1
|
Effectiveness of phototherapy with and without probiotics for the treatment of indirect hyperbilirubinaemia in preterm neonates: a randomised controlled trial. Paediatr Int Child Health 2024; 44:24-29. [PMID: 38482867 DOI: 10.1080/20469047.2024.2328416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 03/05/2024] [Indexed: 04/12/2024]
Abstract
INTRODUCTION Raised serum bilirubin levels can cause kernicterus, and premature infants are at increased risk owing to metabolic immaturity. The standard treatment for neonatal jaundice is phototherapy, but probiotics alone can reduce the duration of phototherapy and hospitalisation. OBJECTIVES To determine the effectiveness of phototherapy with and without probiotics for the treatment of indirect hyperbilirubinaemia in preterm neonates. PATIENTS AND METHODS The open-labelled randomised controlled trial was conducted from January 2022 to January 2023 in the neonatal unit of the University of Lahore Teaching Hospital, Pakistan. A total of 76 preterm neonates who fulfilled the selection criteria were included and divided into two groups. Both groups received standard phototherapy. In Group B, a probiotic (Saccharomyces boulardii) 125 mg, twice daily, orally (in 5 cc of whichever milk the infant was receiving) was given until discharge from hospital. The primary outcome measurements were the duration of phototherapy and the length of hospitalisation. RESULTS The mean (SD) duration of phototherapy was 36.55 (14.25) hours in Group A and 24.61 (9.25) hours in Group B (p <0.05). The mean (SD) duration of hospital stay was 47.36 (16.51) hours in Group A and 33.13 (8.93) hours in Group B (p <0.05). CONCLUSION Oral probiotics (Saccharomyces boulardii) have a significant effect on the duration of phototherapy for neonatal hyperbilirubinaemia, and they decrease the chances of nosocomial infection. Exploration of clinical outcomes by investigating faecal flora and undertaking large randomised controlled trials of various probiotics are needed. ABBREVIATIONS ABE: acute bilirubin encephalopathy; CNS: central nervous system; GA: gestational age; IVIG: intravenous immunoglobulin; KSD: kernicterus; NNU: neonatal unit; RCT: randomised controlled trial; S. boulardii: Saccharomyces boulardii.
Collapse
|
2
|
Application of machine learning algorithms for accurate determination of bilirubin level on in vitro engineered tissue phantom images. Sci Rep 2024; 14:5952. [PMID: 38467676 PMCID: PMC10928098 DOI: 10.1038/s41598-024-56319-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 03/05/2024] [Indexed: 03/13/2024] Open
Abstract
Neonatal Jaundice is a common occurrence in neonates. High excess bilirubin would lead to hyperbilirubinemia, leading to irreversible adverse damage such as kernicterus. Therefore, it is necessary and important to monitor neonates' bilirubin levels in real-time for immediate intervention. However, current screening protocols have their inherent limitations, necessitating more convenient measurements. In this proof-of-concept study, we evaluated the feasibility of using machine learning for the screening of hyperbilirubinemia in neonates from smartphone-acquired photographs. Different machine learning models were compared and evaluated to gain a better understanding of feature selection and model performance in bilirubin determination. An in vitro study was conducted with a bilirubin-containing tissue phantom to identify potential biological and environmental confounding factors. The findings of this study present a systematic characterization of the confounding effect of various factors through separate parametric tests. These tests uncover potential techniques in image pre-processing, highlighting important biological features (light scattering property and skin thickness) and external features (ISO, lighting conditions and white balance), which together contribute to robust model approaches for accurately determining bilirubin concentrations. By obtaining an accuracy of 0.848 in classification and 0.812 in regression, these findings indicate strong potential in aiding in the design of clinical studies using patient-derived images.
Collapse
|
3
|
Sustained lower bilirubin-binding affinity of albumin in extremely preterm infants. Pediatr Res 2023; 94:1400-1407. [PMID: 36528748 DOI: 10.1038/s41390-022-02418-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 11/01/2022] [Accepted: 11/09/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Elevated albumin-free or unbound bilirubin (UB) levels beyond the first week of life have been associated with the development of bilirubin encephalopathy in preterm infants. However, the mechanism(s) that induces this prolonged unbound bilirubinemia has remained unknown. We hypothesized that it may due to a sustained lower bilirubin-binding affinity of albumin in extremely premature infants. METHODS Twenty-two very preterm infants born at 28-31 weeks' gestational age (GA) (VPT Group) and 21 extremely preterm infants born at 22-27 weeks' GA (EPT Group) were retrospectively studied. On days 14, 21, and 28, bilirubin-binding affinity of albumin was assessed by calculating of the UB/total bilirubin ratio, bilirubin-albumin molar ratio (BAMR), and binding affinity (Ka). RESULTS On days 14, 21, and 28, significantly higher UB/total bilirubin ratios were found in the EPT than in the VPT Group. Although BAMRs were comparable, significantly lower Ka values on days 14, 21, and 28 were observed in the EPT than those in the VPT Group (56.1 vs. 70.9 L/μmol, p < 0.001; 55.2 vs. 74.7 L/μmol, p < 0.001; 53.0 vs. 86.5 L/μmol, p < 0.001, respectively). CONCLUSIONS EPT infants have a sustained lower bilirubin-binding affinity of albumin beyond the first week of life. IMPACT Bilirubin encephalopathy is still reported in extremely preterm (EPT) infants. EPT infants often have prolonged unbound bilirubinemia beyond the first week of life. Sustained lower bilirubin-binding affinity of albumin, regardless of the bilirubin-albumin molar ratio (BAMR), is observed in EPT infants. BAMRs should not be used as a surrogate marker of unbound bilirubinemia, especially in EPT infants at a later postnatal period.
Collapse
|
4
|
Free Bilirubin Induces Neuro-Inflammation in an Induced Pluripotent Stem Cell-Derived Cortical Organoid Model of Crigler-Najjar Syndrome. Cells 2023; 12:2277. [PMID: 37759499 PMCID: PMC10527749 DOI: 10.3390/cells12182277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/30/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
Bilirubin-induced neurological damage (BIND), which might progress to kernicterus, occurs as a consequence of defects in the bilirubin conjugation machinery, thus enabling albumin-unbound free bilirubin (BF) to cross the blood-brain barrier and accumulate within. A defect in the UGT1A1 enzyme-encoding gene, which is directly responsible for bilirubin conjugation, can cause Crigler-Najjar syndrome (CNS) and Gilbert's syndrome. We used human-induced pluripotent stem cell (hiPSC)-derived 3D brain organoids to model BIND in vitro and unveil the molecular basis of the detrimental effects of BF in the developing human brain. Healthy and patient-derived iPSCs were differentiated into day-20 brain organoids, and then stimulated with 200 nM BF. Analyses at 24 and 72 h post-treatment point to BF-induced neuro-inflammation in both cell lines. Transcriptome, associated KEGG, and Gene Ontology analyses unveiled the activation of distinct inflammatory pathways, such as cytokine-cytokine receptor interaction, MAPK signaling, and NFκB activation. Furthermore, the mRNA expression and secretome analysis confirmed an upregulation of pro-inflammatory cytokines such as IL-6 and IL-8 upon BF stimulation. This novel study has provided insights into how a human iPSC-derived 3D brain organoid model can serve as a prospective platform for studying the etiology of BIND kernicterus.
Collapse
|
5
|
MGE-Like Neural Progenitor Cell Survival and Expression of Parvalbumin and Proenkephalin in a Jaundiced Rat Model of Kernicterus. Cell Transplant 2022; 31:9636897221101116. [PMID: 35596532 PMCID: PMC9125107 DOI: 10.1177/09636897221101116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 02/27/2022] [Accepted: 04/26/2022] [Indexed: 11/28/2022] Open
Abstract
Kernicterus is a permanent condition caused by brain damage from bilirubin toxicity. Dystonia is one of the most debilitating symptoms of kernicterus and results from damage to the globus pallidus (GP). One potential therapeutic strategy to treat dystonia in kernicterus is to replace lost GP neurons and restore basal ganglia circuits through stem cell transplantation. Toward this end, we differentiated human embryonic stem cells (hESCs) into medial ganglion eminence (MGE; the embryological origin of most of the GP neurons)-like neural precursor cells (NPCs). We determined neurochemical phenotype in cell culture and after transplanting into the GP of jaundiced Gunn rats. We also determined grafted cell survival as well as migration, distribution, and morphology after transplantation. As in the GP, most cultured MGE-like NPCs expressed γ-aminobutyric acid (GABA), with some co-expressing markers for parvalbumin (PV) and others expressing markers for pro-enkephalin (PENK). MGE-like NPCs survived in brains at least 7 weeks after transplantation, with most aggregating near the injection site. Grafted cells expressed GABA and PV or PENK as in the normal GP. Although survival was low and the maturity of grafted cells varied, many cells produced neurite outgrowth. While promising, our results suggest the need to further optimize the differentiation protocol for MGE-like NPC for potential use in treating dystonia in kernicterus.
Collapse
|
6
|
[The Role of Nrf2 Pathway Activation in Hippocampal Neuron Injury of Neonatal Rats with Bilirubin Encephalopathy]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2021; 52:960-965. [PMID: 34841762 PMCID: PMC10408819 DOI: 10.12182/20211160502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To explore the effect of nuclear factor-erythroid 2-related factor (Nrf2) pathway activation on hippocampal neuron damage in neonatal rats with bilirubin encephalopathy. METHODS Neonatal rats were randomly assigned to a control group (Control), a model group (Model) and an Nrf2 activator TBHQ (tert-Butylhydroquinone) group (TBHQ), with 20 rats in each group. Bilirubin solution was injected through the cerebellomedullary cistern to establish the neonatal rat model of bilirubin encephalopathy. Neurobehavioral changes were observed in rats and the water content of the brain tissue was measured. Nissl staining was done to observe the damage of hippocampal neurons. TUNEL staining was used to observe the apoptosis of hippocampal neurons. Colorimetric analysis was done to determine the Caspase-3 activity in the hippocampus. The content of malondialdehyde (MDA) and reduced glutathione (GSH) and the activity of superoxide dismutase (SOD) in the hippocampus were examined by chemical analysis. qRT-PCR and Western blot were done to measure the expression of Nrf2 and heme oxygenase-l (HO-1) mRNA and proteins in the hippocampus. RESULTS After injection of bilirubin into the cerebellomedullary cistern, the young rats in the Model group and the TBHQ group showed different degrees of neurological abnormalities, while those in the control group showed no significant neurobehavioral abnormalities. Compared with the Control group, the Model group had severe neuronal damage, and the water content of brain tissue, the apoptosis of hippocampal neurons, the activity of Caspase-3 and the content of MDA content significantly increased ( P<0.01), while the SOD activity, GSH content, the expression of Nrf2 and HO-1 mRNA and proteins significantly decreased ( P<0.05). Compared with the Model group, neuronal damage was improved in the TBHQ group, and the water content of brain tissue, apoptosis of hippocampal neurons, activity of Caspase-3 and MDA content were all significantly reduced ( P<0.01), while SOD activity, GSH content and the expression of Nrf2 and HO-1 mRNA and proteins were significantly increased ( P<0.05). CONCLUSION Activation of the Nrf2 pathway can improve hippocampal neuronal damage in neonatal rats with bilirubin encephalopathy and inhibit neuronal apoptosis and the oxidation reaction.
Collapse
|
7
|
Increased Serum Expression of Inflammatory Cytokines may Serve as Potential Diagnostic Biomarker for Bilirubin Encephalopathy. Clinics (Sao Paulo) 2020; 75:e1868. [PMID: 33263631 PMCID: PMC7688072 DOI: 10.6061/clinics/2020/e1868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 06/25/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES The present study was designed to explore the roles of inflammatory cytokines interleukin-1β (IL-1β) and Tumor growth factor-β (TGF-β) in the diagnosis and treatment of neonate bilirubin encephalopathy (BE). METHODS A total of 128 BE neonates and 128 normal neonates were included. The serum samples of the BE children and controls were collected, and the levels of IL-1β and TGF-β were examined. Moreover, the correlation between the level of bilirubin and serum expression of IL-1β or TGF-β in BE patients was analyzed. Finally, receiver operating characteristic (ROC) curves were generated to determine the diagnostic value of the cytokines. RESULTS IL-1β and TGF-β levels were higher in the serum of BE patients than those in non-BE patients, and the expression of either IL-1β or TGF-β showed a strong positive correlation with the serum expression of bilirubin in BE patients. Moreover, the results of ROC analysis showed that either IL-1β or TGF-β could distinguish BE patients from healthy controls. CONCLUSION IL-1β and TGF-β levels were upregulated in BE and might function as potential biomarkers or therapeutic targets for BE patients.
Collapse
|
8
|
|
9
|
|
10
|
|
11
|
Der Kernikterus - seine Pathogenese und Therapie unter Berücksichtigung neuer Erkenntnisse über das „direkte” und das „indirekte” Bilirubin1. Dtsch Med Wochenschr 2009; 83:1983-7. [PMID: 13609313 DOI: 10.1055/s-0028-1113913] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
12
|
|
13
|
Abstract
OBJECTIVES The passage of unconjugated bilirubin (UCB) across the blood-brain barrier into the central nervous system is a crucial first step in the development of kernicterus. The objective of the current study was to characterize the passage of UCB across primary bovine brain microvascular endothelial cell (BBMVEC) monolayers in vitro. DESIGN Experimental study. SETTING Research institute. SUBJECTS BBMVECs. INTERVENTIONS Tritiated UCB (H-UCB) transport at 60, 80, 100, 200, 300, and 400 nM concentrations was tested in both the apical to basolateral (A--> B) and basolateral to apical (B-->A) directions in BBMVEC monolayers in vitro with or without preincubation with pharmacologic active transport inhibitors cyclosporine A, indomethacin, or MK571. MEASUREMENTS AND MAIN RESULTS The rate of H-UCB transport in the B-->A direction was 6.2- to 7.3-fold higher than in the A-->B direction, suggesting active efflux of UCB. Cyclosporine A (5 microM), a model inhibitor of P-glycoprotein, enhanced A-->B while decreasing B-->A UCB transport, resulting in an overall decrease in BBMVEC UCB efflux of between 46% and 54%. Indomethacin (10 microM) and MK-571 (50 microM), respectively a substrate and potent inhibitor of multidrug resistance-associated protein-1, had no effect. CONCLUSIONS We conclude that 1) UCB is transported by BBMVEC monolayers in vitro in a net B-->A direction (i.e., active efflux); and 2) cyclosporine A partially inhibits such transport. We speculate that the blood-brain barrier limits the passage and central nervous system retention of UCB by active transport and that this may be accounted in part by P-glycoprotein.
Collapse
|
14
|
|
15
|
|
16
|
Hyperbilirubinaemia and kernicterus in premature and full-term Bantu newborn infants. BRITISH MEDICAL JOURNAL 2000; 1:1004-7. [PMID: 13638612 PMCID: PMC1993191 DOI: 10.1136/bmj.1.5128.1004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
17
|
|
18
|
|
19
|
Studies on kernicterus; relationship with sulfonamide intoxication, report on kernicterus in rats with glucuronyl transferase deficiency and review of pathogenesis. J Neuropathol Exp Neurol 2000; 18:165-87; discussion 187-9. [PMID: 13621251 DOI: 10.1097/00005072-195901000-00011] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
20
|
[Hypercapnia induced reversible opening of the blood-brain barrier in experimental hyperbilirubinemia]. ANALES ESPANOLES DE PEDIATRIA 1997; 46:374-7. [PMID: 9214231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The incidence of bilirubin encephalopathy in extremely ill neonates with low serum bilirubin is stimulating interest in factors that can modify the blood-brain barrier permeability and allow the passage of bilirubin-albumin macrocomplexes, which may be produced by hypercapnia. MATERIALS AND METHODS Without modifying the normal bilirubin-albumin affinity, we increased cerebral flow by two levels of hypercapnia (PCO2 67.1 and 101.9 mmHg), acquired by inhalation of CO2 enriched air (5 and 15%) and a decrease in pH (7.00 and 6.93). RESULTS We demonstrate an increment in cerebral bilirubin deposition (control 2.43 +/- 0.54 mg/g versus 3.29 +/- 0.43 and 3.28 +/- 1.07, F = 4.80, p < 0.05) and I125 albumin (control 26.1 +/- 95.8 micrograms/g versus 364.4 +/- 156.1 and 430.8 +/- 122.4, F03.34, p < 0.05).
Collapse
|
21
|
|
22
|
|
23
|
Kernicterus in preterm infants; lest we forget (to turn on the lights). Pediatrics 1992; 90:757-9. [PMID: 1408550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
|
24
|
[Current developments in the study of kernicterus]. JOSANPU ZASSHI = THE JAPANESE JOURNAL FOR MIDWIFE 1974; 28:484. [PMID: 4497938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
|
25
|
MESH Headings
- Anemia, Hemolytic, Congenital/diagnosis
- Anemia, Hemolytic, Congenital/therapy
- Blood Transfusion
- Chronic Disease
- Diagnosis, Differential
- Drug Hypersensitivity/etiology
- Edema/etiology
- Erythroblastosis, Fetal/diagnosis
- Erythroblastosis, Fetal/therapy
- Erythrocytes/enzymology
- Erythrocytes/immunology
- Exchange Transfusion, Whole Blood
- Female
- Gestational Age
- Glucosephosphate Dehydrogenase Deficiency/complications
- Glucosephosphate Dehydrogenase Deficiency/diagnosis
- Glycolysis
- Heinz Bodies
- Humans
- Hyperbilirubinemia/enzymology
- Infant, Newborn
- Infant, Newborn, Diseases/enzymology
- Kernicterus
- Metabolism, Inborn Errors
- Pregnancy
Collapse
|
26
|
The action of unconjugated bilirubin on some enzyme activities of in vitro cultured cells. RESEARCH IN EXPERIMENTAL MEDICINE. ZEITSCHRIFT FUR DIE GESAMTE EXPERIMENTELLE MEDIZIN EINSCHLIESSLICH EXPERIMENTELLER CHIRURGIE 1973; 161:224-32. [PMID: 4358913 DOI: 10.1007/bf01855049] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
|
27
|
Reserve albumin binding capacity, salicylate saturation index, and red cell binding of bilirubin in neonatal jaundice. Arch Dis Child 1973; 48:393-7. [PMID: 4703070 PMCID: PMC1648373 DOI: 10.1136/adc.48.5.393] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
105 blood samples from 72 infants, mostly with jaundice due to haemolytic disease, were analysed for reserve albumin binding capacity (HBABA method), salicylate saturation index (SI), and red cell binding of bilirubin. 2 infants with clinical symptoms of bilirubin encephalopathy had abnormally large amounts of red cell bound bilirubin, though the HBABA binding capacity and salicylate saturation index did not suggest a risk of bilirubin encephalopathy. On the other hand, 48 of the other samples showed `risk values' for saturation index and 2 of the other samples showed such values as judged by the HBABA method. The discrepancies between these findings are discussed. It is suggested that determination of red cell bound bilirubin may have clinical value in patients with neonatal jaundice, especially in cases of suggested kernicterus.
Collapse
|
28
|
Transfer of bilirubin- 14 C between blood, cerebrospinal fluid, and brain tissue. THE AMERICAN JOURNAL OF PHYSIOLOGY 1971; 221:1264-70. [PMID: 5171406 DOI: 10.1152/ajplegacy.1971.221.5.1264] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|
29
|
[Severe juandice in the newborn]. LES CAHIERS DE MEDECINE 1971; 12:85-102. [PMID: 4926170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
30
|
[Severe jaundice in the newborn]. LES CAHIERS DE MEDECINE 1971; 12:85-102. [PMID: 4928355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
31
|
[5-year experience with work of the consultation clinic for pregnant mothers sensitized in the Rh system]. CESKOSLOVENSKA GYNEKOLOGIE 1969; 34:500-1. [PMID: 4982158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
32
|
Glucose-6-phosphate dehydrogenase deficiency in newborn infants. JOURNAL OF THE INDIAN MEDICAL ASSOCIATION 1968; 51:315-9. [PMID: 5705874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
|
33
|
Risk of kernicterus in newborn infants with a high level of conjugated bilirubin. ACTA PAEDIATRICA SCANDINAVICA 1966; 55:401-4. [PMID: 6007580 DOI: 10.1111/j.1651-2227.1966.tb08812.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
|
34
|
Blood group sensitization in the newborn. The indications for exchange transfusion and its hazards. S Afr Med J 1966; 40:136-40. [PMID: 5948691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
|
35
|
Kittens as experimental model for study of kernicterus. AMERICAN JOURNAL OF DISEASES OF CHILDREN (1960) 1966; 111:161-5. [PMID: 5948121 DOI: 10.1001/archpedi.1966.02090050093006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
|
36
|
[On papillary necrosis of children]. ZENTRALBLATT FUR ALLGEMEINE PATHOLOGIE U. PATHOLOGISCHE ANATOMIE 1965; 107:547-55. [PMID: 5220481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|
37
|
AETIOLOGY OF ATHETOSIS WITH SPECIAL REFERENCE TO NEONATAL ASPHYXIA, IDIOPATHIC ICTERUS, AND ABO-INCOMPATIBILITY. Arch Dis Child 1965; 40:376-84. [PMID: 14329253 PMCID: PMC2019292 DOI: 10.1136/adc.40.212.376] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
38
|
Abstract
Experimental studies suggest that a variety of factors play a role in the pathogenesis of kemicterus—protein-binding, acidosis, anoxia, hypoglycemia, etc. Certain drugs probably play a role also. At present, none of these factors are clearly enough defined or capable of quan titation even to the limited degree that is ac knowledged for the bilirubin level. However, their expressions are definite enough at this time to be considered when reaching what is still fundamentally a clinical judgment as to therapy in patients with hyperbilirubinemia in whom exchange transfusion is not clearly indi cated by the level of bilirubin alone or in com bination with blood type, hemoglobin, reticulo cyte count and Coombs test. It seems clear that judgments about the safety of a drug for the fetus cannot be based entirely on experience with newborns or on experiments with newborn animals. The dan gers to a newborn infant which are inherent in a particular drug may be multiple and may not be fully known.
Collapse
|
39
|
BILIRUBIN TOXICITY KERNICTERUS. VIRGINIA MEDICAL MONTHLY 1965; 92:285-6. [PMID: 14300580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
|
40
|
DEFECTIVE HEARING IN CHILDREN ATTENDING ORDINARY SCHOOLS. THE JOURNAL OF THE ROYAL INSTITUTE OF PUBLIC HEALTH AND HYGIENE 1965; 28:119-27 CONTD. [PMID: 14315163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
|
41
|
|
42
|
[CONSTITUTIONAL METABOLIC JAUNDICE]. JOURNAL DE MEDECINE DE LYON 1965; 46:511-41. [PMID: 14308368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
|
43
|
ASSESSMENT OF HEARING AND SPEECH DISORDERS IN CEREBRAL PALSY. SPASTICS' QUARTERLY 1965; 14:12-7. [PMID: 14290672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
|
44
|
KERNICTERUS IN NEWBORN RABBITS. THE AMERICAN JOURNAL OF PATHOLOGY 1965; 46:331-43. [PMID: 14266216 PMCID: PMC1920364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
|
45
|
KERNICTERUS IN SMALL PREMATURE INFANTS. Pediatrics 1965; 35:483-5. [PMID: 14258661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
|
46
|
HEARING LOSS IN CHILDREN: AN INVESTIGATION INTO THE INCIDENCE OF HEARING DEFECTS AMONG CHILDREN ATTENDING A SOUTH AFRICAN PRIMARY SCHOOL. S Afr Med J 1965; 39:130-6. [PMID: 14269823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023] Open
|
47
|
DIVERSE CHARACTERISTICS OF GLUCOSE-6-PHOSPHATE DEHYDROGENASE FROM GREEK CHILDREN. THE JOURNAL OF LABORATORY AND CLINICAL MEDICINE 1965; 65:212-21. [PMID: 14267246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
|
48
|
[PREVENTION OF BILIRUBIN ENCEPHALOPATHY]. FOLHA MEDICA 1965; 50:151-3. [PMID: 14344951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
|
49
|
[ Kernicterus in newborns]. PEDIATRIIA AKUSHERSTVO I GINEKOLOGIIA 1965; 1:17-9. [PMID: 5879364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
|
50
|
Icterus Neonatorum: The obstetrician's influence on its frequency and prognosis. Acta Obstet Gynecol Scand 1965; 44:180-96. [PMID: 14295840 DOI: 10.3109/00016346509153990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|