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Healthcare, Volume 3, Issue 3 (September 2015), Pages 466-859

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Displaying articles 1-31
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Open AccessReview Assessing the Functional Status of Older Cancer Patients in an Ambulatory Care Visit
Healthcare 2015, 3(3), 846-859; https://doi.org/10.3390/healthcare3030846
Received: 29 June 2015 / Revised: 26 August 2015 / Accepted: 10 September 2015 / Published: 18 September 2015
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Abstract
Functional status assessment is a useful and essential component of the complete history and physical exam of the older patient diagnosed with cancer. Functional status is the ability to conduct activities that are necessary for independence and more executive activities, such as money
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Functional status assessment is a useful and essential component of the complete history and physical exam of the older patient diagnosed with cancer. Functional status is the ability to conduct activities that are necessary for independence and more executive activities, such as money management, cooking, and transportation. Assessment of functional status creates a portal into interpreting the health of in older persons. Understanding limitations and physical abilities can help in developing cancer treatment strategies, patient/family teaching needs, and in-home services that enhance patient/family care. This article will review the benefits of functional assessment, instruments that can be used during an ambulatory care visit, and interventions that can address potential limitations. Full article
(This article belongs to the Special Issue Nursing Care of the Older Adult)
Open AccessReview The Continuing and Growing Epidemic of Chronic Low Back Pain
Healthcare 2015, 3(3), 838-845; https://doi.org/10.3390/healthcare3030838
Received: 7 July 2015 / Revised: 26 August 2015 / Accepted: 6 September 2015 / Published: 15 September 2015
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Abstract
Because of the great prevalence of chronic pain, it is not surprising that there have been a number of influential reports by the Institute of Medicine, National Institutes of Health, and the World Health Organization that have documented the medical, social and economic
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Because of the great prevalence of chronic pain, it is not surprising that there have been a number of influential reports by the Institute of Medicine, National Institutes of Health, and the World Health Organization that have documented the medical, social and economic problems caused by it, and the need for better pain-management programs. The present article briefly reviews these reports, and then focuses on three important areas that need to be considered when addressing the continuing and growing epidemic of one of the most prevalent types of chronic pain [chronic low back pain (CLBP)]: the biopsychosocial model of chronic pain; the paradigm shift in medicine from a disease model to an illness model of CLBP; and a review of the treatment- and cost-effectiveness of interdisciplinary chronic pain management programs. This overview will serve as an important prelude to other topics related to low back pain included in this Special Issue of Healthcare. Topics covered will range from assessment and treatment approaches, to important psychosocial mediators/moderators such as coping and pain beliefs. Full article
Open AccessReview Genomics in Public Health: Perspective from the Office of Public Health Genomics at the Centers for Disease Control and Prevention (CDC)
Healthcare 2015, 3(3), 830-837; https://doi.org/10.3390/healthcare3030830
Received: 31 July 2015 / Revised: 24 August 2015 / Accepted: 8 September 2015 / Published: 15 September 2015
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Abstract
The national effort to use genomic knowledge to save lives is gaining momentum, as illustrated by the inclusion of genomics in key public health initiatives, including Healthy People 2020, and the recent launch of the precision medicine initiative. The Office of Public
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The national effort to use genomic knowledge to save lives is gaining momentum, as illustrated by the inclusion of genomics in key public health initiatives, including Healthy People 2020, and the recent launch of the precision medicine initiative. The Office of Public Health Genomics (OPHG) at the Centers for Disease Control and Prevention (CDC) partners with state public health departments and others to advance the translation of genome-based discoveries into disease prevention and population health. To do this, OPHG has adopted an “identify, inform, and integrate” model: identify evidence-based genomic applications ready for implementation, inform stakeholders about these applications, and integrate these applications into public health at the local, state, and national level. This paper addresses current and future work at OPHG for integrating genomics into public health programs. Full article
(This article belongs to the Special Issue Implementation of Public Health Genomics)
Open AccessArticle Identifying Malnutrition in an Elderly Ambulatory Rehabilitation Population: Agreement between Mini Nutritional Assessment and Validated Screening Tools
Healthcare 2015, 3(3), 822-829; https://doi.org/10.3390/healthcare3030822
Received: 27 May 2015 / Revised: 31 August 2015 / Accepted: 7 September 2015 / Published: 11 September 2015
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Abstract
Malnutrition is common in older adults and often goes unrecognised and untreated. Australian evidence-based guidelines for the management of malnutrition indicate that only the Mini Nutritional Assessment short form (MNA-sf) and Rapid Screen are recommended for use as malnutrition screening tools in the
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Malnutrition is common in older adults and often goes unrecognised and untreated. Australian evidence-based guidelines for the management of malnutrition indicate that only the Mini Nutritional Assessment short form (MNA-sf) and Rapid Screen are recommended for use as malnutrition screening tools in the rehabilitation setting. The aim of this secondary analysis was to assess the validity and reliability of two malnutrition screening tools, validated in other adult sub-groups, in a rehabilitation population aged ≥60 years. The Council on Nutrition Appetite Questionnaire (CNAQ) and the Simplified Nutritional Appetite Questionnaire (SNAQ), were completed by 185 ambulatory rehabilitation patients (48% male; median age 78 years) and results compared to the full MNA as a reference technique. Prevalence of risk of malnutrition was 63% according to the MNA. For identification of risk of malnutrition the CNAQ had sensitivity of 54%, specificity 81%, positive predictive value 83% and negative predictive value 51%, compared to 28%, 94%, 89% and 44%, respectively, using SNAQ. Assessment of reliability indicated significant slight to fair agreement between MNA with CNAQ (κ = 0.309, p < 0.001) and SNAQ (κ = 0.176, p < 0.001). Neither the CNAQ nor the SNAQ have a high level of validity or reliability in this elderly population and are therefore not recommended for use in the ambulatory rehabilitation setting. Further work is necessary to assess the validity and reliability of other malnutrition screening tools to establish their usefulness in this population. Full article
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Open AccessReview Nutrition Promotion to Prevent Obesity in Young Adults
Healthcare 2015, 3(3), 809-821; https://doi.org/10.3390/healthcare3030809
Received: 2 May 2015 / Revised: 24 August 2015 / Accepted: 31 August 2015 / Published: 7 September 2015
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Abstract
Young adulthood is a vulnerable period for weight gain and the health consequences of becoming obese during this life-stage of serious concern. Some unhealthy dietary habits are typical of young adults in many developed nations encountering the obesity epidemic. These include high sugar-sweetened
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Young adulthood is a vulnerable period for weight gain and the health consequences of becoming obese during this life-stage of serious concern. Some unhealthy dietary habits are typical of young adults in many developed nations encountering the obesity epidemic. These include high sugar-sweetened beverage consumption, lower vegetable intake and greater consumption of foods prepared outside the home including fast foods. Each of these dietary behaviours may place young adults at increased risk for overweight and obesity. Evidence suggests many young adults with unhealthy nutrition behaviours are not considering nor preparing to make changes. To improve their nutrition and health as they progress through the lifecycle requires approaches specifically targeted to this age group. Strategies and programs should include both individual level and population approaches. The evidence base for prevention of weight gain and halting overweight and obesity in young adulthood is currently small with few studies of high quality. Studies modifying food environments in colleges and universities are also of limited quality, but sufficiently promising to conduct further research employing better, more sophisticated, study designs and additionally to include health outcome measures. More research into programs tailored to the needs of young adults is warranted with several studies already underway. Full article
Open AccessArticle Acute Cardiovascular Response to Sign Chi Do Exercise
Healthcare 2015, 3(3), 796-808; https://doi.org/10.3390/healthcare3030796
Received: 29 June 2015 / Accepted: 24 August 2015 / Published: 28 August 2015
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Abstract
Safe and gentle exercise may be important for older adults overcoming a sedentary lifestyle. Sign Chi Do (SCD), a novel form of low impact exercise, has shown improved balance and endurance in healthy older adults, and there have been no SCD-related injuries reported.
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Safe and gentle exercise may be important for older adults overcoming a sedentary lifestyle. Sign Chi Do (SCD), a novel form of low impact exercise, has shown improved balance and endurance in healthy older adults, and there have been no SCD-related injuries reported. Sedentary older adults are known to have a greater cardiovascular (CV) response to physical activity than those who regularly exercise. However their CV response to SCD is unknown. This study explored the acute CV response of older adults to SCD. Cross-sectional study of 34 sedentary and moderately active adults over age 55 with no previous experience practicing SCD. Participants completed a 10 min session of SCD. CV outcomes of heart rate, blood pressure, rate pressure product were recorded at 0, 5, 10 min of SCD performance, and after 10 min of rest. HR was recorded every minute. There was no difference in CV scores of sedentary and moderately active older adults after a session of SCD-related activity. All CV scores increased at 5 min, were maintained at 10 min, and returned to baseline within 10 min post SCD (p < 0.05). SCD may be a safe way to increase participation in regular exercise by sedentary older adults. Full article
(This article belongs to the Special Issue Nursing Care of the Older Adult)
Open AccessArticle Pediatric Coccidioidomycosis Patients: Perceptions, Quality of Life and Psychosocial Factors
Healthcare 2015, 3(3), 775-795; https://doi.org/10.3390/healthcare3030775
Received: 6 May 2015 / Revised: 6 August 2015 / Accepted: 13 August 2015 / Published: 28 August 2015
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Abstract
Research investigating the effects of coccidioidomycosis (valley fever) on children and the psychosocial implications of this disease in general is lacking. This study reviews what is known about pediatric coccidioidomycosis patients. It documents the psychological functioning, quality of life, and illness perceptions of
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Research investigating the effects of coccidioidomycosis (valley fever) on children and the psychosocial implications of this disease in general is lacking. This study reviews what is known about pediatric coccidioidomycosis patients. It documents the psychological functioning, quality of life, and illness perceptions of a sample of coccidioidomycosis patient families. Primary caregivers of pediatric patients and patients from a major hospital in the San Joaquin Valley of California were interviewed regarding their perceptions of disease detection, access to care and the patient/family experience. Full article
(This article belongs to the Special Issue Health Psychology in Healthcare Settings)
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Open AccessReview Making the Move: A Mixed Research Integrative Review
Healthcare 2015, 3(3), 757-774; https://doi.org/10.3390/healthcare3030757
Received: 5 June 2015 / Revised: 24 July 2015 / Accepted: 17 August 2015 / Published: 26 August 2015
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Abstract
The purpose of this mixed research integrative review is to determine factors that influence relocation transitions for older adults who are considering a move from independent living to supervised housing, such as assisted living, using the Theory of Planned Behavior as a conceptual
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The purpose of this mixed research integrative review is to determine factors that influence relocation transitions for older adults who are considering a move from independent living to supervised housing, such as assisted living, using the Theory of Planned Behavior as a conceptual guide. PubMED, CINAHL, and PsychInfo databases were queried using key words: relocation, transition, older adults, and, elderly and time limited from 1992 to 2014. Sixteen articles were retained for review. The majority of articles, qualitative in design, reveal that older adults who comprehend the need to move and participate in the decision-making process of a relocation adjust to new living environments with fewer negative outcomes than older adults who experience a forced relocation. The few quantitative articles examined the elements of impending relocation using a variety of instruments but support the necessity for older adults to recognize the possibility of a future move and contribute to the relocation process. Additionally, the influence of family, friends, and health care providers provides the older adult with support and guidance throughout the process. Full article
(This article belongs to the Special Issue Nursing Care of the Older Adult)
Open AccessReview The Importance of the Management of Infectious Complications for Patients with Left Ventricular Assist Device
Healthcare 2015, 3(3), 750-756; https://doi.org/10.3390/healthcare3030750
Received: 1 May 2015 / Revised: 31 July 2015 / Accepted: 18 August 2015 / Published: 26 August 2015
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Abstract
A left ventricular assist device (LVAD) therapy is the viable option for patients with advanced heart failure as a bridge to transplantation, bridge to recovery, or destination therapy. Although application of LVAD support has become a standard option, serious complications or adverse events
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A left ventricular assist device (LVAD) therapy is the viable option for patients with advanced heart failure as a bridge to transplantation, bridge to recovery, or destination therapy. Although application of LVAD support has become a standard option, serious complications or adverse events related with LVAD remain a concern. LVAD-related infection including driveline infection (DLI) and bloodstream infection (BSI) is one of the serious clinical matters for LVAD patients, and especially BSI leads to the high incidence of mortality. The LVAD-related infections negatively impact patient’s quality of life. Therefore, control of infection is one of the primary goals of management in LVAD patients. Several efforts including early and appropriate intervention including antibiotics and wound care may contribute to avert the progress into BSI from localized DLI. Particularly, there are clinical secrets in how to use antibiotics and how to treat wound care in LVAD patients. The rational way of thinking for wound care will be introduced in this review. Full article
(This article belongs to the Special Issue Wound Care) Printed Edition available
Open AccessReview Pandemic of Pregnant Obese Women: Is It Time to Re-Evaluate Antenatal Weight Loss?
Healthcare 2015, 3(3), 733-749; https://doi.org/10.3390/healthcare3030733
Received: 19 June 2015 / Revised: 6 August 2015 / Accepted: 6 August 2015 / Published: 20 August 2015
Cited by 1 | PDF Full-text (137 KB) | HTML Full-text | XML Full-text
Abstract
The Obesity pandemic will afflict future generations without successful prevention, intervention and management. Attention to reducing obesity before, during and after pregnancy is essential for mothers and their offspring. Preconception weight loss is difficult given that many pregnancies are unplanned. Interventions aimed at
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The Obesity pandemic will afflict future generations without successful prevention, intervention and management. Attention to reducing obesity before, during and after pregnancy is essential for mothers and their offspring. Preconception weight loss is difficult given that many pregnancies are unplanned. Interventions aimed at limiting gestational weight gain have produced minimal maternal and infant outcomes. Therefore, increased research to develop evidence-based clinical practice is needed to adequately care for obese pregnant women especially during antenatal care. This review evaluates the current evidence of obesity interventions during pregnancy various including weight loss for safety and efficacy. Recommendations are provided with the end goal being a healthy pregnancy, optimal condition for breastfeeding and prevent the progression of obesity in future generations. Full article
Open AccessReview Assuring Quality Health Care in the Emergency Department
Healthcare 2015, 3(3), 726-732; https://doi.org/10.3390/healthcare3030726
Received: 9 May 2015 / Revised: 2 August 2015 / Accepted: 13 August 2015 / Published: 20 August 2015
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Abstract
The provision of quality healthcare is an international mandate. The provision of quality healthcare for mental health patients poses unique challenges. Nowhere is this challenge greater than in the emergency department. The purpose of this manuscript is to describe evidence-based initiatives for improving
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The provision of quality healthcare is an international mandate. The provision of quality healthcare for mental health patients poses unique challenges. Nowhere is this challenge greater than in the emergency department. The purpose of this manuscript is to describe evidence-based initiatives for improving the quality of care of mental health patients in the emergency department. Specifically, the use of telepsychiatry and reducing provider biases will be presented. Full article
Open AccessArticle Adaptive Challenges Rising from the Life Context of African-American Caregiving Grandmothers with Diabetes: A Pilot Study
Healthcare 2015, 3(3), 710-725; https://doi.org/10.3390/healthcare3030710
Received: 30 June 2015 / Revised: 31 July 2015 / Accepted: 31 July 2015 / Published: 17 August 2015
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Abstract
To understand the challenges arising from the context within which diabetic African-American caregiving grandmothers self-manage their diabetes we used the Adaptive Leadership Framework. Additionally, challenges to retaining this population in a longitudinal study were examined. In this exploratory, longitudinal, qualitative pilot study, data
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To understand the challenges arising from the context within which diabetic African-American caregiving grandmothers self-manage their diabetes we used the Adaptive Leadership Framework. Additionally, challenges to retaining this population in a longitudinal study were examined. In this exploratory, longitudinal, qualitative pilot study, data were collected at five time-points over 18 months. We coded the data using content analysis and conducted the within-case and cross-case analyses using data matrices. Lack of awareness of available resources, represented a technical challenge within the life context of these grandmothers and the remaining three themes: family upheaval; priority setting (with subthemes of difficulty meeting basic needs and competing demands); and self-silencing and self-sacrifice represented adaptive challenges. The context of African-American grandmothers’ lives created primarily adaptive challenges that were complex and without immediate solutions. Research is needed to develop culturally and contextually appropriate interventions to help this vulnerable group develop capacity for adaptive work. Full article
(This article belongs to the Special Issue Nursing Care of the Older Adult)
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Open AccessArticle The Effects of Resistance Training on Physical Function and Quality of Life in Breast Cancer Survivors
Healthcare 2015, 3(3), 695-709; https://doi.org/10.3390/healthcare3030695
Received: 1 April 2015 / Revised: 26 July 2015 / Accepted: 26 July 2015 / Published: 11 August 2015
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Abstract
Breast cancer survivors (BCS) exhibit decreased physical function and quality of life (QOL) following cancer treatments. Resistance training (RT) may elicit positive changes in physical and mental well-being. This study assessed 27 BCS, pre-and post-intervention (six months) on the following variables: muscular strength
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Breast cancer survivors (BCS) exhibit decreased physical function and quality of life (QOL) following cancer treatments. Resistance training (RT) may elicit positive changes in physical and mental well-being. This study assessed 27 BCS, pre-and post-intervention (six months) on the following variables: muscular strength (via one repetition maximum (1RM) of chest press and leg extension), physical function (via the Continuous Scale-Physical Functional Performance test) and QOL (via the Short Form-36 survey). RT consisted of two days/week of ten exercises including two sets of 8–12 repetitions at 52%–69% of their 1RM. A repeated measures analysis of variance revealed BCS significantly (p < 0.05) increased upper (71 ± 22 to 89 ± 22 kg) and lower body (74 ± 18 to 93 ± 24 kg) strength, total physical function (65.5 ± 12.1 to 73.6 ± 12.2 units) and the subcomponents of physical function: upper body strength (63.5 ± 16.3 to 71.2 ± 16.8 units), lower body strength (58.5 ± 14.9 to 68.6 ± 16.3 units), balance and coordination (66.5 ± 12.2 to 74.6 ± 11.6 units), and endurance (67.2 ± 12.0 to 75.0 ± 11.6 units). No changes were observed over time for subjective measures of physical function and QOL. Results showed RT could be an effective means to improve objective physical function in BCS. Further research is needed to clarify the effects of RT on subjective physical function and QOL. Full article
(This article belongs to the Special Issue Holistic Needs of Those Living with and beyond Breast Cancer)
Open AccessArticle Factors Affecting Gynecologic and Sexual Assessment in Older Women: A Lesson for Primary Care Providers
Healthcare 2015, 3(3), 683-694; https://doi.org/10.3390/healthcare3030683
Received: 1 June 2015 / Revised: 19 July 2015 / Accepted: 7 August 2015 / Published: 11 August 2015
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Abstract
Guidelines for screening of cervical cancer and pelvic exams for older women have recently changed. These changes may have unexpected sequelae in women over 65 years of age. This manuscript provides a review of gynecologic screening recommendations for older women in the U.S.
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Guidelines for screening of cervical cancer and pelvic exams for older women have recently changed. These changes may have unexpected sequelae in women over 65 years of age. This manuscript provides a review of gynecologic screening recommendations for older women in the U.S. and potential ramifications of these recent changes. Peer reviewed guidelines from the American College of Obstetrics and Gynecology, U.S. Preventative Task Force Services, the American Cancer Society, The Centers for Disease Control, and multiple original research articles and reviews were reviewed for this manuscript. Women over 65 are at greatest risk to develop late stage diagnoses of cancers, pelvic organ disease, incontinence, and infections. Clinicians will need to acutely consider this fact when communicating and screening this population. We conclude that practitioners should be aware of the new guidelines and should consider including gynecologic health history and symptom analysis as part of annual exams in women of all ages. Full article
(This article belongs to the Special Issue Nursing Care of the Older Adult)
Open AccessArticle Fatty Liver and Fatty Heart—Where do They Stand in the AMIS Syndrome?
Healthcare 2015, 3(3), 666-682; https://doi.org/10.3390/healthcare3030666
Received: 16 March 2015 / Revised: 14 July 2015 / Accepted: 31 July 2015 / Published: 11 August 2015
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Abstract
Meal-induced insulin sensitization (MIS) refers to the augmented glucose uptake response to insulin following a meal. Absence of MIS (AMIS) causes significant decrease in post-meal glucose disposal leading to postprandial hyperglycemia, hyperinsulinemia, hyperlipidemia, adiposity, increased free radical stress, and a cluster of progressive
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Meal-induced insulin sensitization (MIS) refers to the augmented glucose uptake response to insulin following a meal. Absence of MIS (AMIS) causes significant decrease in post-meal glucose disposal leading to postprandial hyperglycemia, hyperinsulinemia, hyperlipidemia, adiposity, increased free radical stress, and a cluster of progressive metabolic, vascular, and cardiac dysfunctions referred to as the AMIS syndrome. We tested the hypothesis that fat accumulation in the liver and heart is part of the AMIS syndrome. Questions examined in the study: (1) Is prediabetic fat accumulation in the heart and liver a component of the AMIS syndrome? (2) Is fatty liver a cause or consequence of peripheral insulin resistance? (3) Is early cardiac dysfunction in the AMIS syndrome attributable to fat accumulation in the heart? and (4) Can the synergistic antioxidant cocktail SAMEC (S-adenosylmethionine, vitamin E, and vitamin C), known to benefit MIS, affect cardiac and hepatic triglyceride levels? Four animal models of AMIS were used in aged male Sprague-Dawley rats (52 weeks ± sucrose ± SAMEC), compared with young controls (nine weeks). Fat accumulation in the heart was not significant and therefore cannot account for the early cardiac dysfunction. Hepatic triglycerides increased only in the most severe AMIS model but the small changes correlated with the much more rapidly developing peripheral adiposity. Systemic adiposity represents an early stage, whereas accumulation of cardiac and hepatic triglycerides represents a late stage of the prediabetic AMIS syndrome. Fat accumulation in the liver is a consequence, not a cause, of AMIS. SAMEC protected against the sucrose effects on whole body adiposity and hepatic lipid accumulation. Full article
(This article belongs to the Special Issue The Close Relationship: Health and Nutrition)
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