Aim
Sarcopenia, or a reduction of lean muscle mass, is associated with poorer outcomes in cancer patients. Few previous studies have examined this potentially correctable risk factor in patients with locally advanced rectal cancer.
Method
Skeletal muscle mass index was measured retrospectively on initial staging CT scans of patients undergoing chemoradiation followed by radical resection for rectal cancer for the period 2007–2013. Patients were categorized as sarcopenic or nonsarcopenic and differences in terms of demographics, pre‐, peri‐ and postoperative outcomes were examined.
Results
Forty‐seven patients were included; their mean age was 59.3 (36–82) years and 61.7% were men. We considered that 55.2% of men and 44.4% of women were sarcopenic; the overall prevalence of sarcopenia was 51.1%. Age, preoperative haemoglobin and albumin were significantly related to sarcopenia. Body mass index (BMI) and obesity (BMI > 30 kg/m2) were not associated with sarcopenia. Blood transfusions were more frequent in sarcopenic patients (P = 0.001). Although readmissions and length of stay were not increased, overall postoperative complications were significantly higher in sarcopenic patients (P = 0.03). Neither BMI nor obesity was associated with postoperative complications.
Conclusion
Sarcopenia was present in over 50% of patients with locally advanced rectal cancer at diagnosis. It was associated with a higher incidence of both blood transfusion and postoperative complications. BMI did not correlate with these negative outcomes. Sarcopenia may be a better predictor of surgical outcomes than BMI or obesity.
Decreased excretion of tDPD suggests low bone resorption in IDDM and NIDDM. Pyridinoline is not glycosylated to a greater extent in diabetes mellitus and tends to be decreased in proportion to the degree of glycosuria. Excretion of gPYD, fPYD and fDPD is depressed in severe glycosuria. Diminshed degradation to the final products, fPYD and fDPD, might represent increased resistance to enzymatic activity or diminished enzymatic activity. The increased molar ratio tPYD/tDPD in urine suggests an increased ratio in bone collagen in diabetes mellitus.
Multivariate image analysis was used to estimate the arsenic concentrations in froths resulting from the flotation of different mixtures of realgar and orpiment particles in a laboratory batch flotation cell. The realgar floated rapidly and in excess of 90% of the mineral could be recovered after 2 minutes, whereas only 48-75% of the orpiment could be recovered in the same time. Textural features, based on grey level co-occurrence matrices (GLCMs), local binary patterns (LBPs), steearable pyramids and textons were used in the analysis. Random forest models could explain approximately 71-77% of the variance in the arsenic using either of the texton, steerable pyramid or LBP features. This was considerably better than what could be obtained with the GLCM features. Monitoring of froth flotation cells was simulated with the batch data. The texton textural features were the most discriminatory with regard to detecting changes in the arsenic content of the froth.
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