The health benefits from exercise, particularly in a sedentary society, have gained a compelling body of evidence in the past decade. Younger adults have a considerably bigger physiologic reserve, both in terms of muscular strength and cardiovascular capacity. The elderly, on the other hand, experience a progressive decline in many physiologic functions, including muscular strength and cardiovascular capacity. Habitual exercise, by improving strength and maximum aerobic capacity (VO2max), can increase the physiologic reserve as well as enhance well-being by reducing fatigue associated with activities of daily living. Mostly importantly, it can delay the development of disability and thereby prolong active life expectancy. In addition to habitual exercise for conditioning, there is increasing evidence that resistance exercise to improve muscle strength along with tailored exercise therapies, including those designed to improve balance or to rehabilitate persons with various chronic diseases and acute ailments, may be of special value for the elderly. There is growing evidence that exercise programs offer measurable health benefits, ranging from increased life expectancy to mitigation of adverse sequelae from aging and from many chronic diseases. The greatest challenges in achieving health benefits from exercise are the limited access to effective programs and poor compliance.
Activities of Daily Living ; Adult ; Aged* ; Aging ; Chronic Disease ; Compliance ; Exercise Therapy ; Fatigue ; Hand ; Humans ; Insurance Benefits ; Life Expectancy ; Muscle Strength

PURPOSE: In IgA nephropathy (IgAN), crescent formation appears to represent a nonspecific response to severe injury to the glomerular capillary wall. This study was performed to evaluate the clinicopathological manifestations of the crescents and their effects on the clinical courses of IgAN. METHODS: The patients diagnosed IgAN were included and the information about their renal biopsies, chemistries and immunohistochemistry findings were collected retrospectively. Some patients that have similar renal function and protenuria were followed up for 12 months to examine the effects of crescents on the renal prognosis. RESULTS: 38 patients with crescents and 177 patients without crescents were enrolled. The patients with IgAN with crescents showed significantly lower renal function (MDRD eGFR 58.5 vs 88.4 ml/min/1.73m2), higher blood pressure, larger amount of proteinuria and more severe hematuria than those patients without crescents. In pathologic findings, HS Lee grades were higher (2.9 vs 1.9). When we selected patients with mildly decreased renal function (serum creatinine <2.5 mg/dL, PCR 0.5-8 g/gCr), the patients with crescents presented lower renal function and higher proteinuria but no statistical significance. After 12 months of treatment, the patients with crescents showed significantly lower renal function (MDRD eGFR 78.6 vs 96.5 ml/min/1.73m2) and higher proteinuria (0.9 vs 0.6 g/gCr). CONCLUSION: The patients with IgAN with crescents showed more deteriorated clinicopathological findings than those without crescents. Despite aggressive treatments, they presented a significantly decreased renal function and larger amount of proteinuria after 1 year. So crescents are supposed to have poor effects on the clinical course.
Biopsy ; Blood Pressure ; Capillaries ; Creatinine ; Glomerulonephritis, IGA ; Hematuria ; Humans ; Immunoglobulin A ; Immunohistochemistry ; Polymerase Chain Reaction ; Proteinuria ; Retrospective Studies