EFFECT OF BILIRUBIN ON DRUG CONJUGATIONS IN CHILDREN

The formation of glucuronides of salicylate, salicylamide, and acetaminophen in two sisters with congenital unconjugated hyperbilirubinemia responsive to phenobarbital was normal at widely different (6 to 37 mg per 100 ml) serum bilirubin concentrations. The conjugation of salicylate with glycine, and the formation of salicylamide sulfate and acetaminophen sulfate were also normal. This shows that unconjugated hyperbilirubinemia per se does not affect the biotransformation of the three drugs tested. The clinical and pharmacokinetic characteristics of the children in this study are consistent with a recently proposed mechanism involving a deficiency in hepatic anion-binding protein (rather than glucuronyl transferase) as one cause of unconjugated hyperbilirubinemia.

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The Maltodextrin System of Escherichia coli: Metabolism and Transport

Journal of Bacteriology ◽

10.1128/jb.187.24.8322-8331.2005 ◽

2005 ◽

Vol 187 (24) ◽

pp. 8322-8331 ◽

Cited By ~ 51

Author(s):

Renate Dippel ◽

Winfried Boos

Keyword(s):

Escherichia Coli ◽

Abc Transporter ◽

Binding Protein ◽

Glycogen Synthesis ◽

Equilibrium Conditions ◽

Per Se ◽

Maltodextrin Phosphorylase ◽

Internal Level

ABSTRACT The maltose/maltodextrin regulon of Escherichia coli consists of 10 genes which encode a binding protein-dependent ABC transporter and four enzymes acting on maltodextrins. All mal genes are controlled by MalT, a transcriptional activator that is exclusively activated by maltotriose. By the action of amylomaltase, we prepared uniformly labeled [14C]maltodextrins from maltose up to maltoheptaose with identical specific radioactivities with respect to their glucosyl residues, which made it possible to quantitatively follow the rate of transport for each maltodextrin. Isogenic malQ mutants lacking maltodextrin phosphorylase (MalP) or maltodextrin glucosidase (MalZ) or both were constructed. The resulting in vivo pattern of maltodextrin metabolism was determined by analyzing accumulated [14C]maltodextrins. MalP− MalZ+ strains degraded all dextrins to maltose, whereas MalP+ MalZ− strains degraded them to maltotriose. The labeled dextrins were used to measure the rate of transport in the absence of cytoplasmic metabolism. Irrespective of the length of the dextrin, the rates of transport at a submicromolar concentration were similar for the maltodextrins when the rate was calculated per glucosyl residue, suggesting a novel mode for substrate translocation. Strains lacking MalQ and maltose transacetylase were tested for their ability to accumulate maltose. At 1.8 nM external maltose, the ratio of internal to external maltose concentration under equilibrium conditions reached 106 to 1 but declined at higher external maltose concentrations. The maximal internal level of maltose at increasing external maltose concentrations was around 100 mM. A strain lacking malQ, malP, and malZ as well as glycogen synthesis and in which maltodextrins are not chemically altered could be induced by external maltose as well as by all other maltodextrins, demonstrating the role of transport per se for induction.

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SUPREX (Stability of Unpurified Proteins from Rates of H/D Exchange) Analysis of the Thermodynamics of Synergistic Anion Binding by Ferric-Binding Protein (FbpA), a Bacterial Transferrin†

Biochemistry ◽

10.1021/bi0481848 ◽

2004 ◽

Vol 43 (50) ◽

pp. 15767-15774 ◽

Cited By ~ 27

Author(s):

Petra L. Roulhac ◽

Kendall D. Powell ◽

Suraj Dhungana ◽

Katherine D. Weaver ◽

Timothy A. Mietzner ◽

...

Keyword(s):

Binding Protein ◽

Anion Binding ◽

Ferric Binding Protein ◽

Bacterial Transferrin

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EFFECT OF PHOTOTHERAPY ON SERUM CALCIUM LEVELS IN NEONATAL JAUNDICE

10.36106/5118478 ◽

2021 ◽

pp. 17-19

Author(s):

Aradhana Gupta ◽

Anand Kumar Bhardwaj ◽

Anisha Aggarwal ◽

Gauri Chauhan

Keyword(s):

Serum Calcium ◽

Neonatal Intensive Care ◽

Neonatal Jaundice ◽

Serum Bilirubin ◽

Calcium Supplementation ◽

Clinical Signs ◽

Total Serum ◽

Medical Sciences ◽

Term Neonates ◽

Unconjugated Hyperbilirubinemia

Background :To study the effect of phototherapy on serum calcium levels in neonates with unconjugated hyperbilirubinemia. Methods : This hospital based longitudinal interventional study was conducted on 100 neonates with neonatal hyperbilirubinemia admitted to Neonatal Intensive Care Unit at Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala. Total serum bilirubin and serum calcium levels of each participants were checked before and at the end of phototherapy. Neonates were also checked for the clinical signs of hypocalcemia i.e. jitteriness, irritability, lethargy, and convulsions. Results : Atotal of 100 neonates with neonatal jaundice were included with 55% boys and 45 % girls whose mean age was 3.0 ± 0.95 days. Mean S.Bilirubin level before phototherapy was 13.92 ± 2.32 mg/dl which was reduced to 8.87 ± 2.18 mg/dl. S.Calcium levels pre-phototherapy were 8.66 ± 0.65 mg/dl which were reduced to 7.94 ± 1.05 mg/dl. It was found that 32% of the participants in total exhibited symptoms related to hypocalcemia. More term neonates (56.3%) experienced symptoms related to hypocalcemia compared to pre-terms (43.8%). Conclusion : It can be deduced that phototherapy induced hypocalcemia is a signicant concern and hence, neonates requiring phototherapy may be considered for calcium supplementation.

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Structural and functional studies of ligandin, a major renal organic anion-binding protein.

Journal of Clinical Investigation ◽

10.1172/jci108001 ◽

1975 ◽

Vol 55 (5) ◽

pp. 1009-1019 ◽

Cited By ~ 94

Author(s):

R Kirsch ◽

G Fleischner ◽

K Kamisaka ◽

I M Arias

Keyword(s):

Binding Protein ◽

Organic Anion ◽

Anion Binding ◽

Functional Studies

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The Effect Of Phototherapy (24 Hours) Towards Jaundice Degrees Of The Newborn In Hospital NICU West Nusa Tenggara Province

Media Keperawatan Indonesia ◽

10.26714/mki.1.2.2018.11-19 ◽

2018 ◽

Vol 1 (2) ◽

pp. 11

Author(s):

Rosalia Selung ◽

Indah Wasliah ◽

Eka Adithya Pratiwi

Keyword(s):

Serum Bilirubin ◽

Rank Correlation ◽

Correlation Coefficients ◽

Bivariate Analysis ◽

Total Serum ◽

Unconjugated Hyperbilirubinemia ◽

Normal Birth ◽

Before And After ◽

Post Test ◽

Study Population

Background: Aximately 60% of normal birth infant become jaundiced in the first week of birth. The incidence of jaundice in the West Nusa Tenggara hospital in 3 years later (2012-2014) there were 1166 cases. Phototherapy of total serum bilirubin (TSB) increased. Clinical trials have validated the efficacy phototherapy in reducing excessive unconjugated hyperbilirubinemia, and its implementation has been drastically confine the use of exchange transfusion (Bhutani, 2011). Objective:The purpose of this study was to determine the degree of jaundice before and after phototherapy, as well as analyze the influence phototherapy before and after the degree of jaundice in the newborn. Method:This type of research is pre-experimental research design using the approach one group pre-test and post-test design. The study population was all jaundice infants who were treated at Hospital NICU room in West Nusa Tenggara Provence in May 2016. The sample was 15 respondents with acsidental sampling techniques. The method of data analysis with descriptive percentage univariate and bivariate analysis with test of rank correlation test (spearman) obtained significance value p = 0.000 < 0.05 and spearman correlation coefficients obtained by value p = 0.025 which means there is a strong correlation between the influence of phototherapy (24 hours) the degree of jaundice in the newborn. Result: The results were obtained degree of jaundice before phototherapy is as many as 9 degree 4 respondents (60%) and as many as 6 degrees five respondents (40%). After 24 hours phototherapy all respondents decreased the degree of jaundice and most have some degreen of jaundice 3 of 10 respondents (66,7%) by 5 respondents (33,3%). Discussion:Recommendations can be given is a gift phototherapy to decrease the degree of jaundice.

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Cholestasis of the Newborn (Obstructive Jaundice)

Pediatrics in Review ◽

10.1542/pir.5.6.163 ◽

1983 ◽

Vol 5 (6) ◽

pp. 163-171

Author(s):

Lawrence M. Gartner

Keyword(s):

Obstructive Jaundice ◽

Serum Bilirubin ◽

General Rule ◽

Water Soluble ◽

Total Serum Bilirubin ◽

Total Serum ◽

Diagnostic Significance ◽

Unconjugated Hyperbilirubinemia ◽

Mechanical Interference ◽

Clinically Significant

Obstructive jaundice of the newborn is a misnomer as fewer than half of all cases usually referred to as "obstructive jaundice" result from mechanical interference with the flow of bile. In the majority of cases, intrinsic liver disease is the cause of this type of jaundice. The term "cholestasis" more comprehensively describes the various disorders and the pathophysiology, which includes retention of direct-reacting (conjugated) bilirubin, bile acids, and other components of bile. Direct-reacting hyperbilirubinemia is almost always the first definitive sign of hepatobiliary dysfunction, often appearing during the first weeks of life just as the normally occurring, indirect-reacting (unconjugated) hyperbilirubinemia of physiologic jaundice of the newborn is receding. Initially, there may be uncertainty as to the significance of the persisting or recurring jaundice, particularly whether the direct-reacting fraction is elevated. As a general rule, when the direct-reacting portion exceeds 2.0 mg/dl and is more than 10% of the total serum bilirubin, it should be considered clinically significant. Although the direct-reacting fraction may occasionally account for 90% of total serum bilirubin, in most cases the direct-reacting portion will range only from 25% to 75%. The degree of variation has no diagnostic significance. As only water-soluble, direct-reacting bilirubin is excreted by the kidney, the presence of bilirubinuria may be used as confirmation of elevation of the direct-reacting fraction.

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Efficacy of prophylactic phototherapy for prevention of hyperbilirubinemia in very low birth weight newborns

Bangabandhu Sheikh Mujib Medical University Journal ◽

10.3329/bsmmuj.v6i2.29132 ◽

2016 ◽

Vol 6 (2) ◽

pp. 151

Author(s):

M. A. Mannan ◽

Ismat Jahan ◽

Sadeka Choudhury Moni ◽

Zahidul Hasan ◽

Arjun Chandra Dey ◽

...

Keyword(s):

Clinical Trial ◽

Birth Weight ◽

Exchange Transfusion ◽

Serum Bilirubin ◽

Serum Bilirubin Level ◽

Total Serum Bilirubin ◽

Total Serum ◽

Control Group ◽

P Value ◽

Unconjugated Hyperbilirubinemia

Background: Jaundice is a common clinical condition in newborn occurring in approximately 60% of term and 80% of preterm infants. Unconjugated hyperbilirubinemia is universally common in all preterm infants especially in newborns with very low biLth weight. Low birth weight and premature infants are at major risk for exaggerated hyperbilirubinemia that can lead to bilirubin encephalopathy. Significant heterogeneity in the approach to the treatment of jaundiced neonates exists throughout the world. Phototherapy is the most common treatment for neonatal hyperbilirubinemia and could be most effective in preventing the sequelae of hyperbilirubinemia if initiated prophylactically. This randomized clinical trial has been proposed with the objective of assessing the efficacy of prophylactic photo therapy in preventing significant rise of unconjugated hyperbilirubinemia in premature neonates weighing less than 1500 gram and therefore to decrease the need for exchange transfusion and finally to reduce hospital stay due to hyperbilirubinemia. Methods: This randomized controlled clinical trial enrolled sixty newborns with birth weight less than 1500 gram. They were divided into two groups: 1) Prophylactic group, in whom phototherapy was started within 24 hours of birth and continued for 7 days and 2) Control group in whom therapeutic phototherapy was started considering serum bilirubin level and other clinical conditions as per institutional guidelines. Mean value of total serum bilirubin (TSB), duration of phototherapy, the need for exchange transfusion and duration of hospital stay in both groups were analyzed.Results: The maximum mean TSB level in prophylactic group was observed on 7th day and in control group it was observed on 3rd day of life. The total serum bilirubin levels were significantly lower in the 3rd and 5th days of life in the prophylactic group in comparison to control group (P value 0.001). Total serum bilirubin level exceeded therapeutic range in 6 (21 %) and 14 (50 %) newborns of the prophylactic group and control groups respectively (P value 0.026). No documented side effects of prophylactic phototherapy was observed. Conclusion: The use of prophylactic photo therapy for infants weighing less than 1500 grn is effective and sate when compared to the control group, considering satisfactory maintenance of low total serum bilimbin levels during first 7 days of life.

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