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Background: Patients with allergic bronchial asthma can develop various types of asthmatic response to bronchial challenge with allergens, such as immediate (IAR), late (LAR) or delayed (DYAR) response, due to different immunological mechanisms. Objective: The DYAR, beginning within 26- 32 h after the challenge, reaching its maximum between 32 and 48 h and resolving within 56 h (p < 0.001), differs from IAR and LAR regarding the clinical features, diagnostic and immunological parameters. Methods: The repeated DYAR (p < 0.001) in 28 patients was supplemented with recording of cytokine concentrations in the serum before and up to 72 h after the bronchial challenge by means of enzyme-linked immunoassay. Results: The DYAR was accompanied by a significant increase in the serum concentration (p < 0.05) of IL-2 at 24, 36 and 48 h; IL-10 at 12, 24, 36 and 48 h; IL-18 at 12 and 24 h; IFN-γ at 24, 36, 48 and 56 h; G-CSF at 1 and 12 h; TNF-α at 12, 36 and 48 h and TGF-β at 12 and 36 h, and a significant decrease in the concentration (p < 0.05) of IL-7 at 36 and 48 h and IL-12p70 at 12 h, as compared both with the prechallenge and with PBS control values. No significant changes in the serum cytokines were recorded during the PBS controls (p > 0.2). Conclusions: These results support the evidence for an active involvement of the Th1 cells, neutrophils, monocytes, macrophages, epithelial cells and endothelial cells, upon cooperation of other cell types, in the immunological mechanism(s) underlying the DYAR. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: In patients with allergic bronchial asthma, different immunologic mechanisms may participate and lead to different types of asthmatic response to allergen challenge, such as immediate/early (IAR/EAR), late (LAR) or delayed asthmatic response (DYAR). Objectives: In 55 of 397 asthmatics, DYAR has been recorded (p < 0.001) and confirmed by repeated bronchial challenge with the same allergen (p < 0.001). DYAR began between 26 and 32 h, reached a maximum between 32 and 48 h and resolved within 56 h after the challenge. DYAR was associated with various clinical symptoms and diagnostic parameters having diverged from those recorded during the IARs/EARs and LARs. Methods: In 25 of 55 patients, repeated DYAR has been supplemented with the recording of leukotriene B4 (LTB4), LTC4, LTE4, prostaglandin D2 (PGD2), PGE2, PGF2α, thromboxane B2, lipoxin A4, eosinophil cationic protein, eosinophil-derived neurotoxin/eosinophil protein X, eosinophilic peroxidase, myeloperoxidase, histamine and tryptase in peripheral blood, and of LTC4, thromboxane B2, eosinophil-derived neurotoxin and 9α,11β-PGF2 in urine, before and up to 72 h after the bronchial allergen challenge, by means of enzyme-linked immunoassay (ELISA/EIA) or ImmunoCAP. Results: DYAR was accompanied by a significant increase in the plasma concentrations of LTB4 (p < 0.05) and myeloperoxidase (p < 0.05) at 24, 36 and 48 h after the challenge, whereas the plasma/serum or urine concentrations of the other factors did not demonstrate any significant changes (p > 0.05). Conclusions: These results would indicate an active and prominent involvement of neutrophils, in addition to the previously demonstrated role of the Th1 lymphocytes, in the clinical DYAR. Copyright © 2011 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Improvement in treatment for patients with recurrent ovarian cancer is needed. Standard therapy in patients with platinum-sensitive recurrent ovarian cancer consists of platinum-based chemotherapy. Median overall survival is reported between 18 and 35 months. Currently, the role of surgery in recurrent ovarian cancer is not clear. In selective patients a survival benefit up to 62 months is reported for patients undergoing complete secondary cytoreductive surgery. Whether cytoreductive surgery in recurrent platinum-sensitive ovarian cancer is beneficial remains questionable due to the lack of level I-II evidence., Methods/design: Multicentre randomized controlled trial, including all nine gynecologic oncologic centres in the Netherlands and their affiliated hospitals. Eligible patients are women, with first recurrence of FIGO stage Ic-IV platinum-sensitive epithelial ovarian cancer, primary peritoneal cancer or fallopian tube cancer, who meet the inclusion criteria. Participants are randomized between the standard treatment consisting of at least six cycles of intravenous platinum based chemotherapy and the experimental treatment which consists of secondary cytoreductive surgery followed by at least six cycles of intravenous platinum based chemotherapy. Primary outcome measure is progression free survival. In total 230 patients will be randomized. Data will be analysed according to intention to treat., Discussion: Where the role of cytoreductive surgery is widely accepted in the initial treatment of ovarian cancer, its value in recurrent platinum-sensitive epithelial ovarian cancer has not been established so far. A better understanding of the benefits and patients selection criteria for secondary cytoreductive surgery has to be obtained. Therefore the 4th ovarian cancer consensus conference in 2010 stated that randomized controlled phase 3 trials evaluating the role of surgery in platinum-sensitive recurrent epithelial ovarian cancer are urgently needed. We present a recently started multicentre randomized controlled trial that will investigate the role of secondary cytoreductive surgery followed by chemotherapy will improve progression free survival in selected patients with first recurrence of platinum-sensitive epithelial ovarian cancer.

The fatty acids in the body fat of 41 British and 37 Dutch infants between birth and 1 year were determined. At birth linoleic acid contributed 1-3% of the total fatty acids of the body fat in infants in both countries. By one month its proportion in the fat of the Dutch infants was about 25% and by four months 32-37%; in the fat of the British infants it was never more than 3%. In the Dutch infants this large increase in the linoleic acid percentage was accompanied by a fall in the percentage contribution of others, particularly the saturated acids myristic, palmitic, and stearic. Infants born preterm showed changes in their fat after birth similar to those in fullterm infants. The difference between the composition of the fat of the infants in the two countries is attributed to the nature of the fat in the milk they received. Until recently most British infants who are not breast-fed have been given milks based on cow's milk with only minor modifications. For the past 10 years many Dutch infants have been given a milk in which all the cow's milk fat has been replaced by maize oil. Dutch infants also had a lower concentration of cholesterol in their serum than British infants, which was not unexpected. The results show that the triglycerides in the adipose tissue are profoundly influenced by the nature of the fat in the diet.