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[PMID]:29429191
[Au] Autor:Zhang YY; Lou HF; Wang CS; Zhang L
[Ad] Endereço:Deparment of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Beijing Key Laboratory of Nasal Diseases, Beijing Institude of Otorhinolaryngology, Beijing 100005, China.
[Ti] Título:[Mechanisms underlying glucocorticoid resistance in chronic rhinosinusitis with nasal polyps].
[So] Source:Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi;53(2):154-160, 2018 Feb 07.
[Is] ISSN:1673-0860
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory disease that occurs in the nasal and sinus mucosa, which is a common disease in otorhinolaryngology. At present, CRSwNP can be effectively treated by glucocorticoids (GC). GC binds to GC receptors in the nasal mucosa, affects the expression of inflammatory genes, inhibits the activation and action of eosinophils, T cell-associated inflammatory responses in nasal polyps, as well as tissue remodeling. However, there are some patients fall reponse to GC, so called GC resistance. The study suggests that the possible mechanism of CRSwNP GC resistance is mainly related to GC receptor abnormal, the role of cytokines and transcription factors, such as Th cells and IL-8. In addition, MAPK-related kinases and histone deacetylase in the GC signaling pathway also play important roles in the GC resistance process. This paper reviews the mechanism of GC treatment of CRSwNP, the mechanism of GC resistance and alternative treatment of GC.
[Mh] Termos MeSH primário: Glucocorticoides/uso terapêutico
Erros Inatos do Metabolismo
Pólipos Nasais/tratamento farmacológico
Receptores de Glucocorticoides/deficiência
Rinite/tratamento farmacológico
Sinusite/tratamento farmacológico
[Mh] Termos MeSH secundário: Doença Crônica
Citocinas/metabolismo
Resistência a Medicamentos
Glucocorticoides/metabolismo
Seres Humanos
Mucosa Nasal/metabolismo
Pólipos Nasais/complicações
Rinite/complicações
Transdução de Sinais
Sinusite/complicações
Fatores de Transcrição/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Cytokines); 0 (Glucocorticoids); 0 (Receptors, Glucocorticoid); 0 (Transcription Factors)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180213
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.1673-0860.2018.02.017


  2 / 9709 MEDLINE  
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[PMID]:29237523
[Au] Autor:Lin SX; Shu JB; Wang C; Pan R; Meng YT; Zhang CH; Zhang BL; Wang D; Zhang YQ
[Ad] Endereço:Tianjin Children's Hospital, Tianjin 300074, China. zhangyuqin0809@sina.com.
[Ti] Título:[Clinical analysis of 15 851 children at risk of inherited metabolic diseases].
[So] Source:Zhongguo Dang Dai Er Ke Za Zhi;19(12):1243-1247, 2017 Dec.
[Is] ISSN:1008-8830
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:OBJECTIVE: To explore the value of urine gas chromatography-mass spectrometry (GC-MS) in the screening of children at risk of inherited metabolic diseases (IMD), and to identify the disease spectrum of IMD and the clinical characteristics of children with IMD. METHODS: The clinical data of 15 851 children at risk of IMD who underwent urine GC-MS in the Tianjin Children's Hospital between February 2012 and December 2016 were retrospectively analyzed. RESULTS: In the 15 851 children, 5 793 (36.55%) were detected to have metabolic disorders. A total of 117 (0.74%) children were confirmed to have IMD, including 77 cases of methylmalonic acidemia (65.8%). The clinical manifestations of confirmed cases in the neonatal period mainly included jaundice, metabolic acidosis, abnormal muscular tension, feeding difficulty, poor response, and lethargy or coma. The clinical manifestations of confirmed cases in the non-neonatal period mainly included delayed mental and motor development, metabolic acidosis, convulsion, recurrent vomiting, and anemia. CONCLUSIONS: GC-MS is an effective method for the screening for IMD in children at risk. Methylmalonic acidemia is the most common IMD. The clinical manifestations of IMD are different between the confirmed cases in the neonatal and non-neonatal periods.
[Mh] Termos MeSH primário: Erros Inatos do Metabolismo/diagnóstico
[Mh] Termos MeSH secundário: Acidose/etiologia
Adolescente
Erros Inatos do Metabolismo dos Aminoácidos/complicações
Erros Inatos do Metabolismo dos Aminoácidos/diagnóstico
Criança
Pré-Escolar
Deficiências do Desenvolvimento/etiologia
Feminino
Cromatografia Gasosa-Espectrometria de Massas
Seres Humanos
Lactente
Recém-Nascido
Masculino
Erros Inatos do Metabolismo/complicações
Estudos Retrospectivos
Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE


  3 / 9709 MEDLINE  
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[PMID]:29302025
[Au] Autor:Guéant JL; Chéry C; Oussalah A; Nadaf J; Coelho D; Josse T; Flayac J; Robert A; Koscinski I; Gastin I; Filhine-Tresarrieu P; Pupavac M; Brebner A; Watkins D; Pastinen T; Montpetit A; Hariri F; Tregouët D; Raby BA; Chung WK; Morange PE; Froese DS; Baumgartner MR; Benoist JF; Ficicioglu C; Marchand V; Motorin Y; Bonnemains C; Feillet F; Majewski J; Rosenblatt DS
[Ad] Endereço:INSERM, UMR_S954 Nutrition-Genetics-Environmental Risk Exposure and Reference Centre of Inborn Metabolism Diseases, University of Lorraine and University Hospital Centre of Nancy (CHRU Nancy), 54505, Nancy, France. jean-louis.gueant@univ-lorraine.fr.
[Ti] Título:APRDX1 mutant allele causes a MMACHC secondary epimutation in cblC patients.
[So] Source:Nat Commun;9(1):67, 2018 01 04.
[Is] ISSN:2041-1723
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:To date, epimutations reported in man have been somatic and erased in germlines. Here, we identify a cause of the autosomal recessive cblC class of inborn errors of vitamin B metabolism that we name "epi-cblC". The subjects are compound heterozygotes for a genetic mutation and for a promoter epimutation, detected in blood, fibroblasts, and sperm, at the MMACHC locus; 5-azacytidine restores the expression of MMACHC in fibroblasts. MMACHC is flanked by CCDC163P and PRDX1, which are in the opposite orientation. The epimutation is present in three generations and results from PRDX1 mutations that force antisense transcription of MMACHC thereby possibly generating a H3K36me3 mark. The silencing of PRDX1 transcription leads to partial hypomethylation of the epiallele and restores the expression of MMACHC. This example of epi-cblC demonstrates the need to search for compound epigenetic-genetic heterozygosity in patients with typical disease manifestation and genetic heterozygosity in disease-causing genes located in other gene trios.
[Mh] Termos MeSH primário: Proteínas de Transporte/genética
Epistasia Genética
Erros Inatos do Metabolismo/genética
Mutação
Peroxirredoxinas/genética
Vitamina B 12/metabolismo
[Mh] Termos MeSH secundário: Alelos
Azacitidina/farmacologia
Sequência de Bases
Inibidores Enzimáticos/farmacologia
Saúde da Família
Feminino
Fibroblastos/efeitos dos fármacos
Fibroblastos/metabolismo
Heterozigoto
Seres Humanos
Masculino
Erros Inatos do Metabolismo/metabolismo
Linhagem
Sequenciamento Completo do Genoma
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Carrier Proteins); 0 (Enzyme Inhibitors); 0 (MMACHC protein, human); EC 1.11.1.15 (PRDX1 protein, human); EC 1.11.1.15 (Peroxiredoxins); M801H13NRU (Azacitidine); P6YC3EG204 (Vitamin B 12)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180106
[St] Status:MEDLINE
[do] DOI:10.1038/s41467-017-02306-5


  4 / 9709 MEDLINE  
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[PMID]:29217800
[Au] Autor:Sachdeva A
[Ad] Endereço:National President, Indian Academy of Pediatrics, 2017 anupamace@yahoo.co.in.
[Ti] Título:Dietary Interventions for Rare Metabolic Disorders - Now Available in India!
[So] Source:Indian Pediatr;54(11):909-910, 2017 11 15.
[Is] ISSN:0974-7559
[Cp] País de publicação:India
[La] Idioma:eng
[Mh] Termos MeSH primário: Erros Inatos do Metabolismo/dietoterapia
[Mh] Termos MeSH secundário: Dietoterapia/métodos
Seres Humanos
Índia
Recém-Nascido
Pediatria/organização & administração
Doenças Raras/dietoterapia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171209
[St] Status:MEDLINE


  5 / 9709 MEDLINE  
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[PMID]:29172660
[Au] Autor:Szabó E; Balogh L; Szabó A; Szatmári I
[Ad] Endereço:I. Gyermekgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Bókay J. u. 53-54., 1083.
[Ti] Título:[Diagnostics of inborn errors of metabolism: laboratory approaches].
[Ti] Título:Ritka örökletes anyagcsere-betegségek diagnosztikája: laboratóriumi vizsgálati megközelítések..
[So] Source:Orv Hetil;158(48):1903-1907, 2017 Dec.
[Is] ISSN:0030-6002
[Cp] País de publicação:Hungary
[La] Idioma:hun
[Ab] Resumo:Inherited errors of metabolism are rare genetic disorders characterized by diverse clinical and biochemical phenotypes. The complexity of signs and symptoms often presents a challenge for both clinicians and laboratory specialists. In many cases, prevention of permanent neurological symptoms or death in patients presenting these disorders is dependent on early diagnosis and introduction of appropriate therapy. For professionals it is indispensable to be familiar with the major clinical signs of inborn errors of metabolism and with the necessary and available laboratory studies to achieve an early diagnosis. The review tries to give a way of approach, diagnostic algorithm of laboratory measurements for the correct diagnosis in inherited errors of metabolism. The combination of biochemical and clinical signs, results of special metabolic investigations represent a portentous challenge in general practice. For the correct diagnosis of an inherited error of metabolism, the teamwork between clinicians and laboratory specialists is indispensable. Orv Hetil. 2017; 158(48): 1903-1907.
[Mh] Termos MeSH primário: Erros Inatos do Metabolismo/diagnóstico
Triagem Neonatal/métodos
[Mh] Termos MeSH secundário: Algoritmos
Técnicas de Laboratório Clínico
Diagnóstico Precoce
Seres Humanos
Recém-Nascido
Comunicação Interdisciplinar
Erros Inatos do Metabolismo/genética
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.1556/650.2017.30899


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[PMID]:29178644
[Au] Autor:Regier DS; Ferreira CR; Hart S; Hadley DW; Muenke M
[Ad] Endereço:Rare Disease Institute, Children's National Health System, Washington, DC, USA.
[Ti] Título:Medical genetics and genomic medicine in the United States. Part 2: Reproductive genetics, newborn screening, genetic counseling, training, and registries.
[So] Source:Mol Genet Genomic Med;5(6):621-630, 2017 11.
[Is] ISSN:2324-9269
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Review of genetics in the United States with emphasis on the prenatal, metabolic, genetic counseling, and training aspects of the field.
[Mh] Termos MeSH primário: Aconselhamento Genético
Genética Médica/educação
Genômica/educação
Triagem Neonatal
[Mh] Termos MeSH secundário: Seres Humanos
Recém-Nascido
Erros Inatos do Metabolismo/diagnóstico
Erros Inatos do Metabolismo/genética
Diagnóstico Pré-Natal
Sistema de Registros
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.1002/mgg3.343


  7 / 9709 MEDLINE  
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[PMID]:29178637
[Au] Autor:Majumdar R; Yori A; Rush PW; Raymond K; Gavrilov D; Tortorelli S; Matern D; Rinaldo P; Feldman GL; Oglesbee D
[Ad] Endereço:Mayo Clinic College of Medicine, Rochester, Minnesota.
[Ti] Título:Allelic spectrum of formiminotransferase-cyclodeaminase gene variants in individuals with formiminoglutamic aciduria.
[So] Source:Mol Genet Genomic Med;5(6):795-799, 2017 11.
[Is] ISSN:2324-9269
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Elevated plasma and urine formiminoglutamic acid (FIGLU) levels are commonly indicative of formiminoglutamic aciduria (OMIM #229100), a poorly understood autosomal recessive disorder of histidine and folate metabolism, resulting from formiminotransferase-cyclodeaminase (FTCD) deficiency, a bifunctional enzyme encoded by FTCD. METHODS: In order to further understanding about the molecular alterations that contribute to FIGLU-uria, we sequenced FTCD in 20 individuals with putative FTCD deficiency and varying laboratory findings, including increased FIGLU excretion. RESULTS: Individuals tested had biallelic loss-of-function variants in protein-coding regions of FTCD. The FTCD allelic spectrum comprised of 12 distinct variants including 5 missense alterations that replace conserved amino acid residues (c.223A>C, c.266A>G, c.319T>C, c.430G>A, c.514G>T), an in-frame deletion (c.1373_1375delTGG), with the remaining alterations predicted to affect mRNA processing/stability. These included two frameshift variants (c.990dup, c.1366dup) and four nonsense variants (c.337C>T, c.451A>T, c.763C>T, c.1607T>A). CONCLUSION: We observed additional FTCD alleles leading to urinary FIGLU elevations, and thus, providing molecular evidence of FTCD deficiency in cases identified by newborn screening or clinical biochemical genetic laboratory testing.
[Mh] Termos MeSH primário: Amônia-Liases/genética
Glutamato Formimidoiltransferase/deficiência
Erros Inatos do Metabolismo/genética
[Mh] Termos MeSH secundário: Alelos
Sequência de Aminoácidos
Códon sem Sentido
Mutação da Fase de Leitura
Deleção de Genes
Genótipo
Glutamato Formimidoiltransferase/genética
Seres Humanos
Erros Inatos do Metabolismo/diagnóstico
Mutação de Sentido Incorreto
Fases de Leitura Aberta/genética
Polimorfismo de Nucleotídeo Único
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Codon, Nonsense); EC 2.1.2.5 (Glutamate Formimidoyltransferase); EC 4.3.1.- (Ammonia-Lyases); EC 4.3.1.4 (formiminotetrahydrofolate cyclodeaminase)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.1002/mgg3.333


  8 / 9709 MEDLINE  
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[PMID]:29240373
[Au] Autor:Goldstein B; Goldfarb DS
[Ti] Título:Early Recognition and Management of Rare Kidney Stone Disorders.
[So] Source:Urol Nurs;37(2):81-9, 102, 2017 Mar-Apr.
[Is] ISSN:1053-816X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Kidney stones, especially those that present in childhood/adolescence, may be due to rare inherited disorders such as cystinuria. Early recognition and prompt treatment can help reduce or even prevent the serious long-term complications of these rare stone disorders.
[Mh] Termos MeSH primário: Adenina Fosforribosiltransferase/deficiência
Cistinúria/diagnóstico
Doença de Dent/diagnóstico
Hiperoxalúria Primária/diagnóstico
Cálculos Renais/etiologia
Erros Inatos do Metabolismo/diagnóstico
Doenças Raras
Urolitíase/diagnóstico
[Mh] Termos MeSH secundário: Cistinúria/complicações
Cistinúria/terapia
Doença de Dent/complicações
Doença de Dent/terapia
Diagnóstico Precoce
Intervenção Médica Precoce
Seres Humanos
Hiperoxalúria Primária/complicações
Hiperoxalúria Primária/terapia
Erros Inatos do Metabolismo/complicações
Erros Inatos do Metabolismo/terapia
Urolitíase/complicações
Urolitíase/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
EC 2.4.2.7 (Adenine Phosphoribosyltransferase)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE


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[PMID]:28468868
[Au] Autor:Ghosh A; Schlecht H; Heptinstall LE; Bassett JK; Cartwright E; Bhaskar SS; Urquhart J; Broomfield A; Morris AA; Jameson E; Schwahn BC; Walter JH; Douzgou S; Murphy H; Hendriksz C; Sharma R; Wilcox G; Crushell E; Monavari AA; Martin R; Doolan A; Senniappan S; Ramsden SC; Jones SA; Banka S
[Ad] Endereço:Manchester Centre for Genomic Medicine, St. Mary's Hospital, Central Manchester NHS Trust, Manchester Academic Health Science Centre, Manchester, UK.
[Ti] Título:Diagnosing childhood-onset inborn errors of metabolism by next-generation sequencing.
[So] Source:Arch Dis Child;102(11):1019-1029, 2017 11.
[Is] ISSN:1468-2044
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Inborn errors of metabolism (IEMs) underlie a substantial proportion of paediatric disease burden but their genetic diagnosis can be challenging using the traditional approaches. METHODS: We designed and validated a next-generation sequencing (NGS) panel of 226 IEM genes, created six overlapping phenotype-based subpanels and tested 102 individuals, who presented clinically with suspected childhood-onset IEMs. RESULTS: In 51/102 individuals, NGS fully or partially established the molecular cause or identified other actionable diagnoses. Causal mutations were identified significantly more frequently when the biochemical phenotype suggested a specific IEM or a group of IEMs (p<0.0001), demonstrating the pivotal role of prior biochemical testing in guiding NGS analysis. The NGS panel helped to avoid further invasive, hazardous, lengthy or expensive investigations in 69% individuals (p<0.0001). Additional functional testing due to novel or unexpected findings had to be undertaken in only 3% of subjects, demonstrating that the use of NGS does not significantly increase the burden of subsequent follow-up testing. Even where a molecular diagnosis could not be achieved, NGS-based approach assisted in the management and counselling by reducing the likelihood of a high-penetrant genetic cause. CONCLUSION: NGS has significant clinical utility for the diagnosis of IEMs. Biochemical testing and NGS analysis play complementary roles in the diagnosis of IEMs. Incorporating NGS into the diagnostic algorithm of IEMs can improve the accuracy of diagnosis.
[Mh] Termos MeSH primário: Sequenciamento de Nucleotídeos em Larga Escala/métodos
Erros Inatos do Metabolismo/diagnóstico
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Feminino
Seres Humanos
Lactente
Masculino
Erros Inatos do Metabolismo/genética
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180124
[Lr] Data última revisão:
180124
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1136/archdischild-2017-312738


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[PMID]:29213153
[Au] Autor:Céspedes N; Valencia A; Echeverry CA; Arce-Plata MI; Colón C; Castiñeiras DE; Hurtado PM; Cocho JA; Herrera S; Arévalo-Herrera M
[Ad] Endereço:Malaria Vaccine and Drug Development Center (MVDC), Cali, Colombia.
[Ti] Título:Reference values of amino acids, acylcarnitines and succinylacetone by tandem mass spectrometry for use in newborn screening in southwest Colombia.
[So] Source:Colomb Med (Cali);48(3):113-119, 2017 Sep 30.
[Is] ISSN:1657-9534
[Cp] País de publicação:Colombia
[La] Idioma:eng
[Ab] Resumo:Introduction: Inborn errors of metabolism (IEM) represent an important public health problem due to current diagnosis and treatment limitations, poor life quality of affected patients, and consequent untimely child death. In contrast to classical methods, tandem mass spectrometry (MS/MS) has allowed simultaneous evaluation of multiple metabolites associated with IEM offering higher sensitivity, low false positive rates and high throughput. Aims: Determine concentration levels for amino acids and acylcarnitines in blood of newborns from Colombia, to establish reference values for further use in diagnosis of IEM. Methods: Implementation of a method to determine amino acids, acylcarnitines and succinylacetone in newborn dried blood spots using MS/MS, and its application in a cross-sectional study conducted in 891 healthy neonates from Cali and Quibdo cities is described. Results: fifty-seven analytes that allow the diagnosis of more than 40 different pathologies were tested. The method showed to be linear, precise and accurate. Healthy neonates 1-18 days of age were included, 523 from Cali and 368 from Quibdo; 52% male and 48% female. Age-related differences on the concentration levels of amino acids and acylcarnitines were observed whereas no significant differences by gender were found. Conclusion: The study has contributed to reveal the usual concentration levels of amino acids, acylcarnitines and succinylacetone that could be used as reference for the establishment of a newborn metabolic screening program in Colombia.
[Mh] Termos MeSH primário: Aminoácidos/sangue
Carnitina/análogos & derivados
Heptanoatos/sangue
Erros Inatos do Metabolismo/diagnóstico
Espectrometria de Massas em Tandem/métodos
[Mh] Termos MeSH secundário: Biomarcadores/sangue
Carnitina/sangue
Colômbia
Estudos Transversais
Reações Falso-Positivas
Seres Humanos
Recém-Nascido
Erros Inatos do Metabolismo/sangue
Valores de Referência
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Amino Acids); 0 (Biomarkers); 0 (Heptanoates); 0 (acylcarnitine); 51568-18-4 (succinylacetone); S7UI8SM58A (Carnitine)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180109
[Lr] Data última revisão:
180109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE
[do] DOI:10.25100/cm.v48i3.2180



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