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Biomedical subjects

J M Bowman

Publications and source records attributed to J M Bowman.

At least 19 recordsLinked to original sources
PubMed1999

Differences in African American and white women with myocardial infarction: history, presentation, diagnostic methods, and infarction type.

BACKGROUND: Despite overall declining death rates from cardiovascular disease, the number of women dying of cardiovascular disease increases each year, with substantially higher rates in African American women than in white women. OBJECTIVE: To investigate differences in presentation, diagnostic method, and type of infarction between African American and white women with myocardial infarction. METHODS: Chart review of all women with discharge diagnosis of myocardial infarction. RESULTS: No significant differences were found between African American and white women in admitting diagnosis, diagnostic methods, or type of infarction. At the time of admission, 2 medical history variables, stroke and hypertension, differed significantly between African American and white women (P = .027 and P = .002, respectively). CONCLUSIONS: Healthcare professionals must be aware of possible racial differences in medical history, signs and symptoms, and prognosis when assessing patients and planning interventions. Studies with larger samples are needed to confirm these findings on African American and white women with myocardial infarction.

Black or African American↗
PubMed1998

Factors that influence patient satisfaction in the emergency department.

This descriptive correlation study examined the satisfaction levels of urgent and nonurgent patients in relation to nursing care, the emergency department (ED) environment, ancillary services, and information received. The sample consisted of 28 subjects, with the majority of patients being very satisfied with nursing care. The primary area of concern was information about the length of waiting time. The satisfaction levels of ED patients with the care they receive has become increasingly important in today's health care environment. ED nurses play an important role in ensuring that patients are satisfied and receive quality care.

Adult↗
PubMed1995

Fetofetal transfusion in triplets.

A case of fetofetal transfusion syndrome (FFTS) in a monochorionic triplet pregnancy, in which all three fetuses shared a common circulation, is reported. All babies were born alive, although two died within two days of delivery. This case highlights the problem of FFTS with accompanying high perinatal morbidity and mortality in naturally occurring monochorionic triplet gestations.

Adult↗
PubMed1994

Neonatal portal vein thrombosis successfully treated by regional streptokinase infusion.

We report a case of portal vein thrombosis (PVT) in a term neonate following an exchange transfusion through an umbilical vein catheter which was left in situ for 16 h after the transfusion. The baby made a complete recovery after successful thrombolysis with regional streptokinase infusion. To our knowledge, this is the first reported case of a PVT following an indwelling portal venous catheter left in situ with complete resolution following thrombolysis with regional streptokinase infusion.

Humans↗
PubMed1994

Perception of surgical pain by nurses and patients.

A descriptive study of postoperative patients was conducted to determine if there were any differences in the pain ratings of nurses and patients using a 10-centimeter graphic rating scale (GRS). The sample consisted of 16 patients: 3 males and 13 females. There were 13 nurses: 54% R.N.s and 46% L.P.N.s. When patients requested pain medication, both the patient and nurse were asked independently to indicate their perception of the patient's pain on the scale. The mean patient score on the GRS was 7.59; the mean for nurses was 4.59. At test revealed a significant difference between the nurses' and patients' pain ratings (t = 4.22, p = .0002). Based on this study, there is further need to examine assessment of the patient and the perceptions of the nurse and patient.

Adult↗
PubMed1994

Attitudes of baccalaureate nursing students in one school toward acquired immune deficiency syndrome.

The purpose of this descriptive study was to gather information about the attitudes of nursing students toward Acquired Immune Deficiency Syndrome (AIDS) and to determine if there was a relationship between demographic variables and the attitudes expressed. In this study the AIDS Attitude Scale developed by Shrum, Turner, and Bruce (1989) was administered to baccalaureate nursing students. The scale contained 54 items using a five-response scale and included six demographic variables. The results indicated that this sample had a positive attitude toward AIDS (mean = 73.58). Personally knowing someone with AIDS and level of knowledge of AIDS were found to significantly affect one's attitude toward AIDS. The findings of this study can assist nurse educators in planning appropriate content for AIDS education.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Fetomaternal hemorrhage following funipuncture: increase in severity of maternal red-cell alloimmunization.

OBJECTIVE: To determine the prevalence of fetomaternal transplacental hemorrhage after funipuncture and its effect on maternal red-cell alloantibody levels. METHODS: The prevalence and size of transplacental hemorrhages at the Health Sciences Centre were studied in two groups of patients: 174 women who were not alloimmunized or were carrying fetuses whose red cells were negative for the antigen to which they were immunized, and 122 women who were alloimmunized and carrying fetuses whose red cells were positive for the antigen to which they were immunized. In the alloimmunized group with affected fetuses, we surveyed the incidence of maternal antibody increase in titer by two or more doubling dilutions and the Rh(D) antibody increase (in microgram/mL of serum) of more than 50% after funipuncture. RESULTS: One hundred of the 174 women (57.5%) in the nonimmunized group and 69 of the 122 women (56.6%) in the immunized group had evidence of transplacental hemorrhages ranging in volume from 0.03 mL to greater than 5 mL of fetal red blood cells. In the latter group, antibody titer increases of 2 to 9 and doubling dilutions occurred in 37 of 74 women (50%) in whom such measurements were carried out. Increases of anti-D exceeding 50% occurred in 44 of 53 women (83%) in whom quantitative measurements were assayed. CONCLUSION: Funipuncture carries a high risk of fetal transplacental hemorrhage. In the immunized woman carrying an antigen-positive fetus, this will increase the level of her antibody and probably increase the severity of hemolytic disease in her fetus. In alloimmunized women, funipuncture should rarely be carried out to determine the fetal antigen status. Serial amniocenteses combined with careful serial ultrasound observation of the fetus are safer. Funipuncture should not be done in alloimmunized women before the cord vessels are of adequate size to allow immediate intravascular fetal transfusion, if required.

Blood Group Antigens↗
PubMed1994

Massive fetomaternal hemorrhage: Manitoba experience.

OBJECTIVE: To determine the incidence, size, and outcome of spontaneous massive fetomaternal transplacental hemorrhage in Manitoba. METHODS: The Kleihauer maternal-fetal screening records at the Rh Laboratory were reviewed for the period October 1970 to December 1992. Rh Laboratory correspondence for the 7-year period ending December 31, 1992, was reviewed to determine those instances of fetomaternal transplacental hemorrhage for which there was knowledge regarding fetal and neonatal outcome. RESULTS: Twenty-seven of 30,944 Rh-negative women undergoing routine Kleihauer screening at delivery had fetomaternal transplacental hemorrhages of at least 80 mL of fetal blood (incidence one in 1146 pregnancies); in 11 of the 27, the hemorrhages were 150 mL of blood or more (one in 2813 pregnancies). In non-routinely screened, selected maternal blood samples, sent because of unexplained fetal distress, fetal death, or neonatal anemia, 36 had evidence of fetomaternal transplacental hemorrhage of at least 80 mL of blood, 28 of which were in the 7-year period ending December 31, 1992 (one in 3893 pregnancies). Of these 28, 25 had hemorrhages of at least 150 mL of blood (one in 4360 pregnancies). Ascertainment of fetomaternal transplacental hemorrhage of 150 mL or more in women referred because of fetal or neonatal problems was 2813/4360 x 100 = 64.5%. Twenty-six cases in the final 7-year period had information regarding perinatal outcome. The incidence of adverse outcomes following massive fetomaternal transplacental hemorrhage was 46% (12 of 26). There were ten perinatal deaths, one infant death at 6 months, and one infant with spastic quadriplegia. CONCLUSIONS: Massive fetomaternal transplacental hemorrhage is uncommon but not rare, and subsequent adverse outcomes are common. A high index of suspicion with prompt investigation and appropriate management may improve the perinatal outcome following massive fetomaternal transplacental hemorrhage.

Female↗
PubMed1993

Maternal CW alloimmunization.

The Winnipeg Rh Laboratory has reviewed its experiences with maternal CW alloimmunization. From September 24, 1956, to March 31, 1992, 12 women with significant CW alloimmunization underwent 18 pregnancies. In 3 (4 pregnancies) the antibody, despite its strength, was 'naturally occurring' (i.e. there was no known exposure to CW-positive red cells). The remaining 9 women (14 pregnancies) had CW-positive husbands. Two had CW-negative babies and a third infant, probably CW negative, was stillborn and macerated at 43 weeks gestation. Eleven babies were CW positive and had hemolytic disease of the newborn (HDN), with antiglobulin-positive red cells. Five did not require treatment; 2 needed phototherapy only, and 4 (born between 1956 and 1963) required exchange transfusions. No anti-CW screening was carried out until 1977; thereafter it was sporadic, 11 of 51 screening red cells being CW positive in the 39-month period ending March 31st, 1992. From November 1, 1977, to March 31, 1992, 24 women (30 pregnancies, 31 conceptuses) with insignificant anti-CW alloantibodies were identified. Extrapolating these figures to the entire period from September 24, 1956, to March 31, 1992, we estimate that at least 430 women (at least 573 pregnancies) were CW alloimmunized, most of the antibodies being 'naturally occurring'. Only 2% of the conceptuses were CW positive and affected; none were severely affected. Anti-CW is relatively common, occurring in about 1 pregnant Manitoban woman in 1,100. On very rare occasions (11 times in Manitoba in 36 years and 5 months) anti-CW HDN occurs which, although not severe, may end in kernicterus with brain damage or neonatal death unless it is detected promptly and treated appropriately.

Coombs Test↗
PubMed1992

Severe anti-C hemolytic disease of the newborn.

OBJECTIVE: Because of referral of a C-alloimmunized pregnant woman with a previous hydropic death whose fetus survived after four intraperitoneal transfusions, prevalence and severity of anti-C hemolytic disease of the newborn were investigated. STUDY DESIGN: The numbers of C- or Ce-alloimmunized pregnancies in Manitoban women and their outcome for the 28-year period ending Oct. 31, 1990, were reviewed. The literature relating to C or Ce alloimmunization from 1944 to 1990 was surveyed. RESULTS: In Manitoba for the period reviewed there were 120 pregnancies in 80 C- or Ce-alloimmunized women. Twenty-two ended in abortion and two in fetal death unrelated to anti-C or anti-Ce. Of the remaining 96, 33 fetuses of 32 pregnancies were affected but only eight (6.7%) required treatment after birth. None were severely affected. In the literature there are only three other reported deaths from C or Ce hemolytic disease; two of the three may have been the same patient. The prevalence of C or Ce alloimmunization reported in various series, including our own, ranged from 8.7 to 185 per 100,000 pregnancies. CONCLUSIONS: Because on rare occasions, C or Ce alloimmunization can cause severe hemolytic disease, criteria for investigative measures such as amniocentesis or cordocentesis do not differ from the criteria for instituting these measures in Rho (D)-alloimmunized pregnancies.

Erythroblastosis, Fetal↗
PubMed1992

Selective criteria for the microbiological examination of faecal specimens.

To assess the effectiveness of predetermined investigation criteria for the examination of faecal samples from inpatients, cultured stool specimens were prospectively examined for Salmonella spp, Shigella spp, Campylobacter spp and Clostridium difficile, and screened microscopically for intestinal parasites. Out of a total of 505 specimens, 421 (83%) fulfilled the criteria for examination for C difficile, 254 (50%) for Salmonella spp, Shigella spp, and Campylobacter spp, and 87 (17%) for intestinal parasites. Isolation rates for these organisms in those groups of patients where examination was indicated were 22.5% for C difficile and 9.1% for Salmonella spp, Shigella spp, and Campylobacter spp; the detection rate for parasites was 3.5%. In those patients where the criteria did not suggest investigation, the isolation or detection rates were 3.6% for C difficile, 0% for Salmonella spp, Shigella spp, and Campylobacter spp, and 1.7% for intestinal parasites, suggesting that the use of predetermined investigation criteria was effective.

Animals↗
PubMed1992

Maternal Kell blood group alloimmunization.

BACKGROUND: Two recent paper have provided conflicting views regarding the severity of Kell hemolytic disease of the newborn. METHODS: We reviewed our experience during 1944-1990 with pregnant Kell-alloimmunized Manitoban women and similar women referred from outside of Manitoba. RESULTS: Between 1944-1990, 311 Kell-immunized Manitoban women had 459 pregnancies, of which 63 ended in abortion or stillbirth unrelated to anti-Kell. Of the infants born, 376 were unaffected and 20 were affected. Twelve did not require treatment; two needed phototherapy, one required a simple transfusion, and one an exchange transfusion. One died of kernicterus and three were hydropic and died; all four deaths occurred between 1948-1954. Fourteen Kell-immunized women with 16 pregnancies were referred from outside Manitoba. Eleven had a history of Kell hydropic fetuses and ten had hydropic fetuses at referral. Five of the hydropic fetuses survived and five died. Five women had Kell-negative infants correctly predicted by amniocentesis (two) and by fetal blood sampling (three). Serial amniotic fluid delta OD 450 readings were 83-89% accurate in predicting the presence and severity of Kell hemolytic disease. Life-threatening inaccuracies occurred, primarily in the early and middle second trimester. CONCLUSIONS: Kell hemolytic disease, although rare, may be as severe as Rh(D) hemolytic disease when it does occur. When there is a history of hydrops or the father is Kell-positive and the maternal anti-Kell indirect antiglobulin titer is 8 or greater, amniocentesis should be performed at 16-20 weeks' gestation. Fetal blood sampling followed by fetal intravascular transfusion is indicated if delta OD 450 readings approach the 65% level in modified zone 2 of Liley or if amniocentesis is precluded because of an anterior placenta and there is a history of hydrops or ultrasound evidence of fetal hemolytic disease.

Amniotic Fluid↗
PubMed1991

Antenatal suppression of Rh alloimmunization.

For more than the past decade, attempts have been made to suppress HDN by the administration of drugs or biologic materials to the Rh-immunized pregnant woman. With the possible exceptions of IGIV therapy and plasma exchange substitution of IGIV for maternal IgG, all such attempts have been ineffective. On the other hand, antenatal administration of RhIg (300 micrograms at 28-30 weeks' gestation) to the pregnant, unimmunized Rh-negative woman is very effective in preventing Rh immunization and is now the accepted standard of obstetric care. Physicians who neglect to carry out antenatal prophylaxis neglect to do so at their patient's and their own peril.

Erythroblastosis, Fetal↗
PubMed1991

The meaning of chronic low back pain.

Chronic pain is experienced by 30% of individuals who suffer from pain in industrial countries. Chronic low back pain is of particular interest to the occupational health nurse. The incidence and financial cost can be documented, but the effects on an individual's life and family are not as easily recognized. This qualitative study using phenomenology describes the meaning of chronic low back pain to individuals. This study indicates that chronic low back pain dominated the lives of the individuals. The primary areas of focus were altered lifestyle and overall quality of life.

Activities of Daily Living↗