Vzácnou, ale závažnou komplikací léčby glifloziny je euglykemická ketoacidóza. Týká se téměř výlučně diabetiků 1. i 2. typu, u nediabetiků užívajících glifloziny se téměř nevyskytuje. Výraznější je riziko ketoacidózy v perioperačním období. Glifloziny by proto měly být 3–4 dny před plánovanou větší operací vysazeny. Před menší operací bez nutnosti lačnění lze glifloziny vynechat pouze den před operací a v den operace. U nechirurgických pacientů se zahájení i pokračování podávání gliflozinů během hospitalizace jeví jako bezpečné, pokud nejsou přítomny rizikové faktory, zejména protrahované lačnění. V případě intervencí spojených s lačněním, jako např. koloskopie či TAVI v celkové anestezii, je vhodné glifloziny 1–3 dny před intervencí vysadit. Při zjištění ketoacidózy je nutná její okamžitá léčba intravenózním inzulinem, až do vymizení ketolátek. Znovunasazení gliflozinů po léčbě ketoacidózy je bezpečné pouze v případě, že byl identifikován jednorázový odstranitelný rizikový faktor.

A rare but serious complication of the treatment with gliflozins is euglycemic ketoacidosis. It predominantly affects individuals with type 1 or type 2 diabetes. In non-diabetic patients taking gliflozin, the risk of ketoacidosis is minimal. The risk is more pronounced in the perioperative period. Therefore, gliflozin should be discontinued 3-4 days prior to the scheduled major surgery. In case of minor surgery without prolonged fasting, gliflozins can be discontinued only one day before and on the day of surgery. In non-surgical patients, the initiation and continuation of gliflozins during hospitalization appears to be safe, unless risk factors, especially prolonged fasting, are present. Prior to an interventional procedure requiring fasting, such as colonoscopy or TAVI under general anesthesia, it is recommended that gliflozins be discontinued 1-3 days ago. If ketoacidosis is diagnosed, immediate treatment with intravenous insulin is necessary until ketone bodies have dissipated. It is only safe to resume gliflozins after treatment of ketoacidosis if a removable risk factor has been identified.

• MeSH
• Diabetes Mellitus drug therapy   MeSH
• Diabetic Ketoacidosis * chemically induced   epidemiology   etiology   drug therapy   MeSH
• Sodium-Glucose Transporter 2 Inhibitors * adverse effects   therapeutic use   MeSH
• Inpatients MeSH
• Insulins administration & dosage   MeSH
• Humans MeSH
• Fasting MeSH
• Preoperative Care MeSH
• Risk Factors MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

Background: Intermittent fasting may be an effective tool for weight loss, but it is still unclear from previous studies to date whether it is as effective as a continuous energy restriction in terms of reducing adipose tissue and whether it leads to unwanted muscle loss. Objectives: The aim of this study was to compare the effect of intermittent fasting (IF) with continuous energy restriction (CER) on the body weight and body composition and to assess the effect of intermittent fasting also in isolation from the energy restriction. Methods: After completion of a three-week dietary intervention, differences in the weight loss and differences in the body composition were compared between three groups. The first group consumed 75% of their calculated energy intake requirements in a six-hour time window. The second group consumed 75% of their calculated energy intake requirements without a time window and the third group consumed 100% of their calculated energy intake requirements in a six-hour time window. The changes in the weight and body composition were assessed by BIA. Results: Of the 95 randomized participants, 75 completed the intervention phase of the study. The highest mean weight loss was achieved by the IF with ER (energy restriction) group (2.3 ± 1.4 kg), followed by the CER group (2.2 ± 1.1 kg); the difference between the groups did not reach statistical significance. The lowest mean weight loss was observed in the IF without ER group (1.1 ± 1.2 kg), the difference reaching statistical significance compared to the IF with ER (p=0.003) and CER (p=0.012) groups. The highest mean adipose tissue loss was observed in the CER group (1.5 ± 1.2 kg) followed by the IF with ER group (1.3 ± 1.1 kg), with no statistically significant differences between the groups. A mean adipose tissue loss was found in the IF without ER group (0.9 ± 1.1 kg) with no statistically significant differences compared to the IF with ER and CER groups. The highest mean fat-free mass loss was found in the IF with ER group (1.1 ± 1.0 kg), followed by the CER group (0.65 ± 0.91 kg) with no statistically significant differences. The IF without ER group showed the lowest mean fat-free mass loss (0.2 ± 1.3 kg), which reached statistical significance compared to the IF with ER group (p=0.027). Conclusion: The results showed a comparable effect in the weight loss and body fat reduction regardless of the timing of the food intake. The diet quality, together with the energy intake, appeared to be one of the most important factors influencing the body composition.

• MeSH
• Anthropometry MeSH
• Adult MeSH
• Energy Intake * physiology   MeSH
• Weight Loss * physiology   MeSH
• Body Mass Index MeSH
• Caloric Restriction * methods   MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Obesity diet therapy   physiopathology   MeSH
• Fasting * physiology   MeSH
• Intermittent Fasting MeSH
• Body Composition * physiology   MeSH
• Body Weight physiology   MeSH
• Adipose Tissue MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Randomized Controlled Trial MeSH

BACKGROUND AND AIMS: Prolonged fasting, which leads to the mobilization of fat from adipose tissue, can result in the development of hepatosteatosis. However, it is not yet known whether the accumulation of fat in the liver after fasting can be affected by concurrent obesity. Therefore, this study aimed to assess how excessive adiposity influences changes in liver fat content induced by fasting and subsequent refeeding. METHODS AND RESULTS: Ten lean women and eleven women with obesity (age: 36.4 ± 7.9 and 34.5 ± 7.9 years, BMI: 21.4 ± 1.7 and 34.5 ± 4.8 kg/m2) underwent a 60-h fasting period followed by 2 days of isocaloric high-carbohydrate refeeding. Magnetic resonance spectroscopy (MRS) examinations of liver were conducted at baseline, after 48 h of fasting, and at the end of refeeding period. Hepatic fat content (HFC) increased in lean women after fasting, whereas no statistically significant change in HFC was observed in women with obesity. Additionally, fasting led to significant reductions in liver volume in both groups, likely attributable to glycogen depletion, with subsequent restoration upon refeeding. Notably, changes in hepatic fat volume (HFV) rather than HFC inversely correlated with baseline liver fat content and HOMA-IR. CONCLUSION: We demonstrated that prolonged fasting results in accumulation of fat in the liver in lean subjects only and that this accumulation is inversely related to baseline fat content and insulin resistance. Moreover, the study underscored the importance of evaluating hepatic fat volume rather than hepatic fat content in studies that involve considerable changes in hepatic lean volume.

• MeSH
• Adiposity * MeSH
• Time Factors MeSH
• Dietary Carbohydrates administration & dosage   MeSH
• Adult MeSH
• Liver * metabolism   diagnostic imaging   MeSH
• Middle Aged MeSH
• Humans MeSH
• Obesity * physiopathology   therapy   metabolism   MeSH
• Fasting * MeSH
• Diet, Carbohydrate Loading adverse effects   MeSH
• Case-Control Studies MeSH
• Fatty Liver diagnostic imaging   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Comparative Study MeSH

INTRODUCTION: Food is a vital human need, and the human visual system is finely tuned to detect and respond to food cues in the environment. The omnipresence of food cues across various settings has been linked to the prevalence of obesity in susceptible populations. However, the influence of the post-prandial state on visual attention to food stimuli remains poorly understood. This study aimed to elucidate how a 12 hour fast affects visual attention to food and non-food stimuli in healthy, non-obese individuals. METHODS: Visual attention was assessed by measuring the total duration of visual fixations on stimuli presented on a computer screen, using a screen-based eye tracker (Tobii X2-60). Participants were divided into two groups: those who had fasted for 12 hours and those tested within two hours after consuming breakfast (satiated state). Additionally, performance on the Food Stroop task and electrodermal activity (EDA) responses were measured to evaluate attentional interference and physiological arousal, respectively. Salivary samples were also collected to assess levels of alpha-amylase and cortisol. RESULTS: Fasted participants exhibited a progressive decline in visual attention toward food stimuli compared to satiated individuals, reflecting a satiated state. This effect was independent of the palatability of the depicted food items and was not observed with stimuli representing non-food items. The Food Stroop task revealed no differences between fasting and satiated participants, indicating that the presence of food-related stimuli does not differentially impact attentional interference under varying hunger states. Moreover, no significant variations were observed in EDA responses across participant groups and stimulus types, suggesting that the modulation of visual attention to food cues by hunger is independent of physiological arousal. Interestingly, satiated subjects exhibited higher levels of salivary alpha-amylase, which was inversely related to their subjective hunger ratings. No differences in salivary cortisol levels were found between groups. DISCUSSION: The findings indicate a novel influence of mild hunger on the processing of visual food cues, independent of physiological arousal. The decline in visual attention to food stimuli in fasted individuals suggests that satiety modulates visual processing. The lack of differences in attentional interference and physiological arousal between fasting and satiated states further supports the notion that visual attention to food cues is primarily driven by hunger-related mechanisms rather than stress. Additionally, the inverse relationship between salivary alpha-amylase levels and hunger ratings implies that alpha-amylase may serve as a marker of satiety rather than stress.

• Publication type
• Journal Article MeSH

Leptin se produkuje v adipocytech a do regulačních neuronů v nucleus arcuatus hypotalamu přináší informaci o nutričním stavu organismu. Je klíčovou součástí homeostatického systému energetické rovnováhy. Deficit leptinu na podkladě patogenních variant LEP genu vede k rychle narůstající obezitě od prvních měsíců života a k pocitu neukojitelného hladu. Je provázen hyperinzulinemií, hypotyreózou, hypogonadotropním hypogonadismem a opožděným neuropsychickým a kognitivním vývojem. Často je narušena imunitní odpověď vlivem nižšího počtu a omezené proliferační schopnosti T lymfocytů. Většina dětí s deficitem leptinu trpí vážnými respiračními infekcemi s hypoxií, často potřebují hospitalizaci na jednotce intenzivní péče a 26 % z nich umírá v dětství. Léčba rekombinantním leptinem (metreleptinem) vede k ústupu obtíží. Druhou indikací podávání leptinu jsou lipodystrofické syndromy, u kterých leptin chybí v důsledku deficitu tukové tkáně. I tato onemocnění, pokud nejsou léčena, zkracují život v důsledku závažných metabolických komplikací.

Leptin is produced in adipocytes and transmits the information about nutritional status to regulation centers in hypothalamic arcuate nucleus. It represents a key component of the homeostatic system of energy balance. Leptin deficiency due to pathogenic variants of LEP gene manifests as progressive obesity since the first months of life and a constant perception of hunger. It is accompanied by hyperinsulinemia, hypothyroidism, hypogonadotropic hypogonadism and delayed neuropsychological and cognitive development. The immune response is being impaired due to low number and limited proliferation capacity of T lymphocytes. Majority of children with leptin deficiency suffer from severe respiratory tract infections with hypoxia. They require frequent hospitalization at intensive care units, and 26% die within childhood. Therapeutic administration of recombinant leptin (metreleptin) is effective in LEP gene defects as well as in lipodystrophic syndromes with low leptin due to the fat tissue deficiency. Even lipodystrophic syndromes if untreated, reduce the life expectancy due to their serious metabolic sequalae.

• MeSH
• Leptin * genetics   metabolism   deficiency   therapeutic use   MeSH
• Humans MeSH
• Lipodystrophy diagnosis   pathology   therapy   MeSH
• Infant, Newborn, Diseases MeSH
• Appetite Regulation MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

The bioavailability of rivaroxaban at the higher doses (15 and 20 mg) is considerably reduced when the drug is administered on an empty stomach. This can lead to inadequate anticoagulant effect, and therefore, it is recommended to use the higher doses at fed state. However, proper posology may represent a barrier for some patients. Therefore, the aim of this study was to evaluate innovative rivaroxaban-containing formulations designed to eliminate the food effect to ensure reliable absorption and thus to improve patient adherence with the treatment. Three prototypes (Cocrystal, HPMCP and Kollidon) with rivaroxaban were developed and their bioavailability and food effect in comparison to the reference product was tested in open label, randomized, single oral dose, crossover studies, where test products were administered under fasting and fed conditions and the reference product was administered under fed conditions. Comparable bioavailability for all tested prototypes both under fed and fasting conditions was demonstrated as the 90% confidence intervals of the geometric mean ratios for area under the concentration-time curve remained within the standard acceptance range of 80.00%-125.00%. An innovative immediate release form of rivaroxaban with no food effect on drug bioavailability has been developed, which may represent an important step toward increasing adherence, improving treatment outcome and reducing health care costs.

• MeSH
• Administration, Oral MeSH
• Biological Availability * MeSH
• Adult MeSH
• Factor Xa Inhibitors pharmacokinetics   administration & dosage   MeSH
• Food-Drug Interactions * MeSH
• Meals MeSH
• Cross-Over Studies * MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Fasting * MeSH
• Drug Compounding methods   MeSH
• Rivaroxaban * pharmacokinetics   administration & dosage   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Randomized Controlled Trial MeSH

AIMS: Abiraterone treatment requires regular drug intake under fasting conditions due to pronounced food effect, which may impact patient adherence. The aim of this prospective study was to evaluate adherence to abiraterone treatment in patients with prostate cancer. To achieve this aim, an abiraterone population pharmacokinetic model was developed and patients' adherence has been estimated by comparison of measured levels of abiraterone with population model-based simulations. METHODS: A total of 1469 abiraterone plasma levels from 83 healthy volunteers collected in a bioequivalence study were analysed using a nonlinear mixed-effects model. Monte Carlo simulation was used to describe the theoretical distribution of abiraterone pharmacokinetic profiles at a dose of 1000 mg once daily. Adherence of 36 prostate cancer patients treated with abiraterone was then evaluated by comparing the real abiraterone concentration measured in each patient during follow-up visit with the theoretical distribution of profiles based on simulations. Patients whose abiraterone levels were ˂5th or ˃95th percentile of the distribution of simulated profiles were considered to be non-adherent. RESULTS: Based on this evaluation, 13 patients (36%) have been classified as non-adherent. We observed significant association (P = .0361) between richness of the breakfast and rate of non-adherence. Adherent patients reported significantly better overall condition in self-assessments (P = .0384). A trend towards a higher occurrence of adverse effects in non-adherent patients was observed. CONCLUSIONS: We developed an abiraterone population pharmacokinetic model and proposed an advanced approach to medical adherence evaluation. Due to the need for administration under fasting conditions, abiraterone therapy is associated with a relatively high rate of non-adherence.

• MeSH
• Medication Adherence * statistics & numerical data   MeSH
• Androstenes * pharmacokinetics   administration & dosage   therapeutic use   MeSH
• Models, Biological * MeSH
• Adult MeSH
• Food-Drug Interactions MeSH
• Middle Aged MeSH
• Humans MeSH
• Monte Carlo Method MeSH
• Prostatic Neoplasms * drug therapy   MeSH
• Fasting MeSH
• Prospective Studies MeSH
• Antineoplastic Agents pharmacokinetics   administration & dosage   MeSH
• Aged MeSH
• Therapeutic Equivalency MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Publication type
• Journal Article MeSH

Chuť i míra hladu, ale i rychlost metabolizmu jsou geneticky determinovány a regulace probíhá na třech úrovních v mozku a také ve střevě, a to pomocí střevních hormonů a neuromodulátorů. Hubnutí není fyziologický proces, tělo je nastaveno tak, že bychom měli neustále přibírat až na hmotnost, která je nám zřejmě geneticky předurčena. Poslední roky se objevují nové moderní a velmi bezpečné léky na hubnutí a na léčbu obezity jako nemoci. Začíná převládat názor, že obezitu je třeba léčit doživotně, za pomoci nejen změny životního stylu, ale také za použití léků nebo postupů bariatrické chirurgie.

Appetite and hunger, as well as metabolic rate, are genetically determined and regulated at three levels in the brain and also in the bowel by bowel hormones and neuromodulators. Weight loss is not a physiological process, the body is set up to enable continuous weigh gaining up to the weight that is probably genetically predetermined for us. In recent years, new modern and very safe drugs are emerging for weight loss and for treating obesity as a disease. The opinion that obesity should be treated for life, not only with lifestyle changes but also with drugs or bariatric surgery procedures, is becoming predominant.

• MeSH
• Bupropion therapeutic use   MeSH
• Phentermine therapeutic use   MeSH
• Glucagon-Like Peptide 1 therapeutic use   MeSH
• Anti-Obesity Agents administration & dosage   therapeutic use   MeSH
• Liraglutide therapeutic use   MeSH
• Overweight etiology   drug therapy   genetics   psychology   therapy   MeSH
• Naltrexone therapeutic use   MeSH
• Obesity etiology   drug therapy   genetics   psychology   therapy   MeSH
• Orlistat therapeutic use   MeSH

This study examines whether exposure to ambient temperature in nineteenth-century urban space affected the ratio of boys to girls at birth. Furthermore, we investigate the details of temperature effects timing upon sex ratio at birth. The research included 66,009 individual births, aggregated in subsequent months of births for the years 1847-1900, i.e. 33,922 boys and 32,087 girls. The statistical modelling of the probability of a girl being born is based on logistic GAM with penalized splines and automatically selected complexity. Our research emphasizes the significant effect of temperature in the year of conception: the higher the temperature was, the smaller probability of a girl being born was observed. There were also several significant temperature lags before conception and during pregnancy. Our findings indicate that in the past, ambient temperature, similar to psychological stress, hunger, malnutrition, and social and economic factors, influenced the viability of a foetus. Research on the effects of climate on the sex ratio in historical populations may allow for a better understanding of the relationship between environmental factors and reproduction, especially concerning historical populations since due to some cultural limitations, they were more prone to stronger environmental stressors than currently.

• MeSH
• History, 19th Century MeSH
• History, 20th Century MeSH
• Humans MeSH
• Urban Population * MeSH
• Infant, Newborn MeSH
• Sex Ratio * MeSH
• Parturition MeSH
• Pregnancy MeSH
• Temperature * MeSH
• Cities MeSH
• Check Tag
• History, 19th Century MeSH
• History, 20th Century MeSH
• Humans MeSH
• Male MeSH
• Infant, Newborn MeSH
• Pregnancy MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Historical Article MeSH
• Geographicals
• Cities MeSH

BACKGROUND: Feeding the world's future population while still facing a variety of socioeconomic and climate change scenarios with uncertain outcomes is a key global societal concern that should be addressed in a science-based manner. Ethiopia boasts a great diversity of wild edible plant species (WEPS), but millions of its citizens still suffer from chronic hunger every year. In this context, we here document the use and conservation of WEPS in the Awi Agäw community, Northwestern Ethiopia. METHODS: We performed a cross-sectional study from October 2021 to June 2022. Ethnobotanical and conservation status data were collected via semi-structured interviews, focus group discussions, field walks and market surveys. A total of 374 respondents from three districts (Guangua, Jawi and Ankasha) were purposely selected for the study. Descriptive statistics, including preference rankings, frequencies and direct matrix rankings, were employed for the data analysis. RESULTS: We identified a total of 39 WEPS plant taxa distributed among 26 families and 32 genera. The Moraceae and Rosaceae had the greatest numbers of plants, with five and three species, respectively. The WEPS are regularly consumed in the study area to alleviate hunger. However, threats such as habitat loss, agricultural expansion, deforestation for firewood and other reasons, and pesticide use threaten WEPS availability. CONCLUSION: Therefore, community-based conservation interventions need to be encouraged to safeguard WEPS and associated traditional knowledge. Furthermore, nutritional quality analysis is recommended for the selection of promising WEPS candidates.

• MeSH
• Adult MeSH
• Ethnobotany * MeSH
• Plants, Edible * MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Cross-Sectional Studies MeSH
• Aged MeSH
• Conservation of Natural Resources * MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Ethiopia MeSH