Preoperative predictors for residual tumor after surgery in patients with ovarian carcinoma

Objectives: Suboptimal debulking (>1 cm residual tumor) results in poor survival rates for patients with an advanced stage of ovarian cancer. The purpose of this study was to develop a prediction model, based on simple preoperative parameters, for patients with an advanced stage of ovarian cancer who are at risk of suboptimal cytoreduction despite maximal surgical effort. Methods: Retrospective analysis of 187 consecutive patients with a suspected clinical diagnosis of advanced-stage ovarian cancer undergoing upfront debulking between January 1998 and December 2003. Preoperative parameters were Karnofsky performance status, ascites and serum concentrations of CA 125, hemoglobin, albumin, LDH and blood platelets. The main outcome parameter was residual tumor >1 cm. Univariate and multivariate logistic regression was employed for testing possible prediction models. A clinically applicable graphic model (nomogram) for this prediction was to be developed. Results: Serum concentrations of CA 125 and blood platelets in the group with residual tumor >1 cm were higher in comparison to the optimally cytoreduced group (p 1 cm based on serum levels of CA 125 and albumin was established. Conclusion: Postoperative residual tumor despite maximal surgical effort can be predicted by preoperative CA 125 and serum albumin levels. With a nomogram based on these two parameters, probability of postoperative residual tumor in each individual patient can be predicted. This proposed nomogram may be valuable in daily routine practice for counseling and to select treatment modality. Copyrigh

The effect of supplementation with docosahexaenoic and arachidonic acid derived from single cell oils on plasma and erythrocyte fatty acids of pregnant women in the second trimester

This study was performed to investigate whether supplementation of docosahexaenoic acid (DHA) and arachidonic acid (AA) to pregnant women would enhance their DHA levels, both in plasma and in erythrocyte phospholipids, without reducing the content of n-6 long-chain ployenes (LCP) usually seen when DHA is supplemented alone. Healthy pregnant women, in the second trimester, were randomly assigned to either the control group (n=12) or the intervention group (n=12). The control group received no supplements and the intervention group received daily during 4 weeks encapsulated algae-derived DHA oil (0.57 g DHA/day) and fungal-derived AA oil (0.26 g AA/day). The fatty acid compositions of plasma and erythrocyte phospholipids were determined in weekly-collected blood samples. DHA and n-6 LCP levels of the control group were unchanged after 4 weeks. Compared to the control group, DHA levels in plasma an erythrocytes of the intervention group increased significantly. No significant reductions were found in the levels of AA and total n-6 LCP. The supplement proved to be effective in increasing the DHA levels in both plasma and erythrocyte without a concomitant decline of the n-6 LCP

Relation between birth order and the maternal and neonatal docosahexaenoic acid status.

Department of Human Biology, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands. OBJECTIVE: To investigate whether succeeding pregnancies will affect the maternal and neonatal docosahexaenoic acid (DHA, 22:6n-3) status. DESIGN: Cross-sectional study. SUBJECTS: Women who were pregnant for the 1st to 7th time and took part in a longitudinal study to investigate the essential fatty acid status of pregnant women and their infants. The total study population comprised 98 primigravidae (PG) and 146 multigravidae (MG). MAIN OUTCOME MEASURES: Fatty acid profiles of phospholipids isolated from maternal plasma samples collected during pregnancy and after delivery, and of umbilical plasma, vein and artery, obtained immediately after birth. RESULTS: The absolute (mg/L) and relative (% of total fatty acids) amounts of DHA in maternal plasma phospholipids (PL) were significantly lower in MG than in PG. In addition, a significant negative correlation was observed between gravida number and the DHA content in maternal plasma samples. The DHA deficiency index (22:5n-6/22;4n-6) was significantly higher and the DHA sufficiency index (22:6n-3/22:5n-6) was significantly lower in umbilical plasma of infants born of MG than in that of infants born of PG. The relative DHA content of umbilical artery and vein vessel walls was significantly lower in MG- than in PG-neonates and significant negative associations were observed between birth order and the relative amounts of DHA in cord tissues. CONCLUSIONS: These results indicate that the maternal DHA status becomes reduced after each following pregnancy, which may result in a lower neonatal DHA status. Whether or not this has also functional consequences needs to be investigated further

The effect of different supplements containing docosahexaenoic acid on plasma and erythrocyte fatty acids of healthy non-pregnant women

To find an appropriate dietary supplement for pregnant women that would enhance their docosahexaenoic acid (DHA, 22:6n-3) status, without decreasing the n-6 long-chain polyenes (LCP) status, both in plasma and in erythrocyte phospholipids, a dose-finding study was performed in healthy non-pregnant women. Six groups of non-pregnant women received daily over a 4-week period one of the following supplements: tuna fish oil (0.266g/d or 0.532 g/d DHA), single cell-derived oils containing either DHA alone (0.285g/d or 0.570 g/d) or DHA and arachidonic acid (AA, 20:4n-6; 0.570 g/d DHA and 0.259 g/d AA). A control group received a placebo containing microcrystalline cellulose. Fatty acids were analyzed in plasma, and erythrocyte phospholipids of the blood samples collected weekly. After 4 weeks of supplementation, the levels of DHA and n-6 LCP of the control group were unchanged. In the other groups, the levels of DHA were significantly and dose-dependently increased as compared to those in the control group. Significant reductions were found in the levels of n-6 LCP, except in the group that received the mixture of DHA and AA enriched single cell oils. So, only this latter mixture was effective in increasing the levels of DHA and preventing an n-3 induced reduction in n-6 LCP. Whether this supplement effect will be the same in pregnant women needs further investigation

Early nutrition, essential fatty acid status and visual acuity of term infants at 7 months of age.

OBJECTIVE: In term infants the relationship between visual acuity and dietary fatty acid composition is not consistent, possibly due to confounders, which were mostly neglected in the studies concerned. In the current study, therefore, the influence of the essential fatty acid status and potential confounders on the visual acuity was investigated. DESIGN: The essential fatty acid status was determined at 7 months of age in red blood cell and plasma phospholipids of breastfed and formula-fed infants, born at term. Visual acuity was measured with Teller Acuity Cards. Information about potential confounding factors was obtained during an interview and with a retrospective questionnaire. RESULTS: This study, like others, showed that the concentrations of docosahexaenoic acid (DHA, 22:6n-3) are lower in plasma and red blood cell phospolipids of formula-fed infants compared to that of breastfed infants. However, no differences in visual acuity could be found between the two groups. Moreover, no significant relationship was found between the amounts of docosahexaenoic acid in plasma and red blood cell phospholipids and the visual acuity. Although dummy (pacifier) use showed a significant positive correlation with visual acuity, it did not influence the relationship between the essential fatty acids in the infant diet and visual acuity. There was also no confounding influence of smoking habits and alcohol use during pregnancy, socioeconomic background and other potential confounders. CONCLUSIONS: At 7 months of age no influence of fatty acid status, infant diet or potential confounders on visual acuity was found

Essential fatty acid status of pku patients

Phenylketonuric patients are on a special diet that lacks certain essential fatty acids. This study evaluates the essential fatty acid status of a group of phenylketonuric patients in the Netherlands undergoing dietary treatment. To this end, the essential fatty acid status of nine phenylketonuria patients was studied. On the basis of age and gender, two control subjects were selected for each patient. The essential fatty acid composition of duplicate food portions and the essential fatty acid status of plasma and erythrocytes were analyzed. Phenylketonuria subjects had a different essential fatty acid profile from their peers, especially concerning the n-3 fatty acids. N-6 and n-3 fatty long-chain polyenes were hardly consumed by phenylketonuria subjects, in contrast to the control subjects. Linoleic acid, on the other hand, was consumed in significantly higher amounts by phenylketonuria subjects and made up about 40% of their daily fat consumption. The essential fatty acid consumption pattern of the phenylketonuria subjects is mirrored by the essential fatty acid concentrations in blood. The essential fatty acid status of the phenylketonuric diet should be improved in order to prevent deficiency in n-3 fatty acids