Fatty Meal Research Articles

Rare Case Reports on Ectopic Liver Tissue: Incidence, Surgical Management, and Outcomes

Introduction and importance: Ectopic liver tissue is a rare finding, often discovered incidentally during procedures like cholecystectomy. Understanding its clinical implications, including potential malignancy and complications, is crucial for effective management and improving patient outcomes. Case presentation: A 45-year-old female presented with six months of biliary colic, worsened by fatty meals. Preoperative ultrasound revealed a gallbladder with microcalculi. During elective laparoscopic cholecystectomy, a brownish tissue fragment resembling hepatic parenchyma was found on the gallbladder fundus and removed. Histopathology confirmed ectopic liver tissue with mild steatosis and no malignancy. Clinical discussion: Ectopic liver tissue, with a prevalence of 0.47%, typically attaches to the gallbladder but can also be found in other abdominal and thoracic locations. It may be linked to congenital malformations and has a risk of degeneration into malignancy due to its incomplete vascular and ductal system. Diagnosis is usually incidental during surgery, and en-bloc removal is advised to prevent complications and potential neoplastic transformation. Identifying its vascular supply before dissection is crucial to avoid severe bleeding. Conclusion: Ectopic liver tissue, despite its rarity, requires careful management due to its potential for malignancy and complications. Timely detection and en-bloc removal are vital to prevent adverse outcomes and ensure optimal patient care.

A randomized controlled cross-over trial investigating the acute inflammatory and metabolic response after meals based on red meat, fatty fish, or soy protein: the postprandial inflammation in rheumatoid arthritis (PIRA) trial.

Rheumatoid Arthritis (RA) has a point prevalence of around 20million people worldwide. Patients with RA often believe that food intake affects disease activity, and that intake of red meat aggravate symptoms. The main objective of the Postprandial Inflammation in Rheumatoid Arthritis (PIRA) trial was to assess whether postprandial inflammation and serum lipid profile are affected differently by a meal including red meat, fatty fish, or a soy protein (vegan) meal. Using a randomized controlled crossover design, 25 patients were assigned to eat isocaloric hamburger meals consisting of red meat (60% beef, 40% pork), fatty fish (salmon), or soy protein for breakfast. Blood samples were taken before meals and at intervals up to 5h postprandial. The analysis included the inflammation marker interleukin 6 (IL-6) and serum lipids. No significant differences in postprandial IL-6 or triglyceride concentrations were found between meals. However, the area under the curve of very low density lipoprotein (VLDL) particle counts, as well as VLDL-4-bound cholesterol, triglycerides, and phospholipids, was higher after the fatty fish compared to both red meat and soy protein. Postprandial inflammation assessed by IL-6 did not indicate any acute negative effects of red meat intake compared to fatty fish- or soy protein in patients with RA. The fatty fish meal resulted in a higher number of VLDL-particles and more lipids in the form of small VLDL particles compared to the other protein sources.

Immunocompetent cells differential response under a fatty meal

Immunocompetent cells differential response under a fatty meal

Developing Self-Nanoemulsifying Drug Delivery Systems Comprising an Artemether-Lumefantrine Fixed-Dose Combination to Treat Malaria.

Despite attempts to control malaria, poor drug bioavailability means malaria still places enormous pressure on health globally. It has been found that the solubility of highly lipophilic compounds can be enhanced through lipid formulations, e.g., self-emulsifying drug delivery systems (SEDDSs). Thus, quality-by-design and characterization were used to justify the development and determine the feasibility of oral oil-in-water SEDDSs comprising a fixed-dose combination (FDC) of artemether-lumefantrine to treat malaria more effectively without the aid of a fatty meal. These formulations were compared to a commercial product containing the same active compounds. Excipient compatibility and spontaneous emulsification capacity of different FDC-excipient combinations were identified by employing isothermal microcalorimetry, solubility, and water titration tests. Pseudoternary phase diagrams were constructed, and checkpoint formulations were selected within the self-emulsification region by reviewing formulation properties essential for optimized drug delivery. SEDDSs capable of enduring phase separation within 24 h were subjected to characterization experiments, i.e., drug concentration determination, cloud point, droplet size, size distribution, self-emulsification time, self-emulsification efficacy, viscosity, zeta potential, and thermodynamic stability analysis. SEDDSs with favorable characteristics were identified in the micro or nano range (SNEDDSs) before being subjected to drug release studies. All final formulations depicted enhanced artemether and lumefantrine release compared to the commercial product, which could not release lumefantrine at a quantifiable concentration in this study. The avocado oil (AVO)4:6 and olive oil (OLV)3:7 SNEDDSs overall portrayed the ideal characteristics and depicted the highest percentage of drug release. This study offers evidence that SNEDDSs from selected natural oils comprising an artemether-lumefantrine FDC can potentially enhance the bioavailability of these lipophilic drugs.

Chronic sleep deprivation, noise and high fat diet markedly induce C-reactive protein level in mice model

Background: C-reactive protein (CRP) is a circulating sign of systemic chronic inflammation that your liver produces if your body is inflamed. Stressful events over a long period of time are linked to inflammatory disorders. Stress pathways are triggered by noise and sleep deprivation, as well as unhealthy habits like fatty meals. Several studies have connected higher CRP levels with plasma levels. The current study aims to explore the potential association’s relationship between chronic sleep deprivation, noise, high fat diet, and CRP disorders.Methods: Three studies were carried out in our study to evaluate C-reactive protein levels in male Swiss albino mice groups after exposure to three different physical stressors for four weeks. The first study mice group were exposed to chronic sleep deprivation; second group was exposed to electrostatic speaker noise stressors; and the third group was fed a high fat diet. Quantitative estimation of C – reactive protein level in plasma using an ELISA kit.Results: Significant changes in inflammatory CRP levels in the examined plasma were detected in the sleep deprivation group. CRP levels were found to be steadily increasing after two weeks, reaching a significant peak in the fourth week (p < 0.001). Moreover, in the fourth week, there were substantial increases in CRP plasma level with independent evidence, in the experimental noise group (p < 0.001). As well, the biomarker of inflammation level increased across the dietary high density fat diet, reaching the highest level at the end of the study (p < 0.05).Conclusion: Our findings contribute to the body of evidence indicating a link between external stress and subclinical inflammatory markers. Furthermore, CRP concentrations are triggered by chronic sleep deprivation and noise exposure, and their concentrations rise with prolonged dietary fatty acid consumption.Keywords: Sleep deprivation; Noise; High fat diet; Inflammation; CRP

More Health Risks in Fatty and Fried Meals

Abstract not available. Eastern Med Coll J. July 2023; 8 (2): viii-ix

Agenesis of the right lobe of the liver: a case report

IntroductionAgenesis of the right hepatic lobe is a rare congenital anomaly. Developmental anomalies of the right lobe of the liver were first reported in 1870 by Heller [6]. Anatomical variations of the liver are common, occur during the normal development of the organ, and correspond to variations in the distribution of liver territories. Agenesis of the right lobe of the liver is an incidental finding revealed by the popularization of ultrasonography, computed tomography, or magnetic resonance imaging due to the condition being asymptomatic.Case presentationA 35-year-old Ethiopian female patient presented to the outpatient clinic with a complaint of right upper abdominal pain for 1 year, along with symptoms of fatty meal intolerance and long-standing epigastric burning pain. Her examination was unremarkable, and imaging investigations were suggestive of right hepatic lobe agenesis with multiple gallstones. Therefore, the patient was operated on and discharged with no perioperative complications.ConclusionSurgical understanding of such anatomical anomalies is necessary for surgical planning, the appropriate interpretation of intraoperative surgical findings, and the design of postoperative therapy. Here we report a case of right hepatic lobe agenesis with cholelithiasis and cholidocholithiasis and a brief review of right lobe agenesis in the literature.

An update on approved and emerging drugs for the treatment of postpartum depression.

<p>Depression, anxiety and psychotic disorders are common perinatal mental health disorders in the postpartum period. Depressive symptoms that occur postpartum are also present in the prenatal period in 50% of patients. Risk factors for the development of postpartum depression include poor relationship with the partner, lack of social support, mother&rsquo;s low socioeconomic status and multiparity. It has been determined that reproductive hormones change significantly during peripartum. Progesterone is one of these hormones and acts on the central nervous system starting from the fetal period; neurogenesis, neuromodulation, sedation are some of these effects. It has also been observed that progesterone has positive effects on learning, memory and mood. Progesterone exerts its effects on the central nervous system by converting into its metabolite allopregnanolone. Allopregnanolone is one of the neuroactive steroids, and found in similar amounts in the circulation of pregnant women and fetuses. It acts on synaptic and extrasynaptic &gamma;-aminobutyric acid type A (GABAA) receptors and is a positive allosteric modulator of the GABAA receptor. Allopregnanolone increases both the receptor&rsquo;s opening frequency and its open duration and improves GABAergic current. Low serum allopregnanolone levels in the second trimester are predictive of postpartum depression. Each 1 ng/mL increase in serum allopregnanolone level reduces the risk of development of postpartum depression by 63%. Brexanolone and zuranolone are synthetic allopregnanolone preparations approved by the FDA for use in female patients with postpartum depression. They act via positive allosteric modulation on the GABAA receptor. Brexanolone is administered via intravenous infusion at varying infusion rates in a healthcare facility over 60 hours. Its effect starts immediately after treatment and continues until the 30th day of follow-up, and depressive mood does not recur. Zuranolone was developed for oral use, and administered as a single dose of 50 mg after a fatty meal. Their effectiveness has been demonstrated in patients with treatment-resistant depression. The development of other novel agents that act on the GABAA receptor and other pathways for the treatment of postpartum depression is in progress.</p>.

Use of a Fatty Meal Cholecystagogue Protocol in Hepatobiliary Scintigraphy for Chronic Functional Gallbladder Disease.

Chronic functional gallbladder disorder, characterized by biliary pain in the absence of structural pathology, poses a diagnostic challenge necessitating reliable cholecystagogues for accurate evaluation. However, recurrent shortages of synthetic cholecystokinin analogs have prompted the exploration of alternative agents. This paper describes the efficacy of Ensure Plus as a viable fatty meal substitute for hepatobiliary scintigraphy in assessing chronic functional gallbladder disorder. Through comparative studies, Ensure Plus demonstrates comparable diagnostic accuracy to cholecystokinin in similar patient populations. Furthermore, Ensure Plus demonstrates significant symptom improvement after cholecystectomy in patients with anomalous gallbladder ejection fractions. This paper offers a detailed protocol for the seamless integration of Ensure Plus into hepatobiliary scintigraphy, providing clinicians with a valuable tool to navigate cholecystokinin shortages while maintaining diagnostic precision in cases of chronic functional gallbladder disorder. The use of Ensure Plus not only addresses practical supply challenges but also underscores its potential as a cost-effective and clinically sound alternative in biliary diagnostics.

Fatty Meal Hepatobiliary Scintigraphy for Gallbladder Ejection Fraction Determination.

Fatty Meal Hepatobiliary Scintigraphy for Gallbladder Ejection Fraction Determination.

Immediate-release niacin and a monounsaturated fatty acid-rich meal on postprandial inflammation and monocyte characteristics in men with metabolic syndrome

When considered separately, long-term immediate-release niacin and fatty meals enriched in monounsaturated fatty acids (MUFA) decrease postprandial triglycerides, but their effects on postprandial inflammation, which is common in individuals with metabolic syndrome, are less known. Moreover, successful combination is lacking and its impact on acute disorders of the innate immune cells in the metabolic syndrome remains unclear. Here, we aimed to establish the effects from combination with niacin of different fats [butter, enriched in saturated fatty acids (SFA), olive oil, enriched in MUFA, and olive oil supplemented with eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids] on plasma inflammatory markers and circulating monocyte subsets, activation and priming at the postprandial period in individuals with metabolic syndrome. A random-order within-subject crossover experiment was performed, in which 16 individuals with metabolic syndrome and 16 age-matched healthy volunteers took 2g immediate-release niacin together with the corresponding fatty meal or a meal with no fat as control. In total, 128 postprandial curves were analysed. We sampled hourly over 6h for plasma concentrations of soluble inflammatory markers and triglycerides. Circulating monocyte subsets (CD14/CD16 balance), activation (CCL2/CCR2 axis) and priming (M1/M2-like phenotype) at the time of postprandial hypertriglyceridemic peak were also addressed. Dietary SFA (combined with niacin) promote postprandial excursions of circulating IL-6, IL-1β, TNF-α and CD14/CCR2-rich monocytes with a pro-inflammatory M1-like phenotype, particularly in individuals with metabolic syndrome. In contrast, dietary MUFA (combined with niacin) postprandially increased circulating CD16-rich monocytes with an anti-inflammatory M2-like phenotype. Omega-3 PUFA did not add to the effects of MUFA. The co-administration of a single-dose of immediate-release niacin with a fatty meal rich in MUFA, in contrast to SFA, suppresses postprandial inflammation at the levels of both secretory profile and monocyte response in individuals with metabolic syndrome. These findings highlight a potential role of combining niacin and dietary MUFA for the homeostatic control of inflammation and the innate immune system, identifying a new search direction for the management of disorders associated with the metabolic syndrome.

Bioconversion of olive oil pomace by black soldier fly increases eco-efficiency in solid waste stream reduction producing tailored value-added insect meals.

Olive oil is one of the most important agricultural products in Mediterranean areas, and currently the European Union is the largest producer. Due to technological innovations, Portugal has become one of the main olive oil producing countries over the last few years, accompanied by large amounts of olive oil pomace (OOP), the most representative residue of the olive oil extraction process. This is causing serious waste management problems since current management solutions also present environmental impacts. Here we explored the black soldier fly (Hermetia illucens) potential to biotransform OOP into valuable insect meals by feeding them OOP-based diets as substrates. Results show that despite survival rates not being affected by higher replacement (75% and 50%) levels of OOP, there was an increase in larval instar duration. Substrate reduction was significantly lower for higher replacement levels but was not affected up to the 50% replacement level. Feed conversion rate differed among all the treatments, increasing as the replacement level increased, while bioconversion rate, which also differed among all the treatments, decreased as replacement level increased. Differences in larval protein content were only seen at higher replacement levels (75%), with an increase in protein content for replacements of up to 25%. One of the most striking results was the change in fatty acid profile, which became more abundant in monounsaturated fatty acids (mostly oleic acid) as the olive pomace replacement levels increased in comparison with the control substrate, rich in saturated fatty acids (palmitic acid). These results show that BSF can be an effective OOP bioconversion agent, and resulting insect meals can be used as alternatives to currently available saturated fatty acid insect meals.

Protein preparations from rapse processing waste: A review of the current status and development prospects of existing technologies

The demand for protein products is increasing due to the demographic growth of the world’s population. As an alternative to traditional sources of protein, waste from plant raw material processing is becoming increasingly popular. An important place in the global economy is occupied by oilseeds, in particular rapeseed, which production volumes are increasing in the Russian Federation every year. Rapeseed (Brassicaceae napus) is of great interest due to its high oil content (39.80–46.00%) and rich fatty acid composition, while cake and meal formed in the process of oil production are characterized by a significant content of crude protein (35.00–45.00%) and crude fiber (8.20–17.50%); however, they are used mainly as a feed additive. Recent studies on the processing of rapeseed waste indicate the value of this raw material as a source of dietary protein, which has a balanced amino acid profile and a high degree of digestibility (up to 85%). To obtain protein, rapeseed processing is envisaged: cleaning, grinding, cold pressing at a temperature of ≤ 40 °C, fat extraction with a solvent. At the next stages, the protein is extracted with 0.1–0.5 M NaCl at pH 5.3–12.0 and a temperature of 5–30 °C for 1 hour. The extracted protein is precipitated at the isoelectric point (pH 4.0) with HCl, separated from the mixture and neutralized. The result is a protein isolate with a protein content of 90.0–98.7%. It is possible to increase the quality and yield of the protein product due to the additional stage of processing the defatted cake with cellulolytic enzyme preparations. In this case, additional studies are required to determine the substrate specificity of commercial cellulase enzyme preparations and the optimal hydrolysis conditions. The parameters of extraction and precipitation of the protein in the case of using the stage of enzymatic lysis should also be specified.

Barriers and shortcomings in access to cardiovascular management and prevention for familial hypercholesterolemia during the COVID-19 pandemic.

Familial hypercholesterolemia (FH) is a hereditary condition caused by mutations in the lipid pathway. The goal in managing FH is to reduce circulating low-density lipoprotein cholesterol and, therefore, reduce the risk of developing atherosclerotic cardiovascular disease (ASCVD). Because FH patients were considered high risk groups due to an increased susceptible for contracting COVID-19 infection, we hypothesized whether the effects of the pandemic hindered access to cardiovascular care. In this review, we conducted a literature search in databases Pubmed/Medline and ScienceDirect. We included a comprehensive analysis of findings from articles in English related and summarized the effects of the pandemic on cardiovascular care through direct and indirect effects. During the COVID-19 pandemic, FH patients presented with worse outcomes and prognosis, especially those that have suffered from early ASCVD. This caused avoidance in seeking care due to fear of transmission. The pandemic severely impacted consultations with lipidologists and cardiologists, causing a decline in lipid profile evaluations. Low socioeconomic communities and ethnic minorities were hit the hardest with job displacements and lacked healthcare coverage respectively, leading to treatment nonadherence. Lock-down restrictions promoted sedentary lifestyles and intake of fatty meals, but it is unclear whether these factors attenuated cardiovascular risk in FH. To prevent early atherogenesis in FH patients, universal screening programs, telemedicine, and lifestyle interventions are important recommendations that could improve outcomes in FH patients. However, the need to research in depth on the disproportionate impact within different subgroups should be the forefront of FH research.

Health risk behaviors among adolescents and related factors in Binh Dinh province in 2019

To describe the prevalence of health - risk behaviors among secondary school students in Binh Dinh province, as well as the associated factors, a cross - sectional study was conducted on 2081 students aged 12 to 15 years from three secondary schools in Binh Dinh province, November 2019. The data were collected by indirect interview using a structured questionnaire. The prevalence of health - risk behaviors among secondary school students in Binh Dinh province was still high, especially consuming fatty foods (32.1%). 14 years-old and 15 years-old consumed more fatty foods and used more smart devices than 12 years-old students. Students of 15 years old consumed more soft drinks and participated in less physical activity than the 12-year-olds. Boys consumed more fast food, alcohol, soft drinks, and tobacco than girls. Additionally, girls consumed more fatty foods, used smart devices more frequently, and engaged in less physical activity than male students. Consumption of fatty meals, soft drinks, and fast food; alcohol usage; less physical activity; smoking habits and use of smart devices were discovered to be associated with age and gender of research participants. Health promotion interventions focusing on health risk behaviors related to eating and living habits should be considered.

Investigation of Cardioprotective Effect of 2, 4-thiazolidinedione Derivative Using HFD-STZ Fed Rats

Abstract: Background: Myocardial infarction is a 2nd most important origin of universal death and after coronary revascularization, cardiovascular events occurs further a lot in subjects through DM: 3.5- as well as 2-fold fatality ranks correspondingly behind percutaneous coronary intervention or coronary bypass graft surgery. Objectives: The aim of an attendance research was to discover usefulness of 2, 4- thiazolidinedione derivatives lying on diabetic MI and HFD-STZ diabetic rats. Materials and Methods: In in-vivo investigation, Type-2 diabetes was elicited by higher fatty meal plus little dosage for streptozotocin and MI was provoked by LAD Coronary artery ligation model. The rats were divided into a variety of groups, including treatment groups (Composite An epalrestat, Composite B pioglitazone). And after 15 days of treatment a variety of factors were evaluated, i.e. serum glucose, total cholesterol, serum triglycerides, lipid profile antioxidant enzymes, ECG analysis, and Histopathological examination of heart were done. Results: In in-vivo investigation, levels of serum glucose, triglycerides, LDL level, LDH level, CK-MB, Troponin I, malondialdehyde (MDA), total cholesterol, infarct area, were considerably decreased in composite A and B treated animals. Whereas the HDL level, antioxidant enzymes, had drastically risen in composite, treated animals balanced to disease control rats. In ECG analysis ST elevation was restored in drug treated animals. Composite treated heart indicated mild congestion and inflammation in histopathological examination. Homogenate of drug treated animals indicated less apoptotic signals and nearer to normal animals. Conclusion: The treatment with Composite A and Composite B notably ameliorated the alterations in MI in a dose dependant manner. Keywords: 2, 4-Thiazolidinedione, Myocardial infarction, Diabetic MI, Type-2 diabetes, LAD, Macrovascular complication.

Age at Menarche among Indonesia Boarding School Students

Background: Menarche is a crucial indicator of a female’s sexual development because of the interaction of the hypothalamus-pituitary-ovarian axis with the reproductive and endocrine systems. The timing of menarche appears to have shifted to younger ages over the past century. A risk factor for early menarche is a lifestyle change, notably the frequency with which fatty meals and junk food are consumed. This study aimed to determine the mean age at menarche in Indonesian adolescents, especially boarding school students in Surabaya. Method: This cross-sectional research included Alif Laam Miim Islamic Boarding School students in Surabaya. The students’ menarche ages were obtained via direct interviews, and their height and weight were assessed using conventional anthropometry. SPSS was used to do the statistical analysis. Mean, standard deviation, frequency, and percentage were used to represent descriptive data. Results: This study included 45 girls with a mean age of 13.72 + 0.72 years old. The mean age of menarche was 11.45 + 0.99, and 3 (6.66%) of our subjects had not had menstruation yet. One student (2.22%) experienced menarche at the age of 9. We found no statistically significant correlation between the mean age of menarche with nutritional status (p = 0.308; r= -0.155). Conclusions: Our study taken on Boarding school students found that the mean age of menarche was 10.66 + 3.03 and it was relatively younger than other studies taken in Indonesia.

Pain Management after Laparoscopic Cholecystectomy by Intraperitoneal Bupivacaine

Aim: To compare the effectiveness of 0.5% bupivacaine spray on the gallbladder at the end of surgery with the effectiveness of no spray in reducing postoperative pain within the first 24 hours. Study design: Randomized Controlled Trial Place and duration: The study was conducted in the Department of General Surge,Combined Military Hospital, Rawalpindi, from 23 July 2018 to 22 January 2019, after receiving approval from the ethics review board. Method: A total of 62 patients underwent laparoscopiccholecystectomy. Indications were symptomatic gallstones (such as dyspepsia, pain in right hypochondrium, and pain after eating fatty meals). The patient age group was between 20-60 years. Patients includedAcutecholecystitis, choledocholithiasis, pancreatitis and bile leakage during surgery. However pregnant females and patients with co-morbidities were not included. Informed consent was taken from all the patients.At the end of the laparoscopic cholecystectomy, Group A infused 0.5% bupivacaine into the gallbladder depression at a standard weight of 2mg/kg, but Group B did not receive a local anaesthetic. Postoperative pain was assessed and scored in both groups from 0 to 10 at 6 and 24 hours using the VAS (Visual Analogue Scale). Result: The mean age of patients in group A was 38.23±8.13 years, and in group B, 38.74±6.64 years. Most of the 35 patients (56.54%) were between 20 and 40 years of age. Among 62 patients, 35(56.54%) were male and 47(75.81%) were female. So the male-to-female ratio is 1:3.2. Efficacy (0.5% bupivacaine) was 22 patients (70.97%) in group A (intervention group) and 11 patients (35.48%) in group B (control group) (p-value = 0.005). Conclusion: The study resulted that the effectiveness of 0.5% bupivacaine spray on the gallbladder at the end of surgery was superior to that of the control group. Keywords: Bupivacaine Spray, LaparoscopicCholecystectomy, Postoperative Pain, VAS (Visual Analogue Scale).

Proteomic analysis of postprandial high-density lipoproteins in healthy subjects

The relationship between the functionality and composition of high-density lipoproteins (HDL) is yet not fully studied, and little is known about the influence of the diet in HDL proteome. Therefore, the aim of this research was to elucidate the HDL proteome associated to postprandial hyperlipidemia. Male volunteers were recruited for an interventional study with high fatty acid-based meals. Blood samples were collected before the intake (baseline), and 2–3 (postprandial peak) and 5–6 (postprandial post peak) hours later. HDL were purified and the protein composition was quantified by LC-MS/MS. Statistical analysis was performed by lineal models (amica) and by ANOVA and multi-t-test of the different conditions (MetaboAnalyst). Additionally, a clustering of the expression profiles of each protein was done with coseq R package (RStudio). Initially, 320 proteins were identified but only 119 remained after the filtering. APOM, APOE, APOB, and APOA2, proteins previously identified in the HDL proteome, were the only proteins with a statistically significant altered expression in postprandial hyperlipidemia when compared to baseline (p values <0.05 and logFC >1). In conclusion, we have been able to describe several behaviors of the whole HDL proteome during the postprandial hyperlipidemic metabolism.

159MO Low-dose abiraterone with fatty food versus standard dose abiraterone in metastatic castration-resistant prostate cancer

Standard dose of Abiraterone Acetate (AA) for metastatic CRPC is 1000mg/day in two divided doses to be taken on empty stomach. Food intake has shown alteration in pharmacokinetics of AA. Phase I studies have shown a 4.4 fold increase in drug absorption when taken with a high fat meal. Based on this hypothesis, studies have shown that low dose AA with a fatty meal is non inferior to standard dose. We did a prospective study of AA to confirm the same.