Body size in early life and risk of epithelial ovarian cancer: results from the Nurses' Health Studies.

Adult body mass index (BMI) has been associated with ovarian cancer risk, but few studies have examined body size earlier in life. We prospectively examined associations of body fatness at ages 5 and 10, BMI at age 18, height, and birthweight with risk of epithelial ovarian cancer in the Nurses' Health Study (NHS: 110 311 women, 735 cases) and Nurses' Health Study II (NHSII: 113 059 women, 137 cases). Cox proportional hazards regression was used to estimate relative risks (RRs) and 95% confidence intervals (CIs). There was a weak inverse association between average body fatness at ages 5 and 10 and risk in the NHS (RR for heaviest vs most lean=0.81, 95% CI: 0.53-1.24, P for trend=0.04) and a nonsignificant positive association in the NHSII (RR=2.09, 95% CI: 0.98-4.48, P for trend=0.10), possibly due to differences in age and menopausal status. Height was positively associated with risk in both cohorts (RR for >or=1.75 vs <1.6 m=1.43, 95% CI: 1.05-1.96, P for trend=0.001). Body mass index at the age of 18 years and birthweight were not associated with risk. Further research should examine the biological mechanisms underlying the observed associations.

Renal cortical necrosis in systemic lupus erythematosus.

A patient with active systemic lupus erythematosus had acute and irreversible renal failure after an uncomplicated cholecystectomy, and renal biopsy established the diagnosis of acute cortical necrosis. Patients with lupus have a diathesis for intravascular coagulation, and the interactive effects of immune complex or endotoxin-induced vascular injury, change in platelet dynamics, impairment of fibrinolysis, alterations in the mononuclear phagocytic system, and/or concomitant use of corticosteroids may have singularly or in combination been important in generating this rare renal complication of systemic lupus erythematosus in our patient.