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- Omega-3 Polyunsaturated Fatty Acid for Cholestasis due to Bile Duct Paucity. [Journal Article]
- Pediatr Gastroenterol Hepatol Nutr 2014 Jun; 17(2):121-4.
Omega (ω)-3 polyunsaturated fatty acids appear to be effective in preventing and treating parenteral nutrition-associated liver disease, and several mechanisms were proposed for this observation. An 8-week-old male infant with cholestasis and acholic stool was diagnosed non-syndromic intrahepatic interlobular bile duct paucity by open-wedge liver biopsy. Initially he was treated with usual supportive medical therapy, including ursodeoxycholic acid. However, the clinical status and laboratory tests did not improve. Omega (ω)-3 polyunsaturated fatty acids (initially intravenous administration and oral administration later), were started and his liver function, including aminotransferase level and bilirubin levels normalized, and the ivory stool color turned green. We report the possible effectiveness of ω-3 polyunsaturated fatty acids as a potent choleretic agent for non-syndromic intrahepatic interlobular bile duct paucity, a very rare structural pediatric hepatic disease.
- Prognostic and predictive value of liver volume in colorectal cancer patients with unresectable liver metastases. [Journal Article]
- Radiat Oncol J 2014 Jun; 32(2):77-83.
To determine the prognostic and predictive value of liver volume in colorectal cancer patients with unresectable liver metastases.Sixteen patients received whole liver radiotherapy (WLRT) between January 1997 and June 2013. A total dose of 21 Gy was delivered in 7 fractions.The median survival time after WLRT was 9 weeks. In univariate analysis, performance status, serum albumin and total bilirubin level, liver volume and extrahepatic metastases were associated with survival. The mean liver volume was significantly different between subgroups with and without pain relief (3,097 and 4,739 mL, respectively; p = 0.002).A larger liver volume is a poor prognostic factor for survival and also a negative predictive factor for response to WLRT. If patients who are referred for WLRT have large liver volume, they should be informed of the poor prognosis and should be closely observed during and after WLRT.
- A novel predictor of infarct-related artery patency before percutaneous intervention and in-hospital outcomes for ST-segment elevation myocardial infarction patients: serum bilirubin level. [Journal Article]
- Postepy Kardiol Interwencyjnej 2014; 10(2):91-7.
Previous studies have reported a relationship between serum bilirubin levels and coronary artery disease (CAD). However, data are rare up to now regarding the relation of bilirubin levels with infarct-related artery (IRA) patency in the setting of ST-segment elevation myocardial infarction (STEMI). Moreover, previous studies reported that increased bilirubin was related to impaired post-intervention coronary flow. To our knowledge, the association between serum total bilirubin (TB) levels and pre-primary percutaneous coronary intervention (PCI) with patency of IRA flow in STEMI patients has not been investigated.To evaluate the association of TB with pre-primary PCI, coronary flow and in-hospital major adverse cardiac events (MACE) in patients with STEMI.A total of 360 consecutive patients with STEMI (mean age = 61.4 ±13.7 years) admitted within 12 h from the time of symptom onset were enrolled. Patients were divided into 2 groups based on the serum TB levels. We defined normal flow as pre-PCI TIMI 3 flow, while impaired flow was defined as pre-PCI TIMI ≤ 2 flow.Pre-PCI impaired flow was higher in the TB group than pre-PCI normal flow (p < 0.001). In-hospital mortality and MACE were significantly higher in the high TB group (p = 0.002, p < 0.001 respectively). In the receiver operating characteristic curve analysis, TB > 0.825 mg/dl predicted impaired IRA flow before p-PCI with a sensitivity of 79% and specificity of 71%.The TB is an inexpensive and readily available marker for STEMI patients undergoing PCI. It can be used for risk stratification in this patient population.
- Evaluation of the hepatroprotective and nephroprotective activities of Scrophularia hypericifolia growing in Saudi Arabia. [Journal Article]
- Saudi Pharm J 2014 Jul; 22(3):258-63.
The hepatroprotective and nephroprotective effects of the ethanol extract of the aerial parts of Scrophularia hypericifolia growing in Saudi Arabia were evaluated at 250 and 500 mg kg(-1) doses using Wistar albino rats as experimental animal model. Toxic doses of paracetamol were used to induce liver and kidney toxicities, while the standard drug silymarin was used as reference. The biochemical parameters such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma glutamyl transpeptidase (GGT) and total bilirubin were estimated as reflections of the liver condition. Kidney condition was investigated through measurement of serum urea, serum creatinine, sodium and potassium levels. Liver and kidney samples of rats treated with 500 mg kg(-1) of the extract were subjected to the histopathological study. The ethanol extract of the aerial parts of S. hypericifolia showed dose dependent moderate level of protection against paracetamol induced hepatrotoxicity and nephrotoxicity as indicated from the obtained results. The reduction of the sodium and potassium levels by the higher dose of the extract exceeded that obtained by silymarin.
- Bilirubin: a potential biomarker and therapeutic target for diabetic nephropathy. [Journal Article]
- Diabetes 2014 Aug; 63(8):2613-6.
- Maternal anti-D prophylaxis during pregnancy and risk of hemolysis among preterm infants. [JOURNAL ARTICLE]
- J Perinatol 2014 Jul 24.
Objective:To evaluate whether Rh-positive preterm newborn infants born to Rh-negative mothers treated with prophylactic anti-D immunoglobulins exhibited signs of hemolytic reaction, including anemia and hyperbilirubinemia.Study design:Retrospective data were collected for 94 Rh-positive preterm newborns born at gestational age (GA) 28 to 34 weeks to 76 Rh-negative mothers and for matched controls.Result:We found 11.7% positive Coombs' tests among infants in the study group and slightly higher bilirubin levels at birth and on the following 3 days. No differences were recorded between the study and the control groups for hematocrit levels throughout hospitalization, maximal bilirubin level, phototherapy treatment or the need for blood transfusion.Conclusion:Among preterm Rh-positive newborn infants born to Rh-negative mothers, there appears to be no evidence of significant hemolytic reaction derived from placental anti-D transfer. Further prospective studies are needed to confirm these findings in order to support anti-D administration close to preterm birth.Journal of Perinatology advance online publication, 24 July 2014; doi:10.1038/jp.2014.134.
- Could Biochemical Liver Profile Help to Assess Metabolic Response to Aerobic Effort in Athletes? [JOURNAL ARTICLE]
- J Strength Cond Res 2014 Aug; 28(8):2180-2186.
Chamera, T, Spieszny, M, Klocek, T, Kostrzewa-Nowak, D, Nowak, R, Lachowicz, M, Buryta, R, and Cięszczyk, P. Could biochemical liver profile help to assess metabolic response to aerobic effort in athletes? J Strength Cond Res 28(8): 2180-2186, 2014-Monitoring and optimizing the effectiveness of training course require wide analyses of athletes' blood parameter changes. The aim of this study was to evaluate the usefulness of biochemical liver profile to assess the metabolic response to semi-long-distance outdoor run in football players. Sixteen football players run outdoor for 60 minutes to achieve aerobic metabolism. Plasma activity of aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ-glutamyltransferase (GGT) and plasma levels of total and direct bilirubin were determined in samples obtained before exercise test (pre-exercise) and immediately after the run (post-exercise). Mean AST plasma activity (U·L) before/after the exercise, respectively, was 78.3/228.3 in women and 76.5/56.2 in men. Mean ALT plasma activity (U·L) before/after the exercise, respectively, was 27.5/59.1 in women and 36.2/35.3 in men. Mean GGT plasma activity (U·L) before/after the exercise, respectively, was 39.3/76.6 in women and 44.7/71.2 in men. Plasma levels of total and direct bilirubin were similar before and after the run regardless of the gender. Statistical significance of the differences between results obtained pre- and post-exercise occurred in women (p = 0.0212 for AST; p = 0.0320 for ALT; p = 0.0067 for GGT, respectively). The training monitoring in athletes should be performed using measurements of performance and biological or physiological parameters. It was found that AST, ALT, and GGT activities could be a valuable tool to assess the metabolic response in high-level fitness female athletes. Therefore, monitoring of those well-known diagnostic markers could prevent the trainee from harmful overtraining.
- Preliminary development of a fiber optic sensor for measuring bilirubin. [Journal Article]
- Anal Chem Insights 2014.:59-65.
Preliminary development of a fiber optic bilirubin sensor is described, where an unclad sensing portion is used to provide evanescent wave interaction of the transmitted light with the chemical environment. By using a wavelength corresponding to a bilirubin absorption peak, the Beer-Lambert Law can be used to relate the concentration of bilirubin surrounding the sensing portion to the amount of absorbed light. Initial testing in vitro suggests that the sensor response is consistent with the results of bulk absorption measurements as well as the Beer-Lambert Law. In addition, it is found that conjugated and unconjugated bilirubin have different peak absorption wavelengths, so that two optical frequencies may potentially be used to measure both types of bilirubin. Future development of this device could provide a means of real-time, point-of-care monitoring of intravenous bilirubin in critical care neonates with hyperbilirubinemia.
- Impact of Providing a Combination Lipid Emulsion Compared With a Standard Soybean Oil Lipid Emulsion in Children Receiving Parenteral Nutrition: A Systematic Review and Meta-Analysis. [JOURNAL ARTICLE]
- JPEN J Parenter Enteral Nutr 2014 Jul 23.
Background: Soybean oil lipid emulsion may compromise immune function and promote hepatic damage due to its composition of long-chain fatty acids, phytosterols, high proportion of ω-6 fatty acids, and low α-tocopherol levels. Combination lipid emulsions have been developed using medium-chain triglyceride oil, fish oil, and/or olive oil, which provide adequate essential fatty acids, a smaller concentration of ω-6 fatty acids, and lower levels of phytosterols. The purpose of this systematic review is to determine if combination lipid emulsions have a more favorable impact on bilirubin levels, triglyceride levels, and incidence of infection compared with soybean oil lipid emulsions in children receiving parenteral nutrition. Methods: This study comprises a systematic review of published studies. Data were sufficient and homogeneous to conduct a meta-analysis for total bilirubin and infection. Results: Nine studies met the inclusion criteria. Meta-analysis showed that combination lipid emulsion decreased total bilirubin by a mean difference of 2.09 mg/dL (95% confidence interval, -4.42 to 0.24) compared with soybean oil lipid emulsion, although the result was not statistically significant (P = .08). Meta-analysis revealed no statistically significant difference in incidence of infection between the combination lipid emulsion and the soybean oil lipid emulsion groups (P = .846). None of the 4 studies that included triglyceride as an outcome detected a significant difference in triglyceride levels between the combination lipid emulsion and soybean oil lipid emulsion groups. Conclusion: There is inadequate evidence that combination lipid emulsions offer any benefit regarding bilirubin levels, triglyceride levels, or incidence of infection compared with soybean oil lipid emulsions.
- Neonatal jaundice and increased risk of attention-deficit hyperactivity disorder: a population-based cohort study. [JOURNAL ARTICLE]
- J Child Psychol Psychiatry 2014 Jul 24.
Previous studies have posited conflicting results regarding the relationship between neonatal jaundice and the subsequent risk of attention-deficit hyperactivity disorder (ADHD). We therefore performed a large population study with a defined neonatal jaundice cohort to investigate the incidence and risk of physician-diagnosed ADHD in Taiwan.From 2000 to 2004, 24,950 neonatal jaundice cases and 69,964 matched nonjaundice controls were identified. At the end of 2008, the incidence rate and hazard ratios (HRs) of physician-diagnosed ADHD were calculated.The incidence of ADHD was 2.48-fold greater in the jaundice cohort than in the nonjaundice cohort (3.84 vs. 1.51 per 100,000 person-years) in the study period. The HR of ADHD was substantially greater for male, preterm, and low-birth-weight infants with neonatal jaundice. The risk of developing ADHD in the jaundice cohort was greater after a diagnosis of neonatal jaundice for more than 6 years (HR: 2.64; 95% confidence interval: 2.13-3.28). The risk of ADHD increased for neonates with higher serum bilirubin levels requiring phototherapy and with longer admission days.Neonates with jaundice are at high risk for developing physician-diagnosed ADHD during their growth period. A risk alert regarding neurologic consequences is urgently required after a neonatal jaundice diagnosis. Additional studies should be conducted to clarify the pathogenesis of these relationships.