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[PMID]:29217804
[Au] Autor:Kapoor D; Singh P; Seth A
[Ad] Endereço:Department of Pediatrics, Lady Hardinge Medical College, New Delhi, India. anjuseth.peds@gmail.com.
[Ti] Título:Current Perspective on Exchange Transfusion.
[So] Source:Indian Pediatr;54(11):961-962, 2017 11 15.
[Is] ISSN:0974-7559
[Cp] País de publicação:India
[La] Idioma:eng
[Mh] Termos MeSH primário: Transfusão Total
Hiperbilirrubinemia Neonatal/terapia
[Mh] Termos MeSH secundário: Transfusão Total/história
Transfusão Total/métodos
História do Século XX
História do Século XXI
Seres Humanos
Índia
Recém-Nascido
[Pt] Tipo de publicação:HISTORICAL ARTICLE; 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


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[PMID]:28954873
[Au] Autor:Amin SB; Saluja S; Saili A; Orlando M; Wang H; Laroia N; Agarwal A
[Ad] Endereço:Departments of Pediatrics, sanjiv_amin@urmc.rochester.edu.
[Ti] Título:Chronic Auditory Toxicity in Late Preterm and Term Infants With Significant Hyperbilirubinemia.
[So] Source:Pediatrics;140(4), 2017 Oct.
[Is] ISSN:1098-4275
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND OBJECTIVES: Significant hyperbilirubinemia (SHB) may cause chronic auditory toxicity (auditory neuropathy spectrum disorder and/or sensorineural hearing loss); however, total serum bilirubin (TSB) does not discriminate neonates at risk for auditory toxicity. Our objective was to compare TSB, bilirubin albumin molar ratio (BAMR), and unbound bilirubin (UB) for their association with chronic auditory toxicity in neonates with SHB (TSB ≥20 mg/dL or TSB that met criteria for exchange transfusion). METHODS: Infants ≥34 weeks' gestational age (GA) with SHB during the first 2 postnatal weeks were eligible for a prospective longitudinal study in India. Comprehensive auditory evaluations were performed at 2 to 3 months of age by using auditory brainstem response, tympanometry, and an otoacoustic emission test and at 9 to 12 months of age by using audiometry. The evaluations were performed by an audiologist unaware of the degree of jaundice. RESULTS: A total of 93 out of 100 infants (mean GA of 37.4 weeks; 55 boys, 38 girls) who were enrolled with SHB were evaluated for auditory toxicity. Of those, 12 infants (13%) had auditory toxicity. On regression analysis controlling for covariates, peak UB (but not peak TSB or peak BAMR), was associated with auditory toxicity (odds ratio 2.41; 95% confidence interval: 1.43-4.07; .001). There was significant difference in the area under the receiver operating characteristic curves between UB (0.866), TSB (0.775), and BAMR (0.724) for auditory toxicity ( = .03) after controlling for covariates. CONCLUSIONS: Unconjugated hyperbilirubinemia indexed by UB (but not TSB or BAMR) is associated with chronic auditory toxicity in infants ≥34 weeks' GA with SHB.
[Mh] Termos MeSH primário: Bilirrubina/sangue
Perda Auditiva Central/etiologia
Perda Auditiva Neurossensorial/etiologia
Hiperbilirrubinemia Neonatal/complicações
Doenças do Prematuro/etiologia
[Mh] Termos MeSH secundário: Biomarcadores/sangue
Doença Crônica
Feminino
Perda Auditiva Central/sangue
Perda Auditiva Central/diagnóstico
Perda Auditiva Central/epidemiologia
Perda Auditiva Neurossensorial/sangue
Perda Auditiva Neurossensorial/diagnóstico
Perda Auditiva Neurossensorial/epidemiologia
Seres Humanos
Hiperbilirrubinemia Neonatal/sangue
Hiperbilirrubinemia Neonatal/diagnóstico
Incidência
Lactente
Recém-Nascido
Recém-Nascido Prematuro
Doenças do Prematuro/sangue
Doenças do Prematuro/diagnóstico
Doenças do Prematuro/epidemiologia
Estudos Longitudinais
Masculino
Estudos Prospectivos
Curva ROC
Medição de Risco
Fatores de Risco
Albumina Sérica/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Biomarkers); 0 (Serum Albumin); RFM9X3LJ49 (Bilirubin)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171015
[Lr] Data última revisão:
171015
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170929
[St] Status:MEDLINE


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[PMID]:28762235
[Au] Autor:Lai NM; Ahmad Kamar A; Choo YM; Kong JY; Ngim CF
[Ad] Endereço:School of Medicine, Taylor's University, Subang Jaya, Malaysia.
[Ti] Título:Fluid supplementation for neonatal unconjugated hyperbilirubinaemia.
[So] Source:Cochrane Database Syst Rev;8:CD011891, 2017 08 01.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Neonatal hyperbilirubinaemia is a common problem which carries a risk of neurotoxicity. Certain infants who have hyperbilirubinaemia develop bilirubin encephalopathy and kernicterus which may lead to long-term disability. Phototherapy is currently the mainstay of treatment for neonatal hyperbilirubinaemia. Among the adjunctive measures to compliment the effects of phototherapy, fluid supplementation has been proposed to reduce serum bilirubin levels. The mechanism of action proposed includes direct dilutional effects of intravenous (IV) fluids, or enhancement of peristalsis to reduce enterohepatic circulation by oral fluid supplementation. OBJECTIVES: To assess the risks and benefits of fluid supplementation compared to standard fluid management in term and preterm newborn infants with unconjugated hyperbilirubinaemia who require phototherapy. SEARCH METHODS: We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 5), MEDLINE via PubMed (1966 to 7 June 2017), Embase (1980 to 7 June 2017), and CINAHL (1982 to 7 June 2017). We also searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. SELECTION CRITERIA: We included randomised controlled trials that compared fluid supplementation against no fluid supplementation, or one form of fluid supplementation against another. DATA COLLECTION AND ANALYSIS: We extracted data using the standard methods of the Cochrane Neonatal Review Group using the Covidence platform. Two review authors independently assessed the eligibility and risk of bias of the retrieved records. We expressed our results using mean difference (MD), risk difference (RD), and risk ratio (RR) with 95% confidence intervals (CIs). MAIN RESULTS: Out of 1449 articles screened, seven studies were included. Three articles were awaiting classification, among them, two completed trials identified from the trial registry appeared to be unpublished so far.There were two major comparisons: IV fluid supplementation versus no fluid supplementation (six studies) and IV fluid supplementation versus oral fluid supplementation (one study). A total of 494 term, healthy newborn infants with unconjugated hyperbilirubinaemia were evaluated. All studies were at high risk of bias for blinding of care personnel, five studies had unclear risk of bias for blinding of outcome assessors, and most studies had unclear risk of bias in allocation concealment. There was low- to moderate-quality evidence for all major outcomes.In the comparison between IV fluid supplementation and no supplementation, no infant in either group developed bilirubin encephalopathy in the one study that reported this outcome. Serum bilirubin was lower at four hours postintervention for infants who received IV fluid supplementation (MD -34.00 µmol/L (-1.99 mg/dL), 95% CI -52.29 (3.06) to -15.71 (0.92); participants = 67, study = 1) (low quality of evidence, downgraded one level for indirectness and one level for suspected publication bias). Beyond eight hours postintervention, serum bilirubin was similar between the two groups. Duration of phototherapy was significantly shorter for fluid-supplemented infants, but the estimate was affected by heterogeneity which was not clearly explained (MD -10.70 hours, 95% CI -15.55 to -5.85; participants = 218; studies = 3; I² = 67%). Fluid-supplemented infants were less likely to require exchange transfusion (RR 0.39, 95% CI 0.21 to 0.71; RD -0.01, 95% CI -0.04 to 0.02; participants = 462; studies = 6; I² = 72%) (low quality of evidence, downgraded one level due to inconsistency, and another level due to suspected publication bias), and the estimate was similarly affected by unexplained heterogeneity. The frequencies of breastfeeding were similar between the fluid-supplemented and non-supplemented infants in days one to three based on one study (estimate on day three: MD 0.90 feeds, 95% CI -0.40 to 2.20; participants = 60) (moderate quality of evidence, downgraded one level for imprecision).One study contributed to all outcome data in the comparison of IV versus oral fluid supplementation. In this comparison, no infant in either group developed abnormal neurological signs. Serum bilirubin, as well as the rate of change of serum bilirubin, were similar between the two groups at four hours after phototherapy (serum bilirubin: MD 11.00 µmol/L (0.64 mg/dL), 95% CI -21.58 (-1.26) to 43.58 (2.55); rate of change of serum bilirubin: MD 0.80 µmol/L/hour (0.05 mg/dL/hour), 95% CI -2.55 (-0.15) to 4.15 (0.24); participants = 54 in both outcomes) (moderate quality of evidence for both outcomes, downgraded one level for indirectness). The number of infants who required exchange transfusion was similar between the two groups (RR 1.60, 95% CI 0.60 to 4.27; RD 0.11, 95% CI -0.12 to 0.34; participants = 54). No infant in either group developed adverse effects including vomiting or abdominal distension. AUTHORS' CONCLUSIONS: There is no evidence that IV fluid supplementation affects important clinical outcomes such as bilirubin encephalopathy, kernicterus, or cerebral palsy in healthy, term newborn infants with unconjugated hyperbilirubinaemia requiring phototherapy. In this review, no infant developed these bilirubin-associated clinical complications. Low- to moderate-quality evidence shows that there are differences in total serum bilirubin levels between fluid-supplemented and control groups at some time points but not at others, the clinical significance of which is uncertain. There is no evidence of a difference between the effectiveness of IV and oral fluid supplementations in reducing serum bilirubin. Similarly, no infant developed adverse events or complications from fluid supplementation such as vomiting or abdominal distension. This suggests a need for future research to focus on different population groups with possibly higher baseline risks of bilirubin-related neurological complications, such as preterm or low birthweight infants, infants with haemolytic hyperbilirubinaemia, as well as infants with dehydration for comparison of different fluid supplementation regimen.
[Mh] Termos MeSH primário: Hidratação/efeitos adversos
Hiperbilirrubinemia Neonatal/terapia
Kernicterus/prevenção & controle
Fototerapia
[Mh] Termos MeSH secundário: Administração Intravenosa
Administração Oral
Bilirrubina/sangue
Aleitamento Materno/estatística & dados numéricos
Paralisia Cerebral/prevenção & controle
Transfusão Total/estatística & dados numéricos
Hidratação/métodos
Seres Humanos
Hiperbilirrubinemia Neonatal/sangue
Recém-Nascido
Peristaltismo
Fototerapia/métodos
Fototerapia/estatística & dados numéricos
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
RFM9X3LJ49 (Bilirubin)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170802
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD011891.pub2


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[PMID]:28694290
[Au] Autor:Chung EK; Gable EK; Golden WC; Hudson JA; Hackman NM; Andrews JP; Jackson DS; Beavers JB; Mirchandani DR; Kellams A; Krevitsky ME; Monroe K; Madlon-Kay DJ; Stratbucker W; Campbell D; Collins J; Rauch D
[Ad] Endereço:Department of Pediatrics, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania and Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware; echung@nemours.org.
[Ti] Título:Current Scope of Practice for Newborn Care in Non-Intensive Hospital Settings.
[So] Source:Hosp Pediatr;7(8):471-482, 2017 08.
[Is] ISSN:2154-1663
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Neonatologia
[Mh] Termos MeSH secundário: Circuncisão Masculina
Seres Humanos
Hiperbilirrubinemia Neonatal/diagnóstico
Hiperbilirrubinemia Neonatal/terapia
Hipoglicemia/diagnóstico
Hipoglicemia/terapia
Fenômenos Fisiológicos da Nutrição do Lactente
Recém-Nascido
Recém-Nascido Prematuro
Ligadura
Freio Lingual/cirurgia
Masculino
Síndrome de Abstinência Neonatal/diagnóstico
Síndrome de Abstinência Neonatal/terapia
Triagem Neonatal
Sepse Neonatal/diagnóstico
Sepse Neonatal/terapia
Polidactilia/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170712
[St] Status:MEDLINE
[do] DOI:10.1542/hpeds.2016-0206


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[PMID]:28399191
[Au] Autor:Mazur-Kominek K; Romanowski T; Bielawski K; Kielbratowska B; Preis K; Domzalska-Popadiuk I; Slominska-Fraczek M; Sznurkowska K; Renke J; Plata-Nazar K; Sledzinska K; Sikorska-Wisniewska G; Góra-Gebka M; Liberek A
[Ad] Endereço:Department of Biotechnology, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, Gdansk, Poland.
[Ti] Título:Association between uridin diphosphate glucuronosylotransferase 1A1 (UGT1A1) gene polymorphism and neonatal hyperbilirubinemia.
[So] Source:Acta Biochim Pol;64(2):351-356, 2017.
[Is] ISSN:1734-154X
[Cp] País de publicação:Poland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To assess the prevalence of UGT1A1*28 and UGT1A1*60 polymorphisms of UGT1A1 gene and their association with hyperbilirubinemia. STUDY DESIGN: The study was performed at a single centre - at the Department of Obstetrics of the Medical University of Gdansk in Poland. DNA was isolated from Guthrie cards of 171 infants. Only full term newborns (gestational age 38-42 weeks) were included in the study. Fluorescent molecular probes were used for UGT1A1 promoter variation analysis. The presence of UGT1A1*28 polymorphism was detected with a dual-probe system, and UGT1A1*60 with a SimpleProbe™. RESULT: Homozygous UGT1A1*28 and UGT1A1*60 genotypes were detected in 14.6% and 20.5% of the newborns, respectively. Homozygous (G/G) genotypes of UGT1A1*60 polymorphism were found in all of the UGT1A1*28 (i.e. (TA) /(TA) ) homozygotes. More than 80% (55/66) of the children with "wild" type UGT1A1*28 genotype (where no polymorphism was detected) (i.e. (TA) /(TA) ) carried the "wild" (T/T) genotype of UGT1A1*60 as well. The UGT1A1*28 polymorphism was detected more often among neonates with elevated bilirubin. Hyperbilirubinemia was diagnosed more frequently in boys. CONCLUSION: Polymorphisms of the UGT1A1 gene frequently co-exist in neonates. The presence of UGT1A1*28 polymorphism and male gender seem to predispose to neonatal hyperbilirubinemia.
[Mh] Termos MeSH primário: Estudos de Associação Genética
Predisposição Genética para Doença
Glucuronosiltransferase/genética
Hiperbilirrubinemia Neonatal/genética
[Mh] Termos MeSH secundário: Criança
Feminino
Genótipo
Seres Humanos
Hiperbilirrubinemia Neonatal/patologia
Recém-Nascido
Polônia
Polimorfismo de Nucleotídeo Único
Gravidez
Caracteres Sexuais
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
EC 2.4.1.- (UGT1A1 enzyme); EC 2.4.1.17 (Glucuronosyltransferase)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170811
[Lr] Data última revisão:
170811
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170412
[St] Status:MEDLINE
[do] DOI:10.18388/abp.2016_1450


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[PMID]:28368263
[Au] Autor:Thakkar P; Chavda H; Doshi V
[Ad] Endereço:Departments of Pediatrics and *Community Medicine, Medical College and SSG Hospital, Vadodara, Gujarat, India. Correspondence to: Dr Pareshkumar Thakkar, 21, Jay Gayatrinagar Society, Near Amitnagar, VIP Road, Vadodara 390 022, Gujarat, India. pareshthakkar@yahoo.com.
[Ti] Título:Transcutaneous Bilirubin Nomogram for Healthy Term and Late Preterm Neonates in First 96 Hours of Life.
[So] Source:Indian Pediatr;54(5):369-372, 2017 May 15.
[Is] ISSN:0974-7559
[Cp] País de publicação:India
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: To develop nomogram of Transcutaneous Bilirubin among healthy term and late-preterm neonates during first 96 hours of age. DESIGN: Longitudinal observational study. SETTING: Neonatal unit of a tertiary care Hospital of Central Gujarat, India. Participants: 1075 healthy term and late preterm neonates (≥35weeks). INTERVENTION: Six-hourly transcutaneous bilirubin was obtained from birth to 96 hour of life using Drager JM 103 Transcutaneous Bilirubinometer. METHODS: Main outcome measures: Nomogram of Transcutaneous Bilirubin with percentile values was obtained, rate of rise of bilirubin was calculated and predictive ability of normative data was analyzed for subsequent need of phototherapy. RESULTS: The age-specific percentile curves and nomogram were developed from the transcutaneous bilirubin readings of 1,010 neonates. Rate of rise in first 12 hour was 0.2 mg/dL and was 0.17 mg/dL in 12 to 24 hour of life which decreased on second day of life. Neonates who required phototherapy had consistently higher readings of transcutaneous bilirubin and also higher rate of rise in first 48 hrs. CONCLUSION: Neonates whose transcutaneous bilirubin is above the 50th percentile should be monitored for the development of significant hyperbilirubinemia.
[Mh] Termos MeSH primário: Bilirrubina/análise
Triagem Neonatal/métodos
Triagem Neonatal/normas
Nomogramas
[Mh] Termos MeSH secundário: Seres Humanos
Hiperbilirrubinemia Neonatal/diagnóstico
Recém-Nascido
Estudos Longitudinais
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
RFM9X3LJ49 (Bilirubin)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170623
[Lr] Data última revisão:
170623
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170404
[St] Status:MEDLINE


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[PMID]:28304323
[Au] Autor:Bryant SN; Herrera CL; Nelson DB; Cunningham FG
[Ti] Título:Diabetic ketoacidosis complicating pregnancy.
[So] Source:J Neonatal Perinatal Med;10(1):17-23, 2017.
[Is] ISSN:1878-4429
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Although diabetic ketoacidosis (DKA) in pregnancy can result in significant adverse consequences for both mother and fetus, the response to treatment, time course of recovery, and perinatal outcomes have not been well studied in pregnancy. OBJECTIVE: We examined the precipitating factors, laboratory abnormalities, treatment strategies, and clinical recovery in pregnancies complicated by DKA. STUDY DESIGN: This is a retrospective cohort study of pregnancies complicated by DKA between October 1999 and June 2015. The diagnosis was verified by hyperglycemia; anion gap >12 mEq/L, pH <7.3, HCO3 <15 mEq/L; and the presence of ketones. Each episode of DKA was reviewed and subsequent perinatal outcomes analyzed. RESULTS: During this period, we identified 33 women with 40 admissions (incidence: 0.2%). The majority of women had type 1 diabetes (67%), and almost all presented with nausea and vomiting (97%). Over half had poor compliance with prescribed insulin. The initial mean blood glucose was 380 mg/dL, within 6 hours, it was <200 mg/dL. By 12 hours, the acidosis had resolved in 90% of patients. CONCLUSION: Nausea and vomiting is a prominent presenting feature of DKA in pregnancy. With aggressive insulin and resuscitation, hyperglycemia and acidosis improve rapidly. With current treatment, good perinatal outcomes can be expected.
[Mh] Termos MeSH primário: Diabetes Mellitus Tipo 1/terapia
Cetoacidose Diabética/terapia
Hidratação/métodos
Hipoglicemiantes/uso terapêutico
Insulina/uso terapêutico
Gravidez em Diabéticas/terapia
[Mh] Termos MeSH secundário: Aborto Espontâneo/epidemiologia
Adulto
Peso ao Nascer
Cesárea
Anormalidades Congênitas/epidemiologia
Diabetes Mellitus Tipo 1/epidemiologia
Diabetes Mellitus Tipo 1/metabolismo
Cetoacidose Diabética/epidemiologia
Cetoacidose Diabética/metabolismo
Progressão da Doença
Feminino
Morte Fetal
Idade Gestacional
Hemoglobina A Glicada/metabolismo
Seres Humanos
Hiperbilirrubinemia Neonatal/epidemiologia
Hipoglicemia/epidemiologia
Recém-Nascido
Doenças do Recém-Nascido/epidemiologia
Unidades de Terapia Intensiva Neonatal/utilização
Soluções Isotônicas/uso terapêutico
Pré-Eclâmpsia/epidemiologia
Gravidez
Complicações na Gravidez/epidemiologia
Complicações na Gravidez/metabolismo
Complicações na Gravidez/terapia
Gravidez em Diabéticas/epidemiologia
Gravidez em Diabéticas/metabolismo
Nascimento Prematuro/epidemiologia
Estudos Retrospectivos
Texas/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Glycated Hemoglobin A); 0 (Hypoglycemic Agents); 0 (Insulin); 0 (Isotonic Solutions); 0 (crystalloid solutions); 0 (hemoglobin A1c protein, human)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170318
[St] Status:MEDLINE
[do] DOI:10.3233/NPM-1663


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[PMID]:28283555
[Au] Autor:Yueh MF; Chen S; Nguyen N; Tukey RH
[Ad] Endereço:Laboratory of Environmental Toxicology, Department of Pharmacology, University of California, San Diego, La Jolla, California mfyueh@ucsd.edu.
[Ti] Título:Developmental, Genetic, Dietary, and Xenobiotic Influences on Neonatal Hyperbilirubinemia.
[So] Source:Mol Pharmacol;91(5):545-553, 2017 May.
[Is] ISSN:1521-0111
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Hyperbilirubinemia, caused by the accumulation of unconjugated bilirubin, is one of the most common clinical diagnoses in both premature and term newborns. Owing to the fact that bilirubin is metabolized solely through glucuronidation by UDP-glucuronosyltransferase (UGT) 1A1, it is now known that immaturity of UGT1A1, in combination with the overproduction of bilirubin during the developmental stage, acts as a bottleneck to bilirubin elimination and predisposes the infant to high total serum bilirubin levels. Although neonatal jaundice is mostly benign, excessively high levels of serum bilirubin in a small percentage of newborns can cause bilirubin-induced neurologic dysfunction, potentially leading to permanent brain damage, a condition known as Although a large portion of hyperbilirubinemia cases in newborns are associated with hemolytic diseases, we emphasize here the impaired ability of UGT1A1 to eliminate bilirubin that contributes to hyperbilirubinemia-induced neurotoxicity in the developmental stage. As a series of hereditary UGT1A1 mutations have been identified that are associated with UGT1A1 deficiency, new evidence has verified that delayed expression of UGT1A1 during the early stages of neonatal development is a tightly controlled event involving coordinated intrahepatic and extrahepatic regulation. This review recapitulates the progress that has been made in recent years in understanding the causes and physiopathology of severe hyperbilirubinemia, investigating molecular mechanisms underlying bilirubin-induced encephalopathy, and searching for potential therapies for treating pathologic hyperbilirubinemia. Several animal models have been developed to make it possible to examine bilirubin-induced neurotoxicity from multiple directions. Moreover, environmental factors that may alleviate or worsen the condition of hyperbilirubinemia are discussed.
[Mh] Termos MeSH primário: Hiperbilirrubinemia Neonatal/etiologia
[Mh] Termos MeSH secundário: Animais
Bilirrubina/biossíntese
Bilirrubina/sangue
Dieta
Glucuronosiltransferase/deficiência
Glucuronosiltransferase/genética
Glucuronosiltransferase/metabolismo
Seres Humanos
Hiperbilirrubinemia Neonatal/sangue
Hiperbilirrubinemia Neonatal/induzido quimicamente
Hiperbilirrubinemia Neonatal/genética
Recém-Nascido
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
EC 2.4.1.- (UGT1A1 enzyme); EC 2.4.1.17 (Glucuronosyltransferase); RFM9X3LJ49 (Bilirubin)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170511
[Lr] Data última revisão:
170511
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170312
[St] Status:MEDLINE
[do] DOI:10.1124/mol.116.107524


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[PMID]:28196932
[Au] Autor:Chang PW; Kuzniewicz MW; McCulloch CE; Newman TB
[Ad] Endereço:Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington; pearlchangmd@gmail.com.
[Ti] Título:A Clinical Prediction Rule for Rebound Hyperbilirubinemia Following Inpatient Phototherapy.
[So] Source:Pediatrics;139(3), 2017 Mar.
[Is] ISSN:1098-4275
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: The American Academy of Pediatrics provides little guidance on when to discontinue phototherapy in newborns treated for hyperbilirubinemia. We sought to develop a prediction rule to estimate the probability of rebound hyperbilirubinemia after inpatient phototherapy. METHODS: Subjects for this retrospective cohort study were infants born in 2012 to 2014 at ≥35 weeks' gestation at 16 Kaiser Permanente Northern California hospitals who received inpatient phototherapy before age 14 days. We defined rebound as the return of total serum bilirubin (TSB) to phototherapy threshold within 72 hours of phototherapy termination. We used stepwise logistic regression to select predictors of rebound hyperbilirubinemia and devised and validated a prediction score by using split sample validation. RESULTS: Of the 7048 infants treated with inpatient phototherapy, 4.6% had rebound hyperbilirubinemia. Our prediction score consisted of 3 variables: gestational age <38 weeks (adjusted odds ratio [aOR] 4.7; 95% confidence interval [CI], 3.0-7.3), younger age at phototherapy initiation (aOR 0.51 per day; 95% CI, 0.38-0.68), and TSB relative to the treatment threshold at phototherapy termination (aOR 1.5 per mg/dL; 95% CI, 1.4-1.7). The model performed well with an area under the receiver operating characteristic curve of 0.89 (95% CI, 0.86-0.91) in the derivation data set and 0.88 (95% CI, 0.86-0.90) in the validation data set. Approximately 70% of infants had scores <20, which correspond to a <4% probability of rebound hyperbilirubinemia. CONCLUSIONS: The risk of rebound hyperbilirubinemia can be quantified according to an infant's gestational age, age at phototherapy initiation, and TSB relative to the treatment threshold at phototherapy termination.
[Mh] Termos MeSH primário: Bilirrubina/sangue
Técnicas de Apoio para a Decisão
Hiperbilirrubinemia Neonatal/terapia
Icterícia Neonatal/terapia
Fototerapia
Medição de Risco
[Mh] Termos MeSH secundário: Fatores Etários
Estudos de Coortes
Feminino
Idade Gestacional
Seres Humanos
Recém-Nascido
Modelos Logísticos
Masculino
Recidiva
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
RFM9X3LJ49 (Bilirubin)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:171111
[Lr] Data última revisão:
171111
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170216
[St] Status:MEDLINE


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[PMID]:28192492
[Au] Autor:Olusanya BO; Mabogunje CA; Imosemi DO; Emokpae AA
[Ad] Endereço:Center for Healthy Start Initiative, Ikoyi, Lagos, Nigeria.
[Ti] Título:Transcutaneous bilirubin nomograms in African neonates.
[So] Source:PLoS One;12(2):e0172058, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The use of transcutaneous bilirubin (TcB) as a screening tool, based on relevant population-specific nomogram, or proxy for total serum bilirubin (TSB) levels in assessing the risk of subsequent hyperbilirubinemia is supported by several clinical guidelines on the management of neonatal hyperbilirubinemia. However, while TcB has been found to significantly over-estimate TSB in neonates of African-American ancestry, with variations across TcB devices, no nomogram has been specifically reported for this racial group. This study therefore set out to develop TcB nomograms for healthy late pre-term and term black African neonates derived from two widely used bilirubinometers. METHODS: A retrospective analysis of 12,377 TcB measurements obtained from 6,373 neonates in the first postnatal week, over a period of 48 months using Bilichek and JM-103 bilirubinometers. TcB percentiles were computed from hour-specific TcB values and nomograms developed for each of the screening devices. Predictive ability of the 75th and 95th percentiles to detect significant hyperbilirubinemia was evaluated between 24-96 hours of age. The 95th percentile curve was compared with those from other populations. RESULTS: The velocity of TcB rise at 75th and 95th percentiles was generally higher with JM-103 than Bilichek. Both percentiles also peaked at higher TcB levels with JM-103. The 95th percentile for both instruments showed a downward trend as from approximately 114 hours. Both instruments had high negative predictive values across the selected time-epochs and lower discriminatory ability than reported in non-black populations. CONCLUSIONS: The predictive utility of TcB as a potential screening tool varies across devices in black African neonates with or without risk of significant hyperbilirubinemia, and lower than levels reported in non-black populations. Equipment-specific nomograms should be considered for TcB monitoring in this racial population where TSB is not routinely available.
[Mh] Termos MeSH primário: Bilirrubina/sangue
Hiperbilirrubinemia Neonatal/sangue
Triagem Neonatal/métodos
Nomogramas
[Mh] Termos MeSH secundário: Grupo com Ancestrais do Continente Africano
Feminino
Seres Humanos
Hiperbilirrubinemia Neonatal/diagnóstico
Hiperbilirrubinemia Neonatal/etnologia
Recém-Nascido
Recém-Nascido Prematuro/sangue
Masculino
Triagem Neonatal/instrumentação
Nigéria
Valor Preditivo dos Testes
Estudos Retrospectivos
Medição de Risco
Fatores de Risco
Pele/irrigação sanguínea
Nascimento a Termo/sangue
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
RFM9X3LJ49 (Bilirubin)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170829
[Lr] Data última revisão:
170829
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170214
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0172058



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