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Purpose Hepatoblastoma is the most common primary liver tumor in children and has a greater incidence in children with a history of prematurity and very low birth weight. To increase awareness of the association between prematurity and hepatoblastoma for health care providers who treat children with Cerebral Palsy (CP), we present two case reports. Methods Two case reports of premature, very low birth weight infants with hepatoblastoma are described and a literature review of hepatoblastoma in the setting of prematurity and cerebral palsy is performed. Results Each patient had a history of 26-28 week prematurity, very low birth weight, and CP. Both presented with worsening constipation and abdominal distension that did not respond to oral medications. Appropriate referrals to the ER were made which lead to a diagnosis of hepatoblastoma. Pediatric rehabilitation was a source of referral for diagnosis in one patient and aided in the rehabilitation course following treatment for both patients. Conclusions Hepatoblastoma is the most common primary liver tumor in children and has an increased incidence in children with a history of prematurity and very low birth weight. Providers who frequently care for the very low birth weight and premature children with CP should be aware of this correlation and include hepatoblastoma in the differential when managing patients with suddenly worsening constipation or abdominal distension. Pediatric physiatrists and other providers for these patients could be a source of referrals and diagnosis leading to timely treatment.

Objective One prevalent characteristic of all stages of chronic kidney disease (CKD) is excessive production of proinflammatory cytokines. Fish oil (FO) supplementation has been reported to lower levels of proinflammatory cytokines. The benefits of FO for an extensive range of populations and a variety of health concerns are apparent, yet the anti-inflammatory benefits for nondialysis CKD patients are not as well documented. Therefore, the purpose of this study was to investigate the effects of the daily consumption of FO (1,400 mg eicosapentaenoic acid + 1,000 mg docosahexaenoic acid) on interleukin 1β (IL-1β), interleukin 6 (IL-6), and tumor necrosis factor α (TNF-α) for 8 weeks in nondialysis CKD patients. Design, Setting, and Subjects In this double-blind, randomized, placebo-controlled intervention, the effect of 8 weeks of FO administration on IL-1β, IL-6, and TNF-α levels in nondialysis CKD patients were evaluated. Intervention Thirty-one nondialysis CKD patients (17 = FO; 14=placebo) randomly received either FO dietary supplementation 2.4 g/day (1,400 mg eicosapentaenoic acid + 1,000 mg docosahexaenoic acid) or placebo (safflower oil) for 8 weeks. Main Outcome Measures IL-1β, IL-6, and TNF-α were all measured as markers of inflammation. Results One-way analysis of variance revealed no significant differences in IL-6 ( P = .06), IL-1β ( P = .18), and TNF-α ( P = .20) between groups in pretest values. Additionally, no pretest differences existed between groups for age ( P = .549), weight ( P = .324), waist circumference ( P = .086), gender ( P = .591), and ethnicity ( P = .875). Covariance was calculated using compliance, age, gender, ethnicity, body weight, and waist circumference as covariates. No significant differences were discovered between groups after FO supplementation for IL-6 ( P = .453) and TNF-α ( P = .242). A significant difference was discovered for IL-1β ( P = .050) with lower levels in the FO group. Conclusions The results of this study are in agreement with some previous studies that suggest that FO supplementation has no effect on plasma proinflammatory cytokines TNF-α or IL-6, but does have an effect on IL-1β in nondialysis CKD patients.

Aims: The purpose of the study was to examine the effects of a moderate dose of commercially available fish oil on lipid variables in non-hemodialysis, chronic kidney disease patients. Study Design: The study utilized a double-blind, randomized, and placebo-controlled experimental design. The experimental intervention consisted of fish oil supplementation or a safflower oil control. Place and Duration of Study: Patients (N=31) from a family medicine center with Chronic Kidney Disease were eligible for the study and followed prospectively for eight weeks. Results: ANCOVA revealed a significant difference at post-test (p=0.02; Cohen’s d=-0.58) in HDL. No significant differences at post-test for triglycerides (p=0.66; Cohen’s Research Article British Journal of Medicine & Medical Research, 3(4): 1356-1366, 2013 1357 d=0.16), total cholesterol (p=0.84; Cohen’s d=-0.04), LDL (p=0.39; Cohen’s d=0.25), total cholesterol/HDL ratio (p=0.34; Cohen’s d=0.20), and ApoB (p=0.52; Cohen’s d=0.11) were discovered. Conclusions: The results of our study suggest the consumption of 2.4 grams of combined EPA and DHA may be an effective over-the-counter nutritional intervention to increase HDL in individuals with CKD. The reasons for non-significant findings in all other cholesterol variables may be due to a dose-response relationship, the short duration of the study, the study population, or the supplements simply may not be effective in improving these variables.

Chronic kidney disease (CKD) is characterized by a continuous reduction in kidney function, increased inflammation, and reduced antioxidant capacity. The objective of this study was to assess the effects of a herbal supplement on systemic inflammation and antioxidant status in non-dialysis CKD patients. Sixteen patients with CKD (56.0±16.0 yrs, 171.4±11.9 cm, 99.3±20.2 kg) were randomly chosen to receive a herbal supplement composed of Curcuma longa and Boswellia serrata, or placebo. Plasma levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), glutathione peroxidase (GPx), and serum C-reactive protein (CRP) were measured at baseline and 8 weeks. Baseline data demonstrated elevated inflammation and low antioxidant levels. A significant time effect (p=0.03) and time x compliance interaction effect (p=0.04) were observed for IL-6. No significant differences were observed for any other variables. This study demonstrates that mild and moderate CKD is associated with chronic inflammation and low antioxidant activity. Systemic inflammation and impaired antioxidant status may be greater in CKD populations with multiple comorbidities. Curcumin and Boswellia serrata are safe and tolerable and helped to improve the levels of an inflammatory cytokine.

Inflammation has been identified as a marker for cardiovascular disease. The purpose of this study is to examine the effects of fish oil fatty acid supplementation on C-reactive protein (CRP) levels.The study uses a double-blind, permuted-randomized, and placebo-controlled experimental protocol. Patients are randomly placed into a fish oil group or a control group. Thirty-three patients in the experimental and control groups ingest 2 soft-gel pills (1 g each) of fish oil supplements containing eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) or placebo at each meal. Patients follow the supplementation protocol for 6 months. Analysis of variance (ANOVA) is used to measure pretest and posttest differences in the variable of interest. A Kolmogorov-Smirnov test for normality is used to test whether CRP levels are normally distributed.The Kolmogorov-Smirnov test for CRP finds a P value of .273 (KS = .997), revealing that the distribution is normal. ANOVA reveals no statistically significant difference between groups at baseline for CRP (F = 4.118, P = .053). ANOVA reveals a significant main effect (F = 4.29, P = .048) for CRP, with the EPA/DHA group having a significant change in values from pretest (16 mg/dL, standard deviation [SD] = 13.80) to posttest (10.22 mg/dL, SD = 7.87). The placebo group's CRP levels do not change significantly from pretest (13.37, standard deviation [SD] = 7.94) to posttest (13.67, SD = 7.07). An observed power calculation using Cohen's D with a computed alpha of .05 is .588.The study demonstrates that consuming 960 mg/d of EPA and 600 mg/d of DHA can lower CRP.

693 sedentary women (47±12 yrs, 163±7 cm; 92±17 kg; 45±4% body fat) were assigned to a control group (C), an exercise group (E); or, a high carbohydrate or a high protein diet group for 10-weeks. D...

633 sedentary women (47±11 yrs, 163±7 cm; 92±18kg; 45±4 body fat) were assigned to a control group (C), an exercise group (E); or, a high carbohydrate or a high protein diet group for 10-weeks. Die...