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	Hyperbilirubinemia: Problems in Newborns: Merck Manual Home Edition
		Hyperbilirubinemia is an abnormally high level of bilirubin in the blood.
		Newborns with hyperbilirubinemia who are showing symptoms of kernicterus may become lethargic and feed poorly; these newborns should be examined immediately by a doctor.
		Moderate hyperbilirubinemia sometimes continues for weeks in infants who are breastfed, a normal phenomenon that poses no problems for the infant and that does not usually require withholding of breastfeeding.
	www.merck.com /mmhe/sec23/ch264/ch264p.html (825 words)

	Case Based Pediatrics Chapter
		Hyperbilirubinemia is more common in neonates due to the shortened life span of their red blood cells, declining hematocrit, immature liver uptake and conjugation of bilirubin, and increased intestinal reabsorption of bilirubin.
		Hyperbilirubinemia of this degree noted in the 24-48 hours line of table 2, is unusual and should suggest hemolysis, concealed hemorrhage, or causes of conjugated (direct) hyperbilirubinemia (10).
		Phototherapy for Hyperbilirubinemia of Hemolytic Disease of the Newborn.
	www.hawaii.edu /medicine/pediatrics/pedtext/s03c02.html (3719 words)

	An Evidence-Based Review of Important Issues Concerning Neonatal Hyperbilirubinemia -- Ip et al. 114 (1): e130 -- ...
		Hyperbilirubinemia and kernicterus in glucose-6-phosphate dehydrogenase-deficient infants in Singapore.
		Amniotic fluid infections, neonatal hyperbilirubinemia, and psychomotor impairment.
		Phototherapy and the brain-stem auditory evoked response in neonatal hyperbilirubinemia.
	pediatrics.aappublications.org /cgi/content/full/114/1/e130 (8603 words)

	Hyperbilirubinemia and Jaundice
		Hyperbilirubinemia is a condition in which there is too much bilirubin in the blood.
		Depending on the cause of the hyperbilirubinemia, jaundice may appear at birth or at any time afterward.
		While hyperbilirubinemia cannot be totally prevented, early recognition and treatment are important in preventing bilirubin levels from rising to dangerous levels.
	www.healthsystem.virginia.edu /uvahealth/peds_hrnewborn/hyperb.cfm (732 words)

	Postgraduate Medicine: Neonatal jaundice
		Breast-feeding is an important risk factor for hyperbilirubinemia, probably owing to high levels of beta-glucuronidase in breast milk and, if maternal milk supply is not yet adequate in the first few days, decreased caloric intake and delayed passage of meconium.
		Polycythemia contributing to hyperbilirubinemia is seen in infants who are large or small for their gestational age, as well as in trisomic syndromes, placental transfusion syndrome (twin-to-twin transfusion) and maternal-fetal transfusion.
		With severe hyperbilirubinemia, intense phototherapy consisting of at least double phototherapy using a fiberoptic blanket and one or two banks of phototherapy light should be initiated while preparations for exchange transfusion are being made.
	www.postgradmed.com /issues/1999/11_99/melton.htm (3182 words)

	THE MERCK MANUAL, Sec. 19, Ch. 260, Disturbances In Newborns And Infants
		Hyperbilirubinemia may be physiologic or due to a specific underlying disorder.
		Physiologic hyperbilirubinemia sufficient to cause mild jaundice appears after 24 h in about 50% of full-term newborns and in a higher percentage of preterm newborns.
		The exact cause of physiologic hyperbilirubinemia is unknown; limiting rates in the binding of bilirubin in the hepatocytes, in the conjugation of bilirubin with glucuronic acid, and in bile secretion have all been implicated, as well as the enterohepatic circulation of bilirubin (see also Bilirubin Excretion under Perinatal Physiology in Ch.
	www.merck.com /pubs/mmanual/section19/chapter260/260i.htm (4575 words)

	CNP Course
		The incidence of hyperbilirubinemia in the average newborn population is 6-10%.
		Caloric intake is inversely correlated with hyperbilirubinemia in preterm infants.
		Hyperbilirubinemia inhibits granulocyte migration, increases phagocytic activity, decreases antibody forming cells in the spleen, increases "activated" lymphocytes and is cytotoxic for lymphocytes and PMNs (146).
	www.peponline.com /cnp/cnpbook.htm (12089 words)

	New Hyperbilirubinemia Guidelines
		Most jaundice is benign, but because of the potential toxicity of bilirubin, newborn infants must be monitored to identify those who might develop severe hyperbilirubinemia and, in rare cases, acute bilirubin encephalopathy or kernicterus.
		Objective: The focus of this guideline is to reduce the incidence of severe hyperbilirubinemia and bilirubin encephalopathy while minimizing the risks of unintended harm such as maternal anxiety, decreased breastfeeding, and unnecessary costs or treatment.
		These guidelines provide a framework for the prevention and management of hyperbilirubinemia in newborn infants of 35 or more weeks of gestation.
	www.fsneo.org /JourClub/5-023.htm (202 words)

	Kernicterus in Full-Term Infants --- United States, 1994--1998
		Kernicterus is a preventable life-long neurologic syndrome caused by severe and untreated hyperbilirubinemia during the neonatal period.
		Treating hyperbilirubinemia with phototherapy and exchange transfusions prevents kernicterus if treatment is initiated promptly and is continued until bilirubin levels normalize.
		Early hyperbilirubinemia detection is critical to the prevention of the irreversible effects of kernicterus.
	www.cdc.gov /mmwr/preview/mmwrhtml/mm5023a4.htm (1612 words)

	FindArticles search for "Hyperbilirubinemia"
		Hyperbilirubinemia is one of the most common problems encountered in term newborns.
		Aggressive treatment of hyperbilirubinemia from the 1950s to the 1970s led to a marked decrease in the occurrence of kernicterus, a rare but devastating...
		Neonatal jaundice (or hyperbilirubinemia) is a higher-than-normal level of bilirubin in the blood.
	www.findarticles.com /p/search?tb=art&qt=Hyperbilirubinemia (748 words)

	Jaundice in Newborns (Hyperbilirubinemia) Topic Overview, Eastern Carolina
		Jaundice is a condition that causes a pronounced yellow tint to the skin and the white part of the eyes as a result of a higher-than-normal amount of bilirubin in the blood (hyperbilirubinemia).
		Bilirubin is a substance produced by the breakdown of red blood cells and hemoglobin, the protein in red blood cells that carries oxygen from the lungs to the rest of the body.
		In rare cases, hyperbilirubinemia may be caused by an underlying disease or disorder, such as blood type incompatibility, digestive system disorders, or infections.
	www.uhseast.com /113231.cfm (744 words)

	Approach to the management of hyperbilirubinemia in term newborn infants
		It provides an overview of the proposed management of hyperbilirubinemia based on available evidence, even though randomized controlled trials are not available to allow a conclusive assessment of the risk associated with hyperbilirubinemia in the clinical situations encountered in practice.
		Hyperbilirubinemia in apparently healthy term newborn infants continues to hold the potential threat of complications from bilirubin encephalopathy and kernicterus.
		Phototherapy of jaundice in the newborn infant: 2.
	www.cps.ca /english/statements/FN/fn98-02.htm (2201 words)

	EHS: WOW-Update on Neonatal Hyperbilirubinemia (Site not responding. Last check: 2007-09-09)
		The American Academy of Pediatric, Subcommittee on Hyperbilirubinemia (2004) recently revised the 1994 guidelines on the management of neonatal hyperbilirubinemia in term and near-term infants born at 35 weeks' or more gestation.
		With early discharge of both mother and newborn it is essential that newborns who are jaundiced during their hospitalization or who are at greater risk for severe hyperbilirubinemia after discharge are identified and followed for evaluation.
		The nurse's contribution to a successful transition for the newborn and family by collaborating with other health professionals in the implementation of these guidelines is important in the overall scheme of preventative health care for children and their families.
	www.mosbysdrugconsult.com /WOW/pu083.html (1069 words)

	Low-pressure mercury-vapor discharge lamp for treatment of hyperbilirubinemia and method - Patent 4246905
		This invention relates to low-pressure mercury-vapor discharge lamps, and in particular, those used for phototherapeutic treatment of infantile hyperbilirubinemia, which is a condition occurring in newborn infants where bilirubin is present in high concentrations such that there is significant red cell destruction.
		This patent shows that utilizing the lamp combination described is effective in the treatment of hyperbilirubinemia because of concentration of the radiated energy in a portion of the spectrum which causes decomposition of the bilirubin constituent.
		When treating infantile hyperbilirubinemia with such a lamp, any tendency of the blue emission of the europium-activated alkaline-earth metal halophosphate to produce nausea in certain attendant individuals is substantially eliminated without appreciably affecting the efficacy of the treatment process.
	www.freepatentsonline.com /4246905.html (1792 words)

	Hyperbilirubinemia
		Hyperbilirubinemia continues to be an ongoing condition of the term and near-term neonate.
		Hyperbilirubinemia is one of the leading causes of readmissions to the hospital during the first month of life.
		I believe that education is a key in preventing hyperbilirubinemia from occuring in infants.
	learn.sdstate.edu /craigg/Wieman.html (3641 words)

	Management of Neonatal Hyperbilirubinemia: Summary of Evidence Report/Technology Assessment, No. 65
		For the two questions on the association of neonatal hyperbilirubinemia with neurodevelopment outcomes, the inclusion criteria were: Infants >34 weeks of gestation or >2,500 grams and a sample size of more than five subjects per arm (except for case reports of kernicterus).
		The predictors were jaundice or hyperbilirubinemia and at least one of the neurodevelopmental outcomes was reported in the article.
		Duration of hyperbilirubinemia, bilirubin binding, and the role of hour-specific bilirubin measurement all merit further investigation.
	www.ahrq.gov /clinic/epcsums/neonatalsum.htm (3035 words)

	Epinions.com - Hyper what? Understanding Hyperbilirubinemia.
		Hyperbilirubinemia is a more severe kind of jaundice.
		The reason that it takes a few days is because while the baby is in the womb, the placenta did the job of excreting toxins from the body, after birth it is the livers job and maturation of the liver takes a few days.
		If the baby has hyperbilirubinemia due to opposite blood types, breast feeding can contribute to the levels of bilirubin rising.
	www.epinions.com /kifm-review-276C-7D6D653-393EF61C-prod4 (903 words)

	Sentinel Event Alert, Issue 18 - April 2001
		It results from hyperbilirubinemia that can be caused by a number of factors.
		Hyperbilirubinemia is characterized by jaundice, and while jaundice in the newborn is common, extreme hyperbilirubinemia that causes kernicterus is rare.
		Policies for assessing the risk of severe hyperbilirubinemia in all infants by history, clinical evaluation and, if necessary, by laboratory measurement.
	www.jcaho.org /about+us/news+letters/sentinel+event+alert/sea_18.htm (1110 words)

	Kernicterus \| Hyperbilirubinemia California Attorneys \| Kernicterus Disabilities \| Kernicterus Definition (Site not responding. Last check: 2007-09-09)
		If your doctor delayed treatment for your baby's jaundice, he or she may be found negligent, resulting in a settlement for your child's pain and suffering.
		Kernicterus and hyperbilirubinemia are preventable conditions that occur in newborn babies when their livers are not developed enough to break down a blood waste called billirubin.
		The Veen Firm may be able to recover a settlement to cover the cost of your child's medical bills and round-the-clock care that will be required for the rest of his or her life.
	www.kernicterus-help.com (347 words)

	Mechanism of indinavir-induced hyperbilirubinemia -- Zucker et al. 98 (22): 12671 -- Proceedings of the National ...
		unconjugated hyperbilirubinemia (2-5) in the absence of histologic
		Unconjugated hyperbilirubinemia is a frequent side-effect of this
		hyperbilirubinemia is because of direct inhibition of enzyme activity.
	www.pnas.org /cgi/content/full/98/22/12671 (3685 words)

	Urgent Clinical Need for Accurate and Precise Bilirubin Measurements in the United States to Prevent Kernicterus -- ...
		Predictive ability of a pre-discharge hour-specific serum bilirubin for subsequent significant hyperbilirubinemia in healthy term and near-term newborns.
		Prediction of hyperbilirubinemia in term and near-term newborns.
		Prediction of hyperbilirubinemia in term and near-term newborn infants.
	www.clinchem.org /cgi/content/full/50/3/477 (1744 words)

	HON Mother & Child Glossary, Prematurity Problems: Hyperbilirubinemia & Jaundice
		Bilirubin is produced when ageing, damaged, or abnormal red blood cells are removed from the circulation, and are broken down by the liver.
		Hyperbilirubinemia, a high level of bilirubin in the blood, and Jaundice, the yellow skin colour due to high bilirubin blood levels, is common in premature infants, who do not have fully developed organs and, thus, their livers cannot process bilirubin rapidly.
		Hyperbilirubinemia may be due to an overproduction and/or underexcretion of bilirubin.
	www.hon.ch /Dossier/MotherChild/prematurity_problems/hyperbilirubinemia.html (138 words)

	Assessing liver function and hyperbilirubinemia in the newborn -- Rosenthal 43 (1): 228 -- Clinical Chemistry
		Jaundice in the newborn: algorithmic diagnosis of conjugated and unconjugated hyperbilirubinemia.
		Hyperbilirubinemia in the breast-fed newborn: controlled trial of four interventions.
		The clinical importance of a protein-bound fraction of serum bilirubin in patients with hyperbilirubinemia.
	www.clinchem.org /cgi/content/full/43/1/228 (3260 words)

	Relationship Between Bilirubin UDP-Glucuronosyl Transferase 1A1 Gene and Neonatal Hyperbilirubinemia -- HUANG et al. 52 ... (Site not responding. Last check: 2007-09-09)
		of neonatal hyperbilirubinemia in Taiwan Chinese is partly attributable
		Monaghan G, Mclellan A, Mcgeeban A, Li VS, Mollica F, Salemi I, Din Z, Cassidy A, Hume R, Burchell B 1999 Gilbert’s syndrome is a contributory factor in prolonged unconjugated hyperbilirubinemia of the newborn.
		Maruo Y, Nishizawa K, Sato H, Sawa H, Shimada M 2000 Prolonged unconjugated hyperbilirubinemia associated with breast milk and mutations of the bilirubin uridine-diphosphate glucuronosyltransferase gene.
	www.pedresearch.org /cgi/content/full/52/4/601 (2614 words)

	Metalloporphyrins for treatment of unconjugated hyperbilirubinemia in neonates
		Unconjugated hyperbilirubinemia is a common problem in the neonatal period, occurring in 30-50% of term newborns (Kivlahan 1984).
		In Martinez 1999, 27% of neonates in the control group developed severe hyperbilirubinemia and were treated with phototherapy whereas none of the metalloporphyrin-treated infants developed severe hyperbilirubinemia.
		Before metalloporphyrin treatment of neonatal unconjugated hyperbilirubinemia can be considered for routine use, further studies with masking of interventions and outcome assessment are required to compare the safety and efficacy of metalloporphyrins and phototherapy.
	www.nichd.nih.gov /cochraneneonatal/Suresh2/SURESH.HTM (5628 words)

	Sentinel Event Alert, Issue 31 - August 31, 2004
		The revised clinical practice guideline is intended to provide health care professionals with specific information to prevent occurrences of kernicterus, ease parents' anxiety and concerns about kernicterus, and educate the public about the risks and complications of severe hyperbilirubinemia leading to kernicterus.
		The updated clinical practice guideline, a product of the AAP Subcommittee on Hyperbilirubinemia, stresses the importance of universal systematic assessment while the newborn is in the hospital, close monitoring and follow-up upon discharge, and prompt intervention once jaundice is diagnosed.
		Perform a systematic assessment for the risk of severe hyperbilirubinemia on all infants prior to discharge.
	www.jcaho.org /about+us/news+letters/sentinel+event+alert/sea_31.htm (733 words)

	Risk Factors for Severe Hyperbilirubinemia in Neonates -- HUANG et al. 56 (5): 682 -- Pediatric Research (Site not responding. Last check: 2007-09-09)
		gene was highly related to neonatal hyperbilirubinemia (12,16).
		hyperbilirubinemia and suspected factors are presented in Table 3.
		Monaghan G, McLellan A, McGeehan A, Li Volti S, Mollica F, Salemi I, Din Z, Cassidy A, Hume R, Burchell B 1999 Gilbert’s syndrome is a contributory factor in prolonged unconjugated hyperbilirubinemia of the newborn.
	www.pedresearch.org /cgi/content/full/56/5/682 (3826 words)

	eMedicine - Hyperbilirubinemia, Unconjugated : Article by Nuri Ozden, MD
		Regarding unconjugated hyperbilirubinemia caused by impaired conjugation of bilirubin, Crigler-Najjar syndrome type I occurs in persons of all ethnic groups and is inherited as an autosomal recessive trait.
		Hemolysis is characterized by unconjugated hyperbilirubinemia, although significant levels of conjugated bilirubin may be observed in the presence of underlying liver disease, sepsis, drugs, or when the amount of bilirubin generated and conjugated exceeds the biliary transport limit for conjugated bilirubin, as may occur in acute hemolytic crises or with multiple blood transfusions.
		Hemolysis due to hereditary abnormalities of erythrocytes (eg, hereditary spherocytosis/elliptocytosis, glucose-6-phosphate dehydrogenase deficiency, pyruvate kinase deficiency, sickle cell disease) generally produces a milder degree of jaundice, which may manifest within a few days of birth or as recurrent episodes during later life, and frequently in association with febrile illnesses.
	www.emedicine.com /med/topic1066.htm (2687 words)

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