Lawrence M. Gartner

University of Chicago

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Kwang‐Sun Lee

Comer Children's Hospital

Arthur I. Eidelman

Shaare Zedek Medical Center

Irwin M. Arias

National Institutes of Health

Mark A Pearlman

University of Delaware

Rachel Morecki

Albert Einstein College of Medicine

Sergio L Vaisman

University of Chile

Stephen R. Kandall

Albert Einstein College of Medicine

Cathy Hammerman

Shaare Zedek Medical Center

Nigel Paneth

Michigan State University

Bruce Grellong

Jewish Board of Family and Children's Services

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Albert Einstein College of Medicine

Campbell Collaboration

Johns Hopkins University

Columbia University

Cornell University

University of Bonn

University of the Basque Country

John F. Kennedy Center for the Performing Arts

University of Chicago

Korea Institute of Science & Technology Information

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BIRTH WEIGHTS AND MATERNAL NARCOTIC USE

Pediatric Research (1974)

Stephen R. Kandall Lawrence M. Gartner Beatrice Bishop Berle

Narcotic

10.1203/00006450-197404000-00142

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Citations (3)

Breastfeeding and Jaundice

Journal of Perinatology (2001)

Lawrence M. Gartner

10.1038/sj.jp.7210629

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Citations (104)

Neonatal Bilirubin Workshop

PEDIATRICS (1994)

Lawrence M. Gartner Charlotte Catz Sumner J. Yaffe

A neonatal bilirubin workshop took place at The Rockefeller University on June 20 through 22, 1993 to consider controversial issues in the field of neonatal jaundice and bilirubin neurotoxicity, particularly as they relate to management. The conference was sponsored by the National Institute of Child Health and Human Development (Pregnancy and Perinatology Branch, Center for Mothers and Children), The Rockefeller University, and the Consiglio Nazionale delle Richerche (Italy). tk;4Presentations and discussion emphasized diagnosis, biochemistry, and mechanisms of bilirubin toxicity, the definition and consequences of kernicterus, and the appropriateness and safety of the various therapies currently in use. Identification of future research needs was an important agenda item. The conferees agreed that conventional management of jaundice in the newborn with phototherapy and exchange transfusion, as well as with phenobarbital in certain situations, had significantly reduced the occurrence of "traditional" kernicterus. However, the conferees acknowledged that the classical definition of kernicterus was in need of re-examination in view of the potential of bilirubin as a CNS toxin. Early discharge of newborns from the hospital has significantly altered diagnostic and therapeutic management of neonatal jaundice, transforming it into an outpatient problem. This transformation raises new questions regarding the best time to ascertain the cause(s) of jaundice and to identify risk factors to insure optimal management of the infant. Review of the current state of knowledge of bilirubin metabolism focused on new methods for measurement of unconjugated and conjugated bilirubin, measurement of bilirubin synthesis rates, the molecular biology of bilirubin conjugation and the developmental role of the family of enzymes known as glucuronyl transferase(s), and the role of genetic and other host factors in determining the safety or toxicity of bilirubin in the newborn.

Kernicterus

Exchange transfusion

Phenobarbital

10.1542/peds.94.4.537

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Practice Patterns in Neonatal Hyperbilirubinemia

PEDIATRICS (1998)

Lawrence M. Gartner Carla T. Herrarias Robert H. Sebring

To determine practice patterns of office-based pediatricians and neonatologists in the treatment of neonatal hyperbilirubinemia in healthy, term newborns during 1992, before the publication of the practice guideline for treatment of neonatal jaundice by the American Academy of Pediatrics (AAP). The survey was undertaken to inform the AAP's Subcommittee on Hyperbilirubinemia on current practices and to aid it in its preparation of the guidelines. It was also anticipated that this survey would serve as a basis for comparison for a second survey to be performed several years after the publication of the practice guidelines.A self-administered questionnaire describing a single case of a jaundiced, breastfed 36-hour-old healthy, full-term infant with a total serum bilirubin concentration of 11.0 mg/dL (188 microM/L) was sent to a random sample of 600 office-based pediatricians and 606 neonatologists who were members of the AAP. The final response rate was 74%. Respondents were asked to answer questions regarding treatment of the case based on their actual practices. Ranges of total serum bilirubin concentration were provided as possible answers to questions on initiation of phototherapy and exchange transfusion, and interruption of breastfeeding. Respondents were also queried about frequency of serum bilirubin testing, locations of phototherapy administration, and factors influencing their therapeutic decisions.Four hundred forty-two office-based pediatricians and 444 neonatologists completed the survey. There was a tendency for neonatologists to initiate both phototherapy and exchange transfusions at lower serum bilirubin concentrations than office-based general pediatricians. At a serum bilirubin of 13 to 19 mg/dL (222 to 325 microM/L), 54% of office-based pediatricians stated they would initiate phototherapy whereas 76% of neonatologists would do so. Forty percent of office-based practitioners said they would perform exchange transfusions at serum bilirubin levels of 20 to 25 mg/dL (342 to 428 microM/L), whereas 60% of neonatologists said they would. Only a small percentage of both office-based practitioners (13%) and neonatologists (16%) indicated they would interrupt breastfeeding at 8 to 13 mg/dL (137 to 222 microM/L); but with each incremental level of serum bilirubin, an increasing proportion of neonatologists would interrupt breastfeeding. Little correlation was found between treatment practices and demographic characteristics except for years in practice; physicians with the fewest years in practice (5 years or less) differed significantly from all other groups of physicians in initiating exchange transfusions at higher serum bilirubin concentrations.The results of this survey indicated a wide range of variation of opinion among both groups of physicians, most likely a reflection of the uncertainty and controversy surrounding these issues. The data may also reflect a possible wide range of "acceptable practice" as opposed to a narrow treatment standard. Office-based practitioners more closely approximated the new 1994 recommendations than neonatologists.

Guideline

Exchange transfusion

Unconjugated hyperbilirubinemia

Serum bilirubin

10.1542/peds.101.1.25

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MEASUREMENT OF BRAIN BILIRUBIN IN GUNN RATS AND THE EFFECT OF ASPHYXIA AND SULFADIMETHOXINE

Pediatric Research (1974)

Arthur L. Rose Vivian Zaby Morris B. Abramson Lawrence M. Gartner

Sulfadimethoxine

Kernicterus