Hyperphagia Research Articles

Metabolic adaptation is associated with a greater increase in appetite following weight loss: a longitudinal study

BackgroundWeight loss is associated with a disproportionate reduction in energy expenditure, along with increases in hunger feelings and ghrelin concentrations. These changes are presumed to be homeostatic mechanisms to counteract the energy deficit. The possibility that these 2 components of the energy balance equation are mechanistically linked has never been examined. ObjectiveThis study aimed to determine if the disproportionate reduction in resting metabolic rate (RMR) seen with weight loss is associated with changes in the plasma concentration of gastrointestinal hormones involved in appetite regulation and subjective appetite ratings. MethodsThis was a longitudinal study with repeated measurements. Fifty-six individuals with obesity (body mass index [BMI]: 34.5±0.5 kg/m2; age: 47±1 y; 26 males) underwent an 8 wk low-energy diet, followed by 4 wk of refeeding and weight stabilization. The RMR, respiratory quotient (RQ), body composition, plasma concentrations of ghrelin, glucagon-like peptide 1, peptide YY, cholecystokinin, insulin, and appetite ratings in the fasting and postprandial states were measured at baseline, Wk9 and 13. Metabolic adaptation was defined as significantly lower when measured versus the predicted RMR (pRMR) (from own regression model using baseline data). ResultsA 14.2±0.6 kg weight loss was seen at Wk9 and maintained at Wk13. RQ was significantly reduced at Wk9 (0.82±0.06 vs. 0.76±0.05, P< 0.001) but returned to baseline at Wk13. Metabolic adaptation was seen at Wk9, but not Wk13 (-341±58, P <0.001 and -75±72 kJ/d, P = 0.305, respectively). The larger the difference between measured and predicted RMR at both timepoints, the greater the increase in hunger, desire to eat, and composite appetite score (fasting and postprandial at Wk9, postprandial only at Wk13), even after adjusting for weight loss and RQ. ConclusionA larger metabolic adaptation during weight loss is accompanied by a greater drive to eat. This might help explain the interindividual differences in weight loss outcomes to dietary interventions.

Aromatherapy Massage of Lemongrass, Kaffir Lime, and Lemon to Increase Appetite, IGF-1 (Insulin-like Growth Factor 1) Levels, Body Weight, and Height In Stunted Toddler

Aromatherapy Massage of Lemongrass, Kaffir Lime, and Lemon to Increase Appetite, IGF-1 (Insulin-like Growth Factor 1) Levels, Body Weight, and Height In Stunted Toddler

Fortification of Moringa Leaves to Fulfill the Nutritional Needs of Stunting Toddler

Nutritional problems are a classic health problem that recurs every year, especially in developed countries and including Indonesia. One of the nutritional problems faced by Indonesia is that there are still stunting cases experienced by toddlers. The problem of stunting is a hotly discussed issue considering that the impact of stunting incidents that are not immediately addressed can have an impact on reducing the quality of life of Indonesian people. The culture of parents to prepare food according to what they consume for stunted toddlers and not to worry about the toddler's short height are two problems that cause stunting in Indonesia. One effort that can be made to overcome the problem of stunting is to ensure that stunted toddlers have a good appetite. When a stunted toddler's appetite increases, the problem of stunting will soon be resolved properly. The aim of this study was to analyze the effectiveness of giving churros made using Moringa leaf flour to increase the height of stunted toddlers. The research design used was pre-experimental. The samples in this study were taken from three working areas of the public health unit in Sooko District, Gondang District and Jatirejo District. The variable studied was the toddler's height. Data analysis tests were carried out using the Mann-Whitney test. From the results of the Mann-Whitney test, a significance value of 0.022 &lt; 0.05 was obtained, so it can be concluded that giving churros made using Moringa leaf flour is effective in increasing height in stunted toddlers

FRI005 Appetite Response To Short-term Energy Restriction In Young Healthy Women

Abstract Disclosure: G.E. Choi: None. C. Okigbo: None. J. Tessa Tonleu: None. S. Shekhar: None. H.F. Leka: None. A.E. Kim: None. B. Purse: None. K.R. Hisch: None. A.E. Smith-Ryan: None. J.E. Hall: None. Short-term caloric restriction, also referred to as energy restriction (ER), is commonly used by women across the weight spectrum to address their weight or health. Chronic ER is associated with increased appetite, but the relationship is poorly characterized in short-term ER or in the absence of obesity. We investigated the impact of controlled short-term ER on appetite and relevant hormone mediators in young women. In the early follicular phase of two menstrual cycles, 19 healthy non-obese women aged 23.36 ± 2.08 years (mean ± SD) with a BMI of 23.15 ± 2.34 kg/m2 (mean ± sem) underwent two five-day diet and exercise interventions: neutral energy availability (NEA) = 45 kcal/kg lean body mass (LBM)/day and deficient energy availability (DEA) = 20 kcal/kg LBM/day. On day 5 of both interventions, a visual analog scale (VAS) appetite questionnaire, body weight, fasting leptin and orexin-A were measured. We used paired t-tests for comparisons of changes from NEA to DEA. Principal-component factor analysis divided VAS items into appetite, satiety, and hunger (Cronbach alphas &amp;gt;0.80). We utilized linear regression models to determine how changes (Δ) in body weight, leptin, and orexin-A affect appetite, satiety, hunger, and cravings. From NEA to DEA, appetite and hunger increased (55% vs 76%; p&amp;lt;0.001 and 52% vs 71%; p&amp;lt;0.001, respectively), while satiety and cravings decreased (42% vs 19%; p &amp;lt;0.01 and 49% to 38%; p&amp;lt;0.01, respectively). DEA resulted in a weight loss of 1.0±0.22 kg (p&amp;lt;0.001), a decrease in leptin of 3.13±0.95 ng/ml, p=0.002), and increased orexin-A (0.06±0.02 ng/ml, p=0.018). Δ body weight was positively associated with Δ leptin (p=0.001) but not Δ orexin-A. When adjusting for leptin and orexin-A, increased appetite was associated with weight loss (p=0.011). Δ satiety was independently correlated with Δ body weight (p=0.002) and Δ leptin (p=0.033). Δ hunger was positively correlated with Δ body weight (p=0.043), independent of Δ orexin-A). Δ leptin, orexin-A, or body weight did not correlate with Δ craving. Thus, even in non-obese women, short-term ER results in a profound effect on homeostatic mechanisms designed to maintain weight; increased appetite and decreased satiety are mediated by even a minor degree of weight loss, both independently and through decreased leptin. It is likely that changes in ghrelin also contribute to these adaptations to ER, however it was not measured in this study for technical reasons. Interestingly, the effect of short-term ER on specific food cravings is overwhelmed by the overall increase in appetite. Presentation: Friday, June 16, 2023

PENGARUH PENERAPAN PIJAT BAYI (BABY MASSAGE) TERHADP KUANTITAS TIDUR BAYI USIA 3 -12 BULAN DI PMB AFITA DELIANAH TUREN

Sleep quantity is a measure by which a person can easily initiate sleep and maintain sleep.Introduction: The effectiveness of baby massage on sleep quantity was influenced by increase in catecholamine hormone that trigger growth and development stimulations, increase appetite, increase body weight, increase sleep quality and quantity, and stimulate brain structure and function development. Objective of the research was to determinw effects of applying a baby massage to quantity of sleep for babies aged 3- 12 months at PMB Afita Delianah Turen. Methods: researcher applied one group pretest and posttest approaches. This research sample was 15 infants aged 3- 12month in accordance with inclusion criteria. In collecting technique applied SOP baby massage and observation sheets. Results: Using wilcoxson Analysis Test that acquiring significant values of 0. 000&lt; (0. 05). Conclusion: There is effects of a baby massage application on sleep quantity of babies aged 3- 12months at PMB Afita Delianah Turen. It is recommended that mothers who have babies with sleep quantity disorders can be overcome with Baby Massage.

Successful Management of Diabetes Mellitus (Madhumeha) With Ayurvedic Modalities (Vaman &amp; Madhutailik Basti) – A Case Study

Ayurveda, an ancient medical system, is becoming more popular as a supplemental and alternative therapy for treatingchronic illnesses. Type 2 diabetes is a chronic condition with serious long-term effects on both the people who have it and thehealthcare system as a whole. Ayurvedic classics have twenty types PramehaKaphaj prameha 20, Pittaja prameha 6, and Vatajaprameha 4. Among this type, Diabetes mellitus is compared with Madhumeha, which is one of the Vataja types of Prameha. It is aKledapradhan vyadhi which is associated with excessive urination. The primary causes of the illness are an excessive intake ofdairy products, sugar products, rice, and seafood, an excessive amount of sleep, and a lack of activity. Various complications ofDiabetes mellitus include nephropathy, neuropathy, retinopathy, and cardiovascular disease. A 51-year-old female patient visitedOPD with chief complaints of Sweetness in her mouth, excessive hunger, thirst, urine, and burning sensation at the sole formore than 3 months, and other associated complaints were excessive mental stress and lethargy for the last 1 month. She wastreated with panchakarma treatment like Vaman, Madhutailik basti, and Shaman chikitsa like Nishamalaki churna and Madhunashinivati. Reduction in blood sugar level was observed at the end of treatment. Hence it can be concluded that shodhan and shamanchikitsa is beneficial in treating symptoms of Madhumeha.

Investigation of Acute Toxicity and Biological Activity of an Extract obtained on the Basis of a Local Medicinal Herbal Collection

The presented article describes the results of research work on the alimentary and hemolytic anemic effect of herbal decoction of medicinal properties, which is used in folk medicine for the treatment of various diseases. The extract of the sum of decoctions of medicinal plants was administered orally to experimental rabbits for 60 days in an amount of 10 ml / kg and 25 ml / kg, and their antianemic activity was assessed by such indicators as the number of shaped blood elements, as well as the general condition of experimental animals and changes in weight. Extract of tincture of sum of medicinal plants in studies of therapeutic effect in alimentary anemia on the other hand, already on the 7th day of treatment, the effect against hemolytic anemia began to manifest itself in less than 21 days, and it becomes more intense until the end of the experiment. These effects were manifested by a positive change in the number of shaped blood elements, an improvement in the general condition of experimental animals, a significant increase in appetite, and the restoration of lost body weight. This entails extensive scientific studies of the activity and mechanism of action of this tincture against the background of various anemia.

PENGARUH PEMBERIAN STIK DAUN KELOR TERHADAP PENINGKATAN NAFSU MAKAN DAN BERAT BADAN BALITA

&lt;p&gt;Decreased immune system and nutritional problems in children under five have a bad impact on the health of children under five for their growth and development. One way that can be done is by utilizing natural ingredients such as Moringa leaves which are processed into foods that are liked by toddlers. The purpose of this study was to determine the effect of giving Moringa leaf sticks to the increase in appetite and weight of toddlers aged 2-5 years in the working area of the Lubuk Gadang Health Center in 2022. The study was conducted in September 2021-March 2022. The research design used was a quantitative study. with a quasi-experimental design of One Group Pretest and Posttest. The population in this study were children aged 2-5 years from October - December 2021 as many as 32 people. The sampling technique is Total Sampling. The data used are primary data and secondary data. Data analysis was carried out univariate and bivariate using the Paired Sample T-Test. The results showed that from the Normality test, the significance value was &amp;gt; 0.05, the data was normally distributed, the univariate test found that the distribution of toddlers' appetite before was more than half of the respondents, 14 people (43.8) had a good appetite, toddler's appetite after that was more from half of the respondents 19 people (59.4) had sufficient appetite, the average weight of toddlers was 12.85 kg to 13.53 kg before and after being given Moringa leaf sticks, and there was a significant effect between appetite and body weight. toddlers before and after being given Moringa leaf sticks with a P-Value value of 0.000 &amp;lt;0.05. Based on the results of the study, it was concluded that there was a significant effect between appetite and toddler body weight before and after being given Moringa leaf sticks. So it is recommended for the working area of the Lubuk Gadang Health Center to often provide innovative complementary foods to toddlers in order to improve the nutritional status of toddlers in Lubuk Gadang&lt;/p&gt;

The effect of anamorelin (ONO-7643) on cachexia in cancer patients: Systematic review and meta-analysis of randomized controlled trials.

Cachexia is associated with increased morbidity and mortality rates in patients with cancer. This meta-analysis aims to explore the effect of anamorelin on cancer cachexia markers. We searched MEDLINE/PubMed, SCOPUS, and WOS from their inception until 5 June 2022. A systematic search was conducted according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. We included trials investigating the effect of anamorelin on body weight, lean body mass, fat mass, insulin-like growth factor 1 (IGF-1), handgrip, quality of life insulin-like growth factor-binding protein 3 (IGFBP-3), and in patients with cancer. A random-effects model was run to pooled results. Five articles providing 1331 participants were analyzed in this study. Pooled analysis revealed a significant increase in body weight (weighted mean difference (WMD): 1.56 kg, 95% confidence interval (CI): 1.20, 1.92; I2= 0%), lean body mass (WMD: 1.36 kg, 95% CI: 0.85, 1.86; I2= 53.1%), fat mass (WMD: 1.02 kg, 95% CI: 0.51, 1.53; I2= 60.7%), IGF-1 (WMD: 51.16 ng/mL, 95% CI: 41.42, 60.90, I2= 0%), and IGFBP-3 (WMD: 0.43 μg/mL, 95% CI: 0.17, 0.68, I2= 98.6%). Results showed no significant increase in appetite when analysis run on all studies without considering different doses 0.29 (95% CI: -0.30, 0.89, I2= 73.8%), however, there was a significant increase in appetite without heterogeneity and inconsistency 0.59 (95% CI: 0.32, 0.86; I2= 0%) in the 100 mg/day group compared to anamorelin non-user. Patients with cancer who receive anamorelin as a treatment for cachexia showed a significant increase in body weight, lean body mass, fat mass, IGF-1, and IGFBP-3.

Study of Adverse Drug Reaction of Anti-Depressants in Adult Patients: A Nepalese Perspective

Background of the study: Depression is a prevalent mental disorder characterized by various symptoms, including low mood, lack of pleasure, changes in appetite and sleep, and difficulty concentrating. Antidepressants are commonly used to manage depression as well as other related disorders, such as anxiety and somatoform disorders. This study aimed to investigate the adverse drug effects experienced by adult patients who were using antidepressants at Chitwan Medical College Teaching Hospital in Nepal. Methods: This study was a retro-prospective, observational study consisting of 117 adult patients under antidepressant medication. The adverse drug profile for the patients was collected using an antidepressant side effect checklist developed by the NHS foundation trust. Statistical analysis was performed using SPSS version 20. Result: The study group consisted of adult patients using antidepressants at Chitwan Medical College Teaching Hospital, Chitwan, Nepal. The mean age of the group was 40.9 ± 12.8, with 63.2% females and 36.7% males. The most common conditions for which antidepressants were prescribed were depression (49.5%), anxiety disorder (31.6%), and somatoform disorder (13.6%). Amitriptyline was the most commonly used medication in monotherapy (64.1%), followed by escitalopram and sertraline. Dry mouth, weight gain, drowsiness, blurred vision, problems with sexual function, and an increase in appetite were the most commonly reported adverse effects. The incidence of certain adverse effects was higher in the multiple therapy group than in the monotherapy group (p &lt; 0.05). Conclusion: The incidence of adverse drug effects is high in patients taking antidepressants, especially those receiving multiple medications. Educating patients about common side effects and prescribing monotherapy whenever possible are crucial in reducing the incidence.

The Effect of Intermittent Fasting on Appetite: A Systematic Review and Meta-Analysis.

Previously, narrative reviews have considered the effects of intermittent fasting on appetite. One suggestion is that intermittent fasting attenuates an increase in appetite that typically accompanies weight loss. Here, we conducted the first systematic review and meta-analysis to quantify the effects of intermittent fasting on appetite, when compared to a continuous energy restriction intervention. Five electronic databases and trial registers were searched in February 2021 and February 2022. Abstracts (N = 2800) were screened and 17 randomized controlled trials (RCTs), consisting of a variety of intermittent fasting regimes, met our inclusion criteria. The total number of participants allocated to interventions was 1111 and all RCTs were judged as having either some concerns or a high risk of bias (Cochrane RoB 2.0 tool). Random effects meta-analyses were conducted on change-from-baseline appetite ratings. There was no clear evidence that intermittent fasting affected hunger (WMD = -3.03; 95% CI [-8.13, 2.08]; p = 0.25; N = 13), fullness (WMD = 3.11; 95% CI [-1.46, 7.69]; p = 0.18; N = 10), desire to eat (WMD = -3.89; 95% CI [-12.62, 4.83]; p = 0.38; N = 6), or prospective food consumption (WMD = -2.82; 95% CI [-3.87, 9.03]; p = 0.43; N = 5), differently to continuous energy restriction interventions. Our results suggest that intermittent fasting does not mitigate an increase in our drive to eat that is often associated with continuous energy restriction.

HIGH-FIBER DIET PROMOTES METABOLIC, HORMONAL, AND SATIETY EFFECTS IN OBESE WOMEN ON A SHORT-TERM CALORIC RESTRICTION.

•Body weight and BMI decrease in both the EG and CG groups during the period of caloric restriction. •For both the EG and CG groups, fat-free mass decreases during food restriction. •Subjects on a high-fiber diet have reduced fasting glucose and basal insulin as well as improved insulin resistance, as attested by the lower HOMA-IR index. •Obese women on a high-fiber diet have suppressed postprandial (after 60 min) acylated ghrelin, confirming that the diet composition influences ghrelin levels from the first day. •In the present study, it was possible to verify that fasting leptin concentration diminishes in obese women on a high-fiber diet. Background - Several mechanisms, including excessive hunger, account for patients' difficulties in maintaining weight loss and dietary changes after caloric restriction. Objective - To evaluate the effect of short-term high-fiber calorie-restricted diet in appetite-regulating hormones, and hunger and satiety sensations in women with obesity. In a randomized controlled trial study, thirty women with body mass index (BMI) higher than 30 kg/m2, and aged from 20 to 50 years were hospitalized following a calorie-restricted diet (1000 kcal/day) for three days. The experimental group (n=15) received high-fiber diet and the control group (n=15), conventional diet. Results - Body weight, BMI, resting energy expenditure (REE), acylated and total ghrelin, leptin, insulin and glucose, and hunger and satiety sensations were evaluated. Linear regression models with mixed effects (fixed and random effects) helped to assess the variables between the two groups and within the groups. Body weight and BMI decreased in both the experimental and control groups (P<0.001). After the high-fiber diet, postprandial acylated ghrelin (P=0.04), glucose (P<0.001), insulin (P=0.04), and leptin (P=0.03) levels as well as the HOMA-IR index (P=0.01) decreased, whereas satiety improved (P=0.02). Obese women that followed the conventional diet had increased body fat percentage (P=0.04) and lower REE (P=0.02). The two diets did not differ in terms of hunger sensation. Conclusion - A short-term high-fiber diet improves satiety sensations and metabolic parameters while suppressing postprandial acylated ghrelin (60 minutes) and maintaining the resting energy expenditure.

Intake of Artificial Sweeteners by Children: Boon or Bane?

Sugar is the main culprit in many health dysfunctions. Excessive sugar intake can negatively affect oral health, precipitate diabetes, and lead to weight gain and obesity. Sucrose is the primary form of sugar, and is strongly correlated with dental caries. Artificial sweeteners are chemically synthesized sugar substitutes that are generally regarded as being low-calorie. This review examines the current evidence in the literature for the need for artificial sweeteners and outlines its implications for the health of children. We briefly outline its adverse effects, and concerns regarding their safety. Artificial sweeteners are a widely used food additive. Six main artificial sweeteners are approved by the food and drug administration (FDA). The conflicting results and divergent regulatory norms of each sweetener are a constant cause of concern and debate. However, most studies have spotlighted the beneficial effects of artificial sweeteners. Dental caries diminish with the increase in sweetener intake. An increase in appetite and eventually weight gain is observed in individuals consuming artificial sweeteners. Artificial sweeteners are indeed a bane according to present studies, although more research on recently discovered non-nutritive artificial sweeteners is required. It also has a positive effect on overall health disorders. If one curbs the onset of dental caries, then the eventual rise is highly unlikely. Artificial sweeteners' effect on lowering dental caries will help to reduce the caries index in general. Oral hygiene is maintained, and the growth of oral bacterium is depressed. Research on novel sweeteners will help to compare their efficacy in caries prevention compared to existing ones. It is necessary to educate people on artificial sweeteners and its implication as one can use them by being aware of their properties.

High acceptability and viral suppression rate for first-Line patients on a dolutegravir-based regimen: An early adopter study in Nigeria.

Nigeria adopted dolutegravir (DTG) as part of first line (1L) antiretroviral therapy (ART) in 2017. However, there is limited documented experience using DTG in sub-Saharan Africa. Our study assessed DTG acceptability from the patient's perspective as well as treatment outcomes at 3 high-volume facilities in Nigeria. This is a mixed method prospective cohort study with 12 months of follow-up between July 2017 and January 2019. Patients who had intolerance or contraindications to non-nucleoside reverse-transcriptase inhibitors were included. Patient acceptability was assessed through one-on-one interviews at 2, 6, and 12 months following DTG initiation. ART-experienced participants were asked about side effects and regimen preference compared to their previous regimen. Viral load (VL) and CD4+ cell count tests were assessed according to the national schedule. Data were analysed in MS Excel and SAS 9.4. A total of 271 participants were enrolled on the study, the median age of participants was 45 years, 62% were female. 229 (206 ART-experienced, 23 ART-naive) of enrolled participants were interviewed at 12 months. 99.5% of ART-experienced study participants preferred DTG to their previous regimen. 32% of particpants reported at least one side effect. "Increase in appetite" was most frequently reported (15%), followed by insomnia (10%) and bad dreams (10%). Average adherence as measured by drug pick-up was 99% and 3% reported a missed dose in the 3 days preceding their interview. Among participants with VL results (n = 199), 99% were virally suppressed (<1000 copies/ml), and 94% had VL <50 copies/ml at 12 months. This study is among the first to document self-reported patient experiences with DTG in sub-Saharan Africa and demonstrated high acceptability of DTG-based regimens among patients. The viral suppression rate was higher than the national average of 82%. Our findings support the recommendation of DTG-based regimen as the preferred 1L ART.

Role of central adiponectin and its interactions with NPY and GABAergic systems on food intake in neonatal layer chicken

Background & AimAdiponectin is a member of the adipokine family and contributes to regulating energy homeostasis, reproduction, and various biological functions, such as insulin receptor signaling pathway sensitivity, mitochondrial biogenesis, oxidative metabolism, neurogenesis, and suppression of inflammation. This study aimed to investigate the effects of intracerebroventricular (ICV) injection of adiponectin and its interaction with the neuropeptide Y (NPY) and GABAergic systems on central appetite regulation in neonatal layer-type chickens. Materials & MethodsIn this study, 6 experiments were conducted, each of which included 4 experimental groups. In the first experiment, the chickens were injected with saline and adiponectin (20.73, 41.45, and 62.18 nmol). In the second experiment, saline, adiponectin (62.18 nmol), B5063 (NPY1 receptor antagonist, 2.12 nmol), and simultaneous injections of adiponectin and B5063 were performed. Experiments 3 to 6 were done in the same way to experiment 1, but the chickens were injected with SF22 (NPY2 receptor antagonist, 2.66 nmol), SML0891 (NPY5 receptor antagonist, 2.89 nmol), picrotoxin (GABAA receptor antagonist, 0.89 nmol), CGP54626 (GABAB receptor antagonist, 0.047 nmol) instead of B5063. Feed consumption was measured 120 min after the injection. ResultsA dose-dependent increase in appetite was observed after the injection of adiponectin (20.73, 41.45, and 62.18 nmol) (P < 0.05). The injection of B5063 + adiponectin attenuated the hyperphagic effect of adiponectin (P < 0.05). In addition, co-injection of picrotoxin and adiponectin significantly decreased adiponectin-induced hyperphagia (P < 0.05). In addition, adiponectin significantly increased the number of steps, jumps, exploratory food, pecks, and standing time, while decreasing sitting time and rest time (P < 0.05). ConclusionThese results suggest that the hyperphagic effects of adiponectin are probably mediated through NPY1 and GABAA receptors in neonatal layer-type chickens.

Evaluation of Serum Ferritin, Creatinine and Liver Enzymes in Patients with ß- thalassemia After Administration of Deferasirox

Background: Iron overload is the most common complication of ß- thalassemia thatcauses morbidity and mortality in children so chelating drugs are essentials forpreventing such complication. Oral deferasirox has a good safety and tolerance tomaintain ferritin level in non-toxic levels that affect heart and liver. Patients andmethods: A cohort retro - prospective study of eighty five patients 45 male(53%), 40female (47%), age from 2-18 years old, with ß-thalassemia who receiving deferasiroxin thalassemia center in Kirkuk city north of Iraq from the first of March to the end ofOctober 2016; that assessed by interview questionnaire, previous documents in thecenter and laboratory investigations for serum creatinine, serum ferritin and liverenzymes. Results: Adverse effects were shown in eight patients (9.4%), each of two(25%) had abdominal pain, increase appetite, and hair loss consecutively, allergy andnervousness in each one patient(12.5%) serum ferritin was decreased below thebaseline in 47 (55.3%), serum creatinine was elevated above the baseline in 22(25.8%) within normal levels, Elevated serum alanine transferase in 16 (18.8%), totalserum bilirubin was elevated in 14(16.6%) of all children; while serum aspartatetransferase elevated in 22(25.8%) of the normal eventually serum alkalinephosphatase was elevated in 22(25.8%). Conclusion: Deferasirox is well tolerated asan iron chelating with suitable dose and long duration has less adverse effects and canbe adjusted by dose modification.

Abstract CT202: Xevinapant plus avelumab in patients (pts) with advanced or metastatic non-small cell lung cancer (NSCLC): Phase 1b dose-expansion results and exploratory biomarker analyses

Abstract BACKGROUND: Combining anti-PD-1/L1 antibodies and agents that restore cancer cell susceptibility to apoptosis may enhance antitumor activity. We report results from a phase 1b dose-expansion cohort of xevinapant, a first-in-class, oral, small-molecule IAP (inhibitor of apoptosis protein) inhibitor that restores cancer cell sensitivity to apoptosis, and avelumab (anti-PD-L1) in pts with advanced NSCLC. METHODS: The recommended phase 2 dose (RP2D; 28-day cycles of xevinapant 200 mg/day [days 1-10 and 15-24] + avelumab 10 mg/kg [days 1 and 15]) was previously established during the dose-escalation part of this phase 1, open-label study. In this dose-expansion cohort, pts with advanced NSCLC who progressed on first-line (1L) platinum-based chemotherapy (CTx) or anti-PD-1/L1 ± platinum-based CTx received xevinapant (at RP2D) + avelumab for 13 cycles. The primary endpoint was objective response rate (ORR) per RECIST 1.1. Secondary endpoints included duration of response (DoR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), safety, and pharmacokinetics (PK). RESULTS: 38 pts were treated: most had squamous cell carcinoma (45%) or adenocarcinoma (42%) of the lung, 11% had prior anti-PD-L1 therapy, 71% were men, and median age was 62 years (range, 35-75). 1 pt completed 13 cycles, and 37 permanently discontinued treatment; most common reasons were progressive disease (PD; 70%) and adverse events (AEs; 27%). ORR was 10.5% (95% CI 2.9-24.8). Best overall response (BOR): 4 pts had a confirmed partial response (PR), 19 had stable disease, and 15 had PD. Median DoR in responders was 15.9 months (95% CI 3.5-29.7); DCR was 60.5% (95% CI 43.4-76.0). Median PFS was 3.5 months (95% CI 1.9-5.1); median OS was 9.4 months (95% CI 6.7-16.2). Most pts (n=37; 97.4%) had treatment-emergent AEs (TEAEs); 21 (55.3%) had grade ≥3. Most common TEAEs were decreased appetite (n=13; 34.2%) and ALT increase (n=11; 28.9%). Nine pts died due to TEAEs; none were considered treatment-related. Xevinapant and avelumab PK were comparable to monotherapy at the same doses. In exploratory biomarker analyses, plasma IL-10 levels increased during the study treatment period. In blood, activated CD4 T cells and Tregs increased during cycle 1, and activated CD8 T cells increased during the treatment period; however, these did not correlate with antitumor activity. In tumor samples, low Ki67 expression was associated with BOR of PR (n=4), and increases in macrophages, Tregs, Th1 cells, and dendritic cells were associated with disease control. CONCLUSION: Xevinapant + avelumab had tolerable safety in pts with advanced NSCLC who progressed on 1L platinum-based CTx or anti-PD-1/L1 ± platinum-based CTx; however, the study did not meet its primary endpoint as antitumor activity was comparable to historic data for avelumab second-line monotherapy. Citation Format: Quincy Chu, Tudor Ciuleanu, Rodryg Ramlau, Daniel Renouf, Rosalyn Juergens, Ewa Kalinka, Piotr Sawrycki, Jonathan Bramson, Brad Nelson, Rafael Crabbé, Daniela A. Sahlender, Philippa Crompton, Elisabeth Rouits, Dany Spaggiari, Franck Brichory, Luke Piggott, Mike Schenker, Glenwood Goss. Xevinapant plus avelumab in patients (pts) with advanced or metastatic non-small cell lung cancer (NSCLC): Phase 1b dose-expansion results and exploratory biomarker analyses [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 2 (Clinical Trials and Late-Breaking Research); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(8_Suppl):Abstract nr CT202.

The impact of acute exercise on appetite control: Current insights and future perspectives

The interaction of exercise with appetite control and energy intake has been widely studied due to the ability of exercise-related energy expenditure to influence energy and substrate balance. Many empirical studies have explored appetite and energy intake responses to acute (single) exercise bouts involving a variety of protocols in diverse populations revealing several consistent trends. The balance of evidence suggests that acute moderate-to-vigorous intensity land-based exercise suppresses subjective appetite feelings and the orexigenic hormone acylated ghrelin and elevates the anorexigenic hormones peptide YY and glucagon-like peptide-1. These perturbations are transient and hormone concentrations usually return to resting values in the hours after exercise without evoking compensatory increases in appetite or energy intake on the same day. This evidence counters the popular assertion that exercise transiently increases appetite and may prompt greater energy intake at subsequent meals. The indifference of the appetite control system to acute exercise-induced energy deficits contrasts with the immediate increases in appetite and energy intake provoked by equivalent diet-induced energy deficits. There is, however, considerable inter-individual variability in subjective appetite and hormonal responses to acute exercise with some individuals experiencing greater exercise-induced appetite suppression than others. Current evidence supports the promotion of exercise as a strategy for inducing a short-term energy deficit but the relevance of this for long-term appetite regulation and the control of body mass remains uncertain.

Current and emerging medications for the management of obesity in adults.

Current and emerging medications for the management of obesity in adults.

The Use of Cannabinoids in the Treatment of Inflammatory Bowel Disease (IBD): A Review of the Literature.

Around the world, about 15 to 40% of individuals with inflammatory bowel disease (IBD) rely on cannabis and cannabinoids to reduce the need for other medications, as well as increase appetite and reduce pain. Whereas more and more patients continue to report benefits accruing from cannabis and cannabinoid usage in IBD, agreement relative to the use of cannabis and its derivatives in IBD remains unclear. This paper reviewed the interplay between cannabinoid use and IBD disease treatment, remission, or symptom relief. The study was conducted from a systematic review perspective. It involved consulting literature from published original research articles, noting outcomes, and performing a meta-analysis to identify trends and draw conclusions. The selected articles were those that had been published in a 10-year period ranging between 2012 and 2022. The motivation was to ensure recency and also relevance to contemporary scientific research and clinical environment practices. Indeed, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework helped in answering the focal question of the investigation, which revolved around whether cannabinoids are beneficial to IBD treatment and to what extent. The aim of using this protocol was to ensure the satisfaction of the article exclusion and inclusion criteria, as well as ensure the utilization of articles directly contributing to the central subject under investigation. In the findings, it was established that on the one hand, cannabinoid usage in IBD treatment comes with promising results as reported in the majority of the selected studies which reported reduced clinical complications which were assessed using Mayo scores, Crohn's Disease Activity Index (CDAI) score, weight gain, enhanced patient health perception, Lichtiger Index and Harvey-Bradshaw Index or general wellbeing. On the other hand, cannabinoid use remains questionable because evidence of high quality is yet to surface vividly, especially in terms of the mode of administration and the appropriate dose. It is also notable that the findings were characterized by a state of high heterogeneity in terms of the study designs of the studies that were selected, disease activity indices, the duration of treatment by different scholarly researchers, the difference in the modes of administration of cannabinoid and cannabis by different researchers, variations in cannabis dosage, differences in the selected studies' inclusion criteria, and variations in their case definitions. The implication is that whereas the efficacy of cannabinoid use in IBD treatment was reported in most studies, outcome generalizability from the review was highly likely to be restricted. In the future, it is recommended that randomized controlled trials center, set universal parameters for IBD treatment using cannabis and cannabinoids to determine intervention safety and effectiveness as well as having homogenous outcomes that can be compared between different studies. In so doing, the appropriate dose and ideal mode of administration of cannabis and its derivatives might be discerned, ensuring relevance based on patient characteristics such as gender and age, as well as the appropriate administration mode and dose as per IBD symptom severity.