Body composition parameters predict survival in pancreatic cancer—A retrospective multicenter analysis

Background Parameters to adapt individual treatment strategies for patients with pancreatic ductal adenocarcinoma (PDAC) are urgently needed. The present study aimed to evaluate body composition parameters as predictors of overall survival (OS) in PDAC patients. Methods Measurements of body composition parameters were performed on computed tomography scans at diagnosis. Height-standardized and Body Mass Index- and sex-adjusted regression formulas deriving cut-offs from a healthy population were used. The Kaplan-Meier method with the log-rank test was performed for survival analysis. Independent prognostic factors were identified with uni- and multivariable Cox regression analyses. Results In total, 354 patients were analyzed. In a multivariable Cox model, besides tumor stage and resection status, only myosteatosis (HR 1.53; 95% CI 1.10–2.14, p = 0.01) was an independent prognostic factor of OS among body composition parameters. Subgroup analyses revealed that the prognostic impact of myosteatosis was higher in patients ≤68 years of age, with advanced tumor stages and patients without curative intended resection. Conclusions The analysis of one of the largest Caucasian cohorts to date, demonstrated myosteatosis to be an independent prognostic factor of OS in PDAC. To improve outcomes, prospective trials aiming to investigate the utility of an early assessment of myosteatosis with subsequent intervention by dieticians, sports medicine physicians, and physiotherapists are warranted

Variability of humidity conditions in the Arctic during the first International Polar Year, 1882-83

Of all the early instrumental data for the Arctic, the meteorological data gathered during the first International Polar Year, in 1882–83 (IPY-1), are the best in terms of coverage, quality and resolution. Research carried out during IPY-1 scientific expeditions brought a significant contribution to the development of hygrometry in polar regions at the end of the 19th century. The present paper gives a detailed analysis of a unique series of humidity measurements that were carried out during IPY-1 at hourly resolutions at nine meteorological stations, relatively evenly distributed in the High Arctic. It gives an overall view of the humidity conditions prevalent in the Arctic at that time. The results show that the spatial distribution of atmospheric water vapour pressure (e) and relative humidity (RH) in the Arctic during IPY-1 was similar to the present. In the annual course the highest values of e were noted in July and August, while the lowest occurred in the cold half of the year. In comparison to present-day conditions (1961–1990), the mean values of RH in the IPY-1 period (September 1882 to July 1883) were higher by 2.4–5.6%. Most of the changes observed between historical and modern RH values are not significant. The majority of historical daily RH values lie between a distance of less than two standard deviations from current long-term monthly means

Prospective 2-Years Follow-up Quality of Life Study after Infrageniculate Bypass Surgery for Limb Salvage: Lasting Improvements Only in Non-diabetic Patients

AbstractObjectivesTo assess health-related quality of life (HRQoL) up to 24 months after successful infrageniculate bypass surgery for limb-threatening ischaemia.Methods89 patients with infrageniculate bypass surgery for limb-salvage were studied. HRQoL was assessed using the Short Form (SF)-36v1 questionnaire before, 6, 12, and 24 months after revascularisation.Results47 patients (53%) with intact limb and functioning graft were assessed after 24 months, 27 patients (30%) died, further 7 required secondary amputation, 3 suffered irremediable graft occlusion, and 4 were lost to follow-up. The 24-months HRQoL-values were significantly improved in 4 domains: physical functioning (p<0.01), bodily pain (p<0.01), mental health (p=0.04), and social functioning (p=0.01). Except for baseline-values, HRQoL remained inferior in diabetics compared to non-diabetics throughout follow-up. Maximum improvement of HRQoL was delayed in diabetics (12 months vs. 6 months) and less pronounced. After 24 months non-diabetic patients maintained improvement in 5 domains and diabetic patients only in bodily pain.ConclusionsImprovement in HRQoL is sustained for more than 12 months after successful infrageniculate bypass surgery. Therefore, an aggressive approach towards revascularisation seems to be justified from the patient's perspective. However, this benefit in quality of life is less in diabetic patients, despite similar limb-salvage rates

Vascular tumors in infants and adolescents

Malignant vascular tumors as part of the vascular anomalies spectrum are extremely rare in children and young adults. Instead, benign vascular neoplasias are frequently encountered in the pediatric patient population. While vascular malformations are congenital vascular lesions, originating from a mesenchymal stem cell defect, vascular tumors are neoplastic transformations of endothelial and other vascular cells. The appropriate differential diagnosis and nomenclature according to the classification of the International Society for the Study of Vascular Anomalies (ISSVA) is decisive to initiate correct therapy. While infantile mangioma can be routinely diagnosed by clinical means and rarely require therapy, more rare vascular tumors are frequently difficult to diagnose, require dedicated cross-sectional imaging, and benefit from an interdisciplinary treatment approach. The focus of this review is to provide an overview over the spectrum of vascular tumors, typical imaging characteristics, and summarize treatment options including interventional radiology approaches

Increased intermediate CD14⁺⁺CD16⁺⁺ monocyte subset levels associate with restenosis after peripheral percutaneous transluminal angioplasty.

BACKGROUND AND AIMS: We aimed at studying the association of three major human monocyte subsets after percutaneous transluminal angioplasty (PTA) in patients with femoropopliteal disease. METHODS: We prospectively studied 67 sequential patients (40 male, 27 female; mean age 71&nbsp;&plusmn;&nbsp;11 years) treated with femoropopliteal angioplasty. Multi-color flow cytometry characterized monocyte subsets from venous blood for expression of CD14 and CD16 and intracellular myeloperoxidase (MPO) prior to, and 3, 6 and 12 months post PTA. Analyses tested associations between monocyte subsets and risk for restenosis. RESULTS: 16/67 patients (24%) developed restenosis within 12 months after PTA. Patients with hyperlipidemia had increased risk for restenosis (HR&nbsp;=&nbsp;1.7, 95% CI 0.7-2.9, p&nbsp;=&nbsp;0.001). Increased baseline monocytes associated with an increased risk of late restenosis (HR&nbsp;=&nbsp;4.9, 95% CI: 1.3-18.6, p&nbsp;=&nbsp;0.047). CD14(++)CD16(++) &#39;intermediate&#39; monocytes assessed at baseline, and after 3, 6, and 12 months significantly associated with the risk for subsequent restenosis: HR&nbsp;=&nbsp;3.9 (95% CI: 2.4-6.5, p&nbsp;=&nbsp;0.029), HR&nbsp;=&nbsp;5.7 (95% CI&nbsp;=&nbsp;0.7-44.7, p&nbsp;=&nbsp;0.013), HR&nbsp;=&nbsp;6.5 (95% CI: 2.5-16.9, p&nbsp;=&nbsp;0.001) and HR&nbsp;=&nbsp;1.5 (95% CI&nbsp;=&nbsp;1.4-15.5 p&nbsp;=&nbsp;0.001), respectively. Moreover, the probability for freedom of restenosis decreased with increased levels of intermediate subsets at 12 months after PTA. Additionally, intracellular MPO expression in CD14(++)CD16(++) measured at 3, 6 and 12 months associated with an increased restenosis risk (HR&nbsp;=&nbsp;1.5, 95% CI: 0.8-2.1, p&nbsp;=&nbsp;0.214, HR&nbsp;=&nbsp;1.9, 95% CI: 1.0-2.3 p&nbsp;=&nbsp;0.051 and HR&nbsp;=&nbsp;1.4, 95% CI: 1.0-1.8, p&nbsp;=&nbsp;0.052). CONCLUSIONS: Our results imply altered innate immunity after angioplasty. Elevated CD14(++)CD16(++) intermediate monocyte frequencies and increased MPO expression may identify individuals at heightened risk for restenosis