Trans-cutaneous bilirubinometery versus serum bilirubin in neonatal jaundice

Abstract- Hyperbilirubinemia is a common problem in neonates and causes serious complications. Thus, serial measurements of bilirubin should be done. This assessment is done through two methods of laboratory measurement in serum sample and transcutaneous bilirubinometer. This descriptive study compared transcutaneous bilirubin assessment and laboratory serum bilirubin. Bilirubin level was assessed among 256 neonates admitted to the Qods Children’s Hospital in Qazvin- Iran, because of neonatal indirect jaundice, through two methods of transcutaneous bilirubinometery from two sites of forehead and sternum and laboratory measurement of bilirubin in serum. The cases were non-hemolytic icteric term neonates weighing 2500 gram or more and had not received phototherapy or other treatments. Neonates with hemolytic forms of jaundice, sepsis and suspicious to metabolic disorders were excluded. Assessments by means of KJ-8000 transcutaneous bilirubinometer from two sites of forehead and sternum and through laboratory measurement of serum bilirubin were registered and analyzed. The results of the current study showed that there was a correlation of 0.82 between serum bilirubin and transcutaneous forehead bilirubin assessment and for the used device sensitivity of 0.844; specificity of 0.842, Youden Index of 0.709 and Shortest of 0.042 for a cut-off of 12.4 in bilirubin of participants. Furthermore, Likelihood Ratio positive and negative (LR) were 5.665 and 0.164, respectively and diagnostic Odds Ratio (LR+/LR-) was 34.56. Transcutaneous bilirubinometery can be considered as a reliable tool to assess bilirubin for the screening of neonatal jaundice in term neonates. © 2015 Tehran University of Medical Sciences. All rights reserved. Acta Med Iran 2015;53(12):764-769. Keywords: Neonatal Jaundice; Transcutaneous bilirubinometery; Bilirubin; Sensitivity; Specificit

Passive smoking is associated with cognitive and emotional impairment in adolescent girls

It is well established that smoking is associated with impaired mental health and sleep problems. However, the possible effects of passive smoking on cognitive and emotional characteristics have not previously been evaluated in adolescents. We investigated the association between passive smoking and cognitive and emotional function, and sleep patterns in 940 adolescent girls. The girls were divided into 2 groups [305 exposed subjects and 635 non-exposed subjects (the controls)]. The passive smokers had a significantly lower cognitive function and higher depression, aggression, and insomnia scores compared to the control group (P <0.05). No significant difference was detected with respect to day-time sleepiness and sleep apnea. Logistic regression analyses showed that the passive smokers were more likely than the controls to have cognitive impairments, depressive mood, aggressive behavior and insomnia. Adolescent passive smokers had significant differences in their cognitive abilities and emotional function

Common polymorphisms in genes related to vitamin D metabolism affect the response of cognitive abilities to vitamin D supplementation

It is possible that vitamin D acts as a neurosteroid and that vitamin D deficiency may have an adverse impact on brain function and cognitive function. There are a few reports that have demonstrated an association between polymorphisms of genes involved in vitamin D metabolism and neurodegenerative disease. We aimed to evaluate the relationship between common, functional vitamin D–associated gene variants and cognitive abilities and to investigate the effect size of this polymorphism on cognitive capabilities associated with high-dose vitamin D supplementation. A total of 319 healthy adolescents received a high dose of vitamin D (50,000 IU)/week for 9 weeks. A questionnaire was used to assess cognitive abilities at baseline and after treatment. The genotypes of the CYP2R1-rs10766197 and GC-rs4588 variants were determined using TaqMan genotyping techniques. At baseline, total cognitive ability scores were higher in the AA group who were homozygous for the uncommon allele, compared with the other (AG and GG) genotypes of the CYP2R1-rs10766197 polymorphism (104.9 ± 27.8 vs. 79.1 ± 38.8 vs. 73.1 ± 25.6; p < 0.001, respectively). During the supplementation period, cognitive ability scores increased in individuals with the AG and GG genotypes, while individuals with a AA genotype did not show significant change in total score after intervention (p = 0.17). For GC SNP (rs4588), no major differences at baseline and trial-net change of cognitive tasks score were observed between the genotypes under three genetic models (pSNP = 0.67). Vitamin D supplements have trait-dependent effects on cognitive performance that suggests a causal role for vitamin D in cognitive performance. The rs10766197 variant, near the CYP2R1 gene locus, significantly modified the efficacy of high-dose vitamin D3 supplementation for its effects on improving cognitive abilities indicate that some subjects might require a higher dose to benefit from in terms of cognitive performance

Metformin inhibits polyphosphate-induced hyper-permeability and inflammation

Circulating inflammatory factor inorganic polyphosphate (polyP) released from activated platelets could enhance factor XII and bradykinin resulted in increased capillary leakage and vascular permeability. PolyP induce inflammatory responses through mTOR pathway in endothelial cells, which is being reported in several diseases including atherosclerosis, thrombosis, sepsis, and cancer. Systems and molecular biology approaches were used to explore the regulatory role of the AMPK activator, metformin, on polyP-induced hyper-permeability in different organs in three different models of polyP-induced hyper-permeability including local, systemic shortand systemic long-term approaches in murine models. Our results showed that polyP disrupts endothelial barrier integrity in skin, liver, kidney, brain, heart, and lung in all three study models and metformin abrogates the disruptive effect of polyP. We also showed that activation of AMPK signaling pathway, regulation of oxidant/ anti-oxidant balance, as well as decrease in inflammatory cell infiltration constitute a set of molecular mechanisms through which metformin elicits it's protective responses against polyP-induced hyper-permeability. These results support the clinical values of AMPK activators including the FDA-approved metformin in attenuating vascular damage in polyP-associated inflammatory diseases.Peer reviewe

Transport and Targeted Binding of Polymer-Coated Nanoparticles in Unsaturated Porous Media

The effectiveness of most in situ remedial technologies lies on successful delivery of reagents to a target treatment zone. Advances in nanoparticle (NP) materials has led to the targeted delivery concept in which the NP coating is engineered so that the NPs are able to transport in a porous medium but bind to specific target contaminants. By taking advantage of this capability, the accumulation of NPs within a target treatment zone increases with a concomitant decrease in the mass of NPs required to achieve treatment goals. In addition to delivery parameters, the transport and binding behaviour of NPs depends on the properties of the NPs and the porous media. NPs coated with an amphiphilic co-polymer (Pluronic) can be tuned so that they have stability in an aqueous suspension as well as preferential binding to oil-water interfaces. The Pluronic coating is comprised of a middle hydrophobic segment which provides sufficient affinity to an oil phase through hydrophobic interactions and two outer, hydrophilic segments that extend into the aqueous phase surrounding the nanoparticle and prevent nanoparticle aggregation. While extensive investigations on this type of engineered NP coating in saturated conditions have been completed, the transport and targeted binding behaviour of these coated NPs in unsaturated conditions has not been studied. Thus, the focus of this research effort was to comprehensively examine the ability of amphiphilic co-polymer coated NPs to transport and bind to a target contaminant in unsaturated porous media. Initially, the effect of porous medium texture, initial water saturation, input dosage, and flowrate on NP transport behaviour was evaluated and then targeted NP binding to a representative non-aqueous phase liquid (i.e., crude oil) zone was examined using a series of short column experiments. To isolate the effects of controlling parameters, NPs (iron oxide (Fe3O4) core material) coated with a high polymer concentration which enhances transport and stability were used except for the targeted NP binding systems where NPs (cobalt ferrite (CoFe2O4)) with lower polymer concentration which promotes binding to an oil phase was used. Building on the findings from the short-column experiments, the transport and binding ability of these NPs at a spatial scale representative of the unsaturated zone above a shallow aquifer system was evaluated using a 1.4-m long column. Finally, to evaluate the capability of the NPs to bind to a heterogeneous crude oil-impacted zone in a less constrained unsaturated system, a two-dimensional physical model experiment was performed. Reactive transport models were used in all investigative phases to support experimental observations and characterize the transport and binding of these NPs. Results from the short column experiments demonstrated that NP retention was influenced by the initial water content, injection flowrate, and clay and silt content. Both initial water content and injection flowrate affect air saturation and hence the abundance of air/water interfaces where NPs are retained. Increased retention of the NPs was observed in sediments with a higher clay and silt content as a result of the larger surface area. NP retention was insensitive over the range of injection doses examined. The transport model that represented the observed NP breakthrough data included mobile and immobile porosity regions, and a simple attachment/detachment reaction with nonlinear Langmuirian blocking for NP retention. The NP binding data demonstrated preferential attachment to the crude oil-impacted sediment under unsaturated conditions. As a result of the lower polymer concentration used in the binding experiments, depth-dependent straining was required to simulate the observed NP retention profile. Observations from the 1.4-m long column experiments also demonstrated preferential NP attachment to the crude oil-impacted sediment consistent with the short-column experiments. Again, depth-dependent straining was required in the transport model to reproduce the observed NP retention near the top of the column. However, as a result of the longer distance that the NP solution travelled, compared to the short-column experiments, a first-order mass loss term was used in the transport model to represent suspected NP aggregation and trapping deeper in the column system. Results from the two-dimensional physical model experiment showed that NP transport and targeted binding were significantly influenced by physical heterogeneities present in the system. Preferential attachment of NPs to the crude oil zone was confirmed; however, substantial retention of NPs was also observed between the infiltration gallery and the top of the crude oil zone as a result straining consistent with the column experiments. Despite the demonstrated targeted binding of the NPs to the crude oil zone, the presence of preferential flow paths reduced NP delivery efficiency to portions of the crude oil zone. An acceptable description of the observed NP retention behaviour in this two-dimensional system was obtained using a single porosity transport model with depth-dependent straining and kinetic attachment/detachment reactions. This thesis provides critical information on the transport of Pluronic-coated NPs in unsaturated porous media and targeted binding to crude oil. The important role of initial water content, flow rate and porous medium texture on NP transport and retention behaviour was established. In addition, the effect of travel distance and heterogeneity on NP targeted binding capability was revealed. The supporting modelling efforts showed that physical and chemical nonequilibrium considerations were required to better represent the observed NP transport and binding behaviour in unsaturated experimental systems investigated. Multiple lines of evidence demonstrated targeted binding of the Pluronic-coated NPs to a crude oil zone in unsaturated porous media which will ultimately improve the treatment efficiency of these systems. The delivery of these NPs to a target NAPL zone distal from the injection location may be a challenge due to the possible aggregation observed at increased travel distances. Furthermore, like other flushing-based technologies, physical heterogeneities may restrict access of the NP solution throughout the NAPL zone. For efficient targeting, these factors should be considered during the design of a NP delivery system to treat a NAPL source in the unsaturated zone

Trans-Cutaneous Bilirubinometery versus Serum Bilirubin in Neonatal Jaundice

Abstract- Hyperbilirubinemia is a common problem in neonates and causes serious complications. Thus, serial measurements of bilirubin should be done. This assessment is done through two methods of laboratory measurement in serum sample and transcutaneous bilirubinometer. This descriptive study compared transcutaneous bilirubin assessment and laboratory serum bilirubin. Bilirubin level was assessed among 256 neonates admitted to the Qods Children’s Hospital in Qazvin- Iran, because of neonatal indirect jaundice, through two methods of transcutaneous bilirubinometery from two sites of forehead and sternum and laboratory measurement of bilirubin in serum. The cases were non-hemolytic icteric term neonates weighing 2500 gram or more and had not received phototherapy or other treatments. Neonates with hemolytic forms of jaundice, sepsis and suspicious to metabolic disorders were excluded. Assessments by means of KJ-8000 transcutaneous bilirubinometer from two sites of forehead and sternum and through laboratory measurement of serum bilirubin were registered and analyzed. The results of the current study showed that there was a correlation of 0.82 between serum bilirubin and transcutaneous forehead bilirubin assessment and for the used device sensitivity of 0.844; specificity of 0.842, Youden Index of 0.709 and Shortest of 0.042 for a cut-off of 12.4 in bilirubin of participants. Furthermore, Likelihood Ratio positive and negative (LR) were 5.665 and 0.164, respectively and diagnostic Odds Ratio (LR+/LR-) was 34.56. Transcutaneous bilirubinometery can be considered as a reliable tool to assess bilirubin for the screening of neonatal jaundice in term neonates. © 2015 Tehran University of Medical Sciences. All rights reserved. Acta Med Iran 2015;53(12):764-769. Keywords: Neonatal Jaundice; Transcutaneous bilirubinometery; Bilirubin; Sensitivity; Specificit

Trans-Cutaneous Bilirubinometery versus Serum Bilirubin in Neonatal Jaundice

Hyperbilirubinemia is a common problem in neonates and causes serious complications. Thus, serial measurements of bilirubin should be done. This assessment is done through two methods of laboratory measurement in serum sample and transcutaneous bilirubinometer. This descriptive study compared transcutaneous bilirubin assessment and laboratory serum bilirubin. Bilirubin level was assessed among 256 neonates admitted to the Qods Children’s Hospital in Qazvin- Iran, because of neonatal indirect jaundice, through two methods of transcutaneous bilirubinometery from two sites of forehead and sternum and laboratory measurement of bilirubin in serum. The cases were non-hemolytic icteric term neonates weighing 2500 gram or more and had not received phototherapy or other treatments. Neonates with hemolytic forms of jaundice, sepsis and suspicious to metabolic disorders were excluded. Assessments by means of KJ-8000 transcutaneous bilirubinometer from two sites of forehead and sternum and through laboratory measurement of serum bilirubin were registered and analyzed. The results of the current study showed that there was a correlation of 0.82 between serum bilirubin and transcutaneous forehead bilirubin assessment and for the used device sensitivity of 0.844; specificity of 0.842, Youden Index of 0.709 and Shortest of 0.042 for a cut-off of 12.4 in bilirubin of participants. Furthermore, Likelihood Ratio positive and negative (LR) were 5.665 and 0.164, respectively and diagnostic Odds Ratio (LR+/LR-) was 34.56. Transcutaneous bilirubinometery can be considered as a reliable tool to assess bilirubin for the screening of neonatal jaundice in term neonates

Acute post sleeve surgery bleeding as rare cause of acute renal failure: a case report

Abstract Background Bariatric surgeries have been considered as one of the most important treatment procedures in recent years. Being aware of the side effects of this surgery will lead to better results after the surgery. Case presentation A 37-year-old Iranian male patient presented one day after sleeve surgery with symptoms of weakness, lethargy, and shortness of breath, which hospitalization and workup to were done to rule out pulmonary embolism. Because of the high creatinine and anuria, we couldn’t perform computed tomography angiography. A bedside ultrasound was done for the patient and showed a mild to moderate amount of fluid around the spleen and some blood clots. Due to the progressive clinical findings and suspected internal bleeding, the patient was a candidate for laparoscopic revision procedure. Gradually, after performing the surgery, removing the blood clot and reducing the compressive effect of that on the inferior verna cava which was the main reason of renal failure, the patient was able to urinate afterwards and was discharged in good general condition. Conclusion Surgeons should be aware of the management of rare surgical complications after bariatric surgeries. To be best of our knowledge, this was the first case report of a patient with acute renal failure after bariatric surgery and the rare cause of clot compression on inferior vena cava and raised abdominal compartment pressure

Exosomes: Promising Delivery Tools for Overcoming Blood-Brain Barrier and Glioblastoma Therapy

Gliomas make up virtually 80% of all lethal primary brain tumors and are categorized based on their cell of origin. Glioblastoma is an astrocytic tumor that has an inferior prognosis despite the ongoing advances in treatment modalities. One of the main reasons for this shortcoming is the presence of the blood-brain barrier and blood-brain tumor barrier. Novel invasive and non-invasive drug delivery strategies for glioblastoma have been developed to overcome both the intact blood-brain barrier and leverage the disrupted nature of the blood-brain tumor barrier to target cancer cells after resection—the first treatment stage of glioblastoma. Exosomes are among non-invasive drug delivery methods and have emerged as a natural drug delivery vehicle with high biological barrier penetrability. There are various exosome isolation methods from different origins, and the intended use of the exosomes and starting materials defines the choice of isolation technique. In the present review, we have given an overview of the structure of the blood-brain barrier and its disruption in glioblastoma. This review provided a comprehensive insight into novel passive and active drug delivery techniques to overcome the blood-brain barrier, emphasizing exosomes as an excellent emerging drug, gene, and effective molecule delivery vehicle used in glioblastoma therapy