INTRODUCTION: Methoxy polyethylene glycol-epoetin ? has been shown to be effective in the treatment of anemia among chronic kidney disease (CKD) patients on dialysis or pre-dialysis. This study evaluated the effectiveness and safety of this drug in the treatment of renal anemia among Filipino patients, demonstrating relevant clinical experiences in drug administration and dose adjustment.

METHODS: This was an open-label, one-arm prospective clinical series conducted in five renal clinics in Metro Manila, which enrolled 28 (27 evaluable) CKD patients, 18 years old and above with ESA-naive renal anemia who fulfilled the eligibility criteria. All patients gave their informed consent. The protocol was approved by the Philippine Council for Research & Development-National Ethics Committee. Methoxy polyethylene glycol-epoetin ? was given as a subcutaneous injection beginning at 0.6 ug/kg body weight once every two weeks with dose adjustment (25% increments/decrements per month) to keep hemoglobin at 11 to 12 g/dL (not to exceed 13 g/dL), and then maintained once every four weeks on a dose equal to twice the previous once-everytwo-weeks dose, over a 24-week study period. Data analysis was done using STATA version 10.

RESULTS: Across the 24 weeks of methoxy polyethylene glycolepoetin ? treatment, there was a mean increase in hemoglobin of >1.0 g/dL from baseline; >60% of patients achieved hemoglobin levels >11 g/dL starting at week 8 (mean time to first target hemoglobin 5.7 weeks) with variability, no blood transfusion, and mean of 1.52±1.25 SD dose adjustments per patient. The manner of dose adjustment can be the main driver of hemoglobin variability. Common adverse events were sudden rise in blood pressure (6 patients), back pain (3), and fever (3). 

CONCLUSION: Methoxy polyethylene glycol-epoetin ? administered once monthly after an initial once every two weeks correction phase can improve hemoglobin levels at target 11 to 12 g/dL, with hemoglobin variability and safety events as expected for a CKD population. 

Human ; Male ; Female ; Aged 80 And Over ; Aged ; Middle Aged ; Adult ; Polyethylene Glycols ; Polyethylene ; Blood Pressure ; Epo Protein, Human ; Erythropoietin ; Anemia ; Hemoglobins ; Renal Insufficiency, Chronic ; Injections, Subcutaneous ; Renal Dialysis

Background: Adolescent onset diabetes is currently showing different facets as far as phenotypic and autoimmune characteristics, clinical course, age at onset of the disease and prevalence of its different types are concerned. Alarming increase in the prevalence of type 2 diabetes (T2DM) has been reported from pediatric diabetes centers in North America and elsewhere in the world. Autoimmunity has been identified not only in type 1 adolescent diabetics but also among patients diagnosed clinically as type 2. Previous studies have shown that race or ethnic differences in this population can be identified. With the foregoing studies, we strongly believed that if significant associations can be made among the clinical, immunological and biochemical variables in this study, these associations can serve as guide for physicians in the management of adolescent onset diabetes.Objectives: To describe the phenotypic and immuno-biochemical characteristics of adolescent onset Filipino diabetic. Specifically to correlate the body mass index, acanthosis nigricans and age at onset of diabetes with C-peptide and anti-GAD antibody levels and to find association between anti-GAD and C-peptide levels.Study Design: Descriptive AnalyticalParticipants: Twenty six adolescent diabetics from Makati Medical Center, camp COPE, and Philippine General Hospital Section of Pediatric Endocrinology service patients were included in the study.Results: A total of 26 subjects were included in the study. The mean age was 15.2 years old with male preponderance (17/26; 65%). Mean age at onset of diabetes mellitus was 12.34 years (range 10 - 18 years) BMI ranged from 13.95 to 39.5 (mean 32.4 kg/m2). Seven (27%) were obese and two (8%) were overweight. The waist circumference ranged from 54 - 126 cm (mean of 73.2), the hip circumference ranged from 54 to 114 cm while the waist to hip ratio ranged from 0.85 to 1.1 cm (mean of 0.97). In six cases (23%) acanthosis nigricans was present while 2 subjects has elevated pressure (8%). Using the NCEP III Criteria, only three subjects (11.5%) fulfilled the criteria for metabolic syndrome. Nine subjects were positive for the anti-GAD antibody while 17 subjects (65%) had normal values. C-peptide values and anti-GAD titers did not significantly vary among obese/ overweight adolescents and non obese. A statistically higher ne underweight / normal BMI than those who are obese had low C-peptide values (13 versus 6), while those with high C-peptide values, a higher frequency were overweight (6 versus 3). (p=0.41). There is a negative or inverse statistical correlation between C-peptides and anti-GAD titers, although the relationship is weak. (r = .127, p=.06).Conclusion: The mean BMI of the adolescent onset Filipino diabetics is 21.4 kg/m2, with mean waist circumference of 73.2cm and mean waist to hip ratio of 0.97cm. Eleven percent of the population has metabolic syndrome. Body mass index has no statistically significant correlation with anti-GAD antibody and C peptide level. However, higher number of patients who are underweight or with normal BMI has low C-peptide levels. Twenty three percent of the population has acanthosis nigricans and 75% of them are obese diabetics with elevated C peptide. A trend towards inverse relationship between anti-GAD antibody levels and C-peptide levels has been identified which needs further studies.
Human ; Adolescent Onset Diabetes ; Diabetes Mellitus

BACKGROUND: From different researches. It was learned that virgin coconut oil (VCO) has the following chemical properties; It is a saturated fat, chemically a medium chain fatty acid (MCFA), which is uniquely different from other fatty acids in that it has the lowest caloric value gram per gram but still provides the highest energy expenditure. Another special feature of MCFA, is that they circulate as fatty acids, not as triglyceride, therefore are not deposited in fat tissues. Furthermore, they raise the body's metaolic rate giving a termogenic effect and like animal fats, induce satiety and make one stop eating, hence can lead to weight loss. Several human studies done from 1965 to 1994 suggested that lauric, myristic, and palmitic acids have cholesterol-raising action but of different potential levels. A meta analysis of 60 controlled trials by Mensink et al 2003 (13) showed that lauric acid greatly increased total cholesterol, but much of its effect was on high density lipoprotein (HDL) cholesterol. Another randomized control trial done in India also showed that low density lipoprotein levels were lower and HDL levels were higher in the serum and tissues of patients given VCO for 45 days compared with those given ground nut and copra oil.

OBJECTIVES: The general objective is to determine the effects of virgin coconut oil on weight, total cholesterol, triglyceride among overweight otherwise healthy individuals.

METHODS: This is an open-label, randomized control trial, a pilot study on the effects of virgin coconut oil on weight, total cholesterol, triglyceride, LDL, HDL, among overweight otherwise healthy individuals, with a computed sample size of 50.

RESULTS: Thirty one patients met the inclusion criteria. Sixteen subjects (52%) were randomized to oral intake of virgin coconut oil (n=16) while 15 subjects (48%) to diet and exercise only (control). Four dropped out, one from the VCO group and three from control group. At baseline, the two groups were comparable in terms of age (p=.67), sex (p=.94), height (p=.59), weight (p=.77), abdominal circumference (p=,80), and body mass index (p=.08) Within-Group Comparison. After 45 days of local intake of virgin coconut oil, a statistically significant reduction in the mean weight was noted from baseline (64 kg to 59.9 kg, p=.001). This finding was also seen with the control group. (65.1 to 61.8 kg, p=.002). A statistically significant decrease in the serum HDL was noted in the control after the trial (56.9 mg/dl to 51.7 mg/dl, p=.021). A non-statistically significant reduction was seen in the VCO group (54.8 to 54.2, p=.69). No significant change was noted in terms of the total cholesterol, triglycerides and LDL. Between-group comparison After 45 days, no observable statistical difference was noted in the mean weight between the VCO group and the control group (VCO=59.9 vs. Control=61.8 kg, p=43). Likewise, total cholesterol (176.8 vs. 181.5, p=.79); triglycerides (66.5 vs. 65.9, p=.91), LDL (107 vs 113.4, p=.61), HDL (54.2 vs 51.7, p=65) were not statistically different.

CONCLUSION: The demonstrated serum lipid-reducing effects in this trial are inconclusive. Although, total cholesterol, triglycerides and LDL showed a decreasing trend from baseline, the effect size was small and statistically insignificant. Large scale trials that rigorously control for variation in serum lipids among the healthy population are still warranted.variation in serum lipids that

Human ; Virgin Coconut Oil