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Middle-aged and older adults who are physically active have lower risk of functional limitations than do inactive adults buy 300mg lodine visa. Physical activity can prevent or delay the onset of substantial functional or role limitations purchase lodine 400 mg line. Older adults who already have functional limitations also beneft from regular physical activity buy lodine 300 mg on-line. Hip fracture is a serious health condition that can have life-changing negative effects for many older people discount 300 mg lodine with mastercard. Physically active people, especially women, appear to have a lower risk of hip fracture than do inactive people. Among older adults, physical activity reduces the risk of falling and injuries from falls. Research demonstrates that multicomponent physical activity programs are most successful at reducing falls and injuries. These programs commonly include muscle-strengthening activities and balance training and may also include gait and coordination training, physical function training, and moderate-intensity activities, such as walking. It is important to note that doing only low-intensity walking does not seem to reduce the risk of fall-related injuries 38 Physical Activity Guidelines for Americans and fractures. Older adults, including those with a variety of health conditions such as Parkinson’s disease, stroke, and hip fracture, and those with frailty obtain benefts from multicomponent physical activities. Brain Health Brain health can be defned in many ways, but the Guidelines focuses on the following areas. Across the lifespan—cognition, anxiety and Learn More depression, quality of life, and sleep. Additional Considerations for Some Adults for a Some of the benefts of physical activity on brain health occur discussion of physical activity and brain immediately after a session of moderate-to-vigorous physical health in conditions such as Parkinson’s activity (acute effect), such as reduced feelings of state anxiety disease, stroke, and spinal cord injury. With regular physical activity (habitual effect), improvements are seen in trait anxiety (long-term anxiety), deep sleep, and components of executive function (including the ability to plan and organize; monitor, inhibit, or facilitate behaviors; initiate tasks; and control emotions). The Benefts of Physical Activity for Brain Health Outcome Population Beneft Acute Habitual Improved cognition (performance on academic Children ages achievement tests, executive function, processing   6 to 13 years speed, memory) Reduced risk of dementia (including Alzheimer’s Cognition Adults  disease) Adults older Improved cognition (executive function, attention, than age 50  memory, crystallized intelligence,* processing speed) years Quality of life Adults Improved quality of life  Depressed Children ages Reduced risk of depression mood and 6 to 17 years  Reduced depressed mood depression and adults Adults Reduced short-term feelings of anxiety (state anxiety)  Anxiety Reduced long-term feelings and signs of anxiety (trait Adults  anxiety) for people with and without anxiety disorders Improved sleep outcomes (increased sleep effciency, Adults sleep quality, deep sleep; reduced daytime sleepiness,  frequency of use of medication to aid sleep) Sleep Improved sleep outcomes that increase with duration Adults  of acute episode Note: the Advisory Committee rated the evidence of health benefts of physical activity as strong, moderate, limited, or grade not assignable. Only outcomes with strong or moderate evidence of effect are included in this table. It is different from fuid intelligence, which is the ability to store and manipulate new information. Physical activity also lowers the risk of developing cognitive impairment, such as dementia, including Alzheimer’s disease. Healthy older adults, even in the absence of dementia, often show evidence of cognitive decline, especially on measures of processing speed, memory, and executive function. Physical activity may be an effective approach for improving cognitive function in older adults. Quality of Life Physically active adults and older adults are likely to report having a better quality of life. Being physically active also improves the sense of a better quality of life among people who have schizophrenia and related disorders. Anxiety and Depression Anxiety and anxiety disorders are the most prevalent mental disorders. Participating in moderate-to-vigorous physical activity over longer durations (weeks or months of regular physical activity) reduces symptoms of anxiety in adults and older adults. Major depression is one of the most common mental disorders in the United States and is a leading cause of disability for middle-aged adults in the United States. The prevalence of depressive episodes is higher among females, both adolescents and adults, than among males. Engaging in regular physical activity reduces the risk of developing depression in children and adults and can improve many of the symptoms experienced by people with depression. Sleep In addition to feeling better, adults who are more physically active sleep better. Greater volumes of moderate to-vigorous physical activity are associated with reduced sleep latency (taking less time to fall asleep), improved sleep effciency (higher percentage of time in bed actually sleeping), improved sleep quality, and more deep sleep. Greater volumes of moderate-to-vigorous physical activity are also associated with signifcantly less daytime sleepiness, better sleep quality, and reduced frequency of use of sleep-aid medications. The improvements in sleep with regular physical activity are also reported by people with insomnia and obstructive sleep apnea. Physical Activity and Health 41 the evidence that habitual moderate-to-vigorous physical activity reduces the risk of excessive weight gain, an important risk factor for obstructive sleep apnea, suggests that physical activity could have a favorable impact on the incidence of obstructive sleep apnea. The number of hours before bedtime at which the activity is performed does not matter. Benefts are similar for physical activity performed more than 8 hours before bedtime, 3 to 8 hours before, and less than 3 hours before bedtime. Cancer Physically active adults have a signifcantly lower risk of developing several commonly occurring cancers, as well as lower risk of several other cancers. Research shows that adults who participate in greater amounts of physical activity have reduced risks of developing cancers of the. People With Chronic Health Conditions and Disabilities Regular physical activity provides important health benefts for adults with chronic health conditions. As seen in Table 2-4, benefts exist for cancer survivors and people with osteoarthritis, hypertension, type 2 diabetes, dementia, multiple sclerosis, spinal cord injury, and other cognitive disorders. Health Benefts Associated With Regular Physical Activity for People With Chronic Health Conditions and Disabilities Cancer Survivors. Lower risk of dying from prostate cancer People with Osteoarthritis (knee and hip).

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Page 44 of 263 the use of protons brings a distinct advantage in lowering radiation dosed to buy discount lodine 300 mg line the population at risk purchase lodine 300 mg online. None of these studies has demonstrated a difference in clinical outcomes Page 45 of 263 related to discount lodine 300mg on line this dosimetric reduction purchase lodine 200 mg visa. Three year relapse free survival was 93% and no late grade 3 or higher nonhematologic toxicities were noted. With median follow up of only 21 months, the 2 year relapse-free survival was 85%, and there were no grade 3 or higher toxicities. With a 38-month median follow up, the 2-year local control rate was 91%, with an in-field recurrence developing at the completion of proton therapy in 1 patient with natural killer/T-cell lymphoma, while no grade 3 toxicities were observed within the rest of the cohort. There were no grade 3 toxicities, and no recurrences noted with only 7 months median follow up. Among 35 patients treated thus far with a median follow-up period of 10 months, no grade 3 toxicities or grade 2 pneumonitis have been observed. Furthermore, only two patients had disease relapse and both of these occurred outside of the proton field. The outcomes with customary photon-based treatment are generally very favorable, with good local control and limited toxicity. The potential for reduction in long-term side effects by reducing the low-dose exposure of organs at risk will take years or decades to properly evaluate. While their data shows a lower risk of second malignancies in the proton group (5. Until sufficient follow-up is available to conduct such studies, assessment of the risks relies on risk projection studies or theoretical models. Two thousand six hundred fifty-eight (2658) patients treated over 3 years were followed over 10 years. Intensity-modulated proton therapy, volumetric-modulated arc therapy, and 3D conformal radiotherapy in anaplastic astrocytoma and glioblastoma: a dosimetric comparison. A systematic review of proton therapy in the treatment of chondrosarcoma of the skull base. Projected second tumor risk and dose to neurocognitive structures after proton versus photon radiotherapy for benign meningioma. Neutron equivalent doses and associated lifetime cancer incidence risks for head & neck and spinal proton therapy. Definitive proton radiation therapy and concurrent cisplatin for unresectable head and neck adenoid cystic carcinoma: a series of 9 cases and a critical review of the literature. Incidence of second malignancies among patients treated with proton versus photon radiation. Prospective evaluation of hypofractionation proton beam therapy with concurrent treatment of the prostate and pelvic nodes for clinically localized, high risk or unfavorable intermediate risk prostate cancer. Early toxicity in patients treated with postoperative proton therapy for locally advanced breast cancer. Stereotactic fractionated radiotherapy for chordomas and chondrosarcomas of the skull base. T011: Proton radiotherapy for mediastinal Hodgkin lymphoma: single institution experience (abstract). Life, liberty, and the pursuit of protons: an evidence-base review of the role of particle therapy in the treatment of prostate cancer. Eye-sparing multidisciplinary approach for the management of lacrimal gland carcinoma. Involved-site image-guided intensity modulated versus 3D conformal radiation therapy in early stage supradiaphragmatic Hodgkin lymphoma. Dosimetric considerations to determine the optimal technique for localized prostate cancer among external photon, proton, or carbon-ion therapy and high-dose-rate or low-dose-rate brachytherapy. Patient-reported outcomes after 3-dimensional conformal, intensity-modulated, or proton beam radiotherapy for localized prostate cancer. Comparison of the effectiveness of radiotherapy with photons, protons and carbon-ions for non-small cell lung cancer: a meta-analysis. Clinical outcomes and patterns of disease recurrence after intensity modulated proton therapy for oropharyngeal squamous carcinoma. Postoperative intensity-modulated proton therapy for head and neck adenoid cystic carcinoma. Dosimetric advantages of intensity-modulated proton therapy for oropharyngeal cancer compared with intensity-modulated radiation: a case-matched control analysis. Involved-node proton therapy in combined modality therapy for Hodgkin’s lymphoma: results of a phase 2 study. Comparative effectiveness study of patient-reported outcomes after proton therapy or intensity-modulated radiotherapy for prostate cancer. Comparative treatment planning between proton and xray therapy in pancreatic cancer. Comparative treatment planning between proton and x-ray therapy in esophageal cancer. The effect on esophagus after different radiotherapy techniques for early stage Hodgkin’s lymphoma. Dosimetric feasibility of hypofractionated proton radiotherapy for neoadjuvant pancreatic cancer treatment. Proton therapy may allow for comprehensive elective nodal coverage for patients receiving neoadjuvant radiotherapy for localized pancreatic head cancers. Incidence of second malignancies after external beam radiotherapy for clinical stage I testicular seminoma. Bayesian randomized trial comparing intensity modulated radiation therapy versus passively scattered proton therapy for locally advanced non-small cell lung cancer. Multi-institutional analysis of radiation modality use and postoperative outcomes of neoadjuvant chemoradiation for esophageal cancer.

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