scholarly journals The Ketogenic Effect of Medium-Chain Triacylglycerides

2021 ◽  
Vol 8 ◽  
Author(s):  
Ting-Yu Lin ◽  
Hung-Wen Liu ◽  
Tsung-Min Hung
Keyword(s):  
Side Effects ◽  
Capric Acid ◽  
Caffeine Intake ◽  
Medium Chain ◽  
Gastrointestinal Discomfort ◽  
Treatment Dose ◽  
Low Carbohydrate ◽  
Starting Dose ◽  
Fasting Duration ◽  
Practical Recommendations

Medium-chain triacylglycerides (MCTs) are dietary supplements that can induce ketosis without the need for a traditional ketogenic diet or prolonged fasting. They have the potential to marginally delay the progression of neurodegenerative diseases, such as Alzheimer's disease. However, there have been inconsistencies in reports of the MCT dose–response relationship, which may be due to differences in MCT composition, participant characteristics, and other factors that can influence ketone generation. To resolve these discrepancies, we reviewed studies that investigated the ketogenic effect of MCTs in healthy adults. Aside from the treatment dose, other factors that can influence the ketogenic response, such as accompanying meals, fasting duration, and caffeine intake, were assessed. Based on the available literature, four practical recommendations are made to optimize the ketogenic effect of MCTs and reduce unwanted side effects (primarily gastrointestinal discomfort and diarrhea). First, the starting dose should be either 5 g of octanoic acid [caprylic acid (C8); a component of MCTs] or 5 g of a combination of C8 and decanoic or capric acid (C10; another component of MCTs), and the dose should be progressively increased to 15–20 g of C8. Second, MCTs should be consumed after an overnight fast, without an accompanying meal if tolerable, or with a low-carbohydrate meal. Third, the addition of caffeine may slightly increase the ketogenic response. Fourth, emulsifying the MCTs might increase their ketogenic effect and alleviate side effects.

Study of a New Analgesic Compound in the Treatment of Tension Headache*

1976 ◽  
Vol 4 (1) ◽  
pp. 74-78 ◽  
Author(s):  
J Borges ◽  
C Zavaleta
Keyword(s):  
Side Effects ◽  
Pharmacological Activity ◽  
Clinical Success ◽  
Tension Headache ◽  
Symptomatic Treatment ◽  
Blind Study ◽  
Effective Combination ◽  
Significant Difference ◽  
Starting Dose ◽  
Single Blind

The effect of a new analgesic compound ( propoxyphene, acetaminophen, caffeine, hydroxyzine) was investigated in a single-blind study comparing it with plain acetaminophen administered to forty patients with tension headache. For the study, patients were assigned to one of two groups of twenty each. Starting dose for each group was one to two tablets followed by one tablet every four to six hours. The results show that 90% clinical success was obtained with the analgesic compound, while a 45% success was obtained with plain acetaminophen. This is a statistically significant difference. Side-effects observed with analgesic compound were primarily drowsiness and dizziness of mild intensity; acetaminophen caused gastro-intestinal alterations ( nausea, vomiting) and dizziness of greater severity. Therapy was withdrawn in 20% of patients taking acetaminophen because of side-effects. The dosage of analgesic compound required to control each episode of tension headache way smaller than that of acetaminophen. These results can be explained by a possible potentiation of pharmacological activity of the compound's components. It can be concluded that the analgesic compound is a new and effective combination for the symptomatic treatment of tension headache.

Comparison of the effectiveness of antibacterial therapy regimens in the treatment of asymptomatic bacteriuria during pregnancy

2018 ◽  
pp. 57-60
Author(s):  
T.G. Romanenko ◽  
◽  
O.M. Sulimenko ◽  
Keyword(s):  
Urinary Tract ◽  
Side Effects ◽  
Bacterial Infection ◽  
Asymptomatic Bacteriuria ◽  
Urine Specimen ◽  
Cultural Research ◽  
Group I ◽  
Group Ii ◽  
American Society ◽  
Practical Recommendations

The objective: to evaluate the effectiveness of the proposed therapy in pregnant women with asymptomatic bacteriuria. Materials and methods. All patients were divided into two groups. І group – 38 patients received the course of amoxicillin with clavulanic acid 625 mg per os twice a day for 7 days, group II – 33 patients received D-mannose (1.2 g), powder of 5.8 g in a sachet 2 times a day for 7 days. Diagnostic criteria for asymptomatic bacteriuria were based on practical recommendations of the American Society of Infectious Diseases. Results. In the first cultural research of the urine specimen (immediately after the end of the course of therapy), the percentage of microorganism’s persistence in the urinary tract of a woman was determined, in case of its detection, an additional course of treatment was prescribed. In the second and subsequent control urine samples, the percentage of relapsing bacteriuria was determined. Percentage of the persistence of the pathogen in the urinary tract among the treated women with bacteriuria remained rather low – 10.5% (4 patients) in group I, but higher than in group II 3.1% (1 patient). The percentage of sterile first urine sample was high and probably did not differ between groups – 31 (81.6%) and 32 (96.9%) women respectively in I and II groups. In the first group, the percentage of relapses during gestation after the diagnosed and treated bacteriuria remained rather high and amounted to 23.7% (9 patients), and in the second group, the relapse was not recorded. Conclusions. The 7-day course of therapy with the D-mannose drug is associated with fewer cases of persistent pathogenic pathogens in urine, no recurrence of bacterial infection, and no side effects. Key words: asymptomatic bacteriuria, D-mannose, urinary tract, pregnancy.

scholarly journals Practical aspects of etomidate use in the management of hypercortisolaemia

2012 ◽  
Vol 167 (5) ◽  
pp. 729 ◽  
Author(s):  
Veronica A Preda ◽  
Ashley B Grossman
Keyword(s):  
Side Effects ◽  
Propylene Glycol ◽  
Cushing’S Syndrome ◽  
Dose Regimen ◽  
Cushing's Syndrome ◽  
Ease Of Use ◽  
Recommended Dose ◽  
Lipid Formulation ◽  
Starting Dose

We appreciate the letter from of Dr Soh et al. regarding our review on the use of etomidate in the treatment of Cushing's syndrome. We note that in their experience, our recommended dose regimen of 2.5 mg/h or thereabouts appears to be a safe and effective starting dose in most patients, and we note the utility and ease of use of the lipid formulation and its relative freedom from side effects compared with the more commonly used propylene glycol formulation; these are very helpful comments. Their experience in treating a further four patients is indeed further evidence of the usefulness of this agent.

scholarly journals The Effect of Medium Chain Triglycerides on Time to Nutritional Ketosis and Symptoms of Keto-Induction in Healthy Adults: A Randomised Controlled Clinical Trial

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Cliff J. d C. Harvey ◽  
Grant M. Schofield ◽  
Micalla Williden ◽  
Joseph A. McQuillan
Keyword(s):  
Clinical Trial ◽  
Healthy Adults ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Medium Chain Triglycerides ◽  
Clinical Trial Registry ◽  
Medium Chain ◽  
Low Carbohydrate ◽  
Randomised Controlled ◽  
Beta Hydroxybutyrate

Medium chain triglycerides (MCTs) are ketogenic and might reduce adverse effects of keto-induction and improve time to ketosis and the tolerability of very low carbohydrate diets. This study investigates whether MCT supplementation improves time to nutritional ketosis (NK), mood, and symptoms of keto-induction. We compared changes in beta-hydroxybutyrate (BOHB), blood glucose, symptoms of keto-induction, and mood disturbance, in 28 healthy adults prescribed a ketogenic diet, randomised to receive either 30 ml of MCT, or sunflower oil as a control, three times per day, for 20 days. The primary outcome measured was the achievement of NK (≥0.5 mmol·L−1 BOHB). Participants also completed a daily Profile of Mood States and keto-induction symptom questionnaire. MCT resulted in higher BOHB at all time points and faster time to NK, a result that failed to reach significance. Symptoms of keto-induction resulted from both diets, with a greater magnitude in the control group, except for abdominal pain, which occurred with greater frequency and severity in the MCT-supplemented diet. There was a possibly beneficial effect on symptoms by MCT, but the effect on mood was unclear. Based on these results, MCTs increase BOHB compared with LCT and reduce symptoms of keto-induction. It is unclear whether MCTs significantly improve mood or time to NK. The trial was registered by the Australia New Zealand Clinical Trial Registry ACTRN12616001099415.

Risk of mineralocorticoid excess syndrome with CYP17 inhibitor abiraterone in prostate cancer patients.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15140-e15140
Author(s):  
Sandy Ann Itwaru ◽  
Arun Gopal ◽  
Omer Bashir ◽  
Joomee Shim ◽  
Xiaolei Zhu ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Clinical Trials ◽  
Side Effects ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Abiraterone Acetate ◽  
Fixed Effects Model ◽  
Starting Dose ◽  
Grade 3 ◽  
American Society

e15140 Background: CYP17 inhibitor abiraterone acetate has been used for the treatment of patients with metastatic castration-refractory prostate cancer (CRPC). Hypertension, hypokalemia and edema are the major side effects associated with its use, and may be secondary to the excess of mineralocorticoids due to CYP17 inhibition. We performed a systematic review and meta-analysis of published clinical trials to determine the effect of abiraterone on the development of these side effects. Methods: Databases including Pubmed (July, 1966 to July, 2011), Web of Science, and abstracts presented at the American Society of Clinical Oncology meetings from 2008 to 2011 were searched to identify relevant studies. Eligible studies were prospective clinical trials of patients with prostate cancer receiving abiraterone acetate at the starting dose of 1,000 mg daily with available data on hypertension, hypokalemia and edema. Incidence and relative risk (RR) were calculated using a random-effects or fixed-effects model. Results: A total of seven studies including 1,387 patients with CRPC were selected for analysis. The incidences of all-grade hypertension, hypokalemia, and edema were 13.3% (95% CI: 8.3 to 20.5%), 31.4 % (95% CI: 12.5-59.5%), and 23.4 % (95% CI: 15.6-33.5%) respectively. The incidences of high-grade (grade 3 and above) toxicity were low, with a rate of 3.6% (95% CI: 2.6-5.1%), 2.8 % (95% CI: 0.9 to 8.2%), and 2.1% (95%CI: 1.3-3.2%) for hypertension, hypokalemia, and edema respectively. The risk of hypertension and edema did not change with and without the addition of prednisone (p=0.48 and p=0.40, respectively); however, the risk of hypokalemia was significantly reduced with the addition of prednisone (p = 0.003). In comparison with prednisone alone, the addition of abiraterone did not increase the risk of hypertension (RR 1.22, 95% CI: 0.82 – 1.83, p=0.31), but significantly increased the risk of edema (RR 1.36, 95% CI: 1.10-1.69, p=0.004) and hypokalemia (RR 2.04, 95% CI: 1.42–2.92, p<0.001). Conclusions: There were differential effects of abiraterone on the development of hypertension, hypokalemia, and edema in patients with advanced prostate cancer. Further studies are recommended for optimal treatment.

N-Acetylcysteine’s Attenuation of Fatigue After Repeated Bouts of Intermittent Exercise: Practical Implications for Tournament Situations

2011 ◽  
Vol 21 (6) ◽  
pp. 451-461 ◽  
Author(s):  
James N. Cobley ◽  
Chris McGlory ◽  
James P. Morton ◽  
Graeme L. Close
Keyword(s):  
Side Effects ◽  
Muscle Fatigue ◽  
Intermittent Exercise ◽  
Adaptive Responses ◽  
Short Term ◽  
Treatment Dose ◽  
Gastrointestinal Side Effects ◽  
Matched Design ◽  
Over Time

Production of reactive oxygen species (ROS) during muscle contractions is associated with muscle fatigue and damage in the short term and adaptive responses in the long term. When adaptation is inconsequential acute antioxidant supplementation may be able to attenuate muscle fatigue and damage to enhance performance. This study aimed to determine the effects of acute oral N-acetylcysteine (NAC) supplementation on Yo-Yo Intermittent Recovery Test Level 1 (YIRT-L1) performance after repeated bouts of damaging intermittent exercise. In a pair-matched design, 12 recreationally trained men engaged in 6 d of either NAC (n = 6) or placebo (n = 6) supplementation. After a treatment-loading day, participants completed 3 testing sessions, on alternating days, consisting of a preexercise isokinetic dynamometry (IKD) test, a damaging intermittent-exercise protocol, YIRT-L1, and a postexercise IKD test. Another IKD test was completed on the 2 intervening d. NAC treatment resulted in a significant preservation of YIRT-L1 performance (p ≤ .0005). IKD performance significantly deteriorated over time at all contraction speeds, and this deterioration was not influenced by treatment group. Plasma creatine kinase values increased significantly over time (p = .002) and were significantly greater in the NAC group than in the placebo group (p = .029). NAC induced mild gastrointestinal side effects. NAC supplementation may be a useful strategy to enhance performance during short-term competitive situations when adaption is inconsequential. Titration studies to elucidate a treatment dose that enhances performance without inducing side effects are now required.

scholarly journals Medium-chain triglyceride supplementation under a low-carbohydrate formula is a promising therapy for adult-onset type II citrullinemia

2014 ◽  
Vol 1 ◽  
pp. 42-50 ◽  
Author(s):  
Kiyoshi Hayasaka ◽  
Chikahiko Numakura ◽  
Kentaro Toyota ◽  
Satoru Kakizaki ◽  
Hisayoshi Watanabe ◽  
...  
Keyword(s):  
Medium Chain Triglyceride ◽  
Type Ii ◽  
Adult Onset ◽  
Medium Chain ◽  
Onset Type ◽  
Low Carbohydrate

scholarly journals Metabolic Syndrome Risk Associated with Atypical Antipsychotic Medication: A Case Report

2021 ◽  
Vol 11 (1) ◽  
pp. 77-79
Author(s):  
Julaeha Julaeha ◽  
Umi Athiyah ◽  
Josephine P Ayuningtyas ◽  
Verra Yuliana ◽  
Andi Hermansyah
Keyword(s):  
Metabolic Syndrome ◽  
Side Effects ◽  
Atypical Antipsychotic ◽  
Atypical Antipsychotics ◽  
Lifestyle Modification ◽  
Screening Program ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Caffeine Intake ◽  
Lipid Abnormalities

People with schizophrenia are vulnerable group suffer from metabolic syndrome events. Atypical antipsychotics associated with weight gain, insulin resistance, and profile lipid abnormalities. The present case was 32-year-old man schizophrenia outpatient had experienced metabolic syndrome side effects. Metabolic syndrome characterized by central obesity, hyperglicemia, hypertriglyceridemia, low High Density Lipoprotein (HDL) cholesterol level, and several months feel an increase in appetite. Metabolic syndrome events might be associated with long-term atypical antipsychotics consuming and tobacco use. As pharmacists, We advised the patient to referral primary healthcare service for managing metabolic syndrome side effects. Pharmacists intervention through education and metabolic syndrome screening program have positive impacts on lifestyle modification such as decreasing number of cigarette consumption and caffeine intake, also increasing physical activity. Keywords: Antipsychotics, Atypical antipsychotic, Metabolic syndrome, Pharmacist, Schizophrenia.

scholarly journals Efficacy of different starting doses of methimazole (mercazolil) in the treatment of diffuse toxic goiter

1996 ◽  
Vol 42 (5) ◽  
pp. 20-23
Author(s):  
F. F. Burumkulova ◽  
G. A. Kotova ◽  
G. A. Gerasimov
Keyword(s):  
Side Effects ◽  
Iodine Deficiency ◽  
Free T4 ◽  
Prior Therapy ◽  
Starting Dose ◽  
Endocrine Ophthalmopathy ◽  
History Of ◽  
Group A ◽  
Group B ◽  
Toxic Goiter

The purpose of this study was to investigate the effects of two different starting doses of methimazole (MMI) on the clinical and biochemical characteristics of patients with Grave's disease and, specifically, to elucidate the effects of various independent factors on the efficacy of MMI. Sixty untreated hyperthyroid patients were enrolled in the trial. Forty-six cases were newly diagnosed, 6 patients presented with relapse following prior therapy or surgery. Eight patients previously treated with MMI in a dose of 30 mg had to interrupt the treatment because of grave side effects; in our study they were administered the drug in a dose of 15 mg. All patients were residents of Russia, living in areas with moderate and mild iodine deficiency; they were divided in two equal groups, A and В with the starting daily doses of 15 and 30 mg MMI, respectively. Free T4 levels in the serum were measured and clinical examinations carried out 3, 4, and 5 weeks after the beginning of MMI therapy. In group A, 86.7% (26/30) patients were euthyroid after 3 weeks and 100% after 4 weeks versus 93.3 (28/30) and 96.7% (29/30) in group B. The time of euthyroidism onset did not depend on the starting dose of the drug (3.130.11 weeks in group A vs. 3.100.12 weeks in group B). No correlation could be traced between the dose efficacy and patients' age, disease standing, size of the thyroid, or presence of endocrine ophthalmopathy. Euthyroidism was attained significantly earlier in group В in comparison with group В (3.00 vs. 4.40.3 weeks) only in patients with very high initial levels of free T4 (75 pmole/liter). There was only one case with minor complications in group A and two cases in group B. In addition, 8 patients in group A with a history of side effects of therapy with MMI in a dose of 30 mg were administered the drug in a dose reduced by half without adverse effects. Our data confirm the previous results that response to thyroid drugs depends mainly on the pretreatment free T4 levels. The majority of patients with Graves' disease from regions with iodine deficiency can be effectively controlled by small starting doses of MMI (e.g., 15 mg) with a lower risk of dose-dependent side effects.

scholarly journals Regulation of triacylglycerol biosynthesis in embryos and microsomal preparations from the developing seeds of Cuphea lanceolata

1990 ◽  
Vol 272 (1) ◽  
pp. 31-38 ◽  
Author(s):  
M Bafor ◽  
L Jonsson ◽  
A K Stobart ◽  
S Stymne
Keyword(s):  
Fatty Acid ◽  
Capric Acid ◽  
Decanoic Acid ◽  
Acyl Donor ◽  
Schematic Model ◽  
Acyl Acceptor ◽  
Medium Chain ◽  
Acyl Acceptors ◽  
Cuphea Lanceolata ◽  
Long Chain

Embryos of Cuphea lanceolata have more than 80 mol% of decanoic acid (‘capric acid’) in their triacylglycerols, while this fatty acid is virtually absent in phosphatidylcholine (PtdCho). Seed development was complete 25-27 days after pollination, with rapid triacylglycerol deposition occurring between 9 and 24 days. PtdCho amounts increased until day 15 after pollination. Analysis of embryo lipids showed that the diacylglycerol (DAG) pool consisted of mainly long-chain molecular species, with a very small amount of mixed medium-chain/long-chain glycerols. Almost 100% of the fatty acid at position sn-2 in triacylglycerols (TAG) was decanoic acid. When equimolar mixtures of [14C]decanoic and [14C]oleic acid were fed to whole detached embryos, over half of the radioactivity in the DAG resided in [14C]oleate, whereas [14C]decanoic acid accounted for 93% of the label in the TAG. Microsomal preparations from developing embryos at the mid-stage of TAG accumulation catalysed the acylation of [14C]glycerol 3-phosphate with either decanoyl-CoA or oleoyl-CoA, resulting in the formation of phosphatidic acid (PtdOH), DAG and TAG. Very little [14C]glycerol entered PtdCho. In combined incubations, with an equimolar supply of [14C]oleoyl-CoA and [14C]decanoyl-CoA in the presence of glycerol 3-phosphate, the synthesized PtdCho species consisted to 95% of didecanoic and dioleic species. The didecanoyl-glycerols were very selectively utilized over the dioleoylglycerols in the production of TAG. Substantial amounts of [14C]oleate, but not [14C]decanoate, entered PtdCho. The microsomal preparations of developing embryos were used to assess the acyl specificities of the acyl-CoA:sn-glycerol-3-phosphate acyltransferase (GPAT, EC 2.3.1.15) and the acyl-CoA:sn-1-acyl-glycerol-3-phosphate acyltransferase (LPAAT, EC 2.3.1.51) in Cuphea lanceolata embryos. The efficiency of acyl-CoA utilization by the GPAT was in the order decanoyl = dodecanoyl greater than linoleoyl greater than myristoyl = oleoyl greater than palmitoyl. Decanoyl-CoA was the only acyl donor to be utilized to any extent by the LPAAT when sn-decanoylglycerol 3-phosphate was the acyl acceptor. sn-1-Acylglycerol 3-phosphates with acyl groups shorter than 16 carbon atoms did not serve as acyl acceptors for long-chain (greater than or equal to 16 carbon atoms) acyl-CoA species. On the basis of the results obtained, we propose a schematic model for triacylglycerol assembly and PtdCho synthesis in a tissue specialized in the synthesis of high amounts of medium-chain fatty acids.

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