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Hyperbilirubinemia

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https://www.readbyqxmd.com/read/29218844/predictors-of-hepatotoxicity-and-pancreatitis-in-children-and-adolescents-with-acute-lymphoblastic-leukemia-treated-according-to-contemporary-regimens
#1
Christopher C Denton, Yasmin A Rawlins, Matthew J Oberley, Deepa Bhojwani, Etan Orgel
BACKGROUND: Hepatotoxicity and pancreatitis are common treatment-related toxicities (TRTs) during contemporary treatment regimens for acute lymphoblastic leukemia (ALL). Limited detailed data from Children's Oncology Group (COG) regimens has been previously reported to enable identification of patient and treatment risk factors for these toxicities and their impact on outcomes. PROCEDURE: We analyzed a retrospective pediatric ALL cohort treated at a single institution according to COG regimens from 2008 to 2015...
December 8, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29208875/predicting-neonatal-hyperbilirubinemia-using-first-day-serum-bilirubin-level-in-late-preterm-and-term-healthy-newborn
#2
K A Khan, J Alam, N Nahar, S K Dey, M A Mannan, M Shahidullah
Hyperbilirubinemia is a common problem during the neonatal period and is the most common reason for readmission after early hospital discharge of the healthy near term and term infants. This early discharge policy along with limited follow-up facilities in developing countries and inadequate communication between physicians and parents necessitates a prognostic test to predict hyperbilirubinemia in these newborns; for early and effective management and prevention of potential complication before it occurred...
October 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29206748/pharmacokinetics-and-pharmacodynamics-of-atazanavir-in-hiv-1-infected-children-treated-with-atazanavir-powder-and-ritonavir-combined-analysis-of-the-prince-1-and-2-studies
#3
Heather Sevinsky, Luna Zaru, Reena Wang, Xiaohui Xu, Cheryl Pikora, Todd A Correll, Timothy Eley
BACKGROUND: Two clinical studies (PRINCE-1 and -2) in HIV-1-infected children assessed the safety, efficacy, and pharmacokinetics of dual nucleos(t)ide reverse transcriptase inhibitor (NRTI) background therapy plus once-daily atazanavir powder formulation boosted with ritonavir (ATV+RTV). Here, we present a combined analysis of ATV pharmacokinetics and pharmacodynamics across these studies. METHODS: Intensive 24-hour pharmacokinetic profiles at steady state compared ATV exposures (area under the concentration-time curve in one dosing interval [AUCτ]) in 5 ATV+RTV baseline weight-band dosing categories with historic data in adults receiving ATV+RTV 300/100-mg capsules...
December 4, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29206747/safety-and-efficacy-of-atazanavir-powder-and-ritonavir-in-hiv-1-infected-infants-and-children-aged-from-3-months-to-11-years-the-prince-2-study
#4
Mark F Cotton, Afaaf Liberty, Indiana Torres-Escobar, Maria Isabel Gonzalez-Tome, Jurgen Lissens, Luna Zaru, Isabelle Klauck, Daniela Cambilargiu, Cheryl Pikora, Todd A Correll
BACKGROUND: Novel antiretroviral formulations that are palatable, safe, and effective are needed for infants and children. METHODS: PRINCE-2 is an ongoing clinical trial assessing safety, efficacy, and palatability of once-daily atazanavir powder formulation boosted with ritonavir (ATV+RTV) plus optimized dual NRTI therapy in ARV-naïve/experienced children with screening HIV-1 RNA ≥1000 copies/mL. Children aged 3 months to <11 years received ATV+RTV by 5 baseline weight bands: 5 to <10kg=150/80mg; 5 to <10kg=200/80mg; 10 to <15kg=200/80mg; 15 to <25kg=250/80mg; and 25 to <35kg=300/100mg...
December 4, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29203650/point-of-care-device-to-diagnose-and-monitor-neonatal-jaundice-in-low-resource-settings
#5
Pelham A Keahey, Mathieu L Simeral, Kristofer J Schroder, Meaghan M Bond, Prince J Mtenthaonnga, Robert H Miros, Queen Dube, Rebecca R Richards-Kortum
Newborns are at increased risk of jaundice, a condition in which excess bilirubin accumulates in blood. Left untreated, jaundice can lead to neurological impairment and death. Jaundice resulting from unconjugated hyperbilirubinemia is easily treated with exposure to blue light, and phototherapy systems have been developed for low-resource settings; however, there are no appropriate solutions to diagnose and monitor jaundice in these settings. To address this need we present BiliSpec, a low-cost reader and disposable lateral flow card designed to measure the concentration of total bilirubin from several drops of blood at the point of care...
December 4, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/29200157/an-infant-with-unusually-high-unconjugated-hyperbilirubinemia-due-to-coexistence-of-hereditary-spherocytosis-and-gilbert-syndrome
#6
Ivona Butorac Ahel, Kristina Baraba Dekanic, Goran Palcevski, Jelena Roganovic
Hereditary spherocytosis is the most frequent congenital hemolytic anemia and is characterized with variable degree of anemia, jaundice, and splenomegaly. In the case of severe hyperbilirubinemia out of proportion with hemolysis, other causes of hyperbilirubinemia must be considered. Gilbert syndrome (GS) is an autosomal dominant disorder characterized with intermittent hyperbilirubinemia without any other sign and symptom of liver disease as a result of reduced activity of uridine diphosphate-glucuronyl transferase 1A1...
December 1, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29192695/israel-transcutaneous-bilirubin-nomogram-predicts-significant-hyperbilirubinemia
#7
R Bromiker, A Goldberg, M Kaplan
OBJECTIVE: We constructed a transcutaneous bilirubin (TcB) nomogram to represent major sectors of the Israeli population. We studied the risk of hyperbilirubinemia, defined as meeting the requirements for phototherapy, per percentile risk category. STUDY DESIGN: Newborns ⩾36 weeks gestation were tested daily for TcB, using Drager JM-103 devices, during birth hospitalization. A nomogram was constructed and divided into four risk groups and validated by calculating the need for phototherapy for each group...
December 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29191700/health-care-utilization-in-the-first-month-after-birth-and-its-relationship-to-newborn-weight-loss-and-method-of-feeding
#8
Valerie Flaherman, Eric W Schaefer, Michael W Kuzniewicz, Sherian Li, Eileen Walsh, Ian M Paul
OBJECTIVE: Guidelines recommend closer outpatient follow-up for exclusively breastfed newborns, especially those with pronounced weight loss, because of increased risk of hyperbilirubinemia and dehydration that might require readmission. Our objective was to determine how feeding method and weight loss are associated with neonatal healthcare utilization. DESIGN: Retrospective cohort study. SETTING: Northern California Kaiser Permanente hospitals in 2009-2013 PATIENTS: 143,889 neonates PREDICTORS: Inpatient method of feeding and inpatient and outpatient weights MAIN OUTCOME MEASURES: Inpatient and outpatient utilization in the 30 days after birth RESULTS: Newborn weight loss and feeding method were each associated with utilization...
November 27, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/29185945/alagille-syndrome-an-overview
#9
Dalacy Jesina
Alagille syndrome (AGS) is a highly complex, multisystem, autosomal dominant disorder that is caused by a defect in the Notch signaling pathway. This syndrome mainly affects the liver, causing significant cholestasis, which is caused by a paucity of intrahepatic bile ducts. There can be cardiac involvement, including, but not limited to, pulmonary stenosis and tetralogy of Fallot. Patients can also present with butterfly vertebra, ocular issues, and vascular events. Because this syndrome follows an autosomal dominant inheritance, it can have variable expression even in the same family line...
November 1, 2017: Neonatal Network: NN
https://www.readbyqxmd.com/read/29185155/successful-treatment-of-follicular-lymphoma-with-second-generation-tyrosine-kinase-inhibitors-administered-for-coexisting-chronic-myeloid-leukemia
#10
Shin-Ichiro Fujiwara, Yuya Shirato, Takashi Ikeda, Shin-Ichiro Kawaguchi, Yumiko Toda, Shoko Ito, Shin-Ichi Ochi, Takashi Nagayama, Kiyomi Mashima, Kento Umino, Daisuke Minakata, Hirofumi Nakano, Kaoru Morita, Ryoko Yamasaki, Yasufumi Kawasaki, Miyuki Sugimoto, Masahiro Ashizawa, Chihiro Yamamoto, Kaoru Hatano, Kazuya Sato, Iekuni Oh, Ken Ohmine, Kazuo Muroi, Yoshinobu Kanda
Tyrosine kinase inhibitors (TKIs) are standard therapy for chronic myeloid leukemia (CML). However, the effects of these agents on mature B cell lymphoma are not well known. We describe a 50-year-old man who was diagnosed with CML in the chronic phase and treated with imatinib. After 3 years of imatinib therapy that achieved a complete cytogenetic response of CML, he developed Philadelphia-negative follicular lymphoma (FL). Rituximab monotherapy induced a partial response of FL, and he subsequently achieved a major molecular response (MMR) of CML...
November 28, 2017: International Journal of Hematology
https://www.readbyqxmd.com/read/29179591/effects-of-gly71arg-mutation-in-ugt1a1-gene-on-neonatal-hyperbilirubinemia-a-systematic-review-and-meta-analysis
#11
Hassan Mehrad-Majd, Monir Sadat Haerian, Javad Akhtari, Yalda Ravanshad, Anoush Azarfar, Gholamali Mamouri
OBJECTIVE: The associations between Gly71Arg polymorphism in the coding region of uridine diphosphate glucuronosyl transferase 1A1 (UGT1A1) gene and the risk of neonatal hyperbilirubinemia remained controversial. Therefore, a meta-analysis of observational studies has been conducted to assess the relationship between UGT1A1 gene polymorphisms of Gly71Arg and neonatal hyperbilirubinemia susceptibility. METHODS: An electronic literature search from online databases, such as PubMed, Embase, Cochrane and Scopus was conducted to identify eligible studies...
November 27, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29178522/direct-hyperbilirubinemia-in-infants-with-congenital-heart-disease
#12
Jun Fujishiro, Masahiko Sugiyama, Tetsuya Ishimaru, Miho Watanabe, Kaori Sato, Noriko Hoshino, Chizue Uotani, Mai Kutsukake, Yoichiro Hirata, Akira Oka
BACKGROUND: An association between congenital heart disease (CHD) and infantile cholestasis, a key finding for the diagnosis of biliary atresia (BA), remains unknown. The aim of this study was to investigate the characteristics of direct hyperbilirubinemia (D-HB) in infants with CHD. METHODS: All neonates who were admitted to our hospital and diagnosed with CHD in 2015 and 2016 were included. D-HB (direct bilirubin≧ 2.0 mg/dL) within 60 days of age and other clinical parameters were retrospectively reviewed...
November 27, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/29176474/hepatic-parenchymal-injury-in-crigler-najjar-type-i
#13
Ellen Mitchell, Sarangarajan Ranganathan, Patrick McKiernan, Robert H Squires, Kevin Strauss, Kyle Soltys, George Mazariegos, James E Squires
BACKGROUND: Crigler-Najjar syndrome type I (CNI) arises from biallelic variants of UGT1A1 that abrogate UGT1A1 activity resulting in unconjugated hyperbilirubinemia. Historically, liver parenchyma in CNI was considered structurally and histologically normal. Recent review of CNI liver explants revealed fibrosis. Our aim was to investigate the association between hepatic histology and disease phenotype in CNI. METHODS: We extracted data from the medical record at the time of liver transplant from 22 patients with CNI at the Children's Hospital of Pittsburgh, and reviewed explant histology...
November 22, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29166493/dystrophic-calcification-of-maxillary-sinus-in-pediatric-patients-with-liver-transplantation-and-pigmentation-of-dental-organ
#14
Adriana Furtado de Macedo, Claudio Costa, Regina Helena Guedes da Motta Mattar, Ramiro Anthero de Azevedo
OBJECTIVE: To report a case of severe dystrophic calcification in maxillary sinus of a child with liver transplantation and dental organs pigmented by hyperbilirubinemia. CASE DESCRIPTION: female patient, 12 years old, with liver transplantation performed at the age of 7 due to extrahepatic biliary atresia (EHBA). The patient was receiving the immunosuppressant tacrolimus (2 mg daily). Intraoral clinical exam showed tooth green pigmentation by bilirubin. Cone-beam volumetric computed tomography (CT) was performed to verify radiographic density of pigmented dental elements...
November 17, 2017: Revista Paulista de Pediatria: Orgão Oficial da Sociedade de Pediatria de São Paulo
https://www.readbyqxmd.com/read/29159025/comparison-of-the-inhibition-potentials-of-icotinib-and-erlotinib-against-human-udp-glucuronosyltransferase-1a1
#15
Xuewei Cheng, Xia Lv, Hengyan Qu, Dandan Li, Mengmeng Hu, Wenzhi Guo, Guangbo Ge, Ruihua Dong
UDP-glucuronosyltransferase 1A1 (UGT1A1) plays a key role in detoxification of many potentially harmful compounds and drugs. UGT1A1 inhibition may bring risks of drug-drug interactions (DDIs), hyperbilirubinemia and drug-induced liver injury. This study aimed to investigate and compare the inhibitory effects of icotinib and erlotinib against UGT1A1, as well as to evaluate their potential DDI risks via UGT1A1 inhibition. The results demonstrated that both icotinib and erlotinib are UGT1A1 inhibitors, but the inhibitory effect of icotinib on UGT1A1 is weaker than that of erlotinib...
November 2017: Acta Pharmaceutica Sinica. B
https://www.readbyqxmd.com/read/29155355/molecular-ellipticity-of-circulating-albumin-bilirubin-complex-associates-with-mortality-in-patients-with-severe-alcoholic-hepatitis
#16
Sukanta Das, Jaswinder Singh Maras, Rakhi Maiwall, S M Shasthry, Md Shabir Hussain, Shvetank Sharma, S Sukriti, T P Singh, Shiv Kumar Sarin
BACKGROUND & AIMS: Hyperbilirubinemia and hypoalbuminemia are features of hepatic dysfunction that associate with disease severity. This is because hepatic insufficiency causes hypoalbuminemia, which indirectly increases the circulating levels of free bilirubin. Circular dichroism (CD) spectroscopy can be used to quantify the molecular ellipticity (ME) of the albumin-bilirubin complex, and might associate with the severity or outcome of severe alcoholic hepatitis (SAH). METHODS: We performed a cross-sectional study of 265 patients with SAH admitted in the Department of Hepatology, Institute of Liver and Biliary Sciences in New Delhi, India from January 2014 through January 2016...
November 16, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29150336/urinary-tract-infections-in-neonates-with-unexplained-pathological-indirect-hyperbilirubinemia-prevalence-and-significance
#17
Elif Bahat Ozdogan, Mehmet Mutlu, Secil Arslansoyu Camlar, Gülcin Bayramoglu, Sebnem Kader, Yakup Aslan
BACKGROUND: It is controversial to test for urinary tract infection (UTI) in patients with unexplained indirect hyperbilirubinemia in the first 2 weeks of life. We aimed to study the prevalence and significance of UTIs in such neonates who were requiring phototherapy. METHODS: Subjects were 2- to 14-day-old neonates with indirect bilirubin levels above phototherapy limit with no other abnormality in their bilirubinaemia-related etiologic workup. UTI was diagnosed by 2 consecutive positive cultures obtained by catheterisation, documenting growth of >10,000 colonies of the same microorganism with consistent antibiograms...
October 28, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/29137095/differences-in-ugt1a1-gene-mutations-and-pathological-liver-changes-between-chinese-patients-with-gilbert-syndrome-and-crigler-najjar-syndrome-type-ii
#18
Lei Sun, Man Li, Liang Zhang, Xiaoying Teng, Xiangmei Chen, Xingang Zhou, Zhiyuan Ma, Liming Qi, Peng Wang
Diagnosis of Crigler-Najjar syndrome type II (CNS-II) and Gilbert syndrome (GS) based on the serum bilirubin concentration is difficult, because this parameter can fluctuate under certain conditions. The aim of this study was to explore differences in UGT1A1 gene mutations, which cause both CNS and GS, and pathological changes between CNS-II and GS.Ninety-five Chinese patients with hereditary unconjugated hyperbilirubinemia were enrolled in this study. Peripheral blood samples obtained from patients were used to evaluate bilirubin levels and for UGT1A1 gene testing...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29132818/bilirubin-albumin-binding-and-unbound-unconjugated-hyperbilirubinemia-in-premature-infants
#19
Sanjiv B Amin, Hongyue Wang
OBJECTIVE: To evaluate the associations between unbound bilirubin (UB) and total serum bilirubin (TSB), bilirubin:albumin molar ratio (BAMR), and bilirubin albumin binding affinity (Ka) as a function of gestational age (GA) in infants born at 24-33 weeks GA. STUDY DESIGN: In a prospective observational study, TSB and UB were measured twice daily at least 8 hours apart during the first postnatal week. Serum albumin was measured to calculate BAMR on each day. The highest UB on each day, corresponding TSB, and serum albumin were used to calculate the Ka on each day...
November 10, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29131919/breast-feeding-friendly-but-not-formula-averse
#20
Juanita Lewis
Breast-feeding is the optimal source of newborn nutrition in term infants and is associated with multiple short- and long-term health benefits. Establishment of breast-feeding may be difficult in a small subset of mothers, which can lead to adverse consequences in the newborn. Some of the consequences of suboptimal nutritional provision to the newborn, such as severe hyperbilirubinemia and breast-feeding-associated hypernatremic dehydration, can have devastating and long-lasting sequelae. Timely identification of mothers and newborns at risk for developing these complications is necessary to avoid significant morbidity and mortality...
November 1, 2017: Pediatric Annals
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