The main problem of transanal excision for early rectal cancer in the present study was the inability to remove all the malignancy. Patients treated with transanal excision had significantly higher rates of local recurrence compared with patients who underwent major surgery. Patients who had transanal excision had inferior survival, but they were older than those who had major surgery.

Please cite this paper as: Stafne S, Salvesen K, Romundstad P, Torjusen I, Mørkved S. Does regular exercise including pelvic floor muscle training prevent urinary and anal incontinence during pregnancy? A randomised controlled trial. BJOG 2012;119:1270–1280. Objective  To assess whether pregnant women following a general exercise course, including pelvic floor muscle training (PFMT), were less likely to report urinary and anal incontinence in late pregnancy than a group of women receiving standard care. Design  A two‐armed, two‐centred randomised controlled trial. Setting  Trondheim University Hospital (St. Olavs Hospital) and Stavanger University Hospital, in Norway. Population  A total of 855 women were included in this trial. Methods  The intervention was a 12‐week exercise programme, including PFMT, conducted between 20 and 36 weeks of gestation. One weekly group session was led by physiotherapists, and home exercises were encouraged at least twice a week. Controls received regular antenatal care. Main outcome measures  Self‐reported urinary and anal incontinence after the intervention period (at 32–36 weeks of gestation). Results  Fewer women in the intervention group reported any weekly urinary incontinence (11 versus 19%, P = 0.004). Fewer women in the intervention group reported faecal incontinence (3 versus 5%), but this difference was not statistically significant (P = 0.18). Conclusions  The present trial indicates that pregnant women should exercise, and in particular do PFMT, to prevent and treat urinary incontinence in late pregnancy. Thorough instruction is important, and specific pelvic floor muscle exercises should be included in exercise classes for pregnant women. The preventive effect of PFMT on anal incontinence should be explored in future trials.

The germline ‘APOBEC3A/B’ deletion polymorphism, previously linked to APOBEC-dependent mutational signatures, was found associated with lung cancer risk among young individuals and age at diagnosis for lung and prostate cancer. No associations were found to breast or colon cancer.

Objective To investigate whether a customised exercise programme influences pregnant women's psychological wellbeing and general health perception reflecting health-related quality of life (HRQoL) in late pregnancy.Design A two-armed, two-centred randomised controlled trial.Setting Trondheim and Stavanger University Hospitals, Norway.Population A total of 855 healthy Caucasian pregnant women.Methods The intervention group was offered a 12-week exercise programme between 20 and 36 weeks of pregnancy. One weekly group session was led by physiotherapists, in addition women were encouraged to follow a home exercise programme at least twice a week. The exercise programme followed standard recommendations and included both aerobic and strength training. The control group received regular antenatal care. Pretests and post-tests were performed at 18-22 and 32-36 weeks of pregnancy.Main outcome measures In the original study primary outcome was gestational diabetes mellitus, but in this report the primary outcome is HRQoL. The questionnaire Psychological General Wellbeing Index (PGWBI) was used to assess psychological wellbeing and self-perceived general health before and after the intervention. PGWBI contains six subscales and it is also possible to summarise all items to a global score.Results No association between antenatal exercise programme allocation and PGWBI (global score and subscales) was found. The study population was homogeneous and had high educational level. ConclusionsThe results indicate that offering women an exercise programme during pregnancy does not seem to influence healthy pregnant women's psychological wellbeing and self-perceived general health. Further research is needed to investigate the effects of exercise in pregnancy on psychological wellbeing and selfperceived general health among women from different sociocultural subgroups.Keywords Exercise, general health, health-related quality of life, pregnancy.Tweetable abstract Exercise in pregnancy does not influence healthy pregnant women's health-related quality of life.Please cite this paper as: Gustafsson MK, Stafne SN, Romundstad PR, Mørkved S, Salvesen K A, Helvik A-S. The effects of an exercise programme during pregnancy on health-related quality of life in pregnant women: a Norwegian randomised controlled trial.

The number of AAA operations in octogenarians has increased considerably during 20 years. Octogenarians operated electively for AAA has higher 30-day mortality as compared to younger patients. Their long-term survival appears similar to a matched control group. The benefit of surgery must be carefully considered against the perioperative risk, especially for the oldest octogenarians.

The higher BMI and larger waist of daughters of women with preeclampsia was only present if their mothers were obese. These results suggest that preeclampsia in obese women may lead to a distinct disadvantage in body size for their daughters in early puberty.

Patients younger than aged 40 years had a more advanced stage at the time of diagnosis and poor prognosis compared with older patients. Young patients treated for cure more often developed distant metastases and had inferior survival.

Although a slight increase in postoperative mortality, major rectal cancer surgery can be performed in very old patients. These patients had similar rates of local recurrence, distant metastasis and relative survival as younger patients.