Low preoperative skeletal muscle density is predictive for negative postoperative outcomes in older women with ovarian cancer

Objective. To determine the predictive value of lumbar skeletal muscle mass and density for postoperative outcomes in older women with advanced stage ovarian cancer.Methods. A multicenter, retrospective cohort study was performed in women >= 70 years old receiving surgery for primary, advanced stage ovarian cancer. Skeletal muscle mass and density were assessed in axial CT slices on level L3. Low skeletal muscle mass was defined as skeletal muscle index = 2).Conclusion. Low skeletal muscle density, as a proxy of muscle quality, is associated with poor postoperative outcomes in older patients with advanced stage ovarian cancer. These findings can contribute to postoperative risk assessment and clinical decision making. (C) 2021 The Author(s). Published by Elsevier Inc.Cervix cance

New genetic loci link adipose and insulin biology to body fat distribution.

Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms

Bowel preparation in MRI for detection of endometriosis: Comparison of the effect of an enema, no additional medication and intravenous butylscopolamine on image quality

Purpose: To compare the effect of three different patient preparation strategies for reducing bowel motion on image quality in pelvic MRI. Methods: Retrospective study in which 95 consecutive patients undergoing pelvic MRI were subdivided based on preparation type for reduction of bowel motion: group 1 (N = 31) fasted 4 h and applied an enema (Bisacodyl 10 mg); group 2 (N = 32) received no medication; group 3 (N = 32) received intravenous butylscopolamine (Buscopan® 50 mg). Image quality was reviewed by visual assessment of delineation (3-point-scale) of pelvic structures: uterus, adnexa, bladder, rectum, sigmoid, uterosacral ligaments, round ligaments and small bowel. As secondary endpoint the presence of rectal wall edema was evaluated. Interobserver agreement was calculated, as well as relative diagnostic odds ratios (RDOR) for the protocols to provide an outcome in the best delineation category. Results: Interobserver agreement proportions varied from 0.48 to 1.00. The rectum and sigmoid colon respectively have a 5.4 and 2.6 RDOR when butylscopolamine is applied compared to Bisacodyl (P = 0.051; P = 0.008), and a 4.2 and 5.7 times higher RDOR with Bisacodyl preparation compared to no medical preparation (P = 0.006; P < 0.01). Small bowel delineation was significantly better with butylscopolamine compared to Bisacodyl (P = 0.007). There was no significant difference in delineation of the other structures between protocols. There is a significant higher chance of observing rectal wall edema with Bisacodyl compared to the other protocols (both P < 0.001). Conclusions: Butylscopolamine provides better delineation of the small bowel and rectosigmoid compared to Bisacodyl, which in turn, provides better delineation of the rectosigmoid compared to no medication. Moreover, Bisacodyl causes rectal wall edema in the majority of cases