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Garcia L, Pearce M, Abbas A, Mok A, Strain T, Ali S, Crippa A, Dempsey PC, Golubic R, Kelly P, Laird Y, McNamara E, Moore S, de Sa TH, Smith AD, Wijndaele K, Woodcock J, Brage S. Non-occupational physical activity and risk of cardiovascular disease, cancer and mortality outcomes: a dose-response meta-analysis of large prospective studies. Br J Sports Med 2023; 57:979-989. [PMID: 36854652 PMCID: PMC10423495 DOI: 10.1136/bjsports-2022-105669] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2022] [Indexed: 03/02/2023]
Abstract
OBJECTIVE To estimate the dose-response associations between non-occupational physical activity and several chronic disease and mortality outcomes in the general adult population. DESIGN Systematic review and cohort-level dose-response meta-analysis. DATA SOURCES PubMed, Scopus, Web of Science and reference lists of published studies. ELIGIBILITY CRITERIA Prospective cohort studies with (1) general population samples >10 000 adults, (2) ≥3 physical activity categories, and (3) risk measures and CIs for all-cause mortality or incident total cardiovascular disease, coronary heart disease, stroke, heart failure, total cancer and site-specific cancers (head and neck, myeloid leukaemia, myeloma, gastric cardia, lung, liver, endometrium, colon, breast, bladder, rectum, oesophagus, prostate, kidney). RESULTS 196 articles were included, covering 94 cohorts with >30 million participants. The evidence base was largest for all-cause mortality (50 separate results; 163 415 543 person-years, 811 616 events), and incidence of cardiovascular disease (37 results; 28 884 209 person-years, 74 757 events) and cancer (31 results; 35 500 867 person-years, 185 870 events). In general, higher activity levels were associated with lower risk of all outcomes. Differences in risk were greater between 0 and 8.75 marginal metabolic equivalent of task-hours per week (mMET-hours/week) (equivalent to the recommended 150 min/week of moderate-to-vigorous aerobic physical activity), with smaller marginal differences in risk above this level to 17.5 mMET-hours/week, beyond which additional differences were small and uncertain. Associations were stronger for all-cause (relative risk (RR) at 8.75 mMET-hours/week: 0.69, 95% CI 0.65 to 0.73) and cardiovascular disease (RR at 8.75 mMET-hours/week: 0.71, 95% CI 0.66 to 0.77) mortality than for cancer mortality (RR at 8.75 mMET-hours/week: 0.85, 95% CI 0.81 to 0.89). If all insufficiently active individuals had achieved 8.75 mMET-hours/week, 15.7% (95% CI 13.1 to 18.2) of all premature deaths would have been averted. CONCLUSIONS Inverse non-linear dose-response associations suggest substantial protection against a range of chronic disease outcomes from small increases in non-occupational physical activity in inactive adults. PROSPERO registration number CRD42018095481.
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Affiliation(s)
- Leandro Garcia
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Matthew Pearce
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Ali Abbas
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Alexander Mok
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Tessa Strain
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Sara Ali
- University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Alessio Crippa
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Paddy C Dempsey
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Rajna Golubic
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Paul Kelly
- Physical Activity for Health Research Centre, University of Edinburgh Institute for Sport, Physical Education and Health Sciences, Edinburgh, UK
| | - Yvonne Laird
- Sydney School of Public Health, Prevention Research Collaboration, The University of Sydney, Sydney, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Eoin McNamara
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Economic and Social Research Institute, Dublin, Ireland
| | - Samuel Moore
- University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Thiago Herick de Sa
- Center for Epidemiological Research in Nutrition and Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Andrea D Smith
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Department of Behavioural Science and Health, University College London, London, UK
| | - Katrien Wijndaele
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - James Woodcock
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
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Insulin-Like Growth Factor 1 (IGF-1) Signaling in Glucose Metabolism in Colorectal Cancer. Int J Mol Sci 2021; 22:ijms22126434. [PMID: 34208601 PMCID: PMC8234711 DOI: 10.3390/ijms22126434] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/04/2021] [Accepted: 06/14/2021] [Indexed: 02/07/2023] Open
Abstract
Colorectal cancer (CRC) is one of the most common aggressive carcinoma types worldwide, characterized by unfavorable curative effect and poor prognosis. Epidemiological data re-vealed that CRC risk is increased in patients with metabolic syndrome (MetS) and its serum components (e.g., hyperglycemia). High glycemic index diets, which chronically raise post-prandial blood glucose, may at least in part increase colon cancer risk via the insulin/insulin-like growth factor 1 (IGF-1) signaling pathway. However, the underlying mechanisms linking IGF-1 and MetS are still poorly understood. Hyperactivated glucose uptake and aerobic glycolysis (the Warburg effect) are considered as a one of six hallmarks of cancer, including CRC. However, the role of insulin/IGF-1 signaling during the acquisition of the Warburg metabolic phenotypes by CRC cells is still poorly understood. It most likely results from the interaction of multiple processes, directly or indirectly regulated by IGF-1, such as activation of PI3K/Akt/mTORC, and Raf/MAPK signaling pathways, activation of glucose transporters (e.g., GLUT1), activation of key glycolytic enzymes (e.g., LDHA, LDH5, HK II, and PFKFB3), aberrant expression of the oncogenes (e.g., MYC, and KRAS) and/or overexpression of signaling proteins (e.g., HIF-1, TGF-β1, PI3K, ERK, Akt, and mTOR). This review describes the role of IGF-1 in glucose metabolism in physiology and colorectal carcinogenesis, including the role of the insulin/IGF system in the Warburg effect. Furthermore, current therapeutic strategies aimed at repairing impaired glucose metabolism in CRC are indicated.
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Conti L, Del Cornò M, Gessani S. Revisiting the impact of lifestyle on colorectal cancer risk in a gender perspective. Crit Rev Oncol Hematol 2019; 145:102834. [PMID: 31790930 DOI: 10.1016/j.critrevonc.2019.102834] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 11/08/2019] [Accepted: 11/11/2019] [Indexed: 02/06/2023] Open
Abstract
Colorectal cancer (CRC) is a leading cause of cancer-related mortality in the world. Patterns and trends in CRC incidence and mortality correlate with increasing adoption of Western lifestyles and with the overweight/obesity epidemic. Both genetic background and a range of modifiable environmental/lifestyle factors play a role in CRC etiology. Among these the links of body weight, dietary patterns and physical activity (PA) behavior with CRC risk are some of the strongest for any type of cancer, with a different impact in women and men. Nonetheless, gender disparities still represent a neglected aspect of CRC management. This review sheds light on gender-related association of obesity and different dietary/PA habits with CRC risk, highlighting the importance of lifestyle modifications in the prevention of this neoplastic disease. In this scenario, intervention studies are strongly recommended to define the most effective dietary/PA regimens for primary prevention of cancer in women and men.
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Affiliation(s)
- Lucia Conti
- Center for Gender-Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy
| | - Manuela Del Cornò
- Center for Gender-Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy.
| | - Sandra Gessani
- Center for Gender-Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy
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McTiernan A, Friedenreich CM, Katzmarzyk PT, Powell KE, Macko R, Buchner D, Pescatello LS, Bloodgood B, Tennant B, Vaux-Bjerke A, George SM, Troiano RP, Piercy KL. Physical Activity in Cancer Prevention and Survival: A Systematic Review. Med Sci Sports Exerc 2019; 51:1252-1261. [PMID: 31095082 PMCID: PMC6527123 DOI: 10.1249/mss.0000000000001937] [Citation(s) in RCA: 434] [Impact Index Per Article: 86.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE This article reviews and updates the evidence on the associations between physical activity and risk for cancer, and for mortality in persons with cancer, as presented in the 2018 Physical Activity Guidelines Advisory Committee Scientific Report. METHODS Systematic reviews of meta-analyses, systematic reviews, and pooled analyses were conducted through December 2016. An updated systematic review of such reports plus original research through February 2018 was conducted. This article also identifies future research needs. RESULTS In reviewing 45 reports comprising hundreds of epidemiologic studies with several million study participants, the report found strong evidence for an association between highest versus lowest physical activity levels and reduced risks of bladder, breast, colon, endometrial, esophageal adenocarcinoma, renal, and gastric cancers. Relative risk reductions ranged from approximately 10% to 20%. Based on 18 systematic reviews and meta-analyses, the report also found moderate or limited associations between greater amounts of physical activity and decreased all-cause and cancer-specific mortality in individuals with a diagnosis of breast, colorectal, or prostate cancer, with relative risk reductions ranging almost up to 40% to 50%. The updated search, with five meta-analyses and 25 source articles reviewed, confirmed these findings. CONCLUSIONS Levels of physical activity recommended in the 2018 Guidelines are associated with reduced risk and improved survival for several cancers. More research is needed to determine the associations between physical activity and incidence for less common cancers and associations with survival for other cancers. Future studies of cancer incidence and mortality should consider these associations for population subgroups, to determine dose-response relationships between physical activity and cancer risk and prognosis, and to establish mechanisms to explain these associations.
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Affiliation(s)
- Anne McTiernan
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
- Schools of Public Health and Medicine, Departments of Epidemiology and Medicine (Geriatrics), University of Washington, Seattle, WA
| | - Christine M. Friedenreich
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, CANADA
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, CANADA
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, CANADA
| | | | - Kenneth E. Powell
- Centers for Disease Control, Georgia Department of Public Health, Atlanta, GA
| | - Richard Macko
- Department of Neurology, University of Maryland School of Medicine; University Maryland Rehabilitation & Orthopedics Institute; Maryland Exercise & Robotics Center of Excellence, Veterans Affairs Maryland Health Care System; Geriatrics Research, Education, and Clinical Center, Veterans Affairs Medical Center, Baltimore, MD
| | - David Buchner
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL
| | - Linda S. Pescatello
- Department of Kinesiology, College of Agriculture, Health and Natural Resources, University of Connecticut, Storrs, CT
| | | | | | - Alison Vaux-Bjerke
- Office of Disease Prevention and Health Promotion, Office of the Assistant Secretary for Health, U.S. Department of Health and Human Services, Rockville, MD
| | - Stephanie M. George
- Office of Disease Prevention, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD
| | - Richard P. Troiano
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD
| | - Katrina L. Piercy
- Office of Disease Prevention and Health Promotion, Office of the Assistant Secretary for Health, U.S. Department of Health and Human Services, Rockville, MD
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Park SY, Wilkens LR, Haiman CA, Le Marchand L. Physical Activity and Colorectal Cancer Risk by Sex, Race/Ethnicity, and Subsite: The Multiethnic Cohort Study. Cancer Prev Res (Phila) 2019; 12:315-326. [PMID: 30910780 DOI: 10.1158/1940-6207.capr-18-0452] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 02/15/2019] [Accepted: 03/18/2019] [Indexed: 01/03/2023]
Abstract
Physical activity has been associated with a lower risk of colorectal cancer. However, data is lacking on whether the association is consistent between sexes and across different races/ethnicities and anatomic subsites of tumors. We analyzed data from the Multiethnic Cohort in Hawaii and California, consisting of mostly African Americans, Native Hawaiians, Japanese Americans, Latinos, and whites ages 45-75 years at recruitment. During a mean follow-up of 16.8 years, 4,430 invasive adenocarcinoma cases of the colorectum were identified among 172,502 eligible participants. Cox proportional hazards models were used to estimate the HR and 95% confidence interval (CI). The multivariate-adjusted HR (95% CI) for the highest versus lowest quintiles of physical activity (metabolic equivalent hours of moderate or vigorous activities per day) was 0.76 (0.66-0.87) in men (P trend < 0.001) and 0.94 (0.80-1.11) in women (P trend = 0.53, P heterogeneity by sex = 0.07). Sleeping and sitting hours were not associated with colorectal cancer risk both in men and women. In men, the inverse association was statistically significant among African Americans and Japanese Americans, for right colon and rectal cancer, and in all body mass index groups, although heterogeneity tests were not significant across race/ethnicity or anatomic subsite of tumors. The findings confirm the inverse association between physical activity and colorectal cancer, which appears to be stronger in men, and suggest possible differences in the strength of the association by race/ethnicity and anatomic subsite of tumors.
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Affiliation(s)
- Song-Yi Park
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii.
| | - Lynne R Wilkens
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii
| | - Christopher A Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Loïc Le Marchand
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii
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Shaw E, Farris MS, Stone CR, Derksen JWG, Johnson R, Hilsden RJ, Friedenreich CM, Brenner DR. Effects of physical activity on colorectal cancer risk among family history and body mass index subgroups: a systematic review and meta-analysis. BMC Cancer 2018; 18:71. [PMID: 29325535 PMCID: PMC5763991 DOI: 10.1186/s12885-017-3970-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 12/21/2017] [Indexed: 02/06/2023] Open
Abstract
Background Physical activity is consistently associated with a reduced risk of colorectal cancer in epidemiologic studies. This association among higher risk subgroups, such as those with a first-degree family history of colorectal cancer or high body mass index remains unclear. Methods We searched MEDLINE for studies examining physical activity and colorectal cancer risk among higher risk subgroups through July 11, 2017. Fifteen and three studies were eligible for inclusion for body mass index and first-degree family history of colorectal cancer subgroups, respectively. Estimates of the highest to lowest comparison of physical activity for each subgroup of risk were pooled using random-effects models. Results The pooled associations of physical activity and colorectal cancer risk for those without and with a first-degree family history of colorectal cancer were 0.56 (95% confidence interval (CI) = 0.39–0.80) and 0.72 (95% CI = 0.39–1.32), respectively (pheterogeneity = 0.586). The pooled associations of physical activity and colorectal cancer risk for the low and high body mass index groups were 0.74 (95% CI = 0.66–0.83) and 0.65 (95% CI = 0.53–0.79), respectively (pheterogeneity = 0.389). Conclusions Overall, a stronger relative risk of physical activity on colorectal cancer risk was observed in the higher body mass index group, although the difference was not statistically significant, suggesting an added benefit of physical activity as a cancer prevention strategy in population groups with strong risk factors for colorectal cancer. Additional research among these subgroups is warranted. Electronic supplementary material The online version of this article (10.1186/s12885-017-3970-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Eileen Shaw
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Holy Cross Centre, Room 513C, Box ACB, 2210 2nd Street S.W., Calgary, AB, T2S 3C3, Canada
| | - Megan S Farris
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Holy Cross Centre, Room 513C, Box ACB, 2210 2nd Street S.W., Calgary, AB, T2S 3C3, Canada
| | - Chelsea R Stone
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Holy Cross Centre, Room 513C, Box ACB, 2210 2nd Street S.W., Calgary, AB, T2S 3C3, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Jeroen W G Derksen
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Holy Cross Centre, Room 513C, Box ACB, 2210 2nd Street S.W., Calgary, AB, T2S 3C3, Canada
| | - Rhys Johnson
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Holy Cross Centre, Room 513C, Box ACB, 2210 2nd Street S.W., Calgary, AB, T2S 3C3, Canada
| | - Robert J Hilsden
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Forzani & MacPhail Colon Cancer Screening Centre, Alberta Health Services, Calgary, AB, Canada
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Holy Cross Centre, Room 513C, Box ACB, 2210 2nd Street S.W., Calgary, AB, T2S 3C3, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Darren R Brenner
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Holy Cross Centre, Room 513C, Box ACB, 2210 2nd Street S.W., Calgary, AB, T2S 3C3, Canada. .,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. .,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
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Sun P, Sun D, Wang X. Effects of Scutellaria barbata polysaccharide on the proliferation, apoptosis and EMT of human colon cancer HT29 Cells. Carbohydr Polym 2017; 167:90-96. [PMID: 28433181 DOI: 10.1016/j.carbpol.2017.03.022] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Revised: 02/12/2017] [Accepted: 03/08/2017] [Indexed: 01/09/2023]
Abstract
A water-soluble polysaccharide SPS2p was isolated from the whole grass of Scutellaria barbata and SPS2p contained 53.6% carbohydrates, 38.5% uronic acid and 8.2% proteins. The molecular weight of SPS2p showed only one molecular weight distribution (2.6×104Da) and the monosaccharide composition of SPS2p showed the presence of arabinose, mannose, glucose and galactose at the ratio of 1.31:1.00:3.59:1.59. The results showed that SPS2p could improve the proliferation inhibition rate; SPS2p could also elevate apoptosis rate, apoptosis index and the levels of Bax and Bak, but lower levels of Bcl-2 and FN; SPS2p could up-regulate the expression of E-cadherin mRNA, and down-regulate the expressions of N-cadherin and vimentin mRNA, and the ratio of p-AKT/AKT in HT29 cells. These results indicate that SPS2p can inhibit the proliferation and EMT, and promote the apoptosis in HT29 cells, which may be related to the inhibition of SPS2p on the PI3K/AKT pathway.
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Affiliation(s)
- Pengda Sun
- Department of Gastrointestinal Nutrition and Hernia Surgery, The Second Hospital of Jilin University, Changchun 130000, China
| | - Dong Sun
- Medical Ethics Committee, The Second Hospital of Jilin University, Changchun 130000, China
| | - Xudong Wang
- Department of Gastrointestinal Nutrition and Hernia Surgery, The Second Hospital of Jilin University, Changchun 130000, China.
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Al-Kindi SG, Oliveira GH. Onco-Cardiology: A Tale of Interplay Between 2 Families of Diseases. Mayo Clin Proc 2016; 91:1675-1677. [PMID: 27916153 DOI: 10.1016/j.mayocp.2016.10.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 10/20/2016] [Indexed: 01/19/2023]
Affiliation(s)
- Sadeer G Al-Kindi
- Onco-Cardiology Program, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center and Case Western Reserve University, Cleveland, OH
| | - Guilherme H Oliveira
- Onco-Cardiology Program, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center and Case Western Reserve University, Cleveland, OH.
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