ABSTRACT
Routine use of transcutaneous bilirubin (TcB) measurement in the newborn nursery could reduce costs, readmission rates for hyperbilirubinemia and the need for total serum bilirubin (TSB) measurements. The aim of this study was to examine the correlation between TcB measurement, as performed using BiliCheck, and TSB, measured with high-pressure liquid chromatography (HPLC) and with standard laboratory methods, and to determine the TcB cutoff points with desirable sensitivity and specificity values for various clinically relevant TSB levels by HPLC. Fifty-four infants of > or = 30 weeks of gestational age were enrolled in the study. Near simultaneous blood collection for TSB analysis by three methods--bedside bilirubinometer, diazo method and HPLC--and TcB measurement were performed. There was good correlation between TcB and HPLC-bilirubin (B) (r = 0.85), TSB by bilirubinometer and HPLC-B (r = 0.91) and TSB by diazo method and HPLC-B (r = 0.91). The cut-off limits providing a sensitivity of 100% for TcB measurements were TcB > or = 9 mg/dl for HPLC-B > 17 mg/dl and TcB > or = 8 mg/dl for HPLC-B > 15 mg/dl and HPLC-B > 13 mg/dl. Despite having good correlation with HPLC, BiliCheck showed worse performance than bilirubinometer and diazo method at various clinically relevant cut-off values. Since BiliCheck required relatively lower thresholds with false-positive results for having a sensitivity of 100%, it cannot be recommended as a complete substitute for serum bilirubin measurements.
Subject(s)
Bilirubin/blood , Female , Humans , Infant, Newborn , Jaundice, Neonatal/diagnosis , Male , Sensitivity and SpecificityABSTRACT
Mitral regurgitation due to papillary muscle rupture after blunt chest trauma is uncommon. Sudden onset severe mitral regurgitation may lead to death due to heart failure if surgical repair is delayed. A previously healthy 12-year-old girl underwent splenectomy and chest tube insertion for pneumothorax after a traffic accident in a vehicle 15 days before. She was discharged from the hospital after a nine-day follow-up. She was presented to our hospital due to respiratory distress. On physical examination, an apical holosystolic murmur radiating to the axillary region was recognized. Transthoracic echocardiogram showed severe mitral regurgitation with freely moving posterior mitral chordae and prolapse of the posterior mitral valve leaflet. She received reimplantation of the complete ruptured posteromedial papillary muscle of the mitral valve. Her medical condition improved after the operation. On the postoperative echocardiogram, the left ventricular systolic function was normal with no mitral regurgitation.
Subject(s)
Heart Injuries/etiology , Mitral Valve , Papillary Muscles/injuries , Wounds, Nonpenetrating/complications , Accidents, Traffic , Child , Female , Humans , Papillary Muscles/diagnostic imaging , Rupture , Ultrasonography, Doppler, ColorABSTRACT
A female newborn with transient neonatal diabetes mellitus is presented. No apparent genetic anomaly was detected, and the diabetes mellitus resolved by day 47 of life.
