Transcutaneous Bilirubinometry


Book Description

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.




Transcutaneous Bilirubinometry


Book Description

This book has been written to summarize 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 newborn infants worldwide. Transcutaneous bilirubinometry has its roots in the old observation that yellow skin color 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, pediatric 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.




Transcutaneous Bilirubinometry in Neonates


Book Description

Most of newborn infants develop hyperbilirubinemia in the first week of life. Moreover, jaundice is the most common cause of neonatal rehospitalization. Excessive hyperbilirubinemia may lead to irreversible bilirubin-induced neurologic dysfunction. Early identification of infants with high bilirubin levels requiring intervention is the key issue in the management of neonatal hyperbilirubinemia. Transcutaneous measurement of bilirubin concentration is an objective, noninvasive method, which provides real-time results and avoids pain due to blood sampling. It is a screening test for identifying the need for laboratory assessment of total serum bilirubin concentration. This book provides overview of neonatal hyperbilirubinemia and its management, and possibilities of noninvasive assessment of jaundice. The presented study evaluates the accuracy of a bilirubinometer with two optical paths in European newborn infants, and assesses the effect of gestational age, phototherapy and measurement site on reliability of transcutaneous measurements. The book should be useful to neonatologists, pediatricians, medical students and nurses, and it aims to serve as a resource for further studies.




Point-of-care testing


Book Description

The underlying technology and the range of test parameters available are evolving rapidly. The primary advantage of POCT is the convenience of performing the test close to the patient and the speed at which test results can be obtained, compared to sending a sample to a laboratory and waiting for results to be returned. Thus, a series of clinical applications are possible that can shorten the time for clinical decision-making about additional testing or therapy, as delays are no longer caused by preparation of clinical samples, transport, and central laboratory analysis. Tests in a POC format can now be found for many medical disciplines including endocrinology/diabetes, cardiology, nephrology, critical care, fertility, hematology/coagulation, infectious disease and microbiology, and general health screening. Point-of-care testing (POCT) enables health care personnel to perform clinical laboratory testing near the patient. The idea of conventional and POCT laboratory services presiding within a hospital seems contradictory; yet, they are, in fact, complementary: together POCT and central laboratory are important for the optimal functioning of diagnostic processes. They complement each other, provided that a dedicated POCT coordination integrates the quality assurance of POCT into the overall quality management system of the central laboratory. The motivation of the third edition of the POCT book from Luppa/Junker, which is now also available in English, is to explore and describe clinically relevant analytical techniques, organizational concepts for application and future perspectives of POCT. From descriptions of the opportunities that POCT can provide to the limitations that clinician’s must be cautioned about, this book provides an overview of the many aspects that challenge those who choose to implement POCT. Technologies, clinical applications, networking issues and quality regulations are described as well as a survey of future technologies that are on the future horizon. The editors have spent considerable efforts to update the book in general and to highlight the latest developments, e.g., novel POCT applications of nucleic acid testing for the rapid identification of infectious agents. Of particular note is also that a cross-country comparison of POCT quality rules is being described by a team of international experts in this field.




Transcutaneous Bilirubinometry in the Context of Early Postnatal Discharge


Book Description

Most Quebec hospitals have undertaken to reduce the length of postpartum stays, with discharge generally taking place about 48 hours after a normal, uncomplicated vaginal delivery. In this context, special attention must be given to the problem of hyperbilirubinemia. (CETS) examined the usefulness of providing each region in Quebec with transcutaneous bilirubinometers. These devices are used to screen for the presence of jaundice in newborns, a sign of an elevated blood bilirubin level. This report evaluates the performance of these devices. In conclusion, transcutaneous bilirubinometry can contribute effectively to detecting cases where a serum bilirubin determination is required. This can be very useful if this technology is part of a well-established perinatal program that includes a systematic follow-up visit to the mother and newborn shortly after discharge. However, based on its analysis, CETS cannot recommend a wide-scale program for the systematic purchase of transcutaneous bilirubinometers.







Implementation of a Transcutaneous Bilirubinometer on a Postpartum Unit at a Magnet Community Hospital


Book Description

A common clinical concern for all newborns in the first few days of life is the risk of hyperbilirubinemia. Hyperbilirubinemia if left untreated can lead to permanent hearing loss, neurological dysfunction, and even irreversible brain damage called kernicterus. Bilirubin monitoring and early intervention can prevent these adverse events from occurring. Best practice recommends the use of transcutaneous bilirubin (TcB) monitoring on all term, low-risk newborns (>38 weeks gestation at birth) at 24-hours of life. Replacing total serum bilirubin (TSB) draws through a heel stick, with TcB assessments leads to utilization of evidence-based practice. The transcutaneous bilirubinometer is a non-invasive, effective way to monitor bilirubin levels for all full term, low-risk newborns. Implementation of TcB assessment on a postpartum unit involved the creation of new policies and procedures (Appendix A) to instruct staff how to intervene with intermediate and high-risk newborns. Various risk factors influence a newborns risk of developing hyperbilirubinemia including: gestational age at birth, race, breastfed vs. bottle fed, prenatal care, and infection (Jaundice & Kernicterus, 2016). A standard of work (Appendix B), nomogram (Appendix C), and algorithms (Appendix D) were created for postpartum Registered Nurses to reference. These documents allow nurses to determine what interventions are necessary based on a neonate's bilirubin level and age. In-service staff education was provided by the Clinical Nurse Leader (CNL) students to educate nurses on the use of the DraÌ8ger Jaundice Meter (JM)-105. Nurse's confidence and competency in using the transcutaneous bilirubinometer was measured before and after in-service staff education through confidence scale surveys (Appendix E). Due to time constraints, post-test data has not been completed but the results are expected to show improved nurse confidence and competency in use of the DraÌ8ger JM-105. Following ten weeks of policy and procedure creation and in-service staff education, successful implementation of transcutaneous bilirubin monitoring was exhibited.







Ethnic Dermatology


Book Description

ETHNIC DERMATOLOGY Principles and Practice Richly pigmented skin is the most common skin type internationally Historically, dermatology has focused on white skin. But rich pigmentation can lead to differences in presentation, disease course and outcome, and reaction to treatment. Some dermatologic conditions are seen either predominantly or exclusively in richly pigmented skin. Ethnic Dermatology: Principles and Practice provides a practical approach to the dermatology of nonwhite skin. Written from a global perspective to include Asian, African-Caribbean and North African skin types, it covers all the bases of dermatology including: Grading scales in dermatologic disease Pediatric dermatology Dermatology and systemic disease Drug eruptions Hair and scalp disorders Cosmetic dermatology. With a central focus on practical action from an international cast of authors, Ethnic Dermatology: Principles and Practice gives you the clinical tools you need when skin color matters.




Tietz Clinical Guide to Laboratory Tests - E-Book


Book Description

This new edition of Norbert Tietz's classic handbook presents information on common tests as well as rare and highly specialized tests and procedures - including a summary of the utility and merit of each test. Biological variables that may affect test results are discussed, and a focus is placed on reference ranges, diagnostic information, clinical interpretation of laboratory data, interferences, and specimen types. New and updated content has been added in all areas, with over 100 new tests added. - Tests are divided into 8 main sections and arranged alphabetically. - Each test includes necessary information such as test name (or disorder) and method, specimens and special requirements, reference ranges, chemical interferences and in vivo effects, kinetic values, diagnostic information, factors influencing drug disposition, and clinical comments and remarks. - The most current and relevant tests are included; outdated tests have been eliminated. - Test index (with extensive cross references) and disease index provide the reader with an easy way to find necessary information - Four new sections in key areas (Preanalytical, Flow Cytometry, Pharmacogenomics, and Allergy) make this edition current and useful. - New editor Alan Wu, who specializes in Clinical Chemistry and Toxicology, brings a wealth of experience and expertise to this edition. - The Molecular Diagnostics section has been greatly expanded due to the increased prevalence of new molecular techniques being used in laboratories. - References are now found after each test, rather than at the end of each section, for easier access.