Effect of Conventional Phototherapy on platelet count in full term and Preterm Neonates with Indirect Hyperbilirubinemia - A Prospective Cohort Study

Background: Thrombocytopenia as a side effect of phototherapy has not been mentioned in the standard literature but was described briefly as isolated case reports after the phototherapy came in vogue in 1958. The purpose of this study was to find the incidence of thrombocytopenia in neonates with uncomplicated indirect hyperbilirubinemia receiving phototherapy in a referral hospital.Methods: This was a prospective cohort study conducted in a referral hospital over a period of 18 months from June 1, 2013 to November 1, 2014.Results: A total of 103 babies were enrolled. The overall incidence of post-phototherapy thrombocytopenia was 45.6% while mild, moderate and severe thrombocytopenia was present in 66%, 21.3% and 12.8% of babies respectively. The lowest platelet count observed was 31,000/mm3 but none of the neonates showed bleeding manifestations. The incidence of thrombocytopenia following phototherapy was significantly higher in preterm babies, infants who received double surface phototherapy, babies who received phototherapy for >72 hours and in babies who received phototherapy on day 2 or 3 of life.Conclusions: Neonates requiring phototherapy for hyperbilirubinemia are at risk of developing thrombocytopenia, hence the treatment should be initiated based on the standard guidelines. Unnecessary use and prolongation of phototherapy should be avoided considering the possible side effects. Platelet count should be monitored particularly in pre-term neonates receiving phototherapy. Neonates receiving double surface phototherapy and those requiring phototherapy for longer duration require more frequent platelet count monitoring.

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Association between plasma cortisol and death or vasopressor refractory hypotension in preterm neonates: a prospective, cohort study

Journal of Perinatology ◽

10.1038/s41372-018-0059-1 ◽

2018 ◽

Vol 38 (6) ◽

pp. 672-680

Author(s):

Monisha Rameshbabu ◽

Venkataseshan Sundaram ◽

Naresh Sachdeva ◽

Rama Walia ◽

Shiv Sajan Saini ◽

...

Keyword(s):

Cohort Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Plasma Cortisol ◽

Preterm Neonates ◽

Refractory Hypotension

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P04 Adiposity of Healthy, Full-Term Breast-Fed and Formula-Fed Infants: A Prospective Cohort Study

Archives of Disease in Childhood ◽

10.1136/archdischild-2013-304107.004 ◽

2013 ◽

Vol 98 (Suppl 1) ◽

pp. A2-A2

Author(s):

C. Gale ◽

S. Jeffries ◽

K. Logan ◽

J. Parkinson ◽

S. Uthaya ◽

...

Keyword(s):

Cohort Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Full Term ◽

Breast Fed

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Methylen Blue Photoinactivated Plasma vs Fresh Frozen Plasma in Thrombotic Thrombocytopenic Purpura Treatment: A Multicentric Prospective Cohort Study.

Blood ◽

10.1182/blood.v110.11.1318.1318 ◽

2007 ◽

Vol 110 (11) ◽

pp. 1318-1318

Author(s):

Alberto Alvarez-Larrán ◽

Julio Del Río-Garma ◽

Javier de la Rubia ◽

Concepción Zamora ◽

Antonio Galmés ◽

...

Keyword(s):

Cohort Study ◽

Platelet Count ◽

Thrombotic Thrombocytopenic Purpura ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Fresh Frozen Plasma ◽

Treatment Schedule ◽

Thrombocytopenic Purpura ◽

Fresh Frozen ◽

Frozen Plasma

Abstract Plasma exchange (PE) with plasma infusion is the treatment of choice for Thrombotic Thrombocytopenic Purpura (TTP) but doubts remain as to whether all kinds of plasma are equally effective. Since October 2004, a multicentric prospective cohort study is being conducted in Spain to compare Methylene Blue Photoinactivated Plasma (MBPIP) with Fresh Frozen Plasma (FFP) in the treatment of TTP. Sixty-three first episodes of idiopathic TTP were included. MBPIP was used in 38 and FFP in 25. The treatment schedule consisted of daily PE (> 40 mL/kg of body weight) and costicosteroids (1.5 mg/kg/d). Response was defined as the achievement of a platelet count >= 150 x 109/L for at least three consecutive days, normal LDH level and absence of TTP-related symptoms and signs. Recurrence was defined as a fall in platelet count below 50 x 109/L or below 50% of the highest count achieved after response. Response lasting for more than 15 days was considered as remission. The prognostic significance of the kind of plasma used was investigated by logistic regression analysis after adjustment for other variables that had previously been found to influence on response to PE (gender; the Rock score; days from first medical attendance to PE; volume of plasma infused in the first 7 days of treatment). Both groups were comparable with regard to clinical and biological parameters at diagnosis. A severe deficit in ADAMTS13 activity was found in 9 out 12 (75%) patients treated with MBPIP and in 12 out of 16 (75%) patients treated with FFP. When compared to FFP, patients treated with MBPIP required a higher number of PEs (16±13 vs 9±7, p=0.004) and a larger volume of plasma (763±678 ml/kg vs 413±326 ml/kg, p=0.02) to achieve a remission and presented more recurrences while on PE treatment (21 out of 38 vs 6 out of 25, p=0.02). Splenectomy or rituximab was required in eight patients (21%) treated with MBPIP to achieve a remission vs in none out of the 25 patients treated with FFP (p= 0.02). After adjustment for other prognostic variables, patients in the MBPIP group had a lower likelihood of remission by the 8th treatment day (OR: 5.1; 95% CI: 1.6 – 15.9) and a higher risk of recurrence while on PE treatment (OR: 4.2; 95% CI: 1.3 – 13.5). In conclusion, MBPIP is less effective than FFP in the treatment of TTP.

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Evaluation of irisin and visfatin levels in very low birth weight preterm newborns compared to full term newborns—A prospective cohort study

PLoS ONE ◽

10.1371/journal.pone.0204835 ◽

2018 ◽

Vol 13 (9) ◽

pp. e0204835 ◽

Cited By ~ 3

Author(s):

Nina Mól ◽

Magdalena Zasada ◽

Przemysław Tomasik ◽

Katarzyna Klimasz ◽

Przemko Kwinta

Keyword(s):

Cohort Study ◽

Birth Weight ◽

Low Birth Weight ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Very Low Birth Weight ◽

Full Term ◽

Term Newborns ◽

Preterm Newborns

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Poor weight gain and its predictors among preterm neonates admitted at Muhimbili National Hospital in Dar-es-salaam, Tanzania: a prospective cohort study

BMC Pediatrics ◽

10.1186/s12887-021-02971-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Victoria Paul Ndembo ◽

Helga Naburi ◽

Rodrick Kisenge ◽

Germana H. Leyna ◽

Candida Moshiro

Keyword(s):

Cohort Study ◽

Weight Gain ◽

Preterm Delivery ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Feeding Practices ◽

Preterm Neonates ◽

Muhimbili National Hospital ◽

National Hospital ◽

Poor Weight Gain

Abstract Background Preterm delivery is among the major public health problems worldwide and the leading cause of morbidity and mortality among neonates. Postnatal poor weight gain, which can contribute to mortality, can be influenced by feeding practices, medical complications and quality of care that is provided to these high-risk neonates. This study aimed to investigate the proportion and predictors of poor weight gain among preterm neonates at Muhimbili National Hospital (MNH), from September 2018 to February 2019. Methods A hospital-based prospective cohort study involving preterm neonates with Gestation age (GA) < 37 weeks receiving care at MNH. Eligible preterm, were consecutively recruited at admission and followed up until discharge, death or end of neonatal period. Poor weight gain was defined as weight gain less than 15 g per kg per day. The risk factors associated with poor weight gain were evaluated. Predictors of poor weight gain were evaluated using a multivariate analysis. Results were considered statistically significant if P -value was < 0.05 and 95% confidence interval (CI) did not include 1. Results A total of 227 preterm neonates < 37 weeks GA, with male to female ratio of 1:1.2 were enrolled in the study. The overall proportion of preterm with poor weight gain was 197/227 (86.8%). Proportion of poor weight gain among the early and late preterm babies, were 100/113 (88.5%) and 97/114 (85.1%) respectively. Predictors of poor weight gain were low level of maternal education (AOR = 2.58; 95%Cl: 1.02–6.53), cup feeding as the initial method of feeding (AOR = 8.65; 95%Cl: 1.59–16.24) and delayed initiation of the first feed more than 48 h (AOR = 10.06; 95%Cl: 4.14–24.43). A previous history of preterm delivery was protective against poor weight gain (AOR = 0.33; 95% Cl: 0.11–0.79). Conclusion and recommendation Poor weight gain was a significant problem among preterm neonates receiving care at MNH. This can be addressed by emphasizing on early initiation of feed and tube feeding for neonates who are not able to breastfeed. Health education and counselling to mothers focusing on feeding practices as well as close supervision of feeding especially for mothers experiencing difficulties in feeding their preterm will potentially minimize risk of growth failure.

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Clinical relevance of thrombocytosis in primary care: a prospective cohort study of cancer incidence using English electronic medical records and cancer registry data

British Journal of General Practice ◽

10.3399/bjgp17x691109 ◽

2017 ◽

Vol 67 (659) ◽

pp. e405-e413 ◽

Cited By ~ 38

Author(s):

Sarah ER Bailey ◽

Obioha C Ukoumunne ◽

Elizabeth A Shephard ◽

Willie Hamilton

Keyword(s):

Colorectal Cancer ◽

Primary Care ◽

Cohort Study ◽

Platelet Count ◽

Prospective Cohort Study ◽

Cancer Incidence ◽

Prospective Cohort ◽

Risk Marker ◽

Incidence Of Cancer ◽

Underlying Malignancy

BackgroundThrombocytosis (raised platelet count) is an emerging risk marker of cancer, but the association has not been fully explored in a primary care context.AimTo examine the incidence of cancer in a cohort of patients with thrombocytosis, to determine how clinically useful this risk marker could be in predicting an underlying malignancy.Design and settingA prospective cohort study using Clinical Practice Research Datalink data from 2000 to 2013.MethodThe 1-year incidence of cancer was compared between two cohorts: 40 000 patients aged ≥40 years with a platelet count of >400 × 109/L (thrombocytosis) and 10 000 matched patients with a normal platelet count. Sub-analyses examined the risk with change in platelet count, sex, age, and different cancer sites.ResultsA total of 1098 out of 9435 males with thrombocytosis were diagnosed with cancer (11.6%; 95% confidence interval [CI] = 11.0 to 12.3), compared with 106 of 2599 males without thrombocytosis (4.1%; 95% CI = 3.4 to 4.9). A total of 1355 out of 21 826 females with thrombocytosis developed cancer (6.2%; 95% CI = 5.9 to 6.5), compared with 119 of 5370 females without (2.2%; 95% CI = 1.8 to 2.6). The risk of cancer increased to 18.1% (95% CI = 15.9 to 20.5) for males and 10.1% (95% CI = 9.0 to 11.3) for females, when a second raised platelet count was recorded within 6 months. Lung and colorectal cancer were more commonly diagnosed with thrombocytosis. One-third of patients with thrombocytosis and lung or colorectal cancer had no other symptoms indicative of malignancy.ConclusionThrombocytosis is a risk marker of cancer in adults; 11.6% and 6.2% cancer incidence in males and females, respectively, is worthy of further investigation for underlying malignancy. These figures well exceed the National Institute for Health and Care Excellence-mandated risk threshold of 3% risk to warrant referral for suspected cancer.

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