CORTISOL METABOLISM IN THE NEWBORN

1964 ◽  
Vol 45 (2) ◽  
pp. 286-296 ◽  
Author(s):  
D. Aarskog ◽  
K. F. Stoa ◽  
T. Thorsen
Keyword(s):  
Ethyl Acetate ◽  
Serum Bilirubin ◽  
Neonatal Period ◽  
Newborn Infants ◽  
Total Radioactivity ◽  
Serum Bilirubin Level ◽  
Maximum Serum ◽  
Cortisol Metabolism ◽  
Methylene Dichloride ◽  
Normal Adults

ABSTRACT Following intravenous administration of cortisol-4-14C to seven full-term and five premature newborn infants, the urinary excretion of free and conjugated substances was measured in different fractions. Three normal adult subjects served as controls. The study comprised the following fractions: a) Free »lowpolar« fraction, extractable with methylene dichloride. b) Free »high-polar« fraction, extractable with ethyl acetate. c) »Low-polar« glucuronoside fraction, extractable with methylene dichloride following β-glucuronidase hydrolysis. d) »High-polar« glucuronoside fraction, extractable with ethyl acetate following β-glucuronidase hydrolysis. e) Solvolysis fraction, extractable with ethyl acetate after previous removal of the free and glucuronoside conjugated fractions and subsequent solvolysis. The excretion of total radioactivity in the group of normal newborns was found to be delayed as compared with the adult subjects. The unconjugated fractions were found to be somewhat higher in the newborn than in the adult subjects. On the other hand, the »low-polar« glucuronosides were essentially lower. These deviations from the findings in normal adults were still more pronounced in the group of premature newborns. An inverse relationship was demonstrated between the percentage excreted as glucoronosides and the maximum serum bilirubin level in the neonatal period.

ACTIVITY OF GLUTAMIC-OXALOACETIC TRANSAMINASE IN THE SERUM IN THE NEONATAL PERIOD

PEDIATRICS ◽  
1957 ◽  
Vol 20 (4) ◽  
pp. 584-589
Author(s):  
Simon Kove ◽  
Stanley Goldstein ◽  
Felix Wróblewski
Keyword(s):  
Neonatal Period ◽  
Newborn Infants ◽  
Normal Range ◽  
Glutamic Oxaloacetic Transaminase ◽  
Newborn Period ◽  
Method Of Determination ◽  
Normal Term ◽  
Pathologic State ◽  
Normal Adults

The activity of glutamic oxaloacetic transaminase (GOT) in the serum was determined by the spectrophotometric method in 63 normal term newborn infants, varying from birth to 11 days of age. The normal range of activity in the newborn period varied from 13 to 105 units (with the exception of one infant in whom the level was 160 units). This is a considerably wider range than that of 5 to 45 units found in normal adults. Allowing for an error of about ±10% inherent in the method of determination of GOT, activity as great as approximately 120 units, which in adults would be indicative of some pathologic state, must be considered physiologic in the newborn infant. The activity of GOT was not related to the age of the infant within the neonatal period studied, and varied widely in different infants for each day of age, without any distinctive pattern. Variations of the activity of GOT in specimens of cord blood studied ranged below 59 units, which was lower than for any other day of the neonatal period adequately investigated. No infants were studied repeatedly. No relation was found between the concentration of bilirubin and the activity of GOT in the serum.

14 SERUM BILIRUBIN LEVEL IN THE NEONATAL PERIOD AND ERYTHROCYTE ACID PHOSPHATASE PHENOTYPE

1977 ◽  
Vol 11 (1) ◽  
pp. 54
Author(s):  
Luca E Carapella-De ◽  
P. Lucarelli ◽  
F. Gloria-Bottini ◽  
R. Scacchi ◽  
Luca T. De ◽  
...  
Keyword(s):  
Acid Phosphatase ◽  
Bilirubin Level ◽  
Serum Bilirubin ◽  
Neonatal Period ◽  
Serum Bilirubin Level

Normal Serum Bilirubin Levels in the Newborn and the Effect of Breast-Feeding

PEDIATRICS ◽  
1986 ◽  
Vol 78 (5) ◽  
pp. 837-843 ◽  
Author(s):  
M. Jeffrey Maisels ◽  
Kathleen Gifford
Keyword(s):  
Breast Feeding ◽  
Bilirubin Level ◽  
Serum Bilirubin ◽  
Strong Association ◽  
The United States ◽  
Serum Bilirubin Level ◽  
Control Group ◽  
Term Infants ◽  
Maximum Serum ◽  
Breast Fed

We measured the serum bilirubin concentrations in 2,416 consecutive infants admitted to our well-baby nursery. The maximum serum bilirubin concentration exceeded 12.9 mg/dL (221 µmol/L) in 147 infants (6.1%), and these infants were compared with 147 randomly selected control infants with maximum serum bilirubin levels ≤12.9 mg/dL. In 66 infants (44.9%), we identified an apparent cause for the jaundice, but in 81 (55%), no cause was found. Of infants for whom no cause for hyperbilirubinemia was found, 82.7% were breast-fed v 46.9% in the control group (P < .0001). Breast-feeding was significantly associated with hyperbilirubinemia, even in the first three days of life. The 95th percentile for bottle-fed infants is a serum bilirubin level of 11.4 mg/dL v 14.5 mg/dL for the breast-fed population, and the 97th percentiles are 12.4 and 14.8 mg/dL, respectively. Of the formula-fed infants, 2.24% had serum bilirubin levels >12.9 mg/dL v 8.97% of breast-fed infants (P < .000001). When compared with previous large studies, the incidence of "readily visibl" jundice (serum bilirubin level >8 mg/dL) appears to be increasing. The dramatic increase in breast-feeding in the United States in the last 25 years may explain this observation. There is a strong association between breast-feeding and jaundice in the healthy newborn infant. Investigations for the cause of hyperbilirubinemia in healthy breast-fed infants may not be indicated unless the serum bilirubin level exceeds approximately 15 mg/dL, whereas in the bottle-fed infant, such investigations may be indicated if the serum bilirubin exceeds approximately 12 mg/dL. If phototherapy is ever indicated in healthy term infants, the overwhelming majority of such infants are likely to be breast-fed; if breast-feeding is, indeed, the cause of such jaundice, a more appropriate approach to hyperbilirubinemia in the breast-fed infant might be to treat the cause (by temporary cessation of nursing) rather than (using phototherapy to treat) the effect.

CURRENT STATUS OF USE OF EXCHANGE TRANSFUSION IN NEWBORN INFANTS

PEDIATRICS ◽  
1964 ◽  
Vol 33 (5) ◽  
pp. 763-767
Author(s):  
R. James Mckay
Keyword(s):  
Exchange Transfusion ◽  
Serum Bilirubin ◽  
Binding Capacity ◽  
Newborn Infants ◽  
Clinical Signs ◽  
Serum Bilirubin Level ◽  
Current Status ◽  
Hemolytic Disease ◽  
Blood Ph ◽  
Absolute Indication

The only absolute indication for exchange transfusion is the appearance of clinical signs of early kernicterus whatever the level of serum bilirubin. The decision as to whether or not to perform an exchange transfusion should be made on an individual basis and should take into consideration factors other than the serum bilirubin level. Such factors include the experience of the operator, the degree of illness of the infant, presence or absence of hemolytic disease, asphyxia, cyanosis, low blood pH, hypoglycemia, hypoproteinemia, and degree of immaturity. The PSP binding capacity of the patient's serum may also turn out to be a valuable guide or even an absolute indication after experience with it has accumulated.

....Beginning to See the Light

PEDIATRICS ◽  
1985 ◽  
Vol 75 (4) ◽  
pp. 792-795
Author(s):  
M. JEFFREY MAISELS
Keyword(s):  
Randomized Controlled Trial ◽  
Exchange Transfusion ◽  
Serum Bilirubin ◽  
Neonatal Period ◽  
Controlled Trial ◽  
Newborn Infants ◽  
Bilirubin Encephalopathy ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial ◽  
Postmortem Finding

In March 1952, Mollison and Walker1 reported the results of their prospective, randomized, controlled trial on the effect of exchange transfusion v simple transfusion in infants with severe erythroblastosis fetalis. They showed that exchange transfusion led to significantly lower mortality and a much lower incidence of fatal kernicterus. In the interim, numerous published studies have examined the relation between serum bilirubin levels in the neonatal period and the postmortem finding of kernicterus or the presence of later, clinical, bilirubin encephalopathy. With few exceptions, the design of these studies has made interpretation of their results hazardous, if not nugatory.2 We now have a study from the National Institute of Child Health and Human Development (NICHD)3 in which the population is sufficiently large and the study design sufficiently rigorous to permit actual, if tentative, conclusions concerning the effect of a different intervention (phototherapy) upon the immediate and later outcome of jaundiced newborn infants.

STUDIES OF THE MECHANICAL FRAGILITY OF ERYTHROCYTES

PEDIATRICS ◽  
1954 ◽  
Vol 13 (1) ◽  
pp. 24-29
Author(s):  
DAVID YI-YUNG HSIA ◽  
RICHARD B. GOLDBLOOM ◽  
SYDNEY S. GELLIS
Keyword(s):  
Serum Bilirubin ◽  
Neonatal Period ◽  
Newborn Infants ◽  
Inverse Correlation ◽  
Erythrocytes Of Newborn Infants

The mechanical fragility of the erythrocytes of newborn infants is markedly elevated and falls to normal levels by the fifth and sixth day. There appears to be an inverse correlation between the rate of fall of mechanical fragility in the neonatal period and the rise of serum bilirubin. There appears to be a direct correlation between the height of mechanical fragility of erythrocytes on the first day and the subsequent degree of hyperbilirubinemia. The relation of these observations to physiologic jaundice are discussed.

scholarly journals The value of transcutaneous method of bilirubin measurement in newborn population with the risk of ABO hemolytic disease

Medicina ◽  
2009 ◽  
Vol 45 (10) ◽  
pp. 792 ◽  
Author(s):  
Dalia Stonienė ◽  
Jūratė Buinauskienė ◽  
Eglė Markūnienė
Keyword(s):  
Bilirubin Level ◽  
Predictive Value ◽  
Serum Bilirubin ◽  
Newborn Infants ◽  
Serum Bilirubin Level ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Hemolytic Disease ◽  
Significant Difference ◽  
Abo Hemolytic Disease

Objective of the study. To evaluate the correlation between total serum bilirubin (TSB) and transcutaneous bilirubin (TcB) levels in newborn infants at risk of ABO hemolytic disease. Material and methods. During a prospective study, 130 full-term (≥37 weeks of gestation) newborn infants with diagnosed ABO blood group incompatibility were examined. TSB level was measured at the age of 6 hours; further measurements were performed at 24, 48, and 72 hours following the first measurement. Blood samples were collected from the peripheral veins. In clinical laboratory, total serum bilirubin level was measured using Jendrassik-Grof method. TcB level in the forehead was measured using a noninvasive bilirubinometer BiliCheck (SpectRX Inc, Norcross, GA) according to the manufacturer’s instructions within ±30 min after getting a blood sample. Results. During the study, 387 double tests were performed to measure TSB and TcB levels. TSB level (114.83 [62.85] μmol/L) closely correlated with TcB level (111.51 [61.31] μmol/L) (r=0.92, P<0.001). The strongest correlation was reported at the age of 54 hours (r=0.873, P<0.001), the weakest – at the age of 6 hours (r=0.729, P<0.001). TSB and TcB levels showed a strong correlation; the difference between these values was significant (95% CI, 0.70; 5.93; P<0.05). The greatest difference between TSB and TcB levels was detected at the age of 6 hours (5.58 [17.46] μmol/L, 95% CI, 2.55; 8.61; P<0.001). No significant difference was reported at the age of 30, 54, and 78 hours. Using linear regression analysis, it was established that correlation of TSB and TcB was described by equation y=14.13+0.903x. Transcutaneously measured bilirubin level underestimated serum bilirubin level. When at the age of 6 hours TcB level is ≥98 μmol/L, ABO hemolytic disease in newborns may be diagnosed with 100% sensitivity and 98% specificity; positive predictive value was 62% and negative predictive value was 100%. While a newborn’s age increases, TcB sensitivity and specificity for diagnosing ABO hemolytic disease decrease. Conclusion. While evaluating bilirubin level transcutaneously according to nomograms of serum bilirubin level, the results should be considered with caution, especially for newborns with a risk of ABO hemolytic disease. The hour-specific nomograms of transcutaneous

Jaundice in the Full-Term Neonate

PEDIATRICS ◽  
1984 ◽  
Vol 73 (4) ◽  
pp. 520-525 ◽  
Author(s):  
Lucy M. Osborn ◽  
Michael I. Reiff ◽  
Roger Bolus
Keyword(s):  
Birth Weight ◽  
Breast Feeding ◽  
Serum Bilirubin ◽  
Neonatal Period ◽  
Serum Bilirubin Level ◽  
Term Infant ◽  
Full Term ◽  
Common Occurrence ◽  
Perinatal Complications ◽  
Breast Fed

Hyperbilirubinemia is the most common problem experienced by the full-term infant in the immediate neonatal period. The development of jaundice was prospectively investigated in 866 newborns. Significant correlations were found between the serum bilirubin level and the method of birth, perinatal complications, blood group incompatibilities, birth weight, and method of feeding. Breast-feeding was highly related to the development of exaggerated jaundice. The most common occurrence of jaundice requiring phototherapy was in breast-feeding infants in whom no cause for the jaundice could be determined. Study findings were most compatible with a theory of relative caloric deprivation as an explanation of the increased incidence of hyperbilirubinemia found in breast-fed newborns.

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