Liver failure caused by prolonged state of malnutrition following bariatric surgery

Bariatric surgery is an effective tool in the treatment of patients with morbid obesity. In these case reports we describe 2 patients who developed liver failure after currently-practiced types of bariatric surgery, caused by a prolonged state of malnutrition provoked by psychiatric problems. Despite intensive guidance of a psychologist and dieticians after surgery, our patients deteriorated psychologically, resulting in a prolonged state of severe malnutrition and anorexia. Finally, a state of starvation was reached, passing a critical level of the liver capacity. Patients who present with signs of severe protein malnutrition after bariatric surgery should be closely monitored and checked for nutritional status. Specific attention should be given to patients who develop psychiatric problems post-bariatric surgery. If refeeding does not result in clinical improvement, reversal surgery should be considered in a timely manner.     

脑干听觉诱发电位诊断新生儿高胆红素血症的临床应用价值

目的 探讨应用脑干听觉诱发电位(BAEP)诊断新生儿高胆红素血症的临床价值.方法 选择2017-08～2019-08阳春市妇幼保健院收治的98例高胆红素血症新生儿作为观察组,另选择同期98名健康新生儿作为对照组.两组均施行BAEP检测,并比较检测结果.结果 观察组有71例(72.45％)发生BAEP异常,对照组有6例(...     

有机阴离子转运因子2的多态性与某省新生儿重症高胆红素血症的相关性研究

目的探讨有机阴离子转运因子2(OATP2)的A388G及T521C基因多态性与云南省新生儿高胆红素血症的相关性。方法 180例新生儿重症高胆红素血症作为病例组,80例无黄疸新生儿作为对照组。采用常规方法提取DNA,用聚合酶链反应(PCR)方法扩增,琼脂糖凝胶电泳鉴定产物,PCR产物进行DNA测序。结果病例组与对照组A388G等位基因突变率分别为25%及23%,病例组A388G基因频率与对照组间差异无统计学意义(χ2=1.056,P>0.05);病例组与对照组T521C基因等位基因突变率分别为9%及3%,病例组T521C基因频率显著高于对照组,差异有统计学意义(χ2=5.590,P<0.05)。结论云南省重症新生儿高胆红素血症的发生与有机阴离子转运因子2的A388G基因突变无关,而与T521C基因的多态性密切相关。     

SLCO1B1 and SLCO1B3 genetic mutations in Taiwanese patients with Rotor syndrome

Rotor syndrome is a rare, benign, inherited disorder that is commonly associated with mild hyperbilirubinemia. It is caused by bi-allelic pathological variants in both SLCO1B1 and SLCO1B3 genes, causing defective OATP1B1 and OATP1B3 in the sinusoidal membrane and interrupted bilirubin uptake of the hepatocytes. We report five Taiwanese pediatric and adult patients aged 5–32 years presenting with conjugated hyperbilirubinemia, and were found to have genetic variants of SLCO1B1 and SLCO1B3. Two also had history of prolonged neonatal jaundice. Genetic analysis using panel-based next generation sequencing revealed three patients with homozygous mutations c.1738C>T (p.R5801) in SLCO1B1 and a transposon LINE-1 insertion in SLCO1B3, one patient with homozygous mutations for another haplotype, c.757C>T (p.R2531) in SLCO1B1 and c.1747+1G>A in SLCO1B3. Another patient had heterozygous c.1738C>T (p.R5801) in SLCO1B1 linked with a LINE-1 insertion in SLCO1B3, and heterozygous c.757C>T (p.R2531) in SLCO1B1 linked with c.1747+1G>A in SLCO1B3. In conclusion, we present the first time of genetic diagnosis of Rotor syndrome in Taiwan. Advanced genetic testing has enhanced the diagnosis of rare diseases with mild symptoms.     

暖箱内间歇蓝光治疗低体重儿黄疸65例的体温观察

目的 了解低体重儿暖箱内间歇蓝光治疗期间影响体温的主要因素.方法 将65例低体重儿暖箱内间歇蓝光治疗24 h内的体温与暖箱温度作Excel趋势图,并行不同时间区间与体温的相关系数分析.结果 体温与箱温在两轴折线图上表现为方向相反、轨迹交叉的两条曲线.光照期体温升高与时间呈正相关,r＝0.997,P＜0.05;间歇期则反...     

Effect of foot reflexology on neonates’ clinical outcomes with hyperbilirubinemia undergoing phototherapy: A randomized controlled trial

BackgroundNeonatal hyperbilirubinemia is the most common reason for neonatal admissions to the Neonatal Intensive Care Unit that can progress to critical levels. Foot reflexology therapy is one of the complementary alternative therapies that can help to upgrade neonatal clinical outcomes with hyperbilirubinemia.AimThis study aimed to investigate the effect of foot reflexology on neonates’ clinical outcomes with hyperbilirubinemia undergoing phototherapy.DesignA Quasi-experimental two groups research design was used to accomplish this study.MethodsThis study was conducted at Neonatal Intensive Care Unit in Alexandria University Children's Hospital at Smouha, Alexandria on 60 full-term neonates with hyperbilirubinemia undergoing phototherapy, were randomly assigned to two groups Neonates of the control group were received only phototherapy for hyperbilirubinemia, While foot reflexology neonates received intervention on the gastrointestinal system zone for 20 min in the morning before feeding once daily for consecutive five days beside phototherapy.Resultsfoot reflexology neonates exhibited a decrease in total bilirubin level to 7.9000 ± 1.81545 on the fifth day compared to 10.1633 ± 1.77054 for the control group neonates. A decline in the mean duration of undergoing phototherapy for neonates in the foot reflexology group to 4.30 ± 0.466 on the contrary with 5.00 ± 1.017 days for the control group.ConclusionApplication of foot reflexology is effective in improving the full-term neonates’ clinical outcomes with hyperbilirubinemia undergoing phototherapy. Thus, this non-pharmacological method is recommended as a supplement treatment for neonates with hyperbilirubinemia beside phototherapy.