Neonatal serum

Kodak Ektachem clinical chemistry slides for the analysis of neonatal serum bilirubin. Clin. Chem. 28, 1552, Abstr. 16. 

E569 Sonntag, O. and Biittner, J. (1989). Determination of bilirubin in neonatal serum using the Ektachem 700. J. Clin. Chem. Clin. Biochem. 27, 763-764, Abstr. VI 72. 

Karmen, A., Lent, R. and Chang, E.S. (1982). Measurement of bilirubin in neonatal serum with the Ames Seralyzer. Clin. Chem. 28, 1552-1553, Abstr. 19. Knopp, P.R. (1982). Erfahrungen mit der Trockenchemie im Praxislabor. No-tabene Medici 8,633-634. 

Khair-El-Din TA, Sicher SC, Vazquez MA, Lu CY. Inhibition of macrophage nitric-oxide production and la-expression by docosahexaenoic acid, a constituent of fetal and neonatal serum. Am J Reprod Immunol 1996 36 1-10. 

The indicator for this condition is neonatal serum thyroid-stimulating hormone (TSH). A prevalence of 1-10% of elevated TSH has been reported from various endemic diseases (Kochupillai et ai, 1986). There is evidence from India of an epidemiological correlation, with subsequent intellectual performance from India (Kochupillai et ai, 1986) and elsewhere (Delange, 1994). 

Figure 121.5 Frequency distribution of neonatal serum TSFI levels in Calabria in the year 1993. From Costante et al., (1997), with the permission of Kurtis Ed. Ordinate indicates the frequency distribution represented as percentage of total for each neonatal TSFI value observed (abscissa) within the normal cut-off range.

Pregnancy In a prospective study of 15 primagravid women, intravenous oxycodone was foxmd to have a decreased half-life of 2.6 h. Maternal and neonatal serum levels were well correlated [64 ]. 

Schulpis KH, Karakonstantakis T, Gavrili S et al. (2004) Maternal-neonatal serum selenium and copper levels in Greeks and Albanians. European Journal of Clinical Nutrition 1 1-5. 

Maany I, Dhopesh V, Arndt lO, et al Increase in desipramine serum levels associated with methadone treatment. Am J Psychiatry 146 1611—1613, 1989 Maas U, Kattner E, Weingart-Jesse B, et al Infrequent neonatal opiate withdrawal following maternal methadone detoxification during pregnancy. J Perinat Med 18 111-118, 1990... 

Half-life increases as the dose and serum concentration increases Volume of distribution Adults 0.7 L/kg Children 0.8 L/kg Neonates 1.2 L/kg Protein binding Adults, children 88-92% Neonates 65% Primary elimination route Hepatic (4-8 pmol/L) unbound concentration osteoporosis, rash... 

Adverse reactions to drugs differ in both type and incidence in the pediatric population. Because of immature metabolic pathways, infants and children may have different metabolic patterns than adults. This at least partially explains why neonates require lower theophylline serum concentrations for the treatment of neonatal apnea and why the incidence of hepatotoxi-city following acetaminophen overdose is much lower in young children than in adults [44,45]. Antibiotic adverse effects unique to the pediatric population may... 

Necheles et al. (N4) first reported a genetically determined homozygous GSH-Px deficiency associated with neonatal jaundice and mild hemolysis. Spontaneous recovery from hemolysis was noted 3 months after birth. Thereafter, several cases with GSH-Px deficiency were reported. Newborn infants exhibit significantly lower red blood cell GSH-Px activity and serum selenium concentrations than adult control subjects, and a significantly positive correlation between selenium concentration and GSH-Px activity has been observed. Furthermore, the addition of selenium stimulates, both in vivo and in vitro, the GSH-Px activity. The neonatal red blood cell GSH-Px deficiency may be partially due to insufficient availability of selenium during pregnancy (P9). Therefore, the diagnosis of GSH-Px deficiency in newborn infants must be made carefully. 

Enterotoxigenic E. coli epitope and rotavirus epitope fused to CTB Potato tuber Mice developed detectable levels of serum and intestinal antibodies. Immunogenic in mice against ETEC, rotavirus, and V. cholerae when delivered orally. Symptoms reduced in passively immunized mouse neonates following rotavirus challenge. 63... 

The answer is c. (Hardman, pp 1134-1135.) Hematologic toxicity is by far the most important adverse effect of chloramphenicol The toxicity consists of two types (1) bone marrow depression (common) and (2) aplastic anemia (rare) Chloramphenicol can produce a potentially fatal toxic reaction, the gray baby syndrome, caused by diminished ability of neonates to conjugate chloramphenicol with resultant high serum concentrations. Tetracyclines produce staining of the teeth and phototoxicity... 

Decrease in neonatal survival and growth after 62 days. After 2 years, no evidence of carcinogenicity, but adverse effects on adult growth and serum enzyme activity levels (Schwetz etal. 1978)... 

In an excellent review of the immunopathogenesis of schistosomiasis, Warren (W3) reported that the egg of the schistosome parasite was the prime factor responsible for the hepatosplenomegaly in the mouse furthermore, that neonatal thymectomy and antilymphocyte serum had marked immunosuppression on the granuloma formation around schistosome eggs injected into the lungs of mice, implying that cell-mediated immunity must play some role in the protection of the host against schistosome infection. 

Excretion - Naloxone is excreted in the urine. The serum half-life in adults ranged from 30 to 81 minutes in neonates, 3.1 0.5 hours. 

Absorption/Distrlbutlon - Phenytoin is slowly absorbed from the small intestine. Rate and extent of absorption varies and is dependent on the product formulation. Bioavailability may differ among products of different manufacturers. Administration IM results in precipitation of phenytoin at the injection site, resulting in slow and erratic absorption, which may continue for up to 5 days or more. Plasma protein binding is 87% to 93% and is lower in uremic patients and neonates. Volume of distribution averages 0.6 L/kg. Phenytoin s therapeutic plasma concentration is 10 to 20 mcg/mL, although many patients achieve complete seizure control at lower serum concentrations. 

Nephrotoxicity The risk of toxicity may be appreciably increased by high serum concentrations or prolonged therapy. Factors that may increase the risk of nephrotoxicity include use in elderly and neonatal patients and concomitant use with other nephrotoxic drugs. 

Chiidren In premature and full-term neonates it may be appropriate to confirm desired vancomycin serum concentrations. 

Children Use with caution in premature infants and neonates because of their renal immaturity and the resulting prolongation of serum half-life of these drugs. 

There is considerable variation in the protein binding among the cephalosporins. Drugs like ceftriaxone that have extensive protein binding (85-95%) may displace bilirubin from serum albumin. Consequently, ceftriaxone may increase the risk of kemicterus in jaundiced neonates. 

The presence of multiple metabolites in the serum of neonates treated with chloramphenicol suggests that the biotransformation of chloramphenicol takes place by multiple routes to include oxidation, reduction, and conjugation. The presence of particular metabolites does not appear to correlate with toxicity. 

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