RESUMO
Obesity and its association with metabolic syndrome are implicated in many disease states. Research has focused on the role of diet and lifestyle modifications in the evolution of prediabetes to diabetes seeking ways to intervene and improve outcomes. Proven nutritional include leaner proteins, an abundance of vegetables, extra-virgin olive oil, and controlled portioning of carbs and starches. The transition from a sedentary state to an exercise routine of moderate intensity has shown efficacy in lowering metabolic risks. The synergy of dietary and physical activity modifications are the building blocks for lifestyle modifications examined in this review as a means of preventing obesity-related diabetes.
Assuntos
Diabetes Mellitus Tipo 2 , Dieta Mediterrânea , Síndrome Metabólica , Estado Pré-Diabético , Humanos , Síndrome Metabólica/etiologia , Síndrome Metabólica/terapia , Diabetes Mellitus Tipo 2/etiologia , Diabetes Mellitus Tipo 2/prevenção & controle , Obesidade/complicações , Obesidade/terapia , Estado Pré-Diabético/terapia , Estilo de VidaAssuntos
Azacitidina/análogos & derivados , Azacitidina/uso terapêutico , Metilação de DNA/efeitos dos fármacos , Leucemia Mielomonocítica Crônica/complicações , Esplenomegalia/prevenção & controle , Idoso , Idoso de 80 Anos ou mais , Antimetabólitos Antineoplásicos/uso terapêutico , Decitabina , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Esplenomegalia/complicações , Esplenomegalia/genética , Resultado do TratamentoRESUMO
BACKGROUND: Chronic myelomonocytic leukemia (CMML) is a malignant hematologic neoplasm characterized by peripheral blood monocytosis and bone marrow dysplasia. The World Health Organization classified therapy-related (t-) myeloid neoplasm (MN) as another category. It is known that t-MNs tend to have a worse prognosis than de novo (dn-) MN (dn-MN). PATIENTS AND METHODS: Previous exposure to chemotherapy (CT), radiotherapy (RT), or both were defined as t-CMML and lack of both as dn-CMML. RESULTS: Of 265 CMML patients, 30 (11%) had t-CMML. Seventeen (57%) patients had previous exposure to CT, 6 (20%) to RT, and 7 (23%) to CT and RT. Leukemic transformation (LT) was seen in 5 (17%). In comparison, only lower platelet count was found to be statistically significant compared with dn-CMML. Median overall survival (OS) was 20 months in the dn-CMML group versus 11 months in the t-CMML group (P = .02). Median OS was 9 months in the CT group versus 4.4 months in the RT group versus 13 months in the CT and RT group (P = .7). CONCLUSION: t-CMML comprises a small portion of all CMML cases (11%). Median OS in the dn-CMML group was longer than in the t-CMML group but LT seemed to be similar in terms of incidence and time to occurrence. Additional studies are needed to confirm our results.
