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Biomedical subjects

D I Rushton

Publications and source records attributed to D I Rushton.

At least 37 records · Page 2Linked to original sources
PubMed1991

Pulmonary intravascular lipid in neonatal necropsy specimens.

The lungs of 482 liveborn infants were examined at necropsy for the presence of intravascular lipid. Forty one patients had received parenteral feeding (including lipid emulsion in 30), and 441 had died before starting feeds or had received enteral feeds alone. Tissue was processed into wax and then stained with Sudan black; intravascular lipid was found in 15 of 30 infants who had received intravenous fat (Intralipid), but in no others. Those patients with positive lipid staining had received significantly more fat during parenteral nutrition than those in whom intravascular lipid was not found but the two groups were otherwise clinically indistinguishable. Using this staining technique intravascular lipid can be shown relatively often, although only in patients who have received intravenous lipid emulsion. The location of fat, predominantly in small pulmonary capillaries, and the absence of lipid emboli in other organs, suggests that lipid coalescence takes place before death and is not a postmortem artefact. The clinical relevance remains uncertain.

Autopsy↗
PubMed1988

Role of upper respiratory tract infection in the deaths occurring in neonatal ferrets infected with influenza virus.

Passive immunization of ferret neonates by colostrally-derived anti-influenza virus IgG did not entirely prevent infection when mothers were immunized with 1 or 2 doses of formalin inactivated vaccine with adjuvant (alhydrogel). Influenza virus replication was almost completely prevented in the lower respiratory tract but only slightly reduced in the upper respiratory tract leading to deaths in about 50% of the neonates. Such neonates showed at most only minor lesions in the lower respiratory tract but moderate to severe inflammatory changes in the upper respiratory tract of most animals. This supports previous results suggesting that deaths, reminiscent of the human sudden infant death syndrome (SIDS), may arise purely as a result of upper respiratory tract infection, possibly following obstruction of the airways.

Animals↗
PubMed1986

Caesarean and post-partum hysterectomy 1968-1983.

There have been 47 caesarean or post-partum hysterectomies over a period of 15 years at Birmingham Maternity Hospital, a frequency of 7 per 10 000 deliveries. In 12 patients the procedure was performed electively for a gynaecological or haematological disorder. In the remainder, emergency hysterectomy was necessary as a life saving measure, in most instances to overcome uncontrollable haemorrhage. The commonest cause of uncontrollable bleeding was a morbidly adherent placenta which occurred in 1 per 4348 pregnancies, and was associated with previous uterine surgery particularly if combined with placenta praevia. Such patients require the presence of an experienced obstetrician to make an early decision to operate and perform a technically demanding operation.

Adult↗
PubMed1985

Placental malaria and foetoplacental function: low plasma oestradiols associated with malarial pigmentation of the placenta.

Placental biopsies were taken immediately post partum from 65 Gambian mothers who had not received anti-malaria chemoprophylaxis during pregnancy whilst living in an area hyperendemic for Plasmodium falciparum malaria. The biopsies were examined without knowledge of the mothers' health or the outcome of pregnancies. Histologically, they were divided into two groups: those with macrophages containing malarial pigment in the inter-villous spaces, and those without such pathology. Babies with pigmented placentae had a mean (SD) weight for gestational age of 83.3 (10.6)%, which was significantly lower (p less than 0.01) than that of 91.2 (7.7)% in the non-pigmented group. The plasma oestradiol concentrations in the mothers who later delivered pigmented placentae were significantly lower from 32 weeks of gestation onwards, and did not continue to rise in the last trimester as they did in the non-pigmented group. The last trimester appears to be the critical time for protection of the foeto-placental unit against malaria. Anti-malaria chemoprophylaxis should be given to all pregnant women.

Birth Weight↗
PubMed1985

Chorioamnionitis and funiculitis in the placentas of 200 births weighing less than 2.5 kg.

A retrospective histopathological study of the placental and non-placental membranes and umbilical cords of 200 live and stillborn babies weighing less than 2.5 kg is reported. The pathological studies were specifically concerned with the presence of infection as evidenced by a polymorphonuclear leucocytic infiltrate at these sites. Inflammatory lesions were demonstrated in 48.5% of specimens. The incidence of inflammatory lesions was highest in those with prolonged rupture of the membranes, and in the placentas of the smallest and least mature infants of a size appropriate to their gestational age. Puerperal pyrexia, neonatal sepsis and perinatal mortality were also more common in the infected group but none of the perinatal deaths was directly attributable to infection. The role of infection as a cause of premature rupture of the membranes, premature labour and subsequent perinatal outcome is still unclear though our data would suggest it is not unimportant.

Amnion↗
PubMed1985

Structure and evolution of echo dense lesions in the neonatal brain. A combined ultrasound and necropsy study.

Sixty seven of 216 infants weighing less than 2 kg at birth had cerebral lesions on ultrasonic scanning. Eight of 17 who had periventricular leukomalacia, with or without subependymal or intraventricular haemorrhage, or both, died. These and one larger baby were the subject of a combined ultrasound, and where appropriate, necropsy study. There was excellent correlation between the ultrasound and necropsy findings, only some of the earlier lesions of periventricular leukomalacia being missed by ultrasound. The data suggest it is now possible to distinguish periventricular leukomalacia and subependymal/intraventricular haemorrhage by ultrasound, that both lesions may be present in the same brain, that apparent parenchymal extension of an intraventricular haemorrhage is more probably the result of haemorrhage into ischaemic periventricular tissue, and that the term 'periventricular haemorrhage' should be abandoned since it confuses two lesions of differing aetiology and differing clinical importance. Future advances in neonatal brain ultrasound depend on accurate assessment of both the nature and site of lesions within the cerebral hemispheres and ventricular system since the interpretation of these parameters is of critical importance.

Autopsy↗
PubMed1984

The classification and mechanisms of spontaneous abortion.

This classification of spontaneous abortions, based on placental rather than embryonic or fetal morphology, does not entail detailed embryological or histological techniques. It is readily adaptable to routine pathological laboratory practice. The advantages that may accrue from proper examination of spontaneous abortions are numerous and include provision of both clinical and epidemiological data pertinent to the immediate management of the aborting patient, as well as basic information that may clarify the mechanisms underlying the major complications of pregnancy which contribute to perinatal mortality in developed societies. The pathology of the placenta in groups 1 and 2 is seen as a possible indicator of the mechanisms leading to spontaneous abortions in man. The lesions are not seen in isolation but are viewed as a logical progression related to the time at which normal development ceases. The key and unifying concept in the hypothesis is the role of the villous circulation in the maintenance of normal trophoblastic function. In the earliest abortions, the villous circulation never develops, resulting in microscopic hydatidiform or hydropic change within the villus and attenuation of the trophoblast, while embryonic or fetal death following the establishment of a villous circulation results in the sequential changes characteristic of group 2 cases. Although the majority of embryonic and fetal deaths still remain unexplained, the hypothesis suggests a mechanism by which the abnormal conceptus may determine the outcome of pregnancy without invoking the concept of maternal rejection. Verification and extension of this hypothesis will require correlation of clinical, endocrinological, and morphological data. The histopathologist has failed to keep pace with advances in modern obstetrics during the last decade, particularly in the field of early pregnancy wastage, thus reinforcing the clinical opinion that morphological examination of abortions has little to offer in the clinical management of these cases. If counseling and therapy are to be based on scientific concepts rather than on empirical data, it is essential that this deficiency be rectified.

Abortion, Spontaneous↗
PubMed1984

The role of lung development in the age-related susceptibility of ferrets to influenza virus.

Newborn (I-day-old) ferrets died following intranasal inoculation of influenza virus (clone 7a) but suckling (15-day-old) ferrets were almost as resistant as adult ferrets. Many of the deaths in newborn ferrets were consequent upon an increased lower respiratory tract infection. One reason for the latter was an increase in susceptibility of both ciliated epithelium and alveolar cells in newborn ferret lungs when compared with the corresponding cells in adult and suckling ferrets (Coates et al. 1984). Work reported here shows that the lungs of newborn ferrets possess a greater proportion of ciliated epithelium-lined airway in comparison with the lungs of suckling and adult ferrets. This situation might also contribute to the increased susceptibility of the lower respiratory tract although the difficulties of assessing this influence precisely are discussed. In addition, the occlusion of the narrower airways of the immature lung in the infected newborn ferret contributes to the increased respiratory complications.

Age Factors↗
PubMed1983

Plasmodial pigmentation of placenta and outcome of pregnancy in West African mothers.

In a region where falciparum malaria is endemic and where pregnant women traditionally receive only curative treatment for parasitaemias and no chemoprophylaxis 65 placental biopsy specimens were examined histologically for malaria pigment. Twenty seven placentas had pigment, but parasitaemias had been diagnosed antenatally in only 12 of these women despite their frequent attendance at antenatal and other clinics. The incidence of parasitaemia in pregnant primigravidas was 17.7%, seven times greater than that in lactating primiparous mothers; pregnant primigravidas also had the highest incidence (67%) of pigmented placentas. First born babies with pigmented placentas had a mean (SD) birth weight of 2580 (260) g, significantly less than the 3150 (400) g of unaffected first babies. All babies weighing less than 2500 g at birth had pigmented placentas. Pigmentation was associated with parasitaemias in the second half of pregnancy, and, although some recovery from early parasitaemias may occur, the fetoplacental unit is inadequately protected by curative treatment alone. Chemoprophylaxis currently remains the procedure of choice.

Birth Weight↗
PubMed1983

The effects of maternal influenzal viraemia in late gestation on the conceptus of the pregnant ferret.

Pregnant ferrets were inoculated intra-cardially on day 30 of gestation with influenza virus. The animals were sacrificed on days 5 to 11 after inoculation and the products of conception including the uterus were examined virologically and histopathologically. The results indicate that the initial site of infection of the conceptus is the haemophagous organ and that spread occurs from this site to the endometrium, placental labyrinth and fetus. Lesions in the fetus are confined to the liver and respiratory tract. In the liver they may represent either a viral hepatitis or a secondary response to placental damage resulting in the stimulation of erythropoiesis. In the respiratory tract they first occur in the nasal sinuses and upper airways suggesting that infection is via the amniotic fluid rather than via the blood stream. The relevance of these findings to human pregnancy is discussed.

Amniotic Fluid↗
PubMed1983

The role of naturally-acquired bacterial infection in influenza-related death in neonatal ferrets.

Concomitant, naturally-acquired bacterial infection was the cause of some deaths occurring in neonatal ferrets infected with the attenuated influenza virus A/Puerto Rico/8/34, these being prevented by antibiotic therapy. Bacterial infection played an insignificant role in the greater number of deaths following inoculation with the virulent clone 7a (of the recombinant influenza virus A/Puerto Rico/8/34-A/England/939/69/(H3N2]. As seen previously with clone 7a some ferret neonates infected with A/PR/8/34 died either from obstruction in the upper respiratory tract or from viral pneumonia, but with the latter virus, both types of lesion were probably attributable to the bacterial superinfection.

Animals↗