitat for aquatic hyphomycetes, but may nevertheless play a vital role as long-term reservoir facilitating rapid recolonization following a collapse in fungal communities in surface waters.
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Expression of ob gene coding the production of the hormone leptin in hepatocytes of liver with steatosis. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2001; 145:15-20. [PMID: 12415637 DOI: 10.5507/bp.2001.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Leptin is a circulating pleiotropic hormone that play an important role in appetite control, fat metabolism, regulation of body weight, fetus growth, growth and aging of adults and hematopoiesis. It is expressed abundantly and specifically in the adipose tissue. A liver cell with developed steatosis represents a cell metabolism similar to metabolism of cells of adipose tissue. Analyses of serum leptin and free leptin receptor in the serum of patients with steatosis showed significant variations from reference limits of normal values. However in liver tissue with verified steatosis detection of mRNA gene for leptin was not proven. Such expression of ob gene for leptin was not found even in the liver tissue without steatosis. With respect to the absence of ob gene expression, the direct effect of ob gene expression on other parameters of leptin metabolism could not be evaluated. The RT-PCR method with verified specificity and satisfying sensitivity was developed. The results obtained from analysis of serum leptin and free leptin receptor in the serum are presented and evaluated. The used methods were verified and reference limits for Czech population were defined in dependence on age and other clinical parameters.
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Cardiovascular responses of cardiac transplant patients to arm and leg exercise. EUROPEAN JOURNAL OF APPLIED PHYSIOLOGY AND OCCUPATIONAL PHYSIOLOGY 1994; 68:441-4. [PMID: 8076626 DOI: 10.1007/bf00843743] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
This investigation compares the cardiovascular responses of normal (n = 10) and cardiac transplant (n = 14) subjects to peak arm and leg exercise. It also tests the hypothesis that the higher heart rate (fc) in normal subjects during light (30 W) submaximal arm versus leg exercise is due to cardiac innervation. In cardiac transplant patients, power output, oxygen consumption (VO2), fc and rate pressure product were 54%, 28%, 7%, and 8% lower during peak arm than leg exercise, respectively. In normal subjects, power output, VO2, fc and rate pressure product were 61%, 33%, 8%, and 11% lower during peak arm than leg exercise, respectively. In cardiac transplant patients there was no significant difference in absolute fc during submaximal arm and leg exercise. In normal subjects, absolute fc during arm and leg exercise was [mean (SD)] 97 (4) beats.min-1 and 92 (4) beats.min-1, respectively (P = 0.07). Plasma noradrenaline was increased more during arm than leg exercise in both cardiac transplant and normal subjects. Maximal leg testing is useful when determining the capacity of cardiac transplant patients to perform arm work. The higher absolute fc reported by other investigators for normal subjects during submaximal arm versus leg exercise may be mediated by cardiac innervation.
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Abstract
This investigation examines the hypothesis that athletes increase stroke volume with submaximal exercise through an augmentation of left ventricular (LV) end-diastolic volume and a reduction of LV end-systolic volume, whereas sedentary adults only increase stroke volume modestly, because LV end-diastolic volume does not increase. Upright bicycle exercise was performed by 17 endurance-trained male athletes and 15 sedentary men. M-mode echocardiograms were obtained during submaximal exercise at predetermined heart rates. Athletes, at a heart rate of 130 beats/min, increased their stroke volume 67% from 72 +/- 18 ml to 120 +/- 26 ml (p less than 0.001). This resulted from an increase of LV end-diastolic volume from 119 +/- 23 to 152 +/- 28 ml (p less than 0.001) and a reduction in LV end-systolic volume from 46 +/- 14 to 31 +/- 9 ml (p less than 0.001). Sedentary men at the same heart rate increased stroke volume 22% from 63 +/- 15 to 77 +/- 21 ml (p less than 0.05). LV end-diastolic volume did not change (96 +/- 20 vs 97 +/- 28 ml) (p = not significant), but LV end-systolic volume decreased (33 +/- 11 vs 20 +/- 9 ml) (p less than 0.001). In conclusion, athletes increased cardiac output through a more prominent augmentation of stroke volume than sedentary subjects at submaximal exercise. This was accomplished through an augmentation of LV end-diastolic volume. This may have a conserving effect on myocardial oxygen consumption at these levels of exercise.
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Abstract
A group of orthotopic heart transplant (OHT, n = 28) and heart surgery (n = 19) patients, with similar ejection fractions and left ventricular end-diastolic pressures, were exercised to symptom-limited maximum to describe differences in cardiovascular and gas exchange responses. Testing was performed at a mean of 3 and 6 mo after surgery, respectively (P less than 0.05). OHT patients have a greater resting systolic and diastolic blood pressure (P less than 0.01) and a significantly greater (P less than 0.01) heart rate (HR) at rest in the supine and standing positions and during minutes 2 through 7 of supine recovery. Peak treadmill time was significantly less (P less than 0.01) in OHT patients. No significant differences were found for systolic blood pressure (SBP) during recovery, peak HR, ventilation, relative O2 uptake (VO2), body weight, ventilatory equivalents for O2 and CO2, O2 pulse, and HR-SBP product (peak HR x peak SBP). Peak pulse pressure, heart rate reserve, total VO2, and absolute VO2 at ventilatory threshold were significantly lower (P less than 0.01) in the OHT patients. We concluded that 1) complete cardiac decentralization is evident, 2) the significantly reduced VO2 at ventilatory threshold should be considered when activities of daily living are prescribed, and 3) SBP response is more appropriate than HR for assessing recovery of the decentralized heart after maximal exercise.
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COMPARISON OF THE CARDIOVASCULAR RESPONSES TO BOTH MAXIMAL ARM AND SUBMAXIMAL ARM AND LEG EXERCISE IN PATIENTS WITH SEVERE LEFT VENTRICULAR DYSFUNCTION. Med Sci Sports Exerc 1992. [DOI: 10.1249/00005768-199205001-00674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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ENDURANCE TRAINED ATHLETES INCREASED LEFT VENTRICULAR END-DIASTOLIC VOLUME AND STROKE VOLUME WITH EXERCISE WHEREAS UNTRAINED SUBJECTS SHOWED NO CHANGE. Med Sci Sports Exerc 1992. [DOI: 10.1249/00005768-199205001-00887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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HEART RATE AND CATECHOLAMINE RESPONSES OF HEART TRANSPLANT PATIENTS TO STANDARD AND EXTENDED DURATION EXERCISE TESTS. Med Sci Sports Exerc 1992. [DOI: 10.1249/00005768-199205001-00511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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THE USEFULNESS OF MONITORING BLOOD GLUCOSE BEFORE AND AFTER EXERCISE IN A CARDIAC REHABILITATION SETTING. Med Sci Sports Exerc 1992. [DOI: 10.1249/00005768-199205001-00956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
Orthotopic heart transplantation (OHT) represents an effective alternative for individuals with end-stage heart disease. The current literature reports only the responses of OHT patients to greater than or equal to 4 mo of exercise training (ET) and frequently lacks adequate controls. Most programs currently treating OHT patients usually provide 6-12 wk of ET. This study describes the effects of a 10-wk supervised ET program in 12 male OHT patients and 5 other male OHT patients who served as a comparison group. Graded exercise tests were performed before and after ET. After ET, maximal O2 consumption was significantly greater for the ET group than the comparison group (P less than 0.05) and the mean increase in peak heart rate was 18 +/- 4 and 6 +/- 4 (SE) min-1 for ET and comparison groups, respectively (P less than 0.05). Maximal ventilation was also significantly greater for the ET group at after ET, while resting heart rate and blood pressure and peak blood pressure, O2 pulse, respiratory rate, and ventilatory equivalents for O2 and CO2 were not significantly changed. We conclude that after OHT a 10-wk ET program improves maximal O2 consumption and, by improving peak heart rate, improves O2 delivery.
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Sjogren's sufferers find hope with latest care. DENTIST (WACO, TEX.) 1990; 68:32. [PMID: 2081438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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516 EFFECTS OF A VERY LOW CALORIE DIET ON BODY COMPOSITION IN HEART TRANSPLANT PATIENTS. Med Sci Sports Exerc 1990. [DOI: 10.1249/00005768-199004000-00516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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257 HEART RATE???PERCEIVED EXERTION RELATIONSHIP DURING EXERCISE IN HEART TRANSPLANT PATIENTS. Med Sci Sports Exerc 1990. [DOI: 10.1249/00005768-199004000-00257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Gas-plasma 'microwave' sterilizes instruments. DENTIST (WACO, TEX.) 1989; 67:23, 27. [PMID: 2635098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Home dental care. Care for the disabled. DENTIST (WACO, TEX.) 1989; 67:35, 38. [PMID: 2534290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Fund steers research to future. DENTIST (WACO, TEX.) 1988; 66:42. [PMID: 3267508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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NIDR chief guides research in geriatrics. DENTIST (WACO, TEX.) 1988; 66:33, 42-4. [PMID: 3067988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Abstract
Mature male and female filarial worms were present in a lymphatic vessel near a retro-auricular lymph node removed from a 2-year old Colombian girl. Although apparently mature microfilariae were present in the uterus of the female, none was detected in blood samples (Knott's) of peripheral blood taken during day or night. The identification of the worms as a species of Brugia is suggested by their location in a dilated lymphatic vessel, morphology of adults, and the distribution pattern of tail nuclei of the microfilariae. This case is similar to another Colombian case reported from the Departamento del Santander del Sur, and suggests that zoonotic filarial infections may not be uncommon in Colombia.
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