Total Bilirubin Concentration Research Articles

UGT1A1 and BLVRA allele and genotype variants in neonatal patients with hyperbilirubinemia in southern China

We explore the allele and genotype distribution of UGT1A1 and BLVRA variants in individuals affected by neonatal hyperbilirubinemia in southern China. Blood specimens were collected from 240 neonates: 126 cases of hyperbilirubinemia and 114 healthy controls. Serum levels of total protein, albumin, bilirubin (total and direct), urea nitrogen, creatinine, and other biochemical parameters were quantified using a biochemical analyzer. Nine UGT1A1 and five BLVRA genetic variants were genotyped using flight time mass spectrometry. The allele and genotype frequencies of these variants and their associations with neonatal hyperbilirubinemia were analyzed. The genotype frequencies of CC and CG for the UGT1A1 variant rs11888492 in the hyperbilirubinemia group were 90.48% and 9.52%, respectively (P = 0.001), in comparison with the control group. The C and G allele frequencies of rs11888492 in the hyperbilirubinemia group were 95.24% and 4.76%, respectively (P = 0.023). Similarly, in the hyperbilirubinemia group, the genotype frequencies for the UGT1A1 variant rs4148325 were 90.48% CC, 8.73% CT, and 0.79% TT (P = 0.001), with corresponding allele frequencies of 94.84% for C and 5.16% for T (P = 0.002). No notable distinctions were detected for other variants. Newborns carrying the CC genotype of rs11888492 exhibited higher total bilirubin (TBIL) levels than those carrying the GG genotype (P = 0.034), whereas newborns carrying the CC genotype of rs4148325 displayed higher TBIL levels than those carrying the CT genotype (P = 0.003). The presence of the G allele at rs11888492 was found to be significantly correlated with a decreased likelihood of developing neonatal hyperbilirubinemia (odds ratio [OR]: 0.363; 95% confidence interval [CI] 0.169–0.777). Furthermore, a substantial reduction in the risk of neonatal hyperbilirubinemia associated with the CT genotype of rs4148325 were revealed (OR = 0.242; 95% CI 0.102–0.574). Additionally, an inverse relationship was identified between TBIL concentration and the quantity of genetic variants. The UGT1A1 variants rs11888492 and rs4148325 are strongly associated with neonatal hyperbilirubinemia in southern China.

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

Background: 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. Objectives: 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. Methods: 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. Results: 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). Conclusions: 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.

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 (> 30 mg/dL), which then plummeted to under the limit of quantification (< 0.1 mg/dL) before surging back to > 30 mg/dL. Methods The total bilirubin in heparinized plasma was measured on the AU5800 by Beckman Coulter. Samples > 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 > 30 mg/dL and <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 < 0.1 mg/dL was tested on an alternative instrument, resulting > 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 > 30 mg/dL on one of the two instrument units. When total bilirubin > 30 mg/dL, the malfunctioning unit erroneously reported values < 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.

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<0.05) in kidney-body weight ratio, kidney, liver and plasma protein concentrations, and a considerable decrease (p<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<0.05) increased in mice with a resultant significant decrease (p<0.05) in the serum, 14 days post-treatment at 20 mL/kg bwt. There was no significant difference (p>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<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.

249 Effects of sorghum silage kernel processing on growth performance and blood metabolites of beef heifers

Abstract Our previous studies suggested that using a shredlage (SHRD) processor or a conventional (CONV) sorghum kernel processor leads to similar apparent total tract nutrient digestibility of whole plant sorghum silage (WPSS). This study evaluated the effects of feeding WPSS harvested using different kernel processors (CONV vs. SHRD), on growth performance of beef heifers. Grain sorghum (ADV2450IG; Advanta Seeds, Argentina) was harvested at the hard-dough stage with a Class Jaguar 950 (Harsewinkel, Germany), switching the kernel processor to generate the forage material for the two treatments: CONV and SHRD. The material was bagged in two 2.7 m diameter bags and allowed to ferment for 3 mo. Black Angus heifers [n = 96; body weight (BW) = 15 ± 1 mo, 249.6 ± 28.6 kg] were blocked by initial BW, and randomly assigned to pens (8 heifers/pen, 6 pens/treatment). Diets consisted, all in DM basis, of WPSS of each respective type (SHRD or CONV) at 90.5%, expeller soybean meal at 7.0%, and a vitamin-mineral-NNP concentrate at 2.5%. The experiment consisted of a 14-d adaptation period, followed by a 56-d growing period; and feed was offered once daily. Data were analyzed as a randomized complete block design, using pen as the experimental unit, with the fixed effect of treatment and the random effect of block. No differences were observed (P > 0.10) for final BW, dry matter intake, and residual feed intake. However, CONV fed heifers tended to gain more BW per day (ADG, 0.83 vs. 0.77 kg/d; P = 0.07) and had greater gain to feed ratio (GF, 0.083 vs. 0.075 kg/kg; P = 0.05) and greater Kleiber ratio (KR, 12.1 vs 11.2 g/kg; P = 0.05) as compared with SHRD fed heifers. Furthermore, performance calculated dietary Net Energy of gain (NEg) in CONV fed heifers tended to be greater than that for SHRD (0.70 vs. 0.65 Mcal/kg of diet DM, respectively; P = 0.06). Moreover, blood serum from CONV fed heifers had 16% greater total bilirubin (P = 0.04), 12% greater cholesterol (P = 0.02), and slightly greater non esterified fatty acids (P = 0.03) concentrations. Noteworthy, serum concentrations of total bilirubin were correlated (P ≤ 0.03) with ADG, GF, KR and NEg. In conclusion, the type of kernel processor utilized for the harvest of sorghum silage may have an impact on feed efficiency of beef cattle. These differences could be related to changes on the site of utilization of nutrients, particularly starch; what could also explain the differences on blood metabolites. However, further research is needed to help explain these findings.

Hepatoprotective Effect of Corn Silk Extract on Carbonated Alcoholic Herbal Beverages Induced Hepatoxicity in Adult Wistar Rats

Corn silk is the long shiny fibers at the top of an ordinary ear of corn (Zea mays). Corn silk contains phytochemicals of medical benefit such as flavonoids compounds which act as antioxidant agents and has been widely reported possess hepatoprotective effect. The objective of this paper is to evaluate the hepatoprotective effect of corn silk extract on carbonated alcoholic herbal beverages (CAHB) induced hepatoxicity in adult Wistar rats. A total of forty five adult Wistar rats weighing between 200g and 250g were randomly assigned into nine groups of five rats each in a group. Group A was the normal control group (no CAHB administration). Groups B, C, D, E, F, G, H and I were the CAHB intoxicated groups and treated with corn silk extract at different doses. After administering a carbonated alcoholic herbal beverage, there was a substantial increase (p≤0.05) in the mean concentration of liver enzymes (ALP, ALT, ALT), total bilirubin, and direct bilirubin. While those characteristics reversed to values similar to the control after being treated with varying doses of corn silk extract The oxidative stress parameter (SOD, GPX, Catalase, MDA) shown significant increase in group. Histological examination of the liver revealed infiltrate of inflammatory cells, vascular ulceration, periportal infiltration of inflammatory cell, and vascular congestion in a group treated with carbonated alcoholic herbal beverages (CAHB). The only group exhibiting normal hepatocyte morphology and kupffer cell activity was the one administered 200 mg/kg of maize silk extract. Group D showed a similar and more powerful hepatic architecture after receiving only 600 mg/kg of maize silk extract. The hepatoprotective and anti- oxidative effects of corn silk extract were confirmed by the treatment groups (200 mg/kg and 600 mg/kg), which displayed normal hepatocytes with minor vascular congestion, respectively. Corn silk administration lowers a number of the harmful effects of in vivo carbonated alcoholic herbal beverage administration in the liver of Wister rats, according to the findings in this study.

Nutritional and safety assessment of aqueous extract of nutmeg seeds, Myristica fragrans

Nutmeg, Myristica fragrans is used as a spice or medicinal plant to manage ailments. This study evaluated the nutritional and safety assessment of an aqueous extract of Myristica fragrans in Wistar rats. Thirty male Wistar rats weighing 180 - 240 g were randomly distributed into five groups: Control received distilled water, while 100, 200, 300, and 400 mg/kg body weight represented the treatment groups, respectively. The extract was orally administered to the animals for 28 days and then euthanized under anesthesia. Blood, serum, and liver homogenates from rats were used for biochemical analysis. The phytate and tannin contents were 0.38 mg/100 g and 0.15 mg/100 g, respectively. The calculated phytic acid to zinc ratio was 0.12. The respective percentage proximate components of the extract include moisture, ash, fat, protein, and carbohydrates: 10.61%, 45.42%, 5.95%, 1.81%, 13.78%, and 22.43%, respectively. Sodium, potassium, calcium, iron, magnesium, zinc, manganese, and lead were present in the extract. There was a significant increase (p<0.05) in serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), and acid phosphatase (ALP) activity in the groups treated with the extract compared to the control groups. Similarly, there was a significant increase (p<0.05) in serum total bilirubin and albumin concentrations in the extract treatment groups compared to control groups. On the contrary, there was a significant decrease (p<0.05) in the liver AST and ALP activity in the treatment groups compared to the control. The liver total protein and albumin concentrations showed a significant decrease (p<0.05) in the extract treatment groups compared to the control. There was a significant decrease (p<0.05) in the pack cell volume (PCV), haemoglobin (Hb), red blood cell (RBC), Mean cell volume (MCV), and platelet (PLT) levels in the animals in the extract treatment groups compared to the control group. Myristica fragrans is abundant in essential nutrients crucial for maintaining optimal physiological functions within the body, however, it is important to avoid excessive dosage or prolonged consumption which might be toxic to liver cells. Key words: Myristica, animals, tannins, phytic acid, chemical and drug Induced liver injury, minerals

Haematological and biochemical studies on Justicia secunda infusion used in treatment of anaemia

The effect of ethanolic and infusion of Justicia secunda leaves in the animal organs was investigated using standard analytical protocols. A total of 40 albino rats divided into four groups of five rats each comprising one normal groups and three groups treated with 125, 250 and 500mg/kg body weight respectively. The infusion of J. secunda leaves was prepared using conventional methods. The hematological, biochemical and histological studies were also carried out as reported in previous literatures. The findings confirmed that Justicia secunda leaves are not toxic at the doses administered, there were significant concentrations of essential minerals such as sodium, potassium, calcium, iron, phosphorus, and sulfur. The hematological study conducted on the infusion of the leaves revealed several positive effects on blood parameters in experimental rats. The extract significantly P<0.05 elevated hemoglobin and platelet count, particularly at higher doses, compared to the control group. The liver function tests showed no significant alterations in AST, ALT, TP, and ALB levels; however, the infusion resulted in some alterations in ALP activity and total bilirubin concentration. The histopathological examination of liver tissues showed mild congestion and degenerative changes in higher dose groups, indicating potential dose-dependent hepatomegaly and stress on hepatic architecture.

Feeding almond hulls to light lambs: Effects on growth performance, digestive utilization and blood metabolites

The effects of including almond hulls (AH) in the concentrate fed to light lambs on animal performance, diet utilization, and blood metabolites. Three isonitrogenous and isoenergetic concentrates were formulated with either 0 (control), 6 (AH6) or 12 (AH12) g of AH per 100 g (fresh matter basis). Thirty Manchega breed lambs (15 males and 15 females; 12.3 ± 0.18 kg body weight (BW)) were distributed into six homogeneous groups according to BW (3 groups of each sex), which were randomly assigned within sex to each experimental concentrate. Lambs were fed concentrate and barley straw ad libitum until reaching about 23.0 kg BW. There were no differences (P ≥ 0.182) between groups in final BW, intake of concentrate and straw, and feed conversion rate. Average daily gain and digestibility of dry matter and crude protein tended (P < 0.10) to decrease by the AH inclusion in the concentrate. Lambs fed AH12 showed greater (P < 0.05) urinary losses than those fed the control concentrate (15.4 and 11.5 g per 100 g of N intake, respectively), despite the similar N intake in all groups. Feeding AH did not affect (P ≥ 0.213) blood concentrations of albumin, globulins, urea, creatinine, glucose, total bilirubin and cholesterol or blood activities of hepatic enzymes. The post-mortem analysis revealed no differences among groups in pH and total volatile fatty acids (VFA) concentrations in the rumen of lambs, but NH3-N concentrations were lower (P < 0.05) in the lambs fed the concentrates with AH. In addition, lambs fed AH12 diet had lower (P < 0.05) molar proportions of propionate and greater (P < 0.05) proportions of butyrate compared with lambs fed control and AH6 concentrate. In general, no concentrate x sex interactions were observed, and sex had no effect on the measured parameters except for some differences in ruminal VFA profile. In conclusion, AH can be included at in light lambs’ concentrate up to 12 g per 100 g of concentrate without impairing animal growth.

Machine learning-causal inference based on multi-omics data reveals the association of altered gut bacteria and bile acid metabolism with neonatal jaundice

ABSTRACT Early identification of neonatal jaundice (NJ) appears to be essential to avoid bilirubin encephalopathy and neurological sequelae. The interaction between gut microbiota and metabolites plays an important role in early life. It is unclear whether the composition of the gut microbiota and metabolites can be used as an early indicator of NJ or to aid clinical decision-making. This study involved a total of 196 neonates and conducted two rounds of “discovery-validation” research on the gut microbiome-metabolome. It utilized methods of machine learning, causal inference, and clinical prediction model evaluation to assess the significance of gut microbiota and metabolites in classifying neonatal jaundice (NJ), as well as the potential causal relationships between corresponding clinical variables and NJ. In the discovery stage, NJ-associated gut microbiota, network modules, and metabolite composition were identified by gut microbiome-metabolome association analysis. The NJ-associated gut microbiota was closely related to bile acid metabolites. By Lasso machine learning assessment, we found that the gut bacteria were associated with abnormal bile acid metabolism. The machine learning-causal inference approach revealed that gut bacteria affected serum total bilirubin and NJ by influencing bile acid metabolism. NJ-associated gut bile acids are potential biomarkers of NJ, and clinical prediction models constructed based on these biomarkers have some clinical effects and the model may be used for disease risk prediction. In the validation stage, it was found that intestinal metabolites can predict NJ, and the machine learning-causal inference approach revealed that bile acid metabolites affected NJ itself by affecting the total bilirubin content. Intestinal bile acid metabolites are potential biomarkers of NJ. By applying machine learning-causal inference methods to gut microbiome-metabolome association studies, we found NJ-associated intestinal bacteria and their network modules and bile acid metabolite composition. The important role of intestinal bacteria and bile acid metabolites in NJ was determined, which can predict the risk of NJ.

Efficiency of Anatomical Hepatectomy in the Treatment of Hepatic Cystic Echinococcosis.

Introduction: Total cystectomy and hepatectomy are the main radical surgical procedures for hepatic cystic echinococcosis (CE). When CE lesions severely invade intrahepatic biliary ducts and vessels or single or multiple lesions occupy one hepatic lobe, performing total cystectomy is not indicated. This study aimed to analyze the clinical efficiency of anatomical hepatectomy in the treatment of patients with hepatic CE. Methods: Clinical data of 74 patients with hepatic CE who received anatomical hepatectomy were retrospectively analyzed from January 2005 to January 2022. The patients were classified into the intrahepatic biliary duct invasion group (group A), the intrahepatic vessel invasion group (group B), and the hepatic lobe occupation group (group C). Results: Among these 74 patients who received anatomical hepatectomy, right hepatectomy was performed in 20 cases (27.03%), left hepatectomy in 26 cases (35.13%), right posterior lobectomy in nine cases (12.16%), and left lateral sectionectomy in 19 cases (25.68%). Short-term post-operative complications occurred in seven cases (9.50%), including abdominal abscess in one case, pleural effusion in three cases, intestinal obstruction in one case, incision infection in one case, and ascites in one case. Long-term post-operative complications occurred in four cases (5.4%), including recurrences of CE in two cases and incisional hernias in another two cases. There were no statistical differences in the concentrations of total bilirubin, alanine aminotransferase, and aspartic transaminase before and after surgery between groups (p > 0.05). However, differences in operative time, short-term post-operative complications, average hospital stay, and number of open hepatectomy cases were statistically significant between groups (p < 0.05). The differences in cases receiving hepatic portal occlusion, intra-operative blood loss, and intra-operative blood transfusion were not statistically significant between groups (p > 0.05). Conclusions: Anatomical hepatectomy is an effective and feasible surgical procedure for patients with hepatic CE with severe invasion of intrahepatic biliary ducts and vessels or patients with huge lesions occupying one hepatic lobe, which effectively avoids residual cavity-related complications.

MANIFESTATIONS OF ENDOGENOUS INTOXICATION SYNDROME DEPENDING ON ITS ACTIVITY ACCORDING THE LEVEL OF MEDIUM-MASS MOLECULES

Substances of endogenous intoxication syndrome (EIS), which belong to medium-mass molecules (MMM), have cardiovascular toxicity; their content is increased in conditions of chronic heart failure. However, the influence of EIS activity has been studied not enough, which determined the relevance and expediency of our study.Aim. In order to compare the laboratory-instrumental features of the course of metabolically associated liver steatosis (LS) under the conditions of pronounced and insignificant activity of EIS, 19 patients (10 men, 9 women; average age 61,8 years) with coronary artery disease (CAD), atherosclerotic cardiosclerosis, HF of I-II FC and sonographically diagnosed LS were examined. Depending on the level of MMM, patients were divided into two groups with pronounced EIS (MMM &gt;0,6 units) and moderate activity (MMM &lt;0,6 units), which were identical in gender and age composition, hemodynamic indicators, body mass index and area body surface. Photometric determination of MMM total and at wave lengths of 238, 254, 266, 282 nm in blood and urine was carried out; determination of blood L-arginine and urine nitrites, leptin were provided; aromaticity coefficient 238/282, hepato-steatosis index, AST/platelet ratio, nuclear intoxication index (NII), the ratio of lymphocytes and neutrophils to monocytes were calculated. All results were calculated statistically, the level of significance was taken as p&lt;0.05.The results. Among the examined patients, 36.8% had high EIS activity (grades 2-3), and in 63.2% it was moderate (grade 1). Patients with pronounced EIS activity were characterized by hypoalbuminemia, dyslipidemia, low leptin content and higher arginine level, peripheral blood lymphopenia, and relative thinning of the heart walls. The content of MMM254,266,282 in blood was correlated with the size of the left ventricle in diastole, MMM266,282 in urine - with total cholesterol, low and very low density its particles and triglycerides, the aromaticity coefficient - with urinary nitrites. Integral hematological NII was directly proportional to diastolic pressure, and the lymphocyte/monocyte ratio - to systolic pressure. The ratio of neutrophils to monocytes and AST/platelets were correlated with the content of total bilirubin; and the hepato-steatosis index - with high-density lipoproteins and the coefficient of atherogenicity.Conclusion. Patients with concomitant metabolic-associated steatosis of the liver and a high level of EIS were characterized by metabolic disorders. Specific indicators of EIS correlated with parameters of lipid metabolism and hemodynamics.

Bilirubin measurements in neonates: uniform neonatal treatment can only be achieved by improved standardization.

Measurement of total bilirubin (TBil) concentration in serum is the gold standard approach for diagnosing neonatal unconjugated hyperbilirubinemia. It is of utmost importance that the measured TBil concentration is sufficiently accurate to prevent under treatment, unnecessary escalation of care, or overtreatment. However, it is widely recognized that TBil measurements urgently require improvement in neonatal clinical chemistry. External quality assessment (EQA) programs for TBil assess for differences between laboratories and provide supporting evidence of significant differences between various methods, manufacturers and measurement platforms. At the same time, many countries have adopted or only slightly adapted the neonatal hyperbilirubinemia management guidelines from the USA or UK, often without addressing differences in the methodology of TBil measurements. In this report, we provide an overview of the components of bilirubin that are measured by laboratory platforms, the availability of current reference measurement procedures and reference materials, and therole of EQA surveys in this context. Furthermore, the current status of agreement in neonatal bilirubin against clinical decision thresholds is reviewed. We advocate for enhancements in accuracy and comparability of neonatal TBil measurements, propose a path forward to accomplish this, and reflect on the position of the International Federation for Clinical Chemistry and Laboratory Medicine (IFCC) Working Group Neonatal Bilirubin (WG-NB) in this matter.

Bilirubin Levels in Infancy and Their Associations with Body Weight, Levels of Iron-Related Parameters and Steroid Hormone Levels.

It is assumed that bilirubin is hormonally regulated and influences weight development by preventing weight gain. However, studies in healthy infants are limited. The present study established reference values for bilirubin and investigated whether bilirubin levels are significantly associated with body weight, levels of ferritin and transferrin as well as steroid hormone levels in a study population of three- and six-month-old healthy infants. Data from a total of 411 study visits from the LIFE Child study (Leipzig, Germany) were analyzed. Associations were examined using linear regression analyses. Besides laboratory parameters, anthropometric data were gathered. We found statistically significant associations between body weight and bilirubin levels. In girls, we observed additional associations between bilirubin levels and both ferritin and transferrin concentrations at three months of age. At six months, steroid hormone levels were significantly associated with concentrations of total and indirect bilirubin, with effects differing by sex. Our study thus confirms associations already reported from animal studies and studies in adult populations. Furthermore, we showed that these associations already exist in the first year of life, are influenced by sex and age and, further, depend on the bilirubin type. Our results provide reference values for bilirubin and assist, therefore, in interpreting bilirubin levels in infancy.

Neuropathological implication of high blood bilirubin in patients and model rats with depression

PurposeElevated bilirubin levels have been associated with major depressive disorder (MDD); however, the exact impact of bilirubin on MDD and the underlying molecular mechanisms remain unclear. Here, we explored the influence of bilirubin on MDD and sought to identify the mechanisms via which bilirubin induces depressive-like behavior. Patients and methodsForty patients who were diagnosed with MDD and received treatment with selective serotonin reuptake inhibitors (SSRIs) were included, with 43 healthy volunteers serving as controls. Clinical symptoms were evaluated using Hamilton depression rating scale-24 (HAMD-24) and the Hamilton anxiety rating scale. Serum concentrations of total bilirubin (TBIL) and indirect bilirubin (IBIL) were measured at baseline and after treatment using an automated biochemical analyzer. The connection between clinical symptoms and TBIL or IBIL was examined using Pearson correlation. Chronic restraint stress (CRS) was employed to generate a rat model of depression. TBIL, IBIL in rat serum were measured by ELISA. Reactive oxygen species (ROS) contents in rat hippocampal tissues were quantified by flow cytometry. The levels of microglial markers and the extent of neuronal damage in the rat hippocampus were assessed by immunofluorescence and transmission electron microscopy, respectively. ResultsSerum TBIL and IBIL levels were higher in patients with MDD than in the healthy controls. After treatment with SSRIs, the serum levels of TBIL and IBIL in MDD patients were significantly reduced. The levels of TBIL and IBIL were associated with HAMD-24 in MDD patients. Compared with the controls, the serum levels of TBIL, IBIL and the hippocampal ROS contents were elevated in CRS-exposed rats. Fluoxetine lowered inflammatory factor levels, mitigated oxidative stress. ConclusionOur findings indicate a possible correlation between elevated serum bilirubin and depressive symptoms. Increases in ROS levels, along with neuronal damage, may represent pathological mechanisms underlying MDD.

ASSOCIATION BETWEEN TOTAL BILIRUBIN LEVELS WITH INCIDENCE OF ATHEROSCLEROSIS: SYSTEMATIC REVIEW AND META-ANALYSIS

Background. Bilirubin is a byproduct of the breakdown of erythrocytes. Bilirubin levels can potentially serve as a biomarker for cardiovascular risk assessment. In this study, we would be investigating most recent manuscripts, published in the last 5 years, that studied association of serum bilirubin level to atherosclerosis progression to elicit how strongly low level of total bilirubin can prognose the disease progression. Methods. Using Pubmed search engine, all articles that included keywords “bilirubin” and “atherosclerosis” were retrieved. In total 67 search results emerged for the 2019-2023 timeline, the last 5 years.6 population-based studies that studied association between total bilirubin concentration and atherosclerosis development were used for the meta-analysis. Results. Increasing blood total bilirubin level seems to decrease the odds of developing atherosclerosis, meaning that there is an inverse correlation between total bilirubin level and arterial plaque formation or stenosis. Pooled odds ratio was found to be 0.86 (95% CI 0.83-0.9), suggesting that there is 14% decreased chance of developing atherosclerosis for each mmol/L increase in bilirubin levels. Overall, higher total serum bilirubin levels were associated with a significantly decreased risk of progression to atherosclerosis. Conclusion. The meta-analysis indicates a significant inverse association between low total bilirubin levels and the risk of developing atherosclerosis, suggesting that higher bilirubin levels may be protective against the progression of this disease.

Clinical and morphological manifestation of the visceral form of candidiasis in the domestic dog (Canis familiaris)

The relevance of this research lies in the current lack of information regarding the pathological manifestations of fungal infections in the parenchymal organs of animals, the manifestations and the host’s response to the fungus. Diagnosis of visceral mycoses is quite complex and insufficiently substantiated. A significant factor is the absence of clear criteria for pathological changes in visceral mycoses and differential diagnosis from similar diseases. This study aimed to reveal and establish the features of the clinical and morphological manifestation of the visceral form of candidiasis in the domestic dog (Canis familiaris). The study employed the following main methods: morphologic and biochemical blood analysis, post-mortem examination, and cytological and histological studies. When conducting biochemical analyses of blood serum in dogs, it was found that the glucose concentration was 2.17 mmol/L, which is almost three times lower than the lower limit of the norm, while the creatinine content exceeded the norm by four times and corresponded to a value of 560.4 mmol/L. As a result of serum analysis, an increase in the content of total and direct bilirubin was also recorded. In particular, the content of total bilirubin exceeded the physiological limit by 20 times and amounted to 222.68 μmol/L, while the level of direct bilirubin increased almost 10-fold and corresponded to a value of 59.4 μmol/L. The activity of aminotransferases, gamma-glutamyl transpeptidase, amylase, and alkaline phosphatase in the blood serum of sick animals increased significantly. Key pathological features of visceral mycoses in domestic dogs include haemolytic jaundice with extensive haemorrhages in organs and tissues. Hepatitis and nephritis, diagnosed in sick dogs, are the result of a generalised infectious process, the etiological factor of which is visceral candidiasis. The obtained data are of practical value for practising veterinarians in the issue of differential diagnosis of candidiasis, revealing the features of clinical and morphologic changes in the visceral form of mycoses in dogs

Investigation of virginiamycin to improve health of growing and finishing steers: I. Effects on ruminal acidosis and liver health*

ObjectiveOur objective was to observe the effects of the interrelationship among virginiamycin (VM) inclusion (240 mg/d), ruminal pH dynamics, and hepatic plasma metabolites on rumen and animal health during a 150-d feeding trial. Materials and MethodsSteers (304 ± 27 kg; n = 120) were assigned randomly to 1 of 6 dietary treatments: no VM (T000); VM for the last 50 d (T001); VM for the last 100 d (T011); VM for the first 50 d (T100); VM for the first 100 d (T110); and VM for 150 d (T111). All animals were orally administered 2 indwelling rumen pH and temperature recording boli on d 0 and 84. Blood samples were collected via jugular venipuncture on d −7, 28, 56, 84, 112, and 140, and plasma was analyzed for concentrations of albumin, alkaline phosphatase, direct bilirubin, total bilirubin, gamma-glutamyl transferase, and total protein using an automated blood analyzer. Concurrently, haptoglobin (HPT) was measured following a colorimetric method based on peroxidase activity. A random coefficients model with pen and animals within treatment as a random effect was used. Results and DiscussionAnimals that received VM for the first 100 d (T110 and T111) had greater mean ruminal pH during d 50 to 100 when compared with animals that did not receive VM (T000 and T001; 6.12 vs. 6.00, respectively). Moreover, T111 tended to have less time under pH 5.8 (3.01 h/d) when compared with T100 and T001 (5.83 and 6.45 h/d, respectively). At slaughter, overall, 3.36% of cattle in the study were identified with liver abscesses (A and A−), and 24.3% had lung lesions. Plasma metabolite concentrations before slaughter did not predict the presence of liver abscesses (P ≥ 0.182). Based on acute phase responses, HPT was notably lower on d 84 after diet transition in VM-treated animals (46.1 vs. 68.9 mg/L). Additionally, VM inclusion boosted indicators of overall health with greater alkaline phosphatase levels and albumin-toglobulin ratios. Implications and ApplicationsVirginiamycin has practical implications for rumen health and overall cattle health, where supplementation during the whole growing to finishing phases was more effective in capturing its full potential.

Incidence and Risk Factors of Cholestasis in Newborns with Hemolytic Disease-A Case-Control Study.

Background/Objectives: One of the rare causes of cholestasis may be hemolytic disease of the fetus and newborn (HDFN). Methods: We retrospectively analyzed 88 medical records of HDFN newborns with cholestasis and 186 records of children with HDFN without cholestasis and conducted an observational, case-control, retrospective study. Results: Factors influencing the risk of cholestasis were lower gestational age at birth (36.83 ± 1.9 vs. 37.57 ± 1.8, p = 0.002), Rh or Kidd HDFN (80.7% vs. 53.2%), and the need for intrauterine transfusion (27.3 vs. 11.8%). The subjects had lower hemoglobin concentrations at birth (14.01 ± 3.8 vs. 16.39 ± 2.8 g/dL) and during whole hospital stay, higher cord blood total bilirubin concentration (4.26 ± 1.8 vs. 2.39 ± 1.4 mg/dL), higher maximum bilirubin concentration (15.27 ± 5.8 vs. 10.24 ± 3.4 mg/dL), and more frequent liver ultrasound abnormalities (19.9 vs. 6.3%). They also required more extended hospitalization due to higher rates of postnatal blood transfusion (33 vs. 3.8%), more frequent need for exchange transfusion (8.8% vs. 2.2%), more extended time and higher risk of phototherapy (94.3 vs. 59.1%), and higher usage of immunoglobulins (55.7 vs. 8.1%), parenteral nutrition (45.5 vs. 12.9%), and antibiotics (14.8 vs. 4.8%). Conclusions: The risk factors for cholestasis in children with HDFN are lower gestational age at delivery, Rh and Kidd serological type of HDFN, and the need for intrauterine transfusions.