New loci associated with birth weight identify genetic links between intrauterine growth and adult height and metabolism.

Birth weight within the normal range is associated with a variety of adult-onset diseases, but the mechanisms behind these associations are poorly understood. Previous genome-wide association studies of birth weight identified a variant in the ADCY5 gene associated both with birth weight and type 2 diabetes and a second variant, near CCNL1, with no obvious link to adult traits. In an expanded genome-wide association meta-analysis and follow-up study of birth weight (of up to 69,308 individuals of European descent from 43 studies), we have now extended the number of loci associated at genome-wide significance to 7, accounting for a similar proportion of variance as maternal smoking. Five of the loci are known to be associated with other phenotypes: ADCY5 and CDKAL1 with type 2 diabetes, ADRB1 with adult blood pressure and HMGA2 and LCORL with adult height. Our findings highlight genetic links between fetal growth and postnatal growth and metabolism

Recurrent Rectal Cancer

Recurrent rectal cancer poses a significant morbidity and mortality. Survival is ultimately shortened while patients concurrently suffer far greater disability with the recurrence. Recurrent pelvic disease often results in a diminished quality of life and is often associated with increased pain, incontinence, sexual and urinary dys­function, and possibly colonic obstruction. The primary goal of therapy for rectal cancer is preventing recurrence by properly managing the disease on initial presentation. The secondary goal is to develop proper follow-up for patients with recurrent rectal cancer in order to detect recurrence early enough so that potentially curative surgery may be undertaken. Determining whether the patient may be cured needs a careful history, physical examination, and selected utilization of radiographic imaging modalities. Surgical intervention is often multidisciplinary combining the resources of colorectal, orthopedic, urologic, gynecologic, and plastic surgeons