Uncombable hair: a condition with autosomal dominant inheritance.

bilirubinometer is somewhat more effective than clinical screening. If both transcutaneous index and clinical acumen were used simultaneously there would be considerably fewer false-positive screens. Discussion Previous studies evaluating the transcutaneous bilirubinometer have been carried out in Japan by Yamanouchi et al.,2 and in the USA by Hegyi et al.3 Hegyi et al.3 obtained a correlation coefficient of 0.77 in forehead measurements on 43 white term infants on no treatment compared with our figure of 0 65. Yamanouchi2 obtained a much more significant correlation coefficient of 0-877 in 40 measurements in the forehead area. Differences in methods of serum bilirubin analysis must be considered when noting the disparity, as Hegyi et al.3 used a spectrophoto-metric technique and Yamanouchi2 used the Amerioan optical bilirubinometer and an alkali AZO bilirubin me hod. Our correlation coefficient of 0-76 in 24 term measurements during phototherapy treatment was in fact better than in the untreated group (r = 0 65). Yamanouchi2 however, found poor correlation of total serum bilirubin and transcutaneous index in term and preterm babies on phototherapy. Since an individual transcutaneous index did not predict a serum bilirubin level accurately, we could not agree with Yamanouchi2 that the instrument could serve as a viable alternative to traditional invasive procedures used to determine serum bilirubin concentration. Evaluation of the screening potential of the instrument has not been previously undertaken. Our study (Table) confirms its va'ue as a screening method in term babies on no treatment. There was an inadequate complement of measurements to estibli-h index screening criteria in preterm infants. Yamanouchi and Hegyi concluded from their studies2 3 that the instrument was precise and accurate and our findings confirmed this. Yama-nouchi et al.2 found that precision decreased at increasing serum bilirubin concentrations but there was no evidence of this in our data. During the study we assessed a subgroup of 4 babies with rhesus haemolytic disease all of whom required exchange transfusion. There was a very poor correlation in the pre-exchange bilirubin level and the transcutaneous index measurement. After exchange transfusions the reduction in the level of serum bilirubin was not associated with any change in the transcutaneous index. This would agree with the opin on of Yamanouchi et al.2 that the trans-cutaneous bilirubin measurement is contraindicated in rhesus haemolytic disease and in babies after exchange transfusion. The transcutaneous bilirubinometer has a useftil role in a busy maternity hospital with a frequent turnover of …