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Hyperbilirubinemia of the neonate and the related risk of brain damage with conseguent important alterations in motor development, particularly in sick preterm babies, remains a major problem in nurseries throughout the world. Since its introduction in the 1950's phototherapy has been used for reducing serum bilirubin concentrations in the newborn with hyperbilirubinemia; however, only recently the photoprocesses invoked by light on various substrates including bilirubin have been clari fied in sufficient detail. Light treatment actually exemplifies the intimate relationship between the clinical and basic sciences: the better understanding of the mechanism of phototherapy as a result of investigations initiated in the laboratory has been extended to the bedside as new types of lamps or new schedules of treatment. As a consequence, phototherapy of hyperbilirubinemia has emerged as a well-established branch of photomedicine, based on molecular photo biology, scientific method, and creative use of physics and sophis ticated electrooptical capabilities. The collaboration and exchange of information between workers in different basic and clinical di sciplines is likely to stimulate a further optimization of photo therapy. The purpose of this monograph is to discuss some of the new aspects of bilirubin metabolism and phototherapeutic treatment. Bilirubin conjugation in the fetal and early neonatal life, the mechanism of bilirubin entry into the brain, the measurements of bilirubin concentration in the skin and serum bilirubin binding capacity are discussed by a number of prominent neonatologists.
Photobiological data from other species indicate that light can be both beneficial and detrimental to many biological processes. The time has come to evaluate the risk-benefit ratio of this modality of therapy for hyperbilirubinemia of the neonate. There has been little, thus far, to indicate immediate hazards from this form of therapy, but long-term sequelae have not been adequately assessed. A review of the experience of the past 15-17 years with this agent was thought to be useful. In. April 1974, the Pregnancy and Infancy Branch of the National Institute of Child Health and Human Development sponsored a conference to assess the photobiological processes involved in phototherapy, as well as to document the long-term clinical experience of clinicians from all parts of the world who have used light in the treatment of hyperbilirubinemia since 1958. The papers and discussions presented in this book by distinguished investigators from the clinical and basic sciences illustrate not only the breadth of the problem, but also the value of an interdisciplinary approach to its resolution.
Every four years the photobio1ogists of the world get together in an International Congress. They discuss and learn not only re search details and findings in their own, often narrow, fields but educate one another broadly in the many biological systems that interact with light. It is this latter purpose that is exemplified by these proceedings - the Symposium papers and Workshop summaries of the VIIth International Congress on Photobiology held in Rome, August 29 - September 3, 1976. Photobiology is one of the few true interdisciplinary fields. It has an air of excitement about it. A glance at the table of contents indicates clearly that photobiology and its practitioners (individuals whose primary interests are in medicine, plant sci ences, animal sciences, molecular properties, and energy conversion) interact with the entire and diverse world of living creatures. We supply not only the basic research background to help evaluate many present-day environmental problems but are also evaluating and pointing the way toward solutions to a number of these problems.
A complete, authoritative guide to the management and treatment of neonatal jaundice Care of the Jaundiced Neonate focuses exclusively on the scientific underpinnings of jaundice, as well as the care of the jaundiced neonate. Edited by three of the field’s most respected neonatal care experts, the book uniquely explains how the imbalance between bilirubin production and elimination leads to jaundice—and that hazardous levels of unconjugated bilirubin can cause kernicterus, or brain damage. In addition, you’ll find the most current and clinically relevant perspectives on the physiology, genetics, and treatment of neonatal jaundice and related hemolytic conditions. FEATURES Covers all aspects of neonatal jaundice—from the biochemistry of bilirubin production to kernicterus Begins with an in-depth examination of the complex gene-environment interactions of bilirubin-induced neurotoxicity and its role in neonatal jaundice Surveys bilirubin production and measurement, its various fractions, and the metabolism and transport of bilirubin Selected chapters highlight the physiology and epidemiology of neonatal unconjugated hyperbilirubinemia; bilirubin toxicity; prevention, screening, and postnatal management; phototherapy and other treatments; and prevention-related public policy. Concluding chapter provides an overview of the key issues surrounding the incidence of neonatal jaundice in low-middle income countries Includes informative review of risk assessment and treatment with phototherapy and other modalities provide key approaches to the effective clinical management of neonatal hyperbilirubinemia
The therapeutic use of ultraviolet radiation for medical purposes has a long history, whether it be sunlight in heliotherapy or artificial lamps in phototherapy, to name a few. The interest in ultraviolet radiation as treatment for various cutaneous diseases increased exponentially in the second half of the twentieth century. UV-based therapies, which include narrowband (NB) UVB, broad-band (BB) UVB, and psoralen and UVA (PUVA), are well-established treatment options for diverse dermatologic conditions such as atopic dermatitis, vitiligo, cutaneous T-cell lymphoma, and psoriasis either as monotherapy or as an adjuvant to systemic therapy. This monography focuses on the principal indications of phototherapy in dermatology.
The Pocket Book is for use by doctors nurses and other health workers who are responsible for the care of young children at the first level referral hospitals. This second edition is based on evidence from several WHO updated and published clinical guidelines. It is for use in both inpatient and outpatient care in small hospitals with basic laboratory facilities and essential medicines. In some settings these guidelines can be used in any facilities where sick children are admitted for inpatient care. The Pocket Book is one of a series of documents and tools that support the Integrated Managem.
Modern Practical Healthcare Issues in Biomedical Instrumentation describes the designs, applications and principles of several medical devices used in hospitals and at home. The book presents practical devices that can potentially be used for healthcare purposes. Sections cover the use of biosensors to monitor the physiological properties of the human body, focusing on devices used to evaluate, measure and manipulate the biological system, and highlighting practical devices that can potentially be used for healthcare purposes. It is an excellent resource for undergraduate, graduate and post-graduate students of biomedical engineering. - Focuses on devices used to evaluate, measure and manipulate the biological system - Describes the designs, applications and principles of several medical devices used in hospitals and at home - Discusses various application and how their usage will help to aid health care delivery
This book has been written to summarise the available knowledge regarding transcutaneous bilirubinometry, the first technique that allows a completely non-invasive measurement of a clinical variable. This technique led to important changes in the management of neonatal jaundice, the most common clinical condition of new-born infants world-wide. Transcutaneous bilirubinometry has its roots in the old observation that yellow skin colour is due to the deposition of bilirubin, a chromophore molecule. More recently, transcutaneous bilirubinometry has involved many disciplines; and accordingly, this book has contributions from physicists, biologists, paediatric dermatologists and neonatologists who have clinical research expertise in the field of neonatal hyperbilirubinemia. We hope that this book may prompt the advancement of research that will answer the as-yet unanswered questions, improve the reliability and usefulness of transcutaneous bilirubinometry, and respond to the clinical needs of our little patients.
There has been a tremendous amount of scientific progress in our understanding of the molecular mechanisms of transport processes in the liver within the last few years. Cloning of various members of organic anion and cation transporters has provided the necessary tools to study their regulation under physiological and pathophysiological conditions and has advanced our knowledge about bile formation. Mutations of various hepatic organic anion transporters have been identified in humans as hereditary defects leading to the heterogenous syndrome of progressive familial intrahepatic cholestasis (PFIC). Various mouse models including knockout animals have given us the opportunity to gain insight into lipid transport by the liver and the genetics of cholesterol gallstone formation. The physiology of bile duct cells and the molecular mechanisms leading to various cholangiopathies have been a main scientific focus in hepatology in recent years. Drug targeting to the liver by hepatic organic anion transporters represents an attractive way of selective delivery of pharmaceutical agents in humans. Ursodeoxycholic acid is successfully used in the treatment of patients with chronic cholestatic liver disease and major advances have been made in understanding its mode of action in liver and bile duct cells. This book, the proceedings of the Falk Workshop held in Aachen, Germany, on 25-26 January 2001, contains chapters on all important aspects of biliary transport by well-known experts in this field. It is an essential resource for new developments in the field of biliary transport, both in basic science and clinical medicine.