Bilirubin Concentration Research Articles

The Impact of Methamphetamine on Liver Injury in Iraqi Male Addicts

Methamphetamine (METH) is a powerful stimulant that affects neurochemical processes controlling heart rate, appetite, blood pressure, body temperature, and wakefulness, making it highly susceptible to abuse. Liver enzymes such as ALT, AST, ALP, and GGT are crucial for liver function. Albumin, a protein synthesized by healthy liver cells, serves as an indicator of chronic liver disease. Additionally, hepatocytes produce bile acids, which are essential for the secretion of bile salts into the bile canaliculi. Disruption in this secretion results in the accumulation of bile salts in the canaliculi, leading to intrahepatic cholestasis. METH-induced liver toxicity involves disruptions in hepatic metabolism, oxidative stress, and increased body temperature, affecting cellular processes such as cell division and the cell cycle and potentially accelerating liver cell apoptosis. The study explores the link between liver toxicity and hepatocyte damage in Iraqi males suffering from addiction. This is a case-control study, conducted at Ibn-Rushed Psychiatric Hospital in Baghdad from July 2023 to February 2024, involved 196 males, with addiction durations exceeding 24 months with varying degrees of methamphetamine (METH) addiction. The study included 187 healthy male controls with no history of drug addiction. Participants were aged 18 to 40 years. Diagnosis was confirmed using a drug test screening card administered by a specialist. The study included liver function tests (ALT, AST, ALP, and GGT), total bilirubin, and albumin concentration assessments. Significant differences were observed between the addicts and controls, particularly a marked decrease in serum albumin concentration in the addicted males. The ROC curve classification model at various thresholds demonstrated that liver enzymes, especially ALT, ALP, and GGT, exhibited increased sensitivity to METH addiction. A histopathological examination was conducted on a deceased 38-year-old male who had a six-year history of chronic amphetamine addiction to confirm liver injury and the resulting elevation of liver enzymes. The findings of this study indicate that METH greatly affects liver function, suggested to the importance of following a preventative measures and effective treatment approaches for monitoring METH addiction progress.

The efficacy of partial versus total splenectomy in the treatment of hereditary spherocytosis in children: a systematic review and meta-analysis.

To explore the comparative postoperative efficacy of partial splenectomy (PS) and total splenectomy (TS) in the treatment of children with hereditary spherocytosis (HS). The relevant HS studies from databases were searched and screened, comparing the differences in hemoglobin concentration, reticulocyte percentage, bilirubin concentration before and after TS and PS surgery, and during the follow-up period, as well as the incidence of postoperative adverse events. Statistical analysis was performed using Review Manager 5.4. A total of 5 studies were included in this meta-analysis, with a cumulative enrollment of 312 children, 130 in the PS group and 182 in the TS group. The meta-analysis results showed that both PS and TS groups had statistically significant differences in postoperative hematological outcomes compared to before surgery, with TS showing better improvement than PS. In the postoperative follow-up, the changes in hematological outcomes between PS and TS were statistically significant for hemoglobin concentration: within 1year [MD = 1.85, 95%CI(1.09,2.60)], 1-2years [MD = 1.74, 95%CI(0.25,3.24)], not statistically significant for 4-6years [MD = 1.28, 95%CI(-1.75,4.32)]; for reticulocyte percentage: within 1year [MD = 2.23, 95%CI(0.80,3.66)] was statistically significant, not statistically significant for 4-6years [MD = 1.77, 95%CI(-2.04,5.59)]; for serum bilirubin concentration: within 1year [MD = 1.55, 95%CI(0.91,2.18)] was statistically significant, not statistically significant for 1-2years [MD = 1.77, 95%CI(-2.04,5.99)]. In the incidence of postoperative adverse events, the incidence of cholelithiasis [MD = 1.77, 95%CI(-2.04,5.99)] showed a statistically significant difference between PS and TS, while there were no statistically significant differences in other included events, such as postoperative infection rate, secondary surgery rate, thrombosis rate, postoperative hemorrhage rate, and transfusion therapy rate. Splenectomy is a beneficial surgical strategy for children with moderate-to-severe HS, reducing; early hematological outcomes of TS are more robust than PS in the follow-up period, and there is no difference between the two in the later period; for postoperative adverse events, the incidence of cholelithiasis in children after PS is higher than after TS, and there is a risk of requiring a second surgery for total splenectomy due to hemolytic recurrences.

The U-shaped association between serum direct bilirubin and incident mild cognitive impairment in hemodialysis patients: a multicenter study

BackgroundPrevious studies have suggested an association between low serum bilirubin concentrations and increased risk of cognitive impairment. This study aimed to explore the association and dose-response relationship between serum direct bilirubin (DBIL) concentrations and mild cognitive impairment (MCI) among hemodialysis patients.MethodsThis is a multicenter cross-sectional study with patients undergoing hemodialysis from 22 dialysis centers in Guizhou Province, China. The outcome was mild cognitive impairment (MCI), measured with a Mini-Mental State Examination. The association and dose-response relationship between serum DBIL and MCI incidence were examined using multivariate logistic regression analysis, restricted cubic spline, and subgroup analysis to explore the association of serum DBIL concentrations with MCI.ResultsOf the 4223 enrolled patients (mean age 55.2 ± 15.3 years, 60.4% males), 1187 (28.1%) had MCI. Serum DBIL of 0.10-1.67umol/L [multivariable-adjusted odds ratios (OR) 1.32, 95% confidence interval (CI): 1.08–1.60, P = 0.005], 2.31-3.20umol/L (OR = 1.22, 95%CI: 1.00-1.49, P = 0.047), and > 3.21umol/L (OR = 1.32, 95%CI: 1.08–1.61, P = 0.006) had increased risk of MCI compared with 1.68-2.30umol/L. The dose-response analysis between serum DBIL and MCI showed a U-shaped relationship (P for non-linearity = 0.009), and the serum DBIL concentrations with the lowest risk of MCI was 2.01umol/L. As the serum DBIL concentrations were lower than the reference, the risk of MCI decreased by 49% per standard deviation (SD) increase in serum DBIL (OR = 0.51, 95%CI: 0.29–0.89, P < 0.001); when the concentration exceeds 2.01umol/L, a rise per SD increased the risk of MCI by 9% (OR = 1.09, 95%CI:1.01–1.17, P < 0.001).ConclusionOur findings suggest a U-shaped association between serum DBIL and MCI among hemodialysis patients.

Effect of disabling biventricular pacing in patients with left ventricular assist device and cardiac resynchronization therapy

Abstract Introduction Taking into account the mechanism of the left ventricular assist device (LVAD) function, the cardiac resynchronization therapy (CRT) seems to be unnecessary and, according to the current reports, the left ventricular lead (LVL) should be disabled. However, observation of the patients suggests that deactivation of the left ventricle (LV) pacing leads to deterioration of the patients condition and progression of the heart failure (HF) symptoms. Purpose The study aimed to determine differences in survival of the patients with LVAD and maintained or disabled CRT, including patients subjected to heart transplantation, as well differences in left and right ventricle function, kidneys and liver condition, NTproBNP value, subjective exercise tolerance and frequency of HF exacerbation before and after CRT deactivation. Methods The study group involved 55 patients with LVAD and CRT devices, including 11 patients with disabled LV pacing. The statistical analysis concerned the comparison of groups with and without biventricular stimulation as well results within the group with disabled LVL before and after its deactivation. Analyzed data included laboratory results, echocardiographic parameters, number of HF exacerbation episodes and exercise tolerance by NYHA classification. Results Total CRT period did not differ in group with maintained and disabled CRT [24 (12-36)months vs. 30 IQR(12-48)months respectively; p=0,74]. The median period of CRT deactivation was 30 IQR(12-48) months after LVAD implantation. Time from LVAD implantation to heart transplantation differed significantly between patients with and without CRT [20 IQR(9-32)months vs. 49,5 IQR(46,5-62)months respectively; p=0,003]. LV disabling was connected with a significant increase of NTproBNP [3072 IQR(2287-6636) pg/ml vs. 2133 IQR(1618-3437) pg/ml before LVL deactivation; p=0,009), without an aggravation of the exercise intolerance by NYHA classification (p=0,11) or total number of HF exacerbation episodes (p=0,72). Lack of LV pacing was not related to change of concentration of creatinine (p=0,13), AST (p=0,89, ALT (p=0,5), bilirubin (p=0,06) and albumin (p=0,69) before and after LV deactivation. Comparison of echocardiographic parameters with and without CRT did not demonstrate significant differences in LV ejection fraction (p=0,37), LV end-diastolic diameter (p=0,33), TAPSE (p=0,72) and tricuspid regurgitation degree (p=0,39). Death-free survival from LVAD implantation has not differed in patients with and without CRT(p=0,08), similarly like death-free survival from heart transplantation (p=0,56), however with tendency to better outcome of patients with CRT till 12 months after the heart transplant. Conclusion CRT does not improve general health condition as well death-free survival in LVAD recipients, including patients subjected to heart transplantation, however with tendency to better outcome of patients with CRT till 12 months after the heart transplant.Death-free surival after LVADDeath-free survival after transplant

Short-term reduction in feed intake by dairy cows in the postpartum period leads to subclinical ketosis development

Subclinical ketosis is widespread in highly productive dairy cows after calving and often remains undiagnosed, leading to reduced productivity. Physiologically controlled feeding in the first weeks after calving and during the intensive lactation period can reduce the incidence of ketosis. The study aimed to determine how a short-term reduction of feed after calving affects the formation of ketone bodies in blood, urine and milk of dairy cows. The group of ten Ukrainian black-spotted dairy breed cows after calving aged from 4 to 6 years was involved in the experiment lasted for 72 h. In 24 h the amount of compound feed, haylage, and silage received by cows was gradually reduced until complete exclusion in the diet. Blood, urine, and milk samples were collected three times a day. The content of ketone bodies, β-hydroxybutyrate and glucose was estimated with the corresponding sets of indicator strips. The content of total bilirubin, cholesterol, albumin and enzymes activity in the blood serum were determined on biochemical analyzer. It was found that in 24 h after the beginning of feed reduction the level of blood glucose decreased, persistent hypoglycemia within 48 and 72 h was developed, the concentration of β-hydroxybutyrate in blood and milk and of ketone bodies in urine was elevated. The increase in total bilirubin concentration and liver enzymes activity in the blood serum with a simultaneous decrease in albumin level and delayed sodium propionate conversion into glucose were observed. Thus, short-term reduction in feed intake by dairy cows after calving causes ketosis development and violation of liver functions. Keywords: dairy сows, feeding level, glucose, ketosis, liver damage, β-hydroxybutyrate

Iodine Bioavailability and Biochemical Effects of Brassica oleracea var. sabellica L. Biofortified with 8-Hydroxy-7-iodo-5-quinolinesulfonic Acid in Wistar Rats.

Iodine is one of the essential trace elements for human life. The main objective of the biofortification of plants with iodine is to obtain food with a higher content of this element compared to conventional food. Biofortification of plants with iodine can increase the intake of this trace element by different populations. In addition, it may reduce the risk of iodine deficiency diseases. The aim of the study was to investigate the effect of kale biofortified with 8-hydroxy-7-iodo-5-quinolinesulfonic acid (8-OH-7-I-5QSA) on iodine bioavailability and biochemical effects in Wistar rats. Kale biofortified with (8-OH-7-I-5QSA) was tested for iodine levels in urine, feces, and selected tissues using the ICP-MS/MS technique. The feeding experiment was designed to investigate potential changes in selected thyroid-regulated biochemical parameters in blood serum of Wistar rats. The dietary intake of Wistar rats fed kale biofortified with (8-OH-7-I-5QSA) from both the "Oldenbor F1" and "Redbor F1" cultivars for 8 weeks resulted in significantly (p ≤ 0.05) higher iodine concentrations in the urine and kidneys of rats, which proves iodine bioavailability. Rats' diets with "Oldenbor F1" and "Redbor F1" kale non- and -biofortified with 8-OH-7-I-5QSA had a significantly (p ≤ 0.05) lower or a tendency for lower concentration of TSH, triglyceride, total and direct bilirubin, TBARs, uric acid, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) concentrations in serum. Dietary intake of "Oldenbor F1" and "Redbor F1" kale biofortified with 8-OH-7-I-5QSA significantly (p ≤ 0.05) increased the total antioxidant status (TAS). Our study confirms that kale biofortified with iodine in organic form iodoquinoline 8-OH-7-I-5QSA is bioavailable and well absorbed by the Wistar rat and has a positive effect on selected biochemical parameters. The results obtained in this study may be highly predictive for further studies in humans.

Propylthiouracil thyroid manipulation positively affects the metabolic adaptability of primiparous dairy cows to early lactation requirements

The study examined effects of thyroid manipulation with propylthiouracil (PTU) on the metabolic adaptability of transitional dairy cows to early lactation. The study included 30 primiparous Holstein-Friesian cows, which were divided into two groups: PTU+ (n = 15; received orally 4 mg/kg PTU during 20 days before expected calving) and PTU− (n = 15; did not receive orally PTU). Blood was sampled from each cow consecutively from − 20, − 17, − 13, − 5, − 4, − 3, − 2, and − 1 days before the expected term of calving, calving day (0), and + 1, + 2, + 3, + 4, + 5, + 10, + 15, + 30 and + 60 days after the calving to measure thyroid stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), insulin, glucose, beta-hydroxybutyrate (BHB), bilirubin, total protein and albumin concentrations. Liver samples were biopsied at −7 ± 2 and +7 day relative to calving from both groups of cows to determine deiodinase (DIO) expressions and fat and glycogen content. Additionally, milk yield was monitored during the first 60 days of lactation. PTU successfully induced thyroid suppression by significantly reducing T3 and T4 concentrations and hepatic DIO1 expressions and caused PTU+ cows to have significantly higher insulin and glucose concentration in the precalving period. After calving, PTU+ cows had higher insulin and glucose concentration, liver glycogen content and overall milk production, lower BHB concentration, BCS loss, and liver fat deposits. Accordingly, cows treated with PTU have a more favourable energy balance and metabolic adaptation to early lactation.

Icteria interference for 34 clinical chemistry analytes on different analytical platforms: Method or analyzer dependent?

ObjectivesIn this study, we aimed to investigate the effect of increasing bilirubin concentration on 34 commonly measured clinical chemistry analytes on four different analytical platforms. We hypothesized that differences in icteria interference are not only method dependent, but also analyzer dependent. MethodsSerum pool was prepared using leftover samples after routine laboratory blood testing. Serum pool was then spiked with dissolved bilirubin stock. Measurements were performed on all four locations at the same time. All measurements were done in duplicate. Mean value was calculated as: (value1 + value2)/2. Those values were multiplied by corresponding dilution factors obtained during the preparation of icteric samples. For each icteric sample (Ix), bias against native (I0) sample was calculated as ((value Ix– valueI0)/ valueI0) × 100 %. Bias was calculated with actual average values. Obtained bias values were compared against acceptance criteria according to External quality assurance (EQA) providers. Difference in bilirubin concentration across platforms was tested using Friedman ANOVA. P values < 0.05 were considered statistically significant. Data are collected and analyzed in MS Excel 2016 (Microsoft, Redmond, Washington) and MedCalc® Statistical Software version 20.015 (MedCalc Software Ltd, Ostend, Belgium). ResultsMany of the tested parameters demonstrated low sensitivity to icterus interference. The highest sensitivity to icterus was observed for triglycerides, cholesterol, and urate. ConclusionsOur results indicate that while some common icteric interferences were consistent across all tested platforms, others were specific to the analyzer used, even when employing the same analytical methods.

A-171 Novel Fluorometric Assay for Pediatric Anti-Factor Xa Testing: Minimizing Bilirubin and Hemolysis Interference in Whole Blood

Abstract Background High bilirubin levels are common in pediatric patients and are noted in patients undergoing extracorporeal membrane oxygenation (ECMO). Acute anticoagulation therapy necessitates frequent monitoring of anti-Factor Xa activity (aFXa), and high bilirubin levels cause interference in chromogenic assays. Moreover, large volumes of blood lead to iatrogenic anemia in pediatric and neonatal patients. We developed a fluorescence assay to measure aFXa activity on a near-patient digital microfluidic (DMF) platform using low volume whole blood samples (&amp;lt; 50 μL) and present the results of interference of bilirubin and hemolysis on aFXa activity. Methods aFXa assay was performed on a DMF cartridge wherein 50 μL whole blood was loaded into the cartridge which separates plasma droplets through agglutination within the cartridge followed by incubation with a droplet containing exogenous FXa and a fluorogenic substrate. The fluorescence is inversely proportional to the concentration of heparin in the sample. All required reagents for the aFXa assay are dried within the cartridge, allowing for integrated sample preparation and assay automation for point of care use. To test the interference of bilirubin, we spiked into whole blood different concentrations of unconjugated bilirubin, ranging from 0-40 mg/dL. We also tested hemoglobin interference by testing 4 different concentrations of hemolysate (0-1,000 mg/dL) on the aFXa assay. All experiments were performed with 6 replicates of each concentration. Results Across each bilirubin concentration, we saw uniform measurements of aFXa activity (see Table). We observed &amp;lt; 5% CV in aFXa activity with 0, 13.33 and 26.67 mg/dL bilirubin levels. All measured unfractionated heparin values for hemolysate interference were &amp;lt;5% CV. Conclusions Our interference results suggest that high bilirubin and hemolysate levels do not interfere with our novel aFXa fluorescence assay. Further clinical studies are underway to establish clinical performance.

A-133 Trusted Test Goes Awry: Investigating Dilution Aberrations for Total Bilirubin

Abstract Background A patient with acute decompensated cirrhosis was hospitalized due to lightheadedness and jaundice, undergoing evaluation for a liver transplant. The attending physician brought to the laboratory’s attention a perplexing pattern in the patient's total bilirubin results. Initially, the patient displayed a consistent trend of elevated total bilirubin levels above the upper limit of linearity, ULOL (&amp;gt; 30 mg/dL), which then plummeted to under the limit of quantification (&amp;lt; 0.1 mg/dL) before surging back to &amp;gt; 30 mg/dL. Methods The total bilirubin in heparinized plasma was measured on the AU5800 by Beckman Coulter. Samples &amp;gt; ULOL are diluted automatically 1:3 utilizing the instrument’s on-board dilution feature. The final test results are reported automatically to an electronic medical record. Following the reported incident, an investigation and troubleshooting plan was developed, encompassing the following steps: Repeat patient testing with total bilirubin concentration &amp;gt; 30 mg/dL and &amp;lt;0.1 mg/dL; Rule out the previously reported potential interferences, including Immunoglobin M and acetaminophen; Conduct a 90-day quality control (QC) review; Perform split test analysis on two instruments within the laboratory and at a reference laboratory; Conduct patient chart reviews to identify discrepancies based on previously reported values; Complete a root cause analysis and develop corrective/preventive action plan. Results Patient sample &amp;lt; 0.1 mg/dL was tested on an alternative instrument, resulting &amp;gt; 30 mg/dL. Patient with normal IgM of 161 mg/dL didn’t reveal any other potential drug interferences in chart review. The 3-month QC review found consistent with peer performance. Split comparison of 6 patients revealed discrepancies for samples &amp;gt; 30 mg/dL on one of the two instrument units. When total bilirubin &amp;gt; 30 mg/dL, the malfunctioning unit erroneously reported values &amp;lt; 0.1 mg/dL after dilution. Review of 34 patient charts showed the impact dates were spanned for 39 days. Since the on-board dilution feature is utilized by 10 other analytes, 892 diluted samples were analyzed for discrepancies. 36 discrepant results were identified among 4 affected assays including total bilirubin, direct bilirubin, creatine kinase, and alanine aminotransferase. These results were corrected, and providers were notified. Conclusions The root cause was traced to a malfunction in one instrument unit, despite no malfunction flags. The laboratory QC concentrations fell within the analytical measurement range, missing the dilution issue during the daily QCs. During an extensive repair period, the on-board dilution was disabled on the affected unit and samples were re-routed to alternative instrument for testing. Policy changes and operator training were initiated for a new result verification process, impacting the laboratory productivity. Autoverification of diluted sample results was disabled for all chemistry analyzers. The vendor identified the issue as sample transfer unit crane misalignment in the up/down direction. It is worth noting that proficiency testing or QCs often do not extend beyond the analytical measurement ranges, leading to undetected incidents. Additional quality measures like periodic patient chart reviews, patient sample comparisons, and other quality assurance tools can aid in on-going dilution performance verification. Open communication between the physicians and laboratories is crucial for prompt issue identification and resolution.

Safety and Efficacy of a Composite Lipid Emulsion with Fish Oil in Hospitalized Neonates and Infants Requiring Prolonged Parenteral Nutrition - A Randomized, Double-Blind, Multicenter, Controlled Trial

BackgroundIntravenous lipids are critical to the care of extremely premature and other high-risk infants. ObjectiveThe study evaluated safety and efficacy of parenteral nutrition (PN) with composite intravenous lipid emulsion (CO-ILE) with fish oil compared to pure soybean oil lipid emulsion (SOLE). MethodsRandomized, controlled, double-blind, multicenter study (NCT02579265) in neonates/ infants anticipated to require ≥28 days of PN due to gastrointestinal malformations or injury. Duration of the initial and extended treatment phase was 28 days and 84 days (for patients with PN indication after day 28). Results83/ 78 patients (mean postnatal age: 11.4/ 8.3 days, 54/ 59 preterm) received CO-ILE and SOLE, respectively. 33 patients per group completed 28 days on treatment. Risk of having conjugated bilirubin values > 2 mg/dL confirmed by a second sample 7 days after the first during the initial treatment phase (primary outcome) was 2.4% (2 of 83) with CO-ILE and 3.8% (3 of 78) with SOLE (risk ratio 0.59 [95% CI: 0.09, 3.76]). Between days 29 and 84, the number of patients with confirmed conjugated bilirubin values > 2 mg/dL did not increase in the CO-ILE group (n=2) and increased in the SOLE group (n=9). At the end of the initial treatment phase, conjugated bilirubin concentrations were 45.6% lower under CO-ILE than under SOLE (p=0.006). There was no clinical or laboratory evidence of essential fatty acid deficiency in patients in the CO-ILE group. Median time to discharge alive was 56.7 and 66.4 days with CO-ILE and SOLE, respectively (hazard ratio: 1.16; 95% CI: 0.81, 1.68). ConclusionsCO-ILE was associated with a possible lower risk of cholestasis and significantly lower conjugated bilirubin at the end of the initial treatment phase in high-risk neonates and infants as compared to patients treated with SOLE. In summary, these data indicate that CO-ILE can be considered safe and may be preferable over SOLE in high-risk neonates.Clinical Trial Registry number: Clinicaltrials.gov, study ID NCT02579265

Toxicological evaluation of a herbal tea made from the leaves of Setaria megaphylla, Ageratum conyzoides and Chromolaena odorata

The toxicological effect of an herbal tea made from leaf extracts of Ageratum conyzoides, Chromolaena odorata, and Setaria megaphylla, plants traditionally used in Nigeria for malaria treatment was studied. Hot aqueous extracts of the ternary combination (1:1:1 ratio) of the plants were administered in varying doses (0, 50, 100, and 200 mg/kg) to assess impact on hepatic, renal and haematologic function parameters, and liver and kidney tissue histology of forty male albino rats divided into four groups of ten animals each. The tea extracts were administered orally daily for 60 days. Biochemical analyses revealed that the extract significantly (p&lt;0.05) reduced ALT (25.91 ± 2.35 to 6.84 ± 0.31 U/L), AST (36.39 ± 1.96 to 19.24 ± 1.19 U/L), and ALP (21.94 ± 3.51 to 11.06 ± 2.76 IU/L) activities, with no significant (p&gt;0.05) changes in bilirubin, protein and albumin concentrations, suggesting non-hepatotoxic property. Among the kidney function, significant (p&lt;0.05) dose-dependent increases was observed only in serum urea ranging from 23.09 ± 0.79 mg/dl (Control group) to 34.90 ± 0.52 mg/dl (200 mg/kg treated group). Increase in WBC count was observed indicative of a possible immune response, while other blood parameters remained stable. Histopathological examination confirmed that lower extract doses were relatively safe, whereas higher doses presented early signs of organ stress. These findings suggest that this herbal tea extract has a favourable safety profile at moderate doses, though higher doses may pose risk of organ toxicity, warranting further studies on dose optimization and elucidation of its folkloric therapeutic potential.

Sub-chronic Toxicological Evaluation of Drinking Water from Internally Displaced Persons (IDP) Camp in Wassa, Federal Capital Territory, Abuja, Nigeria

The number of Internally Displaced Persons (IDPs) camps has increased recently in Nigeria due to insurgency and natural disasters such as floods. This study aimed to evaluate the sub-chronic toxicological effects of the source of the drinking water in Wassa camp, Abuja, Nigeria. Forty-eight (48) mice were randomized into four (4) groups of twelve (12) mice each and orally administered different concentrations (5, 10, and 20 mL/kg body weight respectively) of the water sample from Wassa IDP for fourteen (14) days. The alteration was noticed in the liver and kidney indices of mice by a significant increase (p&lt;0.05) in kidney-body weight ratio, kidney, liver and plasma protein concentrations, and a considerable decrease (p&lt;0.05) in albumin, creatinine, uric acid and total bilirubin concentrations, 14-days post-treatment, particularly at a higher dose. Gamma-glutamyl transaminase in the liver and aspartate transaminase in both liver and kidney significantly (p&lt;0.05) increased in mice with a resultant significant decrease (p&lt;0.05) in the serum, 14 days post-treatment at 20 mL/kg bwt. There was no significant difference (p&gt;0.05) observed in serum triglycerides, very-low-density-lipoprotein cholesterol concentrations at all doses 14-days post-treatment compared with the control but the concentrations of serum low-density-lipoprotein cholesterol and total cholesterol significantly reduced (p&lt;0.05) at 20 mL/kg bwt 14-days post-treatment. The drinking water altered some liver-function indices while the cardiac-function indices were less affected. Therefore, prolonged consumption of the water may not be relatively safe. The provision of clean drinking water for the Wassa IDP camp will prevent adverse biochemical reaction reactions from prolonged water consumption.

2D MoS2 plasmonic nanocavity based SERS platform for bilirubin detection

Although various methods can be used to detect bilirubin at the micromolar level, achieving reliable detection in the sub-nanomolar range remains challenging. Sensitivity at these ultralow levels is vital, as new evidence strongly associates bilirubin with chronic heart, lung, and neurological disorders. This accuracy is also essential for creating diagnostic protocols that can efficiently track bilirubin levels, assisting in managing related conditions. Such advancements will lead to enhanced diagnostic tools and methods, enabling more precise bilirubin monitoring in clinical environments. Here, the aforesaid blind-spot is addressed by utilizing surface enhanced Raman spectroscopy (SERS) as fingerprint technique to detect bilirubin concentrations as low as 0.1 nM. A plasmonically active 2D MoS2 based SERS substrate is formulated and optimized for single step SERS sensing of bilirubin. Plasmonic cavity based approach is utilized to circumvent the problem related to fluorescent background overwhelming the SERS signal. The 2D MoS2 based SERS platform shows threefold enhancement of scattering in comparison to the traditional gold nanoparticle on Si/SiO2 approach. The Raman signature of bilirubin is calibrated by taking citrate as a stable reference analyte and is shown to vary linearly with logarithmic concentration across the picomolar to micromolar range.

Non-invasive detection of bilirubin concentrations during the first week of life in a low-resource setting along the Thailand–Myanmar border

BackgroundNeonatal hyperbilirubinaemia (NH) is a common problem worldwide and is a cause of morbidity and mortality especially in low-resource settings.MethodsA study was carried out at Shoklo Malaria Research Unit (SMRU)...

To study the effect of high blood bilirubin concentrations on the epidermis and dermis in seborrheic dermatitis and seborrheic alopecia

BACKGROUND: Seborrhea is a common problem affecting about 25% of the population. Seborrheic alopecia and seborrheic dermatitis have a negative impact on the quality of life of patients, reducing their self-esteem and social activity. However, the mechanisms underlying these diseases remain poorly understood to this day, which makes it difficult to develop effective treatments for these conditions. AIM: To study the effect of high concentrations of blood bilirubin on the epidermis and dermis in seborrheic dermatitis and seborrheic alopecia. MATERIALS AND METHODS: Seborrheic dermatitis of the scalp was registered in 61 patients, seborrheic alopecia ― in 23. After determining the concentration of bilirubin in the blood (total and direct), formed a group of 16 patients with seborrheic dermatitis (10 people with reference values of total and direct bilirubin and 6 people with hyperbilirubinemia), as well 23 patients as with seborrheic alopecia (9 people with reference values of total and direct bilirubin and 14 people with hyperbilirubinemia) were formed, who A histological examination of the biopsy of the skin of the affected area of the scalp was performed. RESULTS: The formation of a thinner epidermis in seborrheic dermatitis and seborrheic alopecia at high concentrations of bilirubin is associated with the presence of a thinner spiny layer. In conditions of hyperbilirubinemia, pathological changes in the dermis are more associated with the presence of lymphohistiocytic infiltrates and the development of sclerotic changes, especially in seborrheic alopecia. CONCLUSION: Seborrheic dermatitis and seborrheic alopecia against the background of hyperbilirubinemia is a tendency to decrease the thickness of the spiny layer, which affects the thickness of the entire epidermis. The decrease in the thickness of the stratum corneum with an increase in the granular layer, observed in seborrheic dermatitis, is a feature that is not observed in seborrheic alopecia. Manifestations of seborrheic alopecia are manifested by the presence of lymphohistiocytic infiltrates and sclerosis.

Signal Quality in Continuous Transcutaneous Bilirubinometry.

Bilirubin is a product of the metabolism of hemoglobin from red blood cells. Higher levels of bilirubin are a sign that either there is an unusual breaking down rate of red blood cells or the liver is not able to eliminate bilirubin, through bile, into the gastrointestinal tract. For adults, bilirubin is occasionally monitored through urine or invasive blood sampling, whilst all newborns are routinely monitored visually, or non-invasively with transcutaneous measurements (TcBs), due to their biological immaturity to conjugate bilirubin. Neonatal jaundice is a common condition, with higher levels of unconjugated bilirubin concentration having neurotoxic effects. Actual devices used in TcBs are focused on newborn populations, are hand-held, and, in some cases, operate in only two wavelengths, which does not necessarily guarantee reliable results over all skin tones. The same occurs with visual inspections. Based on that, a continuous bilirubin monitoring device for newborns is being developed to overcome visual inspection errors and to reduce invasive procedures. This device, operating optically with a mini-spectrometer in the visible range, is susceptible to patient movements and, consequently, to situations with a lower signal quality for reliable bilirubin concentration estimates on different types of skin. Therefore, as an intermediate development step and, based on skin spectra measurements from adults, this work addresses the device's placement status prediction as a signal quality indication index. This was implemented by using machine learning (ML), with the best performances being achieved by support vector machine (SVM) models, based on the spectra acquired on the arm and forehead areas.

Physiological research of young Russian sturgeons in modern ecological conditions of the Caspian sea

In the Volga-Caspian fisheries basin, artificial reproduction of sturgeon species is the primary source of replenishing their natural populations. The aim of this study is to conduct physiological research on juvenile Russian sturgeon (Acipenser gueldenstaedtii) in the western part of the Northern Caspian Sea, to establish the features of fish homeostasis. The physiological condition of the specimens was studied using a set of physiological and biochemical parameters. Hematological, biochemical, and morpho-histological parameters were evaluated. In the blood of the fish, the contents of hemoglobin, total protein, glucose, inorganic phosphorus, calcium, creatinine, bilirubin, total lipids, cholesterol, and triglycerides were determined. In the muscle tissue of juvenile Russian sturgeon, the physiological and biochemical indicators studied included the content of the main reserve substances of the body — total lipids and water-soluble protein. Histological methods were used to assess the morpho-functional state of the gills. The variability of physiological and biochemical parameters in juvenile Russian sturgeon was calculated using descriptive statistics based on parametric and non-parametric criteria in the blood and muscles. According to the results of correlation statistical analysis, significant changes were observed in the tissues of the sturgeon juveniles, aimed at providing the body with sources of energy and nutrients used for the functioning of body tissues and serving as reserve stocks, as well as maintaining regulatory mechanisms of metabolism and its changes depending on fluctuating environmental conditions. The morphological examination of the gills revealed vascular disorders, hyperplasia, swelling, and hypertrophy of the respiratory epithelium cells, corresponding to borderline disturbances from mild to moderate damage, which was the organ’s response to external environmental influences.

Correlation of bilirubin and toxic bile acids in critically ill patients with cholestatic liver dysfunction and adsorber application

Bilirubin is one of the most frequently used laboratory values to monitor critically ill patients with cholestatic liver dysfunction. Besides bilirubin, toxic bile acids (TBAs), which may cause severe organ damage, are typically elevated. A correlation between both parameters seems plausible, but data are lacking. The aim was to investigate whether there is a correlation between bilirubin and TBAs in patients’ blood and whether a compareable reduction can be observed during the use of the adsorber CytoSorb (CS). As part of the Cyto-SOLVE study (NCT04913298), 16 critically ill patients with cholestatic liver dysfunction, bilirubin concentration > 10 mg/dl, continuous kidney replacement therapy and CS-application were investigated. Bilirubin and TBA concentrations were measured from arterial blood at defined time points (before start, after 6 and 12 h). Relative reduction (RR) was calculated using the formula\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\:\\:{\\boldsymbol{RR}}\\:{\\boldsymbol{\\left(\\%\\right)}}=\\frac{{\\boldsymbol{concentration\\left(pre-post\\right)}}}{{\\boldsymbol{concentration\\left(pre\\right)}}}*{\\boldsymbol{100}}$$\\end{document}. A moderate to high correlation between bilirubin and TBA concentration at all defined timepoints (rstart=0.64, p = 0.008; r6h = 0.85, p < 0.001, r12h = 0.72, p = 0.002) was observed. In the first six hours of CS-application, a significant elimination of TBA (median TBA: 30.8→20.1µmol/l, p < 0.001) and bilirubin (median bilirubin: 17.1→11.9 mg/dl, p < 0.001) was observed. The median RR after 6 h was 26.1% and 39.8% for bilirubin and TBA, respectively. No further reduction was observed after 12 h (RRbilirubin: – 0.6%, RRTBA: 1.8%). There was an at least moderate correlation between bilirubin and TBA in patients with cholestatic liver dysfunction. Therefore, bilirubin seems to be a suitable surrogate parameter for TBA elimination during CytoSorb application.

Unconjugated bilirubin promotes uric acid restoration by activating hepatic AMPK pathway

Hyperuricemia and its development to gout have reached epidemic proportions. Systemic hyperuricemia is facilitated by elevated activity of xanthine oxidase (XO), the sole source of uric acid in mammals. Here, we aim to investigate the role of bilirubin in maintaining circulating uric acid homeostasis. We observed serum bilirubin concentrations were inversely correlated with uric acid levels in humans with new-onset hyperuricemia and advanced gout in a clinical cohort consisting of 891 participants. We confirmed that bilirubin biosynthesis impairment recapitulated traits of hyperuricemia symptoms, exemplified by raised circulating uric acid levels and accumulated hepatic XO, and exacerbated mouse hyperuricemia development. Bilirubin administration significantly decreased circulating uric acid levels in hyperuricemia-inducing (HUA) mice receiving potassium oxonate (a uricase inhibitor) or fed with a high fructose diet. Finally, we proved that bilirubin ameliorated mouse hyperuricemia by increasing hepatic autophagy, restoring antioxidant defense and normalizing mitochondrial function in a manner dependent on AMPK pathway. Hepatocyte-specific AMPKα knockdown via adeno-associated virus (AAV) 8-TBG-mediated gene delivery compromised the efficacy of bilirubin in HUA mice. Our study demonstrates the deficiency of bilirubin in hyperuricemia progression, and the protective effects exerted by bilirubin against mouse hyperuricemia development, which may potentiate clinical management of hyperuricemia.