Use of routinely available clinical, nutritional, and functional criteria to classify cachexia in advanced cancer patients.

Background: Cachexia is a highly prevalent syndrome in cancer and chronic diseases. However, due to the heterogeneous features of cancer cachexia, its identification and classification challenge clinical practitioners.

Objective: To determine the clinical relevance of a cancer cachexia classification system in advanced cancer patients.

Use of prediction equations to determine the accuracy of whole-body fat and fat-free mass and appendicular skeletal muscle mass measurements from a single abdominal image using computed tomography in advanced cancer patients.

Measurements of body composition using dual-energy X-ray absorptiometry (DXA) and single abdominal images from computed tomography (CT) in advanced cancer patients (ACP) have important diagnostic and prognostic value. The question arises as to whether CT scans can serve as surrogates for DXA in terms of whole-body fat-free mass (FFM), whole-body fat mass (FM), and appendicular skeletal muscle (ASM) mass. Predictive equations to estimate body composition for ACP from CT images have been proposed (Mourtzakis et al.

Determining the precision of dual energy x-ray absorptiometry and bioelectric impedance spectroscopy in the assessment of breast cancer-related lymphedema.

Background: The composition of breast cancer-related lymphedema (BCRL) has been shown to evolve from the initial accumulation of fluid to the development of fibrotic lesions and abnormal fat deposition. Therefore, precise and reliable assessments of BCRL are required to develop accurate staging and management. Although dual energy x-ray absorptiometry (DXA) and bioelectric impedance spectroscopy (BIS) have been used to assess BCRL, no study has evaluated the precision of these two modalities in the same cohort.

Estimation of total-body and regional soft tissue composition from DXA bone densitometry of the lumbar spine and hip.

The percent fat in soft tissues adjacent to the lumbar spine and proximal femur, which are required parameters in the calculation of bone mineral by conventional dual-energy X-ray absorptiometry (DXA) of the spine and hip, were analyzed for their relationship with the total-body soft tissue-scanning derivatives. The cohort (N=149), consisting of stable actively treated male human immunodeficiency virus HIV-positive patients, was split in half to obtain prediction equations with one half to be validated by the other half. Prediction equations for the dependent variables total-body fat, total-body lean mass, trunk fat, total arm + leg fat, and leg fat were derived by step-down multiple regression.

[A fractured kidney, an unexpected sequela of a remote lumbar trauma].

A 40-year old man is evaluated for arterial hypertension of one's year duration, which responded well to salt restriction and mild antihypertensive medication. The standard investigation for possible secondary hypertension is negative. In view of a remote history of left renal trauma, it is decided to do an angiogram, which reveals the presence of a fractured left kidney.

Precision and reliability of strength (Jamar vs. Biodex handgrip) and body composition (dual-energy X-ray absorptiometry vs. bioimpedance analysis) measurements in advanced cancer patients.

Important deteriorations in body composition and strength occur and need to be accurately measured in advanced cancer patients (ACPs). The aim of this study was to establish the relationship between a single-frequency bioimpedance analyzer (BIA) and the dual-energy X-ray absorptiometer (DXA), as well as the Jamar handgrip dynometer and the Biodex handgrip attachment, and to determine the precision of each of these instruments in ACPs. Eighty-one ACPs with non-small-cell lung cancer and gastrointestinal cancer were recruited from the McGill University Health Centre (Montreal, Que.

Bone mineral and soft-tissue changes in AIDS-associated lipoatrophy.

It is well established that body weight influences bone mass, but there is considerable controversy in the literature as to whether the principal determinant is lean mass, fat mass, or combinations of both, with variable degrees of relative influence as a function of age and sex. Total body and regional tissue composition studies were performed with DXA in a cohort of 102 HIV+ males who were on highly active antiretroviral therapy. These medications may be associated with a unique peripheral lipoatrophy without commensurate loss of lean tissue mass, and thereby provide an opportunity to assess the relative influence of fat mass on BMC levels in the absence of lean mass change.

Range of change of measured BMD in the femoral neck and total hip with rotation in women.

To obtain a quantitative assessment of the range of variation of bone mineral density (BMD) measurements in the femoral neck and total hip with rotation of the hip, 200 women, ages 21-86 years, were scanned by DXA in the neutral position and with 25% internal rotation of the leg. The difference in BMDs (neutral minus internal rotation) was > or =0 in about 65% of the patients, whereas the remaining 35% were <0. In terms of absolute change, the femoral neck median BMD of 0.