No abstract

The purpose of the present study was to determine the time course of changes in in vitro lipolysis and in perilipin content (Western blot) in the mesenteric and/or the retroperitoneal fat depots in relation to the development of hepatic steatosis in high-fat diet-fed rats. Female Sprague-Dawley rats were submitted to a high-fat diet (HF diet; 42 % as kJ) or a standard diet (SD diet) for 1, 2, 3 or 8 weeks. Fat accretion in the mesenteric and retroperitoneal tissues was higher (P,0·01) in HF diet-fed than in SD diet-fed rats as soon as 1 week after the beginning of the diet. Liver triacylglycerol concentrations were significantly (P,0·01) higher in HF diet-fed than in SD diet-fed rats throughout the experiment, the highest values being reached at week 2 of the diet. Basal and stimulated lipolysis (10 24 to 10 27 M-isoproterienol) in the mesenteric and retroperitoneal fat depots was not changed during the first 3 weeks, regardless of the diet. Lipolysis in the mesenteric adipose tissue in the basal and stimulated states was, however, higher (P,0·01) in HF diet-fed than in SD diet-fed rats after 8 weeks of the diets. There were no significant (P.0·05) effects of diet and time on perilipin content of mesenteric tissue. In spite of a rapid fat accretion, the present results do not provide any evidence of a rapid (3 weeks) increase in in vitro lipolysis in intra-abdominal fat depots upon the undertaking of an HF diet at a time where liver lipid infiltration is the most significant.

No abstract

The introduction of biologic drugs and their expanding use over the last years have transformed the management of patients suffering from severe atopic diseases. Unfortunately, their very high cost also creates new challenges in terms of access and sustainability. This is a problem shared among all medical disciplines. In Europe, the 10 most prescribed biologics accounted for a combined cost of 16.5 billion Euros (14.8 billion USD). 1 In the USA in 2013, they were found to account for 40% of medication costs while representing only 2% of prescription. 2 To evaluate the value and justify coverage of new medications, industry and health technology agencies perform cost-utility analyses, which are the cornerstone of health economic assessment. 3-6 When used within their limits, they can be powerful tools to allow fair comparison of seemingly incomparable health states. Many clinicians feel they have insufficient training to properly interpret health economics studies. 7,8 This is paradoxical since clinicians are often in the best position to judge the credibility of baseline hypotheses, the appropriateness of treatment goals and the applicability to specific patient context and should in fact play a central role in the critical appraisal of such analyses. The objective of this review is to provide key notions to help allergists assess literature on health economics, review and compare available cost-utility studies on the use of biologic drugs in the field of allergy, and reflect on unmet needs and future directions in this area.

Because food allergy is associated with a rare but constant and plausible risk of life-threatening allergic reactions from accidental exposure to the food, the burden of the disease stems mainly from its impact on the quality of life of patients and their families. This has been shown repeatedly in both qualitative and quantitative studies. 1-6 Since strict avoidance of contact with the allergen is the current mainstay of treatment, there is a need for constant vigilance. 2 Fear of reaction is often a source of increased anxiety, social restrictions, and missed opportunities. 1-3,7 Social events such as family reunions, parties, eating at restaurant, sleepovers,