Using simple radiologic measurements to anticipate surgical challenge in endometrial cancer: a prospective study

ObjectivesTo determine if linear measurements of adiposity from pre-operative imaging can improve anticipation of surgical difficulty among endometrial cancer patients.MethodsEighty patients with newly diagnosed endometrial cancer were enrolled. Routine pre-operative imaging (MRI or CT) was performed. Radiologic linear measurements of the following were obtained: anterior-to-posterior skin distance; anterior skin to anterior edge of L5 distance (total anterior); anterior peritoneum to anterior edge of L5 distance (visceral obesity); and posterior edge of L5 to posterior skin distance (total posterior). Surgeons completed questionnaires quantifying preoperative anticipated operative difficulty and postoperative reported operative difficulty. The primary objective was to assess for a correlation between linear measurements of visceral fat and reported operative difficulty.ResultsSeventy-nine patients had questionnaires completed, preoperative imaging obtained, and surgery performed. Univariate analysis showed all four linear measurements, body mass index, weight, and anticipated operative difficulty were associated with increased reported operative difficulty (P< 0.05). Multivariate analysis demonstrated that body mass index and linear measurements visceral obesity and total posterior were independently associated with increased reported operative difficulty (P< 0.05). Compared with body mass index, the visceral obesity measurement was more sensitive and specific for predicting increased reported operative difficulty (visceral obesity; sensitivity 54%, specificity 91 %; body mass index; sensitivity 38%, specificity 89%). A difficulty risk model combining body mass index, visceral obesity, and total posterior demonstrated better predictive performance than any individual preoperative variable.ConclusionsSimple linear measurements of visceral fat obtained from preoperative imaging are more predictive than body mass index alone in anticipating surgeon-reported operative difficulty. These easily obtained measurements may assist in preoperative decision making in this challenging patient population.

Download Full-text

Prognostic significance of body mass index in breast cancer patients with hormone receptor-positive tumours after curative surgery

Clinical & Investigative Medicine ◽

10.25011/cim.v36i6.20627 ◽

2013 ◽

Vol 36 (6) ◽

pp. 297 ◽

Cited By ~ 4

Author(s):

Peng Xing ◽

Ji-Guang Li ◽

Feng Jin ◽

Ting-Ting Zhao ◽

Qun Liu ◽

...

Keyword(s):

Breast Cancer ◽

Body Mass Index ◽

Body Mass ◽

Hormone Receptor ◽

Univariate Analysis ◽

Prognostic Significance ◽

Axillary Lymph ◽

Nodal Stage ◽

Hormone Receptor Positive ◽

High Bmi

Purpose: Obesity has been recognized as a significant risk factor for postmenopausal breast cancer. The aim of this study is to investigate the prognostic significance of body mass index (BMI) in hormone receptor-positive, operable breast cancer. Methods: In this retrospective cohort study, 1,192 consecutive patients with curative resection of primary breast cancer were enrolled. Patients were assigned to two groups according to BMI: normal or underweight (BMI < 23.0 kg/m2) and overweight or obese (BMI ≥23.0 kg/m2). Associations among BMI and clinicopathological characteristics and prognosis of patients were assessed. Results: A high BMI was significantly (P < 0.01) correlated with age, nodal stage, ALNR, ER positivity, PR positivity and menopausal status at diagnosis. Univariate analysis revealed that BMI, pathologic T stage, nodal stage, axillary lymph node ratio (ALNR) and adjuvant radiotherapy history were significantly (P < 0.05) associated with disease-free survival and overall survival, irrespective of tumour hormone receptor status. Multivariate analysis revealed BMI as an independent prognostic factor in all cases and in hormone receptor-positive cases. Conclusion: A high BMI (≥23.0 kg/m^2) is independently associated with poor prognosis in hormone receptor-positive breast cancer.

Download Full-text

Pancreatic Fat Is Associated With Metabolic Syndrome and Visceral Fat but Not Beta-Cell Function or Body Mass Index in Pediatric Obesity

Pancreas ◽

10.1097/mpa.0000000000000771 ◽

2017 ◽

Vol 46 (3) ◽

pp. 358-365 ◽

Cited By ~ 23

Author(s):

Johan Staaf ◽

Viktor Labmayr ◽

Katharina Paulmichl ◽

Hannes Manell ◽

Jing Cen ◽

...

Keyword(s):

Metabolic Syndrome ◽

Body Mass Index ◽

Beta Cell ◽

Body Mass ◽

Visceral Fat ◽

Pediatric Obesity ◽

Beta Cell Function ◽

Cell Function ◽

Pancreatic Fat

Download Full-text

Associations of Body Mass Index, Visceral Fat Area, Waist Circumference, and Waist-to-Hip Ratio with Cognitive Function in Western China: Results from WCHAT Study

The journal of nutrition health & aging ◽

10.1007/s12603-021-1642-2 ◽

2021 ◽

Author(s):

X. Liu ◽

X. Chen ◽

L. Hou ◽

X. Xia ◽

F. Hu ◽

...

Keyword(s):

Body Mass Index ◽

Cognitive Function ◽

Waist Circumference ◽

Body Mass ◽

Visceral Fat ◽

Western China ◽

Visceral Fat Area ◽

Waist To Hip Ratio

Download Full-text

Effects of Exercise Interventions on Weight, Body Mass Index, Lean Body Mass and Accumulated Visceral Fat in Overweight and Obese Individuals: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052635 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2635

Author(s):

Hyun Suk Lee ◽

Junga Lee

Keyword(s):

Body Mass Index ◽

Randomized Controlled Trials ◽

Lean Body Mass ◽

Body Mass ◽

Visceral Fat ◽

Exercise Intervention ◽

Meta Analysis ◽

Controlled Trials ◽

Exercise Interventions ◽

Randomized Controlled

(1) Background: Exercise interventions for overweight and obese individuals help reduce accumulated visceral fat, which is an indicator of cardiometabolic risk, but the effectiveness of these interventions is controversial. The purpose of this meta-analysis was to investigate the effectiveness of exercise interventions in overweight and obese individuals in order to reduce weight, body mass index (BMI), and accumulated visceral fat, and increase lean body mass. (2) Methods: Databases were used to select eligible studies for this meta-analysis. Randomized controlled trials with control and experimental groups were included. The degrees of effectiveness of the exercise interventions were computed to assess the benefits on reducing weight, BMI, and accumulated visceral fat, and increasing lean body mass. (3) Results: Sixteen studies were included in this meta-analysis. Participation in exercise interventions reduced weight (d = −0.58 (95% confidence interval (CI), −0.84–−0.31; p < 0.001; k = 9)), BMI (d = −0.50 (95% CI, −0.78–−0.21; p < 0.001; k = 7)), and accumulated visceral fat (d = −1.08 (95% CI, −1.60–−0.57; p < 0.001; k = 5)), but did not significantly increase lean body mass (d = 0.26 (95% CI, −0.11–0.63; p = 0.17; k = 6)). The average exercise intervention for overweight and obese individuals was of moderate to vigorous intensity, 4 times per week, 50 min per session, and 22 weeks duration. (4) Conclusions: Participating in exercise interventions has favorable effects on weight, BMI, and accumulated visceral fat. Further studies considering different modalities, intensities, durations, and measurements of fatness need to be conducted.

Download Full-text

Serum Periostin as a Potential Biomarker in Pediatric Patients with Primary Hypertension

Journal of Clinical Medicine ◽

10.3390/jcm10102138 ◽

2021 ◽

Vol 10 (10) ◽

pp. 2138

Author(s):

Michał Szyszka ◽

Piotr Skrzypczyk ◽

Anna Stelmaszczyk-Emmel ◽

Małgorzata Pańczyk-Tomaszewska

Keyword(s):

Blood Pressure ◽

Body Mass Index ◽

Uric Acid ◽

Body Mass ◽

Pediatric Patients ◽

Univariate Analysis ◽

Primary Hypertension ◽

Potential Biomarker ◽

Arterial Damage ◽

Serum Periostin

Experimental studies suggest that periostin is involved in tissue repair and remodeling. The study aimed to evaluate serum periostin concentration as potential biomarker in pediatric patients with primary hypertension (PH). We measured serum periostin, blood pressure, arterial damage, biochemical, and clinical data in 50 children with PH and 20 age-matched healthy controls. In univariate analysis, children with PH had significantly lower serum periostin compared to healthy peers (35.42 ± 10.43 vs. 42.16 ± 12.82 [ng/mL], p = 0.038). In the entire group of 70 children serum periostin concentration correlated negatively with peripheral, central, and ambulatory blood pressure, as well as with aortic pulse wave velocity (aPWV). In multivariate analysis, periostin level significantly correlated with age (β = −0.614, [95% confidence interval (CI), −0.831–−0.398]), uric acid (β = 0.328, [95%CI, 0.124–0.533]), body mass index (BMI) Z-score (β = −0.293, [95%CI, −0.492–−0.095]), high-density lipoprotein (HDL)-cholesterol (β = 0.235, [95%CI, 0.054–0.416]), and triglycerides (β = −0.198, [95%CI, −0.394–−0.002]). Neither the presence of hypertension nor blood pressure and aPWV influenced periostin level. To conclude, the role of serum periostin as a biomarker of elevated blood pressure and arterial damage in pediatric patients with primary hypertension is yet to be unmasked. Age, body mass index, uric acid, and lipid concentrations are key factors influencing periostin level in pediatric patients.

Download Full-text

Effect of individual- versus collective-based nutritional-lifestyle intervention on the atherogenic index of plasma in children with obesity: a randomized trial

Nutrition & Metabolism ◽

10.1186/s12986-020-00537-w ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Elvira Verduci ◽

Giuseppe Banderali ◽

Elisabetta Di Profio ◽

Sara Vizzuso ◽

Gianvincenzo Zuccotti ◽

...

Keyword(s):

Body Mass Index ◽

Lifestyle Intervention ◽

Body Mass ◽

Univariate Analysis ◽

Atherogenic Index ◽

Z Score ◽

Blood Profile ◽

Atherogenic Index Of Plasma ◽

Paediatric Obesity ◽

The Individual

Abstract Background The Atherogenic Index of Plasma is a predictive biomarker of atherosclerosis in adults but there is a lack of studies in paediatric population aimed at evaluating the longitudinal changes of the AIP and of the cardiometabolic blood profile related to nutritional interventions. The aim of this study was to compare the effect of individual- versus collective-based nutritional-lifestyle intervention on the Atherogenic Index of Plasma in schoolchildren with obesity. Methods One-hundred sixty-four children aged 6–12 years with Body Mass Index z-score > 2 referred to the Paediatric Obesity Clinic, San Paolo Hospital, Milan, Italy, were consecutively enrolled and randomized to undergo to either an individual- (n = 82) or a collective- (n = 82) based intervention promoting a balanced normo-caloric diet and physical activity. In addition, the individual intervention included a tailored personalized nutritional advice and education based on the revised Coventry, Aberdeen, and London-Refined taxonomy. Both at baseline and after 12 months of intervention, dietary habits and anthropometric measures were assessed, a fasting blood sample were taken for biochemistry analysis. Results The participation rate at 12 months was 93.3% (n = 153 patients), 76 children in the individual-intervention and 77 children in the collective intervention. At univariate analysis, mean longitudinal change in Atherogenic Index of Plasma was greater in the individual than collective intervention (− 0.12 vs. − 0.05), as well as change in triglyceride-glucose index (− 0.22 vs. − 0.08) and Body Mass Index z-score (− 0.59 vs. − 0.37). At multiple analysis, only change in Body Mass Index z-score remained independently associated with intervention (odds ratio 3.37). Conclusion In children with obesity, an individual-based nutritional and lifestyle intervention, including techniques from the CALO-RE taxonomy, could have an additional beneficial effect over a collective-based intervention, although the actual size of the effect remains to be clarified. Trial Registration Clinical Trials NCT03728621

Download Full-text

Major post-prostate biopsy complications under antibiotic augmentation prophylaxis protocol

Journal of Clinical Urology ◽

10.1177/2051415820984037 ◽

2021 ◽

pp. 205141582098403

Author(s):

Antônio Antunes Rodrigues ◽

Valdair Muglia ◽

Emanuel Veras de Albuquerque ◽

Rafael Ribeiro Mori ◽

Rafael Neuppmann Feres ◽

...

Keyword(s):

Risk Factors ◽

Body Mass Index ◽

Antibiotic Prophylaxis ◽

Body Mass ◽

Bacterial Resistance ◽

Univariate Analysis ◽

Specific Antigen ◽

Outlet Obstruction ◽

Psa Density ◽

Biopsy Complications

Objective: To identify risk factors for major post-biopsy complications under augmented prophylaxis protocol. The risk factors already described mainly comprise outdated antibiotic prophylaxis protocols. Material and methods: This retrospective cohort study included patients that underwent transrectal ultrasound-guided biopsies, from 2011 to 2016. All patients had received antibiotic prophylaxis with ciprofloxacin and gentamicin. Patients were grouped according to the presence or absence of post-biopsy complications. Demographic variables and possible risk factors based on routine clinical assessment were registered. Correlation tests, univariate and multivariate analyses were used to identify risk factors for post-biopsy complications. Results: Of the 404 patients that were included, 25 (6.2%) presented 27 post-biopsy complications, distributed as follows: acute urinary retention ( n = 14, 3.5%), infections ( n = 11, 2.7%) and hemorrhage ( n = 2, 0.5%). On univariate analysis, patients who presented complications showed higher body mass index and post-voiding residual volumes. Multivariate analysis identified ethnicity and prostate-specific antigen (PSA) density as possible risk factors for biopsy complications. The presence of bacterial resistance identified by rectal swabs did not correlate with the incidence of complications and infections. Conclusions: Non-infectious post-biopsy complications were more frequent than infectious ones in this cohort. Higher post-voiding residual volumes and PSA density, that indicates prostate enlargement, were identified as risk factors and interpreted as secondary to bladder outlet obstruction. The higher body mass index and ethnicity were also identified as risk factors and attributed to the heterogeneity of the patients included. Level of evidence: Not applicable for this multicentre audit.

Download Full-text