Nutritional aspects of Acute Renal Failure

The patient with acute renal failure is a very ill patient suffering from high urea levels causing poor appetite, nausea and vomiting. These patients are usually treated with a low sodium, low protein and, if the potassium in the blood is high, with a low potassium diet (1). This paper discusses whether or not this is the correct treatment. The symptoms of high urea levels in the blood together with increased needs for energy and protein makes it very hard to prevent the patient becoming malnourished. Often energy‐enriched drinks are necessary to achieve recommendations and it is prudent to let the patient eat and drink what they desire. By calculating the energy and protein needs and comparing these with the intake and the state of illness and by following the patient's body weight over time we can obtain information about the state of nourishment. When we alter the food that's offered we achieve better intake and reduce the risk of malnourishment.     

小儿疳证源流考

疳作为一个病名，最早见于隋《诸病源候论》。首先将疳证作为儿科专有疾病者，为宋初《太平圣惠方》。本病分类最全面，收集方剂最丰富当推宋《幼幼新书》。南宋出版的《小儿卫生总微论方》首次将疳证归类为五疳。本草文献中对本病贡献最大的为明《本草纲目》。清《温病条辨》首次将本病治法作全面总结。１９９４年国家中医药管理局颁布的《中医病证诊断疗效标准》首次以法规的形式将本病作了统一规范     

Successful mitral valve repair for active infective endocarditis accompanied by anorexia nervosa

Infective endocarditis of the mitral area accompanied by anorexia nervosa is extremely rare. A 34-year-old Japanese woman presented with high fever and a heart murmur that had developed over the previous 2-month period. Echocardiography revealed mitral regurgitation and vegetation attached to the anterior mitral leaflet, which had markedly prolapsed to the left atrium. We removed the vegetation with a small part of the anterior mitral leaflet and successfully repaired the mitral valve. The patient showed good recovery, and the mitral regurgitation and left ventricular chamber size had satisfactorily decreased at 2 months after the operation.     

Malnutrition and subsequent ischemic heart disease in former prisoners of war of world war II and the Korean conflict

The harsh treatment of former prisoners of war (POWs) of World War II and the Korean conflict resulted in severe malnutrition. Although rarely linked to specific long-term medical problems, a specific marker of malnutrition, self-reported lower limb edema (presumably due to a vitamin B deficiency) was associated with a three-fold increase in subsequent death attributed to ischemic heart disease (IHD) during the follow-up period from 1967 through 1975. Although there is at present no medical basis for linking edema, which is perhaps a marker for some unmeasured risk factor, to subsequent IHD, this finding may nonetheless have medical implications for the group of former POWs and other populations with severe dietary deficiency. It also suggests there may be a need to reexamine currently held theories on malnutrition and subsequent chronic disease.     

营养不良老年人非药物干预临床实践指南

老年人是营养不良的高发人群,营养不良与众多不良临床结局密切相关,严重影响老年人的身体健康和生活质量,给家庭和社会造成沉重负担。因此,采取有效措施改善老年人的营养不良至关重要,非药物干预是改善营养状况的重要措施。然而,国内尚无专门针对营养不良老年人的非药物干预临床实践指南,因此,中国老年护理联盟、国家老年医学中心和国家老年疾病临床医学研究中心的营养专家,通过对老年人营养不良最新的国内外文献的全面检索与分析,采用推荐意见评估、制订及评价(GRADE)分级体系制订了本指南,针对营养不良老年人非药物干预提出9条推荐意见,以期能够改善老年人营养不良状况,提高生活质量。本指南侧重于可经口进食的营养不良老年人,聚焦于肠内营养,肠外营养不在本指南讨论范围内。     

Motor competence in rats of different stocks reared in large and small litters

The effects of sex and stock on a task of motor competence (balancing on a rod) were studied in Long-Evans, Sprague-Dawley and Wistar rats reared in large and small litters. The data indicated significant sex and stock effects but no effects of rearing condition. Although no nutritional effect was found on this task, the data suggest that stock differences should receive greater attention particularly with regard to the possibilities that such differences provide for the identification and analysis of a broad spectrum of effects.     

Reversal to normal anatomy after one-anastomosis/mini gastric bypass,indications and results: a systematic review and meta-analysis

This review evaluates the indications and outcomes of one-anastomosis/mini gastric bypass (OAGB/MGB) reversal to normal anatomy. A systematic literature search and meta-analysis was performed in PubMed, Web of Science, and Scopus for articles published by October 1, 2020, including the keywords “one anastomosis gastric bypass,” “OAGB,” “mini gastric bypass,” “MGB,” “reversal,” “reverse,” “malnutrition,” and “reversal bariatric surgery”. After examining 182 papers involving 11,578 patients, 14 studies were included. A reversal was performed in 119 patients on average 23.6 months after the primary OAGB/MGB surgery. The mean body mass index (BMI) was 22.92 ± 3.47 kg/m² and the mean albumin level was 25.17 ± 4.21 g/L at reversal. The mean length of the common channel (CC) was 383.57 ± 159.35 cm, with a mean biliopancreatic limb (BPL) length of 214.21 ± 48.45 cm. Pooled estimation of the meta-analysis of prevalence studies reported a prevalence of 1% for reversal. The major signs and symptoms of protein-energy malnutrition were the leading causes of the reversal of OAGB/MGB. Bleeding, leakage, and death due to severe liver failure were the most reported complications after reversal, with an overall incidence of 10.9%. In conclusion, OAGB/MGB reversal has a prevalence of 1% and has a complication rate of 10.9%. Protein-energy malnutrition with hypoalbuminemia was the most common etiology. The mean lengths of BPL and CC were reported as 215 cm and 380 cm, respectively, in the cases. Therefore, special attention should be paid to malnutrition in all OAGB/MGB patients during follow-up to prevent severe malnutrition and subsequent increase in reversal procedures.